The progression of actual 10-2 VF MDs and LMDs.

<p>Orange circles represent three initial actual 10-2 VF MDs, red circles represent 4th and 5th 10-2 VF MDs, the green circle represents the 6th 10-2 VF MD and black circles represent LMDs. Linear regression lines are drawn for the initial five (red; ‘VF10-2 1st to 5th’) and three (orange; ‘VF10-2 1st to 3rd’) actual MDs, and initial three actual MDs plus LMDs (blue; ‘LMD’) in four different patients. The grayscale images illustrate the actual 30-2 VFs and 10-2 VFs. a: case1, 61 years old, male, left eye b: case2, 76 years old, male, right eye. VF: visual field, MD: mean of total deviation, LMD: Lasso-derived 10-2 VF MD.</p

The relationship between the

<p><b> and </b><b> values in the same quadrant.</b> Top left: Supero-temporal quadrant (y = −7.5+0.64 x, R² = 0.34, p<0.0001), Top right: Supero-nasal quadrant (y = −6.8+0.70 x, R² = 0.51, p<0.0001), Bottom left: Infero-temporal quadrant (y = −4.2+0.60 x, R² = 0.32, p<0.0001), Bottom right: Infero-nasal quadrant (y = −4.3+0.77 x, R² = 0.56, p<0.0001). : innermost test points in the 30-2 VF, : innermost 17 test points of the 10-2 VF.</p

Mapping Glaucoma Patients' 30-2 and 10-2 Visual Fields Reveals Clusters of Test Points Damaged in the 10-2 Grid That Are Not Sampled in the Sparse 30-2 Grid

<div><p>Purpose</p><p>To cluster test points in glaucoma patients' 30-2 and 10-2 visual field (VF) (Humphrey Field Analyzer: HFA, Carl Zeiss Meditec, Dublin, CA) in order to map the different regions damaged by the disease.</p><p>Method</p><p>This retrospective study included 128 eyes from 128 patients. 142 total deviation (TD) values (74 from the 30-2 VF and 68 from the 10-2 VF) were clustered using the ‘Hierarchical Ordered Partitioning And Collapsing Hybrid – Partitioning Around Medoids’ algorithm. The stability of the identified clusters was evaluated using bootstrapping.</p><p>Results</p><p>65 sectors were identified in total: 38 sectors were located outside the 10-2 VF whereas 29 sectors were located inside the 10-2 VF (two sectors overlap in both grids). The mapping of many sectors appeared to follow the distribution of retinal nerve fiber bundles. The results of bootstrapping suggested clusters were stable whether they were outside or inside the 10-2 VF.</p><p>Conclusion</p><p>A considerable number of sectors were identified in the 10-2 VF area, despite the fact that clustering was carried out on all points in both the 30-2 VF and 10-2 VF simultaneously. These findings suggest that glaucomatous central VF deterioration cannot be picked up by the 30-2 test grid alone, because of poor spatial sampling; denser estimation of the central ten degrees, than offered by the 30-2 test grid alone, is needed. It may be beneficial to develop a new VF test grid that combines test points from 30-2 and 10-2 VFs – the results of this study could help to devise this test grid.</p></div

Case examples.

<p>Case a: 61-year-old male (right eye, normal tension glaucoma) whose visual acuity was 20/20. The OCT image was obtained using the RS3000 (Nidek Co,.ltd, Gamagori, Aichi, Japan); blue colored regions in the OCT deviation map (left figure) indicate thinner RNFL+GCC than expected; significance is represented in the right figure (significant differences in thickness are colored in red). Case b: 60-year-old male (right eye, normal tension glaucoma) whose visual acuity was 20/20 (right eye). The OCT image was obtained using the 3D OCT-2000 (Topcon Corp, Tokyo, Japan), Case c: 69-year-old male (normal tension glaucoma) whose visual acuities were 20/32 (right eye) and 20/25 (left eye). OCT: Optical coherence tomography. RNFL: retinal nerve fiber layer, GCC: ganglion cell complex.</p

Subject demographics.

<p>sd: standard deviation, NTG: normal tension glaucoma, POAG: primary open angle glaucoma, PEG: pseudoexfoliation glaucoma, MD: mean deviation.</p

The relationship between the mean TD value of the four most central test points in the 30-2 VF and the mean TD value of all 68 points in the 10-2 VF.

<p>There was a significant and strong relationship (y = −3.5+0.84 x, R² = 0.80, p<0.0001). : mean of the TD values of all 74 test points in the 30-2 VF and : mean of the TD values of all 68 test points in the 10-2 VF. Shaded area corresponds to the 95% confidence interval of the pooled regression.</p

Characteristics of the study participants of training and testing datasets.

<p>MD: mean of total deviation values, VF: visual field, SD: standard deviation values at the first visit. POAG: primary open angle glaucoma, NTG: normal tension glaucoma, SOAG: secondary open angle glaucoma, PACG: primary angle closure glaucoma, OH: ocular hypertension.</p

Comparison of the difference of the Lasso-derived MD and the average of the twelve test points within ten degrees from fixation in the 24-2/30-2 VF, against the actual 10-2 VF MD.

<p>The Lasso-derived MD was obtained by leave-one-out cross validation. The difference shown is the absolute value. The difference associated with the Lasso derived MD was significantly smaller than that associated with the average of the central twelve 24-2 VF test points (p<0.05, percentile bootstrap method). MD: mean of total deviation, VF: visual field.</p

Cluster probability plot.

<p>Test points were ordered within a cluster by their reappearance probabilities, obtained by bootstrapping (10,000 times). We can see which clusters are most stable (wide bars) and which pairs of clusters are most likely to exchange test points with one another. Most of the clusters had good stability and the cluster stability did not differ discernibly between 30-2 VF and 10-2 VF sectors.</p

Mapping of 10-2 and 24-2 VF test points.

<p>Blue and green circles represent test points in the 24-2 VF and 10-2 VF, respectively. Red circles show points tested by both the 24-2 VF and 10-2 VF. VF: visual field.</p