Dataset Information

Detection of progression of glaucomatous visual field damage using the point-wise method with the binomial test.

ABSTRACT:

Purpose

To compare the performance of newly proposed point-wise linear regression (PLR) with the binomial test (binomial PLR) against mean deviation (MD) trend analysis and permutation analyses of PLR (PoPLR), in detecting global visual field (VF) progression in glaucoma.

Methods

15 VFs (Humphrey Field Analyzer, SITA standard, 24-2) were collected from 96 eyes of 59 open angle glaucoma patients (6.0 ± 1.5 [mean ± standard deviation] years). Using the total deviation of each point on the 2(nd) to 16(th) VFs (VF2-16), linear regression analysis was carried out. The numbers of VF test points with a significant trend at various probability levels (p<0.025, 0.05, 0.075 and 0.1) were investigated with the binomial test (one-side). A VF series was defined as "significant" if the median p-value from the binomial test was <0.025. Similarly, the progression analysis was carried out using only second to sixth VFs (VF2-6). The performance of each method was evaluated using the 'consistency measures'; proportion both significant (PBS): both VF series (VF2-6 and VF2-16) were "significant", proportion both were not significant (PBNS): both were "not significant", proportion inconsistently significant (PIS): VF2-16 was "not significant" but VF2-6 was "significant". A similar analysis was carried out using VF2-7 and VF2-15 series, and the performance was compared with MD trend analysis and PoPLR.

Results

The PBS of the binomial PLR method (0.14 to 0.86) was significantly higher than MD trend analysis (0.04 to 0.89) and PoPLR (0.09 to 0.93). The PIS of the proposed method (0.0 to 0.17) was significantly lower than the MD approach (0.0 to 0.67) and PoPLR (0.07 to 0.33). The PBNS of the three approaches were not significantly different.

Conclusions

The binomial BLR method gives more consistent results than MD trend analysis and PoPLR, hence it will be helpful as a tool to 'flag' possible VF deterioration.

SUBMITTER: Karakawa A

PROVIDER: S-EPMC3808340 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Detection of progression of glaucomatous visual field damage using the point-wise method with the binomial test.

Karakawa Ayako A Murata Hiroshi H Hirasawa Hiroyo H Mayama Chihiro C Asaoka Ryo R

PloS one 20131025 10

<h4>Purpose</h4>To compare the performance of newly proposed point-wise linear regression (PLR) with the binomial test (binomial PLR) against mean deviation (MD) trend analysis and permutation analyses of PLR (PoPLR), in detecting global visual field (VF) progression in glaucoma.<h4>Methods</h4>15 VFs (Humphrey Field Analyzer, SITA standard, 24-2) were collected from 96 eyes of 59 open angle glaucoma patients (6.0 ± 1.5 [mean ± standard deviation] years). Using the total deviation of each point ...[more]

PMID: 24205283

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Project description:Eye Movement Perimetry (EMP) uses Saccadic Eye Movement (SEM) responses for visual field evaluation. Previous studies have demonstrated significant delay in initiation of SEMs among glaucoma patients in comparison with healthy subjects. The aim of the current study was to develop an EMP-based screening grid to identify glaucomatous visual field defects.An interactive test consisting of 36 locations and two stimulus contrasts (162 cd/m2 and 190 cd/m2 on a background of 140 cd/m2) was evaluated in 54 healthy subjects and 50 primary glaucoma patients. Each subject was presented a central fixation target combined with the random projection of Goldmann size III peripheral targets. Instructions were given to look at each peripheral target on detection and then re-fixate at the central fixation target while the saccades were assessed using an eye tracker. From each seen peripheral target, the Saccadic Reaction Time (SRT) was calculated for contrast level 162 cd/ m2. These values were used to plot Receiver Operating Characteristic (ROC) curves for each test locations and the Area Under the Curve (AUC) values were used to identify the locations with highest susceptibility to glaucomatous damage. Each stimulus location with an AUC less than 0.75 along with its mirrored test location around the horizontal axis were eliminated from the grid.The mean age was 48.1?±?16.6 years and 50.0?±?14.5 years for healthy subjects and glaucoma patients respectively. A significant increase of SRT values by 76.5% (p?<?0.001) was found in glaucoma patients in comparison with the healthy subjects. From the ROC analysis, ten out of 36 locations meeting the cut-off criteria of AUC were eliminated resulting in a new grid containing 26 test locations. SRT values were significantly different (p?<?0.05) between the healthy subjects and glaucoma irrespective of the grids used.The present study resulted in a screening grid consisting of 26 locations predominantly testing nasal, superior and inferior areas of the visual field. An internal validation of the modified grid showed 90.4% of screening accuracy which makes it a potential approach for population based glaucoma screening.

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Dataset Information

Detection of progression of glaucomatous visual field damage using the point-wise method with the binomial test.

Purpose

Methods

Results

Conclusions

Publications

Detection of progression of glaucomatous visual field damage using the point-wise method with the binomial test.

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