Detection of incident field loss using the glaucoma hemifield test

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Testing

Background:

• Elevated intraocular pressure is a risk factor for glaucoma.
• Glaucoma can lead to progressive visual field loss.
• Accurate definition of incident visual field loss is crucial for timely intervention.

Purpose of the Study:

• To evaluate different criteria for defining incident visual field loss.
• To compare definitions based on 1, 2, or 3 consecutive abnormal glaucoma hemifield test results.
• To assess the predictive value of these definitions over a 6-year follow-up period.

Main Methods:

• A cohort of 253 patients with elevated intraocular pressure were followed for 5-9 years.
• Annual C-30-2 Humphrey visual fields were analyzed.
• Three definitions for incident field loss were compared: 1, 2, or 3 consecutive abnormal glaucoma hemifield test results.

Main Results:

• Incidence rates of visual field loss varied significantly based on the definition used (e.g., 63.6 vs. 19.2 per 1000 person-years).
• Using 2 or 3 consecutive abnormal tests resulted in lower incidence rates compared to 1 abnormal test.
• Eyes defined with incident field loss using 2 or 3 consecutive abnormal tests were more likely to show subsequent abnormalities.

Conclusions:

• A single abnormal glaucoma hemifield test result is insufficient for defining incident visual field loss.
• Employing two or three consecutive abnormal glaucoma hemifield test results provides a more reliable definition.
• This refined definition aids in better monitoring and management of glaucoma progression.