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Investigating the clinical usefulness of definitions of progression with 10-2 visual field
British Journal of Ophthalmology ( IF 4.1 ) Pub Date : 2022-08-01 , DOI: 10.1136/bjophthalmol-2020-318188
Shotaro Asano 1, 2 , Hiroshi Murata 1 , Yuri Fujino 3, 4 , Takehiro Yamashita 5 , Atsuya Miki 6, 7 , Yoko Ikeda 8, 9 , Kazuhiko Mori 8 , Masaki Tanito 4 , Ryo Asaoka 3, 10, 11
Affiliation  

Background/Aim To investigate the clinical validity of the Guided Progression Analysis definition (GPAD) and cluster-based definition (CBD) with the Humphrey Field Analyzer 10-2 test in diagnosing glaucomatous visual field (VF) progression, and to introduce a novel definition with optimised specificity by combining the ‘any-location’ and ‘cluster-based’ approaches (hybrid definition). Methods 64 400 stable glaucomatous VFs were simulated from 664 pairs of 10-2 tests (10 sets × 10 VF series × 664 eyes; data set 1). Using these simulated VFs, the specificity to detect progression and the effects of changing the parameters (number of test locations or consecutive VF tests, and percentile cut-off values) were investigated. The hybrid definition was designed as the combination where the specificity was closest to 95.0%. Subsequently, another 5000 actual glaucomatous 10-2 tests from 500 eyes (10 VFs each) were collected (data set 2), and their accuracy (sensitivity, specificity and false positive rate) and the time needed to detect VF progression were evaluated. Results The specificity values calculated using data set 1 with GPAD and CBD were 99.6% and 99.8%. Using data set 2, the hybrid definition had a higher sensitivity than GPAD and CBD, without detriment to the specificity or false positive rate. The hybrid definition also detected progression significantly earlier than GPAD and CBD (at 3.1 years vs 4.2 years and 4.1 years, respectively). Conclusions GPAD and CBD had specificities of 99.6% and 99.8%, respectively. A novel hybrid definition (with a specificity of 95.5%) had higher sensitivity and enabled earlier detection of progression. Data are available upon reasonable request.

中文翻译:

研究 10-2 视野进展定义的临床实用性

背景/目的 使用 Humphrey 视野分析仪 10-2 测试研究引导进展分析定义 (GPAD) 和基于集群的定义 (CBD) 在诊断青光眼视野 (VF) 进展方面的临床有效性,并引入一个新的定义通过结合“任意位置”和“基于集群”的方法(混合定义)来优化特异性。方法从 664 对 10-2 测试(10 组 × 10 VF 系列 × 664 只眼;数据集 1)中模拟了 64 400 个稳定的青光眼 VF。使用这些模拟的 VF,研究了检测进展的特异性和更改参数(测试位置或连续 VF 测试的数量,以及百分位截止值)的影响。混合定义被设计为特异性最接近 95.0% 的组合。随后,收集了来自 500 只眼睛(每只 10 个 VF)的另外 5000 个实际青光眼 10-2 测试(数据集 2),并评估了它们的准确性(敏感性、特异性和假阳性率)和检测 VF 进展所需的时间。结果 使用数据集 1 与 GPAD 和 CBD 计算的特异性值分别为 99.6% 和 99.8%。使用数据集 2,混合定义比 GPAD 和 CBD 具有更高的敏感性,而不会损害特异性或假阳性率。混合定义还检测到进展显着早于 GPAD 和 CBD(分别为 3.1 年和 4.2 年和 4.1 年)。结论 GPAD 和 CBD 的特异性分别为 99.6% 和 99.8%。一种新的混合定义(特异性为 95.5%)具有更高的灵敏度并能够更早地检测到进展。
更新日期:2022-07-21
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