Dataset Information

Visual Field Evaluation Using Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast in Patients With Glaucoma and Healthy Individuals.

ABSTRACT:

Purpose

To evaluate visual fields obtained with Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast from patients with glaucoma and healthy individuals.

Methods

Fifty-five patients with glaucoma (median mean deviation [MD], -7.6 dB; interquartile range [IQR], -15.3 to -2.6 dB) and 22 healthy participants (median MD, -0.6 dB; IQR, -1.7 to 0.2 dB) performed ZATA Standard and ZATA Fast tests on a Henson 9000 perimeter and Swedish Interactive Thresholding Algorithm (SITA) Standard and SITA Fast tests on a Humphrey Field Analyzer. Tests were repeated within 90 days (median, 14 days; range, 7-26 days) to evaluate the test-retest variability.

Results

The mean difference between the MD of the ZATA Standard and SITA Standard tests was 1.7 dB (95% confidence interval [CI], 0.9-2.4). Between ZATA Fast and SITA Fast, it was 0.9 dB (95% CI, 0.2-1.5 dB). Although there were systematic differences between the distributions of sensitivity estimates with ZATA and SITA, they did not affect the overall representation of damage by these tests. ZATA Standard and ZATA Fast were approximately 30% and 6% faster, respectively, than the corresponding SITA tests.

Conclusions

ZATA Standard and ZATA Fast are suitable for clinical practice. However, differences between ZATA and SITA tests suggest that they should not be used interchangeably when patients with glaucoma are followed over time.

Translational relevance

This study examined the characteristics of ZATA visual field tests in a clinical population, and it supports the adoption of these tests for assessing patients with glaucoma.

SUBMITTER: Nasim P

PROVIDER: S-EPMC10833053 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

Visual Field Evaluation Using Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast in Patients With Glaucoma and Healthy Individuals.

Nasim Pinaz P Ve Ramesh S RS Kuzhuppilly Neetha I R NIR Naik Preethi P Ballae Ganeshrao Shonraj S Artes Paul H PH

Translational vision science & technology 20240101 1

<h4>Purpose</h4>To evaluate visual fields obtained with Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast from patients with glaucoma and healthy individuals.<h4>Methods</h4>Fifty-five patients with glaucoma (median mean deviation [MD], -7.6 dB; interquartile range [IQR], -15.3 to -2.6 dB) and 22 healthy participants (median MD, -0.6 dB; IQR, -1.7 to 0.2 dB) performed ZATA Standard and ZATA Fast tests on a Henson 9000 perimeter and Swedish Interactive Thresholding Algorithm (SITA) ...[more]

