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OCTOPUS PERIMETRYGLAUCOMA PROGRESSION ANALYSIS

Dr. Rohit KhatriChair : Dr. Neetha S.

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OCTOPUS PERIMETRY

   The Octopus perietr! s!ste "ocuseso# $etti#$ e%cie#t &e'( e)ai#atio#s

*! shorte#i#$ testi#$ tie there*!re(uci#$ errors cause( *! patie#t"ati$ue.

  It achie+es this *! usi#$ (i,ere#tstrate$ies:

  - sta$i#$ / phasi#$

  0 (!#aic strate$!

  1 te#(e#c! orie#te( perietr!2TOP

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STAGING

   The e)ai#atio# is ru# i# a se3ue#ce o"(ia$#ostica''! re'e+a#t sta$es.

  I# each sta$e a pre(e&#e( su*set o" test'ocatio#s is teste(.

  Priorit! ca# *e a''ocate( to those test'ocatio#s 4hich are ore critica' i# re'atio# to

$'aucoa / these 'ocatio#s are teste( &rst.   Thus5 the esse#tia' part o" the &e'( e)a is

cop'ete( i#itia''! 4he# the patie#t is orea'ert.

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P6ASING

A"ter co#c'u(i#$ a #u*er o" sta$es i#the -st phase5 the 0#( phase o,ers

possi*i'it! to e)te#( the e)ai#atio# i#(i,ere#t (irectio#s:

  - repeat phase -5 to 7#o4 S8.

 

0 $o to periphera' test poi#ts.  1 3ua#ti"! re'ati+e (e"ects.

  9 stop.

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ADANTAGES O8 STAGING/ P6ASING

  A(apti#$ test tie to patie#t;ssituatio#.

 

Shorte#i#$ test tie 4ith i#ia' i#"o'oss.

  Prioriti<i#$ to (ia$#ostica''! re'e+a#t

areas.  E)te#(i#$ the test i# (irectio#s as

re3uire( i# i#(i+i(ua' cases.

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DYNAMIC TESTINGSTRATEGY

  =ith i#crease i# the (e"ect (epth5 thestep si<es i#crease pro$ressi+e'! "ro

0 to -> (?. The thresho'( is crosse(o#'! o#ce.

   The proce(ure a''o4s retesti#$ at a'''ocatio#s.

  It re(uces testi#$ tie *! 9>@> B i#&e'(s 4ith se+ere (epressio#.

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 TENDENCY ORIENTEDPERIMETRY

   TOP a'$orith ta7es i#to accou#t thatthresho'( +a'ues2(i,ere#tia' 'i$ht se#siti+it!o" #ei$h*ori#$ areas are i#terre'ate(.

  It re(uces testi#$ tie *! >B to a*out 0i#utes.

  It assesses the thresho'( i# the 'ocatio#

4here stiu'us is prese#te(5 / a'sothresho'( o" a(ace#t poi#ts *! i#terpo'atio#.

  Especia''! use"u' i# (epresse( &e'(s5 chi'(re#/ e'(er'!.

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 TOP strate$!

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GAE TRACKING

  I#stea( o" usi#$ the *'i#(spot 'ocator4ith &)atio# o#itor as a etho( o"

assessi#$ &)atio# 'osses5 the Octopushas a $a<e trac7i#$ s!ste.

  It 4or7s *! 'ocati#$ the 'i$ht reFe) i#the pupi''ar! area / 'oo7i#$ "or a#!cha#$es i# $a<e to assess &)atio#'osses.

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STANDARD TESTCONDITIONS

OCTOPUS ->-

  ?ac7$rou#( i''ui#a#ce 9 as*

 

Si<e Go'(a## I@  Ma)iu 'ui#a#ce ->>> as*

OCTOPUS 1>>  ?ac7$rou#( i''ui#a#ce 1-.9 as*

  Si<e Go'(a## III5

  Ma)iu 'ui#a#ce 9>> as*

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SEEN@IN@ONE PRINTOUT

  Patie#t (ata

  E)ai#atio# (ata

 

a'ue ta*'e 2ra4 (ata  Gre! sca'e

  Copariso# ta*'e

 

Correcte( copariso# ta*'e  Pro*a*i'it! p'ots

  isua' &e'( i#(ices

  ?e*ie cur+e 2 (e"ect cur+e

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SEEN IN ONE

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ALUE TA?LE

  Gi+es the actua' se#siti+ities o"i#(i+i(ua' poi#ts i# the &e'( i# (eci*e's.

 

 The other ta*'es are (eri+e( *!copari#$ these +a'ues 4ith #orati+e(ata.

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GREYSCALE

  Sta#(ar( $re!sca'e : +a'ue ta*'e +a'uesare (i+i(e( i#to -> <o#es / each is

$i+e# a co'or co(e. Dar7er areas si$#i"!'o4er se#siti+it!.

  Copariso# $re!sca'e : sha(es are$i+e# *ase( o# copariso# ta*'e

+a'ues. A #ora' &e'( resu't 4i'' *e4hite o# this sca'e.

