[Relationship between visual field index and visual field morphological stages of glaucoma and their diagnostic...

Objective: To investigate the rationality of visual field morphological stages of glaucoma, its relationship with visual field index and their diagnostic value. Methods: Retrospective series case study. Two hundred and seventy-four glaucoma patients and 100 normal control received visual field examination by Humphrey perimeter using standard automatic perimetry (SAP) program from March 2014 to September 2014. Glaucoma patients were graded into four stages according to characteristic morphological damage of visual field, distribution of mean defect (MD) and visual field index (VFI) of each stage were plotted and receiver operation characteristic curve (ROC) was used to explore its correlation with MD and VFI. The diagnostic value of MD and VFI was also compared. For the comparison of general data of subjects, categorical variables were compared using χ(2) test, numerical variables were compared using F test. MD and VFI were compared using ANOVA among stages according to visual field, followed by multiple comparisons using LSD method. The correlation between MD and VFI and different stages according to visual field defined their diagnostic value, and compared using area under the curve (AUC) of ROC. Results: No characteristic visual field damage was found in normal control group, and MD and VFI was (-0.06±1.24) dB and (99.15±0.76)%, respectively. Glaucomatous visual field damage was graded into early, medium, late and end stage according to morphological characteristic. MD for each stage were (-2.83±2.00) dB, (-9.70±3.68) dB, (-18.46±2.90) dB, and (-27.96±2.76) dB, respectively. VFI for each stage were (93.84±3.61)%, (75.16±10.85)%, (49.36±11.26)% and (17.65±10.59)%, respectively. MD and VFI of each stage of glaucomatous group and normal control group were all significantly different (F=1 165.53 and P<0.01 for MD; F=1 028.04 and P<0.01 for VFI). AUC of ROC was A(MD)=0.91 and Se(MD)=0.01 (95% confident interval was 0.89-0.94) for MD, and A(VFI)=0.97, Se(VFI)=0.01 (95% confident interval was 0.94-0.10) for VFI. So, AUC(VFI)>AUC(MD) (P<0.05). Conclusions: It is feasible and rational of glaucomatous visual field damage to be graded into early, medium, late and end stage using Humphrey perimeter. Distribution of MD and VFI for each stage was relatively concentrative. Both MD and VFI were useful for grading glaucomatous visual field damage with preference for VFI. (Chin J Ophthalmol, 2017, 53: 92-97).