PMID: 38289611

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Project description:ImportanceEstimating the rate of glaucomatous visual field change provides practical assessment of disease progression and has implications for management decisions.ObjectiveTo assess the rates of visual field change in patients receiving treatment for glaucoma compared with healthy individuals over an extensive follow-up period and to quantify the impact of important covariates for these rates.Design, setting, and participantsThis prospective longitudinal cohort study was conducted in a hospital-based setting from January 1991 to February 2020. The study included 40 patients receiving treatment for open-angle glaucoma and 29 healthy participants. One eye of each participant was randomly selected as the study eye.ExposuresPatients with glaucoma and healthy participants received testing with standard automated perimetry every 6 months. Individual rates of mean sensitivity change were computed using ordinary least-squares regression analysis, and linear mixed-effects modeling was used to estimate the mean rates of mean sensitivity change in the 2 groups and the impact of baseline mean sensitivity, baseline age, and follow-up intraocular pressure for rate estimates.Main outcomes and measuresRate of mean sensitivity change in patients with glaucoma and healthy participants.ResultsA total of 40 patients with glaucoma (median age, 53.07 years [IQR, 48.34-57.97 years]; 21 men [52%]) and 29 healthy participants (median age, 48.80 years [IQR, 40.40-59.07 years], 17 women [59%]) were followed up for a median of 25.65 years (IQR, 22.49-27.02 years) and 19.56 years (IQR, 16.19-26.21 years), respectively. Most participants (65 individuals [94%]) self-identified as White, with the exception of 2 patients with glaucoma (1 self-identified as Black and 1 as South Asian) and 2 healthy participants (both self-identified as South Asian). The mean follow-up intraocular pressure of patients with glaucoma (median, 15.83 mm Hg [IQR, 13.05-17.33 mm Hg]) was similar to that of healthy participants (median, 14.94 mm Hg [IQR, 13.28-16.01 mm Hg]; P = .25). In an ordinary least-squares regression analysis, 31 patients (78%) with glaucoma had rates of mean sensitivity change within the range of healthy participants (ie, between -0.20 dB/y and 0.15 dB/y). Linear mixed-effects modeling revealed that the mean (SE) rate of mean sensitivity change in healthy participants was 0.003 (0.033) dB/y (95% CI, -0.062 to 0.068; P = .93). In comparison, patients with glaucoma had a mean (SE) rate of mean sensitivity change that was -0.032 (0.052) dB/y faster, but this difference was not statistically significant (95% CI, -0.134 to 0.070; P = .53). Among covariates, only baseline mean sensitivity was associated with the rate of mean sensitivity change (mean [SE], 0.021 [0.010] dB/y/dB; 95% CI, 0.002-0.041; P = .03).Conclusions and relevanceThe results of this cohort study suggest that over a median follow-up of more than 25 years, the rate of visual field change in patients receiving treatment for glaucoma was comparable to that of healthy individuals. These findings could guide practitioners in making management decisions.

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Project description:PurposeVisual field testing that is not frequent enough results in delayed identification of open-angle glaucoma (OAG) progression. Guidelines recommend at least annual testing. It is not known how frequently patients with OAG across the United States receive visual field testing and how patient characteristics and circumstances influence this frequency. If US patients with OAG do not receive visual field tests frequently enough, interventions to increase this frequency or to develop other forms of testing visual function may reduce unidentified OAG vision loss.DesignRetrospective cohort study.ParticipantsThe TruvenHealth MarketScan Commercial Claims Database (IBM) contains demographic and claims data for > 160 million individuals across the United States from 2008 to 2017. We identified enrollees in the database with a recorded diagnosis of OAG (International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, Tenth Revision, Clinical Modification codes 356.1x and H40.1x, respectively). We excluded those aged < 40 years at the time of their first OAG diagnosis, those without at least 1 confirmatory OAG diagnosis at a subsequent visit, and those with < 4 years of follow-up data after OAG diagnosis.MethodsWe calculated the number of visual field tests that each enrollee with OAG underwent per year and categorized the enrollees based on that number (0, > 0 to < 0.9, ≥ 0.9 to ≤ 1.1, > 1.1 to ≤ 2.1, and > 2.1). We used negative binomial regression to investigate the demographic or health variables that were associated with the frequency of visual field tests that enrollees with OAG received.Main outcome measuresFrequency of visual field testing among enrollees with OAG.ResultsOf the 380 029 enrollees included in the study, 33 267 (8.8%) did not receive a visual field test during the study period, 259 349 (68.2%) underwent > 0 to < 0.9 visual field tests per year, 42 129 (11.1%) underwent ≥ 0.9 to ≤ 1.1 visual field tests per year, 42 301 (11.1%) underwent > 1.1 to ≤ 2.1 visual field tests per year, and 2983 (0.8%) underwent ≥ 2.1 visual field tests per year. The median number of visual field tests per year was 0.63 (interquartile range, 0.33-0.88; mean, 0.65).ConclusionsMore than 75% of enrollees with OAG received < 1 visual field test per year and, thus, did not receive guideline-adherent glaucoma monitoring.

Dataset Information

Visual Field Evaluation Using Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast in Patients With Glaucoma and Healthy Individuals.

Purpose

Methods

Results

Conclusions

Translational relevance

Publications

Visual Field Evaluation Using Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast in Patients With Glaucoma and Healthy Individuals.

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