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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Pointwise linear regression analysis for detection of visual field progression with absolute versus corrected
Anita Manassakorn1, Kouros Nouri-Mahdavi, Behrooz Koucheki
1Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California 90095, USA.
Investigative Ophthalmology & Visual Science
|June 27, 2006
Summary
Point-wise linear regression analysis using total deviation (TD) is more effective for detecting glaucoma progression than pattern deviation (PD). Agreement between methods decreases with increased glaucoma severity.
Area of Science:
- Ophthalmology
- Visual field testing
- Glaucoma diagnostics
Background:
- Glaucoma management relies on accurate visual field progression detection.
- Point-wise linear regression (PLR) is a method to analyze visual field changes.
- Total deviation (TD) and pattern deviation (PD) are key metrics in visual field analysis.
Purpose of the Study:
- To compare the diagnostic performance of PLR using TD versus PD threshold sensitivities.
- To evaluate the agreement between PLR methods and clinical assessment for glaucoma progression.
Main Methods:
- Analysis of 402 eyes from the Advanced Glaucoma Intervention Study (AGIS).
- PLR criteria: slope <= -1 dB/year, P <= 0.01, with >= 2 worsening points in a Glaucoma Hemifield Test cluster.
- Eyes categorized by mean deviation (MD): mild, moderate, and advanced glaucoma.
Main Results:
- Visual field progression detected in 38% (PLR-TD), 21% (PLR-PD), and 44% (clinical evaluation).
- Higher agreement between clinicians and PLR-TD (kappa=0.48) compared to clinicians and PLR-PD (kappa=0.31).
- Agreement between PLR-TD and PLR-PD decreased with glaucoma severity (mild: 0.60, moderate: 0.41, advanced: 0.33).
Conclusions:
- PLR analysis on TD threshold sensitivities demonstrated superior performance compared to PD.
- Clinical evaluation showed better agreement with PLR-TD than PLR-PD.
- The concordance between TD and PD analyses diminishes in more severe glaucoma cases.
