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Comparative Study
. 2010 Mar;19(3):151-7.
doi: 10.1097/IJG.0b013e318193c45c.

Normal versus high tension glaucoma: a comparison of functional and structural defects

Oraorn Thonginnetra  1 , Vivienne C Greenstein, David Chu, Jeffrey M Liebmann, Robert Ritch, Donald C Hood
Affiliations
Comparative Study

Normal versus high tension glaucoma: a comparison of functional and structural defects

Oraorn Thonginnetra et al. J Glaucoma. 2010 Mar.

Abstract

Purpose: To compare visual field defects obtained with both multifocal visual evoked potential (mfVEP) and Humphrey visual field (HVF) techniques to topographic optic disc measurements in patients with normal tension glaucoma (NTG) and high tension glaucoma (HTG).

Methods: We studied 32 patients with NTG and 32 with HTG. All patients had reliable 24-2 HVFs with a mean deviation of -10 dB or better, a glaucomatous optic disc and an abnormal HVF in at least 1 eye. Multifocal VEPs were obtained from each eye and probability plots created. The mfVEP and HVF probability plots were divided into a central 10-degree radius and an outer arcuate subfield in both superior and inferior hemifields. Cluster analyses and counts of abnormal points were performed in each subfield. Optic disc images were obtained with the Heidelberg Retina Tomograph III. Eleven stereometric parameters were calculated. Moorfields regression analysis and the glaucoma probability score were performed.

Results: There were no significant differences in mean deviation and pattern standard deviation values between NTG and HTG eyes. However, NTG eyes had a higher percentage of abnormal test points and clusters of abnormal points in the central subfields on both mfVEP and HVF than HTG eyes. For Heidelberg Retina Tomograph III, there were no significant differences in the 11 stereometric parameters or in the Moorfields regression analysis and glaucoma probability score analyses of the optic disc images.

Conclusions: The visual field data suggest more localized and central defects for NTG than HTG.

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Figures

Figure 1
Figure 1
HVF and mfVEP probability plots divided into 4 subfields: a central 10-degree (radius) and outer arcuate subfields in both superior and inferior hemifields. (A) HVF probability plot, the 2 most nasal points (rectangle) were excluded from the analysis. (B) mfVEP, the two points that were closest to fixation in each hemifield were excluded from the analysis.
Figure 2
Figure 2
HVF gray scale, pattern standard deviation and mfVEP probability plots. Examples of clusters of abnormal points in the subfields on the HVF and mfVEP probability plots obtained from the left eye (A) and right eye (B) of two patients with NTG. Each mfVEP plot shows a cluster of points in the central superior subfield that correspond to the cluster in the HVF probability plot.
Figure 3
Figure 3
HVF gray scale, pattern standard deviation and mfVEP probability plots. Examples of clusters of abnormal points in subfields on the HVF and mfVEP probability plots obtained from the left eye (A) and right eye (B) of two patients with HTG. Each mfVEP plot shows a cluster of points in the superior arcuate subfield that correspond to the cluster in the HVF probability plot
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