title: Patterns of functional vision loss in glaucoma determined with archetypal analysis.
abstract: Glaucoma is an optic neuropathy accompanied by vision loss which can be mapped by visual field (VF) testing revealing characteristic patterns related to the retinal nerve fibre layer anatomy. While detailed knowledge about these patterns is important to understand the anatomic and genetic aspects of glaucoma, current classification schemes are typically predominantly derived qualitatively. Here, we classify glaucomatous vision loss quantitatively by statistically learning prototypical patterns on the convex hull of the data space. In contrast to component-based approaches, this method emphasizes distinct aspects of the data and provides patterns that are easier to interpret for clinicians. Based on 13 231 reliable Humphrey VFs from a large clinical glaucoma practice, we identify an optimal solution with 17 glaucomatous vision loss prototypes which fit well with previously described qualitative patterns from a large clinical study. We illustrate relations of our patterns to retinal structure by a previously developed mathematical model. In contrast to the qualitative clinical approaches, our results can serve as a framework to quantify the various subtypes of glaucomatous visual field loss.
authors.affiliation: Schepens Eye Research Institute, Harvard Medical School, Boston, MA 02114, USA Max Planck Institute for Mathematics in the Sciences, Leipzig, Germany tobias_elze@meei.harvard.edu.
authors.forename: Tobias
authors.initials: T
authors.lastname: Elze
authors.affiliation: Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Louis R
authors.initials: LR
authors.lastname: Pasquale
authors.affiliation: Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Lucy Q
authors.initials: LQ
authors.lastname: Shen
authors.affiliation: Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Teresa C
authors.initials: TC
authors.lastname: Chen
authors.affiliation: Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Janey L
authors.initials: JL
authors.lastname: Wiggs
authors.affiliation: Schepens Eye Research Institute, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bex
mesh_terms: D001766:Blindness / Q000145:classification / Q000209:etiology / Q000503:physiopathology; D005901:Glaucoma / Q000145:classification / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008954:Models, Biological; D055351:Retinal Neurons
keywords: glaucoma; retinal nerve fibre layer; vision loss