Comparing 10-2 and 24-2 Visual Fields for Detecting Progressive Central Visual Loss in Glaucoma Eyes with Early Central Abnormalities

Ophthalmol Glaucoma. 2019 Mar-Apr;2(2):95-102. doi: 10.1016/j.ogla.2019.01.003. Epub 2019 Jan 14.

Abstract

Purpose: To compare the ability of 10-2 visual field tests and central 12 locations of the 24-2 tests (C24-2) to detect central visual field progression in glaucoma eyes with early central visual field abnormalities.

Design: Observational cohort study.

Participants: Three-hundred eyes of 180 participants with glaucoma or ocular hypertension.

Methods: Participants with both 10-2 and 24-2 tests performed on ≥3 visits over ≥1-year period were included to estimate the longitudinal variability of 10-2 and C24-2 visual field mean deviation (MD). The variability estimates were then used to reconstruct real-world visual field results by computer simulations, in a scenario where eyes had a baseline 10-2 and C24-2 MD was -2 dB and exhibited various rates of change (-0.25, -0.50, -0.75 and -1.00 dB/year), and the time to detect these changes were evaluated using trend-based analyses.

Main outcome measures: Time required to detect progression.

Results: Overall, the time to detect central visual field progression was reduced by 7-9% using the 10-2 compared to C24-2 MD values, equivalent to a total reduction of 0.1-0.3 dB lost. For example, 90% of eyes with a central 10-2 or C24-2 MD loss of -0.50 dB/year would be detected after 5.0 and 5.5 years of semi-annual testing respectively, or after 3.4 and 3.7 years respectively for eyes with a -1.00 dB/year loss.

Conclusions: Trend-based analyses using 10-2 MD resulted in a mild reduction (7-9%) in the time to detect central visual field progression compared to C24-2 MD in glaucoma eyes with early central visual field abnormalities. Further studies are needed to determine whether other progression analyses can better exploit the increased sampling of 10-2 tests. These findings provide evidence-based guidance on the potential value-add of 10-2 testing in the clinical management of glaucoma patients.

Trial registration: ClinicalTrials.gov NCT00221923.

Keywords: 10-2; Glaucoma; Progression; Visual Field.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glaucoma / complications
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Optic Disk / abnormalities*
  • Prospective Studies
  • Scotoma / diagnosis
  • Scotoma / etiology*
  • Scotoma / physiopathology
  • Time Factors
  • Visual Field Tests
  • Visual Fields / physiology*

Associated data

  • ClinicalTrials.gov/NCT00221923