Baseline Central Visual Field Defect as a Risk Factor For NTG Progression: A 5-Year Prospective Study

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Normal-tension glaucoma (NTG) is a progressive optic neuropathy.
• Visual field (VF) defects can manifest centrally or peripherally in NTG patients.
• Understanding progression patterns based on VF defect location is crucial for patient management.

Purpose of the Study:

• To compare the rate and risk of progression in NTG patients with baseline central VF defects versus those with peripheral VF defects.
• To investigate clinical characteristics, including ocular perfusion pressure, associated with progression in these groups.

Main Methods:

• A prospective, longitudinal study of 65 NTG patients over 5 years.
• Patients were grouped based on baseline VF defects in the central (0-10 degrees) or peripheral (10-24 degrees) areas.
• 24-hour intraocular pressure and blood pressure monitoring, and at least 5 VF tests were performed.

Main Results:

• No significant demographic or hemodynamic differences were found between central and peripheral defect groups.
• Eyes with baseline central VF defects showed significantly faster progression (β=-0.78 dB/y, P=0.007).
• NTG patients with central VF involvement had a 3.56 times higher hazard of progression (P=0.025).

Conclusions:

• NTG patients with baseline central visual field defects are at a significantly increased risk of disease progression.
• Central VF involvement in NTG warrants closer monitoring and potentially earlier therapeutic intervention.