Temporal Wedge Defects in Glaucoma: Structure/Function Correlation With Threshold Automated Perimetry of the Full...

Area of Science:

• Ophthalmology
• Medical Imaging
• Visual Neuroscience

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Early detection of glaucoma relies on identifying visual field defects.
• Current visual field tests may not adequately assess peripheral vision loss.

Purpose of the Study:

• To evaluate a novel static automated perimetry test covering the full visual field.
• To correlate peripheral visual field defects with optic disc and retinal nerve fiber layer (RNFL) thinning in glaucoma patients.
• To assess the utility of the Open Perimetry Interface (OPI) peripheral test in glaucoma diagnosis.

Main Methods:

• Developed a full visual field static automated perimetry test using the Open Perimetry Interface (OPI).
• Tested 27 glaucoma subjects with mild vision loss using OPI 30-2, OPI Peripheral, and Cirrus ocular coherence tomography (OCT).
• Assessed correlation between visual field defects and OCT-measured RNFL and ganglion cell thickness.

Main Results:

• About half of the glaucoma cohort showed inferotemporal visual field defects correlating with optic disc damage.
• The OPI peripheral test identified discrete temporal wedge defects in 26% and extensive inferior temporal loss in 22% of cases.
• OCT data showed best correlation with the OPI peripheral test in 8 subjects and the OPI central 30-2 test in 9 subjects.

Conclusions:

• Peripheral inferotemporal visual field defects are common in glaucoma and correlate with optic disc damage.
• Adding a far peripheral automated perimetry test enhances structure-function correlations in glaucoma.
• The OPI peripheral test provides valuable clinical information for glaucoma assessment.