Field Defects In Patients Research Articles

Comparison of visual field defects between newly detected chronic simple glaucoma and normotensive glaucoma

Objective : To study and compare the visual field defects in subjects with newly detected primary open angle glaucoma and normotensive glaucoma using HUMPHREY FIELD ANALYSER 30-2 swedish interactive thresholding algorithm(SITA) standard technique and to establish specific visual field loss patterns in each group and establish varied pathomechanisms. Methods: A prospective study 37 eyes of 25 patients with normal tension glaucoma(NTG) and chronic simple glaucoma(CSG). Patients were subjected to visual field testing using HUMPHREY FIELD ANALYSER(HFA) 30-2, SITA(Swedish interactive thresholding algorithm) standard method. Results: There was significant preponderance of early visual field defects in patients with NTG in comparison to patients with CSG (64% compared to 32.4%). Strong statistical differences were found in number of patients with scotomas falling with 6 degrees of central fixation (p<_0.001) in NTG comparing with CSG. Conclusion : results suggest that field defects between chronic simple and normotensive glaucoma do not differ in most aspects except for those in NTG group being closer to fixation and should not be used to underline different pathomechanisms in the two groups.

Local Relationship between Global-Flash Multifocal Electroretinogram Optic Nerve Head Components and Visual Field Defects in Patients with Glaucoma

Purpose. To investigate the local relationship between quantified global-flash multifocal electroretinogram (mfERG) optic nerve head component (ONHC) and visual field defects in patients with glaucoma. Methods. Thirty-nine patients with glaucoma and 30 normal controls were enrolled. The ONHC amplitude was measured from the baseline to the peak of the second positive deflection of the induced component. The ONHC amplitude was normalized by dividing ONHC amplitude by the average of seven largest ONHC amplitudes. The ONHC amplitude ratio map and ONHC deficiency map were constructed. The local relationship between the ONHC measurements and visual field defects was evaluated by calculating the overlap between the ONHC deficiency maps and visual field defect plots. Results. The mean ONHC amplitude measurements of patients with glaucoma (6.01 ± 1.91 nV/deg2) were significantly lower than those of the normal controls (10.29 ± 0.94 nV/deg2) (P < 0.001). The average overlap between the ONHC deficiency map and visual field defect plot was 71.4%. The highest overlap (75.0%) was between the ONHC ratios less than 0.5 and the total deviations less than 5%. Conclusions. The ONHC amplitude was reduced in patients with glaucoma compared to that in normal controls. Loss of the ONHC amplitude from the global-flash mfERG showed a high local agreement with visual field defects in patients with glaucoma.

Size of the Optic Nerve Head and Its Relationship with the Thickness of the Macular Ganglion Cell Complex and Peripapillary Retinal Nerve Fiber Layer in Patients with Primary Open Angle Glaucoma.

Purpose. To evaluate the relationships among the optic nerve head (ONH) area, macular ganglion cell complex (mGCC) thickness, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and visual field defects in patients with primary open angle glaucoma (POAG). Methods. This retrospective study included 90 eyes of 90 patients with POAG. The ONH area, rim area, mGCC thickness, and cpRNFL thickness were measured using optical coherence tomography. Mean deviation (MD) was measured using standard automated perimetry. The relationships among clinical factors including age, refraction, the ONH area, the rim area, the mGCC thickness, the cpRNFL thickness, and MD were evaluated using correlation coefficients and multiple regression analyses. Results. The significant correlation of the ONH area with refraction (r = 0.362, P < 0.001), the mGCC thickness (r = 0.225, P = 0.033), and the cpRNFL thickness (r = 0.253, P = 0.016) was found. Multiple regression analysis showed that the ONH area, rim area, and MD were selected as significant contributing factors to explain the mGCC thickness and cpRNFL thickness. No factor was selected to explain MD. Conclusions. The ONH area, in other words, the disc size itself may affect the mGCC thickness and cpRNFL thickness in POAG patients.

