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Detecting glaucoma progression from localized rates of retinal changes in parametric and nonparametric statistical framework with type I error control.

Publication ,  Journal Article
Balasubramanian, M; Arias-Castro, E; Medeiros, FA; Kriegman, DJ; Bowd, C; Weinreb, RN; Holst, M; Sample, PA; Zangwill, LM
Published in: Invest Ophthalmol Vis Sci
March 19, 2014

PURPOSE: We evaluated three new pixelwise rates of retinal height changes (PixR) strategies to reduce false-positive errors while detecting glaucomatous progression. METHODS: Diagnostic accuracy of nonparametric PixR-NP cluster test (CT), PixR-NP single threshold test (STT), and parametric PixR-P STT were compared to statistic image mapping (SIM) using the Heidelberg Retina Tomograph. We included 36 progressing eyes, 210 nonprogressing patient eyes, and 21 longitudinal normal eyes from the University of California, San Diego (UCSD) Diagnostic Innovations in Glaucoma Study. Multiple comparison problem due to simultaneous testing of retinal locations was addressed in PixR-NP CT by controlling family-wise error rate (FWER) and in STT methods by Lehmann-Romano's k-FWER. For STT methods, progression was defined as an observed progression rate (ratio of number of pixels with significant rate of decrease; i.e., red-pixels, to disk size) > 2.5%. Progression criterion for CT and SIM methods was presence of one or more significant (P < 1%) red-pixel clusters within disk. RESULTS: Specificity in normals: CT = 81% (90%), PixR-NP STT = 90%, PixR-P STT = 90%, SIM = 90%. Sensitivity in progressing eyes: CT = 86% (86%), PixR-NP STT = 75%, PixR-P STT = 81%, SIM = 39%. Specificity in nonprogressing patient eyes: CT = 49% (55%), PixR-NP STT = 56%, PixR-P STT = 50%, SIM = 79%. Progression detected by PixR in nonprogressing patient eyes was associated with early signs of visual field change that did not yet meet our definition of glaucomatous progression. CONCLUSIONS: The PixR provided higher sensitivity in progressing eyes and similar specificity in normals than SIM, suggesting that PixR strategies can improve our ability to detect glaucomatous progression. Longer follow-up is necessary to determine whether nonprogressing eyes identified as progressing by these methods will develop glaucomatous progression. (ClinicalTrials.gov number, NCT00221897).

Duke Scholars

Published In

Invest Ophthalmol Vis Sci

DOI

EISSN

1552-5783

Publication Date

March 19, 2014

Volume

55

Issue

3

Start / End Page

1684 / 1695

Location

United States

Related Subject Headings

  • Visual Fields
  • Retina
  • Ophthalmoscopy
  • Ophthalmology & Optometry
  • Models, Statistical
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Humans
  • Glaucoma, Open-Angle
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Balasubramanian, M., Arias-Castro, E., Medeiros, F. A., Kriegman, D. J., Bowd, C., Weinreb, R. N., … Zangwill, L. M. (2014). Detecting glaucoma progression from localized rates of retinal changes in parametric and nonparametric statistical framework with type I error control. Invest Ophthalmol Vis Sci, 55(3), 1684–1695. https://doi.org/10.1167/iovs.13-13246
Balasubramanian, Madhusudhanan, Ery Arias-Castro, Felipe A. Medeiros, David J. Kriegman, Christopher Bowd, Robert N. Weinreb, Michael Holst, Pamela A. Sample, and Linda M. Zangwill. “Detecting glaucoma progression from localized rates of retinal changes in parametric and nonparametric statistical framework with type I error control.Invest Ophthalmol Vis Sci 55, no. 3 (March 19, 2014): 1684–95. https://doi.org/10.1167/iovs.13-13246.
Balasubramanian M, Arias-Castro E, Medeiros FA, Kriegman DJ, Bowd C, Weinreb RN, et al. Detecting glaucoma progression from localized rates of retinal changes in parametric and nonparametric statistical framework with type I error control. Invest Ophthalmol Vis Sci. 2014 Mar 19;55(3):1684–95.
Balasubramanian, Madhusudhanan, et al. “Detecting glaucoma progression from localized rates of retinal changes in parametric and nonparametric statistical framework with type I error control.Invest Ophthalmol Vis Sci, vol. 55, no. 3, Mar. 2014, pp. 1684–95. Pubmed, doi:10.1167/iovs.13-13246.
Balasubramanian M, Arias-Castro E, Medeiros FA, Kriegman DJ, Bowd C, Weinreb RN, Holst M, Sample PA, Zangwill LM. Detecting glaucoma progression from localized rates of retinal changes in parametric and nonparametric statistical framework with type I error control. Invest Ophthalmol Vis Sci. 2014 Mar 19;55(3):1684–1695.

Published In

Invest Ophthalmol Vis Sci

DOI

EISSN

1552-5783

Publication Date

March 19, 2014

Volume

55

Issue

3

Start / End Page

1684 / 1695

Location

United States

Related Subject Headings

  • Visual Fields
  • Retina
  • Ophthalmoscopy
  • Ophthalmology & Optometry
  • Models, Statistical
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Humans
  • Glaucoma, Open-Angle