Abstract
PurposeArchetypal analysis, a form of unsupervised machine learning, identifies archetypal patterns within a visual field (VF) dataset such that any VF is described as a weighted sum of its archetypes (ATs) and has been used to quantify VF defects in glaucoma. We applied archetypal analysis to VFs affected by nonglaucomatous optic neuropathy caused by idiopathic intracranial hypertension (IIH).MethodsWe created an AT model from 2862 VFs prospectively collected from 330 eyes in the IIH Treatment Trial (IIHTT). We compared baseline IIH AT patterns with their descriptive VF classifications from the IIHTT.ResultsThe optimum IIH AT model yielded 14 ATs resembling VF patterns reported in the IIHTT. Baseline VFs contained four or fewer meaningful ATs in 147 (89%) of study eyes. AT2 (mild general VF depression pattern) demonstrated the greatest number of study eyes with meaningful AT weight at baseline (n = 114), followed by AT1 (n = 91). Other ATs captured patterns of blind spot enlargement, hemianopia, arcuate, nasal defects, and more nonspecific patterns of general VF depression. Of all ATs, AT1 (normal pattern) had the strongest correlation with mean deviation (r = 0.69, P < 0.001). For 65 of the 93 VFs with a dominant AT, this AT matched the expert classification.ConclusionsArchetypal analysis identifies quantifiable, archetypal VF defects that resemble those commonly seen in IIH.Translational RelevanceArchetypal analysis provides a quantitative, objective method of measuring and monitoring disease-specific regional VF defects in IIH.
Highlights
Visual field (VF) testing is used to diagnose and monitor most optic neuropathies
Archetypal analysis identifies quantifiable, archetypal VF defects that resemble those commonly seen in intracranial hypertension (IIH)
The Intracranial Hypertension Treatment Trial (IIHTT) followed the tenets of the Declaration of Helsinki; informed consent was obtained from the subjects after explanation of the nature and possible consequences of the study; the research was approved by the institutional human experimentation committee or institutional review board; and a Data Safety and Monitoring Committee was in place to monitor the ethical conduct of the study and the accumulation of data for evidence of adverse and beneficial treatment effects
Summary
Visual field (VF) testing is used to diagnose and monitor most optic neuropathies. Changes in threshold perimetry detected through trend or event-based analyses are often used to determine change in visual function. Many commonly used methods, including assessing change in mean deviation (MD), do not provide details of regional VF defects.[1,2] Experts categorize specific patterns of VF loss, but clinical interpretation is descriptive and qualitative. Supervised learning algorithms have been used in glaucoma to monitor disease-specific deficits, but the results of these algorithms frequently disagree with one another.[3,4] Each applies ad hoc rules depending on the stage of disease, and no universally accepted approach exists.[5] subtle patterns of regional VF loss can be missed, some disease-specific
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
