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Asaoka R, Murata H. Prediction of visual field progression in glaucoma: existing methods and artificial intelligence. Jpn J Ophthalmol 2023; 67:546-559. [PMID: 37540325 DOI: 10.1007/s10384-023-01009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/13/2023] [Indexed: 08/05/2023]
Abstract
Timely treatment is essential in the management of glaucoma. However, subjective assessment of visual field (VF) progression is not recommended, because it can be unreliable. There are two types of artificial intelligence (AI) strong and weak (machine learning). Weak AIs can perform specific tasks. Linear regression is a method of weak AI. Using linear regression in the real-world clinic has enabled analyzing and predicting VF progression. However, caution is still required when interpreting the results, because whenever the number of VF data sets investigated is small, the predictions can be inaccurate. Several other non-ordinal, or modern AI methods have been constructed to improve prediction accuracy, such as clustering and more modern AI methods of Analysis with Non-Stationary Weibull Error Regression and Spatial Enhancement (ANSWERS), Variational Bayes Linear Regression (VBLR), Kalman Filter and sparse modeling (The least absolute shrinkage and selection operator regression: Lasso). It is also possible to improve the prediction performance using retinal thickness measured with optical coherence tomography by using machine learning methods, such as multitask learning.
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Grants
- 19H01114 ministry of education, culture, sports, science, and technology of Japan
- 18KK0253 ministry of education, culture, sports, science and technology of Japan
- 20K09784 ministry of education, culture, sports, science and technology of Japan
- 80635748 ministry of education, culture, sports, science and technology of Japan
- TR-SPRINT japan agency for medical reserach and development
- Grant the Japan Glaucoma Society Project Support Program
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Affiliation(s)
- Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, Japan.
- Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
- The Graduate School for the Creation of New Photonics Industries, Hamamatsu, Shizuoka, Japan.
| | - Hiroshi Murata
- Department of Ophthalmology, National Center for Global health and Medicine, Tokyo, Japan
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Omoto T, Oishi A, Asaoka R, Fujino Y, Murata H, Azuma K, Miyata M, Obata R, Inoue T. Development and validation of a visual field cluster in retinitis pigmentosa. Sci Rep 2021; 11:9671. [PMID: 33958698 PMCID: PMC8102544 DOI: 10.1038/s41598-021-89233-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/31/2021] [Indexed: 12/26/2022] Open
Abstract
The aim was to establish and evaluate a new clustering method for visual field (VF) test points to predict future VF in retinitis pigmentosa. A Humphrey Field Analyzer 10-2 test was clustered using total deviation values from 858 VFs. We stratified 68 test points into 24 sectors. Then, mean absolute error (MAE) of the sector-wise regression with them (S1) was evaluated using 196 eyes with 10 VF sequences and compared to pointwise linear regression (PLR), mean sensitivity of total area (MS) and also another sector-wise regression basing on VF mapping for glaucoma (29 sectors; S2). MAE with S1 were smaller than with PLR when between the first-third and first-seventh VFs were used. MAE with the method were significantly smaller than those of S2 when between the first-sixth and first-ninth VFs were used. The MAE of MS was smaller than those with S1 only when first to 3rd and first to 4th VFs were used; however, the prediction accuracy became far larger than any other methods when larger number of VFs were used. More accurate prediction was achieved using this new sector-wise regression than with PLR. In addition, the obtained cluster was more useful than that for glaucoma to predict progression.
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Affiliation(s)
- Takashi Omoto
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Ophthalmology and Visual Sciences, Nagasaki University, Nagasaki, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan. .,Seirei Christopher University, Shizuoka, Japan. .,Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan. .,The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan.
| | - Yuri Fujino
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan.,Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Keiko Azuma
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Manabu Miyata
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryo Obata
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
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Hu R, Racette L, Chen KS, Johnson CA. Functional assessment of glaucoma: Uncovering progression. Surv Ophthalmol 2020; 65:639-661. [PMID: 32348798 PMCID: PMC7423736 DOI: 10.1016/j.survophthal.2020.04.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 04/13/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
Clinicians who manage glaucoma patients carefully monitor the visual field to determine if treatments are effective or interventions are needed. Visual field tests may reflect disease progression or variability among examinations. We describe the approaches and perimetric tests used to evaluate glaucomatous visual field progression and factors that are important for identifying progression. These include stimulus size, which area of the visual field to assess (central versus peripheral), and the testing frequency, evaluating which is important to detect change early while minimizing patient testing burden. We also review the different statistical methods developed to identify change. These include trend- and event-based analyses, parametric and nonparametric tests, population-based versus individualized approaches, as well as pointwise and global analyses. We hope this information will prove useful and important to enhance the management of glaucoma patients. Overall, analysis procedures based on series of at least 5 to 6 examinations that require confirmation and persistence of changes, that are guided by the pattern and shape of the glaucomatous visual field deficits, and that are consistent with structural defects provide the best clinical performance.
