Visual field loss in primary congenital glaucoma.

Abstract

To assess the visual field defects in primary congenital glaucoma (PCG) and to identify associated risk factors. In this cross-sectional study visual fields of consecutive PCG patients were examined using Humphery Field Analyzer (HFA) or Goldmann visual field (GVF). All patients had maintained an intraocular pressure (IOP) ≤14 mm Hg on standard care. Mean deviation, pattern standard deviation (PSD), foveal threshold in HFA, and global visual field extent (degrees) in 24 meridians for targets V4e, I4e, I2e in GVF were recorded and evaluated with respect to baseline IOP and age at detection. Statistical analysis was performed by Kruskal Wallis and Mann-Whitney test. Qualitative analysis of GVF and reliable fields in HFA was performed. A total of 100 eyes of 77 patients were included: 56 eyes of 47 patients were in the HFA group; 44 eyes of 30 patients, in the GVF group. On HFA, mean deviation detected at ≤1 month of age was significantly lower than eyes detected after 1 year (P < 0.001). On GVF, the global visual field extent for target I4e and I2e was significantly lower for PCG detected at ≤1 month of age compared to those seen at >1 year (I4e, P < 0.001; I2e, P = 0.005). Mean deviation, PSD, and foveal threshold were significantly lower in PCG with baseline IOP of >30 mm Hg than with IOP of 20-25 mm Hg (mean deviation, P < 0.001; PSD, P = 0.002; foveal threshold, P = 0.002). Extent for targets V4e and I4e on GVF were significantly lower in patients with baseline IOP of >30 mm Hg compared to those with baseline IOP of 20-25 mm Hg (V4e, P = 0.002; I4e, P = 0.003). Definitive glaucomatous defects were found in 36 eyes (41%), most ommon being arcuate scotoma (19 eyes [22%]). PCG detected at age ≤1 month and those having a baseline IOP of >30 mm Hg show greater visual field loss.