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COMPARISON TA?LE

  P'ots the (i,ere#ce *et4ee# the +a'ueta*'e / a$e atche( #ora'

popu'atio#.

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?E?IE CURE 2CUMULATIEDE8ECT

  It sho4s a'' the se#siti+it! +a'uesarra#$e( i# (esce#(i#$ or(er as a 'i#e$raph.

   The! are use"u' i# c'ear'! / 3uic7'!assessi#$ the characteristics / (epth o"the (e"ect.

   The! ca##ot (isti#$uish *et4ee#$'aucoatous a#( #o#$'aucoatouscauses o" 'oca'i<e( or (i,use +isua' &e'('oss.

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   The ost iporta#t hi$h'i$ht o" the?e*ie cur+e is the <o#e o" a$e

correcte( #ora'it! at the top.  It represe#ts H> B co#&(e#ce i#ter+a'

o" the #ora' popu'atio# 4hich arereprese#te( *! t4o 'i#es 29 (?.

   The (i,use 'oss 2 (e+iatio# isreprese#te( *e'o4 the cur+e i# (?.

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  I" the ?e*ie cur+e is e+e#'! (epresse(*e'o4 the Hth perce#ti'e5 (epressio#

o" the +isua' &e'( is $e#era'i<e(.  I" o#'! the ri$ht si(e o" the cur+e is

(epresse(5 +isua' &e'( 'oss is 'oca'i<e(.

  I" the 4ho'e cur+e is (epresse( *ut i#a# u#e+e# "ashio#5 *oth 'oca'i<e( a#((i,use 'oss is prese#t.

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?E?IE CURE

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CORRECTED COMPARISON TA?LE

  A# estiate o" the (i,use 'oss is(eri+e( "ro the ?e*ie cur+e5 tere(

(e+iatio#;.   This (e+iatio# is reo+e( "ro the

Copariso# ta*'e to arri+e at theCorrecte( Copariso# ta*'e.

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PRO?A?ILITY / CORRECTEDPRO?A?ILITY PLOTS

   These are (eri+e( "ro the copariso#/ correcte( copariso# ta*'es

respecti+e'! *! assi$#i#$ P +a'ues toeach poi#t.

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ISUAL 8IELD INDICES

MEAN SENSITIITY:

  It is the a+era$e o" a'' (i,ere#tia' 'i$ht se#siti+it!+a'ues o# the ra4 (ata.

  It is #ot correcte( "or a$e or (i,use 'oss.

MEAN DE8ECT:

  It is the a+era$e o" a'' the +a'ues o" the

copariso# ta*'e.  It represe#ts the a$e correcte( ea# se#siti+it!.

   The tre#( o" MD o+er tie is a $oo( i#(icator o"pro$ressio#.

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LOSS ARIANCE:

  It is the s3uare +a'ue o" the sta#(ar( (e+iatio# o"the 'oca' (e"ects i# the copariso# ta*'e.

  It is a +er! se#siti+e i#(e) to pic7 up ear'!'oca'i<e( (aa$e.

SJUARE ROOT O8 L:

  It is a ore se#siti+e i#(e) "or "o''o4i#$ up&e'(s to (etect cha#$e i# 'oca' (e"ects o+ertie.

  It is ore sooth o# the tre#( a#a'!sis $raph.

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S6ORT TERM 8LUCTUATION:

  These are +a'ues o*tai#e( a"ter

retesti#$ certai# poi#ts i# the &e'(.  Nora' ra#$e is -. 0. (?

CORRECTED LOSS ARIANCE:  It is (eri+e( *! reo+i#$ the short

ter Fuctuatio#s "ro the 'oss+aria#ce.

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RELIA?ILITY 8ACTOR

  It i#(icates the patie#t;s co@operatio#.

  It is ca'cu'ate( as@ the su o" the "a'se

positi+e / "a'se #e$ati+e a#s4ers(i+i(e( *! the tota' #u*er o" catchtria' 3uestio#s.

  It shou'( #ot *e hi$her tha# -B

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Octopus +s 68A

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MACULAR PROGRAM

  De+e'ope( "or assessi#$ / "o''o4i#$ upce#tra' / parace#tra' &e'(s.

 

M0 pro$ra has 9 test 'ocatio#s4hich test the ce#tra' 9 (e$ree. This$i+es a reso'utio# o" >. (e$ree 4ithGo'(a## si<e III.

   The outer 1 test 'ocatio#s are*et4ee# 9@H (e$ree "ro ce#tre.

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- poi#ts i# (e$ree @Macu'ar

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Macu'ar pro$ra i#A(+a#ce( G'aucoa

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8OLLO= UP 8IELDS

6uphre! &e'( a#a'!<er has STATPAC topri#t "o''o4 up &e'(s i# these "orats:

 

- O+er+ie4 pri#tout  0 Cha#$e a#a'!sis pri#tout

  1 G'aucoa pro$ressio# a#a'!sis

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OERIE= PRINTOUT

  It i#+o'+es chro#o'o$ica' arra#$ee#to" &e'( pri#touts / assessi#$ "or a#!

cha#$e o+er tie.  It has a'' the (ata o" a si#$'e &e'(

e)cept +isua' acuit! / re"racti+ecorrectio#.

