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Determining progressive visual field loss in serial Humphrey visual fields
M K Birch1, P K Wishart, N P O'Donnell
1St. Paul's Eye Unit, Royal Liverpool University Hospital, United Kingdom.
Ophthalmology
|August 1, 1995
Summary
Three algorithms for detecting glaucoma progression showed high variability and poor correlation with clinical outcomes. These tools for analyzing Humphrey visual fields require careful interpretation due to inconsistent results.
Area of Science:
- Ophthalmology
- Clinical Data Analysis
Background:
- Glaucoma is a progressive optic neuropathy characterized by visual field loss.
- Accurate detection of glaucomatous field loss progression is crucial for timely treatment adjustments.
Purpose of the Study:
- To evaluate the performance of three commercially available computerized statistical algorithms in determining glaucomatous visual field progression.
- To compare the results of these algorithms against a retrospective clinical outcome assessment.
Main Methods:
- Linear regression analysis was applied to serial Humphrey visual fields from 102 eyes (ocular hypertensive and glaucomatous).
- The algorithms analyzed included Statpac, glaucoma change probability, and Progressor Programme.
- Results were compared to a retrospectively determined clinical outcome.
Main Results:
- The algorithms identified progression in 11 (Statpac), 23 (glaucoma change probability), and 27 (Progressor Programme) field series.
- Clinical outcome identified significantly less progression (7 eyes) compared to all algorithms.
- A wide variation in results was observed among the algorithms, with Progressor Programme predominantly detecting progression in glaucoma cases.
Conclusions:
- Significant variability exists among the three evaluated algorithms for detecting visual field progression in glaucoma.
- None of the algorithms demonstrated strong correlation with clinical judgment of progression.