Real-World Analysis of the Aging Effects on Visual Field Reliability Indices in Humans

Relationships between age and visual field (VF) reliability indices were investigated using a large real-world dataset (42,421 VF data points from 11,525 eyes of 5930 subjects). All VFs tested and stored at Shimane University Hospital between 1988 and 2019 were exported. Correlations between age, mean deviation (MD), pattern standard deviation (PSD), and reliability indices including fixation losses (FLs), false negatives (FNs), and false positives (FPs) were analyzed. The mean ± standard deviation age was 65.0 ± 15.1 years; MD—−6.9 ± 8.1 decibels (dB); PSD—6.3 ± 4.6 dB; FL—8.6 ± 11.7%; FN—5.3 ± 8.3%; and FP—2.6 ± 5.0%. Univariate analyses showed strong associations between age and FNs (correlation coefficient, ρ = 0.20, p < 0.0001) and MD (ρ = −0.21, p < 0.0001). All FLs, FNs, and FPs were lowest during the third decade (20–29 years) of life. FLs were elevated consistently after that decade, and FNs were elevated sharply after the seventh decade. FPs were relatively stable after the fourth decade (30–39 years). Mixed-effect regression analyses in subjects 40 years and older showed that older age was associated with worse FLs (p < 0.0001) and FNs (p < 0.0001) but not FPs (p = 0.4126). Aging affects FLs and FNs with different modes but had minimal effects on FPs. Decreased VF sensitivity, deteriorated macular function, and technical difficulties with testing may be mechanisms of age-related changes in FLs and FNs.

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New visual field indices of disharmony for early diagnosis of glaucoma, alone or associated with conventional parameters

European Journal of Ophthalmology ◽

10.1177/1120672118762668 ◽

2018 ◽

Vol 28 (5) ◽

pp. 590-597

Author(s):

Rodrigo Abreu-Gonzalez ◽

Marta Gonzalez-Hernandez ◽

Cristina Pena-Betancor ◽

Paloma Rodriguez-Esteve ◽

Manuel Gonzalez De La Rosa

Keyword(s):

Optical Coherence Tomography ◽

Standard Deviation ◽

Visual Field ◽

Early Diagnosis ◽

Structural Data ◽

Cross Sectional Study ◽

University Hospital ◽

Mean Deviation ◽

Optical Coherence ◽

Cross Sectional

Purpose: To evaluate the specificity of new perimetric indices based on harmony, alone and in combination with structural data, for glaucoma detection. Methods: In this prospective observational cross-sectional study, one eye of 105 healthy subjects and 97 early and suspect glaucomas were sequentially included and examined with Cirrus optical coherence tomography, twice with OCULUS Smartfield perimeter (SPARK strategy) and twice with Humphrey Analyzer (24-2 SITA-Fast) at the Ophthalmology Department from the University Hospital La Candelaria. Disharmony in the visual field was evaluated including vertical threshold symmetry, threshold rank), and homogeneity (threshold standard deviation from its maximum) using the patient himself/herself as a reference. We also evaluated disharmony in combination with the mean deviation and the pattern standard deviation in a single index (mismatch) and various combinations of morphological and functional indices. Combinations used a new score based on values above certain critical cut-off levels of each index. Results: For 95% specificity, the highest sensitivities were as follows: vertical cup/disc ratio: 28.9%; SPARK threshold rank: 29.9%; and SITA-Fast threshold standard deviation: 28.9%. For the combined indices and 100% specificity, they were 5 SPARK indices mismatch: 10.3%; 5 SITA-Fast indices mismatch: 11.3%; 8 optical coherence tomography indices: 21.9%; 13 SPARK and optical coherence tomography indices: 27.8%; and 13 SITA-Fast and optical coherence tomography indices: 32.0%. Conclusion: Disharmony combined with normative value-based indices and/or optical coherence tomography indices is useful for very specific early diagnosis of glaucoma.

