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Andrew Lam, MD; Vatinee Bunya, MD; Jody R. Piltz-Seymour, MD

Arch Ophthalmol. 2002;120:1494-1497.

Objective  To evaluate the relationship between peripapillary focal arteriolar narrowing and visual field defects.

Methods  From our institutional practice, we identified 31 patients with glaucoma who had peripapillary focal arteriolar narrowing in only one eye and compared visual field data between the two eyes. Mean deviation (MD) and corrected pattern standard deviation (CPSD) were recorded using Humphrey visual field testing at the time proximal narrowing was apparent on the fundus photograph. Visual field data from subsets of patients with mild and severe narrowing were also compared.

Results  The MD and CPSD were significantly worse in eyes with peripapillary focal arteriolar narrowing. The eyes with narrowing exhibited a mean MD of -8.77 ± 8.27 dB and a mean CPSD of 5.01 ± 3.42 dB. Eyes without narrowing displayed a mean MD of -4.52 ± 6.64 dB and a mean CPSD of 3.01 ± 2.68 dB (P = .003 for both). There was no significant difference in severity of the visual field defect between eyes with mild and severe arteriolar narrowing.

Conclusion  To our knowledge, this is the first study to show that the presence of peripapillary focal arteriolar narrowing is related to the severity of visual field loss in patients with glaucoma.

From the Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia.