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Glaucoma
Comparison of baseline clinical characteristics and patterns of visual field defects between high-tension and normal-tension glaucoma
  1. Zidong Chen1,2,
  2. Wenxin Yang1,2,
  3. Yangfan Yang1,2,
  4. Yuzhen Jiang3,
  5. Yuning Zhang1,2,
  6. Xinyi Zhang1,2,
  7. Chongxuan Luo1,2,
  8. Mingqin Wang1,2,
  9. Yanmei Fan1,2,
  10. Pingping Liu1,2,
  11. Neil Nathwani3,
  12. Gus Gazzard3,
  13. Minbin Yu1,2
  14. LiGHT China Trial Study Group
    1. 1Department of Glaucoma, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, Guangdong, China
    2. 2State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, Guangdong, China
    3. 3National Institute for Health and Care Research Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust and University College London Institute of Ophthalmology, London, UK
    1. Correspondence to Professor Minbin Yu; yuminbin{at}mail.sysu.edu.cn; Gus Gazzard; gus.gazzard{at}moorfields.nhs.uk

    Abstract

    Aims To compare the baseline clinical characteristics and patterns of visual field defects between high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) in the Laser in Glaucoma and Ocular Hypertension (LiGHT) China subjects.

    Methods All patients (n=622) were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. 1105 open-angle glaucoma eyes of 622 patients were classified as NTG (n=559) and HTG eyes (n=546) according to the baseline intraocular pressure (IOP) of 21 mm Hg. The mean deviation (MD), regional MD of the Glaucoma Hemifield Test regions and regional difference values were calculated. Daytime phasing IOP was recorded at 8:00, 10:00, 11:30, 14:30 and 17:00 hour. Multiple regression analyses were conducted for each regional difference.

    Results Patients with NTG were older, more likely to be female, hypertensive and suffer ischaemic heart disease than patients with HTG (p<0.05 for all comparisons). HTG showed higher mean daytime phasing IOP and higher daytime fluctuations than NTG (p<0.001 for all comparisons). HTG and NTG showed similar MD overall (p=0.665). NTG showed significantly greater hemifield asymmetry than HTG. The two arcuate regional differences in NTG were significantly associated with daytime IOP fluctuations (p<0.01 in both regions).

    Conclusions In the LiGHT China trial, NTG and HTG showed similar visual field defects severity at enrolment. However, NTG showed more severe hemifield asymmetry compared with HTG, and higher short-time IOP fluctuations might exacerbate this asymmetry in NTG.

    • Glaucoma
    • Field of vision
    • Clinical Trial
    • Treatment Lasers
    • Treatment Medical

    Data availability statement

    Data are available upon reasonable request.

    https://doi.org/10.1136/bjo-2023-324852

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      Data availability statement

      Data are available upon reasonable request.

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      Footnotes

      • ZC and WY contributed equally.

      • Collaborators The LiGHT China Trial Study Group: Minbin Yu, Mingkai Lin, Xing Liu, Xiulan Zhang, Jian Ge, Jingjing Huang, Yunlan Ling, Yimin Zhong, Yuzhen Jiang, Yangfan Yang, Chengguo Zuo, Jiangang Xu, Hui Xiao, Yixiang Huang, Yuantao Hao, Yanmei Fan, Pingping Liu, Mingjie Deng, Yiming Ye, Zidong Chen, Zongyi Zhan, Shitong Huang, Yunzhen Wang, Yunzhi Xu.

      • Contributors ZC and WY performed the data collection, analysis of the data and contributed equally in writing the manuscript. YY and YJ contributed to study design and quality control. YZ, XZ and NN contributed to the revision. CL and MW contributed to data collection. YF, PL and NN contributed to data quality control. GG and MY were the leader of the study group, designed and in charge of the study, and were also responsible for quality control of the trial. MY was responsible for the overall content as guarantor.

      • Funding This work was supported by the Moorfields Eye Charity (grant number 166186); the British Council For Prevention Of Blindness (grant number 165223); and the National Natural Science Foundation of China (grant number 81870655).

      • Competing interests None declared.

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

      • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.