June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Predicting False-Positive Glaucoma Hemifield Test Results by Representative Glaucomatous Visual Field Patterns
Author Affiliations & Notes
  • Mengyu Wang
    Schepens Eye Research Institute, Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Louis R Pasquale
    Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Lucy Q Shen
    Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Michael V Boland
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Sarah R Wellik
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Carlos Gustavo De Moraes
    Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Jonathan S Myers
    Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Hui Wang
    Schepens Eye Research Institute, Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
    Institute for Psychology and Behavior, Jilin University of Finance and Economics, Changchun, Jilin, China
  • Neda Baniasadi
    Schepens Eye Research Institute, Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
    Department of Biomedical Engineering and Biotechnology, University of Massachusetts Lowell, Lowell, Massachusetts, United States
  • Peter J Bex
    Department of Psychology, Northeastern University, Boston, Massachusetts, United States
  • Tobias Elze
    Schepens Eye Research Institute, Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Mengyu Wang, None; Louis Pasquale, None; Lucy Shen, None; Michael Boland, Alcon (F); Sarah Wellik, None; Carlos De Moraes, None; Jonathan Myers, Haag Streit (F); Hui Wang, None; Neda Baniasadi, None; Peter Bex, United States PCT/US2014/052414 (P); Tobias Elze, United States PCT/US2014/052414 (P)
  • Footnotes
    Support  Lions Foundation Grant 2015; Grimshaw-Gudewicz Foundation 2016; Harvard Glaucoma Center of Excellence; Eleanor and Miles Shore Fellowship; China Scholarship Council NO.201408220092
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2849. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Mengyu Wang, Louis R Pasquale, Lucy Q Shen, Michael V Boland, Sarah R Wellik, Carlos Gustavo De Moraes, Jonathan S Myers, Hui Wang, Neda Baniasadi, Peter J Bex, Tobias Elze; Predicting False-Positive Glaucoma Hemifield Test Results by Representative Glaucomatous Visual Field Patterns. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2849.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : Glaucoma Hemifield Test (GHT) is an important functional measure for glaucoma diagnosis. Assuming that glaucomatous visual field (VF) loss is irreversible, a reversal from 2 consecutive GHT outside normal limits (ONL) to within normal limits (WNL) is considered a false-positive result. In this retrospective cohort study, we investigate the relationships between such GHT reversals and the VF loss patterns of the baseline in early-stage glaucoma patients.

Methods : From 5 large glaucoma practices, eyes with reliable baseline and two annual follow-up Humphrey VFs (fixation loss≤33%, false negative/positive rates≤20%, SITA Standard 24-2), baseline mean deviation (MD) ≥-3dB and GHT ONL for the first 2 VFs were selected. For each baseline VF, the pattern coefficients are calculated for the 11 glaucomatous VF loss archetypes (ATs) and the normal AT, chosen from all 17 VF ATs identified by [1] (see Fig. 1; AT indices according to [1]). Logistic regression was applied to model the relationship between AT coefficients, MD, pattern standard deviation (PSD), and false-positive GHT. Stepwise regression was performed to select the best predictive model for false-positive GHT. 10 times repeated 10-fold cross validation was applied to evaluate the predictive model performance by the area under the receiver operating characteristic curve (AUC).

Results : 2,506 eyes were selected for data analysis. 12.1% of the GHTs reversed from 2 consecutive ONLs to WNL at follow-up. Fig. 2a shows the best predictive model (relevant parameters: 8 ATs, MD, and PSD): Higher values of MD and lower values of PSD and all ATs predict GHT false positives with an AUC of 0.717 (95% confidence interval: [0.715, 0.719]; Fig. 2b). A lower similarity to glaucomatous ATs as well as to the normal AT, reflected by negative coefficients, implies a higher probability of false positive GHTs.

Conclusions : 12.1% of eyes with baseline MD≥-3dB and two consecutive GHT ONL reverse to normality and may therefore be false-positives. Using a previously proposed computational VF decomposition method [1], we show that these false-positives can be statistically predicted by the lack of similarity to typical glaucomatous and typical normal VF patterns at baseline. Our model can be potentially used to recommend patients for VF retest.


[1] Elze et al., J. R. Soc. Interface 12:20141118, 2015

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×