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Mohammadzadeh V, Wu S, Besharati S, Davis T, Vepa A, Morales E, Edalati K, Rafiee M, Martinyan A, Zhang D, Scalzo F, Caprioli J, Nouri-Mahdavi K. Prediction of Visual Field Progression with Baseline and Longitudinal Structural Measurements Using Deep Learning. Am J Ophthalmol 2024; 262:141-152. [PMID: 38354971 DOI: 10.1016/j.ajo.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE Identifying glaucoma patients at high risk of progression based on widely available structural data is an unmet task in clinical practice. We test the hypothesis that baseline or serial structural measures can predict visual field (VF) progression with deep learning (DL). DESIGN Development of a DL algorithm to predict VF progression. METHODS 3,079 eyes (1,765 patients) with various types of glaucoma and ≥5 VFs, and ≥3 years of follow-up from a tertiary academic center were included. Serial VF mean deviation (MD) rates of change were estimated with linear-regression. VF progression was defined as negative MD slope with p<0.05. A Siamese Neural Network with ResNet-152 backbone pre-trained on ImageNet was designed to predict VF progression using serial optic-disc photographs (ODP), and baseline retinal nerve fiber layer (RNFL) thickness. We tested the model on a separate dataset (427 eyes) with RNFL data from different OCT. The Main Outcome Measure was Area under ROC curve (AUC). RESULTS Baseline average (SD) MD was 3.4 (4.9)dB. VF progression was detected in 900 eyes (29%). AUC (95% CI) for model incorporating baseline ODP and RNFL thickness was 0.813 (0.757-0.869). After adding the second and third ODPs, AUC increased to 0.860 and 0.894, respectively (p<0.027). This model also had highest AUC (0.911) for predicting fast progression (MD rate <1.0 dB/year). Model's performance was similar when applied to second dataset using RNFL data from another OCT device (AUC=0.893; 0.837-0.948). CONCLUSIONS DL model predicted VF progression with clinically relevant accuracy using baseline RNFL thickness and serial ODPs and can be implemented as a clinical tool after further validation.
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Affiliation(s)
- Vahid Mohammadzadeh
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Sean Wu
- Department of Computer Science, Pepperdine University (S.W., F.S.), Malibu, California, USA
| | - Sajad Besharati
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Tyler Davis
- Department of Computer Science, University of California Los Angeles (T.D., A.V., F.S.), Los Angeles, California, USA
| | - Arvind Vepa
- Department of Computer Science, University of California Los Angeles (T.D., A.V., F.S.), Los Angeles, California, USA
| | - Esteban Morales
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Kiumars Edalati
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Mahshad Rafiee
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Arthur Martinyan
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - David Zhang
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Fabien Scalzo
- Department of Computer Science, Pepperdine University (S.W., F.S.), Malibu, California, USA; Department of Computer Science, University of California Los Angeles (T.D., A.V., F.S.), Los Angeles, California, USA
| | - Joseph Caprioli
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- From the Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles (V.M., S.B., E.M., K.E., M.R., A.M., D.Z., J.C., K.N.-M.), Los Angeles, California, USA.
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Iwase A, Higashide T, Fujii M, Ohno Y, Tanaka Y, Kikawa T, Araie M. Aging-associated changes of optical coherence tomography-measured ganglion cell-related retinal layer thickness and visual sensitivity in normal Japanese. Jpn J Ophthalmol 2024; 68:117-125. [PMID: 38498066 DOI: 10.1007/s10384-024-01049-3] [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: 05/31/2023] [Accepted: 01/06/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE To report aging-associated change rates in circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and macular ganglion cell-inner plexiform layer and complex thickness (MGCIPLT, MGCCT) in normal Japanese eyes and to compare the data in linear scaled visual field (VF) sensitivity of central 4 points of Humphrey Field Analyzer (HFA) 24-2 test (VF4TestPoints) to that in MGCIPLT in four 0.6-mm-diameter circles corresponding to the four central points of HFA 24-2 adjusted for retinal ganglion cell displacement (GCIPLT4TestPoints). STUDY DESIGN Prospective observational study METHODS: HFA 24-2 tests and spectral-domain optical coherence tomography (SD-OCT) measurements of cpRNFLT, MGCIPLT, MGCCT and GCIPLT4TestPoints were performed every 3 months for 3 years in 73 eyes of 37 healthy Japanese with mean age of 50.4 years. The time changes of SD-OCT-measured parameters and VF4TestPoints were analyzed using a linear mixed model. RESULTS The aging-associated change rates were -0.064 μm/year for MGCIPLT and and -0.095 for MGCCT (P=0.020 and 0.017), but could not be detected for cpRNFLT. They accelerated with aging at -0.009μm/year/year of age for MGCIPLT (P<0.001), at 0.011 for MGCCT (P<0.001) and at 0.013 for cpRNFLT(0.031). The aging-associated decline of -82.1 [1/Lambert]/year of VF4TestPoints corresponded to -0.095 μm/year of GCIPLT4TestPoints. CONCLUSION We report that aging-associated change rates of cpRNFLT, MGCIPLT and MGCCT in normal Japanese eyes were found to be significantly accelerated along with aging. Relationship between VF sensitivity decline rates and SD-OCT measured GCIPLT decline rates during physiological aging in the corresponding parafoveal retinal areas are also documented.
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Affiliation(s)
- Aiko Iwase
- Tajimi Iwase Eye Clinic, 3-101-1, Honmachi, Tajimi, Gifu Prefecture, 507-0033, Japan.
| | - Tomomi Higashide
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Makoto Fujii
- Division of Health and Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuko Ohno
- Division of Health and Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | | | - Makoto Araie
- Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan
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3
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Nishida T, Mahmoudinezhad G, Weinreb RN, Baxter SL, Eslani M, Liebmann JM, Girkin CA, Fazio MA, M Zangwill L, Moghimi S. Smoking and progressive retinal nerve fibre layer thinning in glaucoma. Br J Ophthalmol 2023; 107:1658-1664. [PMID: 36100361 DOI: 10.1136/bjo-2022-321237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To investigate the relationship between smoking and smoking intensity, and the rate of retinal nerve fibre layer (RNFL) thinning in patients with primary open angle glaucoma (POAG). METHODS In this longitudinal study, patients with POAG who had at least 3 years of follow-up with a minimum of 5 visits of optical coherence tomography (OCT) were enrolled. The smoking intensity was calculated as the pack-year at the baseline OCT. Univariable and multivariable linear mixed models were used to determine the effect of each parameter on the rates of RNFL thinning over time. Non-linear least-squares estimation with piecewise regression model was used to investigate the cut-off point for the relationship between circumpapillary RNFL thinning and smoking intensity. RESULTS A total of 466 eyes of 314 patients were included over the mean (95% CI) follow-up of 6.6 (6.4 to 6.7) years. Of the 314 patients, 121 (39%) had reported any history of smoking. Greater smoking intensity was associated with faster RNFL thinning (-0.06 (95% CI -0.11 to 0.00) µm/year per 10 pack-year higher; p=0.031) after adjusted for confounding factors. RNFL thinning became significantly faster when smoking intensity was >8 pack-year. CONCLUSIONS Smoking intensity is associated with faster rates of RNFL thinning. Evaluation of smoking intensity might add information to the assessment of risk of glaucoma progression. Future studies are required to explore if withdrawing smoking as a modifiable risk factor can decrease progression in patients with glaucoma.
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Affiliation(s)
- Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sally L Baxter
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
- Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
| | - Medi Eslani
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA
| | - Christopher A Girkin
- Bernard School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Massimo A Fazio
- Bernard School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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Wei S, Liu Y, Bian Z, Wang Y, Zuo L, Calabresi PA, Saidha S, Prince JL, Carass A. Recurrent Self Fusion: Iterative Denoising for Consistent Retinal OCT Segmentation. OPHTHALMIC MEDICAL IMAGE ANALYSIS : 10TH INTERNATIONAL WORKSHOP, OMIA 2023, HELD IN CONJUNCTION WITH MICCAI 2023, VANCOUVER, BC, CANADA, OCTOBER 12, 2023, PROCEEDINGS. OMIA (WORKSHOP) (10TH : 2023 : VANCOUVER, B.C. ; ONLINE) 2023; 14096:42-51. [PMID: 38318463 PMCID: PMC10840975 DOI: 10.1007/978-3-031-44013-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Optical coherence tomography (OCT) is a valuable imaging technique in ophthalmology, providing high-resolution, cross-sectional images of the retina for early detection and monitoring of various retinal and neurological diseases. However, discrepancies in retinal layer thickness measurements among different OCT devices pose challenges for data comparison and interpretation, particularly in longitudinal analyses. This work introduces the idea of a recurrent self fusion (RSF) algorithm to address this issue. Our RSF algorithm, built upon the self fusion methodology, iteratively denoises retinal OCT images. A deep learning-based retinal OCT segmentation algorithm is employed for downstream analyses. A large dataset of paired OCT scans acquired on both a Spectralis and Cirrus OCT device are used for validation. The results demonstrate that the RSF algorithm effectively reduces speckle contrast and enhances the consistency of retinal OCT segmentation.
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Affiliation(s)
- Shuwen Wei
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Yihao Liu
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Zhangxing Bian
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Yuli Wang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lianrui Zuo
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Peter A Calabresi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Shiv Saidha
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Aaron Carass
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
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Detecting disease progression in mild, moderate and severe glaucoma. Curr Opin Ophthalmol 2023; 34:168-175. [PMID: 36730773 DOI: 10.1097/icu.0000000000000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to examine contemporary techniques for detecting the progression of glaucoma. We provide a general overview of detection principles and review evidence-based diagnostic strategies and specific considerations for detecting glaucomatous progression in patients with mild, moderate and severe disease. RECENT FINDINGS Diagnostic techniques and technologies for glaucoma have dramatically evolved in recent years, affording clinicians an expansive toolkit with which to detect glaucoma progression. Each stage of glaucoma, however, presents unique diagnostic challenges. In mild disease, either structural or functional changes can develop first in disease progression. In moderate disease, structural or functional changes can occur either in tandem or in isolation. In severe disease, standard techniques may fail to detect further disease progression, but such detection can still be measured using other modalities. SUMMARY Detecting disease progression is central to the management of glaucoma. Glaucomatous progression has both structural and functional elements, both of which must be carefully monitored at all disease stages to determine when interventions are warranted.
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Banc A, Biousse V, Newman NJ, Kedar S. Ocular Optical Coherence Tomography in the Evaluation of Sellar and Parasellar Masses: A Review. Neurosurgery 2023; 92:42-67. [PMID: 36519859 PMCID: PMC10158913 DOI: 10.1227/neu.0000000000002186] [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: 04/27/2022] [Accepted: 08/15/2022] [Indexed: 12/23/2022] Open
Abstract
Compression of the anterior visual pathways by sellar and parasellar masses can produce irreversible and devastating visual loss. Optical coherence tomography (OCT) is a noninvasive high-resolution ocular imaging modality routinely used in ophthalmology clinics for qualitative and quantitative analysis of optic nerve and retinal structures, including the retinal ganglion cells. By demonstrating structural loss of the retinal ganglion cells whose axons form the optic nerve before decussating in the optic chiasm, OCT imaging of the optic nerve and retina provides an excellent tool for detection and monitoring of compressive optic neuropathies and chiasmopathies due to sellar and parasellar masses. Recent studies have highlighted the role of OCT imaging in the diagnosis, follow-up, and prognostication of the visual outcomes in patients with chiasmal compression. OCT parameters of optic nerve and macular scans such as peripapillary retinal nerve fiber layer thickness and macular ganglion cell thickness are correlated with the degree of visual loss; additionally, OCT can detect clinically significant optic nerve and chiasmal compression before visual field loss is revealed on automated perimetry. Preoperative values of OCT optic nerve and macular parameters represent a prognostic tool for postoperative visual outcome. This review provides a qualitative analysis of the current applications of OCT imaging of the retina and optic nerve in patients with anterior visual pathway compression from sellar and parasellar masses. We also review the role of new technologies such as OCT-angiography, which could improve the prognostic ability of OCT to predict postoperative visual function.
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Affiliation(s)
- Ana Banc
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Ophthalmology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Valérie Biousse
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA;
| | - Nancy J. Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sachin Kedar
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA;
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Singh K, Bhushan P, Mishra D, Kaur K, Gurnani B, Singh A, Pandey S. Assessment of optic disk by disk damage likelihood scale staging using slit-lamp biomicroscopy and optical coherence tomography in diagnosing primary open-angle glaucoma. Indian J Ophthalmol 2022; 70:4152-4157. [PMID: 36453304 PMCID: PMC9940587 DOI: 10.4103/ijo.ijo_1113_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit-lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open-angle glaucoma (POAG) patients. Methods This was a cross-sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit-lamp fundoscopy with a +78 D lens and high-definition (HD)-OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit-lamp biomicroscopy with best-corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD-OCT. Results The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit-lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1-0.77), whereas on HD-OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07-0.81). The mean deviation on visual field testing in decibels was -14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit-lamp biomicroscopy and DDLS staging by HD-OCT parameters was r = 0.96. Conclusion There is a positive correlation between the DDLS system of optic disk evaluation on slit-lamp biomicroscopy and most of the HD-OCT evaluation parameters.
