Visual field progression in glaucoma: Estimating the overall significance of deterioration with permutation analyses of pointwise linear regression (PoPLR)

Neil O'Leary, Balwantray C. Chauhan, Paul H. Artes

Résultat de recherche: Articleexamen par les pairs

73 Citations (Scopus)

Résumé

PURPOSE: To establish a method for estimating the overall statistical significance of visual field deterioration from an individual patient's data, and to compare its performance to pointwise linear regression. METHODS: The Truncated Product Method was used to calculate a statistic S that combines evidence of deterioration from individual test locations in the visual field. The overall statistical significance (P value) of visual field deterioration was inferred by comparing S with its permutation distribution, derived from repeated reordering of the visual field series. Permutation of pointwise linear regression (PoPLR) and pointwise linear regression were evaluated in data from patients with glaucoma (944 eyes, median mean deviation -2.9 dB, interquartile range: -6.3, -1.2 dB) followed for more than 4 years (median 10 examinations over 8 years). Falsepositive rates were estimated from randomly reordered series of this dataset, and hit rates (proportion of eyes with significant deterioration) were estimated from the original series. RESULTS: The false-positive rates of PoPLR were indistinguishable from the corresponding nominal significance levels and were independent of baseline visual field damage and length of follow-up. At P < 0.05, the hit rates of PoPLR were 12, 29, and 42%, at the fifth, eighth, and final examinations, respectively, and at matching specificities they were consistently higher than those of pointwise linear regression. CONCLUSIONS: In contrast to population-based progression analyses, PoPLR provides a continuous estimate of statistical significance for visual field deterioration individualized to a particular patient's data. This allows close control over specificity, essential for monitoring patients in clinical practice and in clinical trials.

Langue d'origineEnglish
Pages (de-à)6776-6784
Nombre de pages9
JournalInvestigative Ophthalmology and Visual Science
Volume53
Numéro de publication11
DOI
Statut de publicationPublished - oct. 2012

ASJC Scopus Subject Areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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