Archetypal Analysis Reveals Consistent Visual Field Patterns for Stimulus Sizes III and V in Glaucoma and NAION

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Visual electrophysiology

Background:

• Anterior optic nerve disorders create distinct visual field (VF) archetypes (ATs).
• Standard automated perimetry uses different stimulus sizes, with size V potentially reducing variability in advanced vision loss.

Purpose of the Study:

• To determine if VF testing with stimulus size III and size V yields similar ATs in glaucoma and nonarteritic anterior ischemic optic neuropathy (NAION).
• To assess the utility of size V VFs in capturing disease-specific patterns.

Main Methods:

• Archetypal analysis (AA) was performed on 1969 same-day VF pairs (size III and size V) from glaucoma and NAION datasets.
• Raw sensitivities were censored and age-standardized before analysis.
• ATs from separate stimuli were compared using cosine similarity.

Main Results:

• AA identified 14 ATs applicable to both glaucoma and NAION.
• Similar patterns were observed between size III and size V VFs, with 87% of AT pairings showing high cosine similarity (≥0.8).
• Combined ATs effectively retained patterns from individual stimulus VFs.

Conclusions:

• VF testing using stimulus size V demonstrates quantifiable patterns comparable to size III.
• Size V VFs are suitable for monitoring VF progression in moderate to severe glaucoma and NAION.
• This finding supports the use of size V for consistent monitoring across different stimulus sizes.