Comparison of visual field point-wise event-based and global trend-based analysis for detecting glaucomatous progression

Purpose: To compare global trend-based and point-wise event-based analysis for detecting visual field progression in eyes with glaucoma. Methods: The study included a cohort of 367 glaucoma eyes from 265 participants seen over a mean follow-up period of 10 years to develop a computer simulation model of ‘‘real-world’’ visual field results. Progression was evaluated with point-wise event-based analysis using the Guided Progression Analysis (GPA) and global trend-based analysis using the mean deviation (MD) and visual field index (VFI) measures. The specificities of the methods were matched based on a simulated dataset of stable glaucoma eyes, to allow an adequate comparison of their sensitivities for detecting progression. Results: The 5-year cumulative false-positive rate for the GPA alert of ‘‘possible progression’’ and ‘‘likely progression’’ (significant change from baseline at two and three consecutive visits, respectively) were 34.0% and 7.0%, respectively. At matched specificities, 27.7% eyes were detected as having progressed after 5 years using the GPA ‘‘likely progression’’ criterion, while 24.6% and 23.8% were detected as having progressed using the global trend–based analysis with MD and VFI, respectively. There was a moderate level of agreement between the GPA and global trend-based analyses. Conclusions: Pointwise event-based and global trend–based methods had similar performances to detect glaucoma progression when rigorously matched for specificity.

Duke Scholars

Author Felipe Medeiros Ophthalmology, Glaucoma