Deep learning of longitudinal visual fields predicts glaucoma progression rate and identifies fast progressors
This study addresses the challenge that assessing glaucoma progression rates typically requires multiple visual field tests over years, hindering the rapid identification of high-risk patients. We propose GLAM, a model that leverages longitudinal Humphrey visual field data and clinical features via an attention-based fusion mechanism to predict progression rates while quantifying aleatoric uncertainty. The key innovation lies in achieving performance comparable to multimodal approaches using only routine unimodal visual field data, thereby substantially shortening the assessment period. Experimental results demonstrate that GLAM predicts mean deviation (MD) progression rates with a mean absolute error of 0.139 dB/year (R²=0.927), reducing the error by 73.5% compared to baselines. Furthermore, the model attains an AUC of 0.990 for detecting fast progressors, enabling highly accurate and cost-effective early screening.