Dataset Information

Performance of the 10-2 and 24-2 Visual Field Tests for Detecting Central Visual Field Abnormalities in Glaucoma.

ABSTRACT: PURPOSE:To compare the performance of the pattern standard deviation (PSD) values derived from the central 12 locations of the 24-2 visual field test (C24-2) to the entire 10-2 test for detecting central visual field abnormalities in eyes with, suspected of having, or at risk of having glaucoma. DESIGN:Cross-sectional case-control study. METHODS:Eyes with, suspected of having, or at risk of having glaucoma, based on masked grading of optic disc stereophotographs and/or ocular hypertension (intraocular pressure ? 22 mm Hg) were included as cases (n = 523). Eyes from healthy participants were included as controls (n = 107) to allow the 2 tests to be compared at matched specificities. The sensitivity to detect cases at 95% specificity using PSD values derived from the entire 10-2 test and C24-2 were compared. RESULTS:The sensitivity of the 10-2 and C24-2 PSD values was not significantly different between the 10-2 and C24-2 at matched specificities (35.9% and 35.4% respectively; P = .900). There was also a substantial agreement between the cases detected by both methods (kappa = 0.80 ± 0.04), and a very strong association between the PSD values from the 2 methods (R2 = 0.91). CONCLUSIONS:10-2 and 24-2 tests identified a similar number of eyes with, suspected of having, or at risk of having glaucoma as having central visual field abnormalities using PSD values. These findings do not mean that 10-2 tests are not useful, but highlight the need for further studies to determine the potential advantages of 10-2 tests through equivalent comparisons against 24-2 tests to ensure appropriate recommendations are made about its incorporation into the glaucoma standard of care.

SUBMITTER: Wu Z

PROVIDER: S-EPMC6258276 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Performance of the 10-2 and 24-2 Visual Field Tests for Detecting Central Visual Field Abnormalities in Glaucoma.

Wu Zhichao Z Medeiros Felipe A FA Weinreb Robert N RN Zangwill Linda M LM

American journal of ophthalmology 20180810

<h4>Purpose</h4>To compare the performance of the pattern standard deviation (PSD) values derived from the central 12 locations of the 24-2 visual field test (C24-2) to the entire 10-2 test for detecting central visual field abnormalities in eyes with, suspected of having, or at risk of having glaucoma.<h4>Design</h4>Cross-sectional case-control study.<h4>Methods</h4>Eyes with, suspected of having, or at risk of having glaucoma, based on masked grading of optic disc stereophotographs and/or ocul ...[more]

PMID: 30099037

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Project description:PurposeTo quantify the central visual field (VF) loss patterns in glaucoma using artificial intelligence.DesignRetrospective study.ParticipantsVFs of 8712 patients with 13 951 Humphrey 10-2 test results from 13 951 eyes for cross-sectional analyses, and 824 patients with at least 5 reliable 10-2 test results at 6-month intervals or more from 1191 eyes for longitudinal analyses.MethodsTotal deviation values were used to determine the central VF patterns using the most recent 10-2 test results. A 24-2 VF within a 3-month window of the 10-2 tests was used to stage eyes into mild, moderate, or severe functional loss using the Hodapp-Anderson-Parrish scale at baseline. Archetypal analysis was applied to determine the central VF patterns. Cross-validation was performed to determine the optimal number of patterns. Stepwise regression was applied to select the optimal feature combination of global indices, average baseline decomposition coefficients from central VFs archetypes, and other factors to predict central VF mean deviation (MD) slope based on the Bayesian information criterion (BIC).Main outcome measuresThe central VF patterns stratified by severity stage based on 24-2 test results and a model to predict the central VF MD change over time using baseline test results.ResultsFrom cross-sectional analysis, 17 distinct central VF patterns were determined for the 13 951 eyes across the spectrum of disease severity. These central VF patterns could be divided into isolated superior loss, isolated inferior loss, diffuse loss, and other loss patterns. Notably, 4 of the 5 patterns of diffuse VF loss preserved the less vulnerable inferotemporal zone, whereas they lost most of the remaining more vulnerable zone described by the Hood model. Inclusion of coefficients from central VF archetypical patterns strongly improved the prediction of central VF MD slope (BIC decrease, 35; BIC decrease of >6 indicating strong prediction improvement) than using only the global indices of 2 baseline VF results. Eyes with baseline VF results with more superonasal and inferonasal loss were more likely to show worsening MD over time.ConclusionsWe quantified central VF patterns in glaucoma, which were used to improve the prediction of central VF worsening compared with using only global indices.

Project description:ImportanceAlthough the central visual field (VF) in end-stage glaucoma may substantially vary among patients, structure-function studies and quality-of-life assessments are impeded by the lack of appropriate characterization of end-stage VF loss.ObjectiveTo provide a quantitative characterization and classification of central VF loss in end-stage glaucoma.Design, setting, and participantsThis retrospective cohort study collected data from 5 US glaucoma services from June 1, 1999, through October 1, 2014. A total of 2912 reliable 10-2 VFs of 1103 eyes from 1010 patients measured after end-stage 24-2 VFs with a mean deviation (MD) of -22 dB or less were included in the analysis. Data were analyzed from March 28, 2018, through May 23, 2019.Main outcomes and measuresCentral VF patterns were determined by an artificial intelligence algorithm termed archetypal analysis. Longitudinal analyses were performed to investigate whether the development of central VF defect mostly affects specific vulnerability zones.ResultsAmong the 1103 patients with the most recent VFs, mean (SD) age was 70.4 (14.3) years; mean (SD) 10-2 MD, -21.5 (5.6) dB. Fourteen central VF patterns were determined, including the most common temporal sparing patterns (304 [27.5%]), followed by mostly nasal loss (280 [25.4%]), hemifield loss (169 [15.3%]), central island (120 [10.9%]), total loss (91 [8.3%]), nearly intact field (56 [5.1%]), inferonasal quadrant sparing (42 [3.8%]), and nearly total loss (41 [3.7%]). Location-specific median total deviation analyses partitioned the central VF into a more vulnerable superonasal zone and a less vulnerable inferotemporal zone. At 1-year and 2-year follow-up, new defects mostly occurred in the more vulnerable zone. Initial encroachments on an intact central VF at follow-up were more likely to be from nasal loss (11 [18.4%]; P < .001). One of the nasal loss patterns had a substantial chance at 2-year follow-up (8 [11.0%]; P = .004) to shift to total loss, whereas others did not.Conclusions and relevanceIn this study, central VF loss in end-stage glaucoma was found to exhibit characteristic patterns that might be associated with different subtypes. Initial central VF loss is likely to be nasal loss, and 1 specific type of nasal loss is likely to develop into total loss.

Dataset Information

Performance of the 10-2 and 24-2 Visual Field Tests for Detecting Central Visual Field Abnormalities in Glaucoma.

Publications

Performance of the 10-2 and 24-2 Visual Field Tests for Detecting Central Visual Field Abnormalities in Glaucoma.

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