Prediction of Visual Field Progression in Myopic Normal Tension Glaucoma Using a Nomogram-Based Model

Area of Science:

• Ophthalmology
• Glaucoma Research
• Medical Imaging

Background:

• Myopic normal-tension glaucoma (mNTG) poses a risk for visual field (VF) progression.
• Accurate prediction of VF progression is crucial for managing mNTG.
• Integrating structural and vascular parameters may improve predictive models.

Purpose of the Study:

• To develop a nomogram-based prediction tool for estimating VF progression in mNTG.
• To integrate key structural and vascular parameters into the predictive model.
• To identify independent predictors of VF progression in mNTG patients.

Main Methods:

• Retrospective cohort study of 150 eyes from 75 treatment-naïve mNTG patients.
• Evaluation of lamina cribrosa steepness index (LCSI) and choroidal microvascular dropout (cMvD) using OCT and OCTA.
• Development of a predictive nomogram using clustered logistic regression and bootstrap iterations.

Main Results:

• 38.7% of eyes exhibited VF progression over a minimum five-year follow-up.
• Steeper LCSI and presence of parapapillary cMvD were significant independent predictors of progression.
• The nomogram demonstrated high predictive accuracy (AUC 0.922, C-index ~0.92).

Conclusions:

• A nomogram integrating LCSI and cMvD can predict VF progression in mNTG.
• This tool facilitates individualized risk assessment and personalized treatment planning.
• Early identification of high-risk patients can optimize long-term visual outcomes.