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Sex-dependent Pathological Aging Effect on Caudate Functional Connectivity in Mild Cognitive Impairment

10.21203/rs.3.rs-1005572/v1 ◽

2021 ◽

Author(s):

Zhengshi Yang ◽

Jessica Z.K. Caldwell ◽

Jeffrey L. Cummings ◽

Aaron Ritter ◽

Jefferson W. Kinney ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Functional Connectivity ◽

Aging Effect ◽

Analysis Of Covariance ◽

Aging Effects ◽

Mixed Effect ◽

Effect Analysis ◽

Pathological Aging ◽

Age Related

Abstract Purpose To assess the pathological aging effect on caudate functional connectivity among mild cognitive impairment (MCI) participants and examine whether and how sex and amyloid contribute to this process. Materials and Methods 277 functional magnetic resonance imaging (fMRI) sessions from 163 cognitive normal (CN) older adults and 309 sessions from 139 participants with MCI were included as the main sample in our analysis. Pearson’s correlation was used to characterize the functional connectivity (FC) between caudate and each brain region, then caudate nodal strength was computed to quantify the overall caudate FC strength. Association analysis between caudate nodal strength and age was carried out in MCI and CN separately using linear mixed effect (LME) model with covariates (education, handedness, sex, Apolipoprotein E4 and intra-subject effect). Analysis of covariance was conducted to investigate sex, amyloid status and their interaction effects on aging with the fMRI data subset having amyloid status available. LME model was applied to women and men separately within MCI group to evaluate aging effects on caudate nodal strength and each region’s connectivity with caudate. We then evaluated the roles of sex and amyloid status in the associations of neuropsychological scores with age or caudate nodal strength. An independent cohort was used to validate the sex-dependent aging effects in MCI. Results The MCI group had significantly stronger age-related increase of caudate nodal strength compared to the CN group. Analyzing women and men separately revealed that the aging effect on caudate nodal strength among MCI participants was significant only for women (left: P=6.23x10−7, right: P=3.37x10−8), but not for men (P>0.3 for bilateral caudate). The aging effects on caudate nodal strength were not significantly mediated by brain amyloid burden. Caudate connectivity with ventral prefrontal cortex substantially contributed to the aging effect on caudate nodal strength in women with MCI. Higher caudate nodal strength is significantly related to worse cognitive performance in women but not in men with MCI. Conclusion Sex modulates the pathological aging effects on caudate nodal strength in MCI regardless of amyloid status. Caudate nodal strength may be a sensitive biomarker of pathological aging in women with MCI.

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Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

Journal of Ophthalmology ◽

10.1155/2019/1583260 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Cristiana Valente ◽

Elisa D’Alessandro ◽

Michele Iester

Keyword(s):

Statistical Analysis ◽

Standard Deviation ◽

Visual Field ◽

Trend Analysis ◽

Open Angle Glaucoma ◽

Mean Deviation ◽

Threshold Strategy ◽

Visual Field Progression ◽

The Mean

Aim. To evaluate the agreement between different methods in detection of glaucomatous visual field progression using two classification-based methods and four statistical approaches based on trend analysis. Methods. This is a retrospective and longitudinal study. Twenty Caucasian patients (mean age 73.8 ± 13.43 years) with open-angle glaucoma were recruited in the study. Each visual field was assessed by Humphrey Field Analyzer, program SITA standard 30-2 or 24-2 (Carl Zeiss Meditec, Inc., Dublin, CA). Full threshold strategy was also accepted for baseline tests. Progression was analyzed by using Hodapp–Parrish–Anderson classification and the Advanced Glaucoma Intervention Study visual field defect score. For the statistical analysis, linear regression (r2) was calculated for mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI), and when it was significant, each series of visual field was considered progressive. We also used Progressor to look for a significant progression of each visual field series. The agreement between methods, based on statistical analysis and classification, was evaluated using a weighted kappa statistic. Results. Thirty-eight visual field series were analyzed. The mean follow-up time was 6.2 ± 1.53 years (mean ± standard deviation). At baseline, the mean MD was −7.34 ± 7.18 dB; at the end of the follow-up, the mean MD was −9.25 ± 8.65 dB; this difference was statistically significant (p<0.001). The agreement to detect progression was fair between all methods based on statistical analysis and classification except for PSD r2. A substantial agreement (κ = 0.698 ± 0.126) was found between MD r2 and VFI r2. With the use of all the statistical analysis, there was a better time-saving. Conclusions. The best agreement to detect progression was found between MD r2 and VFI r2. VFI r2 showed the best agreement with all the other methods. GPA2 can help ophthalmologists to detect glaucoma progression and to help in treatment decisions. PSD r2 was the worse method to detect progression.

