Park SC, De Moraes CG, Teng CC et al.
New York Eye and Ear Infirmary, New York, NY, USA.
Ophthalmology 2011;118:1782–9.
Editor’s note: Classically, paracentral visual field defects are thought to be more common in patients with normal-tension glaucoma (NTG). In this study, patients presenting with an initial parafoveal scotoma (n=69) were compared with those presenting with an initial nasal step with preservation of the central field (n=53). The authors confirmed the finding that intraocular pressure is significantly lower in initial parafoveal scotoma patients compared with initial nasal step patients. There were more systemic risk factors, such as hypotension, migraine, Raynaud’s phenomena, and sleep apnea, and there were more disc hemorrhages in patients presenting with an initial parafoveal scotoma defect. Interestingly, there was no difference in central corneal thickness between the two groups. One might have anticipated a difference, as patients with NTG tend to have a thinner cornea. The parafoveal scotomas also tended to be deeper and more localized than initial nasal steps.