Central macular OCTA parameters in glaucoma

2021 ◽  
pp. bjophthalmol-2021-319574
Author(s):  
Takashi Nishida ◽  
Won Hyuk Oh ◽  
Sasan Moghimi ◽  
Adeleh Yarmohammadi ◽  
Huiyuan Hou ◽  
...  
Keyword(s):  
Visual Field ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Open Angle Glaucoma ◽  
Foveal Avascular Zone ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Central Visual Field ◽  
Foveal Thickness ◽  
Glaucoma Suspect

Background/aimsTo investigate the relationship between the foveal avascular zone (FAZ) parameters assessed by optical coherence tomography angiography (OCTA) and central visual field parameters in glaucoma and healthy subjects.MethodsOne hundred and eighty-eight subjects (248 eyes), including 24 healthy (38 eyes), 37 glaucoma suspect (42 eyes, and 127 primary open angle glaucoma (POAG) patients (168 eyes), underwent imaging using OCTA and standard automated perimetry using the 24-2 and 10-2 Swedish Interactive Thresholding Algorithm. OCTA-based and OCT-based FAZ parameters (superficial FAZ area, FAZ circumference), foveal vessel density (FD300) and foveal thickness were measured. The correlation between FAZ parameters and visual field parameters was assessed using linear mixed model.ResultsAxial length adjusted-FAZ area was not different among the three groups (mean (95% CI)): in healthy 0.31 (0.27 to 0.36) mm2, glaucoma suspect 0.29 (0.26 to 0.31) mm2 and POAG eyes 0.28 (0.27 to 0.30) mm2 (p=0.578). FD300 was lower in glaucoma suspect 49.1% (47.9% to 50.4%) and POAG eyes 48.7% (48.1% to 49.4%) than healthy eyes 50.5% (49.3% to 51.7%) though the difference was not statistically significant (p=0.071). Lower FD300 was associated with worse 24-2 and 10-2 visual field mean deviation and foveal threshold in multivariable linear mixed models (all p<0.05). In addition, a smaller FAZ area was associated with lower intraocular pressure (IOP) (p=0.026).ConclusionsThe FD300, but not the FAZ area was correlated with 10° central visual field mean deviation and foveal threshold in healthy, glaucoma suspect and POAG eyes. In contrast, a smaller FAZ area was associated with lower IOP.

Quantification of residual ellipsoid zone and its correlation with visual functions in patients with cone-rod dystrophy

2021 ◽  
pp. 112067212199056
Author(s):  
Takumi Hara ◽  
Han Peng Zhou ◽  
Marie Kitano ◽  
Kana Kure ◽  
Ryo Asaoka ◽  
...  
Keyword(s):  
Visual Field ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Intraclass Correlation ◽  
Photoreceptor Cells ◽  
Mean Deviation ◽  
Central Visual Field ◽  
Ellipsoid Zone ◽  
Visual Functions ◽  
The Mean

Cone-rod dystrophy (CORD) is one of the inherited retinal diseases that result in central visual field deterioration and decreased visual acuity (VA). In CORD patients, impaired photoreceptor cells are observed as the disruption of ellipsoid zone (EZ) on optical coherence tomography (OCT) images. In the present study, we calculated the index of residual EZ (rEZ) to quantify the function of photoreceptor cells and investigated the correlation between rEZ index and visual functions. Twenty-six eyes of 13 patients with clinical suspicion of CORD were examined. Visual field was tested with the Humphrey Visual Field Analyzer (HFA 10-2 program). We simultaneously obtained OCT images and calculated the area of decreased EZ intensity (EZa). Using the binarized OCT images, the percentage of the rEZ in a 3 × 3 mm area surrounding the macula was analyzed. To clarify interrator reproducibility, intraclass correlation coefficient (ICC) was calculated. Moreover, we investigated the association between OCT parameters and VA as well as the mean deviation (MD) value measured with HFA. The mean age of the patients was 48.5 ± 16.9 years. The mean central retinal thickness was 122.7 ± 73.2 μm. The mean EZa and rEZ were 22.2 ± 23.6 μm2 and 0.35 ± 0.31, respectively. The ICC of each rEZ index was 0.91 (95% CI: 0.89 < ICC < 0.93). Multivariate analysis indicated rEZ was significantly related to logMAR VA ( p = 0.05) and rEZ and EZa were associated with the MD value ( p = 0.014 and p = 0.009, linear mixed model). Furthermore, rEZ was also associated with photopic a- and b-wave amplitudes ( p = 0.027 and p = 0.0024, respectively, linear mixed model). Taken together, the current results suggested the usefulness of rEZ quantification for predicting visual functions in CORD patients.