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Affiliation(s)
- Kanchan Singh
- Department of Ophthalmology, Northern Railway Central Hospital, New Delhi, India
| | - Prashant Bhushan
- Department of Ophthalmology, Regional Institute of Ophthalmology, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Deepak Mishra
- Department of Ophthalmology, Regional Institute of Ophthalmology, IMS, BHU, Varanasi, Uttar Pradesh, India,Correspondence to: Dr. Deepak Mishra, Regional Institute of Ophthalmology, IMS, BHU, Varanasi, Uttar Pradesh, India. E-mail:
| | - Kirandeep Kaur
- Department of Ophthalmology, Consultant Pediatric Ophthalmology and Strabismus, Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Bharat Gurnani
- Department of Ophthalmology, Consultant Cataract, Cornea and Refractive Services Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Anjali Singh
- Department of Ophthalmology, Autonomous State Medical College Bahraich, Uttar Pradesh, India
| | - Swasti Pandey
- Department of Ophthalmology, Regional Institute of Ophthalmology, IMS, BHU, Varanasi, Uttar Pradesh, India
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Heikka T, Jansonius NM. Influence of signal‐to‐noise ratio, glaucoma stage and segmentation algorithm on
OCT
usability for quantifying layer thicknesses in the peripapillary retina. Acta Ophthalmol 2022; 101:251-260. [PMID: 36331147 DOI: 10.1111/aos.15279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/10/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE OCT can be used for glaucoma assessment, but its usefulness may depend on image quality, disease stage and segmentation algorithm. We aimed to determine how layer thicknesses as assessed with different algorithms depend on image quality and disease stage, how reproducible the algorithms are, and if the algorithms (dis)agree. METHODS Optic disc OCT data (Canon OCT-HS100) from 20 healthy subjects and 28 early, 29 moderate, and 23 severe glaucoma patients were assessed with four different algorithms (CANON, IOWA, FWHM, DOCTRAP). We measured retinal nerve fibre layer thickness (RNFLT) and total retinal thickness (TRT) along the 1.7-mm-radius OCT measurement circle centred at the optic disc. In healthy subjects, image quality was degraded with neutral density filters (0.3-0.9 optical density [OD]); three scans were made to assess repeatability. Results were analysed with ANOVA with Bonferroni corrected t-tests for post hoc analysis and with intraclass correlation coefficient (ICC) analysis. RESULTS For all algorithms, RNFLT was more sensitive to image quality than TRT. Both RNFLT and TRT showed differences between healthy and glaucoma (all algorithms p < 0.001 for both RNFLT and TRT) and between early and moderate glaucoma (RNFLT: p = 0.001 to p = 0.09; TRT: p < 0.001 to p = 0.03); neither was able to discriminate between moderate and severe glaucoma (p = 0.08 to p = 1.0). Generally, repeatability was excellent (ICC >0.75); agreement between algorithms varied from moderate to excellent. CONCLUSIONS OCT becomes less informative with glaucoma progression, irrespective of the algorithm. For good-quality scans, RNFLT and TRT perform similarly; TRT may be advantageous with poor image quality.
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Affiliation(s)
- Tuomas Heikka
- Department of Ophthalmology, University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - Nomdo M. Jansonius
- Department of Ophthalmology, University of Groningen University Medical Center Groningen Groningen The Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences) University of Groningen Groningen The Netherlands
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De Gainza A, Morales E, Rabiolo A, Yu F, Afifi AA, Nouri-Mahdavi K, Caprioli J. A Metascore of Multiple Imaging Methods to Measure Long-Term Glaucoma Structural Progression. Transl Vis Sci Technol 2022; 11:15. [PMID: 36129700 PMCID: PMC9513740 DOI: 10.1167/tvst.11.9.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To develop a structural metascore (SMS) that combines measurements from different devices and expresses them on a single scale to facilitate their long-term analysis. Methods Three structural measurements (Heidelberg Retina Tomograph II [HRT] rim area, HD-Cirrus optical coherence tomography [OCT] average retinal nerve fiber layer [RNFL] thickness, Spectralis OCT RNFL global thickness) were normalized on a scale of 0 to 100 and converted to a reference value. The resultant metascores were plotted against time. SMS performance was evaluated to predict future values (internal validation), and correlations between the average grades assigned by three clinicians were compared with the SMS slopes (external validation). Results The linear regression fit with the variance approach, and adjustment to a Spectralis equivalent was the best-performing approach; this was denominated metascore. Plots were created for 3416 eyes of 1824 patients. The average baseline age (± standard deviation) was 69.8 (±13.9), mean follow-up was 11.6 (±4.7) years, and mean number of structural scans per eye was 10.0 (±4.7). The mean numbers of scans per device were 3.8 (±2.5), 5.0 (±2.9), and 1.3 (±3.0) for HRT, Cirrus, and Spectralis, respectively. The metascore slopes' median was -0.3 (interquartile range 1.1). Correlations between the average grades assigned by the three clinicians and the metascore slopes were -0.51, -0.49, and -0.69 for the first (structural measurement printouts alone), second (metascore plots alone), and third (printouts + metascore plots) series of gradings, respectively. The average absolute predictive ability was 7.63/100 (whereas 100 = entire normalized scale). Conclusions We report a method that converts Cirrus global RNFL and HRT global rim area normalized measurements to Spectralis global RNFL equivalent values to facilitate long-term structural follow-up. Translational Relevance Because glaucoma changes usually occur slowly, patients are often examined with different instruments during their follow-up, a method that "unifies" structural measurements provided by different devices, which could assist patients' longitudinal structural follow-up.
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Affiliation(s)
| | | | | | - Fei Yu
- UCLA, Los Angeles, CA, USA
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10
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Srinivasan VV, Das S, Patel N. Widefield OCT Imaging for Quantifying Inner Retinal Thickness in the Nonhuman Primate. Transl Vis Sci Technol 2022; 11:12. [PMID: 35972432 PMCID: PMC9396678 DOI: 10.1167/tvst.11.8.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the agreement and repeatability of inner retinal thickness measures from widefield imaging compared to standard scans in healthy nonhuman primates. Methods Optical coherence tomography (OCT) scans were acquired from 30 healthy rhesus monkeys, with 11 animals scanned at multiple visits. The scan protocol included 20° × 20° raster scans centered on the macula and optic nerve head (ONH), a 12° diameter circular scan centered on the ONH, and a 55 × 45° widefield raster scan. Each scan was segmented using custom neural network–based algorithms. Bland–Altman analysis were used for comparing average circumpapillary retinal nerve fiber layer (RNFL) thickness and ganglion cell inner plexiform layer (GCIPL) thickness for a 16° diameter region. Comparisons were also made for similar 1° × 1° superpixels from the raster scans. Results Average circumpapillary RNFL thickness from the circular scan was 114.2 ± 5.8 µm, and 113.2 ± 7.3 µm for an interpolated scan path from widefield imaging (bias = −1.03 µm, 95% limits of agreement [LOA] −8.6 to 6.5 µm). GCIPL thickness from standard raster scans was 72.7 ± 4.3 µm, and 73.7 ± 3.7 µm from widefield images (bias = 1.0 µm, 95% LOA −2.4 to 4.4 µm). Repeatability for both RNFL and GCIPL standard analysis was less than 5.2 µm. For 1° × 1° superpixels, the 95% limits of agreement were between −13.9 µm and 13.7 µm for RNFL thickness and −2.5 µm and 2.5 µm for GCIPL thickness. Conclusions Inner retinal thickness measures from widefield imaging have good repeatability and are comparable to those measured using standard scans. Translational Relevance Monitoring retinal ganglion cell loss in the non-human primate experimental glaucoma model could be enhanced using widefield imaging.
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Affiliation(s)
| | - Siddarth Das
- University of Houston College of Optometry, Houston, TX, USA
| | - Nimesh Patel
- University of Houston College of Optometry, Houston, TX, USA
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Chua J, Schwarzhans F, Wong D, Li C, Husain R, Crowston JG, Perera SA, Sng CCA, Nongpiur ME, Majithia S, Tham YC, Thakur S, Da Soh Z, Cheng CY, Aung T, Fischer G, Vass C, Schmetterer L. Multivariate Normative Comparison, a Novel Method for Improved Use of Retinal Nerve Fiber Layer Thickness to Detect Early Glaucoma. Ophthalmol Glaucoma 2022; 5:359-368. [PMID: 34718222 DOI: 10.1016/j.ogla.2021.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/04/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Detection of early glaucoma remains limited with the conventional analysis of the retinal nerve fiber layer (RNFL). This study assessed whether compensating the RNFL thickness for multiple demographic and anatomic factors improves the detection of glaucoma. DESIGN Cross-sectional study. PARTICIPANTS Three hundred eighty-seven patients with glaucoma and 2699 healthy participants. METHODS Two thousand six hundred ninety-nine healthy participants were enrolled to construct and test a multivariate compensation model, which then was applied in 387 healthy participants and 387 patients with glaucoma (early glaucoma, n = 219; moderate glaucoma, n = 97; and advanced glaucoma, n = 71). Participants underwent Cirrus spectral-domain OCT (Carl Zeiss Meditec) imaging of the optic disc and macular cubes. Compensated RNFL thickness was generated based on ethnicity, age, refractive error, optic disc (ratio, orientation, and area), fovea (distance and angle), and retinal vessel density. The RNFL thickness measurements and their corresponding areas under the receiver operating characteristic curve (AUCs) were obtained. MAIN OUTCOME AND MEASURES Measured and compensated RNFL thickness measurements. RESULTS After applying the Asian-specific compensation model, the standard deviation of RNFL thickness reduced, where the effect was greatest for Chinese participants (16.9%), followed by Malay participants (13.9%), and Indian participants (12.1%). Multivariate normative comparison outperformed measured RNFL for discrimination of early glaucoma (AUC, 0.90 vs. 0.85; P < 0.001), moderate glaucoma (AUC, 0.94 vs. 0.91; P < 0.001), and advanced glaucoma (AUC, 0.98 vs. 0.96; P < 0.001). CONCLUSIONS The multivariate normative database of RNFL showed better glaucoma discrimination capability than conventional age-matched comparisons, suggesting that accounting for demographic and anatomic variance in RNFL thickness may have usefulness in improving glaucoma detection.
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Affiliation(s)
- Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore, Republic of Singapore
| | - Florian Schwarzhans
- Center for Medical Statistics Informatics and Intelligent Systems, Section for Medical Information Management, Medical University Vienna, Vienna, Austria
| | - Damon Wong
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore, Republic of Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Republic of Singapore
| | - Chi Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore, Republic of Singapore
| | - Rahat Husain
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Jonathan G Crowston
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Shamira A Perera
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Chelvin C A Sng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Monisha E Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Georg Fischer
- Center for Medical Statistics Informatics and Intelligent Systems, Section for Medical Information Management, Medical University Vienna, Vienna, Austria
| | - Clemens Vass
- Department of Ophthalmology and Optometry, Medical University Vienna, Vienna, Austria
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore, Republic of Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Republic of Singapore; Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
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12
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Chow JY, She PF, Pee XK, Wan Muda WN, Catherine Bastion ML. Comparison of peripapillary retinal nerve fiber layer and macular thickness in non-diabetic chronic kidney disease and controls. PLoS One 2022; 17:e0266607. [PMID: 35385541 PMCID: PMC8985942 DOI: 10.1371/journal.pone.0266607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/23/2022] [Indexed: 12/02/2022] Open
Abstract
Objective This study aimed to compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular thickness (MT) between patients with non-diabetic chronic kidney disease (NDCKD) and controls, as well as between different stages of NDCKD. We also evaluated the correlation between pRNFL thickness and MT with duration of NDCKD. Methods This was a comparative cross-sectional study. Subjects were divided into NDCKD and control groups. Both pRNFL thickness and MT, including center subfield thickness (CST), average MT as well as average ganglion cell-inner plexiform layer (GC-IPL) were measured using spectral-domain optical coherence tomography. One-way ANCOVA test was used to compare the differences in pRNFL and MT between NDCKD and controls, as well as between the different stages of NDCKD. Spearman rank-order correlation coefficients were employed to determine the effects of NDCKD duration on pRNFL thickness and MT. Results A total of 132 subjects were recruited, 66 with NDCKD and 66 controls. There was a statistically significant difference in superior (110.74 ± 23.35 vs 117.36 ± 16.17 μm, p = 0.022), nasal (65.97 ± 12.90 vs 69.35 ± 10.17 μm, p = 0.006), inferior quadrant (117.44 ± 23.98 vs 126.15 ± 14.75 μm, p = 0.006), average pRNFL (90.36 ± 14.93 vs 95.42 ± 9.87 μm, p = 0.005), CST (231.89 ± 26.72 vs 243.30 ± 21.05 μm, p = 0.006), average MT (268.88 ± 20.21 vs 274.92 ± 12.79 μm, p = 0.020) and average GC-IPL (75.48 ± 12.44 vs 81.56 ± 6.48, p = 0.001) values between the NDCKD group and controls. The superior quadrant (p = 0.007), nasal quadrant (p = 0.030), inferior quadrant (p = 0.047), average pRNFL (p = 0.006), average MT (p = 0.001) and average GC-IPL (p = 0.001) differed significantly between different stages of NDCKD. There was no correlation between pRNFL thickness and MT with duration of NDCKD. Conclusion CST, average MT, average GC-IPL thickness, average pRNFL and all quadrants of pRNFL except the temporal quadrant were significantly thinner in NDCKD patients compared to controls. These changes were associated with the severity of CKD, but not its duration.
