UC San Diego

Goal: The purpose of this study was to identify clinically relevant patterns of glaucomatous vision loss through convex representation to predict glaucoma several years prior to disease onset. Methods: We developed a deep archetypal analysis to identify patterns of glaucomatous vision loss, and then projected visual fields over the identified patterns. Projections provided a representation that was more accurate in detecting glaucomatous vision loss, thus, more appropriate for recognizing preclinical signs of glaucoma prior to disease development. To overcome the class imbalance in prediction, we implemented a class-balanced bagging with neural networks. Results: Using original visual field as features of the class-balanced bagging classification provided an area under the receiver-operating characteristic curve (AUC) of 0.55 for predicting glaucoma approximately four years prior to disease development. Using convex representation of the visual fields as input features provided an AUC of 0.61 while using deep convex representation as input features improved the AUC to 0.71. Relevance vector machine (RVM) achieved an AUC of 0.64. Conclusion: Deep archetypal analysis representation of visual functional features with balanced bagging classification could serve as an automated tool for predicting glaucoma. Significance: Glaucoma is the second leading cause of worldwide blindness. Most people with glaucoma have no early symptoms or pain, delaying diagnosis in many patients until they reach late irreversible vision loss stages. In fact, about 50% of people with glaucoma are unaware they have the disease. Deep archetypal analysis models may impact clinical practice in effectively identifying at-risk glaucoma patients well prior to disease development.