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Yang AS, Wang HS, Li TJ, Liu CH, Chen CM. Diagnosis of early glaucoma likely combined with high myopia by integrating OCT thickness map and standard automated and Pulsar perimetries. Sci Rep 2025; 15:13614. [PMID: 40253455 PMCID: PMC12009423 DOI: 10.1038/s41598-025-97883-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 04/08/2025] [Indexed: 04/21/2025] Open
Abstract
Early-stage glaucoma diagnosis is crucial for preventing permanent structural damage and irreversible vision loss. While various machine-learning approaches have been developed for glaucoma diagnosis, only a few specifically address early-stage detection. Moreover, existing early-stage detection methods rely on unimodal information and exclude subjects with high myopia, which contradicts clinical practice and overlooks the adverse effect of high myopia on prediction performance. To develop a clinically practical tool, this study proposes a deep-learning-based, end-to-end early-stage glaucoma detection framework designed for a cohort likely with high myopia. This framework uniquely integrates functional information from visual field (VF) parameters of standard automated perimetry (SAP) and Pulsar perimetry (PP) with structural information derived from optical coherence tomography (OCT) thickness maps. It comprises three key components: 3D OCT ganglion cell complex (GCC) layer segmentation, thickness map generation, and early-stage glaucoma detection. Evaluated on 394 subjects using five-time, 10-fold cross-validation, the proposed system achieved a mean area under the receiver operating characteristic (ROC) curve of 0.887 ± 0.006, outperforming the Asaoka method without transfer learning and nine models based solely on VF parameters. Results further confirmed that incorporating SAP and PP parameters was essential for mitigating the adverse effects of high myopia.
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Affiliation(s)
- Ai-Su Yang
- Department of Biomedical Engineering, National Taiwan University, Taipei, 100, Taiwan
| | - Hong-Siang Wang
- Department of Biomedical Engineering, National Taiwan University, Taipei, 100, Taiwan
| | - Te-Jung Li
- Department of Biomedical Engineering, National Taiwan University, Taipei, 100, Taiwan
| | - Chin-Hsin Liu
- Department of Ophthalmology, Yonghe Cardinal Tien Hospital, New Taipei City, 234, Taiwan
| | - Chung-Ming Chen
- Department of Biomedical Engineering, National Taiwan University, Taipei, 100, Taiwan.
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2
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Pham AT, Pan AA, Bradley C, Hou K, Herbert P, Johnson C, Wall M, Yohannan J. Detecting Visual Field Worsening From Optic Nerve Head and Macular Optical Coherence Tomography Thickness Measurements. Transl Vis Sci Technol 2024; 13:12. [PMID: 39115839 PMCID: PMC11316451 DOI: 10.1167/tvst.13.8.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/20/2024] [Indexed: 08/12/2024] Open
Abstract
Purpose Compare the use of optic disc and macular optical coherence tomography measurements to predict glaucomatous visual field (VF) worsening. Methods Machine learning and statistical models were trained on 924 eyes (924 patients) with circumpapillary retinal nerve fiber layer (cp-RNFL) or ganglion cell inner plexiform layer (GC-IPL) thickness measurements. The probability of 24-2 VF worsening was predicted using both trend-based and event-based progression definitions of VF worsening. Additionally, the cp-RNFL and GC-IPL predictions were combined to produce a combined prediction. A held-out test set of 617 eyes was used to calculate the area under the curve (AUC) to compare cp-RNFL, GC-IPL, and combined predictions. Results The AUCs for cp-RNFL, GC-IPL, and combined predictions with the statistical and machine learning models were 0.72, 0.69, 0.73, and 0.78, 0.75, 0.81, respectively, when using trend-based analysis as ground truth. The differences in performance between the cp-RNFL, GC-IPL, and combined predictions were not statistically significant. AUCs were highest in glaucoma suspects using cp-RNFL predictions and highest in moderate/advanced glaucoma using GC-IPL predictions. The AUCs for the statistical and machine learning models were 0.63, 0.68, 0.69, and 0.72, 0.69, 0.73, respectively, when using event-based analysis. AUCs decreased with increasing disease severity for all predictions. Conclusions cp-RNFL and GC-IPL similarly predicted VF worsening overall, but cp-RNFL performed best in early glaucoma stages and GC-IPL in later stages. Combining both did not enhance detection significantly. Translational Relevance cp-RNFL best predicted trend-based 24-2 VF progression in early-stage disease, while GC-IPL best predicted progression in late-stage disease. Combining both features led to minimal improvement in predicting progression.
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Affiliation(s)
- Alex T. Pham
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Annabelle A. Pan
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chris Bradley
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kaihua Hou
- Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, USA
| | - Patrick Herbert
- Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Jithin Yohannan
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, USA
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Eraslan N, Celikay O. Rates of retinal nerve fiber layer loss in early-stage pseudoexfoliation and primary open-angle glaucoma patients using optical coherence tomography. Int Ophthalmol 2024; 44:250. [PMID: 38907173 DOI: 10.1007/s10792-024-03214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 06/16/2024] [Indexed: 06/23/2024]
Abstract
PURPOSE To characterize glaucoma progression in early-stage patients with retinal nerve fiber layer (RNFL) using the change analysis software (CAS), which was utilized to track RNFL thinning. METHODS We retrospectively analyzed 92 eyes of 92 patients with early-stage glaucoma. Patients were divided into two subgroups based on their diagnosis of pseudoexfoliation glaucoma (PEG) and primary open-angle glaucoma (POAG). A complete ophthalmologic examination was performed on all patients. Additionally, automated perimetry was conducted on each patient. Furthermore, Fourier-domain optical coherence tomography (OCT) was employed to measure RNFL and central corneal thickness. Using the OCT device's CAS, we computed the annual rate of total and glaucomatous RNFL thinning for each patient. RESULTS A total of 44 PEG and 48 POAG patients were included in the study. The right eye measurements of these patients were analyzed and compared. The two groups were not significantly different in age, gender, and the number of visits per year (p > 0.05, for each). However, the difference between the mean RNFL thickness at baseline (91.39 ± 10.71 and 96.9 ± 8.6 µm) and at the last visit (85.2 ± 15.76 µm and 91.56 ± 9.58 µm) was statistically significant between the two groups (p = 0.043, p = 0.039, respectively). Additionally, the difference in annual RNFL thinning rates (1.43 ± 0.81 µm and 1.07 ± 0.32 µm) between the two groups was statistically significant (p = 0.009). CONCLUSION The annual rate of glaucomatous RNFL loss in early-stage PEG patients (1.23 µm) was higher than in POAG patients (0.87 µm). However, despite these loss rates, scotoma was not detected in the visual field tests of these patients. Therefore, using CAS in the follow-up of early-stage glaucoma patients is a useful alternative for monitoring glaucomatous progression. Furthermore, this method can be utilized in future research for the diagnosis and follow-up of glaucoma in special populations (e.g., those with pathological myopia or high hyperopia) that are not included in normative databases.
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Affiliation(s)
- Numan Eraslan
- Department of Ophthalmology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Osman Celikay
- Department of Ophthalmology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Stern-Green EA, Klimo KR, Day E, Shelton ER, Robich ML, Jordan LA, Racine J, VanNasdale DA, McDaniel CE, Yuhas PT. Henle fiber layer thickening and deficits in objective retinal function in participants with a history of multiple traumatic brain injuries. Front Neurol 2024; 15:1330440. [PMID: 38379704 PMCID: PMC10876769 DOI: 10.3389/fneur.2024.1330440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction This study tested whether multiple traumatic brain injuries (TBIs) alter the structure of the Henle fiber layer (HFL) and degrade cell-specific function in the retinas of human participants. Methods A cohort of case participants with multiple TBIs and a cohort of pair-matched control participants were prospectively recruited. Directional optical coherence tomography and scanning laser polarimetry measured HFL thickness and phase retardation, respectively. Full-field flash electroretinography (fERG) assessed retinal function under light-adapted (LA) 3.0, LA 30 Hz, dark-adapted (DA) 0.01, DA 3.0, and DA 10 conditions. Retinal imaging and fERG outcomes were averaged between both eyes, and paired t-tests or Wilcoxon signed-rank tests analyzed inter-cohort differences. Results Global HFL thickness was significantly (p = 0.02) greater in cases (8.4 ± 0.9 pixels) than in controls (7.7 ± 1.1 pixels). There was no statistically significant difference (p = 0.91) between the cohorts for global HFL phase retardation. For fERG, LA 3.0 a-wave amplitude was significantly reduced (p = 0.02) in cases (23.5 ± 4.2 μV) compared to controls (29.0 ± 8.0 μV). There were no other statistically significant fERG outcomes between the cohorts. Discussion In summary, the HFL thickens after multiple TBIs, but phase retardation remains unaltered in the macula. Multiple TBIs may also impair retinal function, indicated by a reduction in a-wave amplitude. These results support the potential of the retina as a site to detect TBI-associated pathology.
