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Scoring of Visual Field Measured through Humphrey Perimetry: Principal Component Varimax Rotation Followed by Validated Cluster Analysis

¹From Hôpital des Quinze-Vingts, Centre Hospitalier National d’Ophtalmologie, Paris, France; ²Laboratoire de Statistique Theorique et Appliquée, Université Pierre et Marie Curie, Paris, France; ³Conservatoire National des Arts et Métiers, Paris, France; and ⁴Alcon France, SA, Paris, France.

PURPOSE. To extract unidimensional, well-separated latent scores that are anatomically and clinically valid from 52 standardized variables collected by Humphrey visual field (VF) perimetry (Carl Zeiss Meditec, Dublin, CA).

METHODS. Visual field data of 437 patients were collected and classified by a glaucoma specialist into seven clinical groups: irregularities of VF (IVF), nasal step (NaS), arcuate scotoma (AC), paracentral scotoma (PCS), blind-spot enlargement (BSE), diffuse deficit (DD), and advanced deficit (AD). The number and content of constituent variable scores were identified by principal components analysis followed by Varimax Rotation and simple clustering, taking spatial distribution homogeneity and visual system anatomy into account. Unidimensionality was checked by a stepwise Cronbach curve. Clinical predictability of the derived scores was checked by comparing clinical groups (ANOVA).

RESULTS. Patients older than 60 years comprised 53.3% of the sample. The average mean deviation was –9.2 dB and pattern standard deviation was 6.5 dB. Six scores were identified: four peripheral scores (nasal superior, NS; nasal inferior, NI; temporal superior, TS; and temporal inferior, TI) and two paracentral scores (PCSs; superior, PCSS; and inferior, PCSI). Cronbach was always >0.90. The six scores decreased sequentially from IVF to DD to AD. Scores of AC were lower in NS, NI, and TS; PCSS was less in PCS; BSE scores were less in TS and TI; NaS scores were less in NS and NI.

CONCLUSIONS. Six well-separated, optimal scores were obtained from the Humphrey perimetry matrix. Internal reliability was good. It was possible to discriminate between clinical subgroups. Further analyses, based on longitudinal data, must be performed to confirm these findings.