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Updated: May 9, 2026
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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Refinement of pointwise linear regression criteria for determining glaucoma progression.
Colleen M Kummet1, K D Zamba, Carrie K Doyle
1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
Investigative Ophthalmology & Visual Science
|August 3, 2013
Summary
Refining pointwise linear regression (PLR) criteria with a stricter slope (less than -1.2 dB/y) and relaxed significance (P < 0.04) improves glaucoma progression detection. This enhances early detection and treatment of glaucoma.
Area of Science:
- Ophthalmology
- Medical Technology
- Data Analysis
Background:
- Glaucoma visual field progression is typically assessed using pointwise linear regression (PLR) criteria.
- Existing PLR criteria have been evaluated on a limited scale, necessitating further investigation into alternative methods.
Purpose of the Study:
- To evaluate a range of PLR slope and significance criteria.
- To define a clinically useful progression decision rule for longitudinal visual field examinations in glaucoma detection.
Main Methods:
- Analysis of visual field data from 140 eyes using the Humphrey Field Analyzer II (HFA II) with the Swedish interactive thresholding algorithm (SITA) standard test strategy.
- Application of the pointwise linear regression A2 (PLRA2) method to nine visual field examinations over 4 years.
- Validation of the developed decision rule using data from the Ocular Hypertension Treatment Study (OHTS).
Main Results:
- Specific slope criteria, notably less than -1.2 dB/y, achieved specificities of 0.90 or higher.
- A slope criterion of less than -1.2 dB/y with P < 0.04 significantly increased the hit rate by over two-fold compared to the standard criterion (less than -1.0 dB/y, P < 0.01).
- The enhanced hit rate was confirmed in the independent OHTS validation dataset.
Conclusions:
- Refining PLR criteria by using a stricter slope threshold (e.g., < -1.2 dB/y) and a relaxed significance level (e.g., P < 0.04) improves glaucoma progression detection.
- Increasing the hit rate of PLR analysis is crucial for the early detection and timely treatment of glaucoma.
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