Mapping Glaucoma Patients' 30-2 and 10-2 Visual Fields Reveals Clusters of Test Points Damaged in the 10-2 Grid That Are Not Sampled in the Sparse 30-2 Grid

PURPOSE: To cluster test points in glaucoma patients' 30-2 and 10-2 visual field (VF) (Humphrey Field Analyzer: HFA, Carl Zeiss Meditec, Dublin, CA) in order to map the different regions damaged by the disease. METHOD: This retrospective study included 128 eyes from 128 patients. 142 total deviation (TD) values (74 from the 30-2 VF and 68 from the 10-2 VF) were clustered using the ‘Hierarchical Ordered Partitioning And Collapsing Hybrid – Partitioning Around Medoids’ algorithm. The stability of the identified clusters was evaluated using bootstrapping. RESULTS: 65 sectors were identified in total: 38 sectors were located outside the 10-2 VF whereas 29 sectors were located inside the 10-2 VF (two sectors overlap in both grids). The mapping of many sectors appeared to follow the distribution of retinal nerve fiber bundles. The results of bootstrapping suggested clusters were stable whether they were outside or inside the 10-2 VF. CONCLUSION: A considerable number of sectors were identified in the 10-2 VF area, despite the fact that clustering was carried out on all points in both the 30-2 VF and 10-2 VF simultaneously. These findings suggest that glaucomatous central VF deterioration cannot be picked up by the 30-2 test grid alone, because of poor spatial sampling; denser estimation of the central ten degrees, than offered by the 30-2 test grid alone, is needed. It may be beneficial to develop a new VF test grid that combines test points from 30-2 and 10-2 VFs – the results of this study could help to devise this test grid.