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Dikmetas O, Gungor G, Kapucu Y, Kocabeyoglu S, Kadayıfcılar S, Eldem B, Karahan S, Cankaya AB. Short-term Effect of Macular Edema on the Peripapillary Retinal Nerve Fiber Layer in Patients with Wet Age-Related Macular Degeneration and Diabetic Macular Edema: A Comparative Study. Photodiagnosis Photodyn Ther 2023; 42:103602. [PMID: 37169170 DOI: 10.1016/j.pdpdt.2023.103602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/19/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND The combined presence of glaucoma and age-related macular degeneration (ARMD), or glaucoma and diabetes mellitus (DM), occur fairly frequently, especially in elderly patients. This study was intended to compare the effect of resolving macular edema due to DM and wet ARMD on peripapillary retinal nerve fiber layer (RNFL) thickness. METHODS This cross-sectional study included 76 patients with macular edema secondary to DM (n = 40, 52.6%) or wet ARMD (n = 36, 47.4%). The control group was comprised of 34 age and sex-matched healthy subjects. All study participants underwent evaluation of central macular thickness (CMT) and the peripapillary RNFL using spectral domain-optical coherence tomography (SD-OCT). Data from eyes that received an anti-VEGF injection were obtained one month after the procedure and were compared with pre-injection data. RESULTS The average initial thickness of the global peripapillary RNFL was 98.9 ±16.7 (61-163) µm in the macular edema group and 92.0±16.0 (84-115) µm in the control group (p = 0.045). The post-injection global peripapillary RNFL thickness was 97.3 ±19.0 (61-163) µm in the macular edema group and 92.2±18.0 (81-126) µm in the control group (p = 0.187). In the DM group, the changes in global RNFL thickness, as well as central and temporal quadrant thicknesses, were found to correlate significantly with the change in CMT (r = 0.356, p = 0.024; r = 0.545, p < 0.001, respectively). CONCLUSIONS Macular edema in wet ARMD appeared not to affect RNFL thickness. Differences in the etiology of macular edema can have varied effects on peripapillary RNFL. It is recommended that peripapillary RNFL thickness be evaluated cautiously in DM patients receiving intravitreal anti-VEGF therapy.
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Affiliation(s)
- Ozlem Dikmetas
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey..
| | - Gulce Gungor
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Yasemin Kapucu
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Kocabeyoglu
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Kadayıfcılar
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Bora Eldem
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ali Bülent Cankaya
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
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A Tool for High-Resolution Volumetric Optical Coherence Tomography by Compounding Radial-and Linear Acquired B-Scans Using Registration. SENSORS 2022; 22:s22031135. [PMID: 35161880 PMCID: PMC8839892 DOI: 10.3390/s22031135] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 12/02/2022]
Abstract
Optical coherence tomography (OCT) is a medical imaging modality that is commonly used to diagnose retinal diseases. In recent years, linear and radial scanning patterns have been proposed to acquire three-dimensional OCT data. These patterns show differences in A-scan acquisition density across the generated volumes, and thus differ in their suitability for the diagnosis of retinal diseases. While radial OCT volumes exhibit a higher A-scan sampling rate around the scan center, linear scans contain more information in the peripheral scan areas. In this paper, we propose a method to combine a linearly and radially acquired OCT volume to generate a single compound volume, which merges the advantages of both scanning patterns to increase the information that can be gained from the three-dimensional OCT data. We initially generate 3D point clouds of the linearly and radially acquired OCT volumes and use an Iterative Closest Point (ICP) variant to register both volumes. After registration, the compound volume is created by selectively exploiting linear and radial scanning data, depending on the A-scan density of the individual scans. Fusing regions from both volumes with respect to their local A-scan sampling density, we achieve improved overall anatomical OCT information in a high-resolution compound volume. We demonstrate our method on linear and radial OCT volumes for the visualization and analysis of macular holes and the surrounding anatomical structures.