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Comparison of Perimetric Outcomes from Melbourne Rapid Fields Tablet Perimeter Software and Humphrey Field Analyzer in Glaucoma Patients

Journal of Ophthalmology ◽

10.1155/2020/8384509 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Harsh Kumar ◽

Mithun Thulasidas

Keyword(s):

Standard Deviation ◽

Visual Field ◽

Rural Areas ◽

Visual Fields ◽

Test Time ◽

Mean Deviation ◽

Time Saving ◽

Humphrey Field Analyzer ◽

Probability Plot ◽

The Mean

Purpose. To compare visual field results obtained using Melbourne Rapid Fields (MRF) iPad-based perimeter software and Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Threshold Algorithm (SITA) standard program in glaucoma patients. Design. A cross-sectional observational study. Methods. In this single-centre study involving patients diagnosed with glaucoma, the perimetric outcomes of MRF were compared against those returned from the HFA 24-2 SITA standard. Outcomes included mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI)/visual capacity (VC), foveal threshold, test time, number of points depressed at P<5% on PSD probability plot, and glaucoma hemifield test/color coded indicator. Results. The study included 28 eyes of 28 glaucoma patients. Mean (standard deviation) test times were 342.07 (56.70) seconds for MRF and 375.11 (88.95) for HFA 24-2 SITA standard P=0.046. Mean MD was significantly lower for MRF (Δ = 3.09, P<0.001), and mean PSD was significantly higher for MRF (Δ = 1.40, P=0.005) compared with HFA. The mean foveal threshold for the MRF was significantly lower than the mean HFA foveal threshold ((Δ = 9.25, P<0.001). The number of points depressed at P<5% on the PSD probability plot was significantly less for MRF P<0.001. Other perimetric outcomes showed no significant differences between both. Bland–Altman plots showed that considerable variability existed between the programs. Conclusion. MRF is a good cost-effective, time-saving, user-friendly tool for monitoring visual fields in settings where access to traditional perimetry is limited. The lack of Internet strength in rural areas and questionable detection of early cases may be two points in MRF fields requiring an upgrade.

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Influence of implantations of extended depth-of-focus on standard automated perimetry

Scientific Reports ◽

10.1038/s41598-020-77214-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jinhee Lee ◽

Yosai Mori ◽

Ryohei Nejima ◽

Keiichiro Minami ◽

Kazunori Miyata

Keyword(s):

Visual Field ◽

Cataract Surgery ◽

Mean Deviation ◽

Automated Perimetry ◽

Depth Of Focus ◽

Standard Automated Perimetry ◽

Multifocal Iol ◽

Reliability Indices ◽

Extended Depth Of Focus ◽

Foveal Sensitivity

AbstractThis prospective study aimed to investigate the influence of an extended depth-of-focus intraocular lens (EDOF IOL) on standard automated perimetry. Ninety eyes of 90 patients who had undergone cataract surgery from February 2018 to December 2018 were included. No patients had any diseases that might affect the visual field. ZMB00 (+ 4.00 D add), ZXR00V (+ 1.75 D add), and ZCB00V (Johnson & Johnson Surgical Vision, Santa Ana, CA, USA) were used as multifocal, EDOF, and monofocal IOLs, respectively. Humphrey Visual Field 10–2 testing was performed 2–3 months after cataract surgery, acceptable reliability indices were measured, and mean deviation (MD), pattern standard deviation (PSD), foveal sensitivity and mean sensitivity (MS) were compared. Seventy-one eyes (ZXR00V: 24 eyes, ZMB00: 25 eyes, ZCB00V: 22 eyes) were used for the analyses. The MD and MS of the EDOF and monofocal groups were significantly higher than those of the multifocal group (P < 0.0051). However, the MD and MS of the EDOF and monofocal groups were not different (P > 0.23). The PSD and foveal sensitivity were not different among the groups. In non-glaucomatous patients, the MD and MS of the EDOF IOL were comparable to those of the monofocal IOL and better than those of the multifocal IOL.

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Effect of fundus tracking on structure–function relationship in glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315070 ◽

2020 ◽

pp. bjophthalmol-2019-315070 ◽

Cited By ~ 1

Author(s):

Giovanni Montesano ◽

Luca M Rossetti ◽

Allison M McKendrick ◽

Andrew Turpin ◽

Paolo Fogagnolo ◽

...

