Prediction of Central Visual Field Severity in Glaucoma

Precis: The severity of central visual field (VF) defects on 24-2 VF and related scotomas on 10-2 VF may be predicted by assessing perimetric defects at abnormal central 12 points on 24-2 VF in early glaucoma. Purpose: Investigating the association between perimetric parameters at abnormal central 12 points on 24-2 VF and the severity of central visual field defects (CVFDs) on 24-2 VF and related parafoveal scotomas on 10-2 VF. Methods: We examined 64 eyes of 56 glaucoma patients with CVFDs on 24-2 VF with a mean deviation better than -7 dB and completed 24-2 and 10-2 VF testing within 6 months. On the basis of 10-2 VFs' pattern defects, eyes were grouped into 3: an arcuate parafoveal scotoma, severe defect; partial arcuate, moderate defect; and minimal defect. VF parameters at abnormal points (P<1%) within the central-most 4 and paracentral 8 points on total deviation/pattern deviation plots on 24-2 VF were analyzed to predict the severity of CVFDs. Results: Eyes with arcuate scotoma showed more functional loss than eyes without arcuate scotoma on 10-2 VF (P<0.001). A significant association was observed between abnormal 24-2 VF points' (<1%) threshold sensitivity lower than 20 dB [odds ratio (OR)=7.2; P=0.002 and OR=5.1; P=0.003 for the central 4 and paracentral 8 points, respectively] and defect values worse than -15 dB (OR=8.0 and 5.6 for the central 4 and paracentral 8 points, respectively, P=0.005) with arcuate scotoma on 10-2 VF. Superior nasal defect in the central 5 degrees on 24-2 VF was significantly associated with an arcuate defect on 10-2 VF (P<0.001). Conclusion: Clinicians may predict the severity of CVFDs on 24-2 VF and parafoveal scotomas on 10-2 VF by measuring threshold sensitivities and defect values at abnormal central 12 points (<1%) on 24-2 VF in early glaucoma.