Dr.TUTUL CHAUKKRAVARTI

Abstract

We assesed accuracy of existing glaucoma staging system based on Mean Deviation (MD), in glaucomatous visual field defects (VFD) on 24-2VF in early glaucoma. We included 86 eyes of 73 POAG patients with VFDs on 24-2VF,MD-7dB. Based on locations, VFDs were grouped into 1) Nasal (ND),2) Central (CD),& 3) Arcuate (AD) defects. All VFDs were graded by Brusini staging (GSS2), and GSS2 grading was compared with MD based grading.The most frequent type of VFD was ND(45%) and the next most common type was AD(35%).The GSS2 classified only 24% of eyes with VFDs as stage1, 63% as stage2, &13% as stage3. Stage 2 was significantly higher (74%)in ND and stage 3(33%) in AD group(P.001). AD showed significant higher PSD(5.6+-2.3,P.001) &lower VFI(88.3+-4.5,P.001)compared to others. AD &ND showed moderate to severe damage even if they were staged as early by the MDbased scoring method. Our findings suggest that MDbased glaucoma staging underrates disease severity in glaucomatous VFDs in early glaucoma.

Full Text