THE PATTERNS OF VISUAL DEFECT IN CHRONIC ANGLE CLOSURE GLAUCOMA

Catherine Jui-ling Liu, Ling-Ing Lau, Joe C.K. Chou, Wen-Ming Hsu and Jorn-Hon Liu

Department of Ophthalmology, Taipei Veterans General Hospital; National Yang-Ming University, School of Medicine, Taiwan

Purpose: To identify and compare the patterns of visual field (VF) defect in chronic primary angle-closure glaucoma (CCAG) with different degrees of glaucomatous optic neuropathy.

Methods: Ninety-five CACG patients (129 eyes) with controlled intraocular pressure (IOP) were enrolled. All eyes had history of persistently elevated IOP in the presence of a patent peripheral iridotomy and glaucomatous VF defects. The VF test was performed with Humphrey Field Analyzer, Program 24-2 with SITA Standard. The VF defect was scored by Advanced Glaucoma Intervention Study scoring system and categorized into mild, moderate, severe and end-stage. The patterns of VF defect (nasal step, paracentral scotoma, partial arcuate, arcuate and hemifield defect) in each group were studied and compared.

Results: Nasal step Paracentral Partial Arcuate Arcuate Hemifield

Mild 77.2 % 45.6 % 52.6 % 17.5 % 0

Moderate 77.8 % 70.4 % 59.3 % 40.7 % 25.9 %

Severe 52.6 % 31.6 % 26.3 % 31.6 % 79.0 %

End-stage 4 % 4 % 0 % 4 % 96 %

In addiction to be the most frequently involved area in mild glaucoma, the nasal field also showed more VF mean deviation than other areas.

Conclusions: Nasal step is the most common defect in both mild and moderate groups of CACG.Hemifield defect constitutes most of the VF defect in the severe and end-stage groups. (We have no proprietary interest in this study)