The following is the summary of “Frequency of Visual Fields Needed to Detect Glaucoma Progression: A Computer Simulation Using Linear Mixed Effects Model,” published in the May 2023 issue of the Glaucoma by Sabouri, et al.
Acceptable results were obtained in diagnosing glaucoma progression using a varying frequency of visual field tests, with relatively short intervals initially and longer intervals later in the disease. It might be challenging to balance the immediate expenditures of evaluating people’s eyes for glaucoma with the potential expenses that may arise from inadequate treatment. The research aims to use a linear mixed effects model (LMM) to simulate real-world scenarios involving visual field data to identify the best follow-up strategy for early diagnosis of glaucoma progression.
The time series of mean deviation sensitivities was simulated using a linear mixed model (LMM) with a random intercept and slope. The residuals were calculated using data from a cohort study of 277 glaucoma eyes monitored for 9.0±1.2 years. Early glaucoma patients with varying rates of visual field loss and regular or irregular follow-up circumstances provided the data. Around 10,000 simulated eye series were examined under each condition, and a single confirmation test was used to determine improvement. The number of misdiagnoses of progression would be significantly reduced if a single confirmatory test was performed.
In the first 2 years, the time to identify progression was shortened for eyes with a regularly spaced 4-monthly schedule. After that point, the testing outcomes two times a year were equivalent to those of exams scheduled three times a year. Acceptable results were obtained in diagnosing glaucoma progression using a varying frequency of visual field tests, with relatively short intervals initially and longer intervals later in the disease. This strategy has the potential to enhance glaucoma monitoring. In addition, data simulation using LMM may yield a more accurate prediction of the duration of the disease’s development.