Expert Evaluation of Visual Field Change in Glaucoma Correlates Better With the Measured Fast Component of Visual Field Loss

Abstract

 

Purpose

 

This study was conducted to compare the assessment of decay in serial visual fields(VF) based on subjective expert evaluation and rates of fast and slow components determined by pointwise exponential regression.

 

Methods

 

Five thousand one hundred eighty seven Humphrey visual field exams from 378 patients with primary open angle glaucoma were evaluated by a glaucoma subspecialist for determination of progression. Serial of VFs were evaluated by an expert for changes using score of 1 (most likely progression) to 5 (least likely) for change and 1 (no change) to 6 (very fast) for rate of changes . Pointwise exponential regression (PER) was used to measure the fast and slow components of VF deterioration.The qualitative and quantitative methods were then compared.

 

Results

 

The correlation coefficient (r) between the fast component and expert evaluation was -0.268 (p<0.0001) and for the slow component -0.156 (p=0.002). Figure 1 shows the relationship between the calculated rate of decay and the score of likelihood of progression for the fast and slow components. Figure 2 shows the relationship between the calculated rate of decay and scored rate of decay based on expert evaluation.

 

Conclusions

 

Expert qualitative evaluation of VF series for change and rates of changes correlate more closely with the fast component of VF decay than the slow component of VF decay.

 

 

Figure 1

 

 

Figure 2

 

Keywords: 758 visual fields • 463 clinical (human) or epidemiologic studies: prevalence/incidence