Deviation Slope Research Articles

Clinical characteristics of disc hemorrhages depending on their locations and glaucoma progression in myopic patients

This study aimed to investigate clinical characteristics and glaucoma progression in eyes with disc hemorrhage (DH) in the region of peripapillary atrophy (PPA) or DH in temporal region among glaucoma patients with myopia. One hundred ninety-six eyes of 196 glaucoma patients with myopia who were observed at least 4 years and had more than six visual field (VF) tests were included. Eyes with DHs located in the optic disc region at the superotemporal or inferotemporal locations were defined as typical DH. PPA area, disc ovality ratio, and disc torsion were measured. Length of γ-zone PPA, distance from disc edge to fovea, angle of scleral bending were measured using optical coherence tomography. Comparison of baseline characteristics between eyes with and without DH in PPA/DH in temporal region showed similar axial length (26.95 ± 1.60 mm; 26.82 ± 1.07 mm). γ-zone PPA was longer and angle of scleral bending was larger in eyes with DH in PPA/DH in temporal region (both p ≤ 0.001). Longer γ-zone PPA (β = 1.001; p = 0.018) and larger angle of scleral bending (β = 1.033; p = 0.008) were associated with presence of DH in PPA/DH in temporal region using logistic regression analysis. Eyes with DH in PPA/DH in temporal region had a smaller mean deviation slope of VF, a larger disc ovality ratio, a longer γ-zone PPA, and a larger PPA area when compared to those of eyes typical DH. VF progression was associated with absence of DH in PPA/DH in temporal region (p = 0.030) and larger angle of scleral bending (p = 0.019) using Cox proportional hazards model. DH in PPA/DH in temporal region was associated with stretching and deformation of sclera that may be result from myopic changes. Associated factors with VF progression was the degree of scleral deformation, not the presence of DH in PPA/DH in temporal region, showing that DH related to scleral deformation may possess clinical significance in glaucoma with myopia.

Spatiotemporal Evolution and Tapio Decoupling Analysis of Energy-Related Carbon Emissions Using Nighttime Light Data: A Quantitative Case Study at the City Scale in Northeast China

As the world’s second-largest economy, China has experienced rapid industrialization and urbanization, resulting in high energy consumption and significant carbon emissions. This development has intensified conflicts between human-land relations and environmental conservation, contributing to global warming and urban air pollution, both of which pose serious health risks. This study uses nighttime light (NTL) data from 2005 to 2019, along with scaling techniques and statistical analysis, to estimate city-scale energy carbon emissions over a 15-year period. Focusing on Northeast China, a traditional industrial region comprising 36 cities across three provinces, we examine spatial patterns of energy carbon emissions and assess spatiotemporal evolution through spatial autocorrelation and dynamic changes. These changes are further evaluated using standard deviation ellipse (SDE) parameters and SLOPE values. Additionally, the Tapio decoupling index is applied to explore the relationship between city-scale emissions and economic growth. Our findings for the 36 cities over 15 years are: (1) Heilongjiang shows low, declining emissions; Jilin improves; Liaoning has high, steadily increasing emissions. (2) The global spatial autocorrelation of energy carbon emissions is significant, with a positive Moran’s I, while significant local Moran’s I clusters are concentrated in Heilongjiang and Liaoning. (3) The greatest emission changes occurred in 2015, followed by 2019, 2005, and 2010. (4) Emission growth is fastest in Heilongjiang, followed by Liaoning and Jilin. (5) Tapio analysis shows positive decoupling in Heilongjiang, declining decoupling in Jilin, and no change in Liaoning. This study provides a quantitative basis for dual carbon goals and offers emission reduction strategies for government, industry, and residents, supporting energy transition and sustainable urban planning.

Wide-Field Optical Coherence Tomography Imaging Improves Rate of Change Detection in Progressing Glaucomatous Eyes Compared With Standard-Field Imaging.