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Affiliation(s)
| | - Kelly R. Klimo
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Elizabeth Day
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Erica R. Shelton
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Matthew L. Robich
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Lisa A. Jordan
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Julie Racine
- Department of Ophthalmology, Nationwide Children’s Hospital, Columbus, OH, United States
| | - Dean A. VanNasdale
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | | | - Phillip T. Yuhas
- College of Optometry, The Ohio State University, Columbus, OH, United States
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5
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Kurysheva NI, Nikitina AD. [Optical coherence tomography and optical coherence tomography angiography for detecting glaucoma progression. Part 1. Study methods, measurement variability and the role of age-related changes]. Vestn Oftalmol 2023; 139:122-128. [PMID: 36924524 DOI: 10.17116/oftalma2023139011122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
This paper reviews the literature on the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in the diagnosis of glaucoma and considers the significance of evaluating retinal nerve fiber layer and ganglion cell complex in assessment of glaucoma progression, variability and reproducibility of the method, as well as the influence of age-related retinal changes on the results, analyzes the role of OCTA in glaucoma monitoring. Optical coherence tomography is a modern standard for glaucoma diagnosis and monitoring, and OCTA shows high potential as an auxiliary diagnostic tool.
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Affiliation(s)
- N I Kurysheva
- Medical Biological University of Innovations and Continuing Education of the Federal Biophysical Center named after A.I. Burnazyan, Moscow, Russia.,Ophthalmological Center of the Federal Medical-Biological Agency - Federal Medical Biophysical Center named after A.I. Burnazyan, Moscow, Russia
| | - A D Nikitina
- Medical Biological University of Innovations and Continuing Education of the Federal Biophysical Center named after A.I. Burnazyan, Moscow, Russia.,Ophthalmological Center of the Federal Medical-Biological Agency - Federal Medical Biophysical Center named after A.I. Burnazyan, Moscow, Russia
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6
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Mohammadzadeh V, Su E, Shi L, Coleman AL, Law SK, Caprioli J, Weiss RE, Nouri-Mahdavi K. Multivariate Longitudinal Modeling of Macular Ganglion Cell Complex: Spatiotemporal Correlations and Patterns of Longitudinal Change. OPHTHALMOLOGY SCIENCE 2022; 2:100187. [PMID: 36245763 PMCID: PMC9559093 DOI: 10.1016/j.xops.2022.100187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 05/20/2022] [Accepted: 06/09/2022] [Indexed: 01/11/2023]
Abstract
Purpose To investigate spatiotemporal correlations among ganglion cell complex (GCC) superpixel thickness measurements and explore underlying patterns of longitudinal change across the macular region. Design Longitudinal cohort study. Subjects One hundred eleven eyes from 111 subjects from the Advanced Glaucoma Progression Study with ≥ 4 visits and ≥ 2 years of follow-up. Methods We further developed our proposed Bayesian hierarchical model for studying longitudinal GCC thickness changes across macular superpixels in a cohort of glaucoma patients. Global priors were introduced for macular superpixel parameters to combine data across superpixels and better estimate population slopes and intercepts. Main Outcome Measures Bayesian residual analysis to inspect cross-superpixel correlations for subject random effects and residuals. Principal component analysis (PCA) to explore underlying patterns of longitudinal macular change. Results Average (standard deviation [SD]) follow-up and baseline 10-2 visual field mean deviation were 3.6 (0.4) years and -8.9 (5.9) dB, respectively. Superpixel-level random effects and residuals had the greatest correlations with nearest neighbors; correlations were higher in the superior than in the inferior region and strongest among random intercepts, followed by random slopes, residuals, and residual SDs. PCA of random intercepts showed a first large principal component (PC) across superpixels that approximated a global intercept, a second PC that contrasted the superior and inferior macula, and a third PC, contrasting inner and nasal superpixels with temporal and peripheral superpixels. PCs for slopes, residual SDs, and residuals were remarkably similar to those of random intercepts. Conclusions Introduction of cross-superpixel random intercepts and slopes is expected to improve estimation of population and subject parameters. Further model enhancement may be possible by including cross-superpixel random effects and correlations to address spatiotemporal relationships in longitudinal data sets.
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Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Erica Su
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Lynn Shi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Anne L. Coleman
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Simon K. Law
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Robert E. Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California,Correspondence: Kouros Nouri-Mahdavi, MD, MS, 100 Stein Plaza, Los Angeles, CA, 90095.
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7
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Naderi Beni A, Entezari D, Koosha N, Kianersi F, Naderan M. Ganglion cell complex and macular thickness layers in primary open-angle glaucoma, pseudoexfoliation glaucoma and healthy eyes: A comparative study. Photodiagnosis Photodyn Ther 2021; 36:102563. [PMID: 34614425 DOI: 10.1016/j.pdpdt.2021.102563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the differences in the ganglion cell complex (GCC) and macular thickness measurements between primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and healthy eyes with optical coherence tomography (OCT)optovue. METHODS In this non-randomized comparative cross-sectional study, 43 healthy eyes, 68 POAG eyes, and 57 PXG eyes were included. Patients were matched for age and disease severity. OCT angiography images were obtained for automated measurement of the GCC and macular thickness layers (inner and outer). RESULTS All GCC parameters were significantly difference between healthy and glaucomatous eyes (mild, and moderate to severe disease).There were no significant differences in GCC parameters between POAG and PXG patients except focal loss volume (FLV) after adjustment. Moderate to severe PXG eyes exhibited significantly lower GCC, larger global loss volume (GLV) values, and FLV values when compared with mild PXG eyes (p<= 0.05). We found significant thinning patterns in inner retinal thickness (fovea, parafovea, and perifovea), and total retinal thickness (parafovea, and perifovea) in moderate to severe PXG eyes when comparing with POAG eyes. Patients with moderate to severe PXG also showed significantly thinning patterns in inner retinal layers (fovea, parafovea and perifovea) and total retinal thickness (nasal parafovea) in compared to mild PXG. CONCLUSION It appears that GCC thickness is not significantly different between POAG and PXG except FLV. Despite similar retinal thickness in mild disease, a significant reduction in total and inner retinal thickness was demonstrated in moderate to severe PXG compared to moderate to severe POAG, in fovea, parafovea and perifovea region.
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Affiliation(s)
- Afsaneh Naderi Beni
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Davoud Entezari
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nima Koosha
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzan Kianersi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Naderan
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Early detection and monitoring are critical to the diagnosis and management of glaucoma, a progressive optic neuropathy that causes irreversible blindness. Optical coherence tomography (OCT) has become a commonly utilized imaging modality that aids in the detection and monitoring of structural glaucomatous damage. Since its inception in 1991, OCT has progressed through multiple iterations, from time-domain OCT, to spectral-domain OCT, to swept-source OCT, all of which have progressively improved the resolution and speed of scans. Even newer technological advancements and OCT applications, such as adaptive optics, visible-light OCT, and OCT-angiography, have enriched the use of OCT in the evaluation of glaucoma. This article reviews current commercial and state-of-the-art OCT technologies and analytic techniques in the context of their utility for glaucoma diagnosis and management, as well as promising future directions.
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Affiliation(s)
- Alexi Geevarghese
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA
- Department of Physiology and Neuroscience, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA
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García G, Del Amor R, Colomer A, Verdú-Monedero R, Morales-Sánchez J, Naranjo V. Circumpapillary OCT-focused hybrid learning for glaucoma grading using tailored prototypical neural networks. Artif Intell Med 2021; 118:102132. [PMID: 34412848 DOI: 10.1016/j.artmed.2021.102132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/22/2022]
Abstract
Glaucoma is one of the leading causes of blindness worldwide and Optical Coherence Tomography (OCT) is the quintessential imaging technique for its detection. Unlike most of the state-of-the-art studies focused on glaucoma detection, in this paper, we propose, for the first time, a novel framework for glaucoma grading using raw circumpapillary B-scans. In particular, we set out a new OCT-based hybrid network which combines hand-driven and deep learning algorithms. An OCT-specific descriptor is proposed to extract hand-crafted features related to the retinal nerve fibre layer (RNFL). In parallel, an innovative CNN is developed using skip-connections to include tailored residual and attention modules to refine the automatic features of the latent space. The proposed architecture is used as a backbone to conduct a novel few-shot learning based on static and dynamic prototypical networks. The k-shot paradigm is redefined giving rise to a supervised end-to-end system which provides substantial improvements discriminating between healthy, early and advanced glaucoma samples. The training and evaluation processes of the dynamic prototypical network are addressed from two fused databases acquired via Heidelberg Spectralis system. Validation and testing results reach a categorical accuracy of 0.9459 and 0.8788 for glaucoma grading, respectively. Besides, the high performance reported by the proposed model for glaucoma detection deserves a special mention. The findings from the class activation maps are directly in line with the clinicians' opinion since the heatmaps pointed out the RNFL as the most relevant structure for glaucoma diagnosis.