Changes in pituitary comorbidities of adult-onset craniopharyngioma depending on date of diagnosis

Conclusion We found significantly less post-operative pituitary insufficiencies and visual field defects in patients diagnosed after 1997. This might be a consequence of improved surgical approach. Furthermore, differences in tumor extension could be due to improvements in diagnostics and earlier treatment of craniopharyngioma. 1 Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Ziemssenstr. 1, 80336 Munchen (Munich, Germany) 2 Max-Planck-Institut fur Psychiatrie, Kraepelinstrase 2-10, 80804 Munchen (Munich, Germany)

Visual acuity and pattern of visual field loss at presentation in pituitary adenoma

Our purpose was to analyse the demographics, prevalence and pattern of visual field defects in patients with pituitary adenoma. We prospectively recruited 103 consecutive patients (206 eyes) presenting to a neurosurgical unit with pituitary adenoma. Ophthalmological examination and standard automated perimetry (Humphrey, 24-2 threshold) was performed. Severity of visual field defects was also assessed. The mean population age was 53.9years (standard deviation=15). Visual loss was the most common reason for presentation (39%) followed by endocrine abnormality (21%) and headache (15%). Patients with endocrine abnormality on presentation were 10.9years younger than those presenting with visual loss (p=0.001). Bitemporal defects were the most prevalent pattern (n=22, 41%) followed by homonymous defects (n=7, 13%). Of the patients with visual field loss, 33% had unilateral visual field defects. The mean visual acuity in those with bitemporal defects was 6/7.5 with half of these patients having 6/6 vision in both eyes. In conclusion, the majority of patients with pituitary adenoma have visual acuity better than 6/7.5 despite having visual field defects. While a bitemporal pattern of visual field loss is the most common, a significant proportion of patients had unilateral and altitudinal defects. Assessment of the visual field is essential to rule out chiasmal compression.

Assessment methods of visual field defects of patients with glaucoma

Glaucoma is a common eye disease which may cause irreversible blindness.This ocular degenerative disease affects retinal ganglion cells (RGCs) and eventually causes optic nerve dysfunction by way of axonal loss.Patients with glaucoma may show characteristic changes of optic disc,damages of visual field and impairment of vision.Detection and evaluation of the impairment of visual field in patients with glaucoma are essential for the diagnosis and estimation of progression of this disease.Numerous techniques have been developed to detect field progression,but no standard has been widely accepted.Assessment Methods including visual field indices,glaucoma hemifield test (GHT),Advanced Glaucoma Intervention Study (AGIS),Early Manifest Glaucoma Trial (EMGT),Collaborative Initial Glaucoma Treatment Study(CIGTS),as well as the strength and limitation of each method were reviewed in this article in order to find out suitable ways to evaluate visual field defects in patients with glaucoma in clinical works and researches. Key words: Glaucoma; Visual field defect; Assessment

Severe visual loss following waterload for transabdominal ultrasound

Dear Editor, A 72-year-old male presented at the emergency services with sudden decrease in vision. The patient gave a history of preceding pelvic ultrasound for prostate evaluation. He was administered around 2 L of water over 10 min prior to the sonography to enable good visualization of prostate. Soon after leaving the radiology clinic, he noticed severe blurring of vision and heaviness in his eyes. His vision was finger counting close to face. He had severe corneal edema with intraocular pressure (IOP) of 54 mm Hg OD 60 mm Hg OS. He was immediately given intravenous mannitol and oral acetazolamide in conjunction with topical ocular hypotensives. The pressures were controlled and the vision improved to 20/40 after few hours and 20/20 the following day. He was a known ocular hypertensive who had been well-investigated 3 years back for glaucoma. Records revealed visual acuity of 20/20 both eyes, open angles, pachymetry of 540 μ OD and 532 μ OS, normal visual fields, and disc examination. His diurnal record had pressures in the range of 12-18 mm Hg in right eye and 14-18 mm Hg left eye with a maximum recorded IOP of 24 mm Hg either eye. The patient was advised 6 monthly follow-up to detect any conversion to open angle glaucoma. However, the patient did not return for follow-up and did not divulge his ocular diagnosis to the radiologist. After the present episode, the pressures normalized with treatment. The patient was emmetropic with bilateral open angles. There was no disc damage and few depressed points in fields left eye hinting toward probable early damage. The current optical coherence tomography is normal. The patient has shown a tendency for extreme response to the water overload and such situation may be repeated in daily life in lesser magnitude. After discussion with the patient, it was found feasible to start him on one medication as his compliance to follow-up visits was also doubtful. He has now been put on topical prostaglandin analogue once at night time both eyes and advised regular follow-up. The regulation of IOP is a complex physiologic trait that depends upon production of aqueous humor, resistance to aqueous humour outflow, and episcleral venous pressure.[1] After drinking water or any hypotonic fluid, there is a consequent rise in IOP. The ability of the eye to recover from this transient IOP rise depends on the outflow facility. Ocular hypertensives and glaucoma patients can have an exaggerated elevation of IOP following ingestion of more than 500 mL of water within a span of 5 min.[2] This pressure response even forms the basis of one of the provocative tests, the water drinking test, sometimes used for diagnosis of glaucoma. Armaly and coworkers[3,4] reported the pressure change after drinking water as one of five potential risk factors significantly related to the development of glaucomatous visual field defects in patients with ocular hypertension. An ignorance about such response in ocular hypertensives or glaucoma patients undergoing water loading can lead to irreversible visual loss. The protocols for a full bladder transabdominal sonography must include a slow ingestion of 500 mL of water as well as at least 90 min time for postprocedural observation and prompt referral to an ophthalmologist in case of need [Fig. 1]. Figure 1 Transabdominal ultrasound with full bladder

