Models of Glaucomatous Visual Field Loss

Chen, Andrew; Nouri‐Mahdavi, Kouros; Otárola, Francisco Jiménez; Yu, Fei; Afifi, Abdelmonem A.; Caprioli, Joseph

doi:10.1167/iovs.14-15435

Cited by 38 publications

(38 citation statements)

References 16 publications

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“…Chen et al compared the ability of pointwise linear, exponential, and logistic functions, and combinations of functions, to model the longitudinal behavior of visual field series and predict future visual field loss in patients with glaucoma. They found that while the logistic model best fit glaucomatous visual field behavior over a long time period, the exponential model provided the best average predictions (Chen et al, 2014). Azarbod et al investigated a pointwise exponential regression model to calculate average rates of faster and slower deteriorating visual field components, as well the entire visual field.…”

Section: Nature Of Glaucomatous Visual Field Progressionmentioning

confidence: 99%

Detection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma

Moraes

Liebmann

Levin

2017

Progress in Retinal and Eye Research

149

123

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Glaucomatous visual field progression has both personal and societal costs and therefore has a serious impact on quality of life. At the present time, intraocular pressure (IOP) is considered to be the most important modifiable risk factor for glaucoma onset and progression. Reduction of IOP has been repeatedly demonstrated to be an effective intervention across the spectrum of glaucoma, regardless of subtype or disease stage. In the setting of approval of IOP-lowering therapies, it is expected that effects on IOP will translate into benefits in long-term patient-reported outcomes. Nonetheless, the effect of these medications on IOP and their associated risks can be consistently and objectively measured. This helps to explain why regulatory approval of new therapies in glaucoma has historically used IOP as the outcome variable. Although all approved treatments for glaucoma involve IOP reduction, patients frequently continue to progress despite treatment. It would therefore be beneficial to develop treatments that preserve visual function through mechanisms other than lowering IOP. The United States Food and Drug Administration (FDA) has stated that they will accept a clinically meaningful definition of visual field progression using Glaucoma Change Probability criteria. Nonetheless, these criteria do not take into account the time (and hence, the speed) needed to reach significant change. In this paper we provide an analysis based on the existing literature to support the hypothesis that decreasing the rate of visual field progression by 30% in a trial lasting 12–18 months is clinically meaningful. We demonstrate that a 30% decrease in rate of visual field progression can be reliably projected to have a significant effect on health-related quality of life, as defined by validated instruments designed to measure that endpoint.

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Section: Nature Of Glaucomatous Visual Field Progressionmentioning

confidence: 99%

Detection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma

Moraes

Liebmann

Levin

2017

Progress in Retinal and Eye Research

149

123

View full text Add to dashboard Cite

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“…Simple linear regression estimates may result in predictions of negative values that are incompatible with the measurements, as well as predictions of improving sensitivities that are not universally accepted to occur after a learning period (Gardiner et al, 2008;Musch et al, 2014). Censoring the estimates of pointwise analysis by not allowing negative sensitivity values or improving sensitivities may greatly improve predictions (Chen et al, 2014).…”

Section: Pointwise Trend Analysismentioning

confidence: 99%

“…Several regression models have been explored to perform trend-based analysis, including simple linear regression, censored linear regression, exponential, robust, quadratic, and logistic (Bryan et al, 2013;Caprioli et al, 2011;Chen et al, 2014;Pathak et al, 2013). An exponential model could better describe the loss of visual field sensitivity over a longer period of time, but a linear model may be appropriate for shorter periods of a few years .…”

Section: Pointwise Trend Analysismentioning

confidence: 99%

How to detect progression in glaucoma

Vianna

Chauhan

2015

Progress in Brain Research

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“…Furthermore, the method appears not to be significantly affected by the level of IOP or progression rate. However, despite a significant reduction in prediction error, the magnitude of this improvement is small relative to previous novel regression models that use only VF data345678910. One of the possible reasons for such a small improvement is that IOP fluctuates in the short and long term21 and measuring IOP at the clinic in approximately three month intervals is too infrequent to observe the true trend in IOP.…”

Section: Discussionmentioning

confidence: 92%

“…We have reported several alternative approaches to improve the prediction accuracy of VF progression, such as robust regression3, least absolute shrinkage and selection operator (Lasso) regression4, cluster-wise regression56, and also variational Bayesian linear regression7. In addition, many other successful efforts have been reported from other researchers891011121314, nonetheless ordinary OLSLR is still very frequently used at the clinical setting. One thing that all these approaches have in common is that VF progression is predicted using only VF measurements; however, other parameters are routinely captured in the clinic which may be useful to supplement any model of VF progression.…”

mentioning

confidence: 99%

A novel method to predict visual field progression more accurately, using intraocular pressure measurements in glaucoma patients

Asaoka¹,

Fujino²,

Murata³

et al. 2016

Sci Rep

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Visual field (VF) data were retrospectively obtained from 491 eyes in 317 patients with open angle glaucoma who had undergone ten VF tests (Humphrey Field Analyzer, 24-2, SITA standard). First, mean of total deviation values (mTD) in the tenth VF was predicted using standard linear regression of the first five VFs (VF1-5) through to using all nine preceding VFs (VF1-9). Then an ‘intraocular pressure (IOP)-integrated VF trend analysis’ was carried out by simply using time multiplied by IOP as the independent term in the linear regression model. Prediction errors (absolute prediction error or root mean squared error: RMSE) for predicting mTD and also point wise TD values of the tenth VF were obtained from both approaches. The mTD absolute prediction errors associated with the IOP-integrated VF trend analysis were significantly smaller than those from the standard trend analysis when VF1-6 through to VF1-8 were used (p < 0.05). The point wise RMSEs from the IOP-integrated trend analysis were significantly smaller than those from the standard trend analysis when VF1-5 through to VF1-9 were used (p < 0.05). This was especially the case when IOP was measured more frequently. Thus a significantly more accurate prediction of VF progression is possible using a simple trend analysis that incorporates IOP measurements.

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Models of Glaucomatous Visual Field Loss

Cited by 38 publications

References 16 publications

Detection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma

Detection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma

How to detect progression in glaucoma

A novel method to predict visual field progression more accurately, using intraocular pressure measurements in glaucoma patients

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