Dual-Level Pattern Tree for Visual Field Improves Glaucoma Progression and Polygenic Risk Prediction
Document Type
Article
Publication Date
12-1-2025
Abstract
PURPOSE: To develop a dual-level pattern tree to characterize visual field (VF) loss subtypes that can be used to better predict glaucoma progression and glaucoma polygenic risk scores (PRSs).
METHODS: This study included 113,030 patients from three datasets, each used for a specific purpose: (1) model training, (2) progression forecasting, and (3) PRS correlations. We applied archetypal analysis to cluster 24-2 VFs into trunk patterns and their branch patterns. The Cox regression model was used to forecast VF progression using mean deviation (MD) slope, MD-fast slope, total deviation (TD) pointwise slope, and visual field index (VFI) slope. Multivariable regression analyses were used to link VF patterns with glaucoma PRSs. The Akaike information criterion (AIC) was used for model comparisons.
RESULTS: We identified 17 trunk patterns and 169 branch patterns, with a mean of 9.9 ± 1.6 branches per trunk. Trunk-branch (T-B) patterns were consistently superior to trunk patterns (all contrast P < 0.05) for forecasting 5-year progression using the area under the receiver operating characteristic curve: MD, 0.60 vs. 0.58; MD-fast, 0.84 vs. 0.78; TD pointwise, 0.68 vs. 0.65; and VFI, 0.64 vs. 0.63. The trunk-branch patterns were superior in predicting PRSs (linear regression showed AIC improvement of 26).
CONCLUSIONS: Trunk-branch VF classifiers were superior to trunk-only characterizations for predicting functional progression and glaucoma PRS.
TRANSLATIONAL RELEVANCE: High-quality clustering of patient VF characteristics may allow physicians to better manage glaucoma patients by aligning with their goal of care and provide researchers with insights into glaucoma subtypes.
Recommended Citation
Song, Luo; Shen, Lucy Q.; Pasquale, Louis R.; Boland, Michael V.; Wellik, Sarah R.; De Moraes, Carlos Gustavo; Segre, Ayellet; Wiggs, Janey L.; Turman, Constance; Myers, Jonathan S.; Elze, Tobias; Zebardast, Nazlee; Friedman, David S.; Kang, Jae H.; and Wang, Mengyu, "Dual-Level Pattern Tree for Visual Field Improves Glaucoma Progression and Polygenic Risk Prediction" (2025). Wills Eye Hospital Papers. Paper 277.
https://jdc.jefferson.edu/willsfp/277
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
41342625
Language
English
Included in
Diagnosis Commons, Ophthalmology Commons, Pathological Conditions, Signs and Symptoms Commons
Comments
This article is the author’s final published version in Translational Vision Science and Technology, Volume 14, Issue 12, 2025, Article number 11.
The published version is available at https://doi.org/10.1167/tvst.14.12.11. Copyright © 2025 The Authors.