Biomarkers of the progression of the glaucoma process in assessing the results of static perimetry

Relevance Glaucoma is a neurodegenerative disease characterized by a gradual decrease in light sensitivity from the peripheral to the central part of the visual field [1, 2]. Correct assessment of diagnostic results allows timely measures to reduce disease progression. Analysis of each point of light sensitivity and derivation of gradation from the most prognostically important to insignificant allowed to speed up the process of assessing the results of static perimetry in the realities of outpatient reception [3–5]. Objective To assess light sensitivity at each point of the visual field and identify biomarkers of the progression of the glaucoma process. Material and methods The study included 500 patients, 200 of whom were a control group without a diagnosis of glaucoma. 300 patients with a verified diagnosis were the main group, which was divided by stages of the disease: initial, developed, advanced. All underwent a standard ophthalmological examination and computer perimetry (Humphrey) according to the 24–2 program. 54 points were assessed, and the mean values ​​and standard deviation of light sensitivity were calculated for each point. Results Patients with early glaucoma showed a decrease in overall light sensitivity. In patients with advanced glaucoma, areas of decreased light sensitivity were found on the periphery of the nasal sector, at the extreme point above the horizontal axis - 14.4 dB and at points going from it to the center up to 10° of the zone - from 17.7 to 22.7 dB. The maximum standard deviation of light sensitivity was found in the nasal sector on both sides of the horizontal line - from 10.7 to 11.5 dB. The average light sensitivity above the horizontal axis in patients with advanced glaucoma was 10.8 dB, which is 2 dB more than the lower half of the visual field - 8.8 dB. The highest values ​​of light sensitivity were found at points 10° from the center to the nose, lying on the horizontal axis - 17.7 dB and the inferotemporal quadrant of the 5° zone - 16.78 dB, the lowest - at the point of the inferonasal quadrant of the 5° zone - 4.5 dB. The average values ​​of the standard deviation of light sensitivity in the upper half of the visual field were 9.6 dB, 1 dB less than in the lower half - 10.6 dB. Conclusion The identified areas of decreased light sensitivity for each stage are predictors of the progression of glaucomatous optic neuropathy. Key words: static perimetry; glaucoma; light sensitivity defects