The rate of visual field loss in optic nerve head drusen.

PURPOSE To define the rate of visual field loss in patients with optic nerve head drusen (ONHD). DESIGN Retrospective chart review. METHODS Goldmann visual field (GVF) testing from initial visit and last follow-up examination were quantified using the modified Esterman grid technique. The rate of visual field loss was calculated by comparing the initial GVF to the last follow-up GVF. A comparative analysis of GVF and age at initial evaluation was performed on all patients with an initial GVF only. SETTING Tertiary academic care center. PARTICIPANTS Inclusion criteria for the rate analysis: (1) diagnosis of ONHD and (2) at least 36 months of follow-up with serial GVF testing. EXCLUSION CRITERIA (1) patients with glaucoma or glaucoma-suspect; (2) history or examination evidence for other ocular disease; and (3) drusen-related macular causes of visual loss. RESULTS Thirty-two of 292 charts were included in the rate analysis. The rate of visual field loss was 1.58%. There was no statistically significant difference between men and women (P = .74). One hundred eighty patients were included in the initial visual field analysis. There was a significant negative correlation between age and GVF, with older patients having lower GVF scores with a Spearman correlation of -0.42 (P < 0.0001); 73% of these 180 patients had mild, minimal, or no visual field loss. CONCLUSIONS The rate of visual field loss for ONHD over a 36-month interval of time was 1.6% per year. Patients with minimal or no visual field loss were younger, and patients with moderate or severe visual loss were older.

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