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Transl Vis Sci TechnolOctober 20240 citations

A Novel Approach To Predict Glaucomatous Impairment in the Central 10° Visual Field, Excluding the Effect of Cataract.

Tomita Ryo, Asaoka Ryo, Hirasawa Kazunori, Fujino Yuri, Omura Tetsuro, Inatomi Tsutomu, Obana Akira, Nishiguchi Koji M, Tanito Masaki


AI Summary

A study accurately predicted central 10° glaucomatous visual field loss after cataract removal using a machine learning model (RFM) with visual acuity and visual field data, but adding OCT data didn't improve accuracy.

Abstract

Purpose

Our previous study predicted genuine glaucomatous visual field (VF) impairment in the central 10° VF, excluding the effect of cataract, using visual acuity (VA) and global indexes of VF more accurately than pattern deviation (PD). This study aimed to improve the accuracy by using pointwise total deviation (TD) values with the machine-learning method of random forest model (RFM) and to investigate whether incorporating optical coherence tomography-measured ganglion cell-inner plexiform layer (GCIPL) thickness is useful.

Methods

This retrospective study included 89 eyes with open-angle glaucoma that underwent successful cataract surgery (with or without iStent implantation or ab interno trabeculotomy). Postoperative TD in each of the 68 VF points was predicted using preoperative (1) PD, (2) VA and VF with a linear regression model (LM), and (3) VA and VF with RFM, and averaged as predicted mean TD (mTDpost). Further prediction was made by incorporating the preoperative GCIPL into the best model.

Results

The mean absolute error (MAE) between the actual and predicted mTDpost with RFM (1.25 ± 1.03 dB) was significantly smaller than that with PD (3.20 ± 4.06 dB, p < 0.01) and LM (1.42 ± 1.06 dB, p < 0.05). The MAEs with the model incorporating GCIPL into RFM (1.24 ± 1.04 dB) and RFM were not significantly different.

Conclusions

Accurate prediction of genuine glaucomatous VF impairment was achieved using pointwise TD with RFM. No merit was observed by incorporating the GCIPL into this model.

Translational relevance: This pointwise RFM could clinically reduce cataract effect on VF.


MeSH Terms

HumansRetrospective StudiesFemaleMaleAgedVisual FieldsGlaucoma, Open-AngleVisual AcuityTomography, Optical CoherenceMiddle AgedCataractRetinal Ganglion CellsVision DisordersCataract ExtractionIntraocular PressureVisual Field TestsAged, 80 and overMachine LearningTrabeculectomy

Key Concepts5

The mean absolute error (MAE) between actual and predicted mean total deviation (mTDpost) with the random forest model (RFM) was 1.25 ± 1.03 dB in 89 eyes with open-angle glaucoma that underwent successful cataract surgery.

PrognosisCohortRetrospective Cohort Studyn=89 eyesCh6Ch7Ch45

The mean absolute error (MAE) for predicting mean total deviation (mTDpost) with the random forest model (RFM) (1.25 ± 1.03 dB) was significantly smaller than with pattern deviation (PD) (3.20 ± 4.06 dB, p < 0.01) in 89 eyes with open-angle glaucoma that underwent successful cataract surgery.

Comparative EffectivenessCohortRetrospective Cohort Studyn=89 eyesCh6Ch7Ch45

The mean absolute error (MAE) for predicting mean total deviation (mTDpost) with the random forest model (RFM) (1.25 ± 1.03 dB) was significantly smaller than with a linear regression model (LM) (1.42 ± 1.06 dB, p < 0.05) in 89 eyes with open-angle glaucoma that underwent successful cataract surgery.

Comparative EffectivenessCohortRetrospective Cohort Studyn=89 eyesCh6Ch7Ch45

Incorporating preoperative ganglion cell-inner plexiform layer (GCIPL) thickness into the random forest model (RFM) for predicting mean total deviation (mTDpost) did not significantly improve accuracy (MAE with GCIPL: 1.24 ± 1.04 dB vs. RFM alone: 1.25 ± 1.03 dB) in 89 eyes with open-angle glaucoma that underwent successful cataract surgery.

PrognosisCohortRetrospective Cohort Studyn=89 eyesCh5Ch6Ch7Ch45

A retrospective study included 89 eyes with open-angle glaucoma that underwent successful cataract surgery (with or without iStent implantation or ab interno trabeculotomy) to predict postoperative total deviation in the central 10° visual field.

MethodologyCohortRetrospective Cohort Studyn=89 eyesCh6Ch12Ch45

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