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Affiliation(s)
- Rongrong Hu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
| | - Kelly S Chen
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Chris A Johnson
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Omodaka K, Kikawa T, Shiga Y, Tsuda S, Yokoyama Y, Sato H, Ohuchi J, Matsumoto A, Takahashi H, Akiba M, Nakazawa T. Usefulness of axonal tract-dependent OCT macular sectors for evaluating structural change in normal-tension glaucoma. PLoS One 2017; 12:e0185649. [PMID: 28973002 PMCID: PMC5626427 DOI: 10.1371/journal.pone.0185649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 09/16/2017] [Indexed: 11/28/2022] Open
Abstract
Purpose To identify sectors of the optical coherence tomography (OCT) macular map that could be used to effectively assess structural progression in patients with normal-tension glaucoma (NTG). Methods This study examined 117 eyes of 117 NTG patients to establish axonal tract-dependent macular sectors, and also examined a separate group of 122 eyes of 81 NTG patients to evaluate the ability of these sectors to reveal glaucoma progression. Longitudinal data, including macular maps from at least 5 OCT examinations performed over at least 2 years, was available for all patients in this group. Circumpapillary retinal nerve fiber layer thickness (cpRNFLT), temporal clockwise sector scans (from 7 to 11 o’clock), macular retinal nerve fiber layer thickness (mRNFLT), and macular ganglion cell layer plus inner plexiform layer thickness (mGCIPLT) were measured with spectral-domain OCT (3D OCT-2000, TOPCON). The axonal tract-dependent macular sectors were identified by calculating Spearman’s rank correlation coefficient for each point on a grid overlaid on the macular map and cpRNFLT in each clockwise scan sector. Trend and event analyses for the slope of progression in each sector and macular map were performed. Visual field progression in the macula was defined by the presence of more than 2 progressive test points in the 16 central test points of the Humphrey field analyzer SITA standard 24–2 program, evaluated with Progressor software. Results The slope of progression in the entire macular area was -0.22 ± 0.58 μm/year for mRNFLT and -0.35 ± 0.52 μm/year for mGCIPLT. The fastest-progressing mRNFLT sector (-1.00 ± 0.84 μm/year, p < 0.001) and mGCIPLT sector (-1.16 ± 0.63 μm/year, p < 0.001) progressed significantly faster than the overall macula. Classifying patients according to visual field progression showed that baseline mRNFLT in the inferior hemifield, 7 and 8 o’clock sectors, as well as baseline mGCIPLT in the overall macular map, inferior hemifield, and 8 o’clock sector, were significantly lower in progressors (22 eyes) than non-progressors (100 eyes). There were significant differences in mRNFLT slope in 8 o’clock sector and in the fastest progressing sector in progressors and non-progressors, but mGCIPLT did not differ, even in the fastest-progressing sector. Event analysis showed that progression occurred most frequently in inferior mRNFLT and superior mGCIPLT in this study. Conclusion Axonal tract-dependent OCT macular sectors could effectively reveal structural change in patients with NTG. Furthermore, mRNFLT slope was consistent with visual field progression. This method promises to open new avenues for the OCT-based evaluation of glaucoma progression.
