Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA; Department of Ophthalmology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Department of Ophthalmology, Otorhinolaryngology and Head Neck Surgery, Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, Brazil.
Am J Ophthalmol. 2020 Aug;216:37-43. doi: 10.1016/j.ajo.2020.03.046. Epub 2020 Apr 9.
To describe the development of a new algorithm for detecting progressive changes in 10-2 visual field (VF) tests using event-based analysis and to test its validity in a second, independent glaucoma cohort.
Prospective cohort study.
Patients with established open-angle glaucoma from the Macular Assessment and Progression Study (MAPS; development cohort, n = 151), and the African Descent and Glaucoma Evaluation Study (ADAGES; validation cohort, n = 52) were evaluated. The 10-2 VF results from MAPS were obtained during 4 test-retest sessions within a 4-month period. For the validation analysis, 10-2 VF results from ADAGES performed on at least 5 visits were used. The event-based pointwise changes on 10-2 tests in the validation cohort were determined using 2 progression criteria: at least 3 progressing VF locations on 2 or 3 consecutive tests ("possible" or "likely" progression). Linear mixed-effects models were used to evaluate VF progression.
In the validation cohort, the mean (SD) follow-up time was 2.3 (0.7) years. The number of eyes experiencing 10-2 VF progression based on "possible" and "likely" progression was 36 (54.5%) and 11 (16.6%), respectively. Eyes experiencing "possible" progression had MD changes (-0.60 dB/year [95% confidence interval (CI): -0.93 to -0.28]) faster than those not meeting this criterion (P < .001), whereas for those with "likely" progression the difference was -0.91 dB/year (95% CI: -1.26 to -0.56, P < .001).
A new event-based progression algorithm using the 10-2 VF can identify eyes experiencing more rapid MD progression and may be used as a tool to assess progressive macular functional changes in glaucoma.
描述一种新的算法，用于通过基于事件的分析检测 10-2 视野 (VF) 测试中的渐进性变化，并在第二个独立的青光眼队列中测试其有效性。
前瞻性队列研究。
来自黄斑评估和进展研究 (MAPS; 开发队列，n=151) 和非裔美国人与青光眼评估研究 (ADAGES; 验证队列，n=52) 的已确诊开角型青光眼患者接受了评估。MAPS 中的 10-2 VF 结果在 4 个月的 4 次测试-复测期间获得。对于验证分析，使用 ADAGES 进行的至少 5 次就诊的 10-2 VF 结果被使用。使用 2 种进展标准确定验证队列中 10-2 测试的基于事件的逐点变化：在 2 次或 3 次连续测试中有 3 个以上进展的 VF 位置（“可能”或“很可能”进展）。线性混合效应模型用于评估 VF 进展。
在验证队列中，平均（SD）随访时间为 2.3（0.7）年。根据“可能”和“很可能”进展，有 10-2 VF 进展的眼数分别为 36 只（54.5%）和 11 只（16.6%）。经历“可能”进展的眼睛的 MD 变化（-0.60 dB/年[95%置信区间（CI）：-0.93 至-0.28]）比不符合该标准的眼睛更快（P<0.001），而对于那些有“很可能”进展的眼睛，差异为-0.91 dB/年（95%CI：-1.26 至-0.56，P<0.001）。
一种新的基于事件的 10-2 VF 进展算法可以识别经历更快速 MD 进展的眼睛，并且可以用作评估青光眼患者黄斑功能进行性变化的工具。
