The Frontloading Fields Study (FFS): Detecting Changes in Mean Deviation in Glaucoma Using Multiple Visual Field Tests Per Clinical Visit

In this retrospective study, clinical characteristics and glaucoma progression of open-angle glaucoma (OAG) patients who discontinued intraocular pressure (IOP)-lowering medication during pregnancy were investigated. Glaucoma progression was determined using either serial visual field tests or optic disc/retinal nerve fiber layer (RNFL) photographs. Age, number of previous pregnancies, diagnosis, average IOP, IOP fluctuation, visual field mean deviation, pattern standard deviation, and RNFL thickness were examined, and their association with glaucoma progression was determined using linear regression analysis. Among 67 eyes (37 patients), 19 eyes (28.4%) exhibited glaucoma progression 13.95 ± 2.42 months after delivery. The progression group showed significantly higher mean IOP than the nonprogression group in the first, second, and third trimesters (p = 0.02, 0.001, and 0.04, respectively). The average IOP in the second, and third trimesters and IOP fluctuation during the entire pregnancy were significantly associated with glaucoma progression according to a univariate analysis (p = 0.04, 0.031, and 0.026, respectively). In conclusion, IOP elevation during pregnancy is associated with glaucoma progression after delivery in patients who had discontinued medication during pregnancy. Therefore, close monitoring of glaucoma is necessary, particularly if patients discontinue medication during pregnancy, and appropriate intervention should be considered in case of increased IOP.

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Tolerable rates of visual field progression in a population-based sample of patients with glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310635 ◽

2017 ◽

Vol 102 (7) ◽

pp. 916-921 ◽

Cited By ~ 3

Author(s):

Angeliki Salonikiou ◽

Panayiota Founti ◽

Vassilis Kilintzis ◽

Antonis Antoniadis ◽

Eleftherios Anastasopoulos ◽

...

Keyword(s):

Visual Field ◽

Visual Impairment ◽

Open Angle Glaucoma ◽

Visual Fields ◽

Field Tests ◽

Population Based ◽

European Population ◽

Mean Deviation ◽

Cross Sectional ◽

Rate Of Progression

AimsTo provide population-based data on the maximum tolerable rate of progression to avoid visual impairment (maxTRoP_VI) and blindness (maxTRoP_BL) from open-angle glaucoma (OAG).MethodsParticipants with OAG in the Thessaloniki Eye Study (cross-sectional, population-based study in a European population) were included in the analysis. Visual impairment was defined as mean deviation (MD) equal to or worse than −12dB and blindness as MD equal to or worse than −24dB. Additional thresholds for visual impairment were tested. For each participant maxTRoP_VI was defined as the rate of progression which would not lead to visual impairment during expected lifetime. MaxTRoP_BL was defined accordingly. Both parameters were calculated for each OAG subject using age, sex, MD and life expectancy data. The eye with the better MD per subject was included in the analysis.ResultsAmong 135 subjects with OAG, 123 had reliable visual fields and were included in the analysis. The mean age was 73±6 years and the median MD was −3.65±5.28dB. Among those, 69.1% would have a maxTRoP_VI slower than −1dB/year and 18.7% would have a maxTRoP_VI between −1 and −2dB/year. Also, 72.4% would have a maxTRoP_BL slower than −2dB/year. For all tested thresholds for visual impairment, approximately 86% of the OAG study participants would not be able to tolerate a rate of progression equal to or faster than −2dB/year.ConclusionsThe majority of patients with glaucoma in our study would have a maximum tolerable rate of progression slower than −1dB/year in their better eye. Patient-tailored strategies to monitor the visual field are important, but raise the issue of feasibility with regard to the number of visual field tests needed.

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Correlation between fundus autofluorescence and visual function in patients with cone-rod dystrophy

Scientific Reports ◽

10.1038/s41598-021-81597-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Satoru Kanda ◽

Takumi Hara ◽

Ryosuke Fujino ◽

Keiko Azuma ◽

Hirotsugu Soga ◽

...

