Central Visual Field Testing in Early Glaucoma: A Report by the American Academy of Ophthalmology

Darrell WuDunn; Hana L Takusagawa; Jullia A Rosdahl; Arthur J Sit; Vikas Chopra; Yvonne Ou; Grace M Richter; O'Rese J Knight; David Solá-Del Valle; Stephen J Kim

doi:10.1016/j.ophtha.2023.10.008

Central Visual Field Testing in Early Glaucoma: A Report by the American Academy of Ophthalmology

Ophthalmology. 2024 Feb;131(2):240-248. doi: 10.1016/j.ophtha.2023.10.008. Epub 2023 Dec 8.

Authors

Affiliations

¹ University of Florida College of Medicine-Jacksonville, Department of Ophthalmology, Jacksonville, Florida.
² VA Eugene Healthcare Center, Eugene, Oregon and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon.
³ Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
⁴ Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota.
⁵ Doheny Eye Centers UCLA and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
⁶ Department of Ophthalmology, University of California San Francisco, San Francisco, California.
⁷ Department of Ophthalmology, Southern California Permanente Medical Group, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California; USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California.
⁸ Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
⁹ Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee.

PMID: 38069944
DOI: 10.1016/j.ophtha.2023.10.008

Abstract

Purpose: To evaluate the current published literature on the utility of the 10-2 visual field (VF) testing strategy for the evaluation and management of early glaucoma, defined here as mean deviation (MD) better than -6 decibels (dB).

Methods: A search of the peer-reviewed literature was last conducted in June 2023 in the PubMed database. Abstracts of 986 articles were examined to exclude reviews and non-English-language articles. After inclusion and exclusion criteria were applied, 26 articles were selected, and the panel methodologist rated them for strength of evidence. Thirteen articles were rated level I, and 8 articles were rated level II. The 5 level III articles were excluded. Data from the 21 included articles were abstracted and reviewed.

Results: The central 12 locations on the 24-2 VF test grid lie within the central 10 degrees covered by the 10-2 VF test. In early glaucoma, defects detected within the central 10 degrees generally agree between the 2 tests. Defects within the central 10 degrees of the 24-2 VF test can predict defects on the 10-2 VF test, although the 24-2 may miss defects detected on the 10-2 VF test. In addition, results from the 10-2 VF test show better association with findings from OCT scans of the macular ganglion cell complex. Modifications of the 24-2 test that include extra test locations within the central 10 degrees improve detection of central defects found on 10-2 VF testing.

Conclusions: Evidence to date does not support routine testing using 10-2 VF for patients with early glaucoma. However, early 10-2 VF testing may provide sufficient additional information for some patients, particularly those with a repeatable defect within the central 12 locations of the standard 24-2 VF test or who have inner retinal layer thinning on OCT scans of the macula.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: central visual field; early glaucoma; glaucoma suspect; macular scotoma; parafoveal scotoma.

MeSH terms

Glaucoma* / complications
Glaucoma* / diagnosis
Humans
Intraocular Pressure
Ophthalmology*
Retinal Ganglion Cells
Scotoma / diagnosis
Tomography, Optical Coherence / methods
United States
Visual Field Tests
Visual Fields