To compare rates of retinal nerve fiber layer change over time in healthy, eyes with nonprogressing glaucoma and eyes with progressing glaucoma using single wide-field (SWF) and optic nerve head (ONH) cube scan optical coherence tomography (OCT) images. Forty-five eyes of 25 healthy individuals and 263 eyes of 161 glaucoma patients from the Diagnostic Innovations in Glaucoma Study were included. All eyes underwent 24-2 visual field testing and OCT (Spectralis SD-OCT) ONH and macular imaging. SWF images (up to 43° × 28°) were created by stitching together ONH cube scans centered on the optic disc and macular cube scans centered on the fovea. Visual field progression was defined as guided progression analysis likely progression and/or a significant (P < 0.01) mean deviation slope of less than -1.0dB/year. Mixed effects models were used to compare rates of change. Highly myopic eyes were included. Thirty glaucomatous eyes were classified as progressing. In eyes with glaucoma, mean global rate of change was -1.22 µm/year (P < 0.001) using SWF images and -0.83 µm/year (P = 0.003) using ONH cube scans. Rate of change was significantly greater in eyes with progressing glaucoma compared with eyes with nonprogressing glaucoma (-1.51 µm/year vs. -1.24 µm/year; P = 0.002) using SWF images and was similar using ONH cube scans (P = 0.27). In this cohort that includes eyes with and without high axial myopia, the mean rate of retinal nerve fiber layer thinning measured using SWF images was faster in eyes with progressing glaucoma than in eyes with nonprogressing glaucoma. Wide-field OCT images including the ONH and macula can be effective for monitoring glaucomatous progression in patients with and without high myopia.

Relationship Between Mean Deviation Slope with Related Risk Factors and Foveal Sensitivity of Humphrey Field Analyzer Test in Open Angle Glaucoma

Introduction &amp; ObjectivesTo analyze relationship between mean deviation (MD) slope with related risk factors and fovealsensitivity of Humphrey field analyzer (HFA) in open angle glaucoma.&#x0D; Patient and MethodsThis study was retrospective and consecutive sampling during a year follow up period in SardjitoGeneral Hospital. A total 95 eyes from 95 patient were exemained the MD slope by HFA (SITAstandard, 24-2 program) being follow up and compared first examination with the final VF test.Relation of MD slope with risk factors and HFA parameters were correlatively analyzed.&#x0D; ResultsMean Deviation slope was observed in 48/95 patients (50.52 %) and no progression was observed in47/95 patients (49.47 %). The related risk factors gender, age, spherical equivalent and IOP do notshowed significant correlation with MD slope (R= 0.02, P= 0.89), (R=0.10, p=0.47), (R=-0.27, p=0.06) and (R=-0,13, p= 0.35). Foveal sensitivity test in HFA parameter do not showed significantcorrelation with MD slope (R= 0.14, p=0.32).&#x0D; ConclusionWorsening value of spherical equivalent and IOP showed negative correlation to MD slope, butstatistically do not showed significant correlation caused there are not much differences betweenprogress and non progress group.

A multi-label transformer-based deep learning approach to predict focal visual field progression.

Tracking functional changes in visual fields (VFs) through standard automated perimetry remains a clinical standard for glaucoma diagnosis. This study aims to develop and evaluate a deep learning (DL) model to predict regional VF progression, which has not been explored in prior studies. The study included 2430 eyes of 1283 patients with four or more consecutive VF examinations from the baseline. A multi-label transformer-based network (MTN) using longitudinal VF data was developed to predict progression in six VF regions mapped to the optic disc. Progression was defined using the mean deviation (MD) slope and calculated for all six VF regions, referred to as clusters. Separate MTN models, trained for focal progression detection and forecasting on various numbers of VFs as model input, were tested on a held-out test set. The MTNs overall demonstrated excellent macro-average AUCs above 0.884 in detecting focal VF progression given five or more VFs. With a minimum of 6 VFs, the model demonstrated superior and more stable overall and per-cluster performance, compared to 5 VFs. The MTN given 6 VFs achieved a macro-average AUC of 0.848 for forecasting progression across 8 VF tests. The MTN also achieved excellent performance (AUCs ≥ 0.86, 1.0 sensitivity, and specificity ≥ 0.70) in four out of six clusters for the eyes already with severe VF loss (baseline MD ≤ - 12dB). The high prediction accuracy suggested that multi-label DL networks trained with longitudinal VF results may assist in identifying and forecasting progression in VF regions.