Keyword(s):

Visual Field ◽

Significant Relationship ◽

Fundus Autofluorescence ◽

Univariate Analysis ◽

Retrospective Chart Review ◽

Mean Deviation ◽

Wide Field ◽

The Mean ◽

The Relationship ◽

Field Imaging

AbstractThis study aimed to investigate the relationship between autofluorescence (AF) signal measured with ultra-wide field imaging and visual functions in patients with cone-rod dystrophy (CORD). A retrospective chart review was performed for CORD patients. We performed the visual field test and fundus autofluorescence (FAF) measurement and visualized retinal structures with optical coherence tomography (OCT) on the same day. Using binarised FAF images, we identified a low FAF area ratio (LFAR: low FAF/30°). Relationships between age and logMAR visual acuity (VA), central retinal thickness (CRT), central choroidal thickness (CCT), mean deviation (MD) value, and LFAR were investigated. Thirty-seven eyes of 21 CORD patients (8 men and 13 women) were enrolled. The mean patient age was 49.8 years. LogMAR VA and MD were 0.52 ± 0.47 and − 17.91 ± 10.59 dB, respectively. There was a significant relationship between logMAR VA and MD (p = 0.001). LogMAR VA significantly correlated with CRT (p = 0.006) but not with other parameters. Conversely, univariate analysis suggested a significant relationship between MD and LFAR (p = 0.001). In the multivariate analysis, LFAR was significantly associated with MD (p = 0.002). In conclusion, it is useful to measure the low FAF area in patients with CORD. The AF measurement reflects the visual field deterioration but not VA in CORD.

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Granulomatosis with Polyangiitis Presenting with Bilateral Orbital Apex Syndrome

Case Reports in Ophthalmology ◽

10.1159/000510329 ◽

2021 ◽

pp. 32-40

Author(s):

Yusuke Murai ◽

Takuji Kurimoto ◽

Sotaro Mori ◽

Kaori Ueda ◽

Mari Sakamoto ◽

...

Keyword(s):

Visual Field ◽

Eye Movement ◽

Endoscopic Sinus Surgery ◽

Granulomatosis With Polyangiitis ◽

Field Tests ◽

Sinus Surgery ◽

Orbital Apex ◽

Orbital Apex Syndrome ◽

Initial Examination ◽

Steroid Pulse

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with bilateral orbital apex syndrome (OAS). A 73-year-old woman with a history of endoscopic sinus surgery for ethmoidal sinusitis experienced a sudden decrease in visual acuity (VA) of both eyes. At the initial examination, her VA had decreased to 0.01 in the right eye and 0.03 in the left eye, and eye movement in both eyes was mildly limited in all directions. Visual field tests of both eyes showed a large central scotoma. Laboratory tests revealed an elevation of myeloperoxidase-anti-neutrophil cytoplasmic antibody. Facial computed tomography demonstrated a thickened mucosal membrane in the entire ethmoidal sinus, and the posterosuperior walls of Onodi cells filled with infiltrative lesions had thinned. Orbital magnetic resonance imaging showed severe inflammation in the orbital apex. From these clinical findings, the patient was diagnosed with GPA presenting with OAS associated with ethmoid sinusitis. Emergent endoscopic sinus surgery was performed for biopsy and debridement of the ethmoidal and sphenoid sinusitis to decompress the optic nerve. One day after endoscopic sinus surgery, the patient’s VA and visual field were improved, and steroid pulse therapy was commenced postoperatively. Four days later, VA had recovered to 1.0 in both eyes, and eye movement and visual field had were improved. Although OAS is a rare manifestation, early surgical treatment should be considered when the orbital lesion presents as risk of rapid deterioration of visual function in patients with GPA.

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Relationship between mean follow-up intraocular pressure, rates of visual field progression and current target intraocular pressure guidelines

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317406 ◽

2020 ◽

pp. bjophthalmol-2020-317406

Author(s):

Bruna Melchior ◽

Carlos Gustavo De Moraes ◽

Jayter S Paula ◽

George A Cioffi ◽

Christopher A Girkin ◽

...

