Predicting the Integrated Visual Field with Wide-Scan Optical Coherence Tomography in Glaucoma Patients

ABSTRACT

Purpose: This study aimed to calculate a predicted integrated visual field (IVF) based on predicted monocular visual fields (MVFs) derived, with a new method, from wide-scan optical coherence tomography (OCT) data.

Materials and Methods: Visual field testing used the central (6 × 4) 24 points of the Humphrey Field Analyzer 24-2 program. OCT scans of a corresponding retinal area, centered on the fovea, were divided into a 6 × 4 grid. The thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer + inner plexiform layer (GCIPL), and mRNFL + GCIPL (GCC) was measured in each grid area. Next, a support vector machine was used to create a MVF prediction model, with training data from 101 eyes of 60 glaucoma patients. Then, the prediction model was validated with data from 108 eyes of 54 glaucoma patients, for MVF and IVF. A simulated IVF was created by merging bilateral simulated MVFs.

Results: The overall average of the median 95% prediction interval length for the MVF prediction model (measured in dB) was 10.0, 18.3, and 11.3 for the mRNFL, GCIPL, and GCC, respectively. In the validation data, the overall average root mean squared error (dB) between actual and predicted sensitivity for the IVF was 9.6, 10.5, and 9.5 for the mRNFL, GCIPL, and GCC, respectively, in the 24 grid areas. The intraclass correlation coefficient between average actual and predicted IVF was 0.61, 0.44, and 0.59 in the mRNFL, GCIPL, and GCC, respectively, in the 24 grid areas.

Conclusions: We calculated a predicted IVF based on predicted MVFs that were derived, with a new method, from OCT data and validated the accuracy of the calculated IVF. This technique should improve glaucoma management in cases when standard visual field testing is difficult.

KEW WORDS:

• Glaucoma
• structure/function
• wide-scan optical coherence tomography
• prediction of the visual field
• integrated visual field

Acknowledgments

The authors thank Mr. Satoshi Miyata for statistical analysis, Mr. Tim Hilts for reviewing this manuscript, Mr. Masahiro Akiba and Mr. Tsutomu Kikawa for their technical assistance, and Ms. Ikumi Takatsu and Ms. Namiki Kishi for the arrangement of the data.

Declaration of Interests

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This article is funded by JSPS KAKENHI: [Grant Numbers 26462630, and 26293372].