Forecasting Risk of Future Rapid Glaucoma Worsening Using Early Visual Field, OCT, and Clinical Data

To assess whether we can forecast future rapid visual field (VF) worsening using deep learning models (DLMs) trained on early VF, OCT, and clinical data. A retrospective cohort study. In total, 4536 eyes from 2962 patients. Overall, 263 (5.80%) eyes underwent rapid VF worsening (mean deviation slope less than -1 dB/year across all VFs). We included eyes that met the following criteria: (1) followed for glaucoma or suspect status; (2) had at least 5 longitudinal reliable VFs (VF1, VF2, VF3, VF4, and VF5); and (3) had 1 reliable baseline OCT scan (OCT1) and 1 set of baseline clinical measurements (clinical1) at the time of VF1. We designed a DLM to forecast future rapid VF worsening. The input consisted of spatially oriented total deviation values from VF1 (including or not including VF2 and VF3 in some models) and retinal nerve fiber layer thickness values from the baseline OCT. We passed this VF/OCT stack into a vision transformer feature extractor, the output of which was concatenated with baseline clinical data before putting it through a linear classifier to predict the eye's risk of rapid VF worsening across the 5 VFs. We compared the performance of models with differing inputs by computing area under the curve (AUC) in the test set. Specifically, we trained models with the following inputs: (1) model V: VF1; (2) VC: VF1+ Clinical1; (3) VO: VF1+ OCT1; (4) VOC: VF1+ Clinical1+ OCT1; (5) V2: VF1+ VF2; (6) V2OC: VF1+ VF2+ Clinical1+ OCT1; (7) V3: VF1+ VF2+ VF3; and (8) V3OC: VF1+ VF2+ VF3+ Clinical1+ OCT1. The AUC of DLMs when forecasting rapidly worsening eyes. Model V3OC best forecasted rapid worsening with an AUC (95% confidence interval [CI]) of 0.87 (0.77-0.97). Remaining models in descending order of performance and their respective AUC (95% CI) were as follows: (1) model V3 (0.84 [0.74-0.95]), (2) model V2OC (0.81 [0.70-0.92]), (3) model V2 (0.81 [0.70-0.82]), (4) model VOC (0.77 [0.65-0.88]), (5) model VO (0.75 [0.64-0.88]), (6) model VC (0.75 [0.63-0.87]), and (7) model V (0.74 [0.62-0.86]). Deep learning models can forecast future rapid glaucoma worsening with modest to high performance when trained using data from early in the disease course. Including baseline data from multiple modalities and subsequent visits improves performance beyond using VF data alone. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

In situ SAXS study on the evolution of coal nanopore structures with uniaxial compressive stress

In this study, an in situ synchrotron radiation small-angle X-ray scattering (SAXS) experiment is used to characterize the evolution of coal nanopore structures under uniaxial compression. The variation in the coal nanopores is measured by analyzing the obtained scattering data. From the results, the coal scattering data show a positive Porod deviation in which the deviation slope decreases with increasing stress. Smaller nanopores are more sensitive to uniaxial compressive stress. There is a positive correlation between scattering intensity I and stress at less than 30 nm. The scattering intensity I of pores larger than 30 nm is negatively correlated with uniaxial compressive stress. The structure of smaller pores is more complex. The surface fractal dimension DS and pore fractal dimension DP increases and decreases with increasing uniaxial compressive stress, respectively. The specific surface area is positively correlated with DS. In the measuring range of 3–80 nm, the coal nanopores show a bimodal distribution. At the stage of below 0.6σp, the average diameter decreases by 1.98%, the porosity and specific surface area increases by 6.21% and 31.5%, respectively; At the stage of above 0.6σp, the average diameter decreases by 1.04%, the porosity and specific surface area increases by 1.18% and 5.57%, respectively. These results suggest that the variation of coal nanopores with stress have phased characteristics, and the evolution of the coal nanopores under uniaxial stress can be divided into two stages. In the nanopore fracture stage, the nanopores are deform, fracture and create new smaller pores with increasing stress, and the roughness of pore surface increase. In the nanopore closure stage, high stress intensifies the degree of pore fracture, and nanopores begin to close and disappear. This study reveals the evolution characteristics of the pore structures of coal under uniaxial compression at the nanoscale.

