June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Sensitivity improvement in detecting visual field progression by modeling Global Visit Effects
Author Affiliations & Notes
  • Susan R Bryan
    Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
    Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
  • Paul Eilers
    Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
  • Emmanuel M.E.H. Lesaffre
    Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
    L-Biostat, KU Leuven, Leuven, Belgium
  • Hans G Lemij
    Glaucoma Service, Rotterdam Eye Hospital, Rotterdam, Netherlands
  • Koenraad Arndt Vermeer
    Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
  • Footnotes
    Commercial Relationships Susan Bryan, None; Paul Eilers, Carl Zeiss Meditec (C); Emmanuel Lesaffre, None; Hans Lemij, Carl Zeiss Meditec (C); Koenraad Vermeer, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3182. doi:
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      Susan R Bryan, Paul Eilers, Emmanuel M.E.H. Lesaffre, Hans G Lemij, Koenraad Arndt Vermeer, Rotterdam Ophthalmic Institute; Sensitivity improvement in detecting visual field progression by modeling Global Visit Effects. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3182.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Previously, we proposed to model the spatially correlated errors which affect all locations from the same VF as Global Visit Effects (GVE) (Bryan et al., ARVO Abstract 3007, 2014). The model including the GVE provides a more robust estimate of the rate of progression than the conventional model, which does not contain the GVE. To evaluate the GVE for detecting VF progression, we determined the increase in sensitivity for the GVE model compared to the conventional model.

 
Methods
 

Series of 6 VFs (24-2 Full Threshold) of 30 eyes of 15 normal individuals from an ongoing study at the Rotterdam Eye Hospital were included in the healthy group. The VFs of each healthy individual were randomly resampled with replacement to obtain a total of 100 eyes from 50 individuals. Series of 15 VFs of 250 eyes of 125 individuals with primary glaucoma were included in the glaucoma group (data available at http://rod-rep.com).<br /> <br /> Limits of stability for a certain specificity were determined from the estimated sensitivity loss per year for each VF location in the healthy group. In the glaucoma group, sensitivity loss was computed from 6 VFs for each VF location. Locations were then classified as progressing based on the limits obtained from the healthy group (see Figure 1). Because no ground truth was available, the true sensitivity loss was estimated from the full series of 15 VFs for each location. The criterion for progression was then defined by using a varying aging effect factor multiplied by the average sensitivity loss for the glaucoma group.

 
Results
 

For a specificity of 95% and an aging effect factor of 3, the sensitivity to detect progression in a series of 6 VFs increased from 47% to 62% by including the GVE. The sensitivity of the GVE model was approximately 15% higher than the conventional model for the tested specificities and aging effect factors (see Figure 2).

 
Conclusions
 

By including the GVE, we were able to improve the sensitivity to detect VF progression. The GVE takes into account a large part of the variability, produces more robust slope estimations and hence is able to correctly detect more locations as progressing.  

 
Figure 1: An example showing the distribution of the slopes for healthy and glaucomatous for the conventional and GVE model using 6 VFs for an aging effect factor of 3.
 
Figure 1: An example showing the distribution of the slopes for healthy and glaucomatous for the conventional and GVE model using 6 VFs for an aging effect factor of 3.
 
 
Figure 2: Sensitivities of the conventional and GVE models over different specificity levels and aging effect factors.
 
Figure 2: Sensitivities of the conventional and GVE models over different specificity levels and aging effect factors.

 
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