Real-World External Evaluation of an OCT Image Analysis System (AI-CO) in Relation to Humphrey Visual Field Mean Deviation
- 1Kora Eye Clinic
Abstract
PurposeTo externally evaluate the unitless optical coherence tomography-derived AI-CO index for association with Humphrey mean deviation (MD) and discrimination of MD-defined visual field severity.
MethodsThis retrospective study included 819 eyes of 424 patients receiving glaucoma care, with AI-CO analysis and Humphrey 24-2 SITA Faster or 30-2 SITA Fast testing within 365 days. The unitless output labeled "peripheral" was termed AI-CO all. Primary analyses assessed Spearman rank correlation and discrimination at MD thresholds of -2, -6, and -12 dB. Additional analyses assessed adjusted associations and one-eye-per-patient and program-specific robustness. Exploratory analyses assessed nonlinearity and cutoffs with patient-level cross-validation.
ResultsAI-CO all correlated with Humphrey MD (Spearman {rho}=0.785; patient-cluster 95% confidence interval [CI], 0.750-0.818). Median AI-CO all values decreased from -2.10 in the normal range to -4.40, -10.15, and -17.35 in mild, moderate, and severe categories, respectively (ordered trend P<0.001). Areas under the receiver operating characteristic curve were 0.870 (95% CI, 0.842-0.895), 0.919 (0.894-0.939), and 0.943 (0.920-0.963) at the three thresholds. The adjusted spline detected modest nonlinearity with little gain in explained variance over a linear model (R2, 0.735 to 0.738). Associations remained after covariate adjustment, and findings were similar in the one-eye-per-patient analysis and across visual field programs.
ConclusionsAI-CO all showed a rank correlation with Humphrey MD and differentiated eyes across specified MD thresholds. It should be interpreted as a severity-related index that complements, rather than replaces, measured perimetry. Exploratory AI-CO all cutoffs require independent validation.
Translational RelevanceIn routine glaucoma care, AI-CO all showed a rank correlation with Humphrey MD and discriminated MD-defined severity.
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BibTeX
@misc{kora2026realworld,
title = {{Real-World External Evaluation of an OCT Image Analysis System (AI-CO) in Relation to Humphrey Visual Field Mean Deviation}},
author = {Y. KORA and H. Kora and T. Kora},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.08.26362248},
url = {https://www.medrxiv.org/content/10.64898/2026.09.08.26362248v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Real-World External Evaluation of an OCT Image Analysis System (AI-CO) in Relation to Humphrey Visual Field Mean Deviation
AU - Y. KORA
AU - H. Kora
AU - T. Kora
PY - 2026
DA - 2026/09/08
PB - medRxiv
DO - 10.64898/2026.09.08.26362248
UR - https://www.medrxiv.org/content/10.64898/2026.09.08.26362248v1
AB - PurposeTo externally evaluate the unitless optical coherence tomography-derived AI-CO index for association with Humphrey mean deviation (MD) and discrimination of MD-defined visual field severity. MethodsThis retrospective study included 819 eyes of 424 patients receiving glaucoma care, with AI-CO analysis and Humphrey 24-2 SITA Faster or 30-2 SITA Fast testing within 365 days. The unitless output labeled "peripheral" was termed AI-CO all. Primary analyses assessed Spearman rank correlation and discrimination at MD thresholds of -2, -6, and -12 dB. Additional analyses assessed adjusted associations and one-eye-per-patient and program-specific robustness. Exploratory analyses assessed nonlinearity and cutoffs with patient-level cross-validation. ResultsAI-CO all correlated with Humphrey MD (Spearman {rho}=0.785; patient-cluster 95% confidence interval [CI], 0.750-0.818). Median AI-CO all values decreased from -2.10 in the normal range to -4.40, -10.15, and -17.35 in mild, moderate, and severe categories, respectively (ordered trend P<0.001). Areas under the receiver operating characteristic curve were 0.870 (95% CI, 0.842-0.895), 0.919 (0.894-0.939), and 0.943 (0.920-0.963) at the three thresholds. The adjusted spline detected modest nonlinearity with little gain in explained variance over a linear model (R2, 0.735 to 0.738). Associations remained after covariate adjustment, and findings were similar in the one-eye-per-patient analysis and across visual field programs. ConclusionsAI-CO all showed a rank correlation with Humphrey MD and differentiated eyes across specified MD thresholds. It should be interpreted as a severity-related index that complements, rather than replaces, measured perimetry. Exploratory AI-CO all cutoffs require independent validation. Translational RelevanceIn routine glaucoma care, AI-CO all showed a rank correlation with Humphrey MD and discriminated MD-defined severity.
ER -