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Affiliation(s)
- Jun Yong Chow
- Faculty of Medicine, Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
- Department of Ophthalmology, Hospital Tengku Ampuan Afzan, Ministry of Health, Kuantan, Pahang, Malaysia
- * E-mail: (MLCB); (JYC)
| | - Poh Fong She
- Faculty of Medicine, Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
- Department of Ophthalmology, Hospital Tengku Ampuan Afzan, Ministry of Health, Kuantan, Pahang, Malaysia
| | - Xu Kent Pee
- Department of Ophthalmology, Hospital Umum Sarawak, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Wan Norliza Wan Muda
- Department of Ophthalmology, Hospital Tengku Ampuan Afzan, Ministry of Health, Kuantan, Pahang, Malaysia
| | - Mae-Lynn Catherine Bastion
- Faculty of Medicine, Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia
- * E-mail: (MLCB); (JYC)
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Rates of Circumpapillary Retinal Nerve Fiber Layer Thinning and Capillary Density Loss in Glaucomatous Eyes with Disc Hemorrhage. Am J Ophthalmol 2022; 235:24-31. [PMID: 34587496 PMCID: PMC9904188 DOI: 10.1016/j.ajo.2021.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate longitudinal changes in rates of optic nerve head circumpapillary retinal nerve fiber layer (cpRNFL) thinning and vessel density loss in patients with primary open-angle glaucoma with or without a history of disc hemorrhage (DH). DESIGN Observational cohort. METHODS In this longitudinal study, 34 eyes with DH and 134 eyes without DH that had ≥1.5 years of follow-up and 3 optical coherence tomography and optical coherence tomography angiography follow-up scans were enrolled. A linear mixed-effects model was used to compare the rates of cpRNFL thinning and vessel density loss between DH and non-DH eyes. RESULTS Rates of whole image capillary density loss were faster in the DH group compared with the non-DH group (mean difference [95% confidence interval] -0.32% [-0.59% to -0.04%] per year; P = .027). Faster mean rates of vessel density loss were found in the inferotemporal, inferonasal, and nasal sectors in eyes with DH than without DH (P < .05). There was no statistically significant difference in the global rate of cpRNFL thinning between the 2 groups (P = .679). The mean rate of cpRNFL thinning was faster in the DH group compared with the non-DH group only in the inferotemporal sector (mean difference [95% confidence interval] -1.01 μm (-1.62 μm to -0.40 μm) per year; P = .001). CONCLUSIONS Mean rates of vessel density loss between DH and non-DH eyes were different not only in the affected area but also in the other regions. In contrast, a significant difference in cpRNFL thinning between the 2 groups was detected only in the inferotemporal sector. Disc hemorrhage is an independent predictor of faster vessel density loss in glaucoma suspects and patients with primary open-angle glaucoma.
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14
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Mahmoudinezhad G, Mohammadzadeh V, Amini N, Delao K, Zhou B, Hong T, Zadeh SH, Morales E, Martinyan J, Law SK, Coleman AL, Caprioli J, Nouri-Mahdavi K. Detection of Longitudinal Ganglion Cell/Inner Plexiform Layer Change: Comparison of Two Spectral-Domain Optical Coherence Tomography Devices. Am J Ophthalmol 2021; 231:1-10. [PMID: 34097896 DOI: 10.1016/j.ajo.2021.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE We compared rates of change of macular ganglion cell/inner plexiform (GCIPL) thickness and proportion of worsening and improving rates from 2 optical coherence tomography (OCT) devices in a cohort of eyes with glaucoma. DESIGN Longitudinal cohort study. METHODS In a tertiary glaucoma clinic we evaluated 68 glaucoma eyes with ≥2 years of follow-up and ≥4 OCT images. Macular volume scans from 2 OCT devices were exported, coregistered, and segmented. Global and sectoral GCIPL data from the central 4.8 × 4.0-mm region were extracted. GCIPL rates of change were estimated with linear regression. Permutation analyses were used to control specificity with the 2.5 percentile cutoff point used to define "true" worsening. Main outcome measures included differences in global/sectoral GCIPL rates of change between 2 OCT devices and the proportion of negative vs positive rates of change (P < .05). RESULTS Average (standard deviation) 24-2 visual field mean deviation, median (interquartile range) follow-up time, and number of OCT images were -9.4 (6.1) dB, 3.8 (3.3-4.2) years, and 6 (5-8), respectively. GCIPL rates of thinning from Spectralis OCT were faster (more negative) compared with Cirrus OCT; differences were significant in superonasal (P = .03) and superotemporal (P = .04) sectors. A higher proportion of significant negative rates was observed with Spectralis OCT both globally and in inferotemporal/superotemporal sectors (P < .04). Permutation analyses confirmed the higher proportion of global and sectoral negative rates of change with Spectralis OCT (P < .001). CONCLUSIONS Changes in macular GCIPL were detected more frequently on Spectralis' longitudinal volume scans than those of Cirrus OCT. OCT devices are not interchangeable with regard to detection of macular structural progression.
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Affiliation(s)
- Golnoush Mahmoudinezhad
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Vahid Mohammadzadeh
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Navid Amini
- Department of Computer Science (N.A., K.D., B.Z., T.H.), California State University Los Angeles, Los Angeles, California
| | - Kevin Delao
- Department of Computer Science (N.A., K.D., B.Z., T.H.), California State University Los Angeles, Los Angeles, California
| | - Bingnan Zhou
- Department of Computer Science (N.A., K.D., B.Z., T.H.), California State University Los Angeles, Los Angeles, California
| | - Tae Hong
- Department of Computer Science (N.A., K.D., B.Z., T.H.), California State University Los Angeles, Los Angeles, California
| | - Sepideh Heydar Zadeh
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Esteban Morales
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Jack Martinyan
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Simon K Law
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Anne L Coleman
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; and the Department of Epidemiology (A.L.C.), Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Joseph Caprioli
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kouros Nouri-Mahdavi
- From the Glaucoma Division (G.M., V.M., S.H.Z., E.M., J.M., S.K.L., A.L.C., J.C., K.N-M.), Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
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Cheng KKW, Tatham AJ. Spotlight on the Disc-Damage Likelihood Scale (DDLS). Clin Ophthalmol 2021; 15:4059-4071. [PMID: 34675474 PMCID: PMC8504474 DOI: 10.2147/opth.s284618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/16/2021] [Indexed: 12/27/2022] Open
Abstract
The disc damage likelihood scale (DDLS) is a tool for classifying glaucomatous structural changes to the optic disc based on the radial width of the neuroretinal rim at its thinnest location, or if no rim is present, the extent of absence of the rim. Unlike cup disc ratio (CDR), the DDLS also considers disc size. Twenty years after its first description, the aim of this review was to critically appraise evidence for the DDLS and evaluate its role in current practice. A literature search by two independent authors identified 33 relevant articles for inclusion. Five studies evaluated reproducibility, 5 diagnostic performance, and 2 studies examined ability to detect progression. Eleven studies evaluated correlation between DDLS and other markers of glaucoma. Despite the widespread availability of imaging devices such as optical coherence tomography (OCT), clinical examination of the optic disc remains an essential component of glaucoma diagnosis and monitoring. The DDLS provides a reliable method for semi-quantitative clinical grading of the optic disc in glaucoma, with higher reproducibility than methods such as CDR.
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16
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Gündogan M, Kiliç S. Comparison of the Thickness of the Fiber Layer of the Retinal Nerves in Spectral Domain Optical Coherence Tomography in Normal Eyes Older Than 40 Years. Klin Monbl Augenheilkd 2021. [PMID: 34528230 DOI: 10.1055/a-1554-5663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare measurements of the thickness of the retinal nerve fibre layer (RNFL) and assess the agreement between three different devices for spectral domain optical coherence tomography. MATERIAL AND METHODS The RNFL thickness of both eyes of 23 normal subjects older than 40 years was measured using Canon HS100, Topcon Maestro, and NIDEK RS-3000 devices. Both eyes of each subject were scanned in random order. All scans were completed on the same day in the morning. The average and four quadrants (superior, inferior, nasal, and temporal) of RNFL thickness were measured. To determine the differences in RNFL thickness, analysis of variance for repeated measurements was performed. A Bland-Altman plot was plotted, and coefficients of determination were calculated. RESULTS A total of 46 eyes of 23 subjects were enrolled in this study. The average RNFL thickness as determined by the three OCT devices was correlated (p < 0.001), but differed significantly between the three devices, as most were quadrant measurements. The mean average RNFL thickness was 98.5 ± 6.6 µm as measured by Canon HS100, 108.5 ± 8.8 µm as measured by Topcon Maestro, and 104.9 ± 9.0 µm as measured by NIDEK RS-3000. Topcon Maestro showed the highest average RNFL thickness value. Bland-Altman plots revealed considerable agreement among the three devices, except for the inferior quadrants between Topcon Maestro and NIDEK RS-3000 measurements. All three devices reveal considerable coefficients of determination values for mean RNFL thickness (0.917 - 0.127). CONCLUSION Although the peripapillary RNFL thickness measurements taken with Canon HS100, Topcon Maestro, and NIDEK RS-3000 were in good agreement, they were not interchangeable in clinical practice, as the values differed significantly.
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Affiliation(s)
- Medine Gündogan
- Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Soner Kiliç
- Neurology, Kayseri City Education and Research Hospital, Kayseri, Turkey
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17
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David RCC, Moghimi S, Ekici E, Do JL, Hou H, Proudfoot JA, Kamalipour A, Nishida T, Girkin CA, Liebmann JM, Weinreb RN. Rates of Retinal Nerve Fiber Layer Thinning in Distinct Glaucomatous Optic Disc Phenotypes in Early Glaucoma. Am J Ophthalmol 2021; 229:8-17. [PMID: 33910053 PMCID: PMC9467437 DOI: 10.1016/j.ajo.2021.04.010] [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: 01/19/2021] [Revised: 04/05/2021] [Accepted: 04/11/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare spectral-domain optical coherence tomography (SDOCT) measured circumpapillary retinal nerve fiber layer (cpRNFL) among 4 glaucomatous optic disc phenotypes in early glaucoma. DESIGN Clinical cohort study METHODS: In this study, 218 early glaucoma eyes that had at least 3 years of follow-up and a minimum of 4 SDOCT scans were recruited. The optic discs were classified into 4 types based on appearance: 76 generalized cup enlargement (GE), 53 focal ischemic (FI), 22 myopic glaucomatous (MY), and 67 senile sclerotic (SS). A linear mixed effects model was used to compare the rates of global and regional cpRNFL thinning among optic disc phenotypes. RESULTS After adjusting for confounders, the SS group (mean [95% CI]: -1.01 [-1.30, -0.73] µm/y) had the fastest mean rate of global cpRNFL thinning followed by FI (-0.77 [-0.97, -0.57] µm/y), MY (0.59 [-0.81, -0.36] µm/y), and GE (-0.58 [-0.75, -0.40] µm/y) at P < .001. The inferior temporal sector had the fastest rate of cpRNFL thinning among the regional measurements except for the MY group (-0.68 [-1.10, -0.26] µm/y, P = .002). In the multivariable analysis, GE (P = .002) and MY (P = .010) phenotypes were associated with significantly slower global rates of cpRNFL thinning compared with the SS phenotype. CONCLUSIONS Rates of cpRNFL thinning were different among the 4 glaucomatous optic disc phenotypes. Those patients with early glaucoma with SS phenotype have the fastest cpRNFL thinning. These patients may benefit from more frequent monitoring and the need to advance therapy if cpRNFL thinning is detected.
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Affiliation(s)
- Ryan Caezar C David
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Sasan Moghimi
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Eren Ekici
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Jiun L Do
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Huiyuan Hou
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - James A Proudfoot
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Alireza Kamalipour
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Takashi Nishida
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California
| | - Christopher A Girkin
- Department of Ophthalmology and Visual Science, Callahan Eye Hospital, University of Alabama-Birmingham (C.A.G.), Alabama and
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center (J.M.L.), New York, New York, USA
| | - Robert N Weinreb
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California (R.C.C.D., S.M., E.E., J.L.D., H.H., J.A.P., A.K., T.N., R.N.W.), San Diego, La Jolla, California.
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18
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Scheuble P, Petrak M, Brinkmann CK. Glaucoma Diagnostic Testing: The Influence of Optic Disc Size. Klin Monbl Augenheilkd 2021; 239:1043-1051. [PMID: 34198350 DOI: 10.1055/a-1478-3978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are various imaging techniques for the assessment of the optic disc in glaucoma patients. However, anatomically conspicuous, large or small optic discs can be quite challenging for an examiner. OBJECTIVE The Bruch's membrane opening (BMO) by spectral domain optical coherence tomography (SD-OCT) is a modern approach for the quantitative measures of retinal nerve fibre layer (RNFL). The study focuses on comparison analysis of the BMO method and the widely used Heidelberg retina tomograph (HRT) method - in terms of detection of glaucoma for different optic disc sizes. METHODS 216 Patients examinations during glaucoma consultation hours. Macro- (Ma) and micro-optic discs (Mi) detected by HRT are analysed via BMO analysis in SD-OCT. Correlation between BMO area and optic disc measured by HRT has been investigated and examined in terms of severity of visual field defect (MD [dB]). RESULTS The results of study show that for micro and macro-optic discs there is a modest correlation between the size of optic disc measured by BMO and the size of optic disc measured by HRT by applying funduscopic examination (correlation rate r = 0,53; Mi: n = 111, Ma: n = 105). For micro-optic discs with a very small BMO area (< 1.5 mm2), there is a significant tendency (linear trend test p < 0.05) towards deeper visual field defects (MD < - 5 dB). CONCLUSION The BMO parameter of SD-OCT allows an assessment of glaucoma for a large range of optic disc sizes. BMO area and optic disc size measured by HRT are not correlated. Micro optic discs with a small BMO area lead to a higher risk of deep visual field defects.
