June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
An evaluation of common methods for detecting progression of early glaucoma with optical coherence tomography
Author Affiliations & Notes
  • Ashley Sun
    Psychology, Columbia University, New York, New York, United States
  • Emmanouil Tsamis
    Psychology, Columbia University, New York, New York, United States
  • Melvi Del Valle Eguia
    New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Jeffrey M Liebmann
    Ophthalmology, Columbia University, New York, New York, United States
  • Dana Blumberg
    Ophthalmology, Columbia University, New York, New York, United States
  • Lama A Al-Aswad
    NYU Langone Eye Center, NYU School of Medicine, New York, New York, United States
  • George A Cioffi
    Ophthalmology, Columbia University, New York, New York, United States
  • C Gustavo De Moraes
    Ophthalmology, Columbia University, New York, New York, United States
  • Donald C Hood
    Psychology, Columbia University, New York, New York, United States
    Ophthalmology, Columbia University, New York, New York, United States
  • Footnotes
    Commercial Relationships   Ashley Sun, None; Emmanouil Tsamis, Topcon Inc. (R); Melvi Eguia, None; Jeffrey Liebmann, Carl Zeiss (C), Heidelberg Eng (C), Heidelberg Eng (S), Topcon (C); Dana Blumberg, None; Lama Al-Aswad, Aries (C), Carl Zeiss (F), Globechek (I), Google (C), New World Medical (F), Save Vision Foundation (F), Topcon (F); George Cioffi, None; C Gustavo De Moraes, Belite (C), Carl Zeiss (C), Galimedix (C), Heidelberg Eng (R), National Institutes of Health (R), Novartis (C), Perfuse Therapeutics (C), Reichert (C), Research to Prevent Blindness (R), Topcon (R); Donald Hood, Heidelberg Eng (F), Heidelberg Eng (C), Heidelberg Eng (R), Novartis (C), Novartis (F), Topcon (F), Topcon (C), Topcon (R)
  • Footnotes
    Support  EY-025253, EY-02115
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3928. doi:
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    • Get Citation

      Ashley Sun, Emmanouil Tsamis, Melvi Del Valle Eguia, Jeffrey M Liebmann, Dana Blumberg, Lama A Al-Aswad, George A Cioffi, C Gustavo De Moraes, Donald C Hood; An evaluation of common methods for detecting progression of early glaucoma with optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3928.

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

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Abstract

Purpose : To evaluate optical coherence tomography (OCT) methods for detecting progression of early glaucoma using a clinically relevant reference standard.

Methods : Widefield swept-source OCT scans (Topcon) from 151 eyes with an average of 3.5 [range 2-5] scans within 6 months formed a short-term group. 49 were healthy controls (H), and 102 eyes were glaucomatous or glaucoma suspects. Of these 151 eyes, 104 (76 patients, 28 H eyes) had another OCT scan at least 1 year after their baseline scan (mean: 24.9±8.7 months); these scans formed the long-term group. Circumpapillary retinal nerve fiber layer (cRNFL) thicknesses from a derived 3.45-mm circle centered on the optic disc and retinal ganglion cell (RGC) thicknesses from a ±8° region around the fovea were obtained from every scan. Global cRNFL (G) and global RGC (Gmac) average thicknesses were calculated. Quantile regression was applied on the G and Gmac metrics, with the independent variable being the baseline values and dependent variable all the follow-up values in the short-term group. Thus, we determined the lower 95% limit of each metric. The long-term group values were then compared to those limits. Eyes that fell below the 95% limit were classified as “statistical progressors.” For a progression reference standard (P-RS), 4 experts evaluated all OCT and 24-2 and 10-2 VF information, including OCT reports with probability maps (Fig. 1).

Results : 24 (G) and 26 (Gmac) of the 76 patient eyes, and 2 (G) and 6 (Gmac) of the 28 H eyes, were classified as “statistical progressors” (Fig. 2). For the P-RS, 28 of the 76 eyes were identified as progressors, while none of the H eyes were progressors. Only 10 of these 28 eyes were identified as statistical progressors on both G and Gmac, while 4 of the 28 were missed by both metrics (Fig. 2), although the OCT maps showed clear progression (Fig. 1, arrows). Further, based on the P-RS, G and/or Gmac metrics falsely identified 13 eyes as statistical progressors. An analysis of the OCTs for these false positives (FP) showed segmentation errors and/or reduced contrast as the cause, rather than progression.

Conclusions : For detecting progression, the common metrics G and Gmac can lead to FPs due to scanning artifacts. Most importantly, G or Gmac metrics can miss eyes with clear signs of progression when assessed by a clinically relevant P-RS that includes RGC and RNFL probability maps.

This is a 2020 ARVO Annual Meeting abstract.

 

 

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