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Poon LYC, Antar H, Tsikata E, Guo R, Papadogeorgou G, Freeman M, Khoueir Z, Lee R, Shieh E, Simavli H, Que CJ, de Boer JF, Chen TC. Effects of Age, Race, and Ethnicity on the Optic Nerve and Peripapillary Region Using Spectral-Domain OCT 3D Volume Scans. Transl Vis Sci Technol 2018; 7:12. [PMID: 30510856 PMCID: PMC6262887 DOI: 10.1167/tvst.7.6.12] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/20/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the effects of age, race, and ethnicity on the optic nerve and peripapillary retina using spectral-domain optical coherence tomography (SD-OCT) three-dimensional (3D) volume scans in normal subjects. Methods This is a cross-sectional study performed at a single institution in Boston. All patients received retinal nerve fiber layer (RNFL) scans and an optic nerve 3D volume scan. The SD-OCT software calculated peripapillary RNFL thickness, retinal thickness (RT), and retinal volume (RV). Custom-designed software calculated neuroretinal rim minimum distance band (MDB) thickness and area. Results There were 272 normal subjects, including 175 whites, 40 blacks, 40 Asians, and 17 Hispanics. Rates of age-related decline were 2.3%, 2.0%, 1.7%, 3.3%, and 4.3% per decade for RNFL, RT, RV, MDB neuroretinal rim thickness, and MDB area, respectively. The RNFL was most affected by racial and ethnic variations, with Asians having thicker global, superior, and inferior RNFL, Hispanics having thicker inferior RNFL, and blacks having thinner temporal RNFL, compared to whites. For MDB thickness and area, Asians had smaller nasal values and blacks had smaller temporal values. Peripapillary RT and RV parameters were not influenced by race and ethnicity. Conclusions All of the parameters exhibited age-related declines. RNFL, MDB thickness, and MDB area demonstrated racial and ethnic variations, while peripapillary RT and RV did not. Translational Relevance This study demonstrates that both normal aging and ethnicity affect several novel 3D OCT parameters used to diagnose and monitor glaucoma (i.e., RT, RV, and MDB), and this should be factored in when making clinical decisions based on these parameters.
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Affiliation(s)
- Linda Yi-Chieh Poon
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hussein Antar
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,University of Massachusetts Medical School, Worcester, MA, USA
| | - Edem Tsikata
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Rong Guo
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Department of Medicine, University of California, Los Angeles, CA, USA
| | - Georgia Papadogeorgou
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Statistical Science, Duke University, Durham, NC, USA
| | - Madeline Freeman
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Smith College School for Social Work, Northampton, MA, USA
| | - Ziad Khoueir
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Beirut Eye and ENT Specialist Hospital, Université Saint-Joseph Medical School, Beirut, Lebanon
| | - Ramon Lee
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,University of Southern California Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Eric Shieh
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Huseyin Simavli
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Christian John Que
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Johannes F de Boer
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Ophthalmology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Teresa C Chen
- Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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Davis BM, Crawley L, Pahlitzsch M, Javaid F, Cordeiro MF. Glaucoma: the retina and beyond. Acta Neuropathol 2016; 132:807-826. [PMID: 27544758 PMCID: PMC5106492 DOI: 10.1007/s00401-016-1609-2] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/02/2016] [Accepted: 08/10/2016] [Indexed: 12/31/2022]
Abstract
Over 60 million people worldwide are diagnosed with glaucomatous optic neuropathy, which is estimated to be responsible for 8.4 million cases of irreversible blindness globally. Glaucoma is associated with characteristic damage to the optic nerve and patterns of visual field loss which principally involves the loss of retinal ganglion cells (RGCs). At present, intraocular pressure (IOP) presents the only modifiable risk factor for glaucoma, although RGC and vision loss can continue in patients despite well-controlled IOP. This, coupled with the present inability to diagnose glaucoma until relatively late in the disease process, has led to intense investigations towards the development of novel techniques for the early diagnosis of disease. This review outlines our current understanding of the potential mechanisms underlying RGC and axonal loss in glaucoma. Similarities between glaucoma and other neurodegenerative diseases of the central nervous system are drawn before an overview of recent developments in techniques for monitoring RGC health is provided, including recent progress towards the development of RGC specific contrast agents. The review concludes by discussing techniques to assess glaucomatous changes in the brain using MRI and the clinical relevance of glaucomatous-associated changes in the visual centres of the brain.
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Affiliation(s)
| | - Laura Crawley
- Western Eye Hospital, Imperial College Healthcare NHS Trust, 153-173 Marylebone Road, London, UK
| | | | - Fatimah Javaid
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, UK
| | - Maria Francesca Cordeiro
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, UK.
- Western Eye Hospital, Imperial College Healthcare NHS Trust, 153-173 Marylebone Road, London, UK.
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Childs A, Li H, Lewittes DM, Dong B, Liu W, Shu X, Sun C, Zhang HF. Fabricating customized hydrogel contact lens. Sci Rep 2016; 6:34905. [PMID: 27748361 PMCID: PMC5066254 DOI: 10.1038/srep34905] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 09/20/2016] [Indexed: 11/09/2022] Open
Abstract
Contact lenses are increasingly used in laboratories for in vivo animal retinal imaging and pre-clinical studies. The lens shapes often need modification to optimally fit corneas of individual test subjects. However, the choices from commercially available contact lenses are rather limited. Here, we report a flexible method to fabricate customized hydrogel contact lenses. We showed that the fabricated hydrogel is highly transparent, with refractive indices ranging from 1.42 to 1.45 in the spectra range from 400 nm to 800 nm. The Young’s modulus (1.47 MPa) and hydrophobicity (with a sessile drop contact angle of 40.5°) have also been characterized experimentally. Retinal imaging using optical coherence tomography in rats wearing our customized contact lenses has the quality comparable to the control case without the contact lens. Our method could significantly reduce the cost and the lead time for fabricating soft contact lenses with customized shapes, and benefit the laboratorial-used contact lenses in pre-clinical studies.
