Archetypal Analysis Reveals Consistent Visual Field Patterns for Stimulus Sizes III and V in Glaucoma and NAION.

Purpose: Disorders of the anterior optic nerve cause quantifiable patterns, or archetypes (AT), in visual fields (VFs) obtained using standardized automated perimetry using stimulus size III (size III). VFs with stimulus size V (size V) can reduce retest variability in eyes with moderate to severe loss. We postulated that VF testing using both stimuli would show similar ATs in eyes with glaucoma and nonarteritic anterior ischemic optic neuropathy (NAION).

Methods: We used 1969 same-day pairs of 24-2 size III and size V VFs from two datasets. QRK207 is the largest NAION study to date, and the VIPII study measured same-day VFs across many stimulus sizes. We censored raw sensitivities of less than 21 dB for size III and 24 dB for size V and age-standardized to total deviations, before archetypal analysis (AA). We compared the ATs between the two stimuli and the combined data.

Results: Using 14 ATs for both glaucoma and NAION, AA captured similar patterns between the two stimuli in both diseases with 87% of AT pairings having a cosine similarity of 0.8 or greater. The combined ATs retained the patterns in the separate stimuli VFs.

Conclusions: AA shows that size V VFs provide quantifiable patterns of loss similar to size III. This aids in comparing stimulus sizes for monitoring VF patterns in disease progression.

Translational relevance: AA shows similar quantifiable patterns of VF loss with size III or size V, supporting the use of size V to monitor eyes with moderate to severe VF loss.