{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:30:58Z","timestamp":1787589058098,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,11,20]],"date-time":"2006-11-20T00:00:00Z","timestamp":1163980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Ophthalmol"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The objective of this report is to describe the methods used to develop and validate a computerized system to analyze Humphrey visual fields obtained from patients with non-arteritic anterior ischemic optic neuropathy (NAION) and enrolled in the Ischemic Optic Neuropathy Decompression Trial (IONDT). The IONDT was a multicenter study that included randomized and non-randomized patients with newly diagnosed NAION in the study eye. At baseline, randomized eyes had visual acuity of 20\/64 or worse and non-randomized eyes had visual acuity of better than 20\/64 or were associated with patients refusing randomization. Visual fields were measured before treatment using the Humphrey Field Analyzer with the 24-2 program, foveal threshold, and size III stimulus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We used visual fields from 189 non-IONDT eyes with NAION to develop the computerized classification system. Six neuro-ophthalmologists (\"expert panel\") described definitions for visual field patterns defects using 19 visual fields representing a range of pattern defect types. The expert panel then used 120 visual fields, classified using these definitions, to refine the rules, generating revised definitions for 13 visual field pattern defects and 3 levels of severity. These definitions were incorporated into a rule-based computerized classification system run on Excel<jats:sup>\u00ae<\/jats:sup> software. The computerized classification system was used to categorize visual field defects for an additional 95 NAION visual fields, and the expert panel was asked to independently classify the new fields and subsequently whether they agreed with the computer classification. To account for test variability over time, we derived an adjustment factor from the pooled short term fluctuation. We examined change in defects with and without adjustment in visual fields of study participants who demonstrated a visual acuity decrease within 30 days of NAION onset (progressive NAION).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Despite an agreed upon set of rules, there was not good agreement among the expert panel when their independent visual classifications were compared. A majority did concur with the computer classification for 91 of 95 visual fields. Remaining classification discrepancies could not be resolved without modifying existing definitions.<\/jats:p>\n            <jats:p>Without using the adjustment factor, visual fields of 63.6% (14\/22) patients with progressive NAION and no central defect, and all (7\/7) patients with a paracentral defect, worsened within 30 days of NAION onset. After applying the adjustment factor, the visual fields of the same patients with no initial central defect and 5\/7 of the patients with a paracentral defect were seen to worsen.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The IONDT developed a rule-based computerized system that consistently defines pattern and severity of visual fields of NAION patients for use in a research setting.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2415-6-34","type":"journal-article","created":{"date-parts":[[2006,11,21]],"date-time":"2006-11-21T08:03:46Z","timestamp":1164096226000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Development and validation of a computerized expert system for evaluation of automated visual fields from the Ischemic Optic Neuropathy Decompression Trial"],"prefix":"10.1186","volume":"6","author":[{"given":"Steven E","family":"Feldon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Levin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta W","family":"Scherer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Arnold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia M","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenworth N","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kosmorsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A","family":"Newman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Langenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P David","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalom E","family":"Kelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Dickersin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"members of the Ischemic Optic Neuropathy Decompression Trial Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2006,11,20]]},"reference":[{"key":"96_CR1","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/S0197-2456(98)00003-8","volume":"19","author":"Ischemic Optic Neuropathy Decompression Trial Research Group","year":"1998","unstructured":"Ischemic Optic Neuropathy Decompression Trial Research Group: The Ischemic Optic Neuropathy Decompression Trial (IONDT): design and methods. Control Clin Trials. 1998, 19: 276-296. 