Pattern of Visual Field Loss in Primary Angle-Closure Glaucoma Across Different Severity Levels

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Primary angle-closure glaucoma (PACG) is a significant cause of vision loss worldwide.
• Understanding visual field (VF) defect patterns is crucial for managing PACG progression.
• Hemifield differences in VF defects are not well-characterized across PACG severity levels.

Purpose of the Study:

• To investigate visual field (VF) defect patterns in primary angle-closure glaucoma (PACG) across varying severity levels.
• To assess differences between the superior and inferior hemifields within each PACG severity group.
• To identify specific regional patterns of VF damage in PACG.

Main Methods:

• A cross-sectional study involving 249 patients diagnosed with PACG was conducted.
• Static automated perimetry (Swedish interactive threshold algorithm standard program 24-2) was used to record point-wise total deviation values.
• Visual field loss severity was categorized as mild, moderate, or severe based on mean deviation (MD) values, and hemifields were analyzed regionally.

Main Results:

• The superior hemifield demonstrated significantly worse mean deviation (MD) values compared to the inferior hemifield across all severity levels.
• Within each hemifield, visual field defects progressively worsened with increasing distance from the fixation point.
• The nasal regions consistently showed more pronounced damage compared to other areas.

Conclusions:

• In clinic-based PACG patients, the superior hemifield is more severely affected than the inferior hemifield.
• The disparity between hemifields intensifies with increasing disease severity in PACG.
• Nasal visual field damage is a consistent finding in PACG, regardless of severity.