Keyword(s):

Visual Field ◽

Structure Function ◽

Retinal Nerve Fibre Layer ◽

Mean Deviation ◽

Mixed Effect ◽

Discrimination Ability ◽

Global Indices ◽

Structure Function Relationship ◽

Registration Number ◽

Function Relationship

AimsTo investigate the effect of fundus tracking perimetry on structure–function relationship in glaucoma.MethodsPerimetric data were acquired with the Humphrey Field Analyzer (HFA) and the Compass fundus perimeter (CMP, equipped with fundus tracking). We included data from 696 eyes from 360 healthy people and 711 eyes from 434 patients with glaucoma from the original study, for which the circumpapillary retinal nerve fibre layer optical coherence tomography scan (Cp-RNFL) was available. We explored the structure–function relationship using both global indices (mean deviation and average Cp-RNFL thickness loss) and anatomically defined visual field clusters comparing the R2 values from mixed-effect models. We then measured the diagnostic ability of a combined Structure Function Index (SFI) using perimetric data from either perimeter. The comparisons were based on partial receiver operating characteristic curves with a minimum specificity of 75% and their areas under the curve.ResultsThe R2 for the global structure–function relationship was 0.50 for the CMP and 0.48 for the HFA. When visual field clusters were included in the model, the R2 was 0.29 for CMP and 0.30 for HFA. Overall, the discrimination ability of the SFI was not significantly higher than the Cp-RNFL for either the CMP (p=0.07) or the HFA (p=0.14). However, it was significantly better in eyes with perimetric damage (p<0.001), in which the CMP-SFI performed significantly better than the HFA-SFI (p=0.03).ConclusionsStructure–function relationship is similar between the two perimeters. Fundus tracking might improve discrimination ability with a combined SFI.Trial registration numberISRCTN13800424.

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Real-world efficacy of the Hydrus microstent in Black and Afro-Latinx patients with glaucoma: a retrospective study

Therapeutic Advances in Ophthalmology ◽

10.1177/2515841420964311 ◽

2020 ◽

Vol 12 ◽

pp. 251584142096431

Author(s):

Daniel Laroche ◽

Gideon Nkrumah ◽

Chester Ng

Keyword(s):

Visual Acuity ◽

Retrospective Study ◽

Visual Field ◽

Cataract Surgery ◽

Field Test ◽

Real World ◽

Common Adverse Effect ◽

Mean Deviation ◽

Visual Field Test ◽

Phacoemulsification Cataract Surgery

Purpose: The purpose was to determine the real-world efficacy of phacoemulsification cataract surgery and Hydrus microstent in Black and Afro-Latinx patients with glaucoma. Methods: A retrospective noncomparative single-center study of 76 Black and Afro-Latinx patients with glaucoma who underwent phacoemulsification cataract surgery and Hydrus microstent placement for treatment of glaucoma at single practice. Investigated parameters were intraocular pressure (IOP), number of medications, mean deviation on visual field test, and visual acuity. Patients were also subgrouped into mild, moderate, and advance glaucoma for further analysis. Results: We reviewed a total of 76 patients who had 6 months of follow up in the study. The mean number of medications decreased significantly from 2.6 ± 1.5 preoperatively to 0.72 ± 1.4 in 6 months ( p < 0.0010), while IOP decreased from 14.7 ± 3.7 to 13.9 ± 4.3 ( p = 0.25). At 6 months, 55 patients (74%) of all patients were medication free ( n = 27, 84.4% mild glaucoma; n = 17, 70.8% moderate glaucoma; n = 10, 50% advance glaucoma). There was significant improvement in visual acuity ( p < 0.00010) and stabilization of mean deviation on visual field test (baseline −9.2; 6 months −9.1; p = 0.22). The most common adverse effect was a transient IOP spike and transient corneal edema ( n = 6, 7.9%; n = 6, 7.9%, respectively) with spontaneous resolution in all cases. No sight-threatening complications were reported at 6 months. Conclusion/clinical relevance: This 6-month retrospective study demonstrated the efficacy of phacoemulsification cataract surgery and Hydrus microstent in reducing the medication burden while maintaining lower IOP in Black and Afro-Latinx patients with glaucoma.

