Cirineo Nila, Morales Esteban, Lee Jun Mo, Ramanathan Meera, Hirunpatravong Pradtana, Lin Mark, Capistrano Vicente, Abdelmonen Afifi, Yu Fei, Nouri-Mahdavi Kouros, Coleman Anne L, Caprioli Joseph
*Ñahui Eye Clinic, Glaucoma Unit, Lima, Peru †The Jules Stein Eye Institute, David Geffen School of Medicine at UCLA ‡Department of Biostatistics, and Epidemiology, Jonathan and Karin Fielding School of Public Health at UCLA, Los Angeles, CA.
J Glaucoma. 2017 Oct;26(10):902-910. doi: 10.1097/IJG.0000000000000763.
To compare the assessment of serial visual fields (VFs) based on subjective expert evaluation with the fast and slow VF component rates determined with pointwise exponential regression (PER) and pointwise linear regression (PLR).
A total of 5272 VF examinations from 376 eyes diagnosed with open-angle glaucoma were included. Three glaucoma specialists assessed each VF qualitatively to evaluate progression status and the qualitative rate of progression. The rates of VF decay were determined with PER and PLR at each VF location, which were ranked according to the regression coefficient and partitioned into 2 groups (fast and slow). A mean rate for the fast and slow partitions was obtained based on the average of the regression coefficients in each partition. κ-values were used to measure the agreement among the experts and the PER and PLR algorithms.
The average baseline VF mean deviation for the study sample was -6.6 (±5.9) dB. The agreement of the likelihood of progression among the dichotomized experts' score and PER was moderate (κ=0.41, P<0.01) and fair (κ=0.39, P<0.01) for PLR. The agreement of the likelihood of progression among the 3 dichotomized experts' scores was fair (κ=0.22, P<0.01). The agreement of the area of worsening among the dichotomized experts' score and PER and PLR were both moderate (κ=0.48, P<0.01; κ=0.46, P<0.01). The eyes flagged by experts as having "fast" progression rates had a higher average rates of decay for PER and PLR at -2.7 (±4.1) %/year and -0.8 (±1.2) dB/year; eyes flagged as "slow" had lower rates of decay at -0.3 (±1.5) %/year and -0.1 (±0.5) dB/year.
Expert qualitative evaluation of field series for change and rate of change correlate more closely with the fast component than with the slow component of VF decay.
比较基于主观专家评估的系列视野（VF）评估与通过逐点指数回归（PER）和逐点线性回归（PLR）确定的快速和慢速VF分量率。
纳入了376只被诊断为开角型青光眼的眼睛的5272次VF检查。三位青光眼专家对每次VF进行定性评估，以评估进展状态和进展的定性率。在每个VF位置通过PER和PLR确定VF衰减率，根据回归系数对其进行排序并分为两组（快速和慢速）。基于每个分区中回归系数的平均值获得快速和慢速分区的平均率。κ值用于衡量专家与PER和PLR算法之间的一致性。
研究样本的平均基线VF平均偏差为-6.6（±5.9）dB。二分法专家评分与PER之间进展可能性的一致性为中等（κ=0.41，P<0.01），与PLR的一致性为一般（κ=0.39，P<0.01）。三位二分法专家评分之间进展可能性的一致性为一般（κ=0.22，P<0.01）。二分法专家评分与PER和PLR之间恶化区域的一致性均为中等（κ=0.48，P<0.01；κ=0.46，P<0.01）。专家标记为具有“快速”进展率的眼睛，PER和PLR的平均衰减率较高，分别为-2.7（±4.1）%/年和-0.8（±1.2）dB/年；标记为“慢速”的眼睛衰减率较低，分别为-0.3（±1.5）%/年和-0.1（±0.5）dB/年。
专家对视野系列变化和变化率的定性评估与VF衰减的快速分量的相关性比与慢速分量的相关性更密切。
