4.6 Article

Learning From Data: Recognizing Glaucomatous Defect Patterns and Detecting Progression From Visual Field Measurements

Journal

IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING
Volume 61, Issue 7, Pages 2112-2124

Publisher

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/TBME.2014.2314714

Keywords

Data analysis; glaucoma; machine learning; progression detection; visual field

Funding

  1. NIH [R01EY022039, R00EY020518, R01EY008208, R01EY011008, R01EY019869, P30EY022589]
  2. Research to Prevent Blindness (New York, NY, USA)
  3. Eyesight Foundation of Alabama
  4. Corinne Graber Research Fund of the New York Glaucoma Research Institute
  5. David and Marilyn Dunn Fund
  6. Alcon Laboratories
  7. Allergan
  8. Pfizer

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A hierarchical approach to learn from visual field data was adopted to identify glaucomatous visual field defect patterns and to detect glaucomatous progression. The analysis pipeline included three stages, namely, clustering, glaucoma boundary limit detection, and glaucoma progression detection testing. First, cross-sectional visual field tests collected from each subject were clustered using a mixture of Gaussians and model parameters were estimated using expectation maximization. The visual field clusters were further estimated to recognize glaucomatous visual field defect patterns by decomposing each cluster into several axes. The glaucoma visual field defect patterns along each axis then were identified. To derive a definition of progression, the longitudinal visual fields of stable glaucoma eyes on the abnormal cluster axes were projected and the slope was approximated using linear regression (LR) to determine the confidence limit of each axis. For glaucoma progression detection, the longitudinal visual fields of each eye on the abnormal cluster axes were projected and the slope was approximated by LR. Progression was assigned if the progression rate was greater than the boundary limit of the stable eyes; otherwise, stability was assumed. The proposed method was compared to a recently developed progression detection method and to clinically available glaucoma progression detection software. The clinical accuracy of the proposed pipeline was as good as or better than the currently available methods.

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