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Affiliation(s)
- Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Yukihiro Shiga
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Yokoyama
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruka Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junko Ohuchi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Hidetoshi Takahashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Medicine, Division of Ophthalmology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Retinal Disease Control, Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
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Murata N, Miyamoto D, Togano T, Fukuchi T. Evaluating Silent Reading Performance with an Eye Tracking System in Patients with Glaucoma. PLoS One 2017; 12:e0170230. [PMID: 28095478 PMCID: PMC5240996 DOI: 10.1371/journal.pone.0170230] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/31/2016] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the relationship between silent reading performance and visual field defects in patients with glaucoma using an eye tracking system. Methods Fifty glaucoma patients (Group G; mean age, 52.2 years, standard deviation: 11.4 years) and 20 normal controls (Group N; mean age, 46.9 years; standard deviation: 17.2 years) were included in the study. All participants in Group G had early to advanced glaucomatous visual field defects but better than 20/20 visual acuity in both eyes. Participants silently read Japanese articles written horizontally while the eye tracking system monitored and calculated reading duration per 100 characters, number of fixations per 100 characters, and mean fixation duration, which were compared with mean deviation and visual field index values from Humphrey visual field testing (24–2 and 10–2 Swedish interactive threshold algorithm standard) of the right versus left eye and the better versus worse eye. Results There was a statistically significant difference between Groups G and N in mean fixation duration (G, 233.4 msec; N, 215.7 msec; P = 0.010). Within Group G, significant correlations were observed between reading duration and 24–2 right mean deviation (rs = -0.280, P = 0.049), 24–2 right visual field index (rs = -0.306, P = 0.030), 24–2 worse visual field index (rs = -0.304, P = 0.032), and 10–2 worse mean deviation (rs = -0.326, P = 0.025). Significant correlations were observed between mean fixation duration and 10–2 left mean deviation (rs = -0.294, P = 0.045) and 10–2 worse mean deviation (rs = -0.306, P = 0.037), respectively. Conclusions The severity of visual field defects may influence some aspects of reading performance. At least concerning silent reading, the visual field of the worse eye is an essential element of smoothness of reading.
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Affiliation(s)
- Noriaki Murata
- Division of Ophthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan
| | - Daiki Miyamoto
- Division of Ophthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tetsuya Togano
- Division of Ophthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takeo Fukuchi
- Division of Ophthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- * E-mail:
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Bousquet PJ, Devillier P, Tadmouri A, Mesbah K, Demoly P, Bousquet J. Clinical relevance of cluster analysis in phenotyping allergic rhinitis in a real-life study. Int Arch Allergy Immunol 2015; 166:231-40. [PMID: 25924687 DOI: 10.1159/000381339] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 02/27/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Disease stratification, using phenotypic characterization performed either by hypothesis- or data-driven methods, was developed to improve clinical decisions. However, cluster analysis has not been used for allergic rhinitis. OBJECTIVE To define clusters in allergic rhinitis and to compare them with ARIA (Allergic Rhinitis and Its Impact on Asthma), a hypothesis-driven approach. METHODS A French observational prospective multicenter study (EVEIL: Echelle visuelle analogique dans la rhinite allergique) was carried out on 990 patients consulting general practitioners for allergic rhinitis and treated as per clinical practice. In this study, changes in symptom scores, visual analogue scales and quality of life were measured at baseline and after 14 days of treatment. A post hoc analysis was performed to identify clusters of patients with allergic rhinitis – using Ward's hierarchical method – and to define their clinical relevance at baseline and after 14 days of treatment. The cluster approach was compared to the ARIA approach. RESULTS Patients were clustered into 4 phenotypes which partly followed the ARIA classes. These phenotypes differed in their disease severity including symptoms and quality of life. Physicians in real-life practice prescribed medication regardless of the phenotype and severity, with the exception of patients with ocular symptoms. Prescribed treatments were comparable in hypothesis- and data-driven analyses. The prevalence of uncontrolled patients during treatment was similar in the 4 clusters, but was significantly different according to the ARIA classes. CONCLUSION Cluster analysis using demographic and clinical parameters only does not appear to add relevant information for disease stratification in allergic rhinitis.
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Contributing factors for progression of visual field loss in normal-tension glaucoma patients with medical treatment. J Glaucoma 2013; 22:250-4. [PMID: 23059475 DOI: 10.1097/ijg.0b013e31823298fb] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate the prognostic factors responsible for the progression of visual field defects (VFDs) in patients with normal-tension glaucoma (NTG) treated with topical antiglaucoma medications. PATIENTS AND METHODS A total of 92 eyes in 92 NTG patients treated with only topical antiglaucoma medications for ≥ 5 years were retrospectively analyzed. To identify subfield-based prognostic factors, the central 30-degree visual field (Humphrey Field Analyzer) was divided into 6 subfields: upper and lower arcuate, paracentral, and cecocentral subfields. Factors related to subfield-based progression (age, refraction, mean intraocular pressure (IOP), IOP variability, central corneal thickness, and disc hemorrhage) were evaluated using a linear mixed model. RESULTS Ninety-two eyes in 92 NTG patients were included in this study. The mean observation period was 7.7 ± 2.7 (5.0 to 15.5) years, and the estimated rate of change in the mean deviation value was -0.16 ± 0.31 dB/y (P<0.001). A subfield-based linear mixed model analysis of the time course of changes in the mean of total deviation identified a greater extent of myopia as a significant positive prognostic factor for VFD progression in the upper paracentral area (P=0.016). The mean IOP, central corneal thickness, disc hemorrhage, age, and IOP variation showed no significant contribution in any of the subfields. CONCLUSIONS The extent of myopia was found to be a significant positive prognostic factor for VFD progression in the upper paracentral subfield for non-high-myopic NTG eyes with an average IOP of 14.2 mm Hg under topical antiglaucoma medication.
