July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Central Visual Field Loss Patterns in Glaucoma
Author Affiliations & Notes
  • Mengyu Wang
    Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Lucy Q Shen
    Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Louis R Pasquale
    Icahn School of Medicine at Mount Sinai, New York Eye and Eye Infirmary of Mount Sinai, New York, New York, United States
  • Michael V Boland
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Sarah R Wellik
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • C 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
  • Peter Bex
    Department of Psychology, Northeastern University, Boston, Massachusetts, United States
  • Osamah Saeedi
    Department of Ophthalmology and Visual Sciences, University of Maryland Medical Center, Baltimore, Maryland, United States
  • Neda Baniasadi
    Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Hui Wang
    Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
    Institute for Psychology and Behavior, Jilin University of Finance and Economics, Changchun, Jilin, China
  • Dian Li
    Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Jorryt Tichelaar
    Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Tobias Elze
    Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Mengyu Wang, Adaptive Sensory Technology (R); Lucy Shen, Topcon (C), Topcon (F); Louis Pasquale, Alcon (S), Bausch+Lomb (C), Eyenovia-Advisory (S), Verily Life Sciences (F); Michael Boland, Heidelberg (C); Sarah Wellik, None; C Gustavo De Moraes, None; Jonathan Myers, None; Peter Bex, United States PCT/US2014/052414 (P); Osamah Saeedi, None; Neda Baniasadi, Adaptive Sensory Technology (R); Hui Wang, None; Dian Li, Adaptive Sensory Technology (R); Jorryt Tichelaar, None; Tobias Elze, Adaptive Sensory Technology (R), United States PCT/US2014/052414 (P)
  • Footnotes
    Support  Lions Foundation; Grimshaw-Gudewicz Foundation; Research to Prevent Blindness; BrightFocus Foundation; Alice Adler Fellowship; NEI Core Grant P30EYE003790
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2855. doi:
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    • Get Citation

      Mengyu Wang, Lucy Q Shen, Louis R Pasquale, Michael V Boland, Sarah R Wellik, C Gustavo De Moraes, Jonathan S Myers, Peter Bex, Osamah Saeedi, Neda Baniasadi, Hui Wang, Dian Li, Jorryt Tichelaar, Tobias Elze; Central Visual Field Loss Patterns in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2855.

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

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Abstract

Purpose : To illustrate and quantify the central visual field (CVF) loss patterns in glaucoma.

Methods : Total deviation values from reliable 10-2 VFs from 5 academic glaucoma services in the US were used to determine the CVF loss patterns for eyes with all glaucoma severities using the most recent 10-2 VFs. Furthermore, the CVF loss patterns were identified for mild, moderate and severe glaucoma separately. The 10-2 VFs tested within 3 months of or before any 24-2 VF with mean deviation (MD) ≥ -6 dB were assigned to mild glaucoma, were assigned to severe glaucoma if tested within 3 months of or after any 24-2 VF with MD < -12 dB, and were assigned to moderate glaucoma if they were tested within 3 months of or between 24-2 VFs with -12 dB ≤ MD < -6 dB. The most recent 10-2 VFs of each eye were selected for each glaucoma stage. An unsupervised machine learning method of archetypal analysis was applied to determine the CVF loss patterns. Cross-validation was performed to determine the optimal number of patterns for archetypal analysis.

Results : 13,951, 3,529, 1,528 and 3,066 VFs were selected to determine the CVF patterns for eyes with all glaucoma severities, mild, moderate and severe glaucoma, respectively, for which 17, 11, 11 and 16 CVF loss patterns were identified. For eyes with all glaucoma severities (Fig. 1), the most common pattern is intact field (38.1%). There were 4, 4, and 5 CVF patterns related to superior loss, inferior loss and overall loss with island of vision, which accounted for 17.2%, 12.5% and 19.8% CVF loss, respectively. The total loss pattern accounted for 5.2% CVF loss. Notably, 4 of the 5 CVF loss patterns with island of vision preserved the less vulnerable zone proposed by Hood and co-workers. When comparing the 3 glaucoma severities, similar CVF defects include superonasal defects and temporal island patterns (Fig. 2a). Unique patterns include central defect (6.0%) and superior-peripheral loss (10.0%) for mild glaucoma, central-nasal loss (5.2%) for moderate glaucoma, and total loss (8.6%) and inferotemporal loss (4.1%) for severe glaucoma (Fig. 2b).

Conclusions : Various CVF loss patterns in glaucoma were illustrated and quantified for the first time. Some CVF defects were present in eyes with all severities, while some were specific to particular glaucoma severities. Our quantified CVF loss patterns are promising to advance understanding of CVF loss in glaucoma.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

 

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