June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Three-Dimensional Bruch’s Membrane Shape Change Over Time with Acetazolamide Treatment in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT)
Author Affiliations & Notes
  • Jui-Kai Wang
    Electrical & Computer Eng, University of Iowa, Iowa City, Iowa, United States
  • Caitlin M Danielson
    Electrical & Computer Eng, University of Iowa, Iowa City, Iowa, United States
  • Randy Kardon
    Center for the Prevention and Treatment of Visual Loss, Iowa City VA Health System, Iowa City, Iowa, United States
    Ophthalmology and Medicine, University of Iowa, Iowa City, Iowa, United States
  • Patrick A Sibony
    Ophthalmology, State University of NY at Stony Brook/UHMC, Stony Brook, New York, United States
  • Mark J Kupersmith
    Mount Sinai West Hospital and NYEEI, New York, New York, United States
  • Mona K Garvin
    Center for the Prevention and Treatment of Visual Loss, Iowa City VA Health System, Iowa City, Iowa, United States
    Electrical & Computer Eng, University of Iowa, Iowa City, Iowa, United States
  • Footnotes
    Commercial Relationships   Jui-Kai Wang, None; Caitlin Danielson, None; Randy Kardon, Acorda (C), Department of Veterans Affairs Research Foundation, Iowa City, IA (S), Fight for Sight (S), Novartis (C); Patrick Sibony, None; Mark Kupersmith, None; Mona Garvin, The University of Iowa (P)
  • Footnotes
    Support   U10 EY017281­01A1, U10 EY017387­01A1, 3U10EY01728101A1S1, R01 EY023279
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4308. doi:
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      Jui-Kai Wang, Caitlin M Danielson, Randy Kardon, Patrick A Sibony, Mark J Kupersmith, Mona K Garvin; Three-Dimensional Bruch’s Membrane Shape Change Over Time with Acetazolamide Treatment in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Invest. Ophthalmol. Vis. Sci. 2017;58(8):4308.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We demonstrated that the Bruch’s membrane (BM) shape change from toward the vitreous to away from vitreous over time is more significant with treatment of diet+acetazolamide (ACZ) than diet+placebo using a 2D BM shape model in IIHTT; next, we extended the 2D BM shape model into a 3D version (Wang et al. ARVO 2015, 2016). In this work, after applying the 3D shape model to the IIHTT data, we further analyzed the 3D shape change over time and the treatment effect.

Methods : The 3D BM and BM opening (BMO) contour was first segmented in each spectral-domain optical coherence tomography (SD-OCT) optic-nerve-head (ONH) volumetric scan using our prior approach. Next, on the pre-segmented BM surface, 288 landmarks were placed along the obtained BMO contour; for every 10o, eight equidistant landmarks were chosen covering 1.5 mm in the radial direction. The flowchart is shown in Fig. 1. By applying principal component analysis (PCA), the first component coefficient was computed to quantify the BM shape change towards/away from the vitreous in 3D (Fig. 2a).

Results : In the IIHTT OCT sub-study, of the 116 right eyes used to generate the baseline 3D BM shape model, 56 subjects had successfully registered ONH and HD raster scans at all study visits. In the ACZ (n=31) group, the 3D BM shape showed significant change after 3 months (p<0.05); the mean change from baseline to 3 (6) months was 0.32±0.94 (0.61±1.02). In the placebo group (n=25), the mean shape change from baseline to 3 (6) months was 0.08±0.51 (0.11±0.64); no significant changes over time (Fig. 2b). The mean 3D BM shape change from baseline to 6 months in the ACZ group was significantly greater than in the placebo group (p<0.01).

Conclusions : BM shape measures in 2D and 3D are highly correlated (ρ=0.81, p<0.01) and have been shown as potential biomarkers of successful treatment of papilledema. The 3D shape measure, compared to the 2D version, has an additional advantage of consolidating 3D information. Developing a fully-automated method and incorporating more principal components from the 3D BM shape models constitute future efforts.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Fig. 1 Flowchart of generating 3D BM shape models

Fig. 1 Flowchart of generating 3D BM shape models

 

Fig. 2 (a) 3D BM shape model variations (b) the 3D shape measures in ACZ/placebo groups at baseline, three and six months

Fig. 2 (a) 3D BM shape model variations (b) the 3D shape measures in ACZ/placebo groups at baseline, three and six months

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