Comparison of the progression rates of the superior, inferior, and both hemifield defects in normal-tension glaucoma patients

Am J Ophthalmol. 2012 Dec;154(6):958-968.e1. doi: 10.1016/j.ajo.2012.05.025. Epub 2012 Sep 7.

Abstract

Purpose: To investigate the progression rates of superior and inferior hemifield defects and each hemifield in bihemifield defects in normal-tension glaucoma patients and to compare the progression rates of each hemifield between groups in eyes with similar baseline hemifield defects.

Design: Retrospective, observational cohort study.

Methods: Medical records of 142 normal-tension glaucoma patients who performed more than 5 reliable standard visual field tests with superior (group 2; n = 51), inferior (group 1; n = 44), or both hemifield (group 3; n = 47) defects were analyzed retrospectively. The changes in the mean thresholds of the 10 zones of the glaucoma hemifield test and the entire hemifield were inspected. A linear mixed effect model was used with age, gender, initial intraocular pressure, mean deviation, and pattern standard deviation controlled.

Results: There were no significant differences in age and systemic and ocular factors between groups except for female gender, which showed a significant difference among the 3 groups (P = .032). The progression rate in group 2 was significantly faster than in group 1 (-0.713 dB/year vs -0.516 dB/year; P = .019), especially in central and nasal zones or than in the superior hemifield of group 3 (-0.717 dB/year vs -0.470 dB/year; P = .001). There was no significant difference in the progression rates between group 1 and the inferior hemifield in group 3 (-0.508 dB/year vs -0.441 dB/year; P = .312) or between the superior and inferior hemifields in group 3 (-0.468 dB/year vs -0.442 dB/year; P = .662).

Conclusions: More careful examination and caution is required in the treatment of normal-tension glaucoma patients with superior hemifield defect.

Publication types

  • Comparative Study

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Betaxolol / therapeutic use
  • Brimonidine Tartrate
  • Cohort Studies
  • Disease Progression
  • Female
  • Humans
  • Intraocular Pressure*
  • Latanoprost
  • Low Tension Glaucoma / diagnosis*
  • Low Tension Glaucoma / drug therapy
  • Low Tension Glaucoma / physiopathology
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Prostaglandins F, Synthetic / therapeutic use
  • Quinoxalines / therapeutic use
  • Retinal Ganglion Cells / pathology*
  • Retrospective Studies
  • Tonometry, Ocular
  • Vision Disorders / diagnosis*
  • Vision Disorders / drug therapy
  • Vision Disorders / physiopathology
  • Visual Field Tests
  • Visual Fields*

Substances

  • Antihypertensive Agents
  • Prostaglandins F, Synthetic
  • Quinoxalines
  • Brimonidine Tartrate
  • Latanoprost
  • Betaxolol