Long-term survival of central visual field in end-stage glaucoma

Purpose: To evaluate the long-term survival of visual field and visual acuity in treated glaucoma patients with end-stage glaucomatous visual field loss defined by a field constricted to a 10-degree radius or less. Design: Retrospective chart review. Participants: Sixty-four patients with end-stage glaucoma. Methods: Serial 10-2 Humphrey visual fields with size III stimulus were analyzed. The following data were recorded for each visual field: mean deviation (MD), pattern standard deviation, the largest horizontal and vertical diameters measured in degrees including only locations with thresholds of 10 decibels or more, and the number of points on the pattern deviation plot with a probability value of more than 5%. Main Outcome Measure: Change in visual acuity and visual field. Results: Eighty-four eyes of 64 patients satisfied inclusion criteria with an average follow-up of 8.34 +/- 3.1 years. Seventy-eight percent of patients were black. During the study period, 14 eyes lost more than 3 lines of visual acuity. Of these 14, 8 eyes progressed to a visual acuity of 20/200 or worse. Seven eyes lost 3 decibels or more from the MD that could be reproduced over 2 visual fields. Conclusions: In this predominantly black population, most treated patients with end-stage glaucoma did not demonstrate a decline in visual acuity or progressive loss of the central visual field during long-term follow-up.