Interventions for visual field defects in patients with stroke

Visual field defects are estimated to affect 20% to 57% of people who have had a stroke. Visual field defects can affect functional ability in activities of daily living (commonly affecting mobility, reading and driving), quality of life, ability to participate in rehabilitation, and depression, anxiety and social isolation following stroke. There are many interventions for visual field defects, which are proposed to work by restoring the visual field (restitution); compensating for the visual field defect by changing behaviour or activity (compensation); substituting for the visual field defect by using a device or extraneous modification (substitution); or ensuring appropriate diagnosis, referral and treatment prescription through standardised assessment or screening, or both. To determine the effects of interventions for people with visual field defects after stroke. We searched the Cochrane Stroke Group Trials Register (February 2011), the Cochrane Eyes and Vision Group Trials Register (December 2009) and nine electronic bibliographic databases including CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (1950 to December 2009), EMBASE (1980 to December 2009), CINAHL (1982 to December 2009), AMED (1985 to December 2009), and PsycINFO (1967 to December 2009). We also searched reference lists and trials registers, handsearched journals and conference proceedings and contacted experts. Randomised trials in adults after stroke, where the intervention was specifically targeted at improving the visual field defect or improving the ability of the participant to cope with the visual field loss. The primary outcome was functional ability in activities of daily living and secondary outcomes included functional ability in extended activities of daily living, reading ability, visual field measures, balance, falls, depression and anxiety, discharge destination or residence after stroke, quality of life and social isolation, visual scanning, adverse events and death. Two review authors independently screened abstracts, extracted data and appraised trials. We undertook an assessment of methodological quality for allocation concealment, blinding of outcome assessors, method of dealing with missing data, and other potential sources of bias. Thirteen studies (344 randomised participants, 285 of whom were participants with stroke) met the inclusion criteria for this review. However, only six of these studies compared the effect of an intervention with a placebo, control or no treatment group and were included in comparisons within this review. Four studies compared the effect of scanning (compensatory) training with a control or placebo intervention. Meta-analysis demonstrated that scanning training is more effective than control or placebo at improving reading ability (three studies, 129 participants; mean difference (MD) 3.24, 95% confidence interval (CI) 0.84 to 5.59) and visual scanning (three studies, 129 participants; MD 18.84, 95% CI 12.01 to 25.66) but that scanning may not improve visual field outcomes (two studies, 110 participants; MD -0.70, 95% CI -2.28 to 0.88). There were insufficient data to enable generalised conclusions to be made about the effectiveness of scanning training relative to control or placebo for the primary outcome of activities of daily living (one study, 33 participants). Only one study (19 participants) compared the effect of a restitutive intervention with a control or placebo intervention and only one study (39 participants) compared the effect of a substitutive intervention with a control or placebo intervention. There is limited evidence which supports the use of compensatory scanning training for patients with visual field defects (and possibly co-existing visual neglect) to improve scanning and reading outcomes. There is insufficient evidence to reach a conclusion about the impact of compensatory scanning training on functional activities of daily living. There is insufficient evidence to reach generalised conclusions about the benefits of visual restitution training (VRT) (restitutive intervention) or prisms (substitutive intervention) for patients with visual field defects after stroke.

