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Monitoring Glaucomatous Functional Loss Using an Artificial Intelligence-Enabled Dashboard
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DOI：10.1016/j.ophtha.2020.03.008.png)
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Abstract
En 中文
Purpose: To develop an artificial intelligence (Al) dashboard for monitoring glaucomatous functional loss. Design: Retrospective, cross-sectional, longitudinal cohort study. Participants: Of 31 591 visual fields (VFs) on 8077 subjects, 13 231 VFs from the most recent visit of each patient were included to develop the Al dashboard. Longitudinal VFs from 287 eyes with glaucoma were used to validate the models. Method: We entered VF data from the most recent visit of glaucomatous and nonglaucomatous patients into a pipeline that included principal component analysis (PCA), manifold learning, and unsupervised clustering to identify eyes with similar global, hemifield, and local patterns of VF loss. We visualized the results on a map, which we refer to as an Al-enabled glaucoma dashboard. We used density-based clustering and the VF decomposition method called archetypal analysis to annotate the dashboard. Finally, we used 2 separate benchmark datasets-one representing likely nonprogression and the other representing likely progression-to validate the dashboard and assess its ability to portray functional change over time in glaucoma. Main Outcome Measures: The severity and extent of functional loss and characteristic patterns of VF loss in patients with glaucoma. Results: After building the dashboard, we identified 32 nonoverlapping clusters. Each cluster on the dashboard corresponded to a particular global functional severity, an extent of VF loss into different hemifields, and characteristic local patterns of VF loss. By using 2 independent benchmark datasets and a definition of stability as trajectories not passing through over 2 clusters in a left or downward direction, the specificity for detecting likely nonprogression was 94% and the sensitivity for detecting likely progression was 77%. Conclusions: The Al-enabled glaucoma dashboard, developed using a large VF dataset containing a broad spectrum of visual deficit types, has the potential to provide clinicians with a user-friendly tool for determination of the severity of glaucomatous vision deficit, the spatial extent of the damage, and a means for monitoring the disease progression. (C) 2020 by the American Academy of Ophthalmology
Keywords:
VISUAL-FIELD LOSS
STANDARD AUTOMATED PERIMETRY
OPEN-ANGLE GLAUCOMA
PROGRESSION
VARIABILITY
PATTERN
PERFORMANCE
THRESHOLD
DEFECTS
SAP
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