Distribution and Severity Correlation of Classic Visual Field Defect Patterns on Standard Automated Perimetry in Newly Diagnosed Primary Open-Angle Glaucoma: A Retrospective Single-Institution Study

Background: Standard automated perimetry (SAP) remains the primary method for assessing visual function loss in primary open-angle glaucoma (POAG), and characteristic defect patterns, including paracentral scotoma, nasal step, and arcuate (Bjerrum) scotoma, have long been described as hallmark findings, but institutional data on the distribution of these defect patterns and their relationship to disease severity are useful for local benchmarking. Methods: We designed a retrospective, single-center study (simulated for this exercise) of patients with newly diagnosed POAG undergoing standard automated perimetry over a one-year period at a hypothetical glaucoma clinic, describing the distribution of classic visual field defect patterns and their association with mean deviation (MD) severity category. Results: In this simulated dataset (n = 436 eyes), arcuate scotoma was the most common defect pattern (38.5%), followed by nasal step (26.4%) and superior paracentral scotoma (21.1%), with a diffuse or non-specific pattern in the remainder. Mean deviation was most severely reduced in eyes with arcuate scotoma (-8.4 dB) and least reduced in eyes with isolated paracentral scotoma (-3.1 dB). Conclusion: These illustrative findings are consistent with the published literature (through 2014) in supporting standard automated perimetry as an essential tool for characterizing the classic, spatially patterned visual field loss of POAG and its correlation with functional disease severity.