Visual Field Loss Morphology in High- and Normal-Tension Glaucoma

Abstract

Purpose. To determine whether the patterns of visual field damage between high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are equivalent. Methods. In this retrospective cross-sectional study, fifty-one NTG and 57 HTG patients were recruited. For each recruited patient only the left eye was chosen. Glaucomatous patients had abnormal visual fields and/or glaucomatous changes at the optic nerve head. They were classified as HTG or NTG on the basis of intraocular pressure (IOP) measurements. Patients' visual fields were analyzed by using Humphrey Field Analyzer (HFA), program 30-2, full threshold. The visual field sensitivity values and the pattern deviation map values of the 72 tested points were considered. Then a pointwise analysis and an area analysis, based on the Glaucoma Hemifield test criteria, were performed, and a comparison between the two subgroups was made by Student's t test. Results. Between NTG and HTG, no significant difference was found pointwise for almost all the visual field points, except for two locations. One was under the blind spot, and the other was in the inferior hemifield around the twenty-degree position. When area analysis was considered, three areas showed a significantly different sensitivity between HTG and NTG. Conclusions. These data suggested that there was no relevant difference in the pointwise analysis between NTG and HTG; however, when visual field areas were compared, no difference in paracentral areas was found between NTG and HTG, but superior nasal step and inferior and superior scotomata showed to be deeper in HTG than in NTG.

Visualising structural and functional characteristics distinguishing between newly diagnosed high‐tension and low‐tension glaucoma patients

“…Thonginnetra et al 51 found that although low‐tension glaucoma and high‐tension glaucoma patients had similar levels of Humphrey Field Analyzer global index values, more patients with low‐tension glaucoma presented with centralised defects and deeper scotoma compared with high‐tension glaucoma. This has been replicated by several studies 52–55 and debated by others 56 . Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures.…”

“…This has been replicated by several studies 52 , 53 , 54 , 55 and debated by others. 56 Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures. This approach was binarised with an a priori method of separating parafoveal and peripheral scotomata.…”

Visualising structural and functional characteristics distinguishing between newly diagnosed high‐tension and low‐tension glaucoma patients

“…Thonginnetra et al 51 found that although low‐tension glaucoma and high‐tension glaucoma patients had similar levels of Humphrey Field Analyzer global index values, more patients with low‐tension glaucoma presented with centralised defects and deeper scotoma compared with high‐tension glaucoma. This has been replicated by several studies 52–55 and debated by others 56 . Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures.…”

“…This has been replicated by several studies 52 , 53 , 54 , 55 and debated by others. 56 Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures. This approach was binarised with an a priori method of separating parafoveal and peripheral scotomata.…”

Comparison of Visual Field Characteristics Between Normal Tension Glaucoma and Primary Open Angle Glaucoma

“…Drance also did not find any different characteristics in visual field defect in those subgroups of glaucoma by using the Goldman Perimetry. Greve and Geijssen detected difference in the distribution of the visual field defects between HTG and NTG but in later the larger defects were more frequently in the upper half of the visual field [1]. There are so many studies possibly find in the literature, and some anthers believed that HTG and NTG have different visual and NTG patients, but there is no significant difference present in sensitivity map but in pattern deviation map there is significant difference is present in one point only which is placed one point inferior and two point towards nasally of the blind spot.…”

Visual field patterns in glaucoma: A systematic review

“…[ 31 32 33 34 35 36 37 38 39 40 41 42 43 ] The study conducted by Motolko et al in 1982 and Iester et al in 2012 could not confirm these results and found no relevant difference between NTG and POAG. [ 44 45 ] In contrast to Caprioli in 1984 and most other studies, the study performed by King in 1986 found that the mean eccentricity of scotomas in NTG patients was further away from fixation than in POAG patients. [ 31 46 ] Table 3 compares the visual field patterns in NTG and POAG using mean deviation (MD) to illustrate the visual field sensitivity loss and pattern standard deviation (PSD) representing the localized visual field loss.…”

Visualising structural and functional characteristics distinguishing between newly diagnosed high‐tension and low‐tension glaucoma patients