10.1016\/S0197-2456(98)00003-8.","journal-title":"Control Clin Trials"},{"key":"96_CR2","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1001\/jama.1995.03520320035038","volume":"273","author":"Ischemic Optic Neuropathy Decompression Trial Research Group","year":"1995","unstructured":"Ischemic Optic Neuropathy Decompression Trial Research Group: Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. JAMA. 1995, 273: 625-632. 10.1001\/jama.273.8.625.","journal-title":"JAMA"},{"key":"96_CR3","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1016\/S0161-6420(94)31171-7","volume":"101","author":"Advanced Glaucoma Intervention Study investigators","year":"1994","unstructured":"Advanced Glaucoma Intervention Study investigators: Advanced glaucoma intervention study: 2. Visual field test scoring and reliability. Ophthalmology. 1994, 101: 1445-1455.","journal-title":"Ophthalmology"},{"key":"96_CR4","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1001\/archopht.1991.01080120068028","volume":"109","author":"J Katz","year":"1991","unstructured":"Katz J, Sommer A, Gaasterland D, Anderson DR: Comparison of analytic algorithms for detecting glaucomatous visual field loss. Arch Ophthalmol. 1991, 109: 1684-1689.","journal-title":"Arch Ophthalmol"},{"key":"96_CR5","doi-asserted-by":"publisher","first-page":"2144","DOI":"10.1016\/S0161-6420(99)90497-9","volume":"106","author":"MC Leske","year":"1999","unstructured":"Leske MC, Heijl A, Hyman L, Bengtsson B: Early Manifest Glaucoma Trial: Design and baseline data. Ophthalmology. 1999, 106: 2144-53. 10.1016\/S0161-6420(99)90497-9.","journal-title":"Ophthalmology"},{"key":"96_CR6","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/S0161-6420(99)90147-1","volume":"106","author":"DC Musch","year":"1999","unstructured":"Musch DC, Lichter PR, Guire KE, Standardi CL, the CIGTS Study Group: The Collaborative Initial Glaucoma Treatment Study: study design, methods, and baseline characteristic of enrolled patients. Ophthalmology. 1999, 106: 653-662. 10.1016\/S0161-6420(99)90147-1.","journal-title":"Ophthalmology"},{"key":"96_CR7","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/0197-2456(93)90016-7","volume":"14","author":"JL Keltner","year":"1995","unstructured":"Keltner JL, Johnson CA, Beck RW, Cleary PA, Spurr JO, the Optic Neuritis Study Group: Quality control functions of the visual field reading center (VFRC) for the Optic Neuritis Study Group. Control Clin Trials. 1995, 14: 143-159. 10.1016\/0197-2456(93)90016-7.","journal-title":"Control Clin Trials"},{"key":"96_CR8","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1055\/s-0038-1634398","volume":"39","author":"G Molino","year":"2000","unstructured":"Molino G, Marzuoli M, Molino F, Battista S, Bar F, Torchio M, Lavelle SM, Corless G, Cappello N: Validation of ICTERUS, a knowledge-based expert system for jaundice diagnosis. Method Inform Med. 2000, 39: 311-318.","journal-title":"Method Inform Med"},{"key":"96_CR9","volume-title":"Visual Field Testing with the Humphrey Field Analyzer","author":"NT Choplin","year":"1995","unstructured":"Choplin NT, Edwards RP: Basic principles of visual field interpretation. Visual Field Testing with the Humphrey Field Analyzer. 1995, SLACK Incorporated, Thorofare, NJ"},{"key":"96_CR10","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1006\/cbmr.1994.1034","volume":"27","author":"C Hernandez","year":"1994","unstructured":"Hernandez C, Sancho JJ, Belmonte MA, Sierra C, Sanz F: Validation of the medical expert system RENOIR. Comput Biomed Res. 1994, 27: 456-71. 10.1006\/cbmr.1994.1034.","journal-title":"Comput Biomed Res"},{"issue":"8668","key":"96_CR11","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1016\/S0140-6736(89)91560-2","volume":"2","author":"GC Sutton","year":"1989","unstructured":"Sutton GC: How accurate is computer-aided diagnosis. Lancet. 1989, 2 (8668): 905-908. 10.1016\/S0140-6736(89)91560-2.","journal-title":"Lancet"},{"key":"96_CR12","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/BF00920027","volume":"228","author":"H-P Hirsbrunner","year":"1990","unstructured":"Hirsbrunner H-P, Fankhauser F, Jenni A, Fundhouser A: Evaluating a perimetric expert system: experience with Octosmart. Graefes Arch Clin Exp Ophthalmol. 1990, 228: 237-241. 10.1007\/BF00920027.","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"96_CR13","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1001\/archopht.1982.01030040605010","volume":"100","author":"EB Werner","year":"1982","unstructured":"Werner EB, Saheb N, Thomas D: Variability of static visual threshold responses in patients with elevated IOPs. Arch Ophthalmol. 1982, 100: 1627-1631.","journal-title":"Arch Ophthalmol"},{"key":"96_CR14","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1001\/archopht.118.9.1187","volume":"118","author":"JL Keltner","year":"2000","unstructured":"Keltner JL, Johnson CA, Quigg JM, Cello KE, Kass MA, Gordon MO for the Ocular Hypertension Treatment Study Group: Confirmation of visual field abnormalities in the Ocular Hypertension Treatment Study. Arch Ophthalmol. 2000, 118: 1187-1194.","journal-title":"Arch Ophthalmol"},{"key":"96_CR15","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/BF00927247","volume":"228","author":"MG De la Rosa","year":"1990","unstructured":"De la Rosa MG, Reyes JAA, Sierra MAG: Rapid assessment of the visual field in glaucoma using an analysis based on multiple correlations. Graefes Arch Clin Exp Ophthalmol. 