Comparison of different methods for detecting glaucomatous visual field progression
Comparison of different methods for detecting glaucomatous visual field progression
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DOI：
10.1167/iovs.02-1171
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发表时间：
2003-09-01
影响因子：
4.4
通讯作者：
Chauhan, BC
中科院分区：
文献类型：
--
作者：
Vesti, E;Johnson, CA;Chauhan, BC
目的。方法：对76例开角型青光眼患者应用Humphrey视野分析仪(Carl Zeiss Meditec，都柏林)的全阈值30-2程序进行视野测量，比较7种方法分析青光眼视野进展的性能特点。一个计算机模拟程序在高度、中等和无变化的条件下产生了14个中期半年视野。采用高级青光眼干预研究(AGIS)、协作性初始青光眼治疗研究(CIGTS)、基于青光眼改变概率(GCP)分析的三个标准和基于逐点线性回归分析(PLRA)的两个标准分析进展情况。结果：在无变异条件下，AGIS进展率为18%，CIGTS进展率为36%，三种GCP方法进展率为47%~62%，两种PLRA方法进展率分别为72%和84%。进展率在三种GCP方法中以更大的变异性增加，而在所有其他方法中则降低。PLRA方法检测确定进展的时间最长，而CIGTS和GCP方法最短。在中等变异性条件下，所有方法均具有较高的特异性。AGIS、CIGTS、GCP和PLRA方法中的一种方法相对耐受高变异性，并保持了较高的特异性。结论：AGIS和CIGTS方法具有较高的特异性，但与其他方法相比，对进展病例的分类较少。GCP方法最早确定了进展；然而，它们通常不是那么具体。基于PLRA的方法是特异的，但确认进展的时间最长。
PURPOSE. To compare the performance characteristics of seven methods for analyzing glaucomatous visual field progression, using a combination of real patient data and computer simulation techniques.METHODS. The initial and final visual field results, separated by 7 years and measured with the full-threshold 30-2 program of the Humphrey Field Analyzer (Carl Zeiss Meditec, Dublin, CA) of 76 patients with open-angle glaucoma were used. A computer simulation program generated 14 interim semiannual visual fields under conditions of high, moderate, and no variability. Progression was analyzed using the methods of the Advanced Glaucoma Intervention Study (AGIS), the Collaborative Initial Glaucoma Treatment Study (CIGTS), three criteria based on the Glaucoma Change Probability (GCP) analysis, and two criteria based on point-wise linear regression analysis (PLRA). Specificities were calculated by using the same visual field of each patient as both the initial and final field (no progression) under conditions of moderate and high variability.RESULTS. Under the no-variability condition, progression rates were 18% for the AGIS, 36% for CIGTS, 47% to 62% for the three GCP methods, and 72% and 84% for the two PLRA methods. Progression rates increased with greater variability with the three GCP methods and decreased with all other methods. The time to detect confirmed progression was longest for the PLRA methods and shortest for the CIGTS and GCP methods. Under the moderate-variability condition, all methods yielded high specificity. The AGIS, CIGTS, and one of the GCP and PLRA methods were relatively resistant to high variability and maintained high specificities.CONCLUSIONS. The AGIS and CIGTS methods had high specificity, but classified fewer cases of progression than the other methods. The GCP methods determined progression earliest; however, they were generally not as specific. Methods based on PLRA were specific but times to confirmed progression were the longest.