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Affiliation(s)
- Pascal Scheuble
- Sektion Glaukom, Universitäts-Augenklinik Bonn, Universitätsklinikum Bonn, Deutschland
| | - Michael Petrak
- Sektion Glaukom, Universitäts-Augenklinik Bonn, Universitätsklinikum Bonn, Deutschland
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19
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Lee SSY, Lingham G, Alonso-Caneiro D, Charng J, Chen FK, Yazar S, Mackey DA. Macular Thickness Profile and Its Association With Best-Corrected Visual Acuity in Healthy Young Adults. Transl Vis Sci Technol 2021; 10:8. [PMID: 34003942 PMCID: PMC7961121 DOI: 10.1167/tvst.10.3.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpose To describe the thickness profiles of the full retinal and outer retinal layers (ORL) at the macula in healthy young adults, and associations with best-corrected visual acuity (BCVA). Methods In total, 1604 participants (19-30 years) underwent an eye examination that included measurements of their BCVA, axial length, and autorefraction. The retinal thickness at the foveal pit and at the nine Early Treatment of Diabetic Retinopathy Study macular regions (0.5-mm radius around the fovea, and superior, inferior, temporal, and nasal quadrants of the inner and outer rings of the macula) were obtained using spectral-domain optical coherence tomography imaging. A custom program was used to correct for transverse magnification effects because of different axial lengths. Results The median full retinal and ORL thicknesses at the central macula were 285 µm and 92 µm. The full retina was thinnest centrally and thickest at the inner macula ring, whereas the ORL was thickest centrally and gradually decreased in thickness with increasing eccentricity. There was no association between axial length and the full retinal or ORL thickness. Increased thicknesses of the full retina at the central macula was associated with better BCVA; however, the effect size was small and not clinically significant. Conclusions This article mapped the full retinal and ORL thickness profile in a population-based sample of young healthy adults. Translational Relevance Thickness values presented in this article could be used as a normative reference for future studies on young adults and in clinical practice.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Western Australia, Australia
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Western Australia, Australia
| | - David Alonso-Caneiro
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Western Australia, Australia
| | - Fred Kuanfu Chen
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Western Australia, Australia.,Royal Perth Hospital, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Western Australia, Australia.,Single Cell and Computational Genomics Lab, Garvan Institute of Medical Research, New South Wales, Australia
| | - David Anthony Mackey
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Western Australia, Australia.,Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia.,School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Tasmania, Australia
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20
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Para-Prieto M, Martin R, Crespo S, Mena-Garcia L, Valisena A, Cordero L, Gonzalez Fernandez G, Arenillas JF, Tellez N, Pastor JC. OCT Variability Prevents Their Use as Robust Biomarkers in Multiple Sclerosis. Clin Ophthalmol 2021; 15:2025-2036. [PMID: 34025119 PMCID: PMC8132465 DOI: 10.2147/opth.s309703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the agreement between the peripapillary retinal nerve fiber layer (pRNFL) and foveal thickness (FT) measurements among three different spectral domain-optical coherence tomography (SD-OCT) instruments in a sample of multiple sclerosis (MS) patients and a healthy age-matched control group. Methods An observational cross-sectional study with three groups: healthy subjects and MS patients w/w a previous clinical diagnosis of optic neuritis (ON) was conducted. The pRNFL and FT were measured using three different SD-OCT instruments (OCT PRIMUS 200 and OCT CIRRUS 500 SD-OCT [Carl Zeiss Meditec] and OCT 3D 2000 [Topcon]). Results Twenty eyes from 10 healthy subjects matched in age with MS patients without a previous history of eye disease and 62 MS eyes from 31 MS patients (29 eyes without history of ON and 33 eyes with history of ON) were enrolled. Healthy subjects and MS patients without ON did not show differences between the pRNFL and FT thickness (P>0.99) with any of the instruments. However, MS eyes with a previous episode of ON showed thinner pRNFL and FT (P<0.01). PRIMUS and CIRRUS OCT showed better agreement of the pRNLF and FT in both healthy and MS eyes. However, 3D OCT showed less agreement in the pRNFL measurement with CIRRUS in both healthy and MS eyes. Interpretation Although OCT is a valuable technology to improve MS patient assessment, differences between devices must be taken into account. It is necessary to create an international group that standardizes the measurement conditions and above all that provides reference bases for normal subjects.
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Affiliation(s)
- Marta Para-Prieto
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Valladolid, 47011, Spain.,Hospital Clínico Universitario, Department of Ophthalmology, Valladolid, 47005, Spain
| | - Raul Martin
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Valladolid, 47011, Spain.,Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Valladolid, 47011, Spain.,Plymouth University, Faculty of Health and Human Sciences, Plymouth, UK
| | - Sara Crespo
- Hospital Clínico Universitario, Department of Ophthalmology, Valladolid, 47005, Spain
| | - Laura Mena-Garcia
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Valladolid, 47011, Spain
| | - Andres Valisena
- Hospital Clínico Universitario, Department of Ophthalmology, Valladolid, 47005, Spain
| | - Lisandro Cordero
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Valladolid, 47011, Spain
| | | | - Juan F Arenillas
- Hospital Clínico Universitario, Department of Neurology, Valladolid, 47005, Spain
| | - Nieves Tellez
- Hospital Clínico Universitario, Department of Neurology, Valladolid, 47005, Spain
| | - Jose Carlos Pastor
- Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Valladolid, 47011, Spain.,Hospital Clínico Universitario, Department of Ophthalmology, Valladolid, 47005, Spain
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21
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Perez CI, Chansangpetch S, Mora M, Nguyen A, Zhao J, Han Y, Lin SC. Ethnicity-Specific Database Improves the Diagnostic Ability of Peripapillary Retinal Nerve Fiber Layer Thickness to Detect Glaucoma. Am J Ophthalmol 2021; 221:311-322. [PMID: 32777372 DOI: 10.1016/j.ajo.2020.07.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/06/2020] [Accepted: 07/30/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine the changes in optical coherence tomography (OCT) color probability codes and diagnostic ability for peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell complex (GCC) analysis after applying Chinese and white subjects normative databases. DESIGN Cross-sectional study. METHODS This study enrolled 219 healthy eyes (108 white and 111 Chinese patients) to construct an ethnicity-specific normative database for pRNFL and macular GCC thickness, which was tested then in 180 eyes with or without glaucoma (102 white and 78 Chinese patients). The percent of change of color probability codes were evaluated after applying the original built-in and the ethnicity-specific normative databases, respectively. Sensitivity and specificity were calculated to evaluate the change in diagnostic ability to detect glaucoma. RESULTS Healthy white subjects had a thinner pRNFL than Chinese subjects in the overall average thickness as well as the superior, inferior, and temporal quadrants (P < .001). Macular GCC did not differ between ethnicities. After applying an ethnicity-specific normative database, the percent of pRNFL abnormal color code labels decreased significantly for the overall average thickness in the white subjects. This resulted in a significant increase in the specificity to detect glaucoma in the white population (P < .001). No significant changes were seen when applying an ethnicity-specific normative database for macular GCC thickness. CONCLUSIONS After applying an ethnicity-specific normative database, the percent of pRNFL abnormal color codes decreased significantly, improving the specificity to detect glaucoma in the white population. These findings suggest there may be utility in having ethnicity-specific normative databases for pRNFL thickness.
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Affiliation(s)
- Claudio I Perez
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA; Fundación Oftalmológica Los Andes, Universidad de los Andes, Santiago, Chile.
| | - Sunee Chansangpetch
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA; Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Marta Mora
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
| | - Anwell Nguyen
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
| | - Jing Zhao
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA; Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Ying Han
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
| | - Shan C Lin
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA; Glaucoma Center of San Francisco, San Francisco, California, USA
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22
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Arnould L, De Lazzer A, Seydou A, Binquet C, Bron AM, Creuzot‐Garcher C. Diagnostic ability of spectral-domain optical coherence tomography peripapillary retinal nerve fiber layer thickness to discriminate glaucoma patients from controls in an elderly population (The MONTRACHET study). Acta Ophthalmol 2020; 98:e1009-e1016. [PMID: 32333503 DOI: 10.1111/aos.14448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/28/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the capacity of retinal nerve fibre layer (RNFL) thickness measured by SD-OCT to discriminate glaucoma patients from controls in an elderly population. METHODS The MONTRACHET (Maculopathy, Optic Nerve, nuTRition, neurovAsCular and HEarT diseases) Study is a population-based study including participants aged 75 years and over. All participants underwent a complete eye examination with optic nerve photographs, visual field testing and OCT peripapillary RNFL thickness measurement. Glaucoma was defined according to the ISGEO (International Society for Epidemiologic and Geographical Ophthalmology) classification. Performance indicators were calculated including area under the receiver operating characteristics curves (AUC), likelihood ratios (LR) and diagnostic odds ratios (DOR). RESULTS In total, 1061 participants were included in the study, of whom 89 were classified as having glaucoma and 972 were classified as normal. The mean (SD) age of the population was 82.3 (3.7) years. The average RNFL thickness was significantly lower in the glaucoma group than in controls 64.0 (14.9) µm versus 88.9 (12.4) µm, respectively, p < 0.001) and in all sectors compared with controls. The average RNFL thickness had the highest AUC (0.901) followed by the temporal-inferior (0.879) and temporal-superior sectors (0.862). When RNFL thickness was classified as abnormal by SD-OCT, the average RNFL thickness had the best sensitivity (83.75%) followed by the temporal-inferior sector (75.64%). The specificity for these two parameters was 87.34% and 91.08%, respectively. The highest DOR was 28.70 for average RNFL thickness and reached 34.84 when using the reference database of the OCT manufacturer. CONCLUSION This study confirms that SD-OCT could be useful as an additional test to discriminate glaucoma patients from controls in an elderly population.
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Affiliation(s)
- Louis Arnould
- Department of Ophthalmology University Hospital Dijon France
| | | | - Alassane Seydou
- Institut National de la Santé et de la Recherche Médicale (INSERM) Clinical Center Investigation Clinical Epidemiology/Clinical Trials Unit University Hospital Dijon France
| | - Christine Binquet
- Institut National de la Santé et de la Recherche Médicale (INSERM) Clinical Center Investigation Clinical Epidemiology/Clinical Trials Unit University Hospital Dijon France
| | - Alain M. Bron
- Department of Ophthalmology University Hospital Dijon France
- Centre des Sciences du Goût et de l'Alimentation AgroSup Dijon CNRS INRAE Université Bourgogne Franche‐Comté Dijon France
| | - Catherine Creuzot‐Garcher
- Department of Ophthalmology University Hospital Dijon France
- Centre des Sciences du Goût et de l'Alimentation AgroSup Dijon CNRS INRAE Université Bourgogne Franche‐Comté Dijon France
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23
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Yılmaz H, Köylü MT, Yılmaz AC, Durukan AH, Uysal Y. Agreement Between Standard Optical Coherence Tomography and Optical Coherence Tomography-Based Angiography in Estimating Retinal Nerve Fiber Layer Thickness. Turk J Ophthalmol 2020; 50:264-270. [PMID: 33342192 PMCID: PMC7610055 DOI: 10.4274/tjo.galenos.2020.18488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives To investigate the agreement between optical coherence tomography (OCT) and OCT-based angiography (OCT-A) in estimating retinal nerve fiber layer thickness (RNFLT) and evaluate the associations between peripapillary vessel density (VD) and RNFLT measurements obtained with both devices. Materials and Methods The AngioVue (Optovue Inc., Fremont, CA, USA) and Spectralis (Heidelberg Engineering, Heidelberg, Germany) images of 325 patients were screened retrospectively. RNFLT values were recorded using both devices. The intraclass correlation coefficient (ICC) and Bland-Altman plots were obtained to investigate the agreement between the devices. Age- and intraocular pressure-corrected associations between VD and RNFLT measured by the two devices were analyzed using linear regression models. Results ICC revealed excellent agreement for global, superior, inferior, and temporal RNFLT and good agreement for the nasal quadrant (ICC=0.895, 0.936, 0.923, 0.887, and 0.614, respectively). The Bland-Altman plots showed poor agreement for all measurements with a large span of limits of agreement and significant proportional bias (p<0.05). VD was found to be strongly associated with the RNFLT measurements of both devices (p<0.001). Conclusion The disagreement between the devices should be considered in clinical practice, and the data should not be used interchangeably. The association of the peripapillary VD with RNFLT using both devices indicated that RNFLT assessed by the AngioVue could be used in glaucoma management along with VD.
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Affiliation(s)
- Hayati Yılmaz
- University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Ophthalmology, İstanbul, Turkey
| | - Mehmet Talay Köylü
- University of Health Sciences Turkey, Gülhane Medical Faculty, Department of Ophthalmology, Ankara, Turkey
| | - Alper Can Yılmaz
- University of Health Sciences Turkey, Gülhane Medical Faculty, Department of Ophthalmology, Ankara, Turkey
| | - Ali Hakan Durukan
- University of Health Sciences Turkey, Gülhane Medical Faculty, Department of Ophthalmology, Ankara, Turkey
| | - Yusuf Uysal
- University of Health Sciences Turkey, Gülhane Medical Faculty, Department of Ophthalmology, Ankara, Turkey
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24
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Asanad S, Mohammed I, Sadun AA, Saeedi OJ. OCTA in neurodegenerative optic neuropathies: emerging biomarkers at the eye-brain interface. Ther Adv Ophthalmol 2020; 12:2515841420950508. [PMID: 32923939 PMCID: PMC7457690 DOI: 10.1177/2515841420950508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 07/13/2020] [Indexed: 12/22/2022] Open
Abstract
OCTA imaging in optic neuropathies.