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Affiliation(s)
- Andre Childs
- Department of Physics and Astronomy, University of Texas at San Antonio, San Antonio, TX, 78249, USA.,Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Hao Li
- Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Daniella M Lewittes
- Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Biqin Dong
- Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA.,Department of Mechanical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Wenzhong Liu
- Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Xiao Shu
- Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Cheng Sun
- Department of Mechanical Engineering, Northwestern University, Evanston IL 60208, USA
| | - Hao F Zhang
- Department of Biomedical Engineering, Northwestern University, Evanston IL 60208, USA.,Department of Ophthalmology, Northwestern University, Chicago IL 60611, USA
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Park J, Cheng JT, Ferguson D, Maguluri G, Chang EW, Clancy C, Lee DJ, Iftimia N. Investigation of middle ear anatomy and function with combined video otoscopy-phase sensitive OCT. BIOMEDICAL OPTICS EXPRESS 2016; 7:238-50. [PMID: 26977336 PMCID: PMC4771445 DOI: 10.1364/boe.7.000238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/09/2015] [Accepted: 12/17/2015] [Indexed: 05/20/2023]
Abstract
We report the development of a novel otoscopy probe for assessing middle ear anatomy and function. Video imaging and phase-sensitive optical coherence tomography are combined within the same optical path. A sound stimuli channel is incorporated as well to study middle ear function. Thus, besides visualizing the morphology of the middle ear, the vibration amplitude and frequency of the eardrum and ossicles are retrieved as well. Preliminary testing on cadaveric human temporal bone models has demonstrated the capability of this instrument for retrieving middle ear anatomy with micron scale resolution, as well as the vibration of the tympanic membrane and ossicles with sub-nm resolution.
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Affiliation(s)
- Jesung Park
- Physical Sciences Inc., Andover, MA 01810, USA
| | - Jeffrey T. Cheng
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
| | | | | | | | | | - Daniel J. Lee
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Abstract
PURPOSE To evaluate the clinical performance of visual field (VF) tests and optical coherence tomography (OCT) in diagnosing glaucoma. METHODS One hundred sets of disc photographs, red-free fundus photographs, VF tests, and OCT images were presented progressively to seven ophthalmologists. Each set was provided in three steps: (1) the disc and red-free fundus photographs were shown first; (2) then, VF tests were also provided; and (3) finally, the OCT results were provided. The same process was repeated on another day. Kappa statistics were used to assess the intraobserver and interobserver agreement, as well as the agreement with the reference standard. RESULTS The intraobserver agreement was almost perfect in this study and did not change markedly with the addition of diagnostic tools. The interobserver agreement increased from 0.54 to 0.61 when VF was added and increased slightly to 0.63 with OCT. The agreement with the reference standard also increased significantly from 0.48 to 0.61 after adding VF and increased slightly with additional OCT. CONCLUSIONS An optic disc evaluation and VF test are sufficient to diagnose glaucoma in most cases. However, OCT can play an important role in detecting glaucoma in cases in which it cannot be identified by optic disc examination and VF.
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Choe TE, Abbott CJ, Piper C, Wang L, Fortune B. Comparison of longitudinal in vivo measurements of retinal nerve fiber layer thickness and retinal ganglion cell density after optic nerve transection in rat. PLoS One 2014; 9:e113011. [PMID: 25393294 PMCID: PMC4231142 DOI: 10.1371/journal.pone.0113011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 10/23/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the relationship between longitudinal in vivo measurements of retinal nerve fiber layer thickness (RNFLT) and retinal ganglion cell (RGC) density after unilateral optic nerve transection (ONT). Methods Nineteen adult Brown-Norway rats were studied; N = 10 ONT plus RGC label, N = 3 ONT plus vehicle only (sans label), N = 6 sham ONT plus RGC label. RNFLT was measured by spectral domain optical coherence tomography (SD-OCT) at baseline then weekly for 1 month. RGCs were labeled by retrograde transport of fluorescently conjugated cholera toxin B (CTB) from the superior colliculus 48 hours prior to ONT or sham surgery. RGC density measurements were obtained by confocal scanning laser ophthalmoscopy (CSLO) at baseline and weekly for 1 month. RGC density and reactivity of microglia (anti-Iba1) and astrocytes (anti-GFAP) were determined from post mortem fluorescence microscopy of whole-mount retinae. Results RNFLT decreased after ONT by 17% (p<0.05), 30% (p<0.0001) and 36% (p<0.0001) at weeks 2, 3 and 4. RGC density decreased after ONT by 18%, 69%, 85% and 92% at weeks 1, 2, 3 and 4 (p<0.0001 each). RGC density measured in vivo at week 4 and post mortem by microscopy were strongly correlated (R = 0.91, p<0.0001). In vivo measures of RNFLT and RGC density were strongly correlated (R = 0.81, p<0.0001). In ONT- CTB labeled fellow eyes, RNFLT increased by 18%, 52% and 36% at weeks 2, 3 and 4 (p<0.0001), but did not change in fellow ONT-eyes sans CTB. Microgliosis was evident in the RNFL of the ONT-CTB fellow eyes, exceeding that observed in other fellow eyes. Conclusions In vivo measurements of RNFLT and RGC density are strongly correlated and can be used to monitor longitudinal changes after optic nerve injury. The strong fellow eye effect observed in eyes contralateral to ONT, only in the presence of CTB label, consisted of a dramatic increase in RNFLT associated with retinal microgliosis.