1990, 228: 387-391. 10.1007\/BF00927247.","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"96_CR16","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/S0161-6420(99)90052-0","volume":"106","author":"J Katz","year":"1999","unstructured":"Katz J: Scoring systems for measuring progression of visual field loss in clinical trials of glaucoma treatment. Ophthalmology. 1999, 106: 391-395. 10.1016\/S0161-6420(99)90052-0.","journal-title":"Ophthalmology"},{"key":"96_CR17","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1007\/BF00184085","volume":"233","author":"AI McNaught","year":"1995","unstructured":"McNaught AI, Crabb DP, Fitzke FW, Hitchings RA: Modelling series of visual fields to detect progression in normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 1995, 233: 750-755. 10.1007\/BF00184085.","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"96_CR18","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1001\/archopht.1993.01090020085029","volume":"111","author":"JL Keltner","year":"1993","unstructured":"Keltner JL, Johnson CA, Spurr JO, Back RW, Optic Neuritis Study Group: Baseline visual field profile of optic neuritis; the experience of the Optic Neuritis Treatment Trial. Arch Ophthalmol. 1993, 111: 231-234.","journal-title":"Arch Ophthalmol"},{"key":"96_CR19","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1001\/archopht.121.5.643","volume":"121","author":"JL Keltner","year":"2003","unstructured":"Keltner JL, Johnson CA, Cello KE, Edwards MA, Bandermann SE, Kass MA, Gordon MO for the Ocular Hypertension Study Group: Classification of visual field abnormalitieis in the Ocular Hypertension Treatment Study. Arch Ophthalmol. 2003, 121: 643-65. 10.1001\/archopht.121.5.643.","journal-title":"Arch Ophthalmol"},{"key":"96_CR20","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/S0002-9394(14)75425-X","volume":"121","author":"L Brigatti","year":"1996","unstructured":"Brigatti L, Hoffman D, Caprioli J: Neural networks to identify glaucoma with structural and functional measurements. Am J Ophthalmol. 1996, 121: 511-521.","journal-title":"Am J Ophthalmol"},{"key":"96_CR21","first-page":"162","volume":"43","author":"MH Goldbaum","year":"2002","unstructured":"Goldbaum MH, Sample PA, Chan K, Williams J, Lee TW, Blumenthal E, Girkin CA, Zangwill LM, Bowd C, Sejnowski T, Weinreb RN: Comparing Machine Learning Classifiers for Diagnosing Glaucoma from Standard Automated Perimetry. Invest Ophthalmol Vis Sci. 2002, 43: 162-169.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"96_CR22","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1088\/0031-9155\/38\/9\/006","volume":"38","author":"D Keating","year":"1993","unstructured":"Keating D, Mutlukan E, Evans A, McGarvie J, Damato B: A back propagation neural network for the classification of visual field data. Phys Med Biol. 1993, 38: 1263-1270. 10.1088\/0031-9155\/38\/9\/006.","journal-title":"Phys Med Biol"},{"key":"96_CR23","first-page":"287","volume-title":"Perimetry Update 1990\/91. Proceedings of the Sixth International Perimetric Society Meeting, Malmo, Sweden, June 17\u201320, 1990","author":"SE Kelman","year":"1991","unstructured":"Kelman SE, Perell HF, D'Autrechy L, Scott RJ: A neural network can differentiate glaucoma and optic neuropathy visual fields through pattern recognition. Perimetry Update 1990\/91. Proceedings of the Sixth International Perimetric Society Meeting, Malmo, Sweden, June 17\u201320, 1990. Edited by: Mills RP, Heijl A. 1991, Amsterdam\/New York: Kugler Publications, 287-290."},{"key":"96_CR24","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1136\/bjo.80.6.526","volume":"80","author":"DB Henson","year":"1996","unstructured":"Henson DB, Spenceley SE, Bull DR: Spatial classification of glaucomatous visual field loss. Br J Ophthalmol. 1996, 80: 526-531.","journal-title":"Br J Ophthalmol"},{"key":"96_CR25","first-page":"269","volume":"102","author":"SE Feldon","year":"2004","unstructured":"Feldon SE: Computerized expert system for evaluation of automated visual fields from the Ischemic Optic Neuropathy Decompression Trial: Methods, baseline fields, and six-month longitudinal follow-up. Trans Am Ophthalmol Soc. 2004, 102: 269-303.","journal-title":"Trans Am Ophthalmol Soc"}],"container-title":["BMC Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2415-6-34.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2415-6-34\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2415-6-34","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2415-6-34.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T21:47:51Z","timestamp":1630446471000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcophthalmol.biomedcentral.com\/articles\/10.1186\/1471-2415-6-34"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,11,20]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,12]]}},"alternative-id":["96"],"URL":"https:\/\/doi.org\/10.1186\/1471-2415-6-34","relation":{},"ISSN":["1471-2415"],"issn-type":[{"value":"1471-2415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,11,20]]},"assertion":[{"value":"27 July 2006","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2006","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2006","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"34"}}