Visual Field and Optic Disc Progression in Patients with Different Types of Optic Disc Damage: A Longitudinal Prospective Study

Objective: To evaluate the incidence of visual field and optic disc progression in glaucoma patients with distinct patterns of optic disc damage. Design: Prospective, observational case series. Participants: One hundred five patients with open-angle glaucoma. Methods: Baseline optic disc photographs of 105 study eyes of 105 patients were reviewed by 2 masked observers and classified according to patterns of disc damage into the following categories: focal, myopic, senile sclerotic, and generalized disc damage. Patients were followed up every 6 months with standard automated perimetry (SAP), high-pass resolution perimetry (HRP), and scanning laser tomography (SLT) with the Heidelberg Retina Tomograph. Main Outcome Measures: Visual field (SAP and HRP) and optic disc (SLT) progression were determined according to predefined criteria. Results: Twenty-four eyes were classified into the focal, 8 into the myopic, 12 into the senile sclerotic, and 28 into the generalized group. Eyes from 33 patients could not be classified by the observers into any of these groups and were excluded from further analysis. Although intraocular pressure during follow-up was similar among the four groups, some differences in frequency of progression were observed. Patients with senile sclerotic discs had the lowest rates of visual field progression (both with SAP and HRP) and optic disc progression, although the differences were significant only for optic disc progression (P = 0.05). Conclusions: Patients with senile sclerotic discs showed a tendency towards less visual field and optic disc progression when compared with patients with other types of disc damage.