Optic disc tilt direction affects regional visual field progression rates in myopic eyes with open-angle glaucoma

Abstract

To compare global and regional visual field (VF) progression rates and determine clinical factors associated with rapid VF progression in myopic patients with open-angle glaucoma (OAG) with different disc tilt directions. The medical records of 182 eyes from 182 myopic OAG patients with progressive VF deterioration during follow-up were analyzed. The rates of change in the mean thresholds of the global and regional VF areas of the horizontal and vertical disc tilt (HDT and VDT) groups were compared using a linear mixed model after controlling for confounding covariates. Clinical factors associated with rapid VF progression in global and regional VF areas were investigated. The VDT group showed significantly faster VF progression at inferior regional zones than the HDT group (P < 0.05). Based on a multivariate linear mixed model, VDT was associated with faster bi-hemifield VF progression in the GHT map, whereas HDT was associated with faster single-hemifield VF progression. Myopic OAG eyes show significantly different regional VF progression rates according to disc tilt direction. VDT is an independent predictor of a rapid rate of regional VF progression in both hemifields, whereas HDT predicts rapid regional VF progression in a single hemifield.