Do pattern deviation values accurately estimate glaucomatous visual field damage in eyes with glaucoma and cataract?

Area of Science:

• Ophthalmology
• Visual field testing
• Glaucoma research

Background:

• Cataracts can influence visual field (VF) test results.
• Accurate assessment of glaucomatous VF damage is crucial for disease management.

Purpose of the Study:

• To evaluate the effectiveness of pattern deviation (PD) values in assessing visual field loss in glaucoma patients, accounting for cataract effects.

Main Methods:

• Compared mean PD (mPD) before cataract surgery with mean total deviation (mTD) after surgery in 48 eyes of 37 glaucoma patients.
• Analyzed visual field measurements (VF(pre) and VF(post)) and calculated differences (εmPD/ΔmTD) to assess true glaucomatous damage and cataract influence.

Main Results:

• A significant difference was observed between mTD values before and after cataract surgery (p<0.001).
• εmPD significantly correlated with mTD in VF(post) and ΔmTD (R(2)=0.56 and 0.27, p<0.001).
• Pattern standard deviation (PSD), mTD, and pre-operative visual acuity accurately predicted post-operative mTD.

Conclusions:

• PD values can underestimate glaucomatous VF damage in advanced disease and overestimate it in early to moderate cataracts.
• Clinicians need to exercise caution when interpreting VF results in glaucoma patients with co-existing cataracts.