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Li-Han LY, Eizenman M, Shi RB, Buys YM, Trope GE, Wong W. Using Fused Data from Perimetry and Optical Coherence Tomography to Improve the Detection of Visual Field Progression in Glaucoma. Bioengineering (Basel) 2024; 11:250. [PMID: 38534524 DOI: 10.3390/bioengineering11030250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Perimetry and optical coherence tomography (OCT) are both used to monitor glaucoma progression. However, combining these modalities can be a challenge due to differences in data types. To overcome this, we have developed an autoencoder data fusion (AEDF) model to learn compact encoding (AE-fused data) from both perimetry and OCT. The AEDF model, optimized specifically for visual field (VF) progression detection, incorporates an encoding loss to ensure the interpretation of the AE-fused data is similar to VF data while capturing key features from OCT measurements. For model training and evaluation, our study included 2504 longitudinal VF and OCT tests from 140 glaucoma patients. VF progression was determined from linear regression slopes of longitudinal mean deviations. Progression detection with AE-fused data was compared to VF-only data (standard clinical method) as well as data from a Bayesian linear regression (BLR) model. In the initial 2-year follow-up period, AE-fused data achieved a detection F1 score of 0.60 (95% CI: 0.57 to 0.62), significantly outperforming (p < 0.001) the clinical method (0.45, 95% CI: 0.43 to 0.47) and the BLR model (0.48, 95% CI: 0.45 to 0.51). The capacity of the AEDF model to generate clinically interpretable fused data that improves VF progression detection makes it a promising data integration tool in glaucoma management.
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Affiliation(s)
- Leo Yan Li-Han
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Moshe Eizenman
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Runjie Bill Shi
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3E2, Canada
| | - Yvonne M Buys
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada
| | - Graham E Trope
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada
| | - Willy Wong
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON M5S 3G4, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3E2, Canada
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Nishida T, Weinreb RN, Arias J, Vasile C, Moghimi S. Comparison of the TEMPO binocular perimeter and Humphrey field analyzer. Sci Rep 2023; 13:21189. [PMID: 38040803 PMCID: PMC10692178 DOI: 10.1038/s41598-023-48105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
This study compared between TEMPO, a new binocular perimeter, with the Humphrey Field Analyzer (HFA). Patients were tested with both TEMPO 24-2 Ambient Interactive Zippy Estimated by Sequential Testing (AIZE)-Rapid and HFA 24-2 Swedish Interactive Threshold Algorithm (SITA)-Fast in a randomized sequence on the same day. Using a mixed-effects model, visual field (VF) parameters and reliability indices were compared. Retinal nerve fiber layer (RNFL) thickness was measured using Cirrus optical coherence tomography (OCT), and coefficient of determinations for VF and OCT parameters were calculated and compared using Akaike information criteria. 740 eyes (including 68 healthy, 262 glaucoma suspects, and 410 glaucoma) of 370 participants were evaluated. No significant differences were seen in mean deviation and visual field index between the two perimeters (P > 0.05). A stronger association between VF mean sensitivity (dB or 1/L) and circumpapillary RNFL was found for TEMPO (adjusted R2 = 0.25; Akaike information criteria [AIC] = 5235.5 for dB, and adjusted R2 = 0.29; AIC = 5200.8 for 1/L, respectively) compared to HFA (adjusted R2 = 0.22; AIC = 5263.9 for dB, and adjusted R2 = 0.22; AIC = 5262.7 for 1/L, respectively). Measurement time was faster for TEMPO compared to HFA (261 s vs. 429 s, P < 0.001). Further investigations are needed to assess the long-term monitoring potential of this binocular VF test.
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Affiliation(s)
- Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, 9500 Campus Point Drive, La Jolla, CA, 92093-0946, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, 9500 Campus Point Drive, La Jolla, CA, 92093-0946, USA
| | - Juan Arias
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, 9500 Campus Point Drive, La Jolla, CA, 92093-0946, USA
| | - Cristiana Vasile
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, 9500 Campus Point Drive, La Jolla, CA, 92093-0946, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, 9500 Campus Point Drive, La Jolla, CA, 92093-0946, USA.
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Nishida T, Weinreb R, Arias J, Vasile C, Moghimi S. Comparison of the TEMPO Binocular Perimeter and Humphrey Field Analyzer. RESEARCH SQUARE 2023:rs.3.rs-3283528. [PMID: 37693597 PMCID: PMC10491334 DOI: 10.21203/rs.3.rs-3283528/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
This study compared between TEMPO, a new binocular perimeter, with the Humphrey Field Analyzer (HFA). Patients were tested with both TEMPO 24 - 2 AIZE-Rapid and HFA 24 - 2 SITA-Fast in a randomized sequence on the same day. Using a mixed-effects model, visual field (VF) parameters and reliability indices were compared. Retinal nerve fiber layer (RNFL) thickness was measured using Cirrus OCT, and coefficient of determinations for visual field and OCT parameters were calculated and compared using Akaike information criteria. 740 eyes (including 68 healthy, 262 glaucoma suspects, and 410 glaucoma) of 370 participants were evaluated. No significant differences were seen in mean deviation and visual field index between the two perimeters (P > 0.05). A stronger association between VF mean deviation and circumpapillary RNFL was found for TEMPO (adjusted R2 = 0.28; AIC = 5210.9) compared to HFA (adjusted R2 = 0.26; AIC = 5232.0). TEMPO had better reliability indices (fixation loss, false positive, and false negative) compared to HFA (all P < 0.05). Measurement time was faster for TEMPO compared to HFA (261sec vs. 429sec, P < 0.001). Further investigations are needed to assess the long-term monitoring potential of this binocular VF test.
