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Which glaucoma patients benefit from 10-2 visual field testing? Proposing the functional vulnerability zone

Jack Phu1,2, Daniel Rafla1, Michael Kalloniatis1,2

  • 1School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia.

Clinical & Experimental Optometry
|December 6, 2023
PubMed
Summary
This summary is machine-generated.

This study introduces a method to identify a functional vulnerability zone (FVZ) in glaucoma patients, guiding the use of the 10-2 visual field test for enhanced monitoring. Identifying an FVZ helps detect subtle visual field sensitivity changes crucial for glaucoma management.

Keywords:
10-224-2Humphrey Field Analyzercentral visual fieldmacula visual fieldsperimetry

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Area of Science:

  • Ophthalmology
  • Visual field testing
  • Glaucoma diagnostics

Background:

  • Glaucoma management requires precise visual field (VF) monitoring.
  • The 10-2 VF test offers greater sensitivity in specific cases.
  • Characterizing a 'functional vulnerability zone' (FVZ) is key to optimizing VF testing strategies.

Purpose of the Study:

  • To pilot a method for determining the optimal deployment of the 10-2 VF test grid in glaucoma.
  • To define the 'functional vulnerability zone' (FVZ) for improved glaucoma assessment.

Main Methods:

  • Cross-sectional analysis of 24-2 and 10-2 VF results from 133 glaucoma patients.
  • Calculation of the 'volume' (arbitrary units, A.U.) under the central Hill of Vision.
  • Identification of 24-2 factors significantly related to A.U. differences between 24-2 and 10-2 tests.

Main Results:

  • Over 55% of patients exhibited an FVZ, indicating greater sensitivity with the 10-2 test.
  • Worse mean deviation and a higher proportion of defective locations on the 24-2 test were associated with FVZ.
  • A 24-2 mean deviation of -3.16 to -3.62 dB and 5+ defective central locations indicated potential 10-2 test utility.

Conclusions:

  • Clinical markers from the 24-2 test can guide the utility of the 10-2 test in glaucoma assessment.
  • The study provides a pilot reference tool for clinicians to assess 10-2 test likelihood within an FVZ context.
  • Identifying an FVZ enhances the potential for future visual field monitoring in glaucoma patients.