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Predicting conversion to glaucoma using standard automated perimetry and frequency doubling technology

  • Glaucoma
  • Published:
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Abstract

Purpose

To test the hypothesis that development of glaucomatous visual fields can be predicted several years earlier from prior visual field information.

Methods

One-hundred and seven eyes with glaucomatous optic neuropathy (n = 47 eyes) or which were suspicious for glaucoma (n = 60) were prospectively enrolled in a longitudinal study. Visual fields were evaluated on an annual basis using standard automated perimetry (SAP), the original version of frequency doubling technology (FDT) perimetry, and a custom version of FDT that used the 24-2 stimulus pattern. All SAP fields were within normal limits at the initial visit. When the SAP glaucoma hemifield test was ‘outside normal limits’ or the pattern standard deviation probability was worse than the lower 5th percentile or more than two clustered locations at the p < 0.05 level were present on the pattern deviation probability plot, an eye was defined as being abnormal. We used a classification tree analysis to predict which eyes would convert, using only baseline test results.

Results

Classification trees that were constructed using only baseline data had excellent specificity (near 100%) but worse sensitivity (25–50%) for predicting which eyes would convert during follow-up.

Conclusions

Predictive information is present in visual field results, even when they are still within normal limits.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Jikei University, School of Medicine, Katsushika Medical Center, Tokyo, Japan

    Genichiro Takahashi

  2. Discoveries in Sight Research Labs, Devers Eye Institute, Portland, OR, USA

    Shaban Demirel

  3. Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA

    Chris A. Johnson

Authors
  1. Genichiro Takahashi
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  2. Shaban Demirel
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  3. Chris A. Johnson
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Corresponding author

Correspondence to Chris A. Johnson.

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Funding

Welch Allyn provided financial support in the form of $ 36,000.00 funding. Welch Allyn had no role in the design or conduct of this research.

Conflict of interest

During the time of this research the third author (CAJ) received research support from Welch Allyn and was a consultant for Welch Allyn. The first author (GT) and the second author (SM) have no financial interest related to this study or manuscript.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Institutional Research Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Legacy Health Systems Institutional Review Board in Portland, Oregon.

Informed consent

All participants in this study provided written informed consent prior to participating in this study, and received a copy of their consent form.

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Takahashi, G., Demirel, S. & Johnson, C.A. Predicting conversion to glaucoma using standard automated perimetry and frequency doubling technology. Graefes Arch Clin Exp Ophthalmol 255, 797–803 (2017). https://doi.org/10.1007/s00417-016-3573-x

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  • DOI: https://doi.org/10.1007/s00417-016-3573-x

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