Refinement of Pointwise Linear Regression Criteria for Determining Glaucoma Progression

Kummet, Colleen; Zamba, K. D.; Doyle, Carrie K.; Johnson, Chris A.; Wall, Michael

doi:10.1167/iovs.13-11680

Cited by 24 publications

(22 citation statements)

References 33 publications

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“…I also examine how this prediction is influenced by checking for progression each time a visual field is added to a series, as might happen clinically. Finally, I examine whether criteria based not simply on the presence of significant progression but also on the magnitude of the estimated rate of progression, as commonly employed in pointwise linear regression analyses, 9 might improve the PPV for detecting rapid visual field loss in glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Significant Glaucomatous Visual Field Progression in the First Two Years: What Does It Mean?

Anderson

2016

Trans. Vis. Sci. Tech.

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PurposeIt has been recommended that multiple visual field examinations be performed in the first 2 years after glaucoma diagnosis so that rapid visual field progression (≤−2 dB/year, using ordinary least squares regression over time of the summary index mean deviation [MD]) can be detected. Here I investigate how predictive a statistically significant regression slope is of truly rapid visual field progression.MethodsI simulated visual field series (N = 100,000) spaced at 4 monthly intervals for the first 2 years. MD values had a standard deviation of 1 dB. The true underlying rates of progression were selected from a modified hyperbolic secant with parameters averaged from fits to large data sets from Canada, Sweden, and the United States.ResultsThe positive predictive value (PPV) for rapid progression was 0.47 after 2 years, whereas the negative predictive value (NPV) was > 0.99. When using the criterion that a significant regression also had to have a slope of ≤ −2 dB/year, the PPV for rapid progression reduced substantially to 0.18 but the NPV was essentially unchanged (NPV >0.99).ConclusionAlthough performing multiple visual fields in the first 2 years provides appropriate power to detect rapid progression, a significant regression slope in the first 2 years is not highly predictive of rapid progression, particularly so if slopes ≤ −2 dB/year are considered only.Translational RelevanceStatistically significant visual field progression in a short period after diagnosis may not necessarily indicate the presence of rapid progression, and so confirmatory signs of rapid progression should be sought before implementing treatment changes.

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Section: Introductionmentioning

confidence: 99%

Significant Glaucomatous Visual Field Progression in the First Two Years: What Does It Mean?

Anderson

2016

Trans. Vis. Sci. Tech.

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“…However, several other criteria have been proposed not only with different rates or p value cutoffs but also with the minimum number of flagged points, their location (clustered or nonclustered; De Moraes et al, 2012), or the requirement of repeatable findings in a consecutive number of exams (Gardiner and Crabb, 2002). More strict criteria present less false positives, but identify less-progressing patients (Kummet et al, 2013); however, there is lack of a much-required consensus on recommended criteria for progression. A recently described method uses permutation analyses of pointwise linear regression to provide a statistical significance estimate of deterioration in the whole visual field with a false-positive rate that is independent of variability, level of damage, or length of follow-up, and can be useful for analyzing individual visual field series or comparisons of different techniques (O'Leary et al, 2012).…”

Section: Pointwise Trend Analysismentioning

confidence: 99%

How to detect progression in glaucoma

Vianna

Chauhan

2015

Progress in Brain Research

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“…The slope and P value chosen should depend on the clinical question being asked—whether one is more concerned with sensitivity or whether specificity is more critical. This issue has been studied20 and while we have shown several optimal criteria that balance sensitivity and specificity, the choice depends on the specific clinical or research setting.…”

Section: Discussionmentioning

confidence: 99%

SITA-Standard perimetry has better performance than FDT2 matrix perimetry for detecting glaucomatous progression

2018

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Purpose The Humphrey Matrix (FDT2) may be more sensitive in detecting glaucomatous visual field loss than SITA standard automated perimetry (SAP) performed on the Humphrey Field Analyzer (HFA). Therefore, FDT may be a good candidate to determine disease progression in patients with glaucoma. Our aim was to test the hypothesis that automated perimetry using the FDT2 would be equal to, or more effective than, HFA SITAStandard, in identifying glaucomatous progression. Methods One hundred and twenty patients with glaucoma were tested twice at baseline and every 6 months for 4 years with HFA SITA-Standard and FDT2. FDT2 values were standardised to HFA SAP values. We used pointwise linear regression (PLR) over the full data series to identify glaucomatous progression and generated an array of results using three different criteria: (1) three or more clustered test locations progressing, (2) three or more non-clustered test locations progressing and (3) total number of progressing test locations. We compared HFA SAP and FDT2 for the number of locations signalled by the PLR detection algorithm. results Regardless of the criteria, HFA SAP with SITAStandard testing detected visual field progression at a higher rate than the FDT2 overall (P<0.001). Conclusion HFA SAP identifies glaucomatous visual field progression at a rate at least as high if not higher than FDT2.

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Refinement of Pointwise Linear Regression Criteria for Determining Glaucoma Progression

Cited by 24 publications

References 33 publications

Significant Glaucomatous Visual Field Progression in the First Two Years: What Does It Mean?

Significant Glaucomatous Visual Field Progression in the First Two Years: What Does It Mean?

How to detect progression in glaucoma

SITA-Standard perimetry has better performance than FDT2 matrix perimetry for detecting glaucomatous progression

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