Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA.
Eye and Glaucoma Care.
J Glaucoma. 2021 Mar 1;30(3):e68-e75. doi: 10.1097/IJG.0000000000001747.
This study demonstrates the substantial association between visual field (VF) defect within the central-most 4 points in 24-2 VF and the VF defect exhibited by 10-2 test pattern relative to the initial defect in 24-2 VF.
To evaluate the significance of central-most visual field defects (CMVFDs) in 24-2 VF in early glaucoma.
This cross-sectional study examined 29 eyes of 28 glaucoma patients with CMVFDs. CMVFD was defined as a glaucomatous defect with at least 1 abnormal point at P<1% within the central 5 degrees on 3 consecutive 24-2 VF tests. 10-2 VFs were categorized into 3 groups by severity of pattern defects: deep arcuate, partial arcuate, and minimal defect. The deep arcuate group was interpreted as the most severe defect on the 10-2 VF. Mann-Whitney test was used to compare the perimetric parameters differences between 24-2 VFs with CMVFD and 10-2 VFs related to the initial defect.
CMVFD was observed in 82% eyes, predominantly in the superior hemifield (86%). Arcuate-like defects (72%) on the 10-2 VF were mostly in superior hemifield (82%). The deep arcuate group showed significantly worse mean deviation (MD) and pattern standard deviation (PSD), (MD= -9.1±4, PSD =10.7±2.1 dB), than partial arcuate and minimal defect groups (all P<0.001). Eyes with deep arcuate defect had severely depressed defect depth (-26 to -35 dB) and low sensitivity (<0 to 10 dB) at abnormal points in the central 5 degrees in 24-2 VF. A significant difference among deep arcuate, partial arcuate (P<0.001), and minimal defect groups (P<0.001) was observed at abnormal points' threshold sensitivity and defect depth.
Given the significance and effect of perimetric factors at abnormal test points in the central 5 degrees of 24-2 VFs, these eyes deserve attention to determine the severity of and functional impact on the CMVFD in early glaucoma by performing 10-2 test.
本研究表明，视野（VF）中央 4 点内的缺陷与 10-2 测试图案相对于 24-2 VF 初始缺陷的 VF 缺陷之间存在显著关联。
评估 24-2 VF 中最中心视野缺陷（CMVFD）在早期青光眼诊断中的意义。
本横断面研究共纳入 28 例青光眼患者的 29 只眼，这些患者存在 CMVFD。CMVFD 定义为在连续 3 次 24-2 VF 测试中，至少有 1 个异常点在中央 5 度内，且异常点的青光眼缺陷概率<1%。根据 10-2 VF 中模式缺陷的严重程度，将其分为 3 组：深弓形、部分弓形和最小缺陷。深弓形组被解释为 10-2 VF 上最严重的缺陷。采用 Mann-Whitney 检验比较 24-2 VF 中存在 CMVFD 与与初始缺陷相关的 10-2 VF 的视野参数差异。
82%的眼观察到 CMVFD，主要位于上半视野（86%）。10-2 VF 上的弓形样缺陷（72%）主要位于上半视野（82%）。深弓形组的平均偏差（MD）和模式标准差（PSD）明显更差，（MD=-9.1±4，PSD=10.7±2.1dB），明显比部分弓形和最小缺陷组差（均 P<0.001）。深弓形缺陷眼在中央 5 度的异常点处视野深度明显下降（-26 至-35dB），且异常点处的敏感度较低（<0 至 10dB）。在异常点的阈值敏感度和缺陷深度方面，深弓形、部分弓形（P<0.001）和最小缺陷组（P<0.001）之间存在显著差异。
鉴于 24-2 VF 中央 5 度内异常测试点的视野参数的重要性和影响，这些眼需要进行 10-2 测试，以确定 CMVFD 在早期青光眼的严重程度和对 CMVFD 的功能影响。
