Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?

Güngör, Sirel Gür; Akman, Ahmet

doi:10.4274/tjo.86461

Cited by 13 publications

(6 citation statements)

References 44 publications

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“…Still, it does not replace the need to use retinography for the structural documentation of the optic nerve for both the diagnosis and assessment of progression, i.e., a positive or negative result obtained by OCT alone does not confirm or exclude the diagnosis and progression of glaucoma [ 15 ]. The evaluation should include the patient’s medical history, detailed ophthalmological examination, OCT optic disc parameters, and visual field tests [ 17 ].…”

Section: Some Approaches To Medical Practice In Glaucomamentioning

confidence: 99%

Clinical Perspectives on the Use of Computer Vision in Glaucoma Screening

Camara,

Cunha

2024

Medicina

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Glaucoma is one of the leading causes of irreversible blindness in the world. Early diagnosis and treatment increase the chances of preserving vision. However, despite advances in techniques for the functional and structural assessment of the retina, specialists still encounter many challenges, in part due to the different presentations of the standard optic nerve head (ONH) in the population, the lack of explicit references that define the limits of glaucomatous optic neuropathy (GON), specialist experience, and the quality of patients’ responses to some ancillary exams. Computer vision uses deep learning (DL) methodologies, successfully applied to assist in the diagnosis and progression of GON, with the potential to provide objective references for classification, avoiding possible biases in experts’ decisions. To this end, studies have used color fundus photographs (CFPs), functional exams such as visual field (VF), and structural exams such as optical coherence tomography (OCT). However, it is still necessary to know the minimum limits of detection of GON characteristics performed through these methodologies. This study analyzes the use of deep learning (DL) methodologies in the various stages of glaucoma screening compared to the clinic to reduce the costs of GON assessment and the work carried out by specialists, to improve the speed of diagnosis, and to homogenize opinions. It concludes that the DL methodologies used in automated glaucoma screening can bring more robust results closer to reality.

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Section: Some Approaches To Medical Practice In Glaucomamentioning

confidence: 99%

Clinical Perspectives on the Use of Computer Vision in Glaucoma Screening

Camara,

Cunha

2024

Medicina

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“… 8 – 11 As is well known, chronic and progressive loss of ganglion cell axons, which is routinely diagnosed by the presence of thinning of peripapillary retinal nerve fiber layer (RNFL), is a cardinal feature of glaucomatous optic neuropathy. 12 – 14 The diagnostic ability of peripapillary vessel density captured by OCTA may be lower or, at best, equal to the thickness of peripapillary RNFL, but it is unclear whether OCTA will add benefit to the standard clinical care and monitoring of scleroderma patients. 11 , 15 The aim of our study was to assess the vessel density of the optic nerve head and peripapillary retina using OCTA, and peripapillary and macular RNFL thickness using spectral-domain optical coherence tomography (SD-OCT) in patients with limited scleroderma and to compare these results with those of healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the optic nerve head vessel density in patients with limited scleroderma

et al. 2021

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Objectives: To investigate the optical coherence tomography angiography (OCTA) parameters of the optic nerve head and peripapillary retina and to assess macular and peripapillary retinal nerve fiber layer (RNFL) thickness by using spectral-domain optical coherence tomography (SD-OCT) in patients with limited scleroderma and to compare these results with those of healthy control subjects. Materials and Methods: 42 patients with a confirmed diagnosis of limited scleroderma and 32 age- and sex-matched healthy control subjects were included in the study. OCTA was performed for the radial peripapillary capillary plexus (RPCP) whole image, inside disc, and peripapillary vessel densities in all participants with XR Avanti AngioVue OCTA (Optovue, Fremont, California, USA). OCT images were obtained with Spectralis OCT with eye-tracking dual-beam technology (Heidelberg Engineering GmbH, Heidelberg, Germany), and peripapillary RNFL thickness was evaluated with circle program. The data from the right eyes of all participants were used for statistical analysis. Results: No significant difference was found between the radial RPCP whole image, inside disc, and peripapillary vessel density values or the RNFL parameters of the scleroderma patients when compared with the controls ( p > 0.05 for all). Conclusion: Decreased peripapillary vessel density on OCTA, which can be an early sign of glaucoma, could not be observed in scleroderma patients in this study. However, further long-term studies are still needed to identify glaucoma tendency in patients with scleroderma before clinically detectable glaucoma.

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“…1 It is a chronic progressive optic neuropathy characterized by the thinning of the peripapillary retinal nerve fiber layer (RNFL) and optic disc cupping as a result of axonal and retinal ganglion cell loss. 2,3 Glaucoma is an irreversible but preventable disease, which requires a management strategy involving risk stratification. Risk assessment is meant to properly allocate intensive treatment and monitoring to those who are more vulnerable while avoiding overburdening both patient and health care system in cases when the disease is less likely to cause loss of visual function.…”

Section: Introductionmentioning

confidence: 99%

OCTA Multilayer and Multisector Peripapillary Microvascular Modeling for Diagnosing and Staging of Glaucoma

Jesus

Brea

Breda

et al. 2020

Trans. Vis. Sci. Tech.

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To develop and assess an automatic procedure for classifying and staging glaucomatous vascular damage based on optical coherence tomography angiography (OCTA) imaging. Methods: OCTA scans (Zeiss Cirrus 5000 HD-OCT) from a random eye of 39 healthy subjects and 82 glaucoma patients were used to develop a new classification algorithm based on multilayer and multisector information. The averaged circumpapillary retinal nerve fiber layer (RNFL) thickness was also collected. Three models, support vector machine (SVM), random forest (RF), and gradient boosting (xGB), were developed and optimized for classifying between healthy and glaucoma patients, primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG), and glaucoma severity groups. Results: All the models, the SVM (area under the receiver operating characteristic [AUROC] 0.89 ± 0.06), the RF (AUROC 0.86 ± 0.06), and the xGB (AUROC 0.85 ± 0.07), with 26, 22, and 29 vascular features obtained after feature selection, respectively, presented a similar performance to the RNFL thickness (AUROC 0.85± 0.06) in classifying healthy and glaucoma patients. The superficial vascular plexus was the most informative layer with the infero temporal sector as the most discriminative region of interest. No significant differentiation was obtained in discriminating the POAG from the NTG group. The xGB model, after feature selection, presented the best performance in classifying the severity groups (AUROC 0.76± 0.06), outperforming the RNFL (AUROC 0.67± 0.06). Conclusions: OCTA multilayer and multisector information has similar performance to RNFL for glaucoma diagnosis, but it has an added value for glaucoma severity classification, showing promising results for staging glaucoma progression. Translational Relevance: OCTA, in its current stage, has the potential to be used in clinical practice as a complementary imaging technique in glaucoma management.

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Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?

Cited by 13 publications

References 44 publications

Clinical Perspectives on the Use of Computer Vision in Glaucoma Screening

Clinical Perspectives on the Use of Computer Vision in Glaucoma Screening

Evaluation of the optic nerve head vessel density in patients with limited scleroderma

OCTA Multilayer and Multisector Peripapillary Microvascular Modeling for Diagnosing and Staging of Glaucoma

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