In this issue of JAMA Ophthalmology, Wang and coworkers1 deal with an important and often overlooked topic, ie, the precise quantification and categorization of very advanced visual field defects in chronic glaucoma. Even if some studies seem to suggest that patients with severe glaucoma may be longitudinally monitored for progression using optical coherence tomography,2,3 it is well known that structure analysis, unlike in early glaucoma, is often of little (if any) clinical use in the late stages of glaucoma damage because of the floor effect, which strongly limits the possibility to detect small variations in optic disc structure and retinal nerve fiber layer thickness. Careful analyses of the visual function that use proper testing methods typically are needed and important in the follow-up and treatment of these patients with late-stage glaucoma to monitor and possibly to prevent further functional loss.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Brusini P. Central Visual Field Loss in End-stage Glaucoma. JAMA Ophthalmol. Published online January 02, 2020. doi:10.1001/jamaophthalmol.2019.5494
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: