Computer perimetry in the diagnosis of glaucoma

Relevance Primary open-angle glaucoma is a chronic disease that leads to irreversible blindness. Fluctuations in intraocular pressure lead to the death of retinal ganglion cells (RGC) and the retinal nerve fiber layer (RNFL) [1–3]. As glaucoma progresses, characteristic structural and functional changes develop. The absence of timely and adequate treatment leads to irreversible vision loss. The "gold standard" in glaucoma diagnostics is computer perimetry. This study allows assessing the state of visual functions by analyzing the differential light sensitivity of the retina at the studied points of the central visual field [4]. Objective To study changes in light sensitivity at each point of the visual field in patients at different stages of glaucoma. Material and methods The data of a prospective analytical study in the case-control format were analyzed. The patients were divided into 4 groups: the control group, patients with initial, developed and advanced glaucoma. All patients underwent computer perimetry using the 24-2 program, retinal sensitivity and its variability were assessed at 54 points. The average sensitivity values ​​for each point were calculated, and an intergroup analysis was performed to assess changes in sensitivity. Results In patients with initial glaucoma, the decrease in sensitivity compared to the control group ranged from 1.5 to 3.6 dB. In the developed glaucoma group, this decrease varied from 2.1 to 11.5 dB. In the advanced glaucoma group - from 14.1 to 28 dB. When passing from initial glaucoma to the developed stage, defects in the upper nasal sector deepen first. Further changes affect the lower half of the visual field, including the temporal sector. Conclusion The most pronounced and profound defects of light sensitivity are observed in the lower part of the visual field in patients diagnosed with advanced glaucoma [5]. Key words: glaucoma; static perimetry; assessment of each point; perimetric defects; light sensitivity