Refinement of Pointwise Linear Regression Criteria for Determining Glaucoma Progression
Refinement of Pointwise Linear Regression Criteria for Determining Glaucoma Progression
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DOI：
10.1167/iovs.13-11680
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发表时间：
2013-09-01
影响因子：
4.4
通讯作者：
Wall, Michael
中科院分区：
文献类型：
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作者：
Kummet, Colleen M.;Zamba, K. D.;Wall, Michael
目的。已经提出了各种逐点线性回归(PLR)标准来确定青光眼视野进展。然而，替代的PLR标准仅在有限的基础上进行了评估。方法：采用Humphrey视野分析仪II程序24-2瑞典交互阈值算法标准测试策略和Goldmann SIZE III刺激物，对140只眼(96例患者和44例对照各1只眼)的视野数据进行了评估。资料采用逐点线性回归A2(PLRA2)方法进行分析，每6个月进行9次视野检查，连续4年。来自眼压治疗研究(OHTS)的数据被用来验证决策规则。结果：几个斜率标准产生的特异度为0.90或更高，特别是斜率标准小于-1.2分贝/年。在P<；0.04的显著性水平下使用小于-1.2分贝/y的斜率标准进行分类时，命中率为0.38，比通常使用的标准斜率标准(P<；0.01)下的小于-1.0分贝/年的斜率标准增加2倍以上。与独立OHTS验证数据中的标准标准相比，斜率小于-1.2分贝/年和P<；0.04时的命中率也有类似的提高。结论：当系统地评估青光眼进展的标准时，PLR标准可以通过要求更严格的斜率标准(如小于-1.2分贝/年)和放宽P<；0.04的显著性标准来改进。提高PLR的命中率将有助于青光眼的早期发现和治疗。
PURPOSE. A variety of pointwise linear regression (PLR) criteria have been proposed for determining glaucomatous visual field progression. However, alternative PLR criteria have only been assessed on a limited basis. The purpose of this study was to evaluate a range of PLR slope and significance criteria to define a clinically useful progression decision rule for longitudinal visual field examinations.METHODS. Visual field data for each of 140 eyes (one per participant among 96 cases and 44 controls) were evaluated using the Humphrey Field Analyzer II program 24-2 Swedish interactive thresholding algorithm standard test strategy and Goldmann size III stimuli. The pointwise linear regression A2 (PLRA2) method was used to analyze the data, which included nine visual field examinations performed every 6 months for 4 years. Data from the Ocular Hypertension Treatment Study (OHTS) were used to validate the decision rule.RESULTS. Several slope criteria produced specificities of 0.90 or higher, particularly slope criteria of less than - 1.2 dB/y. The use of the slope criterion less than - 1.2 dB/y at a significance level of P < 0.04 for classification resulted in a hit rate of 0.38, more than a 2-fold increase compared with a commonly used standard slope criterion of less than -1.0 dB/y at a significance level of P < 0.01. A similar increase in the hit rate was shown for a slope of less than -1.2 dB/y and P < 0.04 compared with the standard criterion in the independent OHTS validation data.CONCLUSIONS. When systematically evaluating criteria for detecting glaucoma progression, PLR criteria can be refined by requiring a stricter slope criterion such as less than -1.2 dB/y and relaxing the significance criterion to P < 0.04. Increasing the hit rate of PLR will be useful for early detection and treatment of glaucoma.