May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Glaucomatous Progression in Series of Stereo-Paired Photographs and Heidelberg Retinal Tomography Images
Author Affiliations & Notes
  • N. O'Leary
    Optometry and Visual Science, City University, London, United Kingdom
  • S. L. Mansberger
    Discoveries in Sight, Devers Eye Institute, Portland, Oregon
  • M. D. Twa
    College of Optometry, University of Houston, Houston, Texas
  • B. A. Fortune
    Discoveries in Sight, Devers Eye Institute, Portland, Oregon
  • M. J. Lloyd
    Discoveries in Sight, Devers Eye Institute, Portland, Oregon
  • G. A. Cioffi
    Discoveries in Sight, Devers Eye Institute, Portland, Oregon
  • C. A. Johnson
    Discoveries in Sight, Devers Eye Institute, Portland, Oregon
  • D. F. Garway-Heath
    Glaucoma Research Unit, Moorfields Eye Hospital, London, United Kingdom
  • D. P. Crabb
    Optometry and Visual Science, City University, London, United Kingdom
  • Footnotes
    Commercial Relationships  N. O'Leary, None; S.L. Mansberger, None; M.D. Twa, None; B.A. Fortune, None; M.J. Lloyd, None; G.A. Cioffi, None; C.A. Johnson, None; D.F. Garway-Heath, Carl Zeiss Meditec, F; Heidelberg Engineering, F; Carl Zeiss Meditec, C; Carl Zeiss Meditec, R; D.P. Crabb, None.
  • Footnotes
    Support  NIH K23EY016225 (MDT); NEI Grant EY-03424 (CAJ)
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 5431. doi:
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      N. O'Leary, S. L. Mansberger, M. D. Twa, B. A. Fortune, M. J. Lloyd, G. A. Cioffi, C. A. Johnson, D. F. Garway-Heath, D. P. Crabb; Glaucomatous Progression in Series of Stereo-Paired Photographs and Heidelberg Retinal Tomography Images. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5431.

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Abstract

Purpose: : Examining change over time as detected by automated analysis of longitudinal series of Heidelberg Retinal Tomography (HRT) images of the Optic Nerve Head (ONH) and making comparisons with the assessments, by glaucoma specialists, of change over time in stereo-paired photography of the same ONHs.

Methods: : Baseline and follow-up stereo-paired photographs and their corresponding HRT series of 107 eyes from 62 patients were selected from those of 336 eyes of 168 patients1. The principal criteria of sufficiently long, good quality HRT series (at least 6 follow-up visits over at least 6 years duration) and the follow-up photograph being taken contemporary to or after the last HRT image acquisition was used for selection. Statistic Image Mapping (SIM, Patterson et al 2005 IOVS 46: 1659-67.), Topographic Change Analysis (TCA) and linear regression of optic disc Rim Area (RA) were applied to all 107 HRT series. Type and location of progressive damage were determined in the stereo-paired photographs as was sectoral location of change in TCA and SIM defined by the location of centre of largest flagged cluster.

Results: : Using the expert assessments of progression in the stereo-paired photographs as a reference standard, HRT analysis had sample specificity and sensitivity of 83% and 34% (SIM), 73% and 36% (TCA), 82% and 40% (linear regression of RA). Sectoral location agreement between SIM and TCA was 67% and for SIM, TCA and RA change at 53%. Out of those eyes flagged as progressing the type of change, as assessed from stereo-photographs most frequently detected by SIM, TCA and linear regression of RA was notching (29%), rim thinning (38%) and rim thinning (42%) respectively.

Conclusions: : The ability of automated techniques in detecting similar significant glaucomatous progressive damage as measured by glaucoma specialists in stereo-paired photographs is poor but the agreement between methods of automated HRT progression analysis is good. This study suggests that analyses of HRT series and expert assessed stereo-paired photographs provides largely independent information about glaucomatous change. The results illustrate the difficulty of comparing methods to detect structural progression in glaucoma in the absence of a gold-standard.1. Mansberger et al (2007). Invest Ophthalmol Vis Sci 48: E-Abstract 3338.

Keywords: optic disc • imaging/image analysis: clinical • microscopy: confocal/tunneling 
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