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Affiliation(s)
- Gabriel García
- Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain.
| | - Rocío Del Amor
- Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Adrián Colomer
- Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Rafael Verdú-Monedero
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena, 30202 Cartagena, Spain
| | - Juan Morales-Sánchez
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena, 30202 Cartagena, Spain
| | - Valery Naranjo
- Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain
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Wang X, Li SM, Liu L, Li S, Li L, Kang M, Wei S, Wang N. An analysis of macular ganglion cell complex in 7-year-old children in China: the Anyang Childhood Eye Study. Transl Pediatr 2021; 10:2052-2062. [PMID: 34584875 PMCID: PMC8429863 DOI: 10.21037/tp-21-323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/12/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study used spectral-domain optical coherence tomography (SD-OCT) imaging to describe the distribution of macular ganglion cell complex (GCC) thickness and its association with ocular and systemic parameters in 7-year-old children in China. METHODS The study involved a school-based, cross-sectional analysis of the Anyang Childhood Eye Study (ACES) and included 2,505 first-grade students from urban areas in Anyang, Henan Province, Central China. All participants underwent systemic and ocular examinations. Both GCC and retinal nerve fiber layer (RNFL) thickness were measured using the iVue-100 OCT (Optovue, Fremont, CA, USA). Intraocular pressure (IOP) was recorded with noncontact tonometer (Huvitz, HNT-7000). Axial length (AL) was measured using optical biometry (Lenstar LS 900, Haag-Streit Diagnostics, Koniz, Switzerland). RESULTS The mean GCC thickness was 95.31±7.67 µm. GCC thickness had negative associations with AL (r=-0.124, P<0.001), cup-to-disc (C-D) area ratio (r=-0.068, P=0.0033), horizontal C-D (H C-D) ratio (r=-0.048, P=0.0384), and vertical C-D (V C-D) ratio (r=-0.074, P=0.0013). Positive correlations were found with spherical equivalent (SE) (r=0.080, P=0.0001), RNFL thickness (r=0.363, P<0.001), height (r=0.059, P=0.0036), fovea parameters, disc area (r=0.078, P=0.0007), rim area (r=0.115, P<0.001), rim volume (r=0.119, P<0.001), and optic nerve head volume (r=0.097, P<0.001). GCC thickness had no significant association with IOP, age, sex, or weight, waist, or head circumference. CONCLUSIONS This study provides normative GCC data for 7-year-old healthy children in China. The findings support an association between GCC and AL, SE, RNFL, height, and C-D ratio in children.
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Affiliation(s)
- Xiaolei Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Luoru Liu
- Department of Ophthalmology, Anyang Eye Hospital, Anyang, China
| | - Siyuan Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Mengtian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Shifei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
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11
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Mohammadzadeh V, Su E, Heydar Zadeh S, Law SK, Coleman AL, Caprioli J, Weiss RE, Nouri-Mahdavi K. Estimating Ganglion Cell Complex Rates of Change With Bayesian Hierarchical Models. Transl Vis Sci Technol 2021; 10:15. [PMID: 34003991 PMCID: PMC8054624 DOI: 10.1167/tvst.10.4.15] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Develop a hierarchical longitudinal regression model for estimating local rates of change of macular ganglion cell complex (GCC) measurements with optical coherence tomography (OCT). Methods We enrolled 112 eyes with four or more macular OCT images and ≥2 years of follow-up. GCC thickness measurements within central 6 × 6 superpixels were extracted from macular volume scans. We fit data from each superpixel separately with several hierarchical Bayesian random-effects models. Models were compared with the Watanabe–Akaike information criterion. For our preferred model, we estimated population and individual slopes and intercepts (baseline thickness) and their correlation. Results Mean (SD) follow-up time and median (interquartile range) baseline 24-2 visual field mean deviation were 3.6 (0.4) years and −6.8 (−12.2 to −4.3) dB, respectively. The random intercepts and slopes model with random residual variance was the preferred model. While more individual and population negative slopes were observed in the paracentral and papillomacular superpixels, superpixels in the superotemporal and inferior regions displayed the highest correlation between baseline thickness and rates of change (r = –0.43 to –0.50 for the top five correlations). Conclusions A Bayesian linear hierarchical model with random intercepts/slopes and random variances is an optimal initial model for estimating GCC slopes at population and individual levels. This novel model is an efficient method for estimating macular rates of change and probability of glaucoma progression locally. Translational Relevance The proposed Bayesian hierarchical model can be applied to various macular outcomes from different OCT devices and to superpixels of variable sizes to estimate local rates of change and progression probability.
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Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Erica Su
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Sepideh Heydar Zadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Simon K Law
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Anne L Coleman
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert E Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Öhnell HM, Heijl A, Bengtsson B. Ageing and glaucoma progression of the retinal nerve fibre layer using spectral-domain optical coherence tomography analysis. Acta Ophthalmol 2021; 99:260-268. [PMID: 33945669 DOI: 10.1111/aos.14553] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 06/20/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE To compare the effects of ageing and glaucoma progression on the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and to evaluate the performance of a set of optical coherence tomography (OCT) progression analyses. METHODS The cpRNFL was measured twice by OCT at each of two visits made 10 years apart in 69 healthy individuals and 49 glaucoma patients. Both visits also included Humphrey 24-2 SITA standard testing. The change in cpRNFL thickness was analysed by linear regression, and a sub-analysis was performed on glaucoma patients with a perimetric mean deviation better than -10 dB at the first visit. The proportion of individuals whose OCT progression analyses indicated progression was also evaluated for the same groups. RESULTS The average cpRNFL thickness deteriorated by a mean of -0.16 μm/year in the healthy cohort, increased by 0.03 μm/year in the glaucoma cohort, and deteriorated by -0.24 μm/year in eyes with less severe glaucoma; there were no statistically significant differences between the groups. For 17 (30%) of 56 healthy individuals, at least one of the three different OCT progression analyses incorrectly indicated progression. CONCLUSIONS No significant differences in change of cpRNFL thickness between visits were found when comparing healthy subjects with glaucoma patients. Also, further cpRNFL thinning was not observed in glaucomatous eyes in which at least one-third of the visual field had been lost. The OCT progression analyses generated a relatively high proportion of false positives. Using OCT for glaucoma follow-up may not be entirely straightforward.
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Affiliation(s)
- Hanna Maria Öhnell
- Ophthalmology Department of Clinical Sciences in Malmö Skåne University Hospital Lund University Malmö Sweden
| | - Anders Heijl
- Ophthalmology Department of Clinical Sciences in Malmö Skåne University Hospital Lund University Malmö Sweden
| | - Boel Bengtsson
- Ophthalmology Department of Clinical Sciences in Malmö Lund University Malmö Sweden
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13
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Kurysheva NI, Pechenkina AA, Goncharova AS. [Examination of patients with glaucoma during the COVID-19 pandemic]. Vestn Oftalmol 2021; 137:75-83. [PMID: 33881266 DOI: 10.17116/oftalma202113702175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the efficacy of the optimal examination technique for patients with glaucoma during the COVID-19 pandemic that includes one of the safest methods of tonometry [transpalpebral tonometry (TPT), contour dynamic tonometry (CDT) and Icare rebound tonometry (RBT)] in combination with spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA). MATERIAL AND METHODS The study included 65 patients with primary open-angle glaucoma (POAG) who sought medical aid at the Ophthalmological Center of FMBA during the COVID-19 pandemic; they were examined using three tonometry methods: RBT, TPT and CDT. All patients underwent central corneal thickness measurement, perimetry, OCT and OCTA with assessment of vessel density (VD) of the superficial plexus in the macula (whole image macula) and peripapillary retina (PPR). RESULTS High correlation was found between the results obtained with RBT, TPT and CDT. None of the methods showed a correlation between IOP and corneal thickness. The correlations between IOP and OCTA parameters were obtained: IOPTPT and VDPPR in the inferior temporal sector (r= -0.386, p=0.027), IOPRBT and VD whole image macula (r= -0.69, p=0.019), and in the macula inferior hemisphere (r= -0.75, p=0.008), as well as between the ocular pulse amplitude (OPA) and VD in the macular inferior hemisphere (r=0.380, p=0.039). The OCTA parameters had a moderate, but significant correlation with the perimetric indices. CONCLUSIONS Tonometry methods (TPB, CDT and RBT) exhibit high correlation with each other and no correlation with corneal thickness. IOP parameters measured by different methods, especially using the Icare tonometer, correlate with OCTA parameters, and the latter - with perimetric indices. The combination of these tonometry methods with SD-OCT and OCTA is optimal for examining patients during the pandemic.
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Affiliation(s)
- N I Kurysheva
- State Scientific Center of the Russian Federation - A.I. Burnazyan Federal Medical and Biophysical Center of FMBA, Moscow, Russia
| | - A A Pechenkina
- State Scientific Center of the Russian Federation - A.I. Burnazyan Federal Medical and Biophysical Center of FMBA, Moscow, Russia
| | - A S Goncharova
- State Scientific Center of the Russian Federation - A.I. Burnazyan Federal Medical and Biophysical Center of FMBA, Moscow, Russia
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14
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Detection of Primary Angle Closure Glaucoma Progression by Optical Coherence Tomography. J Glaucoma 2021; 30:410-420. [PMID: 33710065 DOI: 10.1097/ijg.0000000000001829] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the role of spectral-domain optical coherence tomography (SD-OCT) in regard to retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) assessment in the detection of primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) progression. MATERIALS AND METHODS In the prospective study, 131 subjects with PACG and POAG were examined during 72 months with follow-up visits every 6 months. Visual field (VF) progression was detected using the Guided Progression Analysis (GPA) of the Humphrey visual field analyzer and structural change using SD-OCT while a significant negative trend for the RNFL and GCC was gauged. The diagnostic accuracy of RNFL and GCC thinning in the detection of glaucoma progression was compared between PACG and POAG eyes using the Kaplan-Meier method with the calculation of the log-rank test. RESULTS Progression was detected in 57% of eyes with POAG and 59% of eyes with PACG. The rate of thinning of RNFL (-2.95±1.85 μm/y) and GCC (-3.22±2.96 μm/y) was significantly higher in PACG progression eyes compared with POAG [-1.64±2.00 μm/y (P=0.018) and -1.74±2.05 μm/y (P=0.046), respectively]. The progression was associated with initial pattern standard deviation in both glaucoma subtypes, while only in PACG-with long-term intraocular pressure fluctuations (cutoff >5.2 mm Hg) and lens thickness (cutoff >4.92 mm), and only in POAG-with initial focal loss volume of GCC (cutoff >1.5%).In PACG, the rate of the visual function deterioration correlated with GCC thinning rate (r=0.330, P=0.027), but not with the RNFL thinning rate (r=-0.010, P=0.79), while in POAG, it was significant for both RNFL thinning (r=0.296, P=0.039) and GCC thinning (r=0.359, P=0.011). In PACG patients with progressive GCC thinning, functional progression was detected earlier (log-rank test P≤0.001) than in patients with progressive RNFL thinning (log-rank test P=0.457), while for POAG, these results were P=0.012 and ≤0.001 for GCC and RNFL thinning, respectively. CONCLUSIONS SD-OCT plays an important role in detecting PACG progression. In contrast to POAG, GCC thinning predicted functional loss better than RNFL thinning in PACG.
