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Vascular abnormalities may present as central VF defects in normal-tension glaucoma
Low heart rate variability and abnormal peripheral microcirculation correlated strongly with central visual field defects in patients with normal-tension glaucoma, according to a study.
“[Normal-tension glaucoma] patients with low heart rate variability or abnormal nail capillaroscopy may present as central [visual field] defects,” the study authors said. “Therefore, vascular risk factors need to be considered when [normal-tension glaucoma] patients have central [visual field] defects.”
The prospective study included 60 eyes of 60 patients with normal-tension glaucoma. Mean patient age was 55.37 years.
Patients underwent a comprehensive ophthalmic examination, heart rate variability (HRV) assessment and nailfold capillaroscopy. Patients with visual field (VF) clusters limited to the central 10° or outside the central 10° in one hemifield were selected for analysis.
Patients were assigned to low, middle, and high HRV groups or normal and abnormal capillaroscopy groups.
VF defects were found to be deepest in the superior central sector in the low HRV and abnormal capillaroscopy groups. Frequency of VF defects in the central 10° varied markedly among the low, middle and high HRV groups. In the low HRV group, 12 eyes (60%) had VF defects in the central 10°. In the high HRV group, three eyes (15%) had VF defects within the central 10° and 17 eyes (85%) had VF defects outside the central 10° (P = .014).
Frequency of VF defects in the central 10° was greater in 18 eyes (62.1%) with abnormal peripheral microcirculation, but the difference was statistically insignificant, the authors said.