June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Detection of Open Angle Glaucoma with Patient-Specific Macular Structural Measurements
Author Affiliations & Notes
  • Sami Kabbara
    Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
    Medicine, University of Arizona College of Medicine, Phoenix, Phoenix, Arizona, United States
  • Linda M Zangwill
    Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Christopher Bowd
    Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Felipe Medeiros
    Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Robert N Weinreb
    Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Akram Belghith
    Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Footnotes
    Commercial Relationships   Sami Kabbara, None; Linda Zangwill, Carl Zeiss Meditec Inc. (F), GmbH (F), Heidelberg Engineering GmbH (F), National Eye Institute (F), Optovue Inc. (F), Topcon Medical Systems Inc. Quark (F); Christopher Bowd, None; Felipe Medeiros, Alcon (C), Allergan (C), Bausch & Lomb Inc. (C), Bausch+Lomb (F), Carl-Zeiss Meditec (F), Carl-Zeiss Meditec: (C), GmbH (C), Heidelberg Engineering (F), Heidelberg Engineering (C), National Eye Institute (F), Optovue (F), Reichert (C), Reichert (F), Topcon (F), Valeant Pharmaceuticals (C); Robert Weinreb, Aerie Pharmaceutical (C), Alcon (C), Bausch+Lomb (C), Carl Zeiss Meditec (C), Carl Zeiss Meditec (F), Eyenovia (C), Forsight Vision V (C), Genentech (F), Heidelberg Engineering (F), Optovue (F), Quark (F), Sensimed (C), Topcon (F), Unity (C); Akram Belghith, None
  • Footnotes
    Support  NIH EY11008, P30 EY022589, EY026590 P30EY022589 and participant retention incentive grants in the form of glaucoma medication at no cost from Alcon Laboratories Inc, Allergan, Pfizer Inc, and Santen Inc.Unrestricted grant from Research to Prevent Blindness, New York, New York
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 710. doi:
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    • Get Citation

      Sami Kabbara, Linda M Zangwill, Christopher Bowd, Felipe Medeiros, Robert N Weinreb, Akram Belghith; Detection of Open Angle Glaucoma with Patient-Specific Macular Structural Measurements. Invest. Ophthalmol. Vis. Sci. 2017;58(8):710.

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

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Abstract

Purpose : Glaucomatous damage is most commonly interpreted using ONH based markers, however, growing evidence have shown the role of macular indices in the assessment of glaucoma. In this study, we compare new cubic grid with the standard circular grid scan pattern, as well as test our new Bayesian method in identifying patient-specific structural measures in differentiating between healthy and glaucoma eyes.

Methods : Fifty-six healthy eyes and 73 glaucoma eyes (mean visual field mean deviation= -3.7dB) were included. Spectralis OCT cubic grid macular scans were analyzed in 2 ways; as a 4mm x 4mm with an excluded center of 1.5mm x 1.5mm, and as the standard circular grid scans with a diameter of 3.45mm. The minimum ganglion cell layer (GCL) and the ganglion cell-inner plexiform layer (GCIPL) thicknesses of the 4 quadrants of the cube grid takes into account the subject’s defect location, the minimum thickness measurement that corresponds to the edge of the structural defect. In addition, Bayesian methods were used to calculate the probability of each structural parameter for discriminating between healthy and OAG eyes. Variables with higher probabilities were selected as the best input for the classifier which allowed us to select individual-based defect locations and structural measurements with the best discrimination ability. Area under the receiver operating characteristic (AUROC) curves were used to compare the diagnostic accuracy of Bayesian selection methods and different macular thickness measurements.

Results : The cubic grid (Figure 1A) when compared to the standard circular grid showed improved discrimination between healthy and OAG eyes for both GCIPL and GCL thickness measurements. The AUROC of the 1) minimum thickness measures had similar diagnostic accuracy to 2) global mean values for both GCL (1) AUROC: 0.92 and 2) 0.91, respectively (p-value=0.08) and GCIPL (1) AUROC: 0.92 and 2) 0.91, respectively (p-value=0.10). However, using the Bayesian selection of the best measurements, we obtained significantly better discrimination (AUROC=0.94) than mean GCL or GCIPL alone (p-value=0.02) (Figure 1B).

Conclusions : The new macular cubic grid scan facilitates the identification of patient-specific structural measures and can improve the diagnostic power of OAG detection compared to the standard methods.

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

 

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