Glaucomatous Visual Field Progression in the African Descent and Glaucoma Evaluation Study (ADAGES): Eleven Years of Follow-up

To compare the rates of visual field (VF) progression between individuals of Black and White race and to investigate whether treatment effects may help explain differences previously reported between racial groups. Multicenter prospective observational cohort study. Participants were patients in referral tertiary care glaucoma clinics with open angle glaucoma. Eyes were excluded who had <5 VF tests and <2 years of follow-up or any disease that could affect the optic nerve or the VF. The VF mean deviation (MD) slopes over time (dB/y) were calculated with linear regression models. Socioeconomic variables, rates of glaucoma surgery, medications, treated intraocular pressure (IOP), and central corneal thickness (CCT) were investigated. A total of 516 eyes were included with a mean (95% CI) follow-up time of 11.0 (range, 10.5-11.5) years and 15.0 (range, 14.1-15.8) visits. Participants of Black race were significantly younger (59.7 vs 66.9 years, P < .01) than those of White race. The mean CCT and socioeconomic variables were similar between Black and White groups (P=0.20 and P=.56, respectively), as were treatment with topical medications (P=.90) and the rate of VF MD change (-0.24 [-0.31 to -0.17] dB/year vs -0.32 [-0.36 to -0.27], P=.11), despite higher treated mean IOP (14.9 [14.5 to 15.4] vs 14.0 [13.6 to 14.4] mm Hg, P=.03) and fewer trabeculectomies (29.5% vs 50.0%, P < .01) in the Black race group. Rates of VF progression were similar despite higher treated IOP in the Black race group. Mitigation of health access disparities in this study may have equalized previously reported different rates of VF progression between racial groups.

Long-term results of the safety and effectiveness of a novel microshunt in Japanese patients with primary open-angle glaucoma.

To evaluate the long-term safety and effectiveness of the Preserflo MicroShunt in Japanese primary open-angle glaucoma (POAG) patients. Single-site, nonrandomized observational study. Eight eyes of 7 POAG patients were included. The surgical complications and interventions were monitored. The preoperative and postoperative intraocular pressures (IOPs), numbers of antiglaucoma medications, logarithm of the minimum angle of resolution visual acuity (VA), mean deviation (MD) slope, and corneal endothelial cell density (CECD) were compared retrospectively. The mean follow-up period was 68.9months (range, 48-76months). The baseline IOP of 17.9 ± 3.5mmHg and the number of glaucoma medications of 3.5 ± 0.5 were significantly reduced at subsequent follow-up visits. At 1, 2, 3, 4, 5, and 6years postoperatively, the IOPs were 13.8 ± 2.9, 12.8 ± 2.3, 12.1 ± 3.2, 12.6 ± 2.5, 12.3 ± 1.0, and 13.5 ± 3.1mmHg, respectively, with the use of 1.6 ± 1.4, 1.6 ± 1.6, 1.5 ± 1.4, 1.5 ± 1.4, 1.9 ± 1.3, and 2.0 ± 1.1 medications. Postoperative transient hyphema occurred in 1 eye. Postoperative needling was required in 5 eyes, 12 times in total. No eyes showed significant VA decline, except for 1 eye with a severe central visual field defect that existed preoperatively. The preoperative MD slope of -1.6 ± 1.2dB/year improved significantly, to -0.3 ± 0.2dB/year (P = 0.023), postoperatively. The baseline CECD decreased from 2595 ± 292 to 2478.4 ± 255 postoperatively. The microshunt surgical procedure is safe and effective for Japanese POAG patients.

Microvasculature Recovery Detected Using Optical Coherence Tomography Angiography and the Rate of Visual Field Progression After Glaucoma Surgery.