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15
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Mohammadzadeh V, Fatehi N, Yarmohammadi A, Lee JW, Sharifipour F, Daneshvar R, Caprioli J, Nouri-Mahdavi K. Macular imaging with optical coherence tomography in glaucoma. Surv Ophthalmol 2020; 65:597-638. [PMID: 32199939 PMCID: PMC7423773 DOI: 10.1016/j.survophthal.2020.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
With the advent of spectral-domain optical coherence tomography, imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head, circumpapillary retinal nerve fiber layer, and macula. There is now ample evidence to support the role of spectral-domain optical coherence tomography imaging of the macula for detection of early glaucoma. Macular spectral-domain optical coherence tomography measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular spectral-domain optical coherence tomography imaging emerging as an essential diagnostic tool in glaucoma.
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Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Nima Fatehi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA; Saint Mary Medical Center - Dignity Health, Long Beach, California, USA
| | - Adeleh Yarmohammadi
- Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States
| | - Ji Woong Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Farideh Sharifipour
- Department of Ophthalmology, Shahid Beheshti university of Medical Sciences, Tehran, Iran
| | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
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16
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Scuderi G, Fragiotta S, Scuderi L, Iodice CM, Perdicchi A. Ganglion Cell Complex Analysis in Glaucoma Patients: What Can It Tell Us? Eye Brain 2020; 12:33-44. [PMID: 32099501 PMCID: PMC6999543 DOI: 10.2147/eb.s226319] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/15/2020] [Indexed: 12/15/2022] Open
Abstract
Glaucoma is a group of optic neuropathies characterized by a progressive degeneration of retina ganglion cells (RGCs) and their axons that precedes functional changes detected on the visual field. The macular ganglion cell complex (GCC), available in commercial Fourier-domain optical coherence tomography, allows the quantification of the innermost retinal layers that are potentially involved in the glaucomatous damage, including the retinal nerve fiber (RNFL), ganglion cell and inner plexiform layers. The average GCC thickness and its related parameters represent a reliable biomarker in detecting preperimetric glaucomatous damage. The most accurate GCC parameters are represented by average and inferior GCC thicknesses, and they can be associated with progressive visual field loss. Although the diagnostic accuracy increases with more severe glaucomatous damage and higher signal strength values, it is not affected by increasing axial length, resulting in a more accurate discrimination of glaucomatous damage in myopic eyes with respect to the traditional RNFL thickness. The analysis of the structure-function relationship revealed a good agreement between the loss in retinal sensitivity and GCC thickness. The use of a 10-2° visual field grid, adjusted for the anatomical RGCs displacement, describes more accurately the relationship between RGCs thickness and visual field sensitivity loss.
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Affiliation(s)
- Gianluca Scuderi
- NESMOS Department, Ophthalmology Unit, S. Andrea Hospital, University of Rome "La Sapienza", Rome, Italy
| | - Serena Fragiotta
- NESMOS Department, Ophthalmology Unit, S. Andrea Hospital, University of Rome "La Sapienza", Rome, Italy
| | - Luca Scuderi
- Ophthalmology Unit, Department of Sense Organs, Azienda Policlinico Umberto I, University of Rome "La Sapienza", Rome, Italy
| | | | - Andrea Perdicchi
- NESMOS Department, Ophthalmology Unit, S. Andrea Hospital, University of Rome "La Sapienza", Rome, Italy
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17
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Gubin DG, Malishevskaya ТN, Astakhov YS, Astakhov SY, Cornelissen G, Kuznetsov VA, Weinert D. Progressive retinal ganglion cell loss in primary open-angle glaucoma is associated with temperature circadian rhythm phase delay and compromised sleep. Chronobiol Int 2019; 36:564-577. [PMID: 30663431 DOI: 10.1080/07420528.2019.1566741] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/26/2018] [Accepted: 01/05/2019] [Indexed: 12/25/2022]
Abstract
Advanced primary open-angle glaucoma (POAG) is characterized by progressive retinal ganglion cell complex (RGCC) damage that may cause subsequent disruption of the circadian rhythms. Therefore, we evaluated circadian body temperature (BT) rhythm and sleep characteristics of 115 individuals (38 men and 77 women) diagnosed with POAG. GLV (global loss volume; %), a measure of RGCC damage, was estimated by high-definition optical coherence tomography, and RGC functional ability was assessed by pattern electroretinogram amplitude (PERGA). Depending on dynamics of POAG progression criteria, two groups were formed that were distinctively different in GLV: Stable POAG group (S-POAG; GLV = 5.95 ± 1.84, n = 65) and Progressive POAG group (P-POAG; GLV = 24.27 ± 5.09, n = 50). S-POAG and P-POAG groups were not different in mean age (67.61 ± 7.56 versus 69.98 ± 8.15) or body mass index (24.66 ± 3.03 versus 24.77 ± 2.90). All subjects performed 21 around-the-clock BT self-measurements during a 72-h period and kept activity/sleep diaries. Results showed pronounced disruption of circadian physiology in POAG and its progression with increasing severity of the disease. The daily mean of BT was unusually low, compared to age-matched controls. Moreover, our results revealed distinctive features of BT circadian rhythm alterations in POAG development and POAG progression. S-POAG is associated with lowered BT circadian rhythm robustness and inter-daily phase stability compared to controls. In the P-POAG group, the mean phase of the circadian BT rhythm was delayed by about 5 h and phases were highly scattered among individual patients, which led to reduced group mean amplitude. Circadian amplitudes of individuals were not different between the groups. Altogether, these results suggest that the body clock still works in POAG patients, but its entrainment to the 24-h environment is compromised. Probably because of the internal desynchronization, bedtime is delayed, and sleep duration is accordingly shortened by about 55 min in P-POAG compared to S-POAG patients. In the entire POAG cohort (both groups), later sleep phase and shorter mean sleep duration correlate with the delayed BT phase (r = 0.215; p = 0.021 and r = 0.322; p = 0.0004, respectively). An RGCC GLV of 15% apparently constitutes a threshold above which a delay of the circadian BT rhythm and a shortening of sleep duration occur.
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Affiliation(s)
- D G Gubin
- a Department of Biology , Medical University , Tyumen , Russia
- b Tyumen Cardiology Research Center , Tomsk National Research Medical Center, Russian Academy of Science , Tomsk , Russia
| | - Т N Malishevskaya
- c Department of Organization of Medical Care , State Autonomous Health Care Institution Tyumen Regional Ophthalmological Dispensary , Tyumen , Russia
- d Department of Ophthalmology and Optometry , West-Siberian Institute of Postgraduate Medical Education , Tyumen , Russia
| | - Y S Astakhov
- e Department of Ophthalmology , Pavlov First Saint Petersburg State Medical University , St. Petersburg , Russia
| | - S Y Astakhov
- e Department of Ophthalmology , Pavlov First Saint Petersburg State Medical University , St. Petersburg , Russia
| | - G Cornelissen
- f Halberg Chronobiology Center , University of Minnesota , Minneapolis , MN , USA
| | - V A Kuznetsov
- b Tyumen Cardiology Research Center , Tomsk National Research Medical Center, Russian Academy of Science , Tomsk , Russia
| | - D Weinert
- g Institute of Biology/Zoology , Martin Luther University , Halle-Wittenberg , Germany
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18
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Shin JW, Sung KR, Park SW. Patterns of Progressive Ganglion Cell–Inner Plexiform Layer Thinning in Glaucoma Detected by OCT. Ophthalmology 2018; 125:1515-1525. [DOI: 10.1016/j.ophtha.2018.03.052] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/15/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022] Open
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Ramezani K, Marín-Franch I, Hu R, Swanson WH, Racette L. Prediction Accuracy of the Dynamic Structure-Function Model for Glaucoma Progression Using Contrast Sensitivity Perimetry and Confocal Scanning Laser Ophthalmoscopy. J Glaucoma 2018; 27:785-793. [PMID: 29917001 PMCID: PMC6147243 DOI: 10.1097/ijg.0000000000001005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to determine whether combining a structural measure with contrast sensitivity perimetry (CSP), which has lower test-retest variability than static automated perimetry (SAP), reduces prediction error with 2 models of glaucoma progression. METHODS In this retrospective analysis, eyes with 5 visits with rim area (RA), SAP, and CSP measures were selected from 2 datasets. Twenty-six eyes with open-angle glaucoma were included in the analyses. For CSP and SAP, mean sensitivity (MS) was obtained by converting the sensitivity values at each location from decibel (SAP) or log units (CSP) to linear units, and then averaging all values. MS and RA values were expressed as percent of mean normal based on independent normative data. Data from the first 3 and 4 visits were used to calculate errors in prediction for the fourth and fifth visits, respectively. Prediction errors were obtained for simple linear regression and the dynamic structure-function (DSF) model. RESULTS With linear regression, the median prediction errors ranged from 6% to 17% when SAP MS and RA were used and from 9% to 17% when CSP MS and RA were used. With the DSF model, the median prediction errors ranged from 6% to 11% when SAP MS and RA were used and from 7% to 16% when CSP MS and RA were used. CONCLUSIONS The DSF model had consistently lower prediction errors than simple linear regression. The lower test-retest variability of CSP in glaucomatous defects did not, however, result in lower prediction error.