scholarly journals Relationship between visual field changes and optical coherence tomography measurements in advanced open-angle glaucoma

Folia Medica ◽  
2016 ◽  
Vol 58 (3) ◽  
pp. 174-181 ◽  
Author(s):  
Snezhina S. Kostianeva ◽  
Marieta I. Konareva-Kostianeva ◽  
Marin A. Atanassov
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Structural Changes ◽  
Open Angle Glaucoma ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Open Angle ◽  
Sd Oct

Abstract Aim: To assess relationships between functional changes in visual field and structural changes in advanced open-angle glaucoma (OAG) found using spectral-domain optical coherence tomography (SD-OCT). Methods: Thirty-one eyes of 25 patients with OAG were included in this study. Besides the routine ophthalmological exam the patients underwent standard automated perimetry (SAP) (Humphrey Field Analyzer) and SD-OCT (RTVue–100) performed within 6 months. The global perimetric indices in the study group were as follows: mean deviation (MD) 12.33±6.18 dB and pattern standard deviation (PSD) 9.17±3.41 dB. The relationship between OCT measurements and MD and PSD was evaluated by correlation analysis (Pearson’s correlation coefficient) and regression analysis (linear and nonlinear regression models). Results: Thickness measurements of the lower halves of ganglion cell complex (GCC) and retinal nerve fiber layer by two scanning protocols (ONH and 3.45) showed these to be thinner than the upper halves, but the difference failed to reach statistical significance. The correlations between global indices MD/PSD and most of the analysed quantitative OCT measurements were moderate (r in the range between 0.3 and 0.6). The correlation between MD and GCC showed nonlinear cubic regression (R2=0.417, P=0.004). Good correlation was found between MD and GLV (R2=0.383; P=0.008). Linear regression (P<0.05) was found only between MD and Cup area (R2=0.175, P=0.024) and between MD and RNFL by 3.45 protocol (R2=0.131, P=0.045). Conclusion: Nonlinear regressive models appear to be more appropriate in the assessment of the correlations between functional and structural changes in eyes with advanced glaucoma. The correlations we found were moderate.

scholarly journals Influence of automated visual field testing on intraocular pressure

2020 ◽  
Author(s):  
Samuel Bertaud ◽  
Elisabeth Skarbek Borowski ◽  
Rachid Abbas ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Angle Closure ◽  
Mean Deviation ◽  
Test Duration ◽  
Automated Perimetry ◽  
Significant Difference ◽  
The Impact

Abstract Background To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma. Methods We conducted a prospective observational study from October 2015 to July 2016 at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT with reliable standard automated perimetry (SAP) were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 minutes before and after VF testing. Subanalyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations. Results There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R²=0.12), whether based on duration of the VF test (P = 0.18) or the MD (P = 0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (p = 0.36), chronic angle closure glaucoma (P = 0.85) and OHT (P = 0.42). The subgroup of patients with an IOP elevation > 2 mmHg had a significantly higher SAP test duration (P = 0.002). Conclusion VF testing by SAP does not influence IOP as measured with a non-contact tonometer.

scholarly journals Investigation of progression pattern and associated risk factors in glaucoma patients with initial paracentral scotomas using Humphrey 10-2

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Kyoung Kim ◽  
Hae-Young Lopilly Park ◽  
Kyung Euy Hong ◽  
Da Young Shin ◽  
Chan Kee Park
Keyword(s):  
Risk Factors ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Linear Regression Analysis ◽  
Test Point ◽  
Mean Deviation ◽  
Central Visual Field ◽  
Total Deviation ◽  
Paracentral Scotoma ◽  
Associated Risk Factors

