Montesano, Giovanni;
Crabb, David P;
Wright, David M;
Rabiolo, Alessandro;
Ometto, Giovanni;
Garway-Heath, David F;
(2024)
Estimating the Distribution of True Rates of Visual Field Progression in Glaucoma.
Translational Vision Science & Technology
, 13
(4)
, Article 15. 10.1167/tvst.13.4.15.
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Abstract
Purpose: The purpose of this study was to estimate the distribution of the true rates of progression (RoP) of visual field (VF) loss.// Methods: We analyzed the progression of mean deviation over time in series of ≥ 10 tests from 3352 eyes (one per patient) from 5 glaucoma clinics, using a novel Bayesian hierarchical Linear Mixed Model (LMM); this modeled the random-effect distribution of RoPs as the sum of 2 independent processes following, respectively, a negative exponential distribution (the “true” distribution of RoPs) and a Gaussian distribution (the “noise”), resulting in a skewed exGaussian distribution. The exGaussian-LMM was compared to a standard Gaussian-LMM using the Watanabe-Akaike Information Criterion (WAIC). The random-effect distributions were compared to the empirical cumulative distribution function (eCDF) of linear regression RoPs using a Kolmogorov-Smirnov test.// Results: The WAIC indicated a better fit with the exGaussian-LMM (estimate [standard error]: 192174.4 [721.2]) than with the Gaussian-LMM (192595 [697.4], with a difference of 157.2 [22.6]). There was a significant difference between the eCDF and the Gaussian-LMM distribution (P < 0.0001), but not with the exGaussian-LMM distribution (P = 0.108). The estimated mean (95% credible intervals, CIs) “true” RoP (−0.377, 95% CI = −0.396 to −0.359 dB/year) was more negative than the observed mean RoP (−0.283, 95% CI = −0.299 to −0.268 dB/year), indicating a bias likely due to learning in standard LMMs.// Conclusions: The distribution of “true” RoPs can be estimated with an exGaussian-LMM, improving model accuracy.// Translational Relevance: We used these results to develop a fast and accurate analytical approximation for sample-size calculations in clinical trials using standard LMMs, which was integrated in a freely available web application.
| Type: | Article |
|---|---|
| Title: | Estimating the Distribution of True Rates of Visual Field Progression in Glaucoma |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1167/tvst.13.4.15 |
| Publisher version: | https://doi.org/10.1167/tvst.13.4.15 |
| Language: | English |
| Additional information: | © The Author(s), 2024. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | visual field (VF); perimetry; glaucoma; progression; hierarchical modeling |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10191165 |
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