Binocular Visual Field Loss Patterns in Glaucoma and Their Associations with Demographic Groups

Abstract

Purpose : To quantify the binocular visual field (VF) loss patterns with archetypal (AT) analysis and their associations with different demographic groups.

Methods : Two datasets were used in this study: (1) the Glaucoma Research Network (GRN) dataset excluding the Massachusetts Eye and Ear (MEE)partition for the archetypal model training, and (2) the MEE dataset for demographic correlation analysis. The whole study was restricted to the most recent VF measurements from each subject and binocular VFs were constructed by the integrated visual field method, which was taking the higher sensitivity at each test location. We first applied archetypal analysisto cluster 24-2 binocular VFs into archetypal patterns. The total number of patterns was determined by the Bayes factor. Pearson's correlations analyzed the associations between binocular VF patterns and demographic groups adjusted for age effects, and the coefficients were set to 0 if p-values corrected by multiple comparisons ≥ 0.05.

Results : 77,270 glaucoma patients with last-visit binocular VFs in GRN were used to train the archetypal model. It contains 17 parent patterns with 35,700 VFs as the largest group (Group 1) and 113 VFs as the smallest group (Group 15). Figure 1 shows all 17 binocular VF loss patterns including 3 pairs of real patient VFs of each binocular archetypal pattern. 45,254 MEE patients were used for demographic character analysis. Older age (Figure 2) was particularly associated with binocular patterns of superior altitudinal loss (AT 14; R: 0.1), inferior altitudinal loss (AT 13; R: 0.13), peripheral loss (AT 5; R: 0.12), unilateral diffused loss (ATs 4 and 7; Rs: 0.13 and 0.11), and superior paracentral loss (AT 17; R: 0.09). Compared with Whites and Asians, Blacks were more likely to have binocular patterns of total loss (AT 12; Rs: 0.1 and 0.08) and peripheral loss (AT 5; Rs: 0.07 and 0.08). Blacks were also more likely to have a superior altitudinal loss (AT 14; R: 0.06) than Whites. P values were significant for all mentioned correlations.

Conclusions : Blacks are more likely to have binocular patterns of total loss and peripheral loss compared with Whites and Asians. The quantifications of binocular VF loss patterns by archetypal analysis may help better understand glaucoma’s impact on patients’ quality of life.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Figure 1

 

Figure 2