Journal article
Archetypal analysis quantifies changes in patterns of visual field loss in eyes with acute non-arteritic anterior ischaemic optic neuropathy
British journal of ophthalmology
12/25/2025
DOI: 10.1136/bjo-2025-328673
PMID: 41448866
Abstract
AimsWe characterised visual field (VF) spatial loss patterns in acute non-arteritic anterior ischaemic optic neuropathy (NAION) using archetypal analysis (AA).MethodsWe performed standard automated perimetry on 727 participants with acute NAION at screening, day 1 of enrolment, months 2, 6 and 12. We applied AA, an unsupervised machine learning technique, to identify and quantify distinct VF loss patterns (archetypes, ATs). We used Mann-Whitney U tests and Wilcoxon signed-rank tests to assess demographic differences and longitudinal changes in discrete variables, and linear regression to analyse continuous variables.ResultsAA identified 10 distinct ATs, with three especially prevalent patterns: global VF loss (AT1), inferior altitudinal loss (AT2) and inferior altitudinal with macular sparing (AT3). Between day 1 and month 2, AT1 RW significantly increased from 15.7% to 28.1% (false discovery rate, FDR-adjusted p<0.001). Asian participants consistently exhibited greater RW for AT1 compared with White participants (day 1: 40.7% vs 17.7%; FDR-adjusted p<0.001). Sex differences emerged modestly at months 2 and 6, with females having a higher RW for superior altitudinal loss (FDR-adjusted p=0.049). Older participants showed slightly greater frequency of central horizontal and mild central depression patterns (FDR-adjusted p<0.001).ConclusionsAA effectively quantifies distinct, clinically significant VF spatial loss patterns in NAION, revealing significant temporal changes and demographic differences. Global VF loss represents the predominant AT, increasing notably within 2 months of disease onset. Prominent racial disparities, particularly higher severity in Asian individuals, underscore potential differences in NAION aetiology or susceptibility. These findings provide a foundation for improved disease characterisation and prognosis.
Details
- Title: Subtitle
- Archetypal analysis quantifies changes in patterns of visual field loss in eyes with acute non-arteritic anterior ischaemic optic neuropathy
- Creators
- David Szanto - New York Eye and Ear InfirmaryBrian Woods - Ollscoil na Gaillimhe – University of GalwayJui-Kai Wang - The University of Texas Southwestern Medical CenterMichael Wall - University of IowaTobias Elze - Massachusetts Eye and Ear InfirmaryMark Kupersmith - Icahn School of Medicine at Mount Sinai
- Resource Type
- Journal article
- Publication Details
- British journal of ophthalmology
- DOI
- 10.1136/bjo-2025-328673
- PMID
- 41448866
- NLM abbreviation
- Br J Ophthalmol
- ISSN
- 0007-1161
- eISSN
- 1468-2079
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- Unrestricted grant to the Department of Ophthalmol / Research to Prevent Blindness (http://dx.doi.org/10.13039/100001818) 5IK1RX005029; I01RX003797; I50 RX003002 / Department of Veteran Affairs (VA) Center for the Prevention and Treatment of Visual Loss, Rehabilitation Research and Development EY030413 / National Institute of Health CTSA EY030413 / NIH P30 EY032522 / National Eye Institute (http://dx.doi.org/10.13039/100000053) N/A / Shulman Family NAION Fund at Icahn School of Medicine at Mount Sinai N/A / The Barry Family Center for Ophthalmic Artificial Intelligence and Human Health N/A / The New York Eye and Ear Infirmary Foundation, New York, N.Y ICAT-2022-001 / Health Research Board and ICAT Programme I01 RX000140-03 / VA Merit Review Grant
- Language
- English
- Electronic publication date
- 12/25/2025
- Academic Unit
- Neurology; Ophthalmology and Visual Sciences
- Record Identifier
- 9985096042302771
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