Interventions for Visual Field Defects in Patients With Stroke

An estimated 20% to 57% of people have visual field defects after stroke, affecting function, quality of life, ability to participate in rehabilitation, depression, anxiety, and social isolation. There are many interventions for visual field defects, which are proposed to work by either restoring the visual field (restitution); compensating for the visual field defect by changing behavior or activity (compensation); or substituting for the visual field defect by using a device or extraneous modification (substitution). The objective of this review was to determine the effects of interventions for people with visual field defects after stroke. We searched the Cochrane Stroke Group Trials Register (February 2011), the Cochrane Eyes and Vision Group Trials Register (December 2009), and 9 electronic bibliographic databases including: CENTRAL (2009 Issue 4), MEDLINE (1950 to December 2009), EMBASE (1980 to December 2009), CINAHL (1982 to December 2009), AMED (1985 to December 2009), and PsycINFO (1967 to December 2009). We also …

The Volume of Tumor Mass and Visual Field Defect in Patients with Pituitary Macroadenoma

PurposeWe used the Swedish interactive threshold algorithms (SITA) standard strategy of Humphrey perimetry, to analyze the pattern of visual field (VF) defects and evaluate the quantitative correlation between the tumor volume and severity of VF defects in patients with pituitary macroadenoma.MethodsWe reviewed 50 patients with pituitary macroadenoma who received VF test and 11 patients were excluded. VF analysis was performed with Humphrey perimeter using the SITA standard strategy. The tumor volume was assessed radiologically via brain magnetic resonance images and was calculated using Cavalieri's principle. We used the mean deviation (MD) and pattern standard deviation (PSD) of the Humphrey parameter to measure VF defect severity, and then analyzed the correlation of tumor volume with VF defects.ResultsTwenty nine patients (74%) showed abnormal VF and bitemporal field changes, which were the most common field defects on presentation. Seven patients (18%) had unilateral VF defects, 22 patients (56%) had bilateral VF defects. The tumor volume of the patients with VF defects was significantly larger than that of patients with normal VF (p = 0.006). The tumor volume exhibited significant negative correlation with MD (r = -0.693; p < 0.001) and significant positive correlation with PSD (r = 0.589; p < 0.001).ConclusionsIn patients with pituitary macroadenoma, there was a variety of VF defects and a high correlation between the tumor volume and the severity of VF defects. SITA standard strategy can be a fast and quantitative method for evaluating central VF defects.

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Vigabatrin can cause retinopathy, resulting in bilateral visual field constriction. Previous analyses of results from a prospective, observational study assessing vigabatrin-induced visual field constriction (described below) employed a partially subjective interpretation of static perimetery. To affirm these previous findings through more objective, quantitative methodology, we now report data from a subset analysis of refractory partial epilepsy patients in the study who underwent Goldmann kinetic perimetry. Patients aged ≥ 8 years with refractory partial seizures were enrolled and grouped: those receiving vigabatrin for ≥ 6 months (Group I); those who had received vigabatrin for ≥ 6 months and then had discontinued for ≥ 6 months (Group II); and those naïve to vigabatrin (Group III). Patients underwent static or kinetic perimetry, or both, every 4-6 months for ≤ 3 years. For kinetic perimetry, the temporal and nasal visual fields were measured along the horizontal meridian with the largest (V4e, IV4e) and smallest (I2e, I1e) isopters, respectively. Of 735 patients enrolled, 341 had Goldmann perimetry data. Of these, 258 received vigabatrin. Sixteen percent of vigabatrin-exposed patients had moderate visual field defects (30-60° retained temporal vision), and 3% had severe defects (< 30° retained temporal vision). Visual function questionnaire results indicated a weak correlation between visual field constriction severity and visual symptoms. These results affirm both an analysis of the same study based primarily on static perimetry and findings from cross-sectional studies. The present analysis verifies that visual field constriction, when it occurs, is most often mild or moderate and is not associated with symptoms of abnormal visual function. The clinical decision to prescribe vigabatrin should be based on a benefit-risk analysis for each individual patient.

Homonymous Hemianopia Detected by Short Wavelength Automated Perimetry in a Patient With Normal Standard Perimetry and MRI

To report a case of homonymous hemianopia detected by short wavelength automated perimetry (SWAP) in a patient with normal standard automated perimetry (SAP) and magnetic resonance imaging (MRI) of the brain and orbits. A 61-year-old woman with a history of motor vehicle accident with head injury nearly 50 years before presentation was referred for further evaluation as a glaucoma suspect. Complete ophthalmic examination, corneal pachymetry, SAP, SWAP, retinal nerve fiber layer analysis by ocular coherence tomography, and brain and orbital MRI were done. The patient had intraocular pressure (IOP) of 18-mm Hg and vertical cup-to-disc ratios of 0.8 in each eye. Superior neuroretinal rim pallor was detected in both optic discs on dilated optic nerve examination, and corresponding retinal nerve fiber layer thinning was detected with ocular coherence tomography. SAP indicated minimal nonspecific changes in the right eye, whereas the left eye had a normal visual field. SWAP revealed a left homonymous hemianopia. Neurologic examinations and MRI of the brain and orbits were found to be normal. SWAP can detect subtle hemianopic field defects in patients with normal standard perimetry.

