Detecting glaucomatous progression with infrequent visual field testing

Anderson, Andrew J.; Asokan, Rashima; Murata, Hiroshi; Asaoka, Ryo

doi:10.1111/opo.12439

Cited by 7 publications

(6 citation statements)

References 21 publications

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“… 7 The next issue is whether the benefits of frontloading may be further enhanced by shortening the follow-up interval, such as was suggested by Wu et al 21 The most notable benefit of shortening the follow-up interval from 2 years to 6 months was the much less severe mean deviation loss measured at the case detection visit, similar to the results found by Anderson and colleagues. 32 Thus, clinicians should be cognizant of the expected mean deviation result at the end of the follow-up interval they use.…”

Section: Discussionmentioning

confidence: 99%

The Frontloading Fields Study (FFS): Detecting Changes in Mean Deviation in Glaucoma Using Multiple Visual Field Tests Per Clinical Visit

Phu

Kalloniatis

2021

Trans. Vis. Sci. Tech.

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Purpose To determine the impact of different numbers of visual field tests per visit for detecting mean deviation changes over time in patients with early glaucoma or suspected glaucoma and to identify a practical approach to maximize change detection. Methods Intrasession ( n = 322) and intersession ( n = 323) visual field results for patients with glaucoma or suspected glaucoma were used to model mean deviation change in 10,000 progressing and 10,000 non-progressing computer-simulated patients over time. Variables assessed in the model included follow-up intervals (0.5, 1, or 2 years), reliability rates (70%, 85%, or 100%) and number of visual field tests performed at each visit (one to four). Results Two visual field tests per session compared with one provided higher case detection rates at 2 years (99%–99.8% vs. 34.7%–76.3%, respectively), reduced time to detection (three or four visits vs. six to 10, respectively), and more positive mean deviation score (−4 dB vs. −10 dB, respectively) at the point of mean deviation change identification, especially in the context of unreliable results. Performing two tests per visit offered similar advantages compared with more tests. False positive change detection rates (<2.5%), were similar across all conditions. Patients followed up 6 monthly had less severe mean deviation loss at follow-up compared to 1-year and 2-year follow-up intervals. Conclusions Performing two tests per clinical visit at 6 months is practical using SITA-Faster and provides higher detection rates of mean deviation change in comparison with only one test performed per visit and more spaced-out intervals. Translational Relevance This model provides guidance for selecting the number of tests per visit to detect mean deviation change.

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Section: Discussionmentioning

confidence: 99%

The Frontloading Fields Study (FFS): Detecting Changes in Mean Deviation in Glaucoma Using Multiple Visual Field Tests Per Clinical Visit

Phu

Kalloniatis

2021

Trans. Vis. Sci. Tech.

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“…How many perimetric tests should be administered to the patient per year? Using a simulation method, Anderson and colleagues [39] showed that the predictive values of annual visual fields at 2 years were slightly worse than those obtained using six visual fields. In other words, reduced test frequency (one per year) does not substantially alter the prediction of progression computed with a higher (namely six) numbers of examinations at 2 years.…”

Section: The Question Now Is: What Promotes the Functional Loss Progression In Glaucoma?mentioning

confidence: 99%

Detection of Visual Field Loss Progression in Glaucoma: An Overview and Food for Thought

Aleci

2020

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The damage to the visual field is the main outcome of glaucoma. Basically, there are two different approaches to establish the rate of the functional loss in this clinical condition: event-based analysis and trend-based analysis. The event-based analysis, that relies on the occurrence of pre-established events to detect the progression of the visual field damage, cannot quantify the decay rate of sensitivity. In turn, the trend-based analysis, that aims to measure the rate of progression according to linear regression models, requires a long follow-up. Despite considerable effort, there is still no consensus on the optimal procedure, and a gold standard is still missing. This paper provides a quick overview of the topic as a tribute to the researchers engaged in this field.

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“…A study found the time to detect rapid progression (defined as mean deviation change of 2 dB/year) was 1.7 years with triannual testing versus 5 years with annual testing [18]. Compared with triannual testing in the first 2 years, annual testing in the first 2 years was associated with delayed detection of visual field progression, though the positive-predictive and negative-predictive values of individual fields were unaffected [19]. Frontloading visual fields (two visual fields per visit, per 6 months) has been proposed as an approach to overcome challenges associated with obtaining multiple sets of perimetry data; compared with annual testing, frontloading achieved earlier detection and reduced mean deviation change prior to detecting visual field progression [20 ▪ ,21 ▪ ].…”

Section: Repeat Testingmentioning

confidence: 99%

Assessment of visual field progression in glaucoma

Chen

Gedde

2022

Current Opinion in Ophthalmology

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Purpose of reviewPerimetry plays an important role in the diagnosis and management of glaucoma. This article discusses the assessment of visual field progression in patients with glaucoma.Recent findingsSelecting the best visual field test strategy and establishing a baseline of visual fields will assist clinicians in the detection of glaucomatous progression. Repeat testing serves to confirm or refute changes on visual field testing. More frequent testing after initial diagnosis is recommended to establish a baseline and to identify patients with rapid progression who may need more aggressive management. Statistically significant changes on event analysis can prompt examination of a patient's trend analysis to determine whether clinically significant deterioration may be occurring. Future applications of machine learning can complement existing methods of visual field interpretation.SummaryMany treated patients with glaucoma will experience visual field progression. Optimal utilization of visual field testing strategy and analytical software can help clinicians identify patients with glaucomatous progression likely to cause functional visual disability.

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Detecting glaucomatous progression with infrequent visual field testing

Abstract: Infrequent visual field testing does not dramatically alter predictive values at 2 years, but does substantially delay when significant progression may first be detected.

Cited by 7 publications

References 21 publications

The Frontloading Fields Study (FFS): Detecting Changes in Mean Deviation in Glaucoma Using Multiple Visual Field Tests Per Clinical Visit

The Frontloading Fields Study (FFS): Detecting Changes in Mean Deviation in Glaucoma Using Multiple Visual Field Tests Per Clinical Visit

Detection of Visual Field Loss Progression in Glaucoma: An Overview and Food for Thought

Assessment of visual field progression in glaucoma

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