During a visual field assessment, a decrease in peripheral vision is noted bilaterally. What finding is anticipated during fundoscopic assessment?

In cases where there is a decrease in peripheral vision, particularly bilateral changes, one anticipates that this may be indicative of conditions such as glaucoma or other optic nerve diseases, which can lead to increased intraocular pressure and resultant optic nerve damage. During a fundoscopic assessment, the cup-to-disk ratio is key in evaluating the health of the optic nerve.

A cup-to-disk ratio of 70% suggests that there is significant damage to the optic nerve. This increased ratio indicates a larger cup size relative to the disk, often associated with glaucoma where the nerve fibers are progressively lost due to elevated pressure. This finding aligns with the expected outcome in bilateral peripheral vision loss, as glaucoma can result in both peripheral vision depression and increased cup size.

On the other hand, the normal cup-to-disk ratio or lower ratios like 50% would imply healthier optic nerve function, which would not correlate with the observed decrease in visual fields. A cup-to-disk ratio of 90% would indicate excessive optic nerve damage, and while it suggests a severe case of optic nerve atrophy, it is less commonly encountered compared to a 70% ratio in typical clinical presentations associated with bilateral peripheral vision loss.