  It re3uires e)perie#ce to (etectse3ue#tia' cha#$e i# &e'(s5 / #ostatistica' a#a'!sis is i#+o'+e(.

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   The ost iporta#t aspect to assesspro$ressio# is ea# (e+iatio# i#(e).

 

Accepte( i#crease i# MD i#(e) per !earis >.> (?.

  Co#ce#trate o# pro*a*i'it! p'ots to7#o4 the pro$ressio# i# ters o"e)te#t.

  E)act 'oss o" se#siti+it! ca# *e 7#o4#"ro the ra4 (ata o#'!.

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C6ANGE ANALYSISPRINTOUT

It has 1 copo#e#ts:

  - A *o) p'ot 4ith its re'atio# to the (?

sca'e.  0 Suar! o" the $'o*a' i#(ices.

  1 Li#ear re$ressio# a#a'!sis o" the

ea# (e+iatio#.

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- ?o) p'ot :

  $i+es i#"o re$ar(i#$ the (epth o" the

&e'( (e"ect. Each *o) p'ot represe#tsthe TDNP o" each si#$'e &e'( pri#tout.

0 G'o*a' i#(ices suar! :

 

MD i#(e) / PSD i#(e) are (isp'a!e( i#$raphic "orat.

  U#i"or pro$ressio#  i#crease MD

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  Irre$u'ar $e#era'i<e( pro$ressio# i#crease MD5 i#crease PSD.

1 Li#ear re$ressio# a#a'!sis o" Mea#De+iatio# he'ps to 7#o4 a tepora'cha#$e i# MD i#(e).

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?O PLOT

   The *o) p'ot is co#structe( *! p'aci#$ the TDNP+a'ues i# (ecreasi#$ or(er o" se#siti+it! / (i+i(i#$the i#to 1 <o#es.

 

 To 7#o4 the t!pe o" &e'( (e"ect5 the positio# o" the*o) p'ot i# re'atio# to the (? sca'e as 4e'' as itsshape is iporta#t.

  Loca'i<e( &e'( (e"ect  'e#$the#i#$ o" tai'5 #ocha#$e i# positio# o" *o).

  U#i"or $e#era'i<e( &e'( (e"ect  *o) is 'o4er i#positio#.

  Irre$u'ar $e#era'i<e( &e'( (e"ect  *o) is 'o4er i#positio# as 4e'' as 'e#$the#e(.

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?O PLOT

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LOCALIED 8IELD DE8ECT

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UNI8ORM GENERALIED8IELD DE8ECT

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IRREGULAR GENERALIED8IELD DE8ECT

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GLAUCOMA PROGRESSIONANALYSIS

   The ai# (ra4*ac7 4ith o+er+ie4 pri#toutsor cha#$e a#a'!sis is that copariso#s area(e *et4ee# ra4 (ata 2TDNP o" *ase'i#e /

"o''o4 up.  I# this case 4e (o #ot 7#o4 4hether the

cha#$e is (ue to actua' (isease pro$ressio#or 'o#$ ter Fuctuatio#5 'ear#i#$ e,ects

e(ia opacities.  I# GPA5 copariso#s are a(e *et4ee#

*ase'i#e patter# (e+iatio# #uerica' p'ots /those o# "o''o4 up.

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?ASELINE PRINTOUT

  GPA *ase'i#e pri#tout is a co*i#atio#o":

 

- O+er+ie4 pri#tout o" -st

 t4o tests.  0 Li#ear re$ressio# a#a'!sis o" ea#

(e+iatio# o" cha#$e a#a'!sis pri#tout.

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?ASELINE

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STEPS IN ANALYSIS

- Esta*'ishi#$ the *ase'i#e (ata:

  PDNP o" the -st t4o pri#touts is use(.

0 Esta*'ishi#$ the (e+iatio# "ro *ase'i#e:

  8o''o4 up PDNP is copare( to *ase'i#e /(e+iatio# p'ots co#structe(.

1 Esta*'ishi#$ pro$ressio# a#a'!sis p'ot:

  Each (e+iatio# "ro *ase'i#e is copare( toi#ter@test +aria*i'it! o" sta*'e $'aucoapatie#t / poi#ts 4hich ha+e pro$resse(si$#i&ca#t'! are i#(icate(.

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SYM?OLS ON GPA

    pro$ressio# at HB si$#i&ca#ce'e+e'.

 

  pro$ressio# si$#i&ca#t i# 0co#secuti+e e)as.

    pro$ressio# si$#i&ca#t i# 1co#secuti+e e)as.

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PROGRESSION

   Three i# o#e e)a i#(icatespossi*'e pro$ressio#;.

 

 Three i# o#e e)a i#(icates 'i7e'!pro$ressio#;.

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POSSI?LE PROGRESSION

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LIKELY PROGRESSION

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