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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

744
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
744
Glaucoma: Overview01:25

Glaucoma: Overview

950
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

879
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
879

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Related Experiment Video

Updated: Oct 7, 2025

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Evaluating Visual Field Progression in Advanced Glaucoma Using Trend Analysis of Targeted Mean Total Deviation.

Atsuya Miki1,2, Tomoyuki Okazaki1, Robert N Weinreb3

  • 1Departments of Ophthalmology.

Journal of Glaucoma
|January 12, 2022
PubMed
Summary
This summary is machine-generated.

Glaucoma progression may be underestimated in severe cases. Analyzing visual field data excluding undetectable points, using targeted mean total deviation, offers a more accurate assessment of disease progression.

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Area of Science:

  • Ophthalmology
  • Medical Technology
  • Clinical Research

Background:

  • Glaucoma is a progressive optic neuropathy.
  • Visual field (VF) testing is crucial for monitoring glaucoma.
  • Current trend analysis of global indices may miss progression in severe disease.

Purpose of the Study:

  • To test if trend analysis of visual field global indices underestimates progression in severe glaucoma.
  • To compare VF progression rates with and without exclusion of undetectable points.

Main Methods:

  • Retrospective analysis of 648 eyes from 366 glaucoma patients with >2 years of 30-2 standard automated perimetry.
  • Calculation of targeted mean total deviation (TMTD) excluding consistently undetectable points.
  • Classification of disease severity (early, moderate, advanced, severe) based on baseline mean deviation (MD).

Main Results:

  • The mean deviation (MD) slope in severe glaucoma (-0.34 dB/y) was significantly slower than the targeted mean total deviation (TMTD) slope (-0.42 dB/y).
  • This underestimation was most prominent in eyes with MD < -25 dB.
  • The difference between MD and TMTD slopes was significant in severe glaucoma (P=0.028).

Conclusions:

  • Undetectable visual field locations can lead to underestimation of glaucoma progression rates, particularly in severe stages.
  • Trend analysis using TMTD provides a more accurate and practical method for assessing progression in severe glaucoma.
  • Excluding undetectable points improves the reliability of visual field progression monitoring.