Archetypes of Binocular Visual Field Loss and Their Impact on Vision-Related Quality of Life in Glaucoma Patients

Binocular visual field (VF) loss affects vision-related quality of life (VR-QoL) but the relationship between specific VF loss patterns and difficulties with specific tasks remains poorly understood. Archetypal analysis offers a promising method to elucidate spatial patterns of VF loss. In this study, we aimed to develop archetypes for binocular VF loss and assess their relationship with VR-QoL.

We included 7305 pairs of reliable standard automated perimetry (24-2 SITA fast and standard) test results of patients from 5 glaucoma clinics in England from a Healthcare Quality Improvement Partnership-funded audit. We executed an archetypal analysis on the corresponding integrated VFs (estimates of the binocular VFs from pairs of monocular VFs) to identify the best-fitting set of archetypes from our dataset. Then, we used these archetypes to deconstruct the binocular VF of 269 patients with glaucoma from the Netherlands that had completed 4 different VR-QoL questionnaires. Finally, relationships between each of the archetypes and different aspects of VR-QoL were analyzed.

The archetypal analysis demonstrated that a solution comprising 12 archetypes provides the best-fitting model. Our analysis of the 269 patients' with glaucoma data showed various significant and plausible relationships between the different archetypes and various aspects of VR-QoL.

Our results demonstrate how archetypes can elucidate relationships between the location of a VF defect and different aspects of VR-QoL in glaucoma. This may help clinicians and patients better understand the impact of different types of VF defects.