Sessile serrated adenomas strongly predispose to synchronous serrated polyps in non‐syndromic patients

To determine the prevalence of various colonic polyps removed during a recent 8-month period; to determine the interobserver agreement in the diagnosis of serrated polyps; and to determine if harbouring a sessile serrated adenoma (SSA) predisposes to the presence of synchronous polyps with similar histology. All polyps resected during an 8-month period at a single tertiary medical centre were analysed. We also analysed all polyps in patients with an SSA or SSA with dysplasia since 2003. SSAs accounted for 4.3% of colonic polyps removed during an 8-month period. A review of 276 serrated polyps by two pathologists revealed good interobserver agreement (kappa = 0.66). Patients with one SSA were more likely to harbour additional serrated polyps. After removal of the index SSA, 18% of their remaining polyps were SSAs, SSAs with dysplasia, and traditional serrated adenomas, contrasting with the approximately 5% prevalence of these polyps in the control population. The hyperplastic polyps in the study population were also twice as likely to occur proximal to the splenic flexure. These data indicate that there is a strong colonic mucosal field defect in patients with sporadic SSAs that predispose them to develop additional serrated polyps.

Initial temporal field defect in Leber hereditary optic neuropathy

To determine the site of the initial field defect in patients with Leber hereditary optic neuropathy (LHON). We studied nine eyes of nine consecutive LHON patients with the 11778 mitochondrial DNA mutation who had no visual loss (four eyes) or only minimal visual loss (five eyes). When unilateral visual loss was observed, Humphrey field analysis (HFA) (HFA 30-2 program and sometimes the HFA 10-2 program) was immediately and repeatedly performed on the better eye. For the 12 centralmost points in the visual field, a loss of sensitivity (P<0.02) was initially found in the upper temporal field of nine eyes and in the lower temporal field of three eyes. These results indicate that it was possible to detect the initial site of sensitivity loss in the centralmost temporal test points in all nine cases. The HFA 10-2 program confirmed the sensitivity loss in the temporal field in two cases. The centralmost temporal visual field appears to be the most susceptible site in eyes of LHON patients. This suggests that the most susceptible cells during the early stages of LHON are the retinal ganglion cells located in the corresponding region of the retina.

Expanding Treatment Options for Cocaine Dependence

Expanding Treatment Options for Cocaine Dependence

Acquired color vision and visual field defects in patients with ocular hypertension and early glaucoma

To study acquired color vision and visual field defects in patients with ocular hypertension (OH) and early glaucoma. In a prospective study we evaluated 99 eyes of 56 patients with OH without visual field defects and no hereditary color deficiencies, followed up for 4 to 6 years (mean = 4.7 +/- 0.6 years). Color vision defects were studied using a special computer program for Farnsworth-Munsell 100 hue test and visual field tests were performed with Humphrey analyzer using program 30-2. Both tests were repeated every six months. In fifty-six eyes, glaucomatous defects were observed during the follow-up period. There was a statistically significant difference in total error score (TES) between eyes that eventually developed glaucoma (157.89 +/- 31.79) and OH eyes (75.51 +/- 31.57) at the first examination (t value 12.816, p < 0.001). At the same time visual field indices were within normal limits in both groups. In the glaucomatous eyes the earliest statistical significant change in TES was identified at the first year of follow-up and was -20.62 +/- 2.75 (t value 9.08, p < 0.001) while in OH eyes was -2.11 +/- 4.36 (t value 1.1, p = 0.276). Pearson's coefficient was high in all examinations and showed a direct correlation between TES and mean deviation and corrected pattern standard deviation in both groups. Quantitative analysis of color vision defects provides the possibility of follow-up and can prove a useful means for detecting early glaucomatous changes in patients with normal visual fields.

