Glaucoma Precognition: Recognizing Preclinical Visual Functional Signs of Glaucoma

Deep archetypal analysis (DAA) has recently been proposed as an unsupervised approach for discovering latent structures in data. However, while a few approaches have used classical archetypal analysis (AA), DAA has not been incorporated in medical image analysis as yet. The purpose of this study is to develop a precognition framework to identify preclinical signs of glaucomatous vision loss using convex representations derived from DAA. We first develop an AA structure and a novel DAA framework to recognize hidden patterns of visual functional loss, and then project visual field data over the identified patterns to obtain a representation for glaucoma precognition several years prior to disease onset. We then develop a glaucoma classification framework using class-balanced bagging with neural networks to address the class imbalance problem. In contrast to other classification approaches, DAA, applied to a unique prospective longitudinal dataset with approximately eight years of visual field tests from normal eyes that developed glaucoma, has allowed visualization of the early signs of glaucoma and development of a construct for glaucoma precognition. Our findings suggest that our proposed glaucoma precognition approach could significantly advance state-of-the-art glaucoma prediction.