PurposeWe evaluated microvascular changes using optical coherence tomography angiography (OCT-A) in glaucoma patients who underwent glaucoma surgery.MethodsThe macula and optic nerve head were imaged using an OCT-A device at one day before surgery and at one week, one month, three months, and six months after surgery. Measurements of vessel density (VD) were made in the intradisc region and macula, and the area of the foveal avascular zone (FAZ) was measured in both superficial and deep vascular layers. A mean deviation (MD) slope value of < −1.0 decibel/y was considered to be indicative of VF progression.ResultsA significant increase in VD was observed postoperatively in the deep vascular layer of the intradisc area (P < 0.001), and a significant decrease in the FAZ area was evident in the deep vascular layer (P = 0.018). An increase in the intradisc deep VD (17.48% ± 5.63%) was statistically significant in glaucoma eyes without progression, compared with those with progression (−1.27% ± 2.19%). Worse preoperative MD of the VF (P = 0.006), lower preoperative intradisc VD (P < 0.001), and fewer changes in the intradisc deep VD after surgery (P < 0.001) were significantly associated with MD slope.ConclusionsWe found deep VD changes in the laminar region of the optic nerve head and the macular area at up to postoperative one month after glaucoma surgery. An increase in the deep VD in the laminar region was beneficial to VF progression in glaucoma patients after surgery.

Factors Threatening Central Visual Function of Patients with Advanced Glaucoma: A Prospective Longitudinal Observational Study

To identify risk factors for further deterioration of central visual function in advanced glaucoma eyes. Prospective, observational 5-year study. Advanced glaucoma patients with well-controlled intraocular pressure (IOP), mean deviation (MD) of the Humphrey Field Analyzer (HFA) 24-2 program ≤-20 dB and best-corrected visual acuity (BCVA) of 20/40. The HFA 10-2 test and BCVA examination were performed every 6 months, and the HFA 24-2 test was performed every 12 months for 5 years. The Cox proportional hazards model was used to identify risk factors for deterioration of HFA 10-2 and 24-2 results and BCVA. Deterioration of HFA 10-2 results was defined by the presence of the same ≥3 points with negative total deviation slope ≤-1 dB/year at P < 0.01 on ≥3 consecutive tests, deterioration of HFA 24-2 results by an increase ≥2 in the Advanced Glaucoma Intervention Study score on ≥2 consecutive tests, and deterioration of BCVA by an increase of ≥0.2 logarithm of the minimum angle of resolution (logMAR) on ≥2 consecutive tests. A total of 175 eyes of 175 patients (mean age, 64.1 years; mean baseline IOP, 13.2 mmHg; mean BCVA, 0.02 logMAR; mean HFA 24-2 and 10-2 MD, -25.9 and -22.9 dB, respectively) were included. The probabilities of deterioration in HFA 10-2 and 24-2 results and BCVA were 0.269 ± 0.043 (standard error), 0.173 ± 0.031, and 0.194 ± 0.033, respectively, at 5 years. Lower BCVA at baseline (P= 0.012) was associated significantly with further deterioration of HFA 10-2 results. Better HFA 24-2 MD (P < 0.001) and use of systemic antihypertensive agents (P= 0.009) were associated significantly with further deterioration of HFA 24-2 results, and a greater β-peripapillary atrophy area-to-disc area ratio (P < 0.001), use of systemic antihypertensive agents (P= 0.025), and lower BCVA (P= 0.042) were associated significantly with further deterioration of BCVA, respectively. In advanced glaucoma eyes with well-controlled IOP, BCVA, β-peripapillary atrophy area-to-disc area ratio, and use of systemic antihypertensive agents were significant prognostic factors for further deterioration of central visual function.

The Impact of Superficial Vessel Density on Glaucoma Progression according to the Stage of Glaucoma.

Purpose: To investigate the clinical significance of vessel density (VD) on visual field (VF) progression regarding the severity of glaucoma. Methods: A total of 130 eyes were recruited in this retrospective and longitudinal study. Superficial and deep VDs in circumpapillary and macular regions were measured via ImageJ. The rate of VF progression was defined as the mean deviation (MD) slope (dB/year). Linear regression was used to verify factors affecting deterioration of VF. The eyes with lower superficial VD were further analyzed. Results: Fifty patients with early glaucoma (EG) (MD > −6 dB) and 52 patients with moderate-to-advanced glaucoma (MAG) (MD ≤ −6 dB) were included. A faster progression rate was found in MAG (p = 0.049). Superficial VD was noticeably related to the VF progression rate in total eyes and in MAG (Both Ps ≤ 0.007, respectively). With patients in the lower half of the superficial VD, the VD was significantly associated with the rate of progression (B, 0.049, p = 0.021). This association was independent of the baseline MD and OCT parameters. Conclusion: Decreased superficial VD might conversely affect the progression of glaucoma even in MAG, which suggests superficial VD could be used as a potential marker to foresee the disease progression even in progressed eyes.

