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Abstract #91286 Published in IGR 21-4
Detection of functional deterioration in glaucoma by trend analysis using comprehensive overlapping clusters of locations
Gardiner SK; Mansberger SLScientific reports 2020; 10: 18470
Detecting rapid visual field deterioration is crucial for individuals with glaucoma. Cluster trend analysis detects visual field deterioration with higher sensitivity than global analyses by using predefined non-overlapping subsets of visual field locations. However, it may miss small defects that straddle cluster borders. This study introduces a comprehensive set of overlapping clusters, and assesses whether this further improves progression detection. Clusters were defined as locations from where ganglion cell axons enter the optic nerve head within a θ° wide sector, centered at 1º intervals, for various θ. Deterioration in eyes with or at risk of glaucomatous visual field loss was "detected" if ≥ N clusters had deteriorated with p < p, chosen empirically to give 95% specificity based on permuting the series. N was chosen to minimize the time to detect subsequently-confirmed deterioration in ≥ 1/3rd of eyes. Times to detect deterioration were compared using Cox survival models. Biannual series were available for 422 eyes of 214 participants. Predefined non-overlapping clusters detected subsequently-confirmed change in ≥ 1/3rd of eyes in 3.41 years (95% confidence interval 2.75-5.48 years). After equalizing specificity, no criteria based on comprehensive overlapping clusters detected deterioration significantly sooner. The quickest was 3.13 years (2.69-4.65) for θ° = 20° and N = 25, but the comparison with non-overlapping clusters had p = 0.672. Any improvement in sensitivity for detecting deterioration when using a comprehensive set of overlapping clusters was negated by the need to maintain equal specificity. The existing cluster trend analysis using predefined non-overlapping clusters provides a useful tool for monitoring visual field progression.
Devers Eye Institute, Legacy Research Institute, 1225 NE 2nd Ave, Portland, OR, 97232, USA. sgardiner@deverseye.org.
Full articleClassification:
6.20 Progression (Part of: 6 Clinical examination methods)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