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Treatment Guidelines ◽

Evaluation Study ◽

Mean Deviation ◽

Racial Groups ◽

Current Guideline ◽

Registration Number ◽

The Mean

AimsTo investigate if eyes presenting intraocular pressure (IOP) within the limits of current guideline-driven target IOP indeed experience slow rates of glaucomatous visual field (VF) progression.MethodsA total of 8598 24-2 VF tests from 603 eyes from the African Descent and Glaucoma Evaluation Study with manifest glaucoma were included. The sample was split into three groups based on baseline VF mean deviation (MD): G1 (better than −5.0 dB), G2 (−5.0 to −10 dB) and G3 (worse than −10 dB). We investigated the relationship between existing target IOP guidelines and rates of MD progression in these groups.ResultsFor stable eyes, the medians and IQR of the mean follow-up IOP were G1=15.0 mmHg (IQR: 13.1 to 17.7), G2=13.2 mmHg (IQR: 11.6 to 14.3) and G3=11.9 mmHg (IQR: 10.1 to 13.8) (p<0.01). When considering the mean follow-up IOP within the limits proposed by current guidelines, the median MD slopes were: −0.20 dB/y (IQR: −0.43 to −0.02) for G1<21 mmHg, −0.19 dB/y (IQR: −0.51 to −0.01) for G2<18 mmHg and −0.15 dB/y (IQR: −0.47 to 0.05) for G3<15 mmHg (p=0.63). There were no significant differences between racial groups.ConclusionIn a sample of patients with manifest glaucoma, despite substantial variability between eyes, adherence to treatment guidelines helped slow the rates of global VF progression at various stages of disease.Trial registration numberclinicaltrials.gov Identifier: NCT00221923.

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Association between visual field damage and corneal structural parameters

Scientific Reports ◽

10.1038/s41598-021-90298-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alexandru Lavric ◽

Valentin Popa ◽

Hidenori Takahashi ◽

Rossen M. Hazarbassanov ◽

Siamak Yousefi

Keyword(s):

Machine Learning ◽

Visual Field ◽

Structural Parameters ◽

Corneal Thickness ◽

Anterior Segment ◽

Mean Deviation ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Visual Field Damage ◽

Corneal Shape

AbstractThe main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual field damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual field tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual field damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifiers, we detected visual field abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifier, we detected four visual field severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual field loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss.

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Concentric division of 10° visual field tests in retinitis pigmentosa

Japanese Journal of Ophthalmology ◽

10.1007/s10384-013-0235-y ◽

2013 ◽

Vol 57 (3) ◽

pp. 268-274 ◽

Cited By ~ 2

Author(s):

Ken Ogino ◽

Atsushi Otani ◽

Akio Oishi ◽

Masafumi Kurimoto ◽

Takuro Sekiya ◽

...

Keyword(s):

Visual Field ◽

Retinitis Pigmentosa ◽

Field Tests

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Optic Disc Vascularization in Glaucoma: Value of Spectral-Domain Optical Coherence Tomography Angiography

Journal of Ophthalmology ◽

10.1155/2016/6956717 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 48

Author(s):

Pierre-Maxime Lévêque ◽

Pierre Zéboulon ◽

Emmanuelle Brasnu ◽

Christophe Baudouin ◽

Antoine Labbé

Keyword(s):

Visual Field ◽

Univariate Analysis ◽

Normal Subjects ◽

Vessel Density ◽

Spectral Domain ◽

Control Group ◽

Mean Deviation ◽

Ganglion Cell Complex ◽

Fiber Layer ◽

Spectral Domain Oct

Purpose. To detect changes in optic nerve head (ONH) vascularization in glaucoma patients using spectral-domain OCT angiography (OCT-A).Material and Method. Fifty glaucoma patients and 30 normal subjects were evaluated with OCT-A (AngioVue®, Optovue). The total ONH vessel density and temporal disc vessel density were measured. Clinical data, visual field (VF) parameters, and spectral-domain OCT evaluation (RNFL: retinal nerve fiber layer thickness, GCC: ganglion cell complex thickness, and rim area) were recorded for glaucoma patients. Correlations among total and temporal ONH vessel density and structural and VF parameters were analyzed.Results. In the glaucoma group, total and temporal ONH vessel density were reduced by 24.7% (0.412 versus 0.547;p<0.0001) and 22.88% (0.364 versus 0.472;p=0.001), respectively, as compared with the control group. Univariate analysis showed significant correlation between rim area (mm2) and temporal ONH vessel density (r=0.623;p<0.0001) and total ONH vessel density (r=0.609;p<0.0001). Significant correlations were found between temporal and total ONH vessel density and RNFL, GCC, VF mean deviation, and visual field index.Conclusion. In glaucoma patients OCT-A might detect reduced ONH blood vessel density that is associated with structural and functional glaucomatous damage. OCT-A might become a useful tool for the evaluation of ONH microcirculation changes in glaucoma.

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Visual field defects and myopic macular degeneration in Singapore adults with high myopia

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318674 ◽

2021 ◽

pp. bjophthalmol-2020-318674

Author(s):

Carla Lanca ◽

Chen Hsin Sun ◽

Rachel Chong ◽

Yee Ling Wong ◽

Monisha Esther Nongpiur ◽

...