Long-Term Effectiveness and Safety of Tafluprost, Travoprost, and Latanoprost in Korean Patients with Primary Open-Angle Glaucoma or Normal-Tension Glaucoma: A Multicenter Retrospective Cohort Study (LOTUS Study).

This multicenter retrospective cohort study compared the effectiveness and safety of long-term tafluprost, travoprost, or latanoprost in patients with primary open-angle glaucoma (POAG) or normal-tension glaucoma (NTG). Data were extracted from electronic medical records of 300 patients treated with tafluprost, travoprost, or latanoprost for >6 months. Propensity matching for age and sex was used for effectiveness and safety comparisons. The primary endpoint was visual field (VF) progression via mean deviation (MD) slope. Secondary endpoints were change of MD, intraocular pressure, pattern standard deviation, VF index, and advanced glaucoma intervention study score. Treatment-related adverse events (AEs) were also compared between groups. Overall, 216 POAG or NTG patients were matched into Match Set 1 (72 patients/group), and 177 NTG-only patients in Match Set 2 (59 patients/group) according to: age (mean: 61, 62 years) and sex (male: 53, 56%). There were no statistically significant between-group differences regarding MD slope (p = 0.413, p = 0.374 in Match Sets 1 and 2, respectively). There were no significant between-group differences/tendencies regarding secondary endpoints. No AEs were serious, and there were no significant between-group differences regarding reported AEs. In patients with POAG or NTG, long-term tafluprost, travoprost, or latanoprost showed similar effects. All three prostaglandin analogs had good long-term safety profiles.

Long-term structural and functional outcomes of primary congenital glaucoma.

To investigate the clinical characteristics and long-term outcomes of primary congenital glaucoma (PCG) patients. In this retrospective, longitudinal, cohort study, PCG patients with reliable visual field (VF) tests and optical coherence tomography (OCT) were included. Disease progression was detected using guided progression analysis with OCT and the change analysis of mean deviation (MD) slope with VF tests. Factors associated with the disease progression and visual prognosis were analyzed. Twenty-nine eyes from 11 bilateral and 7 unilateral PCG patients were enrolled. LogMAR visual acuity declined (0.15 vs. 0.40, P < 0.001). The change rate of the average retinal nerve fiber layer thickness was - 0.83 ± 1.45µm/year, and 28% of eyes showed glaucoma progression on OCT. The median of the MD slope was 0.16 (- 1.19 to 1.07) dB/year, and 14% of eyes showed glaucoma progression on the VF test. Higher average intraocular pressure (IOP) (P = 0.046) and IOP fluctuation (P = 0.031) predicted disease progression. None of the fellow eyes of unilateral PCG patients developed glaucoma during the follow-up. At last, 59% of eyes had visual acuity > 20/70, and 31% had MD > - 6dB. Patients with worse baseline visual acuity (P = 0.027), worse baseline MD (P < 0.001), and smaller neuroretinal rim area (P < 0.001) showed worse final MD values. Aggressive IOP control is necessary to prevent structural and functional decline in PCG patients. Their fellow eyes are not at risk of glaucoma. Baseline neuroretinal rim area can predict the functional outcome.

Arduino Mega Based Current Recorder Prototype Implementation

Current measurements in electric power systems are important aspects, both for monitoring and protection. The researchers have designed, created and tested a digital current measuring and recording prototype instrument. The current signals were sensed by the split-core current transformers, entered to the signal conditioning, to the main Arduino Mega 2560 microcontroller, and finally to the three outputs, namely a PC monitor, SD card data logger and LCD. It was tested and the results were compared to the computation results and the clamp ammeter readings, as the reference instrument. On both single and three phase systems, the absolute deviations would considerably rise and the relative deviations would slightly reduce as the load currents increased. Nevertheless, the values on both systems were not exactly same. For the single phase, the average absolute and relative deviation slopes were 0.156548 A/kW and -0.0020772 %/kW respectively. On other hand, for the three phase system, they were 0.12372 A/kW and -0.04176 %/kW respectively. The relative deviations to the computation results were under 6%, tended to be 3%, and the relative deviations to the reference instrument readings were under 3%, tended to be 1%, as the load increased.

