June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Agreement between trend-based and qualitative analysis of the retinal nerve fiber layer thickness for glaucoma progression on Spectral domain-optical coherence tomography
Author Affiliations & Notes
  • Atalie C. Thompson
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Ang Li
    Ophthalmology, Cleveland Clinic, Cleveland, Ohio, United States
  • Sanjay Asrani
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Footnotes
    Commercial Relationships   Atalie Thompson, None; Ang Li, None; Sanjay Asrani, Heidelber engineering (R)
  • Footnotes
    Support  NIH/NEI grant 1K23EY030897-01
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1830. doi:
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      Atalie C. Thompson, Ang Li, Sanjay Asrani; Agreement between trend-based and qualitative analysis of the retinal nerve fiber layer thickness for glaucoma progression on Spectral domain-optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1830.

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

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Abstract

Purpose : To evaluate the agreement between trend-based analysis versus qualitative assessment of the retinal nerve fiber layer (RNFL) thickness for glaucomatous progression on Spectral domain-optical coherence tomography (SDOCT).

Methods : Retrospective cohort of 190 eyes from 103 patients with glaucoma or glaucoma suspect diagnoses who underwent SDOCT imaging during 4 different clinic visits. Trend-based progression was characterized by a significantly negative slope. Progression by qualitative analysis was determined by review of RNFL thickness profiles from automated segmentation and raw B-scan SDOCT images.

Results : The slope was significantly greater in those with progression than without progression for both trend-based and qualitative analysis (p<0.001). However, the qualitative grading classified a significantly greater proportion of eyes as progressing compared to trend-based analysis in both the superotemporal (ST) RNFL (23.2% vs. 10.5%, p=0.001) and inferotemporal (IT) RNFL (27.4% vs 8.4%, p<0.001). The trend-based and qualitative classifications of progression showed poor agreement in both the ST (Kappa 0.0135) and IT RNFL (Kappa 0.1222). The agreement between trend-based and qualitative analysis was lower among eyes with artifacts (ST 58.11%; IT 68.7%) than those without artifacts (ST 80.2%; 74.8% IT). Moreover, among eyes with artifacts, there was no significant difference in slope between those qualitatively categorized as progressing versus not progressing (p>0.05). The figure shows an example of false progression on SDOCT due to vitreomacular traction release.

Conclusions : There is poor agreement between a trend-based definition of glaucoma progression and qualitative analysis of the change in RNFL on SDOCT. Careful qualitative review of SDOCT imaging may identify specific areas of glaucoma progression that are not captured by trend-based methods especially in the presence of artifacts.

This is a 2021 ARVO Annual Meeting abstract.

 

The left panels show a red area of change in the RNFL profile of the ST and IT quadrants. The bottom right panel also shows a significantly negative slope by trend-based analysis. However, qualitative assessment of the raw optical coherence tomography B-scans in the upper right panels demonstrate that the change is due to a release of vitreous traction (red arrows) and is thus an example of false progression.

The left panels show a red area of change in the RNFL profile of the ST and IT quadrants. The bottom right panel also shows a significantly negative slope by trend-based analysis. However, qualitative assessment of the raw optical coherence tomography B-scans in the upper right panels demonstrate that the change is due to a release of vitreous traction (red arrows) and is thus an example of false progression.

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