Archetypal analysis of longitudinal visual fields for idiopathic intracranial hypertension patients presenting in a clinic setting

Joseph Branco; Tobias Elze; Jui-Kai Wang; Louis R Pasquale; Mona K Garvin; Randy Kardon; Mark J Kupersmith

doi:10.1371/journal.pdig.0000240

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Archetypal analysis of longitudinal visual fields for idiopathic intracranial hypertension patients presenting in a clinic setting

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Archetypal analysis of longitudinal visual fields for idiopathic intracranial hypertension patients presenting in a clinic setting

Joseph Branco, Tobias Elze, Jui-Kai Wang, Louis R Pasquale, Mona K Garvin, Randy Kardon and Mark J Kupersmith

PLOS digital health, Vol.2(5), e0000240

05/08/2023

DOI: 10.1371/journal.pdig.0000240

PMCID: PMC10166546

PMID: 37155610

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Abstract

We previously applied archetypal analysis (AA) using visual fields (VF) from the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) to derive a model, which quantified patterns (or archetypes [ATs] of VF loss), anticipated recovery, and identified residual VF deficits. We hypothesized that AA could produce similar results using IIH VFs collected in clinical practice. We applied AA to 803 VFs from 235 eyes with IIH from an outpatient neuro-ophthalmology clinic and created a clinic-derived model of ATs, with the relative weight (RW) and average total deviation (TD) for each AT. We also created a combined-derived model from an input dataset containing the clinic VFs and 2862 VFs from the IIHTT. We used both models to decompose clinic VF into ATs of varying percent weight (PW), correlated presentation AT PW with mean deviation (MD), and evaluated final visit VFs considered "normal" by MD ≥ -2.00 dB for residual abnormal ATs. The 14-AT clinic-derived and combined-derived models revealed similar patterns of VF loss previously identified in the IIHTT model. AT1 (a normal pattern) was most prevalent in both models (RW = 51.8% for clinic-derived; 35.4% for combined-derived). Presentation AT1 PW correlated with final visit MD (r = 0.82, p < 0.001 for the clinic-derived model; r = 0.59, p < 0.001 for the combined-derived model). Both models showed ATs with similar patterns of regional VF loss. The most common patterns of VF loss in "normal" final visit VFs using each model were clinic-derived AT2 (mild global depression with enlarged blind spot; 44/125 VFs; 34%) and combined-derived AT2 (near-normal; 93/149 VFs; 62%). AA provides quantitative values for IIH-related patterns of VF loss that can be used to monitor VF changes in a clinic setting. Presentation AT1 PW is associated with the degree of VF recovery. AA identifies residual VF deficits not otherwise indicated by MD.

Details

Title: Subtitle: Archetypal analysis of longitudinal visual fields for idiopathic intracranial hypertension patients presenting in a clinic setting
Creators: Joseph Branco - New York Medical College, Valhalla, New York, United States of America
Tobias Elze - Harvard University
Jui-Kai Wang - University of Iowa, Ophthalmology and Visual Sciences
Louis R Pasquale - Icahn School of Medicine at Mount Sinai
Mona K Garvin - Iowa City VA Health Care System
Randy Kardon - University of Iowa, Iowa Neuroscience Institute
Mark J Kupersmith - Icahn School of Medicine at Mount Sinai
Resource Type: Journal article
Publication Details: PLOS digital health, Vol.2(5), e0000240
DOI: 10.1371/journal.pdig.0000240
PMID: 37155610
PMCID: PMC10166546
NLM abbreviation: PLOS Digit Health
ISSN: 2767-3170
eISSN: 2767-3170
Grant note: R01 EY030575 / NEI NIH HHS P30 EY003790 / NEI NIH HHS
Language: English
Date published: 05/08/2023
Academic Unit: Electrical and Computer Engineering; Iowa Neuroscience Institute; Ophthalmology and Visual Sciences
Record Identifier: 9984473217102771

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