Effects of input data on the performance of a neural network in distinguishing normal and glaucomatous visual fields

To compare the performance of neural networks for perimetric glaucoma diagnosis when using different types of data inputs: numerical threshold sensitivities, Statpac Total Deviation and Pattern Deviation, and probability scores based on Total and Pattern Deviation probability maps (Carl Zeiss Meditec, Inc., Dublin, CA).

The results of SITA Standard visual field tests in 213 healthy subjects, 127 patients with glaucoma, 68 patients with concomitant glaucoma and cataract, and 41 patients with cataract only were included. The five different types of input data were entered into five identically designed artificial neural networks. Network thresholds were adjusted for each network. Receiver operating characteristic (ROC) curves were constructed to display the combinations of sensitivity and specificity.

Input data in the form of Pattern Deviation probability scores gave the best results, with an area of 0.988 under the ROC curve, and were significantly better (P < 0.001) than threshold sensitivities and numerical Total Deviations and Total Deviation probability scores. The second best result was obtained with numerical Pattern Deviations with an area of 0.980.

The choice of type of data input had important effects on the performance of the neural networks in glaucoma diagnosis. Refined input data, based on Pattern Deviations, resulted in higher sensitivity and specificity than did raw threshold values. Neural networks may have high potential in the production of useful clinical tools for the classification of visual field tests.