Prevalence and Spatial Concordance of Visual Field Deterioration in Fellow Eyes of Glaucoma Patients
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Purpose: To examine the prevalence of visual field deterioration in contralateral eyes of patients with worseningopen-angle glaucoma and to evaluate the spatial concordance of visual field deterioration between both eyes. Methods: One hundred sixteen open-angle glaucoma patients who underwent 8 or more visual field examinationsover ≥6 years of follow-up were included. The rates of the fast and slow components of visual fielddecay for each of 52 visual field test locations were calculated with point-wise exponential regression analysis. The spatial concordance of visual field deterioration in contralateral eyes was evaluated with a concordanceratio (calculated as the number of overlapping locations divided by the total number of deteriorating locations)and by comparing the rate of decay in corresponding modified glaucoma hemifield test clusters. Results: The average visual field mean deviation (±standard deviation [SD]) was -8.5 (±6.4) dB and the mean(±SD) follow-up time was 9.0 (±1.6) years. Sixty-three patients had mild damage, 23 had moderate damage,and 30 had severe damage. The mean concordance ratio (±SD) was 0.46 (±0.32) for the mild group, 0.33(±0.27) for the moderate group, and 0.35 (±0.21) for the severe group. Thirty-one patients (27%) had deteriorationin concordant locations (p < 0.05). Visual field deterioration was greater in the superior hemifield than theinferior hemifield (p < 0.05) when evaluated with both the concordance ratio and modified glaucoma hemifieldtest cluster analysis methods. Conclusions: There is only fair spatial concordance with regard to visual field deterioration between the botheyes of an individual. We conclude that testing algorithms taking advantage of inter-eye spatial concordancewould not be particularly advantageous in the early detection of glaucomatous deterioration.
Abstract
Purpose: To examine the prevalence of visual field deterioration in contralateral eyes of patients with worseningopen-angle glaucoma and to evaluate the spatial concordance of visual field deterioration between both eyes. Methods: One hundred sixteen open-angle glaucoma patients who underwent 8 or more visual field examinationsover ≥6 years of follow-up were included. The rates of the fast and slow components of visual fielddecay for each of 52 visual field test locations were calculated with point-wise exponential regression analysis. The spatial concordance of visual field deterioration in contralateral eyes was evaluated with a concordanceratio (calculated as the number of overlapping locations divided by the total number of deteriorating locations)and by comparing the rate of decay in corresponding modified glaucoma hemifield test clusters. Results: The average visual field mean deviation (±standard deviation [SD]) was -8.5 (±6.4) dB and the mean(±SD) follow-up time was 9.0 (±1.6) years. Sixty-three patients had mild damage, 23 had moderate damage,and 30 had severe damage. The mean concordance ratio (±SD) was 0.46 (±0.32) for the mild group, 0.33(±0.27) for the moderate group, and 0.35 (±0.21) for the severe group. Thirty-one patients (27%) had deteriorationin concordant locations (p < 0.05). Visual field deterioration was greater in the superior hemifield than theinferior hemifield (p < 0.05) when evaluated with both the concordance ratio and modified glaucoma hemifieldtest cluster analysis methods. Conclusions: There is only fair spatial concordance with regard to visual field deterioration between the botheyes of an individual. We conclude that testing algorithms taking advantage of inter-eye spatial concordancewould not be particularly advantageous in the early detection of glaucomatous deterioration.
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