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Affiliation(s)
- Koosha Ramezani
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Iván Marín-Franch
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rongrong Hu
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | | | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
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20
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Besada E, Frauens BJ, Makhlouf R, Shechtman D, Rodman J, Demeritt M, Hardigan P. More sensitive correlation of afferent pupillary defect with ganglion cell complex. JOURNAL OF OPTOMETRY 2018; 11:75-85. [PMID: 28676353 PMCID: PMC5904827 DOI: 10.1016/j.optom.2017.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 02/14/2017] [Accepted: 02/21/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy. METHODS RAPD assessment was performed using a log unit neutral density filter bar. Spectral domain optical coherence tomography RTVue-100 (Optovue) was used to examine the subjects. The optic nerve head pattern (ONH) was subdivided and identified for the purpose of the study into circumpapillary RNFLT (cpRNFLT) and peripheral circumpapillary RNFLT (pcpRNFLT). The cpRNFLT, pcpRNFLT and ganglion cell complex (GCC) parameters were analyzed. RESULTS Eighteen females and twenty three males with asymmetric optic neuropathy and a RAPD participated. Thirty-three subjects had glaucoma and eight had optic neuropathy other than glaucoma. Significant correlations (p<0.02) were obtained for the RAPD and the percentage difference loss of the GCC and RNFLT parameters. The grouped mean percentage difference loss for RNFLT was significantly different from that of the GCC (p<0.001). At a 0.6log unit RAPD, the average mean percentage difference loss was 23% for the CRNFLT, 15% for the GCC, 12% for the global loss volume percentage and 6% for the focal loss volume percentage (FLV%). CONCLUSIONS Significant correlations between RNFLT loss for cpRNFLT, pcpRNFLT and GCC parameters with RAPD were observed. Approximately a 35% higher sensitivity was obtained using GCC compared to CRNFL parameters. The expected change in GCC average for every 0.3log unit increment was approximately 8.49μm. The FLV% corresponded more sensitively to a RAPD but appeared to be influenced by disease severity.
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Affiliation(s)
- Eulogio Besada
- Nova Southeastern University College of Optometry, United States.
| | - Barry J Frauens
- Nova Southeastern University College of Optometry, United States
| | - Rim Makhlouf
- Nova Southeastern University College of Optometry, United States
| | - Diana Shechtman
- Nova Southeastern University College of Optometry, United States
| | - Julie Rodman
- Nova Southeastern University College of Optometry, United States
| | - Marlon Demeritt
- Nova Southeastern University College of Optometry, United States
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21
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Tatham AJ, Medeiros FA. Detecting Structural Progression in Glaucoma with Optical Coherence Tomography. Ophthalmology 2017; 124:S57-S65. [PMID: 29157363 DOI: 10.1016/j.ophtha.2017.07.015] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 06/26/2017] [Accepted: 07/17/2017] [Indexed: 12/12/2022] Open
Abstract
Optical coherence tomography (OCT) is increasingly used to obtain objective measurements of the retinal nerve fiber layer (RNFL), optic nerve head, and macula for assessing glaucoma progression. Although OCT has been adopted widely in clinical practice, uncertainty remains concerning its optimal role. Questions include: What is the best structure to measure? What quantity of change is significant? Are structural changes relevant to the patient? How are longitudinal measurements affected by aging? How can changes resulting from aging be differentiated from true progression? How best should OCT be used alongside visual fields, and how often should OCT be performed? Recent studies have addressed some of these questions. Important developments include appreciation of the need to use a consistent point of reference for structural measurements, leading to the introduction of Bruch's membrane opening (BMO)-based measurements, including BMO-minimum rim width and BMO-minimum rim area. Commercially available OCT devices also permit analysis of macular changes over time, for example, changes in the ganglion cell and inner plexiform layers, the sites of the retinal ganglion cell bodies and dendrites, respectively. Several longitudinal studies have compared rates of change in RNFL and macular measurements, with some suggesting that the relative value of each parameter may differ at different stages of disease. In early disease, looking for change over time also may be useful for glaucoma diagnosis, with advantages over classifying eyes using cross-sectional normative databases. Optimal glaucoma management requires information from imaging and visual fields, and efforts have been made to combine information, reducing the noise inherent in both tests to benefit from their different performances according to the stage of disease. Combining information from different structural measurements may also be useful. There is now substantial evidence that progressive structural changes are of direct clinical relevance, with progressive changes on OCT often preceding functional loss and patients with faster change on OCT at increased risk of worsening visual losses. Identification of such patients offers the possibility of commencing or escalating treatment at an earlier stage. This review appraises recent developments in the use of OCT for assessing glaucoma progression.
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Affiliation(s)
- Andrew J Tatham
- Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, United Kingdom
| | - Felipe A Medeiros
- Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina.
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22
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Lavinsky F, Wollstein G, Tauber J, Schuman JS. The Future of Imaging in Detecting Glaucoma Progression. Ophthalmology 2017; 124:S76-S82. [PMID: 29157365 DOI: 10.1016/j.ophtha.2017.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/11/2017] [Accepted: 10/05/2017] [Indexed: 12/12/2022] Open
Abstract
Ocular imaging has been heavily incorporated into glaucoma management and provides important information that aids in the detection of disease progression. Longitudinal studies have shown that the circumpapillary retinal nerve fiber layer is an important parameter for glaucoma progression detection, whereas other studies have demonstrated that macular parameters, such as the ganglion cell inner plexiform layer and optic nerve head parameters, also are useful for progression detection. The introduction of novel technologies with faster scan speeds, wider scanning fields, higher resolution, and improved tissue penetration has enabled the precise quantification of additional key ocular structures, such as the individual retinal layers, optic nerve head, choroid, and lamina cribrosa. Furthermore, extracting functional information from scans such as blood flow rate and oxygen consumption provides new perspectives on the disease and its progression. These novel methods promise improved detection of glaucoma progression and better insight into the mechanisms of progression that will lead to better targeted treatment options to prevent visual damage and blindness.
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Affiliation(s)
- Fabio Lavinsky
- NYU Langone Eye Center, New York University School of Medicine, New York, New York
| | - Gadi Wollstein
- NYU Langone Eye Center, New York University School of Medicine, New York, New York
| | - Jenna Tauber
- NYU Langone Eye Center, New York University School of Medicine, New York, New York
| | - Joel S Schuman
- NYU Langone Eye Center, New York University School of Medicine, New York, New York.
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Holló G, Shu-Wei H, Naghizadeh F. Evaluation of a New Software Version of the RTVue Optical Coherence Tomograph for Image Segmentation and Detection of Glaucoma in High Myopia. J Glaucoma 2017; 25:e615-9. [PMID: 26066501 DOI: 10.1097/ijg.0000000000000290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the current (6.3) and a novel software version (6.12) of the RTVue-100 optical coherence tomograph (RTVue-OCT) for ganglion cell complex (GCC) and retinal nerve fiber layer thickness (RNFLT) image segmentation and detection of glaucoma in high myopia. MATERIALS AND METHODS RNFLT and GCC scans were acquired with software version 6.3 of the RTVue-OCT on 51 highly myopic eyes (spherical refractive error ≤-6.0 D) of 51 patients, and were analyzed with both the software versions. Twenty-two eyes were nonglaucomatous, 13 were ocular hypertensive and 16 eyes had glaucoma. RESULTS No difference was seen for any RNFLT, and average GCC parameter between the software versions (paired t test, P≥0.084). Global loss volume was significantly lower (more normal) with version 6.12 than with version 6.3 (Wilcoxon signed-rank test, P<0.001). The percentage agreement (κ) between the clinical (normal and ocular hypertensive vs. glaucoma) and the software-provided classifications (normal and borderline vs. outside normal limits) were 0.3219 and 0.4442 for average RNFLT, and 0.2926 and 0.4977 for average GCC with versions 1 and 2, respectively (McNemar symmetry test, P≥0.289). No difference in average RNFLT and GCC classification (McNemar symmetry test, P≥0.727) and the number of eyes with at least 1 segmentation error (P≥0.109) was found between the software versions, respectively. CONCLUSION Although GCC segmentation was improved with software version 6.12 compared with the current version in highly myopic eyes, this did not result in a significant change of the average RNFLT and GCC values, and did not significantly improve the software-provided classification for glaucoma.
