Frontloading visual field tests detect earlier mean deviation progression when applied to real-world-derived early-stage glaucoma data

被引:2
作者
Wang, Henrietta [1 ,2 ,3 ]
Kalloniatis, Michael [1 ,3 ]
Tan, Jeremy C. K. [4 ,5 ]
Phu, Jack [1 ,2 ,3 ,6 ,7 ,8 ]
机构
[1] Univ New South Wales, Sch Optometry & Vis Sci, Kensington, NSW, Australia
[2] Univ New South Wales, Ctr Eye Hlth, Kensington, NSW, Australia
[3] Deakin Univ, Sch Med Optometry, Waurn Ponds, Vic, Australia
[4] Univ New South Wales, Fac Med & Hlth, Kensington, NSW, Australia
[5] Prince Wales Hosp, Dept Ophthalmol, Randwick, NSW, Australia
[6] Univ Sydney, Fac Med & Hlth, Camperdown, NSW, Australia
[7] Concord Repatriat Gen Hosp, Concord Clin Sch, Concord, NSW, Australia
[8] Univ New South Wales, Sch Optometry & Vis Sci, Rupert Myers Bldg North Wing, Sydney, NSW, Australia
基金
英国医学研究理事会;
关键词
Humphrey Field Analyzer; longitudinal; perimetry; SITA-Faster; glaucoma; visual field; OPEN-ANGLE GLAUCOMA; PRACTICAL RECOMMENDATIONS; RATES; PERIMETRY; DEFECTS;
D O I
10.1111/opo.13270
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PurposeTo examine the diagnostic accuracy of performing two (frontloaded) versus one (clinical standard) visual field (VF) test per visit for detecting the progression of early glaucoma in data derived from clinical populations.MethodsA computer simulation model was used to follow the VFs of 10,000 glaucoma patients (derived from two cohorts: Heijl et al., Swedish cohort; and Chauhan et al., Canadian Glaucoma Study [CGS]) over a 10-year period to identify patients whose mean deviation (MD) progression was detected. Core data (baseline MD and progression rates) were extracted from two studies in clinical cohorts of glaucoma, which were modulated using SITA-Faster variability characteristics from previous work. Additional variables included follow-up intervals (six-monthly or yearly) and rates of perimetric data loss for any reason (0%, 15% and 30%). The main outcome measures were the proportions of progressors detected.ResultsWhen the Swedish cohort was reviewed six-monthly, the frontloaded strategy detected more progressors compared to the non-frontloaded method up to years 8, 9 and 10 of follow-up for 0%, 15% and 30% data loss conditions. The time required to detect 50% of cases was 1.0-1.5 years less for frontloading compared to non-frontloading. At 4 years, frontloading increased detection by 26.7%, 28.7% and 32.4% for 0%, 15% and 30% data loss conditions, respectively. Where both techniques detected progression, frontloading detected progressors earlier compared to the non-frontloaded strategy (78.5%-81.5% and by 1.0-1.3 years when reviewed six-monthly; 81%-82.9% and by 1.2-2.1 years when reviewed yearly). Accordingly, these patients had less severe MD scores (six-monthly review: 0.63-1.67 dB 'saved'; yearly review: 1.10-2.87 dB). The differences increased with higher rates of data loss. Similar tendencies were noted when applied to the CGS cohort.ConclusionsFrontloaded VFs applied to clinical distributions of MD and progression led to earlier detection of early glaucoma progression.
引用
收藏
页码:426 / 441
页数:16
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