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Affiliation(s)
- Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego
| | - Robert Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego
| | - Juan Arias
- Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego
| | - Cristiana Vasile
- Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego
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Ganglion Cell Complex Analysis: Correlations with Retinal Nerve Fiber Layer on Optical Coherence Tomography. Diagnostics (Basel) 2023; 13:diagnostics13020266. [PMID: 36673076 PMCID: PMC9858609 DOI: 10.3390/diagnostics13020266] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
The aim of this review is to analyze the correlations between the changes in the ganglion cell complex (GCC) and the retinal nerve fiber layer (RNFL) on optical coherence tomography in different possible situations, especially in eyes with glaucoma. For glaucoma evaluation, several studies have suggested that in the early stages, GCC analysis, especially the thickness of the infero and that of the inferotemporal GCC layers, is a more sensitive examination than circumpapillary RNFL (pRNFL). In the moderate stages of glaucoma, inferior pRNFL thinning is better correlated with the disease than in advanced cases. Another strategy for glaucoma detection is to find any asymmetry of the ganglion cell-inner plexiform layers (GCIPL) between the two macular hemifields, because this finding is a valuable indicator for preperimetric glaucoma, better than the RNFL thickness or the absolute thickness parameters of GCIPL. In preperimetric and suspected glaucoma, GCC and pRNFL have better specificity and are superior to the visual field. In advanced stages, pRNFL and later, GCC reach the floor effect. Therefore, in this stage, it is more useful to evaluate the visual field for monitoring the progression of glaucoma. In conclusion, GCC and pRNFL are parameters that can be used for glaucoma diagnosis and monitoring of the progression of the disease, with each having a higher accuracy depending on the stage of the disease.
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Young SL, Jain N, Tatham AJ. The application of advanced imaging techniques in glaucoma. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Su Ling Young
- Princess Alexandra Eye Pavilion, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Nikhil Jain
- Addenbrooke’s Hospital, Cambridge University Hospitals NHS trust, Cambridge, UK
| | - Andrew J Tatham
- Princess Alexandra Eye Pavilion, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Online circular contrast perimetry via a web-application: optimising parameters and establishing a normative database. Eye (Lond) 2022; 37:1184-1190. [PMID: 35577922 PMCID: PMC9109437 DOI: 10.1038/s41433-022-02085-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To establish a normative database and optimise parameters for personal-computer based perimetry via a web-application using circular contrast targets. METHODS Online 24-degree 52-loci perimetry was delivered through a web-application using circular flickering contrast targets. Embedding contrast differentials within targets allows calculation of relative decibel (rdB) per 256-bit greyscale level differential. Target light-band maximum brightness colour was fixed, while the dark-band varied to achieve the desired rdB level. A staircase system was used with two reversals ranging from 0 to 36 rdB levels. Blind spot localisation at the start of the test was used to optimise viewing distance and subsequently count fixation losses. Gaze was maintained on a spinning golden star which moves mid-test to maximise sampling area. Patients performed the test to each eye separately using a computer in a darkened room at 40-45 cm. RESULTS 158 eyes of 101 patients completed the Online Circular Contrast Perimetry (OCCP) test. Mean age was 62.9 ± 14.3 years old. Mean sensitivity reduced with age, at 1.0 relative decibel per decade. Mean sensitivity per locus correlated with standard automated perimetry (SAP) in a physiological hill of vision, with an average difference of 4.02 decibels (95% confidence interval (CI) = 3.77-4.27, p < 0.001) and good agreement between tests. CONCLUSIONS Online circular contract perimetry provides accurate perimetric testing with comparable results to standard automated perimetry.
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Brusini P. Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma. J Clin Med 2021; 10:4414. [PMID: 34640431 PMCID: PMC8509816 DOI: 10.3390/jcm10194414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. MATERIAL AND METHODS In this study, 283 patients with chronic open-angle glaucoma (OAG) at different stages and 67 healthy subjects were tested with both standard automated perimetry and spectral domain OCT for retinal nerve fiber layer (RNFL) assessment. The visual field data were classified using the Glaucoma Staging System 2, whereas OCT results were processed with the OCT Glaucoma Staging System. These data were used to create a new staging system (global glaucoma staging system, GGSS), in which the severity of visual field and RNFL damage is reported on the Y and X axis, respectively. The GGSS was tested in a different sample of 147 patients with manifest OAG, 56 with preperimetric glaucoma and 43 normal subjects. A six-stage clinical classification, based on the analysis of visual fields and optic disc appearance, was used as gold standard. RESULTS The GGSS was able to correctly classify in the same stage or within the immediately adjacent stages 145 cases on 147 (98.6%). Fifty-four preperimetric cases (96.4%) were classified as borderline or abnormal (Stage 1 or 2). Here, 41 normal eyes out of 43 were correctly classified as Stage 0, with a specificity of 95.3%. CONCLUSIONS Preliminary results from this study are encouraging and suggest that the new GGSS is able to provide information concerning the severity of structural and functional damage in an integrated manner.
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Affiliation(s)
- Paolo Brusini
- Department of Ophthalmology Health Clinic "Città di Udine", 33100 Udine, Italy
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