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.