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Affiliation(s)
- Gábor Holló
- *Department of Ophthalmology, Semmelweis University, Budapest, Hungary †University of Central Florida, College of Medicine, Orlando, FL
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24
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Evaluation of Retinal Nerve Fiber Layer Thickness and Ganglion Cell Complex Progression Rates in Healthy, Ocular Hypertensive, and Glaucoma Eyes With the Avanti RTVue-XR Optical Coherence Tomograph Based on 5-Year Follow-up. J Glaucoma 2017; 25:e905-e909. [PMID: 26950575 DOI: 10.1097/ijg.0000000000000410] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine retinal nerve fiber layer thickness (RNFLT) and ganglion cell complex (GCC) progression rates for healthy eyes and undertreatment ocular hypertensive (OHT) and glaucoma eyes with the Avanti RTVue-XR optical coherence tomography. MATERIALS AND METHODS Seventeen healthy subjects (34 eyes), 17 medically treated OHT patients (34 eyes), and 67 medically treated glaucoma patients (122 eyes) were imaged prospectively at 6-month intervals (median follow-up 5.3 y, 11 visits). RESULTS A minimal negative correlation between baseline RNFLT and RNFLT progression was found in the glaucoma group (r=-0.1708, P=0.0493). In the other groups no correlation between baseline RNFLT or GCC and RNFLT or GCC progression was found, respectively. The mean±SD of the rate of change was -0.33±0.51, -0.44±0.62, and -0.69±0.93 μm/y for average RNFLT, and -0.53±0.36, -0.54±0.52, and -0.80±0.78 for average GCC, for the normal, OHT, and glaucoma eyes, respectively (P>0.05 for all between-group comparisons). In the normal group the highest progression rate was -1.52 μm/y for average RNFLT and -1.28 μm/y for average GCC. Despite maximal medical treatment, progression in the glaucoma group exceeded the highest progression rate of the normal group in 18 eyes (14.8%) for average RNFLT and 24 eyes (19.7%) for average GCC. CONCLUSIONS We determined progression rates for untreated healthy and under treatment OHT and glaucoma eyes with the Avanti RTVue-XR optical coherence tomography. We found that an average RNFLT progression rate faster than -1.5 μm/y, and an average GCC progression rate faster than -1.3 μm/y are strongly suggestive for uncontrolled glaucomatous progression. Detection of uncontrolled structural progression with trend analysis may assist the early detection of fast progressors.
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25
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Shin JW, Sung KR, Lee GC, Durbin MK, Cheng D. Ganglion Cell-Inner Plexiform Layer Change Detected by Optical Coherence Tomography Indicates Progression in Advanced Glaucoma. Ophthalmology 2017; 124:1466-1474. [PMID: 28549518 DOI: 10.1016/j.ophtha.2017.04.023] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To examine the performance of Guided Progression Analysis (GPA; Carl Zeiss Meditec, Dublin, CA) in spectral-domain optical coherence tomography (OCT) in detecting progressive thinning of ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) in glaucoma. DESIGN Longitudinal, observational study. PARTICIPANTS A total of 196 eyes of 123 primary open-angle glaucoma patients (mean follow-up, 5.0 years). METHODS Macular GCIPL and peripapillary RNFL thicknesses were measured by Cirrus HD-OCT (Zeiss, Dublin, CA), and progressive GCIPL and RNFL thinning were assessed by GPA. The reference standard of glaucoma progression was determined by visual field (VF) progression. Glaucomatous eyes were classified into mild (117 eyes) or moderate to advanced (79 eyes) groups based on VF defects. Ganglion cell-inner plexiform layer and RNFL thinning rates were compared between progressors and nonprogressors. Visual field survival estimates in eyes with and without progressive GCIPL and RNFL thinning were evaluated by Kaplan-Meier survival analysis and compared with the log-rank test. MAIN OUTCOME MEASURES Progressive GCIPL and RNFL thinning assessed by OCT GPA. RESULTS Seventy-six eyes (38.8%) and 43 eyes (21.9%) demonstrated progressive GCIPL and RNFL thinning, respectively, and 48 eyes (24.5%) were classified as progressors by reference standard. The rate of change in the average GCIPL thickness was significantly higher in progressors (-1.05±0.98 μm/year for mild glaucoma and -0.66±0.30 μm/year for moderate to advanced glaucoma) than in nonprogressors (-0.47±0.54 μm/year for mild glaucoma and -0.31±0.50 μm/year for moderate to advanced glaucoma), regardless of glaucoma severity (P < 0.05). Eyes with progressive GCIPL thinning had lower VF survival estimates than eyes without, regardless of glaucoma severity. However, the rate of change in the average RNFL thickness did not differ significantly in moderate to advanced glaucoma (P = 0.765; -0.26±0.55 μm/year for progressors and -0.33±0.92 μm/year for nonprogressors), and VF survival estimates did not differ significantly between eyes with and without progressive RNFL thinning in moderate to advanced glaucoma (P = 0.781). CONCLUSIONS Ganglion cell-inner plexiform layer GPA provides a new approach for evaluating glaucoma progression. It may be more useful for detecting progression in the advanced stages of glaucoma than RNFL GPA.
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Affiliation(s)
- Joong Won Shin
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
| | - Kyung Rim Sung
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
| | - Gary C Lee
- Research and Development, Carl Zeiss Meditec, Inc., Dublin, California
| | - Mary K Durbin
- Research and Development, Carl Zeiss Meditec, Inc., Dublin, California
| | - Daniel Cheng
- Research and Development, Carl Zeiss Meditec, Inc., Dublin, California
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Kita Y, Soutome N, Horie D, Kita R, Hollό G. Circumpapillary ganglion cell complex thickness to diagnose glaucoma: A pilot study. Indian J Ophthalmol 2017; 65:41-47. [PMID: 28300739 PMCID: PMC5369292 DOI: 10.4103/ijo.ijo_437_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the applicability of a new optical coherence tomography parameter, the circumpapillary ganglion cell complex (cpGCC) thickness for glaucoma diagnostics. SUBJECTS AND METHODS The RS-3000 Advance SD-OCT (NIDEK, Aichi, Japan) was used to measure global and sector macular GCC (mGCC) thickness, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, cpGCC, and circumpapillary total retina (cpTR) thickness in 1 eye of 48 preperimetric/early perimetric primary open-angle glaucoma patients and 28 healthy Japanese participants. Area under the receiver-operating characteristic (AUROC) curves were used for between-method comparisons. RESULTS All global and sector parameters except for the nasal sector differed significantly between the patient groups (P ≤ 0.009). The AUROC for global mGCC (0.917) was significantly higher (P < 0.01) than that for global cpRNFL (0.760), global cpGCC (0.828), and global cpTR (0.812). The AUROC values of global and temporal cpGCC were significantly higher than those of the corresponding cpRNFL parameters (P < 0.05). Correlation between the visual field means deviation and each of the global thickness parameters was similar (r: 0.418-0.473, P< 0.001). At >90% specificity, the cpGCC, cpTR, and cpRNFL were able to detect 4%, 10%, and 0% of glaucoma eyes that were not detected by the mGCC thickness. CONCLUSIONS In Japanese eyes, the diagnostic accuracy of cpGCC is lower than that of mGCC but higher than that of cpRNFL. Our results suggest that the use of cpGCC may not improve glaucoma diagnostics when there is no macular disease but may be of benefit when macular diseases prevent successful mGCC measurements.
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Affiliation(s)
- Yoshiyuki Kita
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Norihisa Soutome
- Department of Ophthalmology, Kyorin University School of Medicine; Department of Ophthalmology, Kosei General Hospital, Tokyo, Japan
| | - Daisuke Horie
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Ritsuko Kita
- Department of Ophthalmology, Kyorin University School of Medicine; Department of Ophthalmology, Kosei General Hospital, Tokyo, Japan
| | - Gaborá Hollό
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Salonikiou A, Pappas T, Raptou A, Topouzis F. Challenges of assessing the optic nerve in glaucoma. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1586/17469899.2016.1158646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kita Y, Hollό G, Kita R, Horie D, Inoue M, Hirakata A. Differences of Intrasession Reproducibility of Circumpapillary Total Retinal Thickness and Circumpapillary Retinal Nerve Fiber Layer Thickness Measurements Made with the RS-3000 Optical Coherence Tomograph. PLoS One 2015; 10:e0144721. [PMID: 26657805 PMCID: PMC4682851 DOI: 10.1371/journal.pone.0144721] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/23/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the intrasession reproducibility of various thickness parameters used to diagnose and follow-up glaucoma, in particular circumpapillary total retinal thickness (cpTR) provided by the RS-3000 optical coherence tomograph (OCT). METHODS Fifty-three healthy eyes of 28 subjects underwent three consecutive imaging with the RS-3000 Advance OCT (NIDEK, Aichi,Japan) to evaluate the intrasession reproducibility of circumpapillary total retinal thickness (cpTR), circumpapillary retinal nerve fiber layer thickness (cpRNFL), macular ganglion cell complex thickness (mGCC) and macular total retina thickness (mTR) measurements. Intraclass correlation (ICC), coefficient of variation (CV) and reproducibility coefficient (RC) were calculated for each parameter. RESULTS The ICC and CV values for mean cpTR and cpRNFL were 0.987 and 0.897, and 0.60% and 2.81%, respectively. The RC values for the mean cpTR and cpRNFL were 5.95 μm and 9.04 μm, respectively. For all cpTR parameters the ICC values were higher and both the CV and RC values were lower than those for the corresponding cpRNFL parameters. The ICC and CV values for superior mGCC, inferior mGCC, superior mTR and inferior mTR were 0.983, 0.980, 0.983 and 0.988, and 0.84%, 0.98%, 0.48% and 0.43%, respectively. The RC values for superior mGCC, inferior mGCC, superior mTR and inferior mTR were 2.86 μm, 3.12 μm, 4.41 μm and 4.43 μm, respectively. CONCLUSIONS Intrasession reproducibility of cpTR, mGCC and mTR measurements made on healthy eyes was high. Repeatability of cpTR measurements was better than that of the corresponding cpRNFL measurements. These results suggest that future clinical investigations addressing detection of glaucoma and glaucomatous progression with the RS-3000 OCT may benefit from focusing on the cpTR parameters.
