An Evaluation of a New 24-2 Metric for Detecting Early Central Glaucomatous Damage

Hood, Donald C.; Thenappan, Abinaya; Tsamis, Emmanouil; Liebmann, Jeffrey M.; Moraes, Carlos Gustavo De

doi:10.1016/j.ajo.2020.07.045

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…Because 3 of the 5 study parameters directly correspond to central function or structure (abnormal central points on the 24-2 VF test, PPAA, and macular GCL thickness), most combinations of 3 items will include both structural and functional central abnormalities that may help explain the strength of this indicator. 39 This result may also correspond with a recent report by Hood et al 40 in which a combined structure/function parameter was found to have improved sensitivity for detecting central damage versus using a functional parameter in isolation.…”

Section: Discussionsupporting

confidence: 87%

Prediction of 10-2 Visual Field Loss Using Optical Coherence Tomography and 24-2 Visual Field Data

Sullivan-Mee

Hedayat

Charry

et al. 2021

Journal of Glaucoma

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Precis: Using standard glaucoma structural and functional tests, clinicians accurately predicted the presence/absence of 10-2 glaucomatous visual field (VF) loss in 90% of the eyes in this study.Purpose: To investigate how well clinicians with variable experience can predict the presence and location of 10-2 VF loss using structural and functional data that are routinely obtained for glaucoma assessment.Methods: Within a test set of 416 eyes (210 subjects) who were diagnosed glaucoma suspect or primary open-angle glaucoma (with most eyes having mild disease), 6 clinicians were asked to predict the presence and hemispheric location of 10-2 VF loss using 24-2 VF and spectral-domain optical coherence tomography structural data. Prediction accuracies were calculated for each clinician and compared using the weighted κ-statistic. Receiver operating characteristic analyses were used to evaluate models for predicting 10-2 VF loss.Results: Among the 6 clinicians, mean (range) accuracy, false negatives, and false positives for predicting presence/absence of 10-2 VF loss were 90% (87% to 92%), 4.7% (2.4% to 7.0%), and 5.4% (1.7% to 7.5%) respectively. The mean (range) weighted κ-statistic was 0.75 (0.64 to 0.83), suggesting good or very good inter-rater agreement between examiners. Mean accuracy for correctly predicting hemispheric location was 73% (range, 65% to 82%) with the most common error occurring in eyes with both superior and inferior 10-2 VF defects in which one hemisphere was correctly identified but the other missed.Conclusions: In this study, the presence/absence of 10-2 glaucomatous VF loss was highly predictable using standard functional and structural clinical metrics. These findings suggest that 10-2 VF testing is not needed to reliably recognize and confirm central VF involvement in most eyes with glaucoma. Whether error related to identifying second hemisphere involvement in 10-2 VF loss is important requires further study.

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Section: Discussionsupporting

confidence: 87%

Prediction of 10-2 Visual Field Loss Using Optical Coherence Tomography and 24-2 Visual Field Data

Sullivan-Mee

Hedayat

Charry

et al. 2021

Journal of Glaucoma

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“…For example, one VF metric that was not reported here is a PSD measure of the 12 most-central points of the 24-2 (C24-2), proposed by Wu et al 46 In fact, we have previously shown that the C24-2 metric, like the PSD 10 metric, will miss eyes with central glaucomatous damage, clearly identified in the total and pattern deviation maps. 47 Another example, and for an OCT metric, previous studies have shown that the ganglion cell complex has better repeatability as compared with other macular summary metrics and greater discriminability for both the detection and progression of glaucomatous damage, especially in cases with moderate to advanced glaucoma. 48 – 51 Ganglion cell complex summary metrics were not calculated in this study because they were not readily available.…”

Section: Discussionmentioning

confidence: 99%

Detection of Early Glaucomatous Damage: Performance of Summary Statistics From Optical Coherence Tomography and Perimetry

Tsamis

Bruna

Leshno

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose To evaluate the diagnostic performance of optical coherence tomography (OCT) and visual field (VF) summary statistics (metrics) that are available in OCT and VF reports. Methods OCT disc and macular scans and 24-2 and 10-2 VFs were obtained from 56 healthy control (HC) eyes/participants and 61 eyes/patients with 24-2 mean deviation of better than –6 dB. All metrics were obtained from OCT radial, circle, and posterior pole cube scans and 24-2 and 10-2 VFs. Their diagnostic performances were evaluated, in isolation and in combinations. For specificity, the 56 HC eyes were used. For sensitivity, 40 of the 61 patient eyes were deemed likely glaucomatous based on an automated topographic method that evaluates structure–function (S–F) agreement. Any 1 of these 40 eyes not judged as abnormal by any given metric was considered a false negative. Results All single OCT and VF metrics misclassified HCs as glaucomatous and missed likely glaucomatous eyes. The best performing single metric was the temporal inferior thickness of the 3.5-mm circle scan, with 96% specificity and 83% sensitivity. Combinations of OCT–OCT and OCT–VF metrics markedly improved specificity. A newly proposed metric that evaluates structure–structure (S–S) agreement at a hemifield level had the highest accuracy. This S–S metric had 98% specificity and 80% sensitivity. Conclusions OCT and VF metrics, single or in combinations, have only moderate sensitivity for eyes with early glaucoma. Translational Relevance OCT and VF metrics combinations evaluating S–S or S–F agreement can be highly specific, which is an important implication for clinical and research purposes.

