Siamak Yousefi1, Tobias Elze2, Louis R Pasquale3, Osamah Saeedi4, Mengyu Wang2, Lucy Q Shen5, Sarah R Wellik6, Carlos G De Moraes7, Jonathan S Myers8, Michael V Boland9. 1. Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, Tennessee. Electronic address: siamak.yousefi@uthsc.edu. 2. Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts. 3. Department of Ophthalmology, Eye and Vision Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York. 4. Department of Ophthalmology and Visual Sciences, University of Maryland, Baltimore, Maryland. 5. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. 6. Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida. 7. Edward S. Harkness Eye Institute, Columbia University, New York, New York. 8. Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania. 9. Wilmer Eye Institute and Division of Health Sciences Informatics, Johns Hopkins University, Baltimore, Maryland.
Abstract
PURPOSE: To develop an artificial intelligence (AI) dashboard for monitoring glaucomatous functional loss. DESIGN: Retrospective, cross-sectional, longitudinal cohort study. PARTICIPANTS: Of 31 591 visual fields (VFs) on 8077 subjects, 13 231 VFs from the most recent visit of each patient were included to develop the AI dashboard. Longitudinal VFs from 287 eyes with glaucoma were used to validate the models. METHOD: We entered VF data from the most recent visit of glaucomatous and nonglaucomatous patients into a "pipeline" that included principal component analysis (PCA), manifold learning, and unsupervised clustering to identify eyes with similar global, hemifield, and local patterns of VF loss. We visualized the results on a map, which we refer to as an "AI-enabled glaucoma dashboard." We used density-based clustering and the VF decomposition method called "archetypal analysis" to annotate the dashboard. Finally, we used 2 separate benchmark datasets-one representing "likely nonprogression" and the other representing "likely progression"-to validate the dashboard and assess its ability to portray functional change over time in glaucoma. MAIN OUTCOME MEASURES: The severity and extent of functional loss and characteristic patterns of VF loss in patients with glaucoma. RESULTS: After building the dashboard, we identified 32 nonoverlapping clusters. Each cluster on the dashboard corresponded to a particular global functional severity, an extent of VF loss into different hemifields, and characteristic local patterns of VF loss. By using 2 independent benchmark datasets and a definition of stability as trajectories not passing through over 2 clusters in a left or downward direction, the specificity for detecting "likely nonprogression" was 94% and the sensitivity for detecting "likely progression" was 77%. CONCLUSIONS: The AI-enabled glaucoma dashboard, developed using a large VF dataset containing a broad spectrum of visual deficit types, has the potential to provide clinicians with a user-friendly tool for determination of the severity of glaucomatous vision deficit, the spatial extent of the damage, and a means for monitoring the disease progression.
PURPOSE: To develop an artificial intelligence (AI) dashboard for monitoring glaucomatous functional loss. DESIGN: Retrospective, cross-sectional, longitudinal cohort study. PARTICIPANTS: Of 31 591 visual fields (VFs) on 8077 subjects, 13 231 VFs from the most recent visit of each patient were included to develop the AI dashboard. Longitudinal VFs from 287 eyes with glaucoma were used to validate the models. METHOD: We entered VF data from the most recent visit of glaucomatous and nonglaucomatouspatients into a "pipeline" that included principal component analysis (PCA), manifold learning, and unsupervised clustering to identify eyes with similar global, hemifield, and local patterns of VF loss. We visualized the results on a map, which we refer to as an "AI-enabled glaucoma dashboard." We used density-based clustering and the VF decomposition method called "archetypal analysis" to annotate the dashboard. Finally, we used 2 separate benchmark datasets-one representing "likely nonprogression" and the other representing "likely progression"-to validate the dashboard and assess its ability to portray functional change over time in glaucoma. MAIN OUTCOME MEASURES: The severity and extent of functional loss and characteristic patterns of VF loss in patients with glaucoma. RESULTS: After building the dashboard, we identified 32 nonoverlapping clusters. Each cluster on the dashboard corresponded to a particular global functional severity, an extent of VF loss into different hemifields, and characteristic local patterns of VF loss. By using 2 independent benchmark datasets and a definition of stability as trajectories not passing through over 2 clusters in a left or downward direction, the specificity for detecting "likely nonprogression" was 94% and the sensitivity for detecting "likely progression" was 77%. CONCLUSIONS: The AI-enabled glaucoma dashboard, developed using a large VF dataset containing a broad spectrum of visual deficit types, has the potential to provide clinicians with a user-friendly tool for determination of the severity of glaucomatous vision deficit, the spatial extent of the damage, and a means for monitoring the disease progression.
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Authors: Anna S Mursch-Edlmayr; Wai Siene Ng; Alberto Diniz-Filho; David C Sousa; Louis Arnold; Matthew B Schlenker; Karla Duenas-Angeles; Pearse A Keane; Jonathan G Crowston; Hari Jayaram Journal: Transl Vis Sci Technol Date: 2020-10-15 Impact factor: 3.283