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Identifying central 10° visual subfield associated with future worsening of visual acuity in eyes with advanced glaucoma
  1. Ryo Asaoka1,2,3,4,
  2. Kenji Sugisaki5,6,
  3. Toshihiro Inoue7,
  4. Keiji Yoshikawa8,
  5. Akiyasu Kanamori9,
  6. Yoshio Yamazaki10,
  7. Shinichiro Ishikawa11,
  8. Kenichi Uchida12,
  9. Aiko Iwase13,
  10. Makoto Araie6,14
  11. For Advanced Glaucoma Study Members in Japan Glaucoma Society
    1. 1 Department of Ophthalmology, Seirei Hamamatsu Byoin, Hamamatsu, Shizuoka, Japan
    2. 2 Seirei Christopher University, Hamamatsu, Japan
    3. 3 Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan
    4. 4 The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
    5. 5 Department of Ophthalmology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
    6. 6 Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
    7. 7 Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
    8. 8 Yoshikawa Eye Clinic, Machida, Japan
    9. 9 Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
    10. 10 Yamazaki Eye Clinic, Tokyo, Japan
    11. 11 Department of Ophthalmology, Saga University Faculty of Medicine, Saga, Japan
    12. 12 Tokyo Kyosai Hospital, Tokyo, Japan
    13. 13 Tajimi Iwase Eye Clinic, Tajimi, Japan
    14. 14 Sekikawa Hospital, Tokyo, Japan
    1. Correspondence to Dr Ryo Asaoka, Department of Ophthalmology, Seirei Hamamatsu Byoin, Hamamatsu JP 430-8558, Shizuoka, Japan; rasaoka-tky{at}umin.ac.jp

    Abstract

    Background/aims To determine a cluster of test points: visual subfield (VSF) of Humphrey Field Analyzer 10–2 test (HFA 10–2) of which baseline sensitivities were associated with future worsening of visual acuity (VA) in eyes with advanced glaucoma.

    Methods A total of 175 advanced glaucoma eyes of 175 advanced glaucoma patients with well controlled intraocular pressure (IOP), a mean deviation of the Humphrey Field Analyzer 24–2 (HFA 24–2) test ≤ −20 decibels and best corrected VA ≥20/40, were included. At baseline, HFA 24–2 and HFA 10–2 tests were performed along with VA measurements. All patients underwent prospective follow-up of 5 years, and VA was measured every 6 months. The Cox proportional hazards model was used to identify visual field sensitivities associated with deterioration of VA and also blindness.

    Results Deterioration of VA and blindness were observed in 15.4% and 3.4% of the eyes, respectively. More negative total deviation (TD) values in the temporal papillomacular bundle VSF were significantly associated with deterioration in VA. Averages of the TD values in this area of the HFA 10–2 test had the most predictive power of future VA deterioration (OR: 0.92, p<0.001). A very similar tendency was observed for blindness.

    Conclusion In advanced glaucoma eyes with well-controlled IOP, careful attention is needed when the mean TD values in the temporal papillomacular bundle VSF, measured with a HFA 10–2 test is deteriorated. TD values of this VSF indicate higher risks for future deterioration of VA and also blindness.

    • Glaucoma

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    Footnotes

    • Collaborators Department of Ophthalmology, University of Tokyo Graduate School of Medicine (Tokyo, Japan): MA, MD.PhD. (Current affiliation; Department of Ophthalmology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan), Atsuo Tomidokoro, MD.PhD. (Current affiliation; Higashinakano Tomidokoro Eye Clinic, Tokyo, Japan), KS, MD. (Current affiliation; Department of Ophthalmology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan), RA, MD.PhD. (Current affiliation; Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka Japan), Hiroshi Murata, MD. Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University (Kumamoto, Japan): Hidenobu Tanihara, MD.PhD., Masaru Inatani, MD.PhD. (Current affiliation; Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan), TI, MD.PhD., Yoshikawa Eye Clinic (Tokyo, Japan): KY, MD Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine (Kobe, Japan): Akira Negi, MD.PhD., Hidetaka Maeda, MD.PhD., (Current affiliation; Maeda Eye Clinic, Osaka, Japan), AK MD.PhD., Yuko Nakanish, MD.PhD.Department of Ophthalmology, Nihon University School of Medicine (Tokyo, Japan): YY MD.PhD., (Current affiliation; Yamazaki Eye Clinic, Tokyo, Japan.), Kenji Mizuki, MD.PhD. (Current affiliation; Hakata Mizuki Eye Clinic, Fukuoka, Japan)Department of Ophthalmology, Saga University Faculty of Medicine (Saga, Japan): Satoshi Okinami, MD.PhD., Ryo Iwakiri, MD.PhD, (Current affiliation; Department of Ophthalmology, National Hospital Organization Ureshino Medical Center, Saga, Japan), SI, MD,PhD.Department of Ophthalmology, Tokyo Post and Telecommunication Hospital (Tokyo, Japan): Shun Matsumoto, MD.PhD., KU, MD., (Current affiliation; Tokyo Kyosai Hospital, Tokyo, Japan), Koichi Mishima, MD,PhD, (Current affiliation: Department of Ophthalmology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan), Hodaka Nemoto, MD., (Current affiliation: Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan)Tajimi Iwase Eye Clinic (Gifu, Japan): AI, MD.PhD.

    • Contributors The authors were involved in the design and conduct of the study (RA, KS, IT, YK, KA, YY, IS, UK, IA, and MA); collection, management, analysis and interpretation of data (RA, MA); and preparation, review and approval of the manuscript (RA, KS, IT, YK, KA, YY, IS, UK, IA, and MA). RA is the guarantor.

    • Funding This study was supported in part by grants (numbers 20K09785, 19H01114, 18KK0253 and 20K09784) from the Ministry of Education, Culture, Sports, Science and Technology of Japan and grant JPMJCR19U4 AIP acceleration research from the Japan Science and Technology Agency.

    • Competing interests None declared.

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

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