June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Diagnostic accuracy of inner retinal layer thickness and reflectance intensity measurements assessed in 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
  • Juan Reynaud
    Devers Eye Institute Optic Nerve Head Research Laboratory, 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
  • 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
  • Xiue Jiang
    Devers Eye Institute Optic Nerve Head Research Laboratory, 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 Nicolela
    Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • 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
  • Stuart Keith Gardiner
    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), oclar therapeutics (C); Jayme Vianna, None; Marcelo Nicolela, None; Balwantray Chauhan, CenterVue (F), Heidelberg Engineering (F), Heidelberg Engineering (C), Topcon (F); Claude Burgoyne, Heidelberg Engineering (F), Heidelberg Engineering (C); Stuart Gardiner, None; Brad Fortune, None
  • Footnotes
    Support  R01-EY02128, Legacy Good Samaritan Foundation
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1836. doi:
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      Hongli Yang, Juan Reynaud, Glen P Sharpe, Dawn Jennings, Cindy Albert, Galen Williams, Xiue Jiang, Shaban Demirel, Steven L Mansberger, Jayme R Vianna, Marcelo Nicolela, Balwantray C Chauhan, Claude F Burgoyne, Stuart Keith Gardiner, Brad Fortune; Diagnostic accuracy of inner retinal layer thickness and reflectance intensity measurements assessed in posterior pole OCT scans of healthy and glaucomatous eyes. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1836.

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

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Abstract

Purpose : To determine whether quantifying reflectance intensity in addition to layer thickness improves the ability to discriminate glaucomatous (GL) from healthy control (HC) eyes.

Methods : Posterior pole OCT scans (Spectralis, Heidelberg Engineering GmbH) were obtained in 188 GL and 360 HC eyes (61 B-scans, 768 A-lines each, spanning a 30°× 25° area). GL eyes were defined as having 24-2 visual field (VF) pattern standard deviation or glaucoma hemifield test outside normal limits on 2 consecutive tests. Automated segmentations within each B-scan were manually corrected when necessary. Mean thickness and intensity values for each A-line were measured for nerve fiber layer (NFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). These intensity values were also normalized using the average value of the 7-pixels corresponding to the retinal pigmented epithelial (RPE) layer to generate axially (vertically) normalized (AN) intensity. Values were age-adjusted using the HC eyes. The average thickness, intensity and AN intensity values were calculated and used to create receiver operating characteristic (ROC) curves. Logistic regression models were used to assess whether intensity added additional diagnostic power.

Results : The median VF mean deviation in the GL eyes was -4.37 dB. The highest univariate areas under the ROC curve (AUROC) were for NFL thickness (NFLT: 0.916) and intensity (0.903, Table 1). The AUROC for GCL thickness (GCLT) was significantly smaller (0.882) than for NFLT (p=0.04), comparable to NFL intensity (p=0.24), but higher than all other parameters (all p<0.001). NFL intensity (p<0.001), NFLT (p<0.001) and GCLT (p=0.01) were significant predictors of the probability of having glaucoma. Addition of NFL intensity to thickness significantly improved this prediction (p<0.001). A model also including GCLT had higher AUROC (0.958) than any other combination (all p < 0.02, Figure 1).

Conclusions : In this group of mostly early GL eyes, the best diagnostic predictors were NFLT, NFL intensity, and GCLT. Current axial normalization of intensity values to RPE reflectance did not enhance diagnostic accuracy. Macular NFL reflectance intensity provides diagnostic information beyond thickness values alone and may have pathophysiological significance.

This is a 2021 ARVO Annual Meeting abstract.

 

 

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