AbstractCentral visual field (VF) progression could directly threaten patientss visual function compared to glaucomatous damage. This study was designed to investigate visual field (VF) progression pattern and associated risk factors including optical coherence topography angiographic (OCT-A) findings in glaucoma patients with initial paracentral scotoma. This prospective, observational study included 122 eyes presenting as initial paracentral scotomas with serial 24-2 and 10-2 VF tests at the glaucoma clinic of Seoul St Mary's Hospital between November 2017 and August 2020. The participants underwent at least 5 serial VF exams and OCT-A at baseline. Numerical values of the initial and final 10-2 VF tests were averaged for each VF test point using the total deviation map. Innermost 10-2 VF progression was defined as three or more new contiguous points at the central 12 points on 10-2 VF. Other clinical characteristics were collected including history of disc hemorrhage and vessel density (VD) was measured from OCT-A images. Linear regression analysis was performed to obtain the change of mean deviation and a cut-off for progression was defined for both 24-2 and 10-2 VFs. The average total deviation maps of the initial 10-2 VF tests shows initial paracentral scotoma located in the superior region in an arcuate pattern that was deep in the 4°–6° region above fixation. This arcuate pattern was more broadly located in the 4°–10° region in the primary open-angle glaucoma (POAG) group, while it was closer to fixation in 0°–4° region in the normal-tension glaucoma (NTG) group. The final average map shows deepening of scotomas in the 4°–10° region in POAG, which deepened closer to the region of fixation in NTG. The diagnosis of NTG (β 1.892; 95% CI 1.225–2.516; P = 0.035) and lower choroidal VD in the peripapillary atrophy (PPA) region (β 0.985; 95% CI 0.975 to 0.995; P = 0.022) were significantly related to innermost 10-2 VF progression. Initial paracentral scotomas in NTG tended to progress closer to the region of fixation, which should be monitored closely. Important progression risk factors related to paracentral scotoma near the fixation were the diagnosis of NTG and reduced choroidal VD in the β-zone PPA region using OCT-A. We should consider vascular risk factors in NTG patients presenting with initial paracentral scotoma to avoid vision threatening progression of glaucoma.

scholarly journals Association between visual field damage and corneal structural parameters

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandru Lavric ◽  
Valentin Popa ◽  
Hidenori Takahashi ◽  
Rossen M. Hazarbassanov ◽  
Siamak Yousefi
Keyword(s):  
Machine Learning ◽  
Visual Field ◽  
Structural Parameters ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Visual Field Damage ◽  
Corneal Shape

AbstractThe main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual field damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual field tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual field damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifiers, we detected visual field abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifier, we detected four visual field severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual field loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss.

Visual Field Damage and Progression in Glaucomatous Myopic Eyes

2007 ◽  
Vol 17 (4) ◽  
pp. 534-537 ◽  
Author(s):  
A. Perdicchi ◽  
M. Iester ◽  
G. Scuderi ◽  
S. Amodeo ◽  
E.M. Medori ◽  
...  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Linear Regression Analysis ◽  
Visual Fields ◽  
Light Sensitivity ◽  
Progressive Increase ◽  
Central Visual Field ◽  
Trend Function ◽  
Visual Field Damage ◽  
Loss Variance

Purpose To make a visual field retrospective analysis on a group of patients with primary open angle glaucoma (POAG) and to evaluate whether different refractive errors could have different progression of the 30° central sensitivity. Methods A total of 110 patients with POAG (52 men and 58 women) were included in the study. All the patients were divided into four subgroups based on the refractive error. The visual field of all the included patients was assessed by an Octopus 30° central visual field every 6 months, for a total of 837 visual fields examined. The resulting data were analyzed by PERIDATA for Windows 1.7 TREND function. Mean defect (MD) and loss variance (LV) were considered for the analysis. Results At the first examination, 82% of eyes showed a global decrease of differential light sensitivity (MD >2 dB) and in 67% the distribution of the defect was nonhomogeneous (LV >6 dB). The analysis of variance for subgroups showed a more significant decrease of MD in highly myopic patients. A linear regression analysis highlighted a statistically significant change in time of MD in 36% and of LV in 34% of the eyes studied. Highly myopic patients had the highest (p<0.01) percentage of change of MD and LV (46% and 42%, respectively). Among the four subgroups, there was no difference in progression of MD decrease in time. Conclusions These results showed that after 5 years of glaucoma, the visual field was altered in most of the eyes examined (82%) and that in 67% of cases, its defect was nonhomogeneous and worsened with the increase of myopia. The regression linear analysis of visual field changes in time showed a progressive increase of MD and LV in approximately one third of all the eyes examined.

