@article{2a86b4a8d6c14cb8b78e8f1ca90ef664,
title = "Agreement and Predictors of Discordance of 6 Visual Field Progression Algorithms",
abstract = "Purpose: To determine the agreement of 6 established visual field (VF) progression algorithms in a large dataset of VFs from multiple institutions and to determine predictors of discordance among these algorithms. Design: Retrospective longitudinal cohort study. Participants: Visual fields from 5 major eye care institutions in the United States were analyzed, including a subset of eyes with at least 5 Swedish interactive threshold algorithm standard 24-2 VFs that met our reliability criteria. Of a total of 831 240 VFs, a subset of 90 713 VFs from 13 156 eyes of 8499 patients met the inclusion criteria. Methods: Six commonly used VF progression algorithms (mean deviation [MD] slope, VF index slope, Advanced Glaucoma Intervention Study, Collaborative Initial Glaucoma Treatment Study, pointwise linear regression, and permutation of pointwise linear regression) were applied to this cohort, and each eye was determined to be stable or progressing using each measure. Agreement between individual algorithms was tested using Cohen's κ coefficient. Bivariate and multivariate analyses were used to determine predictors of discordance (3 algorithms progressing and 3 algorithms stable). Main Outcome Measures: Agreement and discordance between algorithms. Results: Individual algorithms showed poor to moderate agreement with each other when compared directly (κ range, 0.12–0.52). Based on at least 4 algorithms, 11.7% of eyes progressed. Major predictors of discordance or lack of agreement among algorithms were more depressed initial MD (P < 0.01) and older age at first available VF (P < 0.01). A greater number of VFs (P < 0.01), more years of follow-up (P < 0.01), and eye care institution (P = 0.03) also were associated with discordance. Conclusions: This extremely large comparative series demonstrated that existing algorithms have limited agreement and that agreement varies with clinical parameters, including institution. These issues underscore the challenges to the clinical use and application of progression algorithms and of applying big-data results to individual practices.",
author = "Saeedi, {Osamah J.} and Tobias Elze and Loris D'Acunto and Ramya Swamy and Vikram Hegde and Surabhi Gupta and Amin Venjara and Joby Tsai and Myers, {Jonathan S.} and Wellik, {Sarah R.} and {De Moraes}, {Carlos Gustavo} and Pasquale, {Louis R.} and Shen, {Lucy Q.} and Boland, {Michael V.}",
note = "Funding Information: Supported by the National Institutes of Health, Bethesda, Maryland (Career Development Award no.: K23EY025014 [O.J.S.]); the National Eye Institute, and National Institutes of Health, Bethesda, Maryland (grant nos.: R01 EY025253 [C.G.D.M.] and R01 EY015473 [L.R.P.]); the BrightFocus Foundation (E.T.); the Lions Foundation (E.T.); the Grimshaw-Gudewicz Foundation (E.T.); Research to Prevent Blindness, Inc, New York, New York (E.T., C.G.D.M.), the Alice Adler Fellowship (E.T.); and the Harvard Glaucoma Center of Excellence, Boston, Massachusetts. Financial Disclosure(s): The author(s) have made the following disclosure(s): O.J.S.: Financial support – Heidelberg Engineering (Franklin, MA), Vasoptic, Inc (Baltimore, MD), Zeiss Meditec (also Carl Zeiss Meditec; Dublin, CA); Patent – System and method of determining visual field progression. J.S.M.: Financial support – Aerie (Durham, NC), Allergan (Dublin, Ireland [US: Madison, NJ]), Alcon (Fort Worth, TX), Glaukos (San Clemente, CA), Heidelberg Engineering, MicroOptx (Maple Grove, MN), Carl Zeiss Meditec, Haag-Streit (Koniz, Switzerland), Diopsys (Pine Brook, NJ). L.R.P.: Financial support – Verily (San Francisco, CA). L.Q.S.: Consultant and Financial support – Topcon Medical Systems (Oakland, NJ). Supported by the National Institutes of Health, Bethesda, Maryland (Career Development Award no.: K23EY025014 [O.J.S.]); the National Eye Institute, and National Institutes of Health, Bethesda, Maryland (grant nos.: R01 EY025253 [C.G.D.M.] and R01 EY015473 [L.R.P.]); the BrightFocus Foundation (E.T.); the Lions Foundation (E.T.); the Grimshaw-Gudewicz Foundation (E.T.); Research to Prevent Blindness, Inc, New York, New York (E.T., C.G.D.M.), the Alice Adler Fellowship (E.T.); and the Harvard Glaucoma Center of Excellence, Boston, Massachusetts. Obtained funding: Saeedi, Elze, Hegde, Venjara, Myers, De Moraes, Pasquale, Shen, Boland Publisher Copyright: {\textcopyright} 2019 American Academy of Ophthalmology",
year = "2019",
month = jun,
doi = "10.1016/j.ophtha.2019.01.029",
language = "English (US)",
volume = "126",
pages = "822--828",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "6",
}