Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA 90095, USA.
Invest Ophthalmol Vis Sci. 2013 Feb 1;54(2):1208-13. doi: 10.1167/iovs.12-10833.
To estimate rates of change in glaucoma eyes deteriorating according to pointwise event analysis (Guided Progression Analysis, GPA).
A total of 274 eyes with six or more reliable visual fields (vf) 5 years were enrolled (baseline mean deviation [MD]: -4.2 ± 4.5 dB). Pointwise and global rates of decay from linear regression analyses were estimated up to the time of VF deterioration according to GPA or until the last follow-up visit in stable eyes. Relationship of rates of decay with time to worsening and eccentricity and agreement of global and pointwise trend analyses with GPA were explored.
Seventy eyes (25.5%) worsened according to GPA. A statistically significant global rate of decay (P < 0.05) was observed in 54% (MD) and 62% (visual field index) of deteriorating eyes compared to 22% and 22% in stable eyes (κ = 0.32 vs. 0.37 for agreement with GPA). Rates of decay diminished with longer time to initial worsening and were faster in points within the central 10° of fixation compared to 20° and 30° regions (P = 0.025 and 0.279, respectively). Established criteria for pointwise linear regression (PLR) detected only 31% of locations deteriorating by GPA. Less stringent PLR criteria led to improved agreement with GPA at the expense of higher false detection rate.
Global and pointwise rates of decay decreased with longer time to VF deterioration. The agreement between pointwise event analysis and global trend analyses was fair. Less stringent criteria for PLR led to improved agreement with GPA at the expense of higher false detection rate.
根据逐点事件分析（Guided Progression Analysis，GPA）估计青光眼眼睛恶化的变化率。
共纳入 274 只具有 6 个或更多可靠视野（vf）的眼睛，随访时间为 5 年（基线平均偏差[MD]：-4.2 ± 4.5 dB）。根据 GPA 或稳定眼的最后一次随访，估计从线性回归分析得出的逐点和全局衰减率，直至 VF 恶化。探讨衰减率与恶化时间、偏心度的关系，以及全局和逐点趋势分析与 GPA 的一致性。
根据 GPA，70 只眼（25.5%）恶化。与稳定眼相比，54%（MD）和 62%（视野指数）的恶化眼中观察到统计学上显著的全局衰减率（P < 0.05），而稳定眼中为 22%和 22%（κ=0.32 与 GPA 的一致性）。衰减率随初始恶化时间的延长而降低，在注视中心 10°内的点比在 20°和 30°区域更快（P=0.025 和 0.279）。已建立的逐点线性回归（PLR）标准仅检测到 31%的 GPA 恶化点。较不严格的 PLR 标准可提高与 GPA 的一致性，但代价是更高的误检率。
全局和逐点衰减率随 VF 恶化时间的延长而降低。逐点事件分析与全局趋势分析之间的一致性为中等。较不严格的 PLR 标准可提高与 GPA 的一致性，但代价是更高的误检率。
