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Accuracy of pattern deviation in estimating the glaucomatous damage in the central 10° visual field in eyes with glaucoma and cataract
  1. Ryo Tomita1,
  2. Ryo Asaoka2,3,4,
  3. Kazunori Hirasawa5,
  4. Yuri Fujino2,6,
  5. Shunsuke Nakakura7,
  6. Hiroshi Murata8,
  7. Tetsuo Omura6,
  8. Nobuyuki Shoji9,
  9. Akira Obana2,10,
  10. Koji M Nishiguchi1,
  11. Masaki Tanito6
  1. 1 Ophthalmology, Nagoya University Graduate School of Medicine Faculty of Medicine, Nagoya, Japan
  2. 2 Department of Ophthalmology, Seirei Hamamatsu Hospital, Hamamatsu, Japan
  3. 3 Seirei Christopher University, Hamamatsu, Japan
  4. 4 The Graduate School for the Creation of New Photonics Industries, Hamamatsu, Japan
  5. 5 Ophthalmology, Kitasato University School of Medicine, Sagamihara, Japan
  6. 6 Ophthalmology, Shimane University Faculty of Medicine Graduate School of Medicine, Izumo, Japan
  7. 7 Ophthalmology, Tsukazaki Hospital, Himeji, Japan
  8. 8 Ophthalmology, National Center for Global Health and Medicine, Shinjuku-ku, Japan
  9. 9 Ophthalmology, Kitasato University, Minato-ku, Japan
  10. 10 Department of Medical Spectroscopy, Hamamatsu University School of Medicine Preemenent Medical Photonics Education and Research Center Institute for Medical Photonics Research, Hamamatsu, Japan
  1. Correspondence to Dr Ryo Asaoka, Department of Ophthalmology, Seirei Hamamatsu Hospital, Hamamatsu 430-8558, Japan; rasaoka-tky{at}


Background/aims The accuracy of pattern deviation (PD) in estimating the damage to the glaucomatous visual field (VF) in the central 10° in eyes with glaucoma and cataract is unclear.

Methods This retrospective study includes 63 eyes of 52 glaucoma patients who successfully underwent cataract surgery or cataract surgery plus iStent implantation. Using the Humphrey Field Analyser 10–2 test, VF was measured within 6 months preoperatively and postoperatively (VFpre and VFpost, respectively). The mean total deviation values in VFpost (mTDpost) indicates glaucomatous damage without cataract and the difference between this value and mean PD values in VFpre (mPDpre) was evaluated (εmPD). The effect of cataract was then evaluated as the difference between mTDpost and mTDpre (ΔmTD), while the effects of mTDpost and ΔmTD on εmPD were also assessed. In addition, based on preoperative visual acuity (VApre) and VFpre, the optimal model for predicting mTDpost was identified. The error of this method (εOptimalModel) was estimated as the difference against mTDpost, which was compared with εmPD.

Results Compared with mTDpre, there was a significant improvement in mTDpost (p=0.028). A significant difference was observed between mPDpre and mTDpost (p<0.001). Further, εmPD significantly increased with the increase of mTDpost or ΔmTD (p<0.001 and p=0.0444, respectively). The absolute εOptimalModel was significantly smaller than the absolute εmPD (p<0.001).

Conclusions This study warns clinicians that PD of the central 10° VF might underestimate the glaucomatous VF damage with the progression of glaucoma and overestimate it as a cataract progresses.

  • Glaucoma
  • Field of vision

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors The authors were involved in the design and conduct of the study (RT and RA); collection, management, analysis, and interpretation of data (RT, RA, KH, YF, SN, HM, TO, NS, AO, KMN and MT); and preparation, review, and approval of the manuscript (RT, RA, KH, YF, SN, HM, TO, NS, AO, KMN and MT). RA is responsible for the overall content as guarantor.

  • Funding This study was supported by grants (numbers 19H01114, 18KK0253, 20K09784 and 21K16870) from the Ministry of Education, Culture, Sports, Science and Technology of Japan; the Translational Research Program, Strategic Promotion for Practical Application of Innovative Medical Technology (TR-SPRINT) from the Japan Agency for Medical Research and Development (AMED) and the Japan Glaucoma Society Research Project Support Programme.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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