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Araie M, Shirato S, Yamazaki Y, Kitazawa Y, Ohashi Y. Visual field loss in patients with normal-tension glaucoma under topical nipradilol or timolol: subgroup and subfield analyses of the nipradilol-timolol study. Jpn J Ophthalmol 2010; 54:278-85. [PMID: 20700793 DOI: 10.1007/s10384-010-0815-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 02/16/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To estimate the deterioration rates of visual field loss in Japanese normal-tension glaucoma (NTG) patients under either topical nipradilol or timolol, and to explore intergroup differences in the treatment results. METHODS A total of 146 NTG patients with mild to moderate damage were randomized to either nipradilol or timolol and followed for 3 years with a periodic comprehensive ophthalmological visual field examination (30-2 Humphrey perimeter program) every 6 months (the Nipradilol-Timolol Study). The time course of mean deviation (MD), the average total deviation (TD(mean)) in four subfields, and the corrected pattern standard deviation (CPSD) were compared between the two groups using regression analysis with a linear mixed effect model. RESULTS The estimated slope for MD (dB/year) was -0.03 in the nipradilol and -0.05 in the timolol group (P > 0.4). In both groups, TD(mean) in the superior-central subfield and CPSD showed significant changes (-0.3 and 0.2-0.3, P <or= 0.001). In the patients with early visual field loss or those younger than 40 years, deterioration of some visual field parameters tended to be slower in the nipradilol group than in the timolol group. CONCLUSION During 3 years of monotherapy with either nipradilol or timolol in NTG patients, only TD(mean) in the superior-central subfield and the CPSD changed significantly without any intergroup differences.
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Affiliation(s)
- Makoto Araie
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
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Araie M, Shirato S, Yamazaki Y, Kitazawa Y, Ohashi Y. Clinical efficacy of topical nipradilol and timolol on visual field performance in normal-tension glaucoma: a multicenter, randomized, double-masked comparative study. Jpn J Ophthalmol 2008; 52:255-264. [PMID: 18773262 DOI: 10.1007/s10384-008-0540-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Accepted: 03/31/2008] [Indexed: 11/28/2022]
Affiliation(s)
- Makoto Araie
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
| | | | - Yoshio Yamazaki
- Department of Ophthalmology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | | | - Yasuo Ohashi
- Department of Biostatistics, School of Public Health, University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Boden C, Chan K, Sample PA, Hao J, Lee TW, Zangwill LM, Weinreb RN, Goldbaum MH. Assessing visual field clustering schemes using machine learning classifiers in standard perimetry. Invest Ophthalmol Vis Sci 2008; 48:5582-90. [PMID: 18055807 DOI: 10.1167/iovs.06-0897] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To compare machine learning classifiers trained on three clustering schemes to determine whether distinguishing healthy eyes from those with glaucomatous optic neuropathy (GON) can be optimized by training with clustered data. METHODS Two machine learning classifiers-quadratic discriminant analysis (QDA) and support vector machines with Gaussian kernel (SVMg)-were trained separately using standard perimetry data from the Diagnostic Innovations in Glaucoma Study (DIGS), clustered using three clustering schemes on a training data set (123 eyes/123 glaucoma patients with GON; 135 eyes/135 normal control subjects). Trained classifiers were then applied to an independent data set containing 69 eyes of 69 glaucoma patients with early visual field loss and 83 eyes of 83 normal control subjects. Two control conditions were included: unclustered data and a random assignment of locations to clusters. RESULTS Areas under the receiver operating characteristic (ROC) curve ranged from 0.85 (SVMg, thresholds clustered by Glaucoma Hemifield Test sectors) to 0.92 (QDA, thresholds clustered by Garway-Heath mapping) for the training data set. Use of clustered data showed no significant optimization of sensitivity over use of unclustered data, and no single clustering method resulted in significantly higher performance in the independent data set. Sensitivities tended to be higher with QDA than with SVMg, regardless of specificity cutoff and clustering METHOD CONCLUSIONS QDA performed better with the early glaucoma data set than did the SVMg. Clustering may be advantageous when data-dimension reduction is needed-for example, when combining field results with other high-dimensional data (e.g., structural imaging data)-but it is not necessary for visual field data alone.
