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The Rationale for Applying a Visual Field Rate of Progression Analysis Using a Hierarchical, Censored, Bayesian Model to the 5-Year HORIZON Data

By ximena.balbin
June 30, 2025
Alcon Publications
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The Rationale for Applying a Visual Field Rate of Progression Analysis Using a Hierarchical, Censored, Bayesian Model to the 5-Year HORIZON Data

KEY TAKEAWAY POINTS 

 

  • The clinical relevance of visual fields has progressed over time, and is a relevant functional indicator of the status of a patient’s glaucoma
  •  Standardized automated perimetry has been an essential tool to help best guide disease management for glaucoma patients • Several models beyond those found within standardized automated perimetry have attempted to better predict progression of visual field loss 
  • A hierarchical model that has the ability to describe the rates of progression between groups as well as at Garway-Heath clusters and point locations, and that accounts for censoring of 0 dB readings may provide practical advantages and can identify deeper insight into identified patterns of visual field loss 
  • A model by Montesano et al that was used in the Laser in Glaucoma and Ocular Hypertension Trial (LiGHT) and Treatment of Advanced Glaucoma Study (TAGS) was applied in a retrospective, post-hoc manner to the 5-year visual field data of the HORIZON Trial.
  •  This post-hoc analysis revealed a difference in the rate of progression between groups, but it was apparent that there were a greater number of fast progressors in the cataract surgery-alone group that could account for these differences.
  • A number of limitations to this analysis must be understood to interpret these findings within context

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