Comparison of methods to predict visual field progression in glaucoma

Arch Ophthalmol. 2007 Sep;125(9):1176-81. doi: 10.1001/archopht.125.9.1176.

Abstract

Objective: To compare performance of pointwise linear regression, Glaucoma Change Probability Analysis (GCPA), and the Advanced Glaucoma Intervention Study (AGIS) method in predicting visual field progression in glaucoma.

Design: Longitudinal visual field data from AGIS. Proportion of progressing eyes and time to progression were the main outcome measures. One hundred fifty-six patients with 8 or more years of follow-up were included. Prediction of outcomes at 8 years was used to evaluate the performance of each method (pointwise linear regression, GCPA, and AGIS).

Results: Visual field progression at 8 years was detected in 35%, 31%, and 22% of patients by pointwise linear regression, GCPA, and the AGIS method, respectively. Baseline mean deviation was not different for nonprogressing vs progressing eyes for all methods (P > .05). Pointwise linear regression and GCPA had the highest pairwise concordance (kappa = 0.58 [SD, 0.07]). The false prediction rates at 4 and 8 years varied between 1% and 3%. Glaucoma Change Probability Analysis predicted final outcomes better than pointwise linear regression at 4 years (P = .001).

Conclusions: All algorithms had low false prediction rates. Glaucoma Change Probability Analysis predicted outcomes better than pointwise linear regression early during follow-up. Algorithms did not perform differently as a function of baseline damage. Pointwise linear regression and GCPA did not agree well regarding spatial distribution of worsening test locations.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Diagnostic Techniques, Ophthalmological*
  • Disease Progression
  • False Positive Reactions
  • Female
  • Follow-Up Studies
  • Glaucoma / diagnosis*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Optic Nerve Diseases / diagnosis*
  • Predictive Value of Tests
  • Probability
  • Reproducibility of Results
  • Vision Disorders / diagnosis*
  • Visual Fields*