To Evaluate the Differences in Visual Field Patterns of Primary Open Angle Glaucoma and Normal Tension Glaucoma
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Aim: Different pathogenesis of primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) has lead to dichotomy of views about the difference between visual field patterns of two. One group of ophthalmologists believe that the visual field defects in NTG are steeper, focal and closer to fixation; while other groups believe that there is no significant difference between the two. Since the data on Indian population is lacking, we have devised this study to evaluate the visual field differences between primary open angle glaucoma (POAG) and normal tension glaucoma (NTG). Materials and Methods: This prospective cross-sectional study included glaucoma patients, which were segregated into- primary open angle and normal tension glaucoma group, each group having 25 eyes. Patients of two groups (after matching based on severity of disease) were compared point-to-point wise for pattern standard deviation (PSD) values. The glaucoma hemifields were also matched for pattern standard deviation (PSD) values. Results: The age, refractive error, mean deviation and central corneal thickness of POAG and NTG group was 63.2±10.9 and 60.5±11.4 years, 1.73±3.05 and 1.56±2.53 diopters, -7.65±5.93 and -6.25±6.12 decibels and 0.571±0.031 and 0.562±0.033 mm respectively. Cup to disc ratio for POAG and NTG group is 0.568±0.151 and 0.516±0.158 respectively. None of the values were significant. Other fundus findings were also not found to be significant. Patients were then recruited into groups based on perimetric findings. Mean deviation of mild defects were -4.7±0.862 and -4.92±0.79, moderate defects were -7.04±1.06 and -7.12±0.98 and severe defects were -12.34 and -12.17±0.165 in POAG and NTG groups respectively. None of the values were significant. Then the pattern standard deviation values were compared between two groups and only one point located superior to blind spot came out to be significant. Rest was non-significant. Further on comparing the glaucoma hemifields, none of the area came out to be significant between POAG and NTG group. Conclusion: No significant difference between visual field defects of POAG and NTG were found, suggesting that NTG is continuum of the spectra of POAG, rather than totally different entity. Clinical significance: To know whether normal tension glaucoma is different from primary open angle glaucoma?
Authors and Affiliations
Dr. Harsimran Singh, Dr. Amanjot Kaur, Dr. Sachin Walia, Dr. David Aggarwal
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