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Affiliation(s)
- Yoshiyuki Kita
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Gábor Hollό
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Ritsuko Kita
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Daisuke Horie
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Makoto Inoue
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Akito Hirakata
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
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Importance of Normal Aging in Estimating the Rate of Glaucomatous Neuroretinal Rim and Retinal Nerve Fiber Layer Loss. Ophthalmology 2015; 122:2392-8. [DOI: 10.1016/j.ophtha.2015.08.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/22/2015] [Accepted: 08/14/2015] [Indexed: 11/15/2022] Open
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Sturm A, Noske W. Comparative glaucomatous diagnosis using macular optical coherence tomography and perimetry with centrally condensed stimuli: English version. Ophthalmologe 2015; 113 Suppl 1:S1-12. [PMID: 26463214 DOI: 10.1007/s00347-015-0104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The presentation and measurement of the internal retinal layers by current optical coherence tomography (OCT) instruments allow a precise topographic localization of macular glaucomatous damage. Ganglion cell analysis in particular can reveal slight central defects and can effectively be correlated with perimetric strategies with centrally condensed stimuli, so that small glaucomatous defects can be confirmed earlier and more confidently. Progression can also be verified in the early stages of the disease as enlargement and deepening of small localized defects. Macular OCT (mOCT) cannot sufficiently detect peripheral glaucomatous defects and may be impaired by macular pathologies; therefore, mOCT should be combined with other morphometric examinations. In order to take advantage of the technical capabilities of current OCT devices appropriate perimetric strategies should also be applied. As the algorithms for documentation and evaluation of the results of current OCT instruments are far less advanced than the technical capabilities, OCT results still have to be visually scrutinized together with the visual field results to benefit from the technical possibilities provided by modern OCT devices.
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Affiliation(s)
- A Sturm
- Klinik für Augenheilkunde, Städtisches Klinikum Brandenburg, Hochstr. 29, 14770, Brandenburg a.d. Havel, Germany
| | - W Noske
- Klinik für Augenheilkunde, Städtisches Klinikum Brandenburg, Hochstr. 29, 14770, Brandenburg a.d. Havel, Germany.
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31
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The clinical utility of measuring the macular outer retinal thickness in patients with glaucoma. Eur J Ophthalmol 2015; 26:118-23. [PMID: 26391163 DOI: 10.5301/ejo.5000678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE Few optical coherence tomography (OCT) studies have investigated outer retinal thickness including the photoreceptor layer in glaucoma. We measured changes in the macular outer retinal thicknesses using OCT in patients with glaucoma with an average follow-up of 2.9 ± 0.8 years. METHODS A total of 39 eyes of 39 patients with primary open-angle glaucoma were analyzed. The RTVue-100 was used to measure the macular outer retinal, macular ganglion cell complex, and circumpapillary retinal nerve fiber layer thicknesses, global loss volume, and focal loss volume. Using the paired t test, baseline parameters were compared with those at the last follow-up. RESULTS The average baseline mean deviation value in the Humphrey Field Analyzer was -2.13 dB. The ganglion cell complex thickness significantly decreased over the follow-up period (baseline thickness, 79.66 ± 7.71 μm; final thickness, 76.79 ± 7.39 μm; p<0.001). There were significant differences between baseline and final visit measurements for circumpapillary retinal nerve fiber layer thickness, global loss volume, and focal loss volume (p<0.001, p<0.001, and p = 0.004, respectively). However, there was no significant change in outer retinal thickness (baseline thickness, 167.56 ± 7.26 μm; final thickness, 167.25 ± 7.93 μm; p = 0.540). CONCLUSIONS Outer retinal thickness was not altered during the follow-up period. The stability of outer retinal thickness may indicate the reliability of OCT analysis for glaucoma follow-up.
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[Correlation of morphological and functional glaucoma diagnostics with macular OCT and perimetry with centrally condensed stimuli: German version]. Ophthalmologe 2015; 112:626-38. [PMID: 26245850 DOI: 10.1007/s00347-015-0103-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The presentation and measurement of the internal retinal layers by current optical coherence tomography (OCT) instruments allow a precise topographic localization of macular glaucomatous damage. Ganglion cell analysis in particular can reveal slight central defects and can effectively be correlated with perimetric strategies with centrally condensed stimuli, so that small glaucomatous defects can be confirmed earlier and more confidently. Progression can also be verified in the early stages of the disease as enlargement and deepening of small localized defects. Macular OCT (mOCT) cannot sufficiently detect peripheral glaucomatous defects and may be impaired by macular pathologies; therefore, mOCT should be combined with other morphometric examinations. In order to take advantage of the technical capabilities of current OCT devices appropriate perimetric strategies should also be applied. As the algorithms for documentation and evaluation of the results of current OCT instruments are far less advanced than the technical capabilities, OCT results still have to be visually scrutinized together with the visual field results to benefit from the technical possibilities provided by modern OCT devices.
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Abstract
Detecting glaucoma progression remains one of the most challenging aspects of glaucoma management, since it can be hard to distinguish disease progression from exam variability and changes due to aging. In this review article, we discuss the use of perimetry, confocal scanning laser tomography and optical coherence tomography to detect glaucoma progression, and the techniques available to evaluate change with these modalities. Currently, there is no consensus on the best technique or criteria to detect glaucoma progression, or what amount of change would be clinically meaningful. New techniques have been developed to assess glaucoma progression, which make more comprehensive and complex use of data. They have the potential of detecting progression with better accuracy, with shorter follow-up periods, and generating better prognostics. Further validation of these new techniques is still required, but their incorporation into clinical practice is likely to yield significant benefits.
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Affiliation(s)
- Jayme R Vianna
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
| | - Balwantray C Chauhan
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada.
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Abe RY, Gracitelli CPB, Medeiros FA. The Use of Spectral-Domain Optical Coherence Tomography to Detect Glaucoma Progression. Open Ophthalmol J 2015; 9:78-88. [PMID: 26069520 PMCID: PMC4460225 DOI: 10.2174/1874364101509010078] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 03/30/2015] [Accepted: 03/30/2015] [Indexed: 11/26/2022] Open
Abstract
Detection of progression and measurement of rates of change is at the core of glaucoma management, and the use of Spectral Domain Optical Coherence Tomography (SD-OCT) has significantly improved our ability to evaluate change in the disease. In this review, we critically assess the existing literature on the use of SD-OCT for detecting glaucoma progression and estimating rates of change. We discuss aspects related to the reproducibility of measurements, their accuracy to detect longitudinal change over time, and the effect of aging on the ability to detect progression. In addition, we discuss recent studies evaluating the use of combined structure and function approaches to improve detection of glaucoma progression.
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Affiliation(s)
- Ricardo Y Abe
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA ; Department of Ophthalmology, University of Campinas, Campinas, Brazil
| | - Carolina P B Gracitelli
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA ; Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Felipe A Medeiros
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
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Meshi A, Goldenberg D, Armarnik S, Segal O, Geffen N. Systematic review of macular ganglion cell complex analysis using spectral domain optical coherence tomography for glaucoma assessment. World J Ophthalmol 2015; 5:86-98. [DOI: 10.5318/wjo.v5.i2.86] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 12/12/2014] [Accepted: 04/07/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To review the use of spectral domain optical coherence tomography (SD-OCT) for macular retinal ganglion cells (RGC) and ganglion cell complex (GCC) measurement in glaucoma assessment, specifically for early detection and detection of disease progression.
METHODS: A systematic review was performed by searching PubMed, Medline, and Web of Science for articles published in English through July 2014 describing the various macular SD-OCT scanning strategies developed for glaucoma assessment. The review focused on papers evaluating the use of macular RGC/GCC SD-OCT to detect early glaucoma and its progression. The search included keywords corresponding to the index test (macular ganglion cell/RGC/GCC/Spectral domain OCT), the target condition (glaucoma), and diagnostic performance. The RGC/GCC SD-OCT scanning strategies used to assess glaucoma of most commonly used SD-OCT instruments were described and compared. These included the Cirrus high definition-OCT (Carl Zeiss Meditec, Inc., Dublin, CA, United States), RTVue (Optovue, Inc., Fremont, CA, United States), Spectralis (Heidelberg Engineering, Heidelberg, Germany) and the 3D OCT 2000 (Topcon Corporation, Tokyo, Japan). Studies focusing on the ability of RGC/GCC SD-OCT to detect early glaucomatous damage and on the correlation between glaucomatous progression and RGC/GCC measurement by SD-OCT were reviewed.
