Patterns of visual field defects in chronic angle-closure glaucoma with different disease severity

AbstractTo investigate the peripapillary vascular metrics in early normal tension glaucoma (NTG) and early primary angle closure glaucoma (PACG) eyes using optical coherence tomography angiography (OCT-A). One or both eyes of each subject were imaged for a 3 × 3 mm peripapillary region by swept-source OCT-A (DRI-OCT Triton, Topcon, Japan) and assessed by an automated MATLAB program. OCT-A metrics including circumpapillary vessel density (cpVD) and fractal dimension (cpFD) were compared. Their association with visual field (VF) parameters and retinal nerve fiber layer (RNFL) thickness were determined. Sixty-eight eyes of 51 PACG, 68 eyes of 48 NTG, and 68 eyes of 49 control subjects were cross-sectionally analyzed. NTG eyes had significantly lower global cpVD (52.369 ± 0.781%) compared with PACG eyes (55.389 ± 0.721%, P = 0.004) that had comparable disease severity and average RNFL thickness. Multivariable analysis revealed that, for PACG and NTG eyes, decreased cpVD ([PACG] β = −4.242; CI: −8.120, −0.363 vs [NTG] β = −5.531; CI: −9.472, −1.590) and cpFD ([PACG] β = −8.894;CI: −11.925, −5.864 vs [NTG] β = −12.064; CI: −17.095, −6.932) were associated with decreased RNFL thickness (all P ≤ 0.032); with a stronger association between decrease cpFD and decreased RNFL thickness in NTG eyes (P = 0.028). Decreased cpVD was associated with decrease mean deviation (MD) in NTG eyes (β = −0.707; CI: −1.090, −0.324; P ≤ 0.001) and not associated with the visual field parameters in PACG eyes. Early NTG had lower global cpVD compared with early PACG, despite similar disease severity and average RNFL thickness.

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Profile of the glaucomas and intervention in a large eye care centre in South-East Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v2i1.3697 ◽

1970 ◽

Vol 2 (1) ◽

pp. 3-9 ◽

Cited By ~ 2

Author(s):

S Sarkar ◽

C Mardin ◽

A Henning

Keyword(s):

Visual Field ◽

Visually Impaired ◽

Open Angle Glaucoma ◽

Outcome Measurement ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Visual Field Defects ◽

Primary Angle Closure ◽

North East ◽

Primary Angle Closure Glaucoma

Introduction: Glaucoma is the second leading cause of blindness worldwide. Objective:To estimate the prevalence and risk factors of glaucoma and modes of therapeutical intervention in a rural population of a developing country. Patients and methods: A single centre-based cross-sectional study was carried out over a seven-month period in Sagarmatha Choudhary Eye Hospital (SCEH), Lahan/NEPAL, including the patients with glaucoma. Outcome measurement: The patients' demography, type of the glaucomas, visual acuity, vertical cup-disc ratio, intra-ocular pressure and visual field findings were the parameters studied. Results: A total of 3986 eyes with suspected glaucoma were identified. 53.7 % of the patients were between 41- 60 years of age. 53.9 % were male. 26.5 % were blind or severely visually impaired. 37.2 % had IOP more than 35 mmHg. 46.4 % had vertical cup-disc ratio (VCDR) higher than 0.8. Severe visual field defects were found in 28.4 % eyes. 35.3% eyes had primary angle-closure glaucoma, 22.6 % eyes primary open-angle glaucoma, and 14.6 % eyes normaltension glaucoma. 10.2 % eyes suffered from lens induced glaucoma. Only in 9 eyes was pseudoexfoliation syndrome with glaucoma diagnosed. 25.7 % eyes were advised for trabeculectomy. 11.5 % eyes underwent extra-capsular cataract surgery. IOP lowering medication was prescribed in 5.9 % patients. Conclusions: The most common glaucoma seen in the out-patient department of a large eyecare centre in South-East Nepal is primary angle-closure glaucoma. 25 % of the glaucoma patients are visually impaired or blind at the time of presentation. In more than one-fourth of the patients, trabeculectomy is the therapy of choice. Keywords: glaucoma; South-East Nepal; North-East India; Bihar; blindness. DOI: 10.3126/nepjoph.v2i1.3697 Nep J Oph 2010;2(1):3-9

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