A New Visual Field Test in Empty Sella Syndrome: Rarebit Perimetry

Several visual field defects can be seen in empty sella syndrome (ESS). In this study, the authors aimed to evaluate the visual field defects in patients with ESS by rarebit perimetry and to compare the results with Humphrey perimetry. Left eyes of 13 patients with ESS and left eyes of 15 age-matched normal subjects were included in the study. Visual field testing was performed by Humphrey Visual Field Analyzer II (Fastpack 30-2 strategy) and rarebit perimetry (regular test). Statistical analysis was performed by independent-samples t-test, Mann-Whitney U test, receiver operating characteristic (ROC) curves, and Pearson correlation test. Humphrey perimetry mean deviation was -3.67 dB in control group and -6.06 dB in patients with ESS (p=0.12). Mean hit rate calculated by rarebit test was 91.8% in control group and 75.9% in cases with ESS (p=0.005). Area under ROC curve was 0.756 for Humphrey visual field test and 0.827 for rarebit hit rate (p=0.59). There was a significant correlation between rarebit hit rate and Humphrey visual field test mean deviation (r=0.755, p<0.001). Rarebit perimetry correlates significantly with Humphrey perimeter in detecting visual field defects related with ESS and has a higher sensitivity and specificity.

Expression of Nitrotyrosine and Oxidative Consequences in the Trabecular Meshwork of Patients with Primary Open-Angle Glaucoma

To evaluate the possible correlation between the visual field defects in patients with primary open-angle glaucoma (POAG) and the expression and enzymatic activity of nitric oxide synthase (NOS) isoenzymes and nitrotyrosine in trabecular meshwork (TM) samples. TM specimens were collected from 146 patients with POAG by using standard filtration surgery. Visual field defects were evaluated by perimetry. Expression of endothelial (e)NOS and inducible (i)NOS were evaluated by quantitative RT-PCR. Constitutive (Ca2+-dependent) and iNOS (Ca2+-independent) activities were measured by the conversion of L-[14C]-arginine to L-[14C]-citrulline. In four TM specimens from POAG-affected eyes and in three human donor control eyes, 3-nitrotyrosine was localized by immunohistochemistry. The marker of lipid peroxidation malondialdehyde (MDA) was measured by the thiobarbituric acid test in samples of aqueous humor (AH) from 48 patients with either POAG or cataracts. The results showed an upregulation of iNOS and a downregulation of calcium-dependent NOS correlated with visual field defects. Expression and activity of iNOS increased in parallel with visual field defects. However, constitutive activity decreased as the visual field defect increased. Nitrotyrosine was observed only in the cells of the TM specimens from eyes with severe POAG. The increased expression and activity of iNOS in the TM of patients with POAG are proportional to the visual field defect and could lead to the increased of nitrotyrosine levels which may serve as marker of oxidative stress in the progression of cell death of the TM in POAG.

Correlation between ocular pulse amplitude measured by dynamic contour tonometer and visual field defects

To investigate the correlation between ocular pulse amplitude and visual field defects in patients with glaucoma, ocular hypertension, and glaucoma suspicion when measured with the Pascal Dynamic Contour Tonometer, and to verify if the ocular pulse amplitude is an independent predictor for visual field parameters. Seventy-seven eyes (42 patients) with glaucoma, ocular hypertension or glaucoma suspicion were examined. Ocular pulse amplitude was measured with the dynamic contour tonometer by one investigator masked to the visual field data. Visual fields were performed within three months of ocular pulse amplitude measurement by the Octopus or Humphrey Field Analyser, and were analysed with Peridata Software. Mean defect, pattern standard deviation ( radical Loss Variance) and regression analysis of those parameters (Trend Indices) were correlated with the ocular pulse amplitude for each eye. Forty-nine eyes had glaucoma, 14 had ocular hypertension, and 14 were glaucoma suspects. The mean follow-up was 46.5 (range 6-96) months. There was a significant correlation between OPA and MD and OPA and PSD, even after correction for IOP (and diagnostic group and eye): the estimated slope equals 2.68 (S.E. = 0.82, p = 0.003) and -0.86 (S.E. = 0.33, p = 0.014), respectively. There was even a weak correlation between OPA and the evolution of MD (dB/year). The slope estimate for OPA equals 0.070 (S.E. = 0.033), p = 0.037. However, after correction for IOP (and diagnostic group and eye), the strength of the relationship is reduced and the evidence disappears: the slope estimate for OPA now equals 0.039 (S.E. = 0.041), p = 0.34. There is no evidence for an association between OPA and the evolution of Trend-PSD. A small ocular pulse amplitude, as measured with a dynamic contour tonometer, is correlated with moderate to severe glaucomatous visual field loss and might be a risk factor for the development of glaucomatous visual field defects.