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Affiliation(s)
- Samuel Asanad
- Department of Ophthalmology and Visual Sciences, University of Maryland Eye Associates, University of Maryland Medical Center and University of Maryland School of Medicine, 419 W. Redwood St., Baltimore, MD 21201, USA
| | - Isa Mohammed
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alfredo A Sadun
- Doheny Eye Center, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Osamah J Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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25
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Mahmoudinezhad G, Mohammadzadeh V, Amini N, Toriz V, Pourhomayoun M, Heydarzadeh S, Mylavarapu A, Morales E, Caprioli J, Nouri-Mahdavi K. Local Macular Thickness Relationships between 2 OCT Devices. Ophthalmol Glaucoma 2020; 4:209-215. [PMID: 32866692 DOI: 10.1016/j.ogla.2020.08.012] [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: 08/07/2020] [Revised: 08/07/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare local ganglion cell-inner plexiform layer (GCIPL) thickness measurements between 2 OCT devices and to explore factors that may influence the difference in measurements. DESIGN Cross-sectional study. PARTICIPANTS Sixty-nine glaucoma eyes (63 patients) with evidence of central damage or mean deviation (MD) of -6.0 dB or worse on a 24-2 visual field (VF). METHODS Cirrus and Spectralis OCT macular volume scans were exported, data from the central 20° of both OCT devices were centered and aligned, and 50 × 50 arrays of 0.4° × 0.4° superpixels were created. We estimated nonparametric (Spearman's) correlations and used Bland-Altman plots to compare GCIPL thickness measurements between the two OCTs at the superpixel level. Factors that may have influenced the differences between thickness measurements between the two devices were explored with linear mixed models. MAIN OUTCOME MEASURES Pooled and individual-eye Spearman's correlation and agreement between thickness measurements from the two devices. RESULTS The median 24-2 VF MD was -6.8 dB (interquartile range [IQR], -4.9 to -12.3 dB). The overall pooled Spearman's correlation between the two devices for all superpixels and eyes was 0.97 (P < 0.001). The median within-eye correlation coefficient was 0.72 (IQR, 0.59-0.79). Bland-Altman plots demonstrated a systematic bias in most individual eyes, with Spectralis GCIPL measurements becoming larger than Cirrus measurements with increasing superpixel thickness. The average superpixel thickness and distance to the fovea influenced the thickness difference between the two devices in multivariate models (P < 0.001). CONCLUSIONS Local macular thickness measurements from the Spectralis and Cirrus devices are highly correlated, but not interchangeable. Differences in thickness measurements between the two devices are influenced by the location of superpixels and their thickness.
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Affiliation(s)
- Golnoush Mahmoudinezhad
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Navid Amini
- Department of Computer Science, California State University, Los Angeles, California
| | - Veronica Toriz
- Department of Computer Science, California State University, Los Angeles, California
| | - Mohammad Pourhomayoun
- Department of Computer Science, California State University, Los Angeles, California
| | - Sepideh Heydarzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Apoorva Mylavarapu
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Esteban Morales
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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26
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Arnljots U, Nilsson M, Hed Myrberg I, Åden U, Hellgren K. Profile of macular ganglion cell-inner plexiform layer thickness in healthy 6.5 year- old Swedish children. BMC Ophthalmol 2020; 20:329. [PMID: 32787847 PMCID: PMC7425168 DOI: 10.1186/s12886-020-01601-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/06/2020] [Indexed: 11/12/2022] Open
Abstract
Background The purpose was to study the macular ganglion cell- inner plexiform layer (GC-IPL) thickness in healthy 6.5 year- old Swedish children using Optical Coherence Tomography (OCT) and to study topography symmetry within eyes and between eye pairs. Methods A total of 181 eyes of 92 healthy children (39 girls, 53 boys) aged 6.5 and serving as a term-born control group in the Extremely Preterm Infants in Sweden Study (EXPRESS), were examined with Cirrus HD-OCT. Main outcome measures were average and minimum values of GC-IPL thickness of the device’s predefined macular sectors. Single sectors, combined sectors defined as superior and inferior hemispheres and temporal and nasal sectors were evaluated. Intra-individual GC-IPL thickness between eye pairs was analyzed. Visual acuity, refraction and general cognition were assessed and correlated to GC-IPL outcome. Results Eighty-five children completed the OCT examination and 155 out of 181 scans (86%) were analyzed. The mean average GC-IPL thickness was 85.9 μm (± 5.3; 5th and 95th percentiles were 76.0 and 94.6 μm). The mean minimum GC-IPL thickness was 83.6 μm (± 4.9; 5th and 95th percentiles were 75.4 and 92.3 μm). The difference in thickness between nasal and temporal sectors and between superior and inferior hemisphere sectors were less than 2 μm. The difference between average GC-IPL thickness and minimum GC-IPL thickness was 2.3 μm (± 1.9; 5th and 95th percentiles were 0.0 and 6.0 μm). The difference between the thickest and thinnest sector within eye was 6.4 μm (± 2.2; 5th and 95th percentiles were 3.0 and 10.0 μm). There was a moderate correlation in the difference between the nasal combined and the temporal combined sectors within eye pairs (p < 0.0001, Spearman’s ρ 0.58). The average GC-IPL thickness was weakly positively correlated with SE (spherical equivalent; combined sphere and ½ cylinder) (p = 0.031, Spearman’s ρ 0.23). Conclusions This study provides normative GC-IPL thickness values for healthy 6.5 year- old Swedish children. The GC-IPL thickness variations within eyes and within eye pairs are generally small. It could therefore be assumed that larger variations are sensitive markers of focal GC-IPL thinning due to damage to the primary visual pathways in children.
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Affiliation(s)
- Urszula Arnljots
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Maria Nilsson
- Department of Clinical Neuroscience, Unit of Optometry, Karolinska Institutet, Stockholm, Sweden
| | - Ida Hed Myrberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Åden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Hellgren
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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27
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Bianchi-Marzoli S, Fenu S, Melzi L, Benzoni C, Antonazzo F, Tomas Roldan E, Farina L, Tremolada G, Mauro E, Pensato V, Gellera C, Pareyson D, Salsano E. Optical coherence tomography in adult adrenoleukodystrophy: a cross-sectional and longitudinal study. Neurol Sci 2020; 42:235-241. [PMID: 32632637 DOI: 10.1007/s10072-020-04576-2] [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: 02/23/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Adrenoleukodystrophy (ALD) encompasses different neurological phenotypes, ranging from the most severe cerebral forms (C-ALD) to the less severe adrenomyeloneuropathy (AMN). As visual system can be varyingly involved, we aimed at exploring whether optical coherence tomography (OCT) may detect retinal abnormalities and their longitudinal changes in adult ALD patients. METHODS In this cross-sectional and longitudinal study, we measured the thicknesses of peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell complex (mGCC), and segmented inner and outer macula at baseline and their changes over time in 11 symptomatic adult ALD males and 10 age- and sex-matched healthy controls. Statistical analyses were performed for the patients as complete group, and splitting them into two subgroups, one (C-ALD) with and the other (AMN) without cerebral parieto-occipital white matter (WM) lesions. RESULTS In the complete ALD group and in the C-ALD subgroup, the average pRNFL, mGCC, and inner macula were significantly thinner than in controls (p ≤ 0.01), whereas in the AMN subgroup, they were constantly, though non-significantly, thinner. Significant outer macula thinning was also observed (p < 0.01). In the complete ALD group, follow-up assessment (mean 26.8 months, range 8-48) showed mildly progressive thinning of inferior pRNFL, average mGCC, and inner macula. CONCLUSIONS In adult ALD patients, OCT can reveal retinal abnormalities which are prominent in the more compromised patients, namely those with parieto-occipital WM lesions. The inferior pRNFL, average mGCC and inner macula thicknesses might be sensitive-to-change OCT parameters, but their utility and consistency for short-term longitudinal studies deserve further investigations.
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Affiliation(s)
- Stefania Bianchi-Marzoli
- Neuro-ophthalmology Center and Ocular Electrophysiology Laboratory, Istituto Auxologico Italiano IRCCS Capitanio Hospital, Milan, Italy
| | - Silvia Fenu
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy
| | - Lisa Melzi
- Neuro-ophthalmology Center and Ocular Electrophysiology Laboratory, Istituto Auxologico Italiano IRCCS Capitanio Hospital, Milan, Italy
| | - Chiara Benzoni
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy
| | | | - Eugenia Tomas Roldan
- Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Laura Farina
- Unit of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Gemma Tremolada
- Neuro-ophthalmology Center and Ocular Electrophysiology Laboratory, Istituto Auxologico Italiano IRCCS Capitanio Hospital, Milan, Italy
| | - Elena Mauro
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy
| | - Viviana Pensato
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cinzia Gellera
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy
| | - Ettore Salsano
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy. .,Neuroscience PhD Program, University of Milano-Bicocca, Monza, Italy.
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Optical coherence tomography in mild cognitive impairment - Systematic review and meta-analysis. Clin Neurol Neurosurg 2020; 196:106036. [PMID: 32623211 DOI: 10.1016/j.clineuro.2020.106036] [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: 11/08/2019] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 11/23/2022]
Abstract
Thinning of retinal layers, measured using optical coherence tomography (OCT), is associated with some neurodegenerative disorders such as established Alzheimer's disease and multiple sclerosis. The evidence for retinal layer thinning in both mild cognitive impairment (MCI), a precursor of dementia, and delirium, a potential pre-clinical stage of neurodegenerative disorder, is unclear. We performed a systematic review of the associations, in older people, between retinal layer thickness changes (measured using OCT) and delirium or MCI compared to controls (Protocol registration ID (Prospero) CRD42019122165). We did not identify any relevant studies on delirium. This report is therefore a review of retinal nerve layer changes in mild cognitive impairment. Databases were searched using predetermined keywords such as mild cognitive impairment, retinal nerve fibre layer and delirium. Where there were sufficient data, meta-analyses were performed. Twenty-six relevant studies were identified on retinal layer thickness in people with MCI compared to controls. There was significant heterogeneity in the studies for all retinal layers investigated (retinal nerve fibre layer (RNFL), ganglion cell inner plexiform layer (GCIP), foveal thickness and macular volume). Analysis of 17 studies of mean RNFL thickness in MCI (n = 622) compared to controls (n = 1154), irrespective of the type of OCT device, demonstrated a significant thinning in MCI (SMD: - 0·42 and 95 % confidence interval: - 0·68 to - 0·16). This difference was non-significant when studies using only spectral-domain devices were analysed. Subgroup analysis of studies using spectral-domain devices in amnestic MCI diagnosed using comparable criteria, showed statistically significant thinning of RNFL in amnestic MCI (p = 0·02). Meta-analysis of foveal thickness did not show a significant difference between MCI and controls. In conclusion, there is some evidence of an association between retinal nerve fibre layer thinning and MCI. We found no data on the association between RNFL and delirium.
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Asanad S, Fantini M, Sultan W, Nassisi M, Felix CM, Wu J, Karanjia R, Ross-Cisneros FN, Sagare AP, Zlokovic BV, Chui HC, Pogoda JM, Arakaki X, Fonteh AN, Sadun A. A. AA, Harrington MG. Retinal nerve fiber layer thickness predicts CSF amyloid/tau before cognitive decline. PLoS One 2020; 15:e0232785. [PMID: 32469871 PMCID: PMC7259639 DOI: 10.1371/journal.pone.0232785] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background Alzheimer’s disease (AD) pathology precedes symptoms and its detection can identify at-risk individuals who may benefit from early treatment. Since the retinal nerve fiber layer (RNFL) is depleted in established AD, we tested whether its thickness can predict whether cognitively healthy (CH) individuals have a normal or pathological cerebrospinal fluid (CSF) Aß42 (A) and tau (T) ratio. Methods As part of an ongoing longitudinal study, we enrolled CH individuals, excluding those with cognitive impairment and significant ocular pathology. We classified the CH group into two sub-groups, normal (CH-NAT, n = 16) or pathological (CH-PAT, n = 27), using a logistic regression model from the CSF AT ratio that identified >85% of patients with a clinically probable AD diagnosis. Spectral-domain optical coherence tomography (OCT) was acquired for RNFL, ganglion cell-inner plexiform layer (GC-IPL), and macular thickness. Group differences were tested using mixed model repeated measures and a classification model derived using multiple logistic regression. Results Mean age (± standard deviation) in the CH-PAT group (n = 27; 75.2 ± 8.4 years) was similar (p = 0.50) to the CH-NAT group (n = 16; 74.1 ± 7.9 years). Mean RNFL (standard error) was thinner in the CH-PAT group by 9.8 (2.7) μm; p < 0.001. RNFL thickness classified CH-NAT vs. CH-PAT with 87% sensitivity and 56.3% specificity. Conclusions Our retinal data predict which individuals have CSF biomarkers of AD pathology before cognitive deficits are detectable with 87% sensitivity. Such results from easy-to-acquire, objective and non-invasive measurements of the RNFL merit further study of OCT technology to monitor or screen for early AD pathology.
