RT Journal Article
SR Electronic
T1 Visual field defect classification in the Zhongshan Ophthalmic Center–Brien Holden Vision Institute High Myopia Registry Study
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1697
OP 1702
DO 10.1136/bjophthalmol-2015-307942
VO 100
IS 12
A1 Xiaohu Ding
A1 Robert T Chang
A1 Xinxing Guo
A1 Xing Liu
A1 Chris A Johnson
A1 Brien A Holden
A1 Mingguang He
YR 2016
UL http://bjo.bmj.com/content/100/12/1697.abstract
AB Purpose To describe a new combined myopia and glaucoma visual field classification system in order to report the visual field defects in a population of mostly young Chinese high myopes aged 7–70 years.Methods A total of 1434 visual fields (including confirmatory repeats of abnormal defects) from 487 high myopes (sphere ≤−6.0 D) were analysed from the prospective Zhongshan Ophthalmic Center–Brien Holden Vision Institute (ZOC–BHVI) High Myopia Registry Study. The predefined classification definitions covering high myopia and glaucoma categories were: normal, enlarged blind spot, abnormal suspect and abnormal with nine subtypes. Two independent graders reviewed the first 150 of 1434 fields for initial grading calibration and the remaining 1284 fields were used to assess intergrader agreement. For the percentage distribution of visual fields, the repeats and unreliable fields were excluded, leaving 894 fields.Results The intergrader agreement of this combined classification system was a κ value of 0.61 (95% CI 0.59 to 0.63). Among the 894 unique fields, the most common visual field was normal at 33.7% followed by enlarged blind spot at 25.6%. The per cent of ‘arcuate-like’ field defects (combining nasal step, early arcuate and advanced arcuate) was 16.1% with advanced arcuate at 3.4%.Conclusions A proposed combined visual field classification for high myopia and glaucoma demonstrates acceptable intergrader agreement. A total of 16.1% of defects in young high myopes were found to mimic classic glaucomatous defects. These subjects are being followed prospectively to assess which ones will progress to differentiate myopic from glaucomatous field defects.