Rate and pattern of visual field decline in primary open-angle glaucoma.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Understanding the rate and pattern of visual field decline is crucial for managing POAG.
• Longitudinal studies are essential to characterize disease progression.

Purpose of the Study:

• To investigate the rate and pattern of visual field decline in patients with POAG.
• To identify factors associated with asymmetric visual field progression.

Main Methods:

• Retrospective observational case series of 40 eyes from 40 POAG patients.
• Minimum 8-year longitudinal follow-up with serial Goldmann visual fields.
• Manual quantification of the I4e isopter and analysis of visual field regions (central, peripheral, superior, inferior, nasal, temporal, and quadrants).
• Linear regression used to estimate rates of decline; asymmetry compared among quadrants.

Main Results:

• The overall visual field decline rate was -1.3% per year.
• All visual field sections showed decline, with the superonasal quadrant declining fastest (-1.8% per year).
• Approximately half of patients exhibited asymmetric visual field progression, associated with disc hemorrhage, overall progression rate, and surgical intervention.

Conclusions:

• All sections of the visual field progressively decline over time in selected POAG patients.
• Disc hemorrhage is a significant factor associated with more asymmetric visual field progression.
• Findings suggest focal damage to the optic disc contributes to asymmetric POAG progression.