Measuring and predicting visual field progression with longitudinal-survival CART

描述（由申请人提供）：视野进展的检测和预测已被认为是青光眼管理和护理的关键发展。视野进展的表征将允许对高危眼进行直接随访，早期检测和治疗青光眼，更好地减缓患病眼的进展，以及延迟视野损伤的方案。作为次要结局，它还将为青光眼的临床试验和研究提供合理有效的进展结局指标。然而，同样公认的是，进展的表征是青光眼研究和临床评价中最具挑战性的方面之一，但可能是对管理策略/理念具有高度影响的发现。本研究项目的主要目的是开发临床指标和预后因素，用于检测和预测青光眼视野进展。这些目标将通过将新的分类和回归树（CART）方法应用于青光眼视野检查和心理物理学（PPIG）研究的数据来实现。PPIG研究包括168名患有中高危高眼压或早期青光眼的个体，随访长达11年，每年进行视野检查。数据包括进行性青光眼视神经病变（pGON）的测量、标准自动视野检查视野测试模式和总结、视盘总结以及其他临床和社会人口学观察结果。新开发的CART方法考虑了在吸收视野数据时视野测量的时间序列中同伴眼睛和空间变异性之间的相关性。因此，CART分析充分利用PPIG研究数据创建昏迷性视野进展分类系统，用于从随访视野检测视野进展和从基线观察预测视野进展的明确措施。

DESCRIPTION (provided by applicant): Detection and prediction of visual field progression has been recognized as a crucially needed development for glaucoma management and care. Characterization of visual field progression will allow for directed follow-up of high risk eyes, early detection and treatment of glaucoma, better potential for slowing progression of diseased eyes, and a protocol for delaying visual field damage. As a secondary outcome, it will also provide a justifiable and valid progression outcome measure for clinical trials and studies of glaucoma. However, it is equally well recognized that characterization of progression is one of the most challenging aspects of glaucoma research and clinical evaluation but perhaps a finding with high impact on management strategies/philosophies. The primary aims of this research project are to develop clinical indicators and prognostic factors for detecting and predicting glaucomatous visual field progression. These aims will be met through applications of novel classification and regression tree (CART) methods to data from the perimetry and psychophysics in glaucoma (PPIG) study. The PPIG study consists of 168 individuals with moderate to high risk ocular hypertension or early glaucoma followed for up to eleven years with annual visual field examinations. The data includes a measure of progressive glaucomatous optic neuropathy (pGON), standard automated perimetry visual field test patterns and summaries, optic disc summaries, and other clinical and sociodemographic observations. The new CART methods developed account for correlations between fellow eyes and spatial variability in the temporal series of visual field measurements in assimilating visual field data. The CART analyses thus take full advantage of the PPIG study data in creating glaucomatous visual field progression classification systems, definitive measures for detecting visual field progression from follow-up visual fields and for predicting visual field progression from baseline observations.