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Investigating the usefulness of a cluster-based trend analysis to detect visual field progression in patients with open-angle glaucoma
  1. Shuichiro Aoki1,
  2. Hiroshi Murata1,
  3. Yuri Fujino2,
  4. Masato Matsuura3,
  5. Atsuya Miki4,
  6. Masaki Tanito5,
  7. Shiro Mizoue6,7,
  8. Kazuhiko Mori8,
  9. Katsuyoshi Suzuki9,
  10. Takehiro Yamashita10,
  11. Kenji Kashiwagi11,
  12. Kazunori Hirasawa12,
  13. Nobuyuki Shoji13,
  14. Ryo Asaoka14
  1. 1 Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
  2. 2 Department of Ophthalmology, Tokyo Hospital, Tokyo, Japan
  3. 3 The University of Tokyo, Tokyo, Japan
  4. 4 Department of Ophthalmology, Osaka Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Suita, Osaka, Japan
  5. 5 Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan
  6. 6 Department of Ophthalmology, Minami-matsuyama Hospital, Matsuyama-shi, Ehime, Japan
  7. 7 Department of Ophthalmology, Ehime University School of Medicine, Toon-shi, Ehime, Japan
  8. 8 Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  9. 9 Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
  10. 10 Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
  11. 11 Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Japan
  12. 12 Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
  13. 13 Department of Rehabilitation, Orthoptics and Visual Science, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
  14. 14 Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
  1. Correspondence to Dr Ryo Asaoka, Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; ryoasa0120{at}


Background/aims To investigate the usefulness of the Octopus (Haag-Streit) EyeSuite’s cluster trend analysis in glaucoma.

Methods Ten visual fields (VFs) with the Humphrey Field Analyzer (Carl Zeiss Meditec), spanning 7.7 years on average were obtained from 728 eyes of 475 primary open angle glaucoma patients. Mean total deviation (mTD) trend analysis and EyeSuite’s cluster trend analysis were performed on various series of VFs (from 1st to 10th: VF1-10 to 6th to 10th: VF6-10). The results of the cluster-based trend analysis, based on different lengths of VF series, were compared against mTD trend analysis.

Result Cluster-based trend analysis and mTD trend analysis results were significantly associated in all clusters and with all lengths of VF series. Between 21.2% and 45.9% (depending on VF series length and location) of clusters were deemed to progress when the mTD trend analysis suggested no progression. On the other hand, 4.8% of eyes were observed to progress using the mTD trend analysis when cluster trend analysis suggested no progression in any two (or more) clusters.

Conclusion Whole field trend analysis can miss local VF progression. Cluster trend analysis appears as robust as mTD trend analysis and useful to assess both sectorial and whole field progression. Cluster-based trend analyses, in particular the definition of two or more progressing cluster, may help clinicians to detect glaucomatous progression in a timelier manner than using a whole field trend analysis, without significantly compromising specificity.

  • glaucoma
  • cluster
  • progression

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  • Contributors Substantial contributions to the conception or design of the work: SA, HM and RA. Acquisition, analysis or interpretation of data for the work: SA, HM, YF, MM, AM, MT, SM, KM, KS, TY, KK, KH, NS and RA. Drafting the work or revising it critically for important intellectual content: SA, HM, YF, MM, AM, MT, SM, KM, KS, TY, KK, KH, NS and RA. Final approval of the version to be published: SA, HM, YF, MM, AM, MT, SM, KM, KS, TY, KK, KH, NS and RA. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: SA, HM, YF, MM, AM, MT, SM, KM, KS, TY, KK, KH, NS and RA.

  • Funding This work was supported by the Ministry of Education, Culture, Sports, Science and Technology of Japan and Japan Science and Technology Agency (JST) CREST 26462679 .

  • Competing interests None declared.

  • Ethics approval The review board of each institute, including the Tokyo University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.