Intraocular asymmetry of visual field defects in primary angle-closure glaucoma, high-tension glaucoma, and normal-tension glaucoma in a Chinese population

Junhong Jiang,Jingjing Hu,Xiang Xu,Fan Lu,Jingwei Zheng,Xiaoyan Wang,Yuanbo Liang,Jingjing Zuo,Xiao Shang,Wenqing Ye,Shaodan Zhang,Nathan Congdon,Cong Ye,Hongte Zhang,Cong Zhang

doi:10.1038/s41598-021-91173-8

Abstract

Direct comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available. We aimed to compare the intraocular asymmetry of VF loss among patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF defects were categorized into 3 stages (early, moderate, and advanced), and each hemifield was divided into 5 regions according to the Glaucoma hemifield test (GHT). The mean total deviation (TD) of each GHT region was calculated. In the early stage, the paracentral, peripheral arcuate 1 and peripheral arcuate 2 regions in the superior hemifield in the NTG group had significantly worse mean TDs than their corresponding regions in the inferior hemifield. In the advanced stage, the central region in the superior hemifield in the PACG group had a significantly worse mean TD than that in the inferior hemifield. There was no significant difference in the mean TD for any of the five regions between hemifields across all severity levels in the in the HTG group. The superior hemifield was affected more severely than the inferior hemifield in all three subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG than in PACG and HTG.

Highlights

Direct comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available
primary open-angle glaucoma (POAG) is subdivided into high-tension glaucoma (HTG) and normal-tension glaucoma (NTG)
PACG was defined as the presence of angle closure together with evidence of glaucomatous optic neuropathy and a corresponding VF defect, and angle closure was defined as the inability to visualize the posterior trabecular meshwork for ≥ 180° on gonioscopy

Summary

Introduction

Direct comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available. The differences among VF defects in PACG, NTG and HTG have been reported by several studies utilizing automated perimetry; in both PACG and HTG, the superior hemifield is more severely affected than the inferior hemifield[22,23], and the VF defects in HTG tend to be more localized than those in PACG 22,24. Each of these studies included only one or two types of glaucoma. We compared the intraocular VF defect asymmetry among patients with PACG, NTG and HTG across different severity levels

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Conclusion