Purpose We investigated whether the blind spot is larger in early “preperimetric” glaucoma with already deeply excavated optic discs than in normal persons. Methods We examined eight eyes of five patients with definite glaucomatous optic disc cupping but normal visual fields. Ten eyes of five normal healthy volunteers, with normal central excavation, served as controls. With SLO-perimetry we measured the differential light sensitivity 0.5-1.0° outside the disc margins, “within” the center (Goldmann V stimulus) and along the horizontal meridian of the optic discs. Optic disc topography was documented with the Heidelberg Retina Tomograph (HRT). Results Differential light sensitivities adjacent to the optic discs did not differ in the two groups (normal 8.3dB, early glaucoma 8.4dB). Goldmann IV stimuli presented on the horizontal meridian of optic discs with glaucomatous cupping were seen up to 0.7° centrally (i.e., towards the center) of the disc margin. In the control group this distance was significantly greater (1.3°). The light differential thresholds with stimulus presentation in the disc center (Goldmann V) were significantly higher in the glaucoma group (0±2.8dB) than in the normal controls (6.6±1.3dB), though disc size was the same in both groups. Conclusions Blind spots of normal discs seem to be smaller than those of deeply excavated discs in eyes with early glaucoma, possibly because there is more light scattering by the normal disc surface towards the adjacent functioning retina.
Re: De Moraes et al.: 24-2 Visual fields miss central defects shown on 10-2 tests in glaucoma suspects, ocular hypertensives, and early glaucoma ( Ophthalmology . 2017;124:1449-1456)