Keyword(s):

Visual Field ◽

Macular Degeneration ◽

High Myopia ◽

Cross Sectional Study ◽

Visual Field Defects ◽

Mean Deviation ◽

Cross Sectional ◽

Sensitivity Loss ◽

Fundus Photographs ◽

Generalised Estimating Equations

AimsTo characterise the association between visual field (VF) defects and myopic macular degeneration (MMD) in highly myopic adults without glaucoma.MethodsParticipants (n=106; 181 eyes) with high myopia (HM; spherical equivalent ≤−5.0 D or axial length (AL) ≥26 mm), after excluding glaucoma and glaucoma suspects, from the Singapore Epidemiology of Eye Diseases-HM study were included in this cross-sectional study. Humphrey VF (central 24–2 threshold), cup-disc ratio (CDR) and intraocular pressure (IOP) measurements were performed. Mean deviation (MD) and pattern SD (PSD), VF defects (normal or abnormal; p<0.05 in ≥3 non-edge contiguous locations) and pattern (eg, generalised sensitivity loss) were analysed. MMD presence was diagnosed from fundus photographs. Generalised estimating equations were used for analysing factors (MD, PSD, VF defects, CDR and IOP) associated with MMD.ResultsMean age was 55.4±9.9 years and 51.9% were women (AL=26.7±1.1 mm). MMD eyes had lower MD (−3.8±2.9 dB vs −1.1±1.4 dB) and higher PSD (2.8±1.7 dB vs 1.7±0.6 dB). A higher percentage of MMD eyes (n=48) had abnormal VF (62.5% vs 28.6%; p<0.001) compared with no MMD (n=133 eyes). VF pattern in MMD eyes was significantly different from eyes without MMD (p=0.001) with greater generalised sensitivity loss (53.3% vs 10.5%) and arcuate defects (16.7% vs 10.5%). In multivariate analyses, MD (OR=1.52) and PSD (OR=1.67) were significantly (p=0.003) associated with MMD, but VF defects were not associated with MMD.ConclusionHighly myopic adults with MMD may have VF loss when compared with highly myopic patients without MMD even in adults without glaucoma.

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Comparing the usefulness of a new algorithm to measure visual field using the variational Bayes linear regression in glaucoma patients, in comparison to the Swedish interactive thresholding algorithm

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318304 ◽

2021 ◽

pp. bjophthalmol-2020-318304

Author(s):

Hiroshi Murata ◽

Ryo Asaoka ◽

Yuri Fujino ◽

Masato Matsuura ◽

Kazunori Hirasawa ◽

...

Keyword(s):

Visual Field ◽

Linear Regression ◽

Open Angle Glaucoma ◽

Variational Bayes ◽

Mean Deviation ◽

Test Duration ◽

Field Analyser ◽

Measurement Duration ◽

Measurement Algorithm ◽

Thresholding Algorithm

Background/aimsWe previously reported that the visual field (VF) prediction model using the variational Bayes linear regression (VBLR) is useful for accurately predicting VF progression in glaucoma (Invest Ophthalmol Vis Sci. 2014, 2018). We constructed a VF measurement algorithm using VBLR, and the purpose of this study was to investigate its usefulness.Method122 eyes of 73 patients with open-angle glaucoma were included in the current study. VF measurement was performed using the currently proposed VBLR programme with AP-7700 perimetry (KOWA). VF measurements were also conducted using the Swedish interactive thresholding algorithm (SITA) standard programme with Humphrey field analyser. VF measurements were performed using the 24–2 test grid. Visual sensitivities, test–retest reproducibility and measurement duration were compared between the two algorithms.ResultMean mean deviation (MD) values with SITA standard were −7.9 and −8.7 dB (first and second measurements), whereas those with VBLR-VF were −8.2 and −8.0 dB, respectively. There were no significant differences across these values. The correlation coefficient of MD values between the 2 algorithms was 0.97 or 0.98. Test–retest reproducibility did not differ between the two algorithms. Mean measurement duration with SITA standard was 6 min and 02 s or 6 min and 00 s (first or second measurement), whereas a significantly shorter duration was associated with VBLR-VF (5 min and 23 s or 5 min and 30 s).ConclusionVBLR-VF reduced test duration while maintaining the same accuracy as the SITA-standard.

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