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Affiliation(s)
- Samuel Asanad
- Doheny Eye Institute, Los Angeles, CA, United States of America
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Michele Fantini
- Doheny Eye Institute, Los Angeles, CA, United States of America
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
- Department of Medicine, Ophthalmology, University of Udine, Udine, Italy
| | - William Sultan
- Doheny Eye Institute, Los Angeles, CA, United States of America
| | - Marco Nassisi
- Doheny Eye Institute, Los Angeles, CA, United States of America
- Department of Clinical Sciences and Community Health, Ophthalmological Unit, IRCCS-Cà Granda Foundation—Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Christian M. Felix
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Jessica Wu
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Rustum Karanjia
- Doheny Eye Institute, Los Angeles, CA, United States of America
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
- Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Abhay P. Sagare
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Berislav V. Zlokovic
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Helena C. Chui
- Department of Neurology, University of Southern California, Los Angeles, CA, United States of America
| | - Janice M. Pogoda
- Cipher Biostatistics & Reporting, Reno, NV, United States of America
| | - Xianghong Arakaki
- Huntington Medical Research Institutes, Pasadena, CA, United States of America
| | - Alfred N. Fonteh
- Huntington Medical Research Institutes, Pasadena, CA, United States of America
| | - Alfredo A. Sadun A. A.
- Doheny Eye Institute, Los Angeles, CA, United States of America
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Michael G. Harrington
- Huntington Medical Research Institutes, Pasadena, CA, United States of America
- * E-mail:
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Ruiz Caro Larrea JM, Cabrejas Martínez L, Mahíllo Fernández I, Alonso Peralta MA, Jiménez-Alfaro Morote I. Agreement in retinal nerve fiber layer values and comparison in children using two optical coherence tomography devices. ACTA ACUST UNITED AC 2020; 95:171-177. [PMID: 32014298 DOI: 10.1016/j.oftal.2019.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess absolute agreement and differences in peripapillary retinal nerve fiber layer (pRNFL) values according to sex, age, laterality, origin and optical coherence tomography (OCT) type in normal pediatric patients undergoing OCT scans using both Cirrus and Spectralis. MATERIAL AND METHODS Prospective, cross-sectional, and comparative study. We used Spectralis OCT and Cirrus OCT to measure optic disc values of both eyes in one hundred pediatric patients (age 5 to 15years), with no previous ocular pathology or systemic disease that could affect the eye. Due to the similarity between eyes, only right eyes were considered (n=100). RESULTS The average peripapillary retinal nerve fiber layer (pRNFL) values were 99.6μm with Cirrus and 106.7μm with the Spectralis system. The four quadrants followed the ISNT rule (inferior-superior-nasal-temporal). The average pRNFL measures correlated negatively with the AL (P<.01) in both OCTs, and the degree of agreement between OCTs for pRNFL and inferior RNFL was moderate (CCI: 0.67 and 0.61, respectively), and low in the rest of the sectors. The average pRNFL values of both OCTs were higher in women than in men (P>.05) and there were also no statistical differences in the pRNFL according to age or laterality (P>.05). All RNFL values were significantly different between both types of OCTs (P<.05) and average pRNFL values were significantly thicker (P<.05) in Latin American than in European children in both eyes. CONCLUSIONS We suggest that the respective peripapillary RNFL values obtained using these two OCTs should not be considered interchangeable in pediatric patients.
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Affiliation(s)
- J M Ruiz Caro Larrea
- Servicio de Oftalmología, Fundación Jiménez Diaz University Hospital, Madrid, España.
| | - L Cabrejas Martínez
- Servicio de Oftalmología, Fundación Jiménez Diaz University Hospital, Madrid, España
| | - I Mahíllo Fernández
- Servicio de Oftalmología, Fundación Jiménez Diaz University Hospital, Madrid, España
| | - M A Alonso Peralta
- Servicio de Oftalmología, Fundación Jiménez Diaz University Hospital, Madrid, España
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Abstract
PURPOSE To develop a new structural algorithm derived from optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and asymmetry and validate it as a discriminate among normal, suspect, and early primary open-angle glaucoma (POAG). STUDY DESIGN A case-controlled observational clinical study. MATERIALS AND METHODS In total, 150 subjects (299 eyes) were selected, 61 normal, 46 suspect, and 43 early glaucoma, from Al-Azhar University Hospitals. They were in fifth decade and free from any ocular or systemic diseases affecting the retinal nerve fiber layer. They were investigated by two consecutive perimetry (1 month apart), and three scans of circumpapillary retinal nerve fiber layer (cpRNFL) by using Nidek spectral domain (SD)-OCT 3000 Lite. The cpRNFL thickness (cpRNFLT) and inter-eye asymmetry parameters were analyzed among the three groups. Then some selected parameters were selected and analyzed using a binary logistic regression analysis for developing the new algorithm. The new algorithm was tested for the best fitting, accuracy, and diagnostic ability among the three groups and was validated in the suspect group. RESULTS The new algorithm model [early glaucoma discrimination index (EGDI)] works well with only four variables; whole cpRNFLT, inferior quadrant cpRNFLT, inferotemporal clock hour (CH) cpRNFLT, and absolute inter-eye inferior quadrants asymmetry. The highest area under the curve (AUC) obtained from the EGDI among the three groups was 0.854. The validation analysis in the suspect group revealed a higher diagnostic ability in discrimination of early glaucoma with AUC of 0.989 (0.976-1.003). CONCLUSION The EGDI showed better diagnostic ability for diagnosis of glaucoma in the pre-perimetric stage. The new OCT algorithm is simple and can be run in any SD-OCT device without dependence on normative data. HOW TO CITE THIS ARTICLE Safwat H, Nassar E, Rashwan A. Early Glaucoma Discrimination Index. J Curr Glaucoma Pract 2020;14(1):16-24.
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Affiliation(s)
- Hend Safwat
- Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Elaraby Nassar
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Afaf Rashwan
- Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
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Kudsieh B, Fernandez-Vigo JI, De-Pablo-Gómez-de-Liaño L, Fernández-Vigo C, Ruiz Moreno JM, Fernández-Vigo JÁ. Agreement between Fourier-domain and swept-source optical coherence tomography used for optic nerve head measurements. J Fr Ophtalmol 2019; 43:25-30. [PMID: 31733916 DOI: 10.1016/j.jfo.2019.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/10/2019] [Accepted: 06/26/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To assess the correlation between optic nerve head measurements generated by Fourier-domain (FD) and swept-source (SS) optical coherence tomography (OCT) both in healthy Caucasian subjects and patients with primary open angle glaucoma (POAG). MATERIALS AND METHODS This was a cross-sectional study of the right eyes of 118 subjects. In each participant, the measurements of disc area, cup to disc ratio (CDR), vertical cup to disc ratio (VCDR), rim area and rim volume were performed consecutively by FD-OCT and then SS-OCT. Participant age, gender and spherical equivalent were also recorded. Agreement between the two devices was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS The study sample consisted of 95 healthy eyes and 23 eyes with glaucoma. Mean participant age was 48.6±20.0 years, 54.2% were female, and mean spherical equivalent was -1.6±3.0 diopters. FD-OCT and SS-OCT measurements were respectively: mean disc area 1.79±0.3 vs 1.83±0.3 mm2 (ICC=0.71), mean CDR 0.38±0.2 vs 0.33±0.2 (ICC=0.91), mean VCDR 0.58±0.2 vs 0.52±0.2 (ICC=0.92), mean rim area 1.05±0.4mm2 vs 1.03±0.5mm2 (ICC=0.29), and mean rim volume 0.14±0.11 vs 0.21±0.17mm3 (ICC=0.53). Good agreement between the devices was noted for rim area and rim volume in glaucoma subjects (ICC=0.76 and 0.68 respectively), while weak agreement was observed for these variables in healthy subjects (ICC≤0.50). CONCLUSIONS The CDR and VCDR measurements provided by FD and SS OCT showed excellent agreement for the overall sample. When the devices were used for rim measurements, agreement was excellent only in the POAG patients.
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Affiliation(s)
- B Kudsieh
- Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | - J I Fernandez-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Department of Ophthalmology, Hospital Clínico San-Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - L De-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Ophthalmology department, Hospital 12 de Octubre, Madrid, Spain
| | | | - J M Ruiz Moreno
- Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Ophthalmology department, Universidad de Extremadura, Badajoz, Spain
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Optical Coherence Tomography Angiography Macular Vascular Density Measurements and the Central 10-2 Visual Field in Glaucoma. J Glaucoma 2019; 27:481-489. [PMID: 29664832 DOI: 10.1097/ijg.0000000000000964] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the association between macula vascular density assessed by optical coherence tomography angiography (OCT-A) and central visual field (VF) threshold sensitivities in healthy, glaucoma suspect, and glaucoma patients. METHODS A total of 185 eyes from 38 healthy participants, 31 glaucoma suspects, 72 mild glaucoma patients, and 44 moderate/severe glaucoma patients from the Diagnostic Innovations in Glaucoma Study who underwent OCT-A images of the macula and 10-2 VF testing were enrolled in this observational cross-sectional study. The relationship between central VF mean sensitivity (MS) and superficial macula whole-image vessel density (wiVD), and the relationship between the MS of the 4 central points of the 10-2 VF (MS4) and parafoveal vessel density (pfVD), were assessed using linear regression models. RESULTS Mean wiVD (52.5%, 49.8%, 49.4% and 45.2%, respectively) and mean pfVD (54.9%, 52.1%, 51.8% and 47.7%, respectively) were found to be significantly higher in healthy eyes and glaucoma suspect eyes compared with glaucoma eyes with mild and moderate/severe disease [analysis of covariance (ANCOVA) P<0.001]. The univariate associations between 10-2 MS and wiVD (R=26.9%) and between 10-2 MS4 and pfVD (R=16.8%) were statistically significant (P<0.001 for both). After adjusting for scan quality, age, sex and intraocular pressure, superficial macula wiVD and pfVD were still independently associated with central VF loss. Macula wiVD performed better [area under the receiver operator characteristic (AUROC)=0.70] than ganglion cell complex thickness (AUROC=0.50) for differentiating between glaucoma suspect and healthy eyes (P=0.010). CONCLUSIONS Loss of OCT-A macula vessel density is associated with central 10-2 VF defects. Macula vessel density is a clinically relevant parameter that may enhance monitoring of glaucoma suspects and patients.
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Ghahari E, Bowd C, Zangwill LM, Proudfoot J, Hasenstab KA, Hou H, Penteado RC, Manalastas PIC, Moghimi S, Shoji T, Christopher M, Yarmohammadi A, Weinreb RN. Association of Macular and Circumpapillary Microvasculature with Visual Field Sensitivity in Advanced Glaucoma. Am J Ophthalmol 2019; 204:51-61. [PMID: 30878489 DOI: 10.1016/j.ajo.2019.03.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the association between optical coherence tomography angiography (OCTA) macular and circumpapillary vessel density and visual field mean deviation (MD) in advanced primary open angle glaucoma. DESIGN Cross-sectional study. METHODS Macula (superficial layer) and optic nerve head (ONH) with capillary density (CD) and without vessel density (VD) automated removal of large vessels OCTA of 34 eyes (34 patients, MD < -10 dB) were investigated as macula whole image VD (wiVD), parafoveal VD (pfVD), ONH wiVD, wiCD, circumpapillary VD, and cpCD. Spectral domain OCT circumpapillary retinal nerve fiber layer, macular ganglion cell complex, and ganglion cell inner plexiform layer were also analyzed. RESULTS Macular and ONH VD decreased significantly with worsening MD. Each 1-dB decrease in MD was associated with a reduction of 0.43% and 0.46% for macular wiVD and pfVD with R2 of 0.28 and 0.27, respectively (all P < .01). The association between MD and VD was strongest for measures of ONH with large vessels removed, wiCD, and cpCD, followed by wiVD and circumpapillary VD with R2 of 0.26, 0.22, 0.17, 0.14, and a VD reduction of 0.43%, 0.51%, 0.33%, and 0.40%, respectively (all P < .02). There was a reduction of 1.19 μm in Avanti parafoveal ganglion cell complex, 1.13 μm in Spectralis ganglion cell inner plexiform layer, and 1.01 μm in Spectralis circumpapillary retinal nerve fiber layer, with R2 of 0.19 (P = .006), 0.23 (P = .002), and 0.24 (P = .002), respectively. CONCLUSIONS ONH and macula OCTA VD and thickness are associated with the severity of visual field damage in advanced primary open angle glaucoma.
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Ogata NG, Boer ER, Daga FB, Jammal AA, Stringham JM, Medeiros FA. Visual Crowding in Glaucoma. Invest Ophthalmol Vis Sci 2019; 60:538-543. [PMID: 30716149 PMCID: PMC6361551 DOI: 10.1167/iovs.18-25150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Crowding refers to the phenomenon in which objects that can be recognized when viewed in isolation are unrecognizable in clutter. Crowding sets a fundamental limit to the capabilities of the peripheral vision and is essential in explaining performance in a broad array of daily tasks. Due to the effects of glaucoma on peripheral vision, we hypothesized that neural loss in the disease would lead to stronger effects of visual crowding. Methods Subjects were asked to discriminate the orientation of a target letter when presented with surrounding flankers. The critical spacing value (scritical), which was required for correct discrimination of letter orientation, was obtained for each quadrant of the visual field. scritical values were correlated with standard automated perimetry (SAP) mean sensitivity (MS) and optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness measurements. Results The study involved 13 subjects with mild glaucomatous visual field loss and 13 healthy controls. Glaucomatous eyes had significantly greater (worse) scritical than controls (170.4 ± 27.1 vs. 145.8 ± 28.0 minimum of visual angle, respectively; P = 0.007). scritical measurements were significantly associated with RNFL thickness measurements (R2 = 26%; P < 0.001) but not with SAP MS (P = 0.947). Conclusions In glaucoma patients, a pronounced visual crowding effect is observed, even in the presence of mild visual field loss on standard perimetry. scritical was associated with the amount of neural loss quantified by OCT. These results may have implications for understanding how glaucoma patients are affected in daily tasks where crowding effects may be significant.
