Vessel-inpainted Retinal Nerve Fiber Layer Photography for Diagnosis of Glaucoma

Abstract

Purpose : To assess the diagnostic value of vessel-inpainted retinal nerve fiber layer (RNFL) photographs for glaucoma compared with that of conventional ones.

Methods : Conventional RNFL photographs were retrospectively collected from participants (with or without glaucoma) who had undergone the RNFL imaging test at Seoul National University Hospital (SNUH) between January 2015 and December 2022. A large mask inpainting (LaMa) technique was applied to the conventional photographs to generate vessel-inpainted RNFL images, and both types of the images were evaluated by eight ophthalmology trainees with different levels of experience (senior or junior ophthalmologists), with a washout period between sessions. The diagnostic accuracy and efficiency, as measured with mean time to diagnosis, of the trainees were calculated.

Results : A total of 124 conventional RNFL photographs of glaucomatous or normal eyes (62 images each) were obtained, from which the vessel-inpainted RNFL photographs have been generated. Overall, the trainees achieved high level of accuracy for differentiating glaucoma and normal eyes, with either vessel-inpainted or conventional RNFL photographs (0.86 ± 0.05 and 0.89 ± 0.05 respectively, p = 0.23). The mean time to diagnosis was shorter with the vessel-inpainted RNFL photographs, though without statistical significance (12.32 ± 3.17 vs. 13.69 ± 5.34 sec, p = 0.52). The same trend was found when analyzing in the subgroup of junior ophthalmologists, with marked decrement of the mean time to diagnosis using the vessel-inpainted RNFL photographs (11.77 ± 3.30 vs. 15.06 ± 7.28 sec).

Conclusions : Vessel-inpainted RNFL photography would help clinicians to diagnose glaucoma efficiently, which could be utilized as a diagnostic support tool in clinical practice.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Representative images of conventional and vessel-inpainted retinal nerve fiber layer (RNFL) photographs. Conventional RNFL photograph of a 42-year-old female patient diagnosed with glaucomatous optic neuropathy in the right eye revealed a wedge-shaped RNFL defect in the infero-temporal area (Fig A). Upon applying a large mask inpainting (LaMa) technique, a vessel-inpainted RNFL photograph has been generated (Fig B).