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Br J OphthalmolApril 201721 citations

Investigating the usefulness of a cluster-based trend analysis to detect visual field progression in patients with open-angle glaucoma.

Aoki Shuichiro, Murata Hiroshi, Fujino Yuri, Matsuura Masato, Miki Atsuya, Tanito Masaki, Mizoue Shiro, Mori Kazuhiko, Suzuki Katsuyoshi, Yamashita Takehiro


AI Summary

This study found cluster visual field analysis detects localized glaucoma progression often missed by whole-field analysis, potentially enabling earlier clinical intervention without significant specificity loss.

Abstract

Background/aims: To investigate the usefulness of the Octopus (Haag-Streit) EyeSuite's cluster trend analysis in glaucoma.

Methods

Ten visual fields (VFs) with the Humphrey Field Analyzer (Carl Zeiss Meditec), spanning 7.7 years on average were obtained from 728 eyes of 475 primary open angle glaucoma patients. Mean total deviation (mTD) trend analysis and EyeSuite's cluster trend analysis were performed on various series of VFs (from 1st to 10th: VF1-10 to 6th to 10th: VF6-10). The results of the cluster-based trend analysis, based on different lengths of VF series, were compared against mTD trend analysis.

Result: Cluster-based trend analysis and mTD trend analysis results were significantly associated in all clusters and with all lengths of VF series. Between 21.2% and 45.9% (depending on VF series length and location) of clusters were deemed to progress when the mTD trend analysis suggested no progression. On the other hand, 4.8% of eyes were observed to progress using the mTD trend analysis when cluster trend analysis suggested no progression in any two (or more) clusters.

Conclusion

Whole field trend analysis can miss local VF progression. Cluster trend analysis appears as robust as mTD trend analysis and useful to assess both sectorial and whole field progression. Cluster-based trend analyses, in particular the definition of two or more progressing cluster, may help clinicians to detect glaucomatous progression in a timelier manner than using a whole field trend analysis, without significantly compromising specificity.


MeSH Terms

AdolescentAdultAgedAged, 80 and overCluster AnalysisDisease ProgressionFemaleGlaucoma, Open-AngleHumansIntraocular PressureMaleMiddle AgedROC CurveRetrospective StudiesScotomaVisual Field TestsVisual FieldsYoung Adult

Key Concepts6

The Octopus (Haag-Streit) EyeSuite's cluster trend analysis and mean total deviation (mTD) trend analysis results were significantly associated in all clusters and with all lengths of visual field (VF) series in 728 eyes of 475 primary open angle glaucoma patients.

Comparative EffectivenessCohortRetrospective Cohort Studyn=728 eyes of 475 primary open angle gl…Ch5Ch6

Between 21.2% and 45.9% (depending on visual field series length and location) of clusters were deemed to progress using the Octopus (Haag-Streit) EyeSuite's cluster trend analysis when the mean total deviation (mTD) trend analysis suggested no progression in 728 eyes of 475 primary open angle glaucoma patients.

DiagnosisCohortRetrospective Cohort Studyn=728 eyes of 475 primary open angle gl…Ch5Ch6

4.8% of eyes were observed to progress using the mean total deviation (mTD) trend analysis when the Octopus (Haag-Streit) EyeSuite's cluster trend analysis suggested no progression in any two (or more) clusters in 728 eyes of 475 primary open angle glaucoma patients.

DiagnosisCohortRetrospective Cohort Studyn=728 eyes of 475 primary open angle gl…Ch5Ch6

Whole field trend analysis can miss local visual field progression in patients with open-angle glaucoma, as indicated by a retrospective cohort study of 728 eyes of 475 primary open angle glaucoma patients.

DiagnosisCohortRetrospective Cohort Studyn=728 eyes of 475 primary open angle gl…Ch5Ch6

The Octopus (Haag-Streit) EyeSuite's cluster trend analysis appears as robust as mean total deviation (mTD) trend analysis and is useful to assess both sectorial and whole field progression in patients with open-angle glaucoma, based on a retrospective cohort study of 728 eyes of 475 primary open angle glaucoma patients.

DiagnosisCohortRetrospective Cohort Studyn=728 eyes of 475 primary open angle gl…Ch5Ch6

Cluster-based trend analyses, particularly the definition of two or more progressing clusters, may help clinicians to detect glaucomatous progression in a timelier manner than using a whole field trend analysis, without significantly compromising specificity, in patients with open-angle glaucoma.

DiagnosisCohortRetrospective Cohort Studyn=728 eyes of 475 primary open angle gl…Ch5Ch6

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