Comparing the usefulness of a new algorithm to measure visual field using the variational Bayes linear regression in glaucoma patients, in comparison to the Swedish interactive thresholding algorithm

2021 ◽  
pp. bjophthalmol-2020-318304
Author(s):  
Hiroshi Murata ◽  
Ryo Asaoka ◽  
Yuri Fujino ◽  
Masato Matsuura ◽  
Kazunori Hirasawa ◽  
...  
Keyword(s):  
Visual Field ◽  
Linear Regression ◽  
Open Angle Glaucoma ◽  
Variational Bayes ◽  
Mean Deviation ◽  
Test Duration ◽  
Field Analyser ◽  
Measurement Duration ◽  
Measurement Algorithm ◽  
Thresholding Algorithm

Background/aimsWe previously reported that the visual field (VF) prediction model using the variational Bayes linear regression (VBLR) is useful for accurately predicting VF progression in glaucoma (Invest Ophthalmol Vis Sci. 2014, 2018). We constructed a VF measurement algorithm using VBLR, and the purpose of this study was to investigate its usefulness.Method122 eyes of 73 patients with open-angle glaucoma were included in the current study. VF measurement was performed using the currently proposed VBLR programme with AP-7700 perimetry (KOWA). VF measurements were also conducted using the Swedish interactive thresholding algorithm (SITA) standard programme with Humphrey field analyser. VF measurements were performed using the 24–2 test grid. Visual sensitivities, test–retest reproducibility and measurement duration were compared between the two algorithms.ResultMean mean deviation (MD) values with SITA standard were −7.9 and −8.7 dB (first and second measurements), whereas those with VBLR-VF were −8.2 and −8.0 dB, respectively. There were no significant differences across these values. The correlation coefficient of MD values between the 2 algorithms was 0.97 or 0.98. Test–retest reproducibility did not differ between the two algorithms. Mean measurement duration with SITA standard was 6 min and 02 s or 6 min and 00 s (first or second measurement), whereas a significantly shorter duration was associated with VBLR-VF (5 min and 23 s or 5 min and 30 s).ConclusionVBLR-VF reduced test duration while maintaining the same accuracy as the SITA-standard.

scholarly journals Comparison of Latanoprost/Timolol with Carbonic Anhydrase Inhibitor and Dorzolamide/Timolol with Prostaglandin Analog in the Treatment of Glaucoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kenji Inoue ◽  
Shoichi Soeda ◽  
Goji Tomita
Keyword(s):  
Visual Field ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Field Testing ◽  
Mean Deviation ◽  
Single Action ◽  
Before And After ◽  
Group 2 ◽  
Concomitant Medications ◽  
Medication Changes

Purpose.We retrospectively reviewed medical records of glaucoma patients to investigate how switching medications may affect intraocular pressure (IOP) management. Three concomitant medications were changed to two medications: one combination drop and one single-action drop. Associated adverse effects were also examined.Subjects and Methods.A total of 112 patients with primary open-angle glaucoma or ocular hypertension were examined. All patients were concomitantly using a prostaglandin (PG) analog, aβ-blocker, and a carbonic anhydrate inhibitor (CAI). Fifty-five patients began using latanoprost (PG analog)/timolol (β-blocker) fixed-combination (LTFC) drops and a CAI (group 1), and 57 patients began using dorzolamide (CAI)/timolol fixed-combination (DTFC) drops and a PG analog (group 2). The IOP was measured every 6 months for 2 years following medication changes. Changes in visual field mean deviation (MD) and medication discontinuations were also examined.Results.There were no significant differences in IOP or MD values before and after medication changes in either group. The proportion of medication discontinuations, uncontrolled IOP, and adverse reactions was similar in both groups.Conclusion.Switching patients from multiple single-action medications to combination medications was not associated with changes in IOP, visual field testing results, or adverse event frequency.

