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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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Prediction of repeatable glaucomatous visual field defects based on cluster characteristics.

Jeremy C K Tan^1,2, Jack Phu^3,4, Katharina Bell^5,6

¹Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia jeremy.c.tan@unsw.edu.au.

The British Journal of Ophthalmology

|July 3, 2025

Summary

Characteristics of initial visual field (VF) defects, including size and volume of clusters, can predict repeatable defects in subsequent tests. This helps identify glaucoma patients at higher risk for progressive vision loss.

Keywords:

Field of vision Glaucoma Psychophysics Visual perception

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Area of Science:

Ophthalmology
Glaucoma research
Visual field testing

Background:

Glaucoma is a leading cause of irreversible blindness.
Early detection and monitoring of glaucoma progression are crucial.
Visual field testing is a standard method for assessing glaucomatous damage.

Purpose of the Study:

To determine if initial visual field (VF) defect cluster characteristics predict repeatability in subsequent tests.
To identify specific VF defect features associated with higher risk of repeatable defects in glaucoma patients.

Main Methods:

Retrospective cohort study of 197 eyes from 103 patients with glaucoma.
Analysis of initial VF tests to define cluster number, size, and volume at various probability levels (p<5% to p<0.5%).
Evaluation of the predictive value of cluster characteristics for repeatable defects on subsequent VFs.

Main Results:

Only 26.9% of initial defects (p<5%) were repeatable.
Cluster size and volume were predictive of repeatable defects (AUC 0.80).
Optimal thresholds for predicting repeatability were established based on cluster size and probability levels.

Conclusions:

Initial VF defect cluster location, size, and volume may predict subsequent repeatability.
These findings can aid in distinguishing eyes with a higher risk of repeatable defects.
This approach may improve the monitoring and management of glaucoma patients.