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Affiliation(s)
- Nara G Ogata
- Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina, United States
| | - Erwin R Boer
- Entropy Control, La Jolla, California, United States
| | - Fábio B Daga
- Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina, United States
| | - Alessandro A Jammal
- Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina, United States
| | - James M Stringham
- Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina, United States
| | - Felipe A Medeiros
- Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina, United States
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Mailankody P, Lenka A, Pal PK. The role of Optical Coherence Tomography in Parkinsonism: A critical review. J Neurol Sci 2019; 403:67-74. [PMID: 31228766 DOI: 10.1016/j.jns.2019.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 05/11/2019] [Accepted: 06/09/2019] [Indexed: 12/21/2022]
Abstract
Optical coherence tomography (OCT) has been evaluated as a tool to assess retinal changes in various neurodegenerative disorders. Parkinson's disease (PD), is a neurodegenerative disorder wherein dopaminergic deficiency results in some of the symptoms. As retina also has high concentration of dopamine, it would be of interest for both the clinician as well as the basic scientist to know if there is a correlation between the clinical features and the retinal changes. The objective of this review is to critically evaluate the literature and study the utility of OCT as a tool to evaluate retinal changes in PD.
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Affiliation(s)
- Pooja Mailankody
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
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Yoon SP, Grewal DS, Thompson AC, Polascik BW, Dunn C, Burke JR, Fekrat S. Retinal Microvascular and Neurodegenerative Changes in Alzheimer's Disease and Mild Cognitive Impairment Compared with Control Participants. Ophthalmol Retina 2019; 3:489-499. [PMID: 31174670 PMCID: PMC6586560 DOI: 10.1016/j.oret.2019.02.002] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/30/2018] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Evaluate and compare the retinal microvasculature in the superficial capillary plexus (SCP) in Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively intact controls using OCT angiography. OCT parameters were also compared. DESIGN Cross-sectional study. PARTICIPANTS Seventy eyes from 39 AD participants, 72 eyes from 37 MCI participants, and 254 eyes from 133 control participants were enrolled. METHODS Participants were imaged using Zeiss Cirrus HD-5000 with AngioPlex (Carl Zeiss Meditec, Dublin, CA) and underwent cognitive evaluation with Mini-Mental State Examination. MAIN OUTCOME MEASURES Vessel density (VD) and perfusion density (PD) in the SCP within the Early Treatment Diabetic Retinopathy Study 6-mm circle, 3-mm circle, and 3-mm ring were compared between groups. Foveal avascular zone (FAZ) area, central subfield thickness (CST), macular ganglion cell-inner plexiform layer (GC-IPL) thickness, and peripapillary retinal nerve fiber layer (RNFL) thickness were also compared. RESULTS Alzheimer's participants showed significantly decreased SCP VD and PD in the 3-mm ring (P = 0.001 and P = 0.002, respectively) and 3-mm circle (P = 0.003 and P = 0.004, respectively) and decreased SCP VD in the 6-mm circle (P = 0.047) compared with MCI and significantly decreased SCP VD and PD in the 3-mm ring (P = 0.008 and P = 0.004, respectively) and 3-mm circle (P = 0.015 and P = 0.009, respectively) and SCP PD in the 6-mm circle (P = 0.033) when compared with cognitively intact controls. There was no difference in SCP VD or PD between MCI and controls (P > 0.05). FAZ area and CST did not differ significantly between groups (P > 0.05). Alzheimer's participants showed significantly decreased GC-IPL thickness over the inferior (P = 0.032) and inferonasal (P = 0.025) sectors compared with MCI and significantly decreased GC-IPL thickness over the entire (P = 0.012), superonasal (P = 0.041), inferior (P = 0.004), and inferonasal (P = 0.006) sectors compared to controls. MCI participants showed significantly decreased temporal RNFL thickness (P = 0.04) compared with controls. CONCLUSIONS Alzheimer's participants showed significantly reduced macular VD, PD, and GC-IPL thickness compared with MCI and controls. Changes in the retinal microvasculature may mirror small vessel cerebrovascular changes in AD.
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Affiliation(s)
- Stephen P Yoon
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Dilraj S Grewal
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Atalie C Thompson
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Bryce W Polascik
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Cynthia Dunn
- Department of Neurology, Duke University, Durham, North Carolina
| | - James R Burke
- Department of Neurology, Duke University, Durham, North Carolina
| | - Sharon Fekrat
- Department of Ophthalmology, Duke University, Durham, North Carolina.
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Li Z, Wen X, Zeng P, Liao Y, Fan S, Zhang Y, Li Y, Xiao J, Lan Y. Do microvascular changes occur preceding neural impairment in early-stage diabetic retinopathy? Evidence based on the optic nerve head using optical coherence tomography angiography. Acta Diabetol 2019; 56:531-539. [PMID: 30656435 DOI: 10.1007/s00592-019-01288-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/05/2019] [Indexed: 12/16/2022]
Abstract
AIMS To evaluate the microvascular and neural differences of the optic nerve head (ONH) between type 2 diabetes mellitus (T2DM) subjects and controls. METHODS This was a cross-sectional observational study. One hundred and eight eyes of 108 T2DM subjects with or without diabetic retinopathy (DR) (54 preclinical DR and 54 mild-to-moderate DR) were included. Fifty-two eyes of 52 healthy subjects were included as controls. The 4.5-mm Angio Disc scan mode and the ganglion cell complex scan mode were performed with all participants using AngioVue software 2.0 of the optical coherence tomography angiography (OCTA) device. RESULTS Regarding ONH radial peripapillary capillary (RPC) density, the peripapillary region was mainly significantly reduced in the No-DR (NDR) group. Moreover, the RPC density of the peripapillary region and the inside optic disc area were significantly reduced in the non-proliferative DR (NPDR) group. When compared to the controls, significantly reduced peripapillary capillary density in six sections was observed in the NPDR group. However, reduced density was observed in only two sections in the NDR group. The NPDR group had significantly increased focal loss volume (FLV) and reduced peripapillary RNFL thickness in the inferior nasal section compared to those in the controls, but similar changes were not observed in the NDR group. A regression model identified RPCs inside the optic disc as a significant parameter in early-stage DR detection. In the NPDR group, BCVA showed a significantly negative correlation with RPCs inside the optic disc and a significantly positive correlation with FLV. CONCLUSIONS OCTA findings of the ONH area may provide evidence that microvascular changes occur preceding neural impairment in early-stage DR. However, further researches are still needed to support the statement. Reduced ONH perfusion inside the optic disc may be one of the crucial biomarkers in early-stage DR detection and is a possible sensitive visual acuity predictor in early-stage DR subjects. With the ONH mode, OCTA may be a more promising tool in DR screening.
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Affiliation(s)
- Zijing Li
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Xin Wen
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Peng Zeng
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Yunru Liao
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Shuxian Fan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Yichi Zhang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Yuanjun Li
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Jianhui Xiao
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Yuqing Lan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
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Zacharias LC, Azevedo BM, de Araujo RB, Ciongoli MR, Hatanaka M, Preti RC, Monteiro MLR. Effect of panretinal photocoagulation on the peripapillary retinal nerve fiber layer in diabetic retinopathy patients. Clinics (Sao Paulo) 2019; 74:e1163. [PMID: 31778429 PMCID: PMC6844141 DOI: 10.6061/clinics/2019/e1163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 09/24/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To determine the effect of panretinal photocoagulation (PRP) on the peripapillary retinal nerve fiber layer (RNFL) in nonglaucomatous patients with proliferative diabetic retinopathy (PDR). METHODS This is a prospective, single center, observational study. Thirty-eight eyes of 26 diabetic patients underwent PRP for proliferative diabetic retinopathy. Peripapillary RNFL thickness was measured using scanning laser polarimetry (SLP) with variable corneal compensation (GDx VCC; by Carl Zeiss Meditec, Dublin, CA) and spectral-domain optical coherence tomography (OCT) (Heidelberg Spectralis, Carlsbad, USA) at baseline and 12 months after PRP was performed. RESULTS Thirty-eight eyes of 26 patients (15 female) with a mean age of 53.7 years (range 26 to 74 years) were recruited. No significant difference was found among all RNFL thickness parameters tested by GDx VCC software (p=0.952, 0.464 and 0.541 for temporal-superior-nasal-inferior-temporal (TSNIT) average, superior average, inferior average, respectively). The nerve fiber indicator (NFI) had a nonsignificant increase (p=0.354). The OCT results showed that the average RNFL thickness (360° measurement) decreased nonsignificantly from 97.2 mm to 96.0 mm at 1 year post-PRP (p=0.469). There was no significant difference when separately analyzing all the peripapillary sectors (nasal superior, temporal superior, temporal, temporal inferior, nasal inferior and nasal thickness). CONCLUSION Our results suggest that PRP, as performed in our study, does not cause significant changes in peripapillary RNFL in diabetic PDR patients after one year of follow-up.
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Affiliation(s)
- Leandro Cabral Zacharias
- Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Breno M.S. Azevedo
- Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rafael B. de Araujo
- Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marina R. Ciongoli
- Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcelo Hatanaka
- Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rony C. Preti
- Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Medeiros FA, Jammal AA, Thompson AC. From Machine to Machine: An OCT-Trained Deep Learning Algorithm for Objective Quantification of Glaucomatous Damage in Fundus Photographs. Ophthalmology 2018; 126:513-521. [PMID: 30578810 DOI: 10.1016/j.ophtha.2018.12.033] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/13/2018] [Accepted: 12/11/2018] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Previous approaches using deep learning (DL) algorithms to classify glaucomatous damage on fundus photographs have been limited by the requirement for human labeling of a reference training set. We propose a new approach using quantitative spectral-domain (SD) OCT data to train a DL algorithm to quantify glaucomatous structural damage on optic disc photographs. DESIGN Cross-sectional study. PARTICIPANTS A total of 32 820 pairs of optic disc photographs and SD OCT retinal nerve fiber layer (RNFL) scans from 2312 eyes of 1198 participants. METHODS The sample was divided randomly into validation plus training (80%) and test (20%) sets, with randomization performed at the patient level. A DL convolutional neural network was trained to assess optic disc photographs and predict SD OCT average RNFL thickness. MAIN OUTCOME MEASURES The DL algorithm performance was evaluated in the test sample by evaluating correlation and agreement between the predictions and actual SD OCT measurements. We also assessed the ability to discriminate eyes with glaucomatous visual field loss from healthy eyes with area under the receiver operating characteristic (ROC) curves. RESULTS The mean prediction of average RNFL thickness from all 6292 optic disc photographs in the test set was 83.3±14.5 μm, whereas the mean average RNFL thickness from all corresponding SD OCT scans was 82.5±16.8 μm (P = 0.164). There was a very strong correlation between predicted and observed RNFL thickness values (Pearson r = 0.832; R2 = 69.3%; P < 0.001), with mean absolute error of the predictions of 7.39 μm. The area under the ROC curves for discriminating glaucomatous from healthy eyes with the DL predictions and actual SD OCT average RNFL thickness measurements were 0.944 (95% confidence interval [CI], 0.912-0.966) and 0.940 (95% CI, 0.902-0.966), respectively (P = 0.724). CONCLUSIONS We introduced a novel DL approach to assess fundus photographs and provide quantitative information about the amount of neural damage that can be used to diagnose and stage glaucoma. In addition, training neural networks to predict SD OCT data objectively represents a new approach that overcomes limitations of human labeling and could be useful in other areas of ophthalmology.
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Affiliation(s)
- Felipe A Medeiros
- Vision, Imaging and Performance (VIP) Laboratory, Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina.
| | - Alessandro A Jammal
- Vision, Imaging and Performance (VIP) Laboratory, Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Atalie C Thompson
- Vision, Imaging and Performance (VIP) Laboratory, Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina
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Baek SU, Kim KE, Kim YK, Park KH, Jeoung JW. Development of Topographic Scoring System for Identifying Glaucoma in Myopic Eyes. Ophthalmology 2018; 125:1710-1719. [DOI: 10.1016/j.ophtha.2018.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 12/30/2022] Open
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Normative Database and Color-code Agreement of Peripapillary Retinal Nerve Fiber Layer and Macular Ganglion Cell-inner Plexiform Layer Thickness in a Vietnamese Population. J Glaucoma 2018; 27:665-673. [DOI: 10.1097/ijg.0000000000001001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Patel SB, Reddy N, Lin X, Whitson JT. Optical coherence tomography retinal nerve fiber layer analysis in eyes with long axial lengths. Clin Ophthalmol 2018; 12:827-832. [PMID: 29765196 PMCID: PMC5939921 DOI: 10.2147/opth.s162023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the relationship between axial length (AL) and retinal nerve fiber layer (RNFL) profile and to characterize differences in optical coherence tomography RNFL of myopic glaucomatous eyes compared to nonglaucomatous eyes. Methods Retrospective chart review of 170 eyes of 89 subjects with optical biometry and optical coherence tomography RNFL assessment was conducted. Results Temporal RNFL thickness showed no association with AL in either glaucomatous or nonglaucomatous eyes. Nasal thinning was most strongly associated with glaucoma in myopic eyes. Both myopic glaucomatous and nonglaucomatous eyes had a mean RNFL thickness of 16-22 µm thinner than mean RNFL thickness of normal AL eyes. Conclusion An average of 16-22 µm thinning of RNFL compared to nomogram can be tolerated in patients with long AL. Prominent nasal thinning likely represents changes from axial elongation. Temporal RNFL thinning in those with long AL tends to be mild, and significant thinning should raise suspicion for glaucoma.