Progressive Thinning of Retinal Nerve Fiber Layer and Ganglion Cell–Inner Plexiform Layer in Glaucoma Eyes with Disc Hemorrhage

To evaluate the thinning of the circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) in primary open-angle glaucoma eyes with and without a history of disc hemorrhage (DH). Observational cohort study. Thirty-nine 39 eyes (34 participants) with DH and 117 eyes (104 participants) without DH from the Diagnostic Innovations in Glaucoma Study and the African Decent and Glaucoma Evaluation Study. Participants had at least 1.5 years of follow-up, with a minimum of 3 visits with biannual spectral-domain OCT cpRNFL and mGCIPL thickness measurements and visual fields (VFs). The rates of cpRNFL and mGCIPL thinning were calculated using mixed-effects models. The dynamic range-based normalized rates of cpRNFL and mGCIPL thinning were calculated and compared between the DH and non-DH groups. Rates of cpRNFL and mGCIPL thinning. The rate of mGCIPL thinning was significantly faster in the DH group compared with the non-DH group (-0.62 μm/year vs. -0.38 μm/year; P= 0.024). The rate of cpRNFL thinning in the DH quadrant and rate of mGCIPL thinning in the inferotemporal sector in the DH group were faster than the corresponding regions in the non-DH group after adjusting for intraocular pressure (-1.33 μm/year vs. -0.58 μm/year; P= 0.053) and race (-0.82 μm/year vs. -0.44 μm/year; P= 0.048). In the DH group, percent rate of loss was significantly faster for the mGCIPL than the cpRNFL (-1.59 %/year vs. -1.31 %/year; P= 0.046). Rates of mGCIPL thinning were associated weakly with mean deviation slope, VF index slope, and guided progression analysis (GPA). The areas under the receiver operating characteristic curve for VF progression were 0.75 for mGCIPL and 0.56 for cpRNFL in the DH group. The rate of mGCIPL and cpRNFL thinning was faster in DH eyes than non-DH eyes. Compared with cpRNFL, mGCIPL showed higher proportional rates of thinning and greater association with functional progression. In addition to cpRNFL, clinicians should consider incorporating mGCIPL imaging to monitor glaucoma progression, especially in glaucoma eyes with DH.

Evaluation of fornix-based trabeculectomy outcomes in Japanese glaucoma patients based on concrete long-term preoperative data.

To investigate the outcomes of fornix-based trabeculectomy in Japanese patients with glaucoma based on more than five years of preoperative data. Retrospective case series METHODS: This study consisted of 35 eyes of 35 Japanese glaucoma patients (mean age: 60.6, standard deviation (SD) 11.5years) who received initial fornix-based trabeculectomy from a single ophthalmology clinic, with one or more reliable visual field test results per year from at least five years before and after the surgery. Measurements included postoperative mean intraocular pressure (IOP), standard deviation of IOP, medication scores, mean deviation slope, and total deviation slope were evaluated based on preoperative data. The relationship between mean IOP, SD-IOP and the visual field (VF) deterioration speed was also analysed. The mean follow-up period before surgery was 6.15 (SD 0.97) years and post surgery it was 5.95 (SD 0.63) years. The preoperative mean IOP of 14.6 (SD 2.3)mmHg significantly decreased to 9.2 (SD 2.2)mmHg (P <.001). The preoperative medication score 2.7 (SD 0.5) significantly decreased to 0.1 (SD 0.4, P <.001). The preoperative MD slope of -0.52 (SE 0.047) dB/year significantly improved to -0.31 (SE 0.14) dB/year (P <.01), with improvement in the superior hemifield (P ≤.018). Inferior hemifield (P >.10) did not follow the trend. Neither mean IOP nor SD-IOP correlated with the VF deterioration speed. Fornix-based trabeculectomy is an acceptable procedure for initial surgical management of glaucoma, especially for maintenance of superior VF.