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Visual field changes in glaucoma patients after blepharoptosis surgery

European Journal of Ophthalmology ◽

10.1177/11206721211073254 ◽

2022 ◽

pp. 112067212110732

Author(s):

Aya Taniguchi ◽

Tatsuya Yunoki ◽

Mitsuya Otsuka ◽

Atsushi Hayashi

Keyword(s):

Visual Field ◽

Field Test ◽

University Hospital ◽

Mean Deviation ◽

Visual Field Test ◽

Corrected Visual Acuity ◽

Field Assessment ◽

Significant Difference ◽

Before And After ◽

The Mean

Purpose To examine changes in parameters of the visual field test before and after blepharoptosis surgery in patients with glaucoma. Methods Twenty-three eyes of 14 glaucoma patients who underwent blepharoptosis surgery at Toyama University Hospital between July 2015 and September 2020 were included in this study. Pre- and post-operative values for the mean deviation (MD), pattern standard deviation (PSD) and total deviation (TD) of the upper or lower hemi-visual field in the Humphrey visual field test, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and margin reflex distance (MRD)-1 were compared. Results MRD-1 showed a significant improvement after blepharoptosis surgery (preoperative MRD-1: 1.0 ± 0.82 mm, postoperative MRD-1: 3.26 ± 0.66 mm, p < 0.001). There were no significant differences in BCVA, IOP, MD and PSD values before and after surgery. On the other hand, there was a significant improvement in the superior TD (preoperative: −11.29 ± 6.57 dB, postoperative: −9.88 ± 7.31 dB, p = 0.044) although no significant difference was detected in the inferior TD postoperatively. The preoperative parameters of 2 groups (improvement and non-improvement groups of postoperative superior TD) were compared. Preoperative MD and superior TD were significantly lower in the improvement group (p = 0.03, p = 0.004, respectively), although there was no significant difference in preoperative PSD and inferior TD between the two groups. Conclusion In glaucoma patients, blepharoptosis may interfere with accurate visual field assessment, especially of superior TD.

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Comparison of imo and Humphrey field analyzer perimeters in glaucomatous eyes

International Journal of Ophthalmology ◽

10.18240/ijo.2021.12.11 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1882-1887

Author(s):

Yoshinori Nakai ◽

◽

Yuko Shono ◽

Kaori Taoka ◽

Yoshihide Nakai ◽

...

Keyword(s):

Standard Deviation ◽

Visual Field ◽

Mean Deviation ◽

Diagnostic Ability ◽

Visual Field Index ◽

Pattern Standard Deviation ◽

Humphrey Field Analyzer ◽

The Difference ◽

Field Disturbance ◽

Sensitivity Specificity

AIM: To compare the imo perimeter, a new portable head-mounted perimeter unit that enables both eyes to be examined quickly and simultaneously, with the Humphrey field analyzer (HFA) perimeter to investigate correlations and their diagnostic ability in glaucomatous eyes. METHODS: The performance of the equipment in 128 glaucomatous eyes and 40 normal eyes were tested. We investigated the correlations of mean deviation, pattern standard deviation, visual field index, and the sensitivity. RESULTS: Measurements of mean deviation (r=0.886, P<0.001), pattern standard deviation (r=0.814, P<0.001), and visual field index (r=0.871, P<0.001) in both perimeters were strongly and positively correlated. The sensitivities in the imo perimeter were 80.5% for mean deviation, 81.2% for pattern standard deviation, and 80.5% in visual field index; those in the HFA were 63.3% for mean deviation, 74.5% for pattern standard deviation, and 80.5% for visual field index. Both perimeters demonstrated high diagnostic ability. CONCLUSION: The parameters by the imo and HFA in glaucomatous eyes show strong positive correlations with favorable sensitivity, specificity, and diagnostic ability. However, the difference between imo and HFA results increases with the increase in visual field disturbance.

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Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection

Current HIV Research ◽

10.2174/1570162x18666200720000344 ◽

2020 ◽

Vol 18 (5) ◽

pp. 381-386

Author(s):

Yusuke Yoshino ◽

Ichiro Koga ◽

Yoshitaka Wakabayashi ◽

Takatoshi Kitazawa ◽

Yasuo Ota

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Standard Deviation ◽

Hiv Infection ◽

Free Testosterone ◽

Serum Levels ◽

University Hospital ◽

Rapid Decline ◽

Total Testosterone ◽

Immunodeficiency Virus

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. Method: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis. Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

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