Horizontal Gaze Tolerance and Its Effects on Visual Sensitivity in Glaucoma

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Glaucoma is a progressive optic neuropathy characterized by visual field loss.
• Structural changes in the posterior globe are observed in glaucoma patients.
• Understanding functional deficits related to eye movements is crucial for glaucoma management.

Purpose of the Study:

• To evaluate the impact of 6° horizontal gaze deviations on visual field mean sensitivity (MS) in glaucoma patients.
• To investigate if eye positioning affects visual field measurements in glaucoma.
• To correlate structural findings with functional visual field changes.

Main Methods:

• A cross-sectional study included 161 eyes (85 primary open-angle glaucoma [POAG], 76 healthy).
• Visual field tests were conducted using an automated perimeter at central gaze, 6° abduction, and 6° adduction.
• Propensity score matching and mixed-effects models were used for analysis.

Main Results:

• In healthy eyes, MS did not significantly differ across gaze positions (P = 0.650).
• In glaucoma eyes, MS was significantly lower in adduction compared to central gaze (P = 0.001) and abduction (P = 0.022).
• Matched analysis included 41 POAG and 41 healthy eyes.

Conclusions:

• Horizontal gaze, especially adduction, significantly reduces visual sensitivity in glaucoma.
• Eye movement and positioning play a critical role in visual field sensitivity in glaucoma.
• Further research is needed to explore the clinical significance of these findings.