Essentials of Automated Perimetry

Visual Fields ◽  
2010 ◽  
Author(s):  
George Shafranov
Keyword(s):  
Visual Field ◽  
Digital Data ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Central Visual Field ◽  
Kinetic Perimetry ◽  
Field Of Vision ◽  
Stationary Test ◽  
Variable Light ◽  
Defects Analysis

Standard automated perimetry is a standard method of measuring peripheral visual function. Automated static perimetry gained wide acceptance among clinicians due to the test’s high reproducibility and standardization and ability to store, exchange, and statistically analyze digital data. Advances in the computerized visual field assessment have contributed to our understanding of the role that field of vision plays in clinical evaluation and management of patients. The Humphrey Visual Field Analyzer/HFA II-i is the most commonly used automated perimeter in the United States, and the examples in this chapter have been obtained with this instrument. Aubert and Förster in the 1860s developed the arc perimeter, which led to the mapping of peripheral neurologic visual field abnormalities and advanced glaucomatous field defects. Analysis of the central visual field was not seen as clinically important by most clinicians until 1889, when Bjerrum described a detected arcuate paracentral scotoma. Later, Traquair further contributed to kinetic perimetry on the tangent screen. In 1893, Groenouw proposed the term “isopter” for lines with the same sensitivity on a perimetry chart. Rønne further developed kinetic isopter perimetry in 1909 and described the nasal step in glaucoma. Although the first bowl perimeter was introduced in 1872 by Scherk, due to problems with achieving even illumination on the screen, it did not become popular. The version of the bowl perimeter introduced by Goldmann in 1945 became widely accepted and is a significant contribution to clinical perimetry. The Goldmann perimeter incorporated a projected stimulus on an illuminated bowl, with standardization of background illumination as well as size and intensity of the stimulus, and allowed effective use of both static and kinetic techniques. For these reasons, the Goldmann instrument has remained the clinical standard throughout the world until widespread acceptance of automated perimetry. Harms and Aulhorn later designed the Tübingen perimeter with a bowl-type screen exclusively for the measurement of static threshold fields, using stationary test objects with variable light intensity. While excellent threshold measurements were possible with this instrument, the time and effort involved in such measurements prevented this perimeter from becoming widely used.

scholarly journals Estimating Rates of Progression and Predicting Future Visual Fields in Glaucoma Using a Deep Variational Autoencoder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel I. Berchuck ◽  
Sayan Mukherjee ◽  
Felipe A. Medeiros
Keyword(s):  
Visual Field ◽  
Learning Algorithm ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Absolute Error ◽  
Rate Of Change ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Deep Learning Algorithm

AbstractIn this manuscript we develop a deep learning algorithm to improve estimation of rates of progression and prediction of future patterns of visual field loss in glaucoma. A generalized variational auto-encoder (VAE) was trained to learn a low-dimensional representation of standard automated perimetry (SAP) visual fields using 29,161 fields from 3,832 patients. The VAE was trained on a 90% sample of the data, with randomization at the patient level. Using the remaining 10%, rates of progression and predictions were generated, with comparisons to SAP mean deviation (MD) rates and point-wise (PW) regression predictions, respectively. The longitudinal rate of change through the VAE latent space (e.g., with eight dimensions) detected a significantly higher proportion of progression than MD at two (25% vs. 9%) and four (35% vs 15%) years from baseline. Early on, VAE improved prediction over PW, with significantly smaller mean absolute error in predicting the 4th, 6th and 8th visits from the first three (e.g., visit eight: VAE8: 5.14 dB vs. PW: 8.07 dB; P < 0.001). A deep VAE can be used for assessing both rates and trajectories of progression in glaucoma, with the additional benefit of being a generative technique capable of predicting future patterns of visual field damage.

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