Enhancing central visual field loss representation with a hybrid unsupervised approach

Purpose: To effectively represent central visual field (VF) loss for individual patients using a hybrid unsupervised approach. Methods: We obtained 7927 10–2 VF test data from 3328 patients in 5 hospitals. We propose a hybrid approach that combines archetypal analysis (AA) and fuzzy c-means (FCM) to identify characteristic patterns and decompose 10–2 VF without loss. To compare the performance between hybrid approach using FCM and AA single approach, mean deviation (MD) change prediction was performed through supervised learning using decomposition coefficient changes and a linear mixed-effects model was built to investigate the relationship between the MD slope and baseline decomposition coefficients. Results: We identified 10 representative archetypes for 10–2 VF test. The hybrid approach using FCM outperformed the AA single approach in predicting MD change, achieving lower mean squared error and higher pearson correlation coefficient (all P ≤ 0.039). According to the linear mixed-effects model, the hybrid approach using FCM provides a better fit for predicting MD slope compared to the AA single approach, as reflected by lower akaike information criterion (AIC) and bayesian information criterion (BIC) scores (AIC decrease: 20.31, BIC decrease: 13.33). Eyes with baseline VFs with more inferior and both hemifield loss and less intact field and nearly total loss were associated with faster central VF progression (all P ≤ 0.026). Conclusion: A hybrid approach combining AA and FCM to analyze 10–2 VF can visualize central VF tests in characteristic patterns and enhance prediction of central VF progression with minimized projection loss decomposition compared with AA single approach.