A Wide-Field Optical Coherence Tomography Normative Database Considering the Fovea-Disc Relationship for Glaucoma Detection

Kim, H.; Lee, Jong Sub; Park, Hae Min; Cho, Hyunsoo; Lim, Han Woong; Seong, Mincheol; Park, Junhong; Lee, Won June

doi:10.1167/tvst.10.2.7

Cited by 11 publications

(10 citation statements)

References 26 publications

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“…The benefits of cluster analysis have been previously described by Yoshioka et al, 37 where age‐regression models of GCL thickness were far more apparent than when applying pointwise methods, and has since been applied to elucidate patterns of ageing in VFs and corneal parameters 31,43,61 and to optimise detection of pathological changes in VF and OCT results 32,62 . Additionally, cluster analysis allowed for the holistic incorporation of fovea to optic disc tilt into our models, which has been identified previously as a source of heterogeneity in GCIPL thicknesses in healthy cohorts that is likely to influence variability in pointwise analyses 39,63 . The relative preservation of sensitivity but improved specificity of clustered normative models, despite some loss of spatial information as a result of cluster‐based pooling, highlights the benefits of cluster analysis approaches in detection of GCIPL measurements corresponding to VF results with greater accuracy than conventional methods.…”

Section: Discussionmentioning

confidence: 89%

“…32,62 Additionally, cluster analysis allowed for the holistic incorporation of fovea to optic disc tilt into our models, which has been identified previously as a source of heterogeneity in GCIPL thicknesses in healthy cohorts that is likely to influence variability in pointwise analyses. 39,63 The relative preservation of sensitivity but improved specificity of clustered normative models, despite some loss of spatial information as a result of cluster-based pooling, highlights the benefits of cluster analysis approaches in detection of GCIPL measurements corresponding to VF results with greater accuracy than conventional methods.…”

Section: Advantages Of Clustered Models Over Pointwise Methodsmentioning

confidence: 99%

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Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Tong

Alonso‐Caneiro

Kalloniatis

et al. 2022

Ophthalmic Physiologic Optic

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Purpose To assess the accuracy of cluster analysis‐based models in predicting visual field (VF) defects from macular ganglion cell‐inner plexiform layer (GCIPL) measurements in glaucomatous and healthy cohorts. Methods GCIPL measurements were extracted from posterior pole optical coherence tomography (OCT), from locations corresponding to central VF test grids. Models incorporating cluster analysis methods and corrections for age and fovea to optic disc tilt were developed from 493 healthy participants, and 5th and 1st percentile limits of GCIPL thickness were derived. These limits were compared with pointwise 5th and 1st percentile limits by calculating sensitivities and specificities in an additional 40 normal and 37 glaucomatous participants, as well as applying receiver operating characteristic (ROC) curve analyses to assess the accuracy of predicting VF results from co‐localised GCIPL measurements. Results Clustered models demonstrated globally low sensitivity, but high specificity in the glaucoma cohort (0.28–0.53 and 0.77–0.91, respectively), and high specificity in the healthy cohort (0.91–0.98). Clustered models showed similar sensitivities and superior specificities compared with pointwise methods (0.41–0.65 and 0.71–0.98, respectively). There were significant differences in accuracy between clusters, with relatively poor accuracy at peripheral macular locations (p < 0.0001 for all comparisons). Conclusions Cluster analysis‐based models incorporating age correction and holistic consideration of fovea to optic disc tilt demonstrated superior performance in predicting VF results to pointwise methods in both glaucomatous and healthy eyes. However, relatively low sensitivity and poorer performance at the peripheral macula indicate that OCT in isolation may be insufficient to predict visual function across the macula accurately. With modifications to criteria for abnormality, the concepts suggested by the described normative models may guide prioritisation of VF assessment requirements, with the potential to limit excessive VF testing.

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Section: Discussionmentioning

confidence: 89%

Section: Advantages Of Clustered Models Over Pointwise Methodsmentioning

confidence: 99%

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Tong

Alonso‐Caneiro

Kalloniatis

et al. 2022

Ophthalmic Physiologic Optic

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“…4 ). Inbuilt normative databases do not incorporate a whole host of variables affecting inter-individual variations in GCIPL thickness, including but not limited to spherical equivalent refractive error and position of the optic disc relative to the fovea related to differences in trajectory of the papillomacular fibers, 33 – 35 which can translate to errors as highlighted in these examples. These findings highlight the pitfalls of overreliance on comparisons to normative databases, and reinforce the importance of interpreting these in conjunction with raw OCT data to arrive at accurate clinical assessments of pathological OCT findings.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluations of Macular Structure-Function Concordance With and Without Drasdo Displacement

