Spatial occurrence of glaucomatous visual field damage in the combined 24–2 and 10–2 test locations

PURPOSE: This study identified areas where glaucomatous visual field (VF) defects most and least frequently occur in the combined 24–2 and 10–2 test locations. METHODS: Five hundred three eyes of 503 glaucoma patients were included. All patients underwent both 24–2 (or 30–2) and 10–2 tests using the Humphrey Visual Field Analyzer. An abnormal test location was defined as a total deviation probability of < 5%. The combined dataset of 24–2 and 10–2 test locations was resampled using the bootstrap method. Test locations were classified into six grades based on the percentile ranks of abnormality frequency. Hierarchical cluster analysis was additionally performed to explore spatial patterns of abnormal test locations. RESULTS: The mean age of the participants was 61.4 ± 12.7 years. The median mean deviation (MD) of the 24–2 (or 30–2) and 10–2 tests was -5.2 dB (interquartile range [IQR]: -11.7 to -2.1) and -4.0 dB (IQR: -11.2 to -1.5), respectively. Abnormal test locations were most frequently observed in the superior nasal area of the combined test grids. Conversely, the lowest frequency of glaucomatous damage was observed in the central inferior region adjacent to the physiological blind spot. Hierarchical cluster analysis identified 27 clusters, broadly divided into superior and inferior regions by the horizontal meridian. CONCLUSION: Superior nasal locations are important for detecting early glaucomatous VF changes, whereas central inferior locations adjacent to the physiological blind spot are useful for assessing residual visual function in advanced disease. Our results inform optimized selection of VF test locations by disease severity.