Stuart K Gardiner1, Shaban Demirel2. 1. Devers Eye Institute, Legacy Research Institute, Portland, Oregon. Electronic address: sgardiner@deverseye.org. 2. Devers Eye Institute, Legacy Research Institute, Portland, Oregon.
Abstract
PURPOSE: Various global indices are available to summarize results from standard automated perimetry. This study asks which index can detect significant deterioration earliest, for a fixed specificity. DESIGN: Comparison of prognostic indices. METHODS: Two cohorts were tested. A test-retest cohort contained 5 reliable visual fields, within a short interval, from 45 eyes of 23 participants with glaucoma and/or likelihood of developing glaucoma. A separate longitudinal cohort contained 508 eyes from 330 participants, tested on average 13 times. Three global indices were extracted: mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI). For each index we defined a critical P value CritIndex, such that 5% of test-retest series showed significant deterioration with P < CritIndex, using artificial "test dates" in random order. Therefore these criteria have 95% specificity over series of 5 tests. The times to detect significant deterioration in the longitudinal cohort were compared using a survival analysis model. RESULTS: The median time to detect significant deterioration with MD was 7.3 years (95% confidence interval [CI] 6.8-7.9 years). For VFI, the median was 8.5 years (95% CI 7.9-9.0 years); this comparison had P = .088. For PSD, the median was 10.5 years (95% CI 9.3-11.7 years), slower than MD with P < .001. Within the first 5 years of a series, MD detected significant deterioration in 138 eyes, vs 104 for VFI (P = .0013) and 107 for PSD (P = .029). CONCLUSIONS: MD detected significant deterioration sooner than VFI or PSD. In particular, MD detected more eyes in the first 5 years of their follow-up, which were presumably undergoing more rapid progression.
PURPOSE: Various global indices are available to summarize results from standard automated perimetry. This study asks which index can detect significant deterioration earliest, for a fixed specificity. DESIGN: Comparison of prognostic indices. METHODS: Two cohorts were tested. A test-retest cohort contained 5 reliable visual fields, within a short interval, from 45 eyes of 23 participants with glaucoma and/or likelihood of developing glaucoma. A separate longitudinal cohort contained 508 eyes from 330 participants, tested on average 13 times. Three global indices were extracted: mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI). For each index we defined a critical P value CritIndex, such that 5% of test-retest series showed significant deterioration with P < CritIndex, using artificial "test dates" in random order. Therefore these criteria have 95% specificity over series of 5 tests. The times to detect significant deterioration in the longitudinal cohort were compared using a survival analysis model. RESULTS: The median time to detect significant deterioration with MD was 7.3 years (95% confidence interval [CI] 6.8-7.9 years). For VFI, the median was 8.5 years (95% CI 7.9-9.0 years); this comparison had P = .088. For PSD, the median was 10.5 years (95% CI 9.3-11.7 years), slower than MD with P < .001. Within the first 5 years of a series, MD detected significant deterioration in 138 eyes, vs 104 for VFI (P = .0013) and 107 for PSD (P = .029). CONCLUSIONS: MD detected significant deterioration sooner than VFI or PSD. In particular, MD detected more eyes in the first 5 years of their follow-up, which were presumably undergoing more rapid progression.
Authors: Christopher K S Leung; Cong Ye; Robert N Weinreb; Marco Yu; Gilda Lai; Dennis S Lam Journal: Ophthalmology Date: 2013-08-30 Impact factor: 12.079
Authors: Paul H Artes; Neil O'Leary; Donna M Hutchison; Lisa Heckler; Glen P Sharpe; Marcelo T Nicolela; Balwantray C Chauhan Journal: Invest Ophthalmol Vis Sci Date: 2011-06-08 Impact factor: 4.799
Authors: Augusto Azuara-Blanco; L Jay Katz; George L Spaeth; Stephen A Vernon; Fiona Spencer; Ines M Lanzl Journal: Am J Ophthalmol Date: 2003-11 Impact factor: 5.258
Authors: Jung Hwa Na; Kyung Rim Sung; Seunghee Baek; Yoon Jeon Kim; Mary K Durbin; Hye Jin Lee; Hwang Ki Kim; Yong Ho Sohn Journal: Invest Ophthalmol Vis Sci Date: 2012-06-20 Impact factor: 4.799
Authors: Siamak Yousefi; Madhusudhanan Balasubramanian; Michael H Goldbaum; Felipe A Medeiros; Linda M Zangwill; Robert N Weinreb; Jeffrey M Liebmann; Christopher A Girkin; Christopher Bowd Journal: Transl Vis Sci Technol Date: 2016-05-03 Impact factor: 3.283
Authors: Xiaoqin Huang; Fatemeh Saki; Mengyu Wang; Tobias Elze; Michael V Boland; Louis R Pasquale; Chris A Johnson; Siamak Yousefi Journal: J Glaucoma Date: 2022-06-03 Impact factor: 2.290