Suitability of the visual field index according to glaucoma severity

Marina C.C. Sousa, Luis G. Biteli, Syril Dorairaj, Jessica S. Maslin, Mauro T. Leite, Tiago S. Prata

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: To investigate the suitability of the visual field index (VFI) in different degrees of disease severity in glaucoma patients. Methods: In this cross-sectional study, we consecutively enrolled patients with primary open-angle glaucoma and glaucoma suspects (ocular hypertension). All eyes required a reliable standard automated perimetry (SAP) test to be included. Subjects were categorized into five groups based on glaucoma severity using SAP’s mean deviation (MD). To evaluate the correlation among VFI, MD and pattern standard deviation (PSD), a linear regression model was built. To evaluate the nature of the correlation (i.e. linear vs nonlinear), results were plotted in a scatterplot graph. Results: One hundred and twenty-two eyes of 81 patients (mean age, 59.8 ± 14.5 years) were included. A strong, positive association was found between MD and VFI values (R2 = 0.98, p < 0.001), showing a 3.2% reduction in the VFI for each dB loss in the MD index. It was noticed that 15% of eyes with mild glaucoma (average MD of –3.1 dB) had VFI ≥ 99%. Considering only the eyes with mild and moderate damage in the regression, we found a weaker (nonlinear) correlation than the one we found using all eyes (R2 = 0.85, p < 0.001). There was also a significant, nonlinear correlation between VFI and PSD (R2 = 0.85, p < 0.001). Although higher PSD values were found with increasing visual field damage, this initial trend was reversed when VFI became smaller than 50%, approximately. Conclusion: Visual field index had a strong correlation with MD; however, this correlation was weaker in mild disease, as some patients with early disease had very high VFI values (ceiling effect). Therefore, initial deterioration in visual field status (as assessed by MD values) in patients with early disease may not be detectable using the VFI alone.

Original languageEnglish (US)
Pages (from-to)65-68
Number of pages4
JournalJournal of Current Glaucoma Practice
Volume9
Issue number3
DOIs
StatePublished - Sep 1 2015

Fingerprint

Visual Fields
Glaucoma
Ocular Hypertension
Linear Models
Visual Field Tests
Cross-Sectional Studies

Keywords

  • Functional correlation
  • Functional evaluation
  • Glaucoma blindness
  • Stages of glaucoma
  • Visual field index

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Suitability of the visual field index according to glaucoma severity. / Sousa, Marina C.C.; Biteli, Luis G.; Dorairaj, Syril; Maslin, Jessica S.; Leite, Mauro T.; Prata, Tiago S.

In: Journal of Current Glaucoma Practice, Vol. 9, No. 3, 01.09.2015, p. 65-68.

Research output: Contribution to journalArticle

Sousa, Marina C.C. ; Biteli, Luis G. ; Dorairaj, Syril ; Maslin, Jessica S. ; Leite, Mauro T. ; Prata, Tiago S. / Suitability of the visual field index according to glaucoma severity. In: Journal of Current Glaucoma Practice. 2015 ; Vol. 9, No. 3. pp. 65-68.
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abstract = "Purpose: To investigate the suitability of the visual field index (VFI) in different degrees of disease severity in glaucoma patients. Methods: In this cross-sectional study, we consecutively enrolled patients with primary open-angle glaucoma and glaucoma suspects (ocular hypertension). All eyes required a reliable standard automated perimetry (SAP) test to be included. Subjects were categorized into five groups based on glaucoma severity using SAP’s mean deviation (MD). To evaluate the correlation among VFI, MD and pattern standard deviation (PSD), a linear regression model was built. To evaluate the nature of the correlation (i.e. linear vs nonlinear), results were plotted in a scatterplot graph. Results: One hundred and twenty-two eyes of 81 patients (mean age, 59.8 ± 14.5 years) were included. A strong, positive association was found between MD and VFI values (R2 = 0.98, p < 0.001), showing a 3.2{\%} reduction in the VFI for each dB loss in the MD index. It was noticed that 15{\%} of eyes with mild glaucoma (average MD of –3.1 dB) had VFI ≥ 99{\%}. Considering only the eyes with mild and moderate damage in the regression, we found a weaker (nonlinear) correlation than the one we found using all eyes (R2 = 0.85, p < 0.001). There was also a significant, nonlinear correlation between VFI and PSD (R2 = 0.85, p < 0.001). Although higher PSD values were found with increasing visual field damage, this initial trend was reversed when VFI became smaller than 50{\%}, approximately. Conclusion: Visual field index had a strong correlation with MD; however, this correlation was weaker in mild disease, as some patients with early disease had very high VFI values (ceiling effect). Therefore, initial deterioration in visual field status (as assessed by MD values) in patients with early disease may not be detectable using the VFI alone.",
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