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Affiliation(s)
- Sagar B Patel
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Nisha Reddy
- Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Xihui Lin
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Jess T Whitson
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, TX, USA
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Lee YG, Hwang YH. A Comparison of Retinal Nerve Fiber Layer Thickness Measured Using Five Different Optical Coherence Tomography Devices. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.3.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Youn Gon Lee
- Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Young Hoon Hwang
- Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
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Avoiding Clinical Misinterpretation and Artifacts of Optical Coherence Tomography Analysis of the Optic Nerve, Retinal Nerve Fiber Layer, and Ganglion Cell Layer. J Neuroophthalmol 2017; 36:417-438. [PMID: 27636747 PMCID: PMC5113253 DOI: 10.1097/wno.0000000000000422] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Optical coherence tomography (OCT) has become an important tool for diagnosing optic nerve disease. The structural details and reproducibility of OCT continues to improve with further advances in technology. However, artifacts and misinterpretation of OCT can lead to clinical misdiagnosis of diseases if they go unrecognized. Evidence Acquisition: A literature review using PubMed combined with clinical and research experience. Results: We describe the most common artifacts and errors in interpretation seen on OCT in both optic nerve and ganglion cell analyses. We provide examples of the artifacts, discuss the causes, and provide methods of detecting them. In addition, we discuss a systematic approach to OCT analysis to facilitate the recognition of artifacts and to avoid clinical misinterpretation. Conclusions: While OCT is invaluable in diagnosing optic nerve disease, we need to be cognizant of the artifacts that can occur with OCT. Failure to recognize some of these artifacts can lead to misdiagnoses and inappropriate investigations.
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Kara-José AC, Melo LAS, Esporcatte BLB, Endo ATNH, Leite MT, Tavares IM. The disc damage likelihood scale: Diagnostic accuracy and correlations with cup-to-disc ratio, structural tests and standard automated perimetry. PLoS One 2017; 12:e0181428. [PMID: 28727836 PMCID: PMC5519156 DOI: 10.1371/journal.pone.0181428] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
Our objective was to compare the diagnostic accuracies of and to determine the correlations between the disc damage likelihood scale (DDLS) and anatomical and functional tests used for glaucoma detection. A total of 54 healthy subjects (54 eyes) and 47 primary open-angle glaucoma patients (47 eyes) were included in this cross-sectional observational study. DDLS scores and cup-to-disc (C/D) ratios were evaluated. Subjects underwent standard automated perimetry (SAP), optic disc and retinal nerve fiber layer (RNFL) imaging with time and spectral-domain optical coherence tomography (TD and SD-OCT), Heidelberg Retina Tomograph (HRT II), and scanning laser polarimetry (GDx-VCC). Areas under the receiver operating characteristic curves (AROCs) for DDLS and diagnostic tests parameters were calculated. DDLS correlations (Spearman's rank) among these parameters were analyzed. Fifty-four eyes were healthy and 47 had glaucoma, including 16 preperimetric glaucoma. DDLS, vertical and horizontal C/D ratios had the largest AROCs (0.92, 0.94 and 0.91, respectively). DDLS diagnostic accuracy was better than the accuracies of HRT II parameters, TD and SD-OCT RNFL thicknesses, and SAP mean deviation (MD) index. There were no significant differences between the accuracies of the DDLS and the C/D ratios, TD-OCT vertical (0.89) and horizontal (0.86) C/D ratios, TD-OCT C/D area ratio (0.89), and GDx-VCC NFI (0.81). DDLS showed significant strong correlations with vertical (r = 0.79) and horizontal (0.74) C/D ratios, and with the parameters vertical C/D ratio and C/D area ratio from HRT II (both 0.77) and TD-OCT (0.75 and 0.72, respectively). DDLS had significant moderate correlations with most of the other structural measurements and SAP MD. The optic disc clinical evaluation with DDLS system and C/D ratio demonstrated excellent accuracy in distinguishing glaucomatous from healthy eyes. DDLS had moderate to strong correlations with most structural and functional parameters. These findings stress the importance of optic disc clinical examination to detect glaucoma in a clinical scenario.
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Affiliation(s)
- Andrea C. Kara-José
- Glaucoma Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
- * E-mail:
| | - Luiz Alberto S. Melo
- Glaucoma Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
| | - Bruno L. B. Esporcatte
- Glaucoma Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
| | - Angelica T. N. H. Endo
- Glaucoma Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
| | - Mauro Toledo Leite
- Glaucoma Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ivan Maynart Tavares
- Glaucoma Division, Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
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Agrawal A, Baxi J, Calhoun W, Chen CL, Ishikawa H, Schuman JS, Wollstein G, Hammer DX. Optic Nerve Head Measurements With Optical Coherence Tomography: A Phantom-Based Study Reveals Differences Among Clinical Devices. Invest Ophthalmol Vis Sci 2017; 57:OCT413-20. [PMID: 27409500 PMCID: PMC4968925 DOI: 10.1167/iovs.15-18738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Optical coherence tomography (OCT) can monitor for glaucoma by measuring dimensions of the optic nerve head (ONH) cup and disc. Multiple clinical studies have shown that different OCT devices yield different estimates of retinal dimensions. We developed phantoms mimicking ONH morphology as a new way to compare ONH measurements from different clinical OCT devices. Methods Three phantoms were fabricated to model the ONH: One normal and two with glaucomatous anatomies. Phantoms were scanned with Stratus, RTVue, and Cirrus clinical devices, and with a laboratory OCT system as a reference. We analyzed device-reported ONH measurements of cup-to-disc ratio (CDR) and cup volume and compared them with offline measurements done manually and with a custom software algorithm, respectively. Results The mean absolute difference between clinical devices with device-reported measurements versus offline measurements was 0.082 vs. 0.013 for CDR and 0.044 mm3 vs. 0.019 mm3 for cup volume. Statistically significant differences between devices were present for 16 of 18 comparisons of device-reported measurements from the phantoms. Offline Cirrus measurements tended to be significantly different from those from Stratus and RTVue. Conclusions The interdevice differences in CDR and cup volume are primarily caused by the devices' proprietary ONH analysis algorithms. The three devices yield more similar ONH measurements when a consistent offline analysis technique is applied. Scan pattern on the ONH also may be a factor in the measurement differences. This phantom-based study has provided unique insights into characteristics of OCT measurements of the ONH.
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Affiliation(s)
- Anant Agrawal
- Division of Biomedical Physics Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Jigesh Baxi
- Division of Biomedical Physics Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, United States
| | - William Calhoun
- Division of Biomedical Physics Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Chieh-Li Chen
- Department of Ophthalmology, University of Pittsburgh School of Medicine, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States 3Department of Bioengineering, Swanson School of En
| | - Hiroshi Ishikawa
- Department of Ophthalmology, University of Pittsburgh School of Medicine, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States 3Department of Bioengineering, Swanson School of En
| | - Joel S Schuman
- Department of Ophthalmology, University of Pittsburgh School of Medicine, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States 3Department of Bioengineering, Swanson School of En
| | - Gadi Wollstein
- Department of Ophthalmology, University of Pittsburgh School of Medicine, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States 3Department of Bioengineering, Swanson School of En
| | - Daniel X Hammer
- Division of Biomedical Physics Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, United States
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Chen CL, Ishikawa H, Wollstein G, Bilonick RA, Kagemann L, Schuman JS. Signal Normalization Reduces Image Appearance Disparity Among Multiple Optical Coherence Tomography Devices. Transl Vis Sci Technol 2017; 6:13. [PMID: 28275528 PMCID: PMC5338476 DOI: 10.1167/6.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/09/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the effect of the previously reported optical coherence tomography (OCT) signal normalization method on reducing the discrepancies in image appearance among spectral-domain OCT (SD-OCT) devices. Methods Healthy eyes and eyes with various retinal pathologies were scanned at the macular region using similar volumetric scan patterns with at least two out of three SD-OCT devices at the same visit (Cirrus HD-OCT, Zeiss, Dublin, CA; RTVue, Optovue, Fremont, CA; and Spectralis, Heidelberg Engineering, Heidelberg, Germany). All the images were processed with the signal normalization. A set of images formed a questionnaire with 24 pairs of cross-sectional images from each eye with any combination of the three SD-OCT devices either both pre- or postsignal normalization. Observers were asked to evaluate the similarity of the two displayed images based on the image appearance. The effects on reducing the differences in image appearance before and after processing were analyzed. Results Twenty-nine researchers familiar with OCT images participated in the survey. Image similarity was significantly improved after signal normalization for all three combinations (P ≤ 0.009) as Cirrus and RTVue combination became the most similar pair, followed by Cirrus and Spectralis, and RTVue and Spectralis. Conclusions The signal normalization successfully minimized the disparities in the image appearance among multiple SD-OCT devices, allowing clinical interpretation and comparison of OCT images regardless of the device differences. Translational Relevance The signal normalization would enable direct OCT images comparisons without concerning about device differences and broaden OCT usage by enabling long-term follow-ups and data sharing.
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Affiliation(s)
- Chieh-Li Chen
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA ; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hiroshi Ishikawa
- NYU Langone Eye Center, New York University School of Medicine, New York, New York, USA
| | - Gadi Wollstein
- NYU Langone Eye Center, New York University School of Medicine, New York, New York, USA
| | - Richard A Bilonick
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Larry Kagemann
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA ; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joel S Schuman
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA ; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA ; NYU Langone Eye Center, New York University School of Medicine, New York, New York, USA
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Bowd C, Zangwill LM, Weinreb RN, Medeiros FA, Belghith A. Estimating Optical Coherence Tomography Structural Measurement Floors to Improve Detection of Progression in Advanced Glaucoma. Am J Ophthalmol 2017; 175:37-44. [PMID: 27914978 DOI: 10.1016/j.ajo.2016.11.010] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE "Floor effects" in retinal imaging are defined as the points at which no further structural loss can be detected. We estimated the measurement floors for spectral-domain optical coherence tomography (SDOCT) measurements and compared global change over time in advanced glaucoma eyes. DESIGN Validity study to investigate measurement floors. METHODS A longitudinal "Variability group" of 41 eyes with moderate to advanced glaucoma (standard automated perimetry mean deviation ≤-8 dB) was used to estimate measurement floors. Minimum rim width (MRW), ganglion cell-inner plexiform layer thickness (GC-IPLT), and circumpapillary retinal nerve fiber layer thickness (cpRNFLT) were determined. Floors were defined as the average image area with a loss less than first-percentile confidence interval of the variability in this group. Global rate of change and percentage of the region of interest that did not reach the measurement floor at baseline were calculated in 87 eyes with advanced glaucoma (SAP MD ≤-12 dB). RESULTS Global change over time in longitudinal eyes was -1.51 μm/year for MRW, -0.21 μm/year for GC-IPL, and -0.36 μm/year cpRNFL (all P ≤ .03). The percentage of region of interest that did not reach the floor at baseline was 19% for MRW, 36% for GC-IPLT, and 14% for cpRNFLT. Average (± standard deviation) floors were 105 μm (± 15.9 μm) for MRW, 38 μm (± 3.4 μm) for GC-IPLT, and 38 μm (± 4.2 μm) for cpRNFLT. CONCLUSIONS In advanced glaucoma, more GC-IPL tissue remains above the measurement floor compared with other measurements, suggesting GC-IPL thickness is the better candidate for detecting progression. Progression in SDOCT measurements is observable in advanced disease.
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Arıkan S, Erşan İ, Eroğlu M, Yılmaz M, Tufan HA, Gencer B, Kara S, Aşık M. Does Retinal Neurodegeneration Seen in Diabetic Patients Begin in the Insulin Resistance Stage? Turk J Ophthalmol 2017; 46:264-269. [PMID: 28050322 PMCID: PMC5177782 DOI: 10.4274/tjo.68888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/09/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To investigate whether retinal neurodegeneration and impairment in contrast sensitivity (CS), which have been demonstrated to begin in diabetic patients before the presence of signs of diabetic retinal vasculopathy, also occur in the stage of insulin resistance. MATERIALS AND METHODS The average, minimum and sectoral (inferior, superior, inferonasal, superonasal, inferotemporal and superotemporal) thicknesses of the ganglion cell-inner plexiform layer (GCIPL) measured using optical coherence tomography were compared between an insulin-resistant group and control group in order to evaluate the presence of retinal neurodegeneration. The CS of the two groups was also compared according to the logarithmic values measured at spatial frequencies of 1.5, 3, 6, 12 and 18 cycles per degree in photopic light using functional acuity contrast test (FACT). RESULTS Twenty-five eyes of 25 patients with insulin resistance (insulin resistant group) and 25 eyes of 25 healthy subjects (control group) were included in this study. There were no statistically significant differences between the two groups in any of the spatial frequencies in the FACT. The mean average GCIPL thickness and mean GCIPL thickness in the inferotemporal sector were significantly less in the insulin-resistant group when compared with the control group (mean average GCIPL thicknesses in the insulin-resistant and control groups were 83.6±4.7 µm and 86.7±3.7 µm respectively, p=0.01; mean inferotemporal GCIPL thicknesses in the insulin-resistant and control groups were 83±6.0 µm and 86.7±4.6 µm respectively, p=0.02). CONCLUSION Although it may not lead to functional visual impairment such as CS loss, the retinal neurodegeneration seen in diabetic patients may begin in the insulin resistance stage.
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Affiliation(s)
- Sedat Arıkan
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey
| | - İsmail Erşan
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey
| | - Mustafa Eroğlu
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Endocrinology and Metabolism, Çanakkale, Turkey
| | - Mehmet Yılmaz
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey
| | - Hasan Ali Tufan
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey
| | - Baran Gencer
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey
| | - Selçuk Kara
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey
| | - Mehmet Aşık
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Endocrinology and Metabolism, Çanakkale, Turkey
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