Korean J Ophthalmol.  2014 Dec;28(6):436-443. 10.3341/kjo.2014.28.6.436.

Prevalence and Spatial Concordance of Visual Field Deterioration in Fellow Eyes of Glaucoma Patients

• Kim MK
• Lee JM
• Morales E
• Caprioli J

• KMID: 2345819
• DOI: http://doi.org/10.3341/kjo.2014.28.6.436

Abstract

PURPOSE
To examine the prevalence of visual field deterioration in contralateral eyes of patients with worsening open-angle glaucoma and to evaluate the spatial concordance of visual field deterioration between both eyes.
METHODS
One hundred sixteen open-angle glaucoma patients who underwent 8 or more visual field examinations over > or =6 years of follow-up were included. The rates of the fast and slow components of visual field decay for each of 52 visual field test locations were calculated with point-wise exponential regression analysis. The spatial concordance of visual field deterioration in contralateral eyes was evaluated with a concordance ratio (calculated as the number of overlapping locations divided by the total number of deteriorating locations) and by comparing the rate of decay in corresponding modified glaucoma hemifield test clusters.
RESULTS
The average visual field mean deviation (+/-standard deviation [SD]) was -8.5 (+/-6.4) dB and the mean (+/-SD) follow-up time was 9.0 (+/-1.6) years. Sixty-three patients had mild damage, 23 had moderate damage, and 30 had severe damage. The mean concordance ratio (+/-SD) was 0.46 (+/-0.32) for the mild group, 0.33 (+/-0.27) for the moderate group, and 0.35 (+/-0.21) for the severe group. Thirty-one patients (27%) had deterioration in concordant locations (p < 0.05). Visual field deterioration was greater in the superior hemifield than the inferior hemifield (p < 0.05) when evaluated with both the concordance ratio and modified glaucoma hemifield test cluster analysis methods.
CONCLUSIONS
There is only fair spatial concordance with regard to visual field deterioration between the both eyes of an individual. We conclude that testing algorithms taking advantage of inter-eye spatial concordance would not be particularly advantageous in the early detection of glaucomatous deterioration.

Keyword

Point-wise exponential regression analysis; Spatial concordance; Visual field deterioration

MeSH Terms

Aged
Female
Glaucoma, Open-Angle/diagnosis/*epidemiology/physiopathology
Humans
Male
Middle Aged
Prevalence
Space Perception/*physiology
Vision Disorders/diagnosis/*epidemiology/physiopathology
Visual Field Tests
Visual Fields/*physiology

Figure

• 

  Fig. 1 Schematic demonstrating the method for calculating the concordance ratio. Matching visual field locations of the left and right eyes were examined to determine if they belonged to the fast component in both eyes (overlapping defects-locations marked by A), if only one of them belonged to the fast component (non-overlapping defects: locations marked by C in the right eye and B in the left eye), or if both locations belonged to the slow component in the fellow eyes. The amount of overlap in fast components between the right and left eyes was calculated as the ratio of overlapping fast components to total number of fast components. A concordance ratio of '1' refers to a scenario where both eyes match 100%, whereas a concordance ratio of '0' denotes that field losses in the two eyes are independent of each other.

• 

  Fig. 2 The graph demonstrates the concordance ratio and defect size in the study sample as a function of glaucoma severity.

• 

  Fig. 3 The frequency of belonging to the fast component at each visual field test location and frequency of deterioration at 12 modified glaucoma hemifield test clusters for 232 eyes of 116 patients. (A) The numbers at each test location represent the total number of locations belonging to the fast component, and the numbers in parentheses refer to the percentage out of 232 eyes. The number (proportion) of test locations belonging to the fast components was 2,974 (50.6%) and 2,898 (49.4%) for the superior and inferior hemifields, respectively, with a p-value of 0.049. (B) Diagram shows the frequency of deterioration for 12 modified glaucoma hemifield test clusters in 232 eyes of 116 patients. The average number of deteriorating clusters was 4.3 (±4.6). The number of deteriorating clusters in the superior and inferior hemifields were 298 (59.4%) and 204 (40.6%), respectively (p = 0.035). C = cluster (percentage for 232 eyes).

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