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Do pattern deviation values accurately estimate glaucomatous visual field damage in eyes with glaucoma and cataract?
  1. Aya Matsuda1,
  2. Takeshi Hara2,
  3. Kazunori Miyata3,
  4. Hiroshi Matsuo4,
  5. Hiroshi Murata1,
  6. Chihiro Mayama1,
  7. Ryo Asaoka1
  1. 1Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
  2. 2Hara Eye Hospital, Tochigi, Japan
  3. 3Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan
  4. 4Matsuo Eye Clinic, Tokyo, Japan
  1. Correspondence to Dr Ryo Asaoka, Department of Ophthalmology, the University of Tokyo, Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; rasaoka-tky{at}umin.ac.jp

Abstract

Background/aims To study the efficacy of pattern deviation (PD) values in the estimation of visual field compensating the influence of cataract in eyes with glaucoma.

Methods The study subjects comprised of 48 eyes of 37 glaucoma patients. Mean total deviation value (mTDs) on Humphrey Field Analyzer after cataract surgery was compared with mean PD (mPD) before the surgery. Visual field measurements were carried out ≤6 months before (VFpre) and following (VFpost) successful cataract surgery. The difference between the mPD or mTD values in the VFpre and mTD values in the VFpost (denoted as εmPD/ΔmTD) was calculated, and the influence of the extent of ‘true’ glaucomatous visual field damage or cataract (as represented by εmPD and ΔmTD, respectively) on this difference was also investigated.

Results There was a significant difference between mTD in the VFpre and mTD in the VFpost (p<0.001, repeated measures analysis of variance). There was not a significant difference between mPD in the VFpre and mTD in the VFpost (p=0.06); however, εmPD was significantly correlated with the mTD in VFpost and also ΔmTD (R2=0.56 and 0.27, p<0.001, Pearson's correlation). The accurate prediction of the mTD in the VFpost can be achieved using the pattern standard deviation (PSD), mTD and also visual acuity before surgery.

Conclusions Clinicians should be very careful when reviewing the VF of a patient with glaucoma and cataract since PD values may underestimate glaucomatous VF damage in patients with advanced disease and also overestimate glaucomatous VF damage in patients with early to moderate cataract.

  • Glaucoma

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