PT - JOURNAL ARTICLE AU - Joseph Branco AU - Tobias Elze AU - Jui-Kai Wang AU - Louis R Pasquale AU - Mona K Garvin AU - Randy Kardon AU - Mark J Kupersmith TI - Longitudinal visual field archetypal analysis of optic neuritis treated in a clinical setting AID - 10.1136/bmjophth-2022-001136 DP - 2022 Nov 01 TA - BMJ Open Ophthalmology PG - e001136 VI - 7 IP - 1 4099 - http://bmjophth.bmj.com/content/7/1/e001136.short 4100 - http://bmjophth.bmj.com/content/7/1/e001136.full SO - BMJ Open Ophth2022 Nov 01; 7 AB - Background/aims We previously used archetypal analysis (AA) to create a model that quantified patterns (archetypes (ATs)) of visual field (VF) loss that can predict recovery and reveal residual VF deficits from eyes in the Optic Neuritis Treatment Trial (ONTT). We hypothesised that AA could produce similar results for ON VFs collected in clinical practice.Methods We applied AA to a retrospective data set of 486 VFs collected in 1 neuro-ophthalmology service from 141 eyes with acute ON and typical VF defects, to create a clinic-derived AT model. We also used the ONTT-derived AT model to analyse this new dataset. We compared the findings of both models by decomposing VFs into component ATs of varying per cent weight (PW), correlating presentation AT PW with mean deviation (MD) at final visits for each eye and identifying residual deficits in VFs considered normal.Results Both models, each with 16 ATs, decomposed each presentation VF into 0–6 abnormal ATs representative of known patterns of ON-related VF loss. AT1, the normal pattern in both models, correlated strongly with MD for VFs collected at presentation (r=0.82; p<0.001) and the final visit (r=0.81, p<0.001). The presentation AT1 PW was associated with improvement in MD over time. 67% of VFs considered ‘normal’ at final visit had 1.2±0.4 abnormal ATs, and both models revealed similar patterns of regional VF loss.Conclusions AA is a quantitative method to measure change and outcome of ON VFs. Presentation AT features are associated with MD at final visit. AA identifies residual VF deficits not otherwise indicated by MD.All data relevant to the study are included in the article or uploaded as online supplemental information.