June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Diagnostic accuracy of individual and combined retinal layer thickness measurements assessed at each pixel within posterior pole OCT scans of healthy and glaucomatous eyes
Author Affiliations & Notes
  • Hongli Yang
    Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Juan Reynaud
    Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Glen P Sharpe
    Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Dawn Jennings
    Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Cindy Albert
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Galen Williams
    Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Xiue Jiang
    Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Shaban Demirel
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Steven L Mansberger
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Jayme R Vianna
    Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Marcelo T Nicolela
    Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Stuart Keith Gardiner
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Balwantray C Chauhan
    Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Claude F Burgoyne
    Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Brad Fortune
    Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Hongli Yang, None; Juan Reynaud, None; Glen Sharpe, None; Dawn Jennings, None; Cindy Albert, None; Galen Williams, None; Xiue Jiang, None; Shaban Demirel, None; Steven Mansberger, Allergan Research (C), Nicox (C), ocular therapeutics (C); Jayme Vianna, None; Marcelo Nicolela, None; Stuart Gardiner, None; Balwantray Chauhan, Allergan (C), CenterVue (F), Heidelberg Engineering (F), Heidelberg Engineering (C), Topcon (F); Claude Burgoyne, Heidelberg Engineering (C), Heidelberg Engineering (F); Brad Fortune, None
  • Footnotes
    Support  R01-EY02128, Legacy Good Samaritan Foundation
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3935. doi:
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    • Get Citation

      Hongli Yang, Juan Reynaud, Glen P Sharpe, Dawn Jennings, Cindy Albert, Galen Williams, Xiue Jiang, Shaban Demirel, Steven L Mansberger, Jayme R Vianna, Marcelo T Nicolela, Stuart Keith Gardiner, Balwantray C Chauhan, Claude F Burgoyne, Brad Fortune; Diagnostic accuracy of individual and combined retinal layer thickness measurements assessed at each pixel within posterior pole OCT scans of healthy and glaucomatous eyes. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3935.

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

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Abstract

Purpose : To compare the ability of individual and combined inner retinal layer thickness measurements to discriminate glaucomatous (GL) from healthy control (HC) eyes on a pixel-by-pixel basis.

Methods : GL eyes were included if 24-2 visual field (VF) pattern standard deviation or glaucoma hemifield test was outside normal limits on 2 consecutive tests. Posterior pole OCT scans (Spectralis, Heidelberg Engineering, GmbH) were obtained in 188 GL and 355 HC eyes (61 B-scans, 768 A-lines each, spanning total area of 30°×25° centered on the fovea and oriented parallel to the Fovea-Bruch’s Membrane Opening (FoBMO) axis. Segmentations within each B-scan were manually corrected and thickness values were measured for individual inner retinal layers: nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), as well as for the ganglion cell complex (GCC) and the total neural retina (TR). Values at each pixel were adjusted to the mean age and FoBMO distance of HC eyes. For each eye, the number of pixels with thickness values <5th percentile of the HC distribution was used to create a receiver operating characteristic (ROC) curve for each layer and for layer combinations.

Results : The median VF mean deviation (MD) in GL was -4.37 dB (range: −27.0 to 0.72 dB). The individual inner retinal layers with the highest area under the ROC curve (AUROC) were the NFL and GCL; IPL performance was significantly lower (Table 1, Fig 1). GCC had a slightly (but not significantly) higher AUROC (94.4%) than either NFL or GCL (92.8% and 92.6%), but GCC accuracy was significantly higher than IPL (86.9%) and TR (90.5%). The highest AUROC (94.8%) was found for a combination criterion NFL or GCL, which had 83% sensitivity at 95% specificity.

Conclusions : Using pixel-based thickness measurements, the diagnostic accuracy of the NFL and GCL exceeded that of IPL and TR. GCC had marginally higher AUROC than NFL but lower sensitivity at 95% specificity. Boolean combinations of individual layers provided only a modest (and statistically insignificant) improvement in diagnostic accuracy. The best posterior pole OCT parameters were comparable to minimum rim width and peripapillary NFL in a similar cohort (Yang et al AJO in press). Combining anatomic sites in a topographically linked manner may further improve the diagnostic accuracy of OCT in glaucoma.

This is a 2020 ARVO Annual Meeting abstract.

 

 

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