A new uncertain linear regression model based on slope mean

The least squares estimation can fully consider the given data and minimize the sum of squares of the residuals, and it can solve the linear regression equation of the imprecisely observed data effectively. Based on the least squares estimation and uncertainty theory, we first proposed the slope mean model, which is to calculate the slopes of expected value and each given data, and the average value of these slopes as the slope of the linear regression equation, substituted into the expected value coordinates, and we can get the linear regression equation. Then, we proposed the deviation slope mean model, which is a very good model and the focus of this paper. The idea of the deviation slope mean model is to calculate the slopes of each given data deviating from the regression equation, and take the average value of these slopes as the slope of the regression equation. Substituted into the expected value coordinate, we can get the linear regression equation. The deviation slope mean model can also be extended to multiple linear regression equation, we transform the established equations into matrix equation and use inverse matrix to solve unknown parameters. Finally, we put forward the hybrid model, which is a simplified model based on the combination of the least squares estimation and deviation slope mean model. To illustrate the efficiency of the proposed models, we provide numerical examples and solve the linear regression equations of the imprecisely observed data and the precisely observed data respectively. Through analysis and comparison, the deviation slope mean model has the best fitting effect. Part of the discussion, we are explained and summarized.

Assessing Glaucoma Progression Using Machine Learning Trained on Longitudinal Visual Field and Clinical Data

Rule-based approaches to determining glaucoma progression from visual fields (VFs) alone are discordant and have tradeoffs. To detect better when glaucoma progression is occurring, we used a longitudinal data set of merged VF and clinical data to assess the performance of a convolutional long short-term memory (LSTM) neural network. Retrospective analysis of longitudinal clinical and VF data. From 2 initial datasets of 672 123 VF results from 213 254 eyes and 350 437 samples of clinical data, persons at the intersection of both datasets with 4 or more VF results and corresponding baseline clinical data (cup-to-disc ratio, central corneal thickness, and intraocular pressure) were included. After exclusion criteria-specifically the removal of VFs with high false-positive and false-negative rates and entries with missing data-were applied to ensure reliable data, 11 242 eyes remained. Three commonly used glaucoma progression algorithms (VF index slope, mean deviation slope, and pointwise linear regression) were used to define eyes as stable or progressing. Two machine learning models, one exclusively trained on VF data and another trained on both VF and clinical data, were tested. Area under the receiver operating characteristic curve (AUC) and area under the precision-recall curve (AUPRC) calculated on a held-out test set and mean accuracies from threefold cross-validation were used to compare the performance of the machine learning models. The convolutional LSTM network demonstrated 91% to 93% accuracy with respect to the different conventional glaucoma progression algorithms given 4 consecutive VF results for each participant. The model that was trained on both VF and clinical data (AUC, 0.89-0.93) showed better diagnostic ability than a model exclusively trained on VF results (AUC, 0.79-0.82; P < 0.001). A convolutional LSTM architecture can capture local and global trends in VFs over time. It iswell suited to assessing glaucoma progression because of its ability to extract spatiotemporal features thatother algorithms cannot. Supplementing VF results with clinical data improves the model's ability to assess glaucoma progression and better reflects the way clinicians manage data when managing glaucoma.

Aqueous Flare and Progression of Visual Field Loss in Patients With Retinitis Pigmentosa.

PurposeTo investigate the association between aqueous flare and progression of visual field loss using the Humphrey Field Analyzer in patients with retinitis pigmentosa (RP).MethodsWe examined a total of 101 eyes of 101 patients who were diagnosed with typical RP. Sixty-one percent of the patients were female, and the mean age of the total group was 47.4 years. Aqueous flare, visual field (by an Humphrey Field Analyzer, the central 10-2 SITA-Standard program), and optical coherence tomography measurements were obtained for all patients. The slope, which was derived from serial values of mean deviation, macular sensitivity, or foveal sensitivity for each eye with univariate linear regression, was used for analysis.ResultsAqueous flare values were significantly correlated with the mean deviation slope (r = −0.20, P = 0.046), macular sensitivity slope (r = −0.28, P = 0.005) and foveal sensitivity slope (r = −0.20, P = 0.047). The values of the retinal sensitivity slope significantly decreased as the aqueous flare level increased (all P < 0.05). These associations remained unchanged after adjustment for age, sex, and posterior subcapsular cataract, and epiretinal membrane.ConclusionsElevation of aqueous flare is a risk factor for the decline of central visual function in RP. Aqueous flare may be a useful marker for disease progression in RP.