“…Thonginnetra et al 51 found that although low‐tension glaucoma and high‐tension glaucoma patients had similar levels of Humphrey Field Analyzer global index values, more patients with low‐tension glaucoma presented with centralised defects and deeper scotoma compared with high‐tension glaucoma. This has been replicated by several studies 52–55 and debated by others 56 . Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures.…”

“…This has been replicated by several studies 52 , 53 , 54 , 55 and debated by others. 56 Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures. This approach was binarised with an a priori method of separating parafoveal and peripheral scotomata.…”

Comparison of Visual Field Characteristics Between Normal Tension Glaucoma and Primary Open Angle Glaucoma

“…Drance also did not find any different characteristics in visual field defect in those subgroups of glaucoma by using the Goldman Perimetry. Greve and Geijssen detected difference in the distribution of the visual field defects between HTG and NTG but in later the larger defects were more frequently in the upper half of the visual field [1]. There are so many studies possibly find in the literature, and some anthers believed that HTG and NTG have different visual and NTG patients, but there is no significant difference present in sensitivity map but in pattern deviation map there is significant difference is present in one point only which is placed one point inferior and two point towards nasally of the blind spot.…”

Visual field patterns in glaucoma: A systematic review

“…[ 31 32 33 34 35 36 37 38 39 40 41 42 43 ] The study conducted by Motolko et al in 1982 and Iester et al in 2012 could not confirm these results and found no relevant difference between NTG and POAG. [ 44 45 ] In contrast to Caprioli in 1984 and most other studies, the study performed by King in 1986 found that the mean eccentricity of scotomas in NTG patients was further away from fixation than in POAG patients. [ 31 46 ] Table 3 compares the visual field patterns in NTG and POAG using mean deviation (MD) to illustrate the visual field sensitivity loss and pattern standard deviation (PSD) representing the localized visual field loss.…”

Visualising structural and functional characteristics distinguishing between newly diagnosed high‐tension and low‐tension glaucoma patients

“…Thonginnetra et al 51 found that although low‐tension glaucoma and high‐tension glaucoma patients had similar levels of Humphrey Field Analyzer global index values, more patients with low‐tension glaucoma presented with centralised defects and deeper scotoma compared with high‐tension glaucoma. This has been replicated by several studies 52–55 and debated by others 56 . Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures.…”

“…This has been replicated by several studies 52 , 53 , 54 , 55 and debated by others. 56 Park et al 57 examined glaucoma patients with initial parafoveal and peripheral scotomas, where patients with lower maximum untreated intraocular pressure tended to have more initial parafoveal visual field loss compared with those with higher intraocular pressures. This approach was binarised with an a priori method of separating parafoveal and peripheral scotomata.…”

Comparison of Visual Field Characteristics Between Normal Tension Glaucoma and Primary Open Angle Glaucoma

“…Drance also did not find any different characteristics in visual field defect in those subgroups of glaucoma by using the Goldman Perimetry. Greve and Geijssen detected difference in the distribution of the visual field defects between HTG and NTG but in later the larger defects were more frequently in the upper half of the visual field [1]. There are so many studies possibly find in the literature, and some anthers believed that HTG and NTG have different visual and NTG patients, but there is no significant difference present in sensitivity map but in pattern deviation map there is significant difference is present in one point only which is placed one point inferior and two point towards nasally of the blind spot.…”

Visual field patterns in glaucoma: A systematic review

“…[ 31 32 33 34 35 36 37 38 39 40 41 42 43 ] The study conducted by Motolko et al in 1982 and Iester et al in 2012 could not confirm these results and found no relevant difference between NTG and POAG. [ 44 45 ] In contrast to Caprioli in 1984 and most other studies, the study performed by King in 1986 found that the mean eccentricity of scotomas in NTG patients was further away from fixation than in POAG patients. [ 31 46 ] Table 3 compares the visual field patterns in NTG and POAG using mean deviation (MD) to illustrate the visual field sensitivity loss and pattern standard deviation (PSD) representing the localized visual field loss.…”