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Affiliation(s)
- Catherine Boden
- Department of Ophthalmology, University of California, San Diego, La Jolla, CA 92093-0946, USA
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Kurita N, Tomidokoro A, Mayama C, Aihara M, Araie M. No Apparent Association Between Ocular Perfusion Pressure and Visual Field Damage in Normal-Tension Glaucoma Patients. Jpn J Ophthalmol 2006; 50:547-549. [PMID: 17180531 DOI: 10.1007/s10384-006-0375-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 06/12/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the correlation of ocular perfusion pressure (OPP) with general and localized visual field damage in normal-tension glaucoma (NTG) patients. METHODS Correlations between OPP, blood pressure, age, intraocular pressure, refractive error, and extent of visual field damage in the eye with the worst mean deviation (MD) were investigated retrospectively in 94 eyes of 94 NTG patients. Visual fields were analyzed statistically with respect to 15 sectors between two age-matched groups of subjects with high or low OPP. RESULTS Significant positive correlations were found between OPP and age (P < 0.001), blood pressure and age (P < 0.05), and MD and refractive error (P < 0.01). OPP had no significant correlation with MD or mean sensitivity in the visual field in any of the visual field sectors. CONCLUSION OPP and systemic blood pressure have no evident effect on the extent or pattern of visual field damage in NTG.
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Affiliation(s)
- Naoyuki Kurita
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Atsuo Tomidokoro
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Chihiro Mayama
- Department of Ophthalmology, Saitama Red Cross Hospital, Saitama, Japan.
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Makoto Araie
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Tochel CM, Morton JS, Jay JL, Morrison JD. Relationship between visual field loss and contrast threshold elevation in glaucoma. BMC Ophthalmol 2005; 5:22. [PMID: 16159386 PMCID: PMC1249580 DOI: 10.1186/1471-2415-5-22] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 09/13/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a considerable body of literature which indicates that contrast thresholds for the detection of sinusoidal grating patterns are abnormally high in glaucoma, though just how these elevations are related to the location of visual field loss remains unknown. Our aim, therefore, has been to determine the relationship between contrast threshold elevation and visual field loss in corresponding regions of the peripheral visual field in glaucoma patients. METHODS Contrast thresholds were measured in arcuate regions of the superior, inferior, nasal and temporal visual field in response to laser interference fringes presented in the Maxwellian view. The display consisted of vertical green stationary laser interference fringes of spatial frequency 1.0 c deg(-1) which appeared in a rotatable viewing area in the form of a truncated quadrant extending from 10 to 20 degrees from fixation which was marked with a central fixation light. Results were obtained from 36 normal control subjects in order to provide a normal reference for 21 glaucoma patients and 5 OHT (ocular hypertensive) patients for whom full clinical data, including Friedmann visual fields, had been obtained. RESULTS Abnormally high contrast thresholds were identified in 20 out of 21 glaucoma patients and in 2 out of 5 OHT patients when compared with the 95% upper prediction limit for normal values from one eye of the 36 normal age-matched control subjects. Additionally, inter-ocular differences in contrast threshold were also abnormally high in 18 out of 20 glaucoma patients who had vision in both eyes compared with the 95% upper prediction limit. Correspondence between abnormally high contrast thresholds and visual field loss in the truncated quadrants was significant in 5 patients, borderline in 4 patients and absent in 9 patients. CONCLUSION While the glaucoma patients tested in our study invariably had abnormally high contrast thresholds in one or more of the truncated quadrants in at least one eye, reasonable correspondence with the location of the visual field loss only occurred in half the patients studied. Hence, while contrast threshold elevations are indicative of glaucomatous damage to vision, they are providing a different assessment of visual function from conventional visual field tests.
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Affiliation(s)
- CM Tochel
- Institute of Biomedical & Life Sciences, West Medical Building, University of Glasgow, Glasgow, Scotland, UK
| | - JS Morton
- Institute of Biomedical & Life Sciences, West Medical Building, University of Glasgow, Glasgow, Scotland, UK
| | - JL Jay
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western, Road, Glasgow, Scotland, UK
| | - JD Morrison
- Institute of Biomedical & Life Sciences, West Medical Building, University of Glasgow, Glasgow, Scotland, UK
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