Borrowing the Best from Industrial Process Control for Detecting Progression of Eye Disease: CUSUM Charts for Assessing the Visual Field and Retinal Nerve Fiber Layer Thickness

Johannes Ledolter, Randy Kardon

Publikation: Wissenschaftliche FachzeitschriftOriginalbeitrag in FachzeitschriftForschungBegutachtung


Purpose: The cumulative sum (CUSUM) is proposed and tested in a group of glaucoma
patients and healthy subjects as a method for monitoring disease progression and for
identifying clinically significant step changes in visual structure or function.
Methods: The CUSUM procedure is the recommended method for the timely
detection of small step changes in manufacturing process control. The CUSUM
procedure is discussed and compared with traditional approaches for the detection of
change in the status of the visual system over time. The CUSUM approach is used to
monitor over time visual field (VF) mean deviations and optical coherence
tomography (OCT) measurements of retinal nerve fiber layer (RNFL) thickness in 53
healthy subjects and 103 patients with glaucoma.
Results: The CUSUM method detects VF progression for 35 of the 103 glaucoma
patients (34.0%), and OCT RNFL reductions for 20 of the 103 glaucoma patients
Conclusions: The CUSUM method is effective in detecting small level changes. This
method can be used to monitor the progression of disease and it benefits the clinician
who must decide, on the basis of a time series of variable data, whether a change has
Translational Relevance: A cumulative sum chart helps the clinician decide whether
a step change has taken place, and it does so as quickly as possible. This approach is
particularly effective for detecting small step changes, which very likely are unnoticed
with currently used change detection approaches.
Seiten (von - bis)1 - 9
FachzeitschriftTranslational Vision Science & Technology
PublikationsstatusVeröffentlicht - 1 Okt. 2013