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Affiliation(s)
- Tiffany E. Choe
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States of America
| | - Carla J. Abbott
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States of America
| | - Chelsea Piper
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States of America
| | - Lin Wang
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States of America
| | - Brad Fortune
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States of America
- * E-mail:
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Prasse M, Rauscher FG, Wiedemann P, Reichenbach A, Francke M. Optical properties of retinal tissue and the potential of adaptive optics to visualize retinal ganglion cells in vivo. Cell Tissue Res 2013; 353:269-78. [PMID: 23529360 DOI: 10.1007/s00441-013-1602-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
Abstract
Many efforts have been made to improve the diagnostic tools used to identify and to estimate the progress of ganglion cell and nerve fibre degeneration in glaucoma. Imaging by optical coherence tomography and measurements of the dimensions of the optic nerve head and the nerve fibre layer in central retinal areas is currently used to estimate the grade of pathological changes. The visualization and quantification of ganglion cells and nerve fibres directly in patients would dramatically improve glaucoma diagnostics. We have investigated the optical properties of cellular structures of retinal tissue in order to establish a means of visualizing and quantifying ganglion cells in the living retina without staining. We have characterized the optical properties of retinal tissue in several species including humans. Nerve fibres, blood vessels, ganglion cells and their cell processes have been visualized at high image resolution by means of the reflection mode of a confocal laser scanning microscope. The potential of adaptive optics in current imaging systems and the possibilities of imaging single ganglion cells non-invasively in patients are discussed.
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Affiliation(s)
- Martina Prasse
- Institute of Brain Research, University of Leipzig, Jahnallee 59, 04109, Leipzig, Germany
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Xu J, Ishikawa H, Wollstein G, Bilonick RA, Folio LS, Nadler Z, Kagemann L, Schuman JS. Three-dimensional spectral-domain optical coherence tomography data analysis for glaucoma detection. PLoS One 2013; 8:e55476. [PMID: 23408988 PMCID: PMC3569462 DOI: 10.1371/journal.pone.0055476] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/23/2012] [Indexed: 12/03/2022] Open
Abstract
Purpose To develop a new three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) data analysis method using a machine learning technique based on variable-size super pixel segmentation that efficiently utilizes full 3D dataset to improve the discrimination between early glaucomatous and healthy eyes. Methods 192 eyes of 96 subjects (44 healthy, 59 glaucoma suspect and 89 glaucomatous eyes) were scanned with SD-OCT. Each SD-OCT cube dataset was first converted into 2D feature map based on retinal nerve fiber layer (RNFL) segmentation and then divided into various number of super pixels. Unlike the conventional super pixel having a fixed number of points, this newly developed variable-size super pixel is defined as a cluster of homogeneous adjacent pixels with variable size, shape and number. Features of super pixel map were extracted and used as inputs to machine classifier (LogitBoost adaptive boosting) to automatically identify diseased eyes. For discriminating performance assessment, area under the curve (AUC) of the receiver operating characteristics of the machine classifier outputs were compared with the conventional circumpapillary RNFL (cpRNFL) thickness measurements. Results The super pixel analysis showed statistically significantly higher AUC than the cpRNFL (0.855 vs. 0.707, respectively, p = 0.031, Jackknife test) when glaucoma suspects were discriminated from healthy, while no significant difference was found when confirmed glaucoma eyes were discriminated from healthy eyes. Conclusions A novel 3D OCT analysis technique performed at least as well as the cpRNFL in glaucoma discrimination and even better at glaucoma suspect discrimination. This new method has the potential to improve early detection of glaucomatous damage.
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Affiliation(s)
- Juan Xu
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Hiroshi Ishikawa
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Gadi Wollstein
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Richard A. Bilonick
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Lindsey S. Folio
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Zach Nadler
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Larry Kagemann
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Joel S. Schuman
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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