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Addis V, Chen M, Zorger R, Salowe R, Daniel E, Lee R, Pistilli M, Gao J, Maguire MG, Chan L, Gudiseva HV, Zenebe-Gete S, Merriam S, Smith EJ, Martin R, Parker Ostroff C, Gee JC, Cui QN, Miller-Ellis E, O’Brien JM, Sankar PS. A Precise Method to Evaluate 360 Degree Measures of Optic Cup and Disc Morphology in an African American Cohort and Its Genetic Applications. Genes (Basel) 2021; 12:genes12121961. [PMID: 34946910 PMCID: PMC8701339 DOI: 10.3390/genes12121961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Vertical cup-to-disc ratio (CDR) is an important measure for evaluating damage to the optic nerve head (ONH) in glaucoma patients. However, this measure often does not fully capture the irregular cupping observed in glaucomatous nerves. We developed and evaluated a method to measure cup-to-disc ratio (CDR) at all 360 degrees of the ONH. (2) Methods: Non-physician graders from the Scheie Reading Center outlined the cup and disc on digital stereo color disc images from African American patients enrolled in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. After converting the resultant coordinates into polar representation, the CDR at each 360-degree location of the ONH was obtained. We compared grader VCDR values with clinical VCDR values, using Spearman correlation analysis, and validated significant genetic associations with clinical VCDR, using grader VCDR values. (3) Results: Graders delineated outlines of the cup contour and disc boundaries twice in each of 1815 stereo disc images. For both cases and controls, the mean CDR was highest at the horizontal bisector, particularly in the temporal region, as compared to other degree locations. There was a good correlation between grader CDR at the vertical bisector and clinical VCDR (Spearman Correlation OD: r = 0.78 [95% CI: 0.76–0.79]). An SNP in the MPDZ gene, associated with clinical VCDR in a prior genome-wide association study, showed a significant association with grader VCDR (p = 0.01) and grader CDR area ratio (p = 0.02). (4) Conclusions: The CDR of both glaucomatous and non-glaucomatous eyes varies by degree location, with the highest measurements in the temporal region of the eye. This method can be useful for capturing innate eccentric ONH morphology, tracking disease progression, and identifying genetic associations.
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Affiliation(s)
- Victoria Addis
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Min Chen
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; (M.C.); (J.C.G.)
| | - Richard Zorger
- Penn Vision Research Center, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Rebecca Salowe
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Ebenezer Daniel
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Roy Lee
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Maxwell Pistilli
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Jinpeng Gao
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Maureen G. Maguire
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Lilian Chan
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Harini V. Gudiseva
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Selam Zenebe-Gete
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Sayaka Merriam
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Eli J. Smith
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Revell Martin
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Candace Parker Ostroff
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - James C. Gee
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; (M.C.); (J.C.G.)
| | - Qi N. Cui
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Eydie Miller-Ellis
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
| | - Joan M. O’Brien
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
- Correspondence: Joan.O’; Tel.: +1-215-662-8657; Fax: +1-215-662-9676
| | - Prithvi S. Sankar
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.A.); (R.S.); (E.D.); (R.L.); (M.P.); (J.G.); (M.G.M.); (L.C.); (H.V.G.); (S.Z.-G.); (S.M.); (E.J.S.); (R.M.); (C.P.O.); (Q.N.C.); (E.M.-E.); (P.S.S.)
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