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“…For visual field parameters, Visual Field Index, mean deviation (MD) and pattern standard deviation (PSD), fixation losses and false positive rates were extracted. We also reported the number of test locations within the central 10° of the 24‐2 (described as the C24‐2 by previous studies) which exhibited a defective on pattern deviation map at p < 0.05 or lower, as per the methods reported by previous studies 29–31 . This was performed in the absence of 10‐2 data to identify patients with a presentation of glaucoma which is potentially central‐affecting compared with peripheral‐affecting (a reported feature distinguishing high‐ and low‐tension glaucoma).…”

Section: Methodsmentioning

confidence: 99%

“…We also reported the number of test locations within the central 10° of the 24-2 (described as the C24-2 by previous studies) which exhibited a defective on pattern deviation map at p < 0.05 or lower, as per the methods reported by previous studies. [29][30][31] This was performed in the absence of 10-2 data to identify patients with a presentation of glaucoma which is potentially centralaffecting compared with peripheral-affecting (a reported feature distinguishing high-and low-tension glaucoma). These test locations corresponded to Cartesian coordinates for right eye orientation in the supero-temporal quadrant of (3, 3), (3,9), (9,3) and their respective mirror locations in the respective quadrants of the 24-2 test grid (see Figure 2a).…”

Section: Data Extractionmentioning

confidence: 99%

Visualising structural and functional characteristics distinguishing between newly diagnosed high‐tension and low‐tension glaucoma patients

Rafla

Khuu

Kashyap

et al. 2023

Ophthalmic Physiologic Optic

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Purpose To determine whether there are quantifiable structural or functional differences that can distinguish between high‐tension glaucoma (HTG; intraocular pressure [IOP] > 21 mm Hg) and low‐tension glaucoma (LTG; IOP ≤ 21 mm Hg) at diagnosis. Method This was a retrospective, cross‐sectional study. Clinical results of one eye from 90 newly diagnosed HTG and 319 newly diagnosed LTG patients (117 with very‐low‐tension glaucoma [vLTG; ≤15 mm Hg] and 202 with middling LTG [mLTG; >15 mm Hg, ≤21 mm Hg]) were extracted, which included relevant demographic covariates of glaucoma, quantitative optical coherence tomography (including the optic nerve head, retinal nerve fibre layer and ganglion cell‐inner plexiform layer) measurements and standard automated perimetry global metrics. We used binary logistic regression analysis to identify statistically significant clinical parameters distinguishing between phenotypic groups for inclusion in principal component (PC) (factor) analysis (PCA). The separability between each centroid for each cohort was calculated using the Euclidean distance (d(x,y)). Results The binary logistic regression comparing HTG and all LTG identified eight statistically significant clinical parameters. Subsequent PCA results included three PCs with an eigenvalue >1. PCs 1 and 2 accounted for 21.2% and 20.2% of the model, respectively, with a d(x,y) = 0.468, indicating low separability between HTG and LTG. The analysis comparing vLTG, mLTG and HTG identified 15 significant clinical parameters, which were subsequently grouped into five PCs. PCs 1 and 2 accounted for 24.1% and 17.8%, respectively. The largest separation was observed between vLTG and HTG (d(x,y) = 0.581), followed by vLTG and mLTG (d(x,y) = 0.435) and lastly mLTG and HTG (d(x,y) = 0.210). Conclusion Conventional quantitative structural or functional parameters could not distinguish between pressure‐defined glaucoma phenotypes at the point of diagnosis and are therefore not contributory to separating cohorts. The overlap in findings highlights the heterogeneity of the primary open‐angle glaucoma clinical presentations among pressure‐defined groups at the cohort level.

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An Evaluation of a New 24-2 Metric for Detecting Early Central Glaucomatous Damage

Cited by 14 publications

References 24 publications

Prediction of 10-2 Visual Field Loss Using Optical Coherence Tomography and 24-2 Visual Field Data

Prediction of 10-2 Visual Field Loss Using Optical Coherence Tomography and 24-2 Visual Field Data

Detection of Early Glaucomatous Damage: Performance of Summary Statistics From Optical Coherence Tomography and Perimetry

Visualising structural and functional characteristics distinguishing between newly diagnosed high‐tension and low‐tension glaucoma patients

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