Diffuse field loss and diffuse retinal nerve-fiber loss in glaucoma

A total of 61 eyes of 61 patients were examined by light-sense, flicker and resolution perimetry. All fields were classified as being normal or showing diffuse loss, localized defects or diffuse plus localized loss. For the assessment of diffuse field loss, cumulative defect curves were derived. Retinal nerve-fiber layer (RNFL) loss was assessed by a semiquantitative scoring technique. In light-sense and flicker perimetry, the total diffuse and total overall RNFL scores for eyes with diffuse field loss were approximately twice those obtained for eyes without diffuse field loss. These differences were highly statistically significant (P = 0.0055 and 0.0087 for light-sense perimetry, P = 0.0033 and 0.0042 for flicker perimetry). In resolution perimetry, eyes with diffuse field loss also showed higher RNFL scores; the differences, however, were not statistically significant. The results show that diffuse field loss in light-sense and flicker perimetry is accompanied by diffuse nerve-fiber loss.