RESULTS: According to the literature, macular RGC/GCC SD-OCT has high diagnostic power of preperimetric glaucoma, reliable discrimination ability to differentiate between healthy eyes and glaucomatous eyes, with good correlation with visual filed damage. The current data suggests that it may serve as a sensitive detection tool for glaucomatous structural progression even with mild functional progression as the rate of change of RGC/GCC thickness was found to be significantly higher in progressing than in stable eyes. Glaucoma assessment with RGC/GCC SD-OCT was comparable with and sometimes better than circumpapillary retinal nerve fiber layer thickness measurement.
CONCLUSION: An increasing body of evidence supports using macular RGC/GCC thickness as an indicator for early glaucoma. This might be a useful tool for monitoring disease progression.
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Holló G, Naghizadeh F, Hsu S, Filkorn T, Bausz M. Comparison of the current and a new RTVue OCT software version for detection of ganglion cell complex changes due to cataract surgery. Int Ophthalmol 2015; 35:861-7. [PMID: 25813376 DOI: 10.1007/s10792-015-0064-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 03/21/2015] [Indexed: 10/23/2022]
Abstract
The purpose was to compare the current (6.3) and a novel software version (6.12) of the RTVue-100 optical coherence tomograph (RTVue OCT) for ganglion cell complex (GCC) and retinal nerve fibre layer thickness (RNFLT) changes after phacoemulsification in healthy cataract eyes, and to investigate whether version 6.12, in which image segmentation is improved, provides benefits over version 6.3 for RNFLT and GCC imaging via mild cataract. One eye of 22 consecutive healthy cataract patients were imaged before and 1 month after uncomplicated cataract surgery using RTVue-100 OCT software version 6.3. The images were analysed with both software versions. Signal strength index increased significantly after surgery for both RNFLT and the GCC measurements (p ≤ 0.0015). No difference was seen for any RNFLT parameter between the software versions and time points (p ≥ 0.0140). The GCC values did not differ between the versions either before or after surgery (p ≥ 0.4471), but all increased significantly after surgery with software version 6.12 (p < 0.0001). Neither focal loss volume (FLV) nor global loss volume (GLV) differed between the software versions before and after surgery, respectively, but GLV decreased (improved) significantly after surgery (p = 0.010 and <0.001 for versions 6.3 and 6.12, respectively). Cataract surgery induced similar changes with both software versions, but version 6.12 identified the increase of GCC thickness and the decrease of GLV better than the current version. Although no significant difference between software versions was seen before surgery, our results suggest that version 6.12 may be more precise in measuring GCC parameters than the currently available version.
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Affiliation(s)
- Gábor Holló
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary.
| | - Farzaneh Naghizadeh
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary
| | - Sofia Hsu
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary.,College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Tamás Filkorn
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary
| | - Mária Bausz
- Department of Ophthalmology, Semmelweis University, Mária u. 39, Budapest, 1085, Hungary
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Influence of a New Software Version of the RTVue-100 Optical Coherence Tomograph on Ganglion Cell Complex Segmentation in Various Forms of Age-Related Macular Degeneration. J Glaucoma 2015; 24:245-50. [PMID: 25055214 DOI: 10.1097/ijg.0000000000000092] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Influence of a new software version of the RTVue-100 optical coherence tomograph on the detection of glaucomatous structural progression. Eur J Ophthalmol 2015; 25:410-5. [PMID: 25684156 DOI: 10.5301/ejo.5000576] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 01/24/2023]
Abstract
PURPOSE To compare the current (6.3) and a novel software version (6.12) of the RTVue-100 optical coherence tomograph (RTVue-OCT) for detection of glaucomatous inner macular retinal thickness (ganglion cell complex [GCC]) and retinal nerve fiber layer thickness (RNFLT) progression. METHODS In this prospective, observational study, 109 participants (17 healthy controls, 20 patients with ocular hypertension, and 72 patients with glaucoma) were investigated with RTVue-OCT at 6-month intervals (mean follow-up 5 years). One eye per participant was evaluated. RESULTS Long-term measurement variability (residual standard deviation) was significantly lower with software version 6.12 than version 6.3 for all parameters in the total population, the normal controls, and the glaucoma group, respectively (p≤0.0065). The between-software-version difference of residual standard deviation did not correlate with the measured thickness for any parameter. In the glaucoma group, the negative GCC slopes (µm/visit) were significantly (p<0.001) steeper, while the negative RNFLT slopes were either similar or less steep with software version 6.12. Significantly more significant negative GCC parameter slopes were found in the glaucoma group and the total population with version 6.12, while no between-software-version difference was seen for the other groups, and for the RNFLT parameters in all groups. CONCLUSIONS The new software version reduces long-term RNFLT and GCC measurement variability, provides steeper GCC progression slopes, and provides more cases of significant GCC progression slopes in glaucoma than the current software version. Since version 6.12 is employed in the recently introduced Widefield RTVue-XR instrument, it may improve detection of glaucomatous progression in clinical practice.
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Bussel II, Wollstein G, Schuman JS. OCT for glaucoma diagnosis, screening and detection of glaucoma progression. Br J Ophthalmol 2013; 98 Suppl 2:ii15-9. [PMID: 24357497 PMCID: PMC4208340 DOI: 10.1136/bjophthalmol-2013-304326] [Citation(s) in RCA: 285] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Optical coherence tomography (OCT) is a commonly used imaging modality in the evaluation of glaucomatous damage. The commercially available spectral domain (SD)-OCT offers benefits in glaucoma assessment over the earlier generation of time domain-OCT due to increased axial resolution, faster scanning speeds and has been reported to have improved reproducibility but similar diagnostic accuracy. The capabilities of SD-OCT are rapidly advancing with 3D imaging, reproducible registration, and advanced segmentation algorithms of macular and optic nerve head regions. A review of the evidence to date suggests that retinal nerve fibre layer remains the dominant parameter for glaucoma diagnosis and detection of progression while initial studies of macular and optic nerve head parameters have shown promising results. SD-OCT still currently lacks the diagnostic performance for glaucoma screening.
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Affiliation(s)
- Igor I Bussel
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Gadi Wollstein
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Joel S Schuman
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Anraku A, Enomoto N, Takeyama A, Ito H, Tomita G. Baseline thickness of macular ganglion cell complex predicts progression of visual field loss. Graefes Arch Clin Exp Ophthalmol 2013; 252:109-15. [PMID: 24253499 DOI: 10.1007/s00417-013-2527-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 10/14/2013] [Accepted: 11/07/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous studies reported that the thickness of the macular ganglion cell complex (mGCC) showed good diagnostic ability for detecting glaucoma. However, its impact on the progression of visual field loss in primary open angle glaucoma (POAG) is unknown. The purpose of this study was to assess whether baseline mGCC thickness is associated with the progression of visual field loss in POAG. METHODS Fifty-six patients with POAG were included in the study. All patients were followed for more than 2 years after baseline optical coherence tomography (OCT) measurements. They had at least five reliable Humphrey visual field tests with 30-2 Swedish Interactive Threshold Algorithm standard tests during the follow-up period. The subjects were divided into two groups according to the slope of the mean deviation (MD): the fast progression group (MD slope < -0.4 dB/y) and the slow progression group (MD slope ≥ -0.4 dB/y). Factors compared between the groups were as follows: age, baseline intraocular pressure (IOP), mean IOP during the follow-up, refraction, baseline MD, pattern standard deviation (PSD), and baseline OCT measurements. RESULTS There were no significant differences between the two groups in age, baseline IOP, mean IOP during the follow-up, refraction, baseline MD or PSD, average thickness of retinal nerve fiber layer (RNFL), or disc parameters. However, the baseline mGCC thickness (average and inferior hemifield) was significantly thinner in the fast progression group than in the slow progression group (74.0 ± 7.2 μm vs. 80.3 ± 8.6 μm; 68.0 ± 6.6 μm vs. 78.2 ± 11.6 μm, respectively). Moreover, global loss volume and focal loss volume, which are parameters of mGCC, showed significantly higher rates in the fast progression group than in the slow progression group. In multivariate analysis, only mGCC thickness of the inferior hemifield was associated with disease progression (P = 0.007). CONCLUSIONS Baseline mGCC thickness can be predictive of progressive visual field loss in patients with POAG.
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Affiliation(s)
- Ayako Anraku
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-17-6, Ohashi Meguro-ku, Tokyo, 153-8515, Japan,
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Renard JP, Fénolland JR, El Chehab H, Francoz M, Marill AM, Messaoudi R, Delbarre M, Maréchal M, Michel S, Giraud JM. Analyse du complexe cellulaire ganglionnaire maculaire (GCC) en tomographie par cohérence optique (SD-OCT) dans le glaucome. J Fr Ophtalmol 2013; 36:299-309. [DOI: 10.1016/j.jfo.2013.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 01/29/2013] [Indexed: 10/27/2022]
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