July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Effects of fundus tracking on structure-function relationship in glaucoma
Author Affiliations & Notes
  • Giovanni Montesano
    Optometry and Visual Sciences, City, University London, London, United Kingdom
    Eye Clinic, University of Milan, Milan, Italy
  • Luca Mario Rossetti
    Eye Clinic, University of Milan, Milan, Italy
  • Paolo Fogagnolo
    Eye Clinic, University of Milan, Milan, Italy
  • Francesco Oddone
    Glaucoma unit, IRCCS GB Bietti Eye Foundation, Milan, Italy
  • Paolo Lanzetta
    Department of Ophthalmology, University of Udine, Udine, Italy
  • Andrea Perdicchi
    Azienda ospedaliera Sant'Andrea, Rome, Italy
  • Chris A Johnson
    Ophthal & Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • David F Garway-Heath
    NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
  • David P Crabb
    Optometry and Visual Sciences, City, University London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Giovanni Montesano, None; Luca Rossetti, CenterVue (C); Paolo Fogagnolo, CenterVue (C); Francesco Oddone, CenterVue (C); Paolo Lanzetta, CenterVue (C); Andrea Perdicchi, None; Chris Johnson, CenterVue (C); David Garway-Heath, ANSWERS (P), Moorfields MDT (P), T4 (P); David Crabb, Allergan (R), ANSWERS (P), CenterVue (C), Roche (F), Santen (R), T4 (P)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3922. doi:https://doi.org/
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    • Get Citation

      Giovanni Montesano, Luca Mario Rossetti, Paolo Fogagnolo, Francesco Oddone, Paolo Lanzetta, Andrea Perdicchi, Chris A Johnson, David F Garway-Heath, David P Crabb; Effects of fundus tracking on structure-function relationship in glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3922. doi: https://doi.org/.

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

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Abstract

Purpose : To investigate if fundus perimetry can improve the diagnostic precision of structure-function (SF) metrics in glaucoma.

Methods : We analysed data from 1009 eyes of 244 healthy subjects and 329 with glaucoma from the validation study of the Compass fundus perimeter (CMP, CenterVue). All subjects were tested with a 24-2 grid with CMP and with the Humphrey Field Analyzer (HFA, Zeiss Meditec) and underwent an OCT scan of the peripapillary Retinal Nerve Fibre Layer (RNFL). SF correlation was assessed between the mean deviation (MD) of six visual field clusters and the corresponding RNFL sector thickness using a multivariate mixed effect model.
For discrimination analysis, we used global MD, average RNFL thickness and a combined SF Index (SFI) obtained as the predicted logit from a logistic regression with the average RNFL thickness and the MD as predictors and the binary classification (Healthy/Glaucoma) as the response. A fixed effect accounted for systematic differences between the two SD-OCT devices used in different centres, the Spectralis (Heidelberg Engineering) and the RTVue XR Avanti (Optovue). We balanced the Healthy:Glaucoma proportions to be 1:1 with each OCT device by random constrained sampling, leaving a total of 786 eyes. We calculated partial Receiver Operating Characteristic (pROC) curves (minimum specificity at 75%, Figure 2) and Areas Under the Curve (pAUCs). Confidence intervals (CIs) and p-values were computed via paired bootstrap.

Results : The R2 of the SF model was the same (0.47) for HFA and for CMP (Figure 1). The pAUC was greater with MD from CMP than HFA (p < 0.001). There was no statistically significant difference between the CMP SFI and the HFA SFI (p = 0.075). The pAUC was significantly higher with both the CMP SFI (p = 0.002) and HFA SFI (p = 0.017) compared to the RNFL alone and MD alone (p < 0.001).

Conclusions : Metrics from CMP and HFA have similar SF relationship. Functional data from perimetry can be integrated with structural information to significantly increase discrimination ability of structure and function alone. No evidence could be found that fixation stabilization significantly increased diagnostic precision.

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

 

Figure 1. SF relationship with the CMP (left) and the HFA (right)

Figure 1. SF relationship with the CMP (left) and the HFA (right)

 

Figure 2. pROC curves and relative CIs. HFA Glaucoma Hemifield Test (GHT) is reported for reference

Figure 2. pROC curves and relative CIs. HFA Glaucoma Hemifield Test (GHT) is reported for reference

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