Tong

Phu

Alonso‐Caneiro

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose The purpose of this study was to compare concordance between ganglion cell-inner plexiform layer (GCIPL) data from the Cirrus optical coherence tomographer (OCT) Ganglion Cell Analysis (GCA) and visual fields (VFs), with and without Drasdo displacement. Methods From 296 open-angle glaucoma participants, GCIPL deviation and raw thickness data were extracted over locations per the 10-2 VF test grid, with and without application of Drasdo displacement, with global and eccentricity-dependent sensitivities and specificities calculated for both. With OCT and VF data classified as within or outside normative limits, pattern deviation values were compared using paired t -tests and Spearman correlations. Regression models were applied to pattern deviation values as a function of GCIPL thickness, and differences in model performance with and without displacement were compared using extra sums-of-squares F tests. Results There were small but significant improvements in global specificity without displacement (0.58–0.59 with displacement and 0.61 without displacement), without notable differences in sensitivity (0.77–0.78 with displacement and 0.76–0.78 without displacement). At abnormal VF locations and without displacement, a higher proportion of correct OCT classifications ( P = 0.0008) and significant correlation with worsening pattern deviation values were observed ( r = 0.50, P = 0.002). Regression models indicated significantly steeper slopes with Drasdo displacement centrally ( P = 0.002–0.04). Conclusions With GCA deviation maps, small improvements in structure-function concordance were observed without displacement, which are unlikely to be clinically meaningful. Using GCIPL thickness data, significantly better structure-function concordance was observed centrally with Drasdo displacement. Translational Relevance Applying Drasdo displacement on probability-based reports is unlikely to alter clinical impressions of structure-function concordance, but applying displacement with GCIPL thickness data may improve detection of structure-function concordance.

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“…To compensate for this, Chauhan and Burgoyne [ 59 ] proposed that both image acquisition and analysis should be performed according to the specific FoBMO axis of an individual to ensure the correct anatomical correspondence of all ONH, RNFL, and macular thickness measurements. Kim et al [ 60 ] confirmed the clinical value of FoBMO axis by applying a new wide-field normative database considering the Fovea-Disc relationship that significantly improved the diagnostic performance of DRI-OCT in Korean patients.…”

Section: Discussionmentioning

confidence: 98%

Comparison of Diagnostic Ability Between Wide-Field Swept-Source Optical Coherence Tomography Imaging Maps and Heidelberg Retina Tomograph 3 Optic Nerve Head Assessment to Discriminate Glaucomatous and Non-glaucomatous Eyes

Kourkoutas¹,

Triantafyllopoulos²,

Georgiou³

et al. 2022

Cureus

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BackgroundIn this study, we aimed to determine the diagnostic performance of optic nerve head (ONH), macular, and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements of wide-field maps (12 × 9 mm) using swept-source optical coherence tomography (SS-OCT) compared to measurements of the ONH and RNFL parameters measured by Heidelberg Retina Tomograph (HRT3). MethodologyThis case-control study included 39 eyes of 39 glaucoma patients and 36 eyes of 36 normal subjects (control group). All participants underwent standard automated perimetry (SAP) as well as structural measurements by SS-OCT (DRI-OCT, Triton; Topcon Inc., Tokyo, Japan) and HRT3 (Heidelberg Engineering, Heidelberg, Germany). The abilities of the continuous parameters to discriminate between glaucoma and control groups were assessed using areas under the receiver operating characteristic curves (AUCs). To assess the glaucoma diagnostic abilities of each of the categorical variables, sensitivity, specificity, positive predictive value, and negative predictive value were tested. ResultsThe highest sensitivities were achieved by the DRI-OCT categorical parameters of Superpixel-200 map and cpRNFL (12 sectors) thickness analysis. The best performing HRT3 continuous parameter was rim volume (AUC = 0.829, 95% confidence interval (CI) = 0.735-0.922), and the best continuous parameter for DRI-OCT wide-field was vertical cdr (AUC = 0.883, 95% CI = 0.805-0.951), followed by total cpRNFL thickness (AUC = 0.862, 95% CI = 0.774-0.951). AUCs for disc area, rim area, linear cdr, and RNFL thickness were not significantly different between the two technologies. Using either the most or the least specific criteria, SuperPixel-200 map always showed the highest sensitivity among the categorical parameters of both technologies (82.1% and 89.7%, respectively). The highest sensitivity among HRT3 classification parameters was shown by MRA and GPS classification algorithms. ConclusionsBoth wide-field DRI-OCT maps and HRT3 showed good diagnostic performance in discriminating glaucoma. Although DRI-OCT thickness values and normative diagnostic classification showed the best performance, more studies are required to determine the clinical role of wide-field DRI-OCT scan in glaucoma diagnosis.

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A Wide-Field Optical Coherence Tomography Normative Database Considering the Fovea-Disc Relationship for Glaucoma Detection

Cited by 11 publications

References 26 publications

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Clinical Evaluations of Macular Structure-Function Concordance With and Without Drasdo Displacement

Comparison of Diagnostic Ability Between Wide-Field Swept-Source Optical Coherence Tomography Imaging Maps and Heidelberg Retina Tomograph 3 Optic Nerve Head Assessment to Discriminate Glaucomatous and Non-glaucomatous Eyes

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