Avoiding Clinical Misinterpretation and Artifacts of Optical Coherence Tomography Analysis of the Optic Nerve, Retinal Nerve Fiber Layer, and Ganglion Cell Layer

Chen, John J.; Kardon, Randy H.

doi:10.1097/wno.0000000000000422

Cited by 77 publications

(68 citation statements)

References 69 publications

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“…Several studies have demonstrated that the ability to detect glaucomatous changes on OCT scans is more challenging in high myopes than emmetropes due to thinner peripapillary RNFL thickness and inaccuracies in delineating the RNFL. 23 If eyes with long axial lengths were included in this study, manual segmentation would likely perform better than automated segmentation. Studying RNFL segmentation error in eyes with higher refractive errors will be an interesting area of future study.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time

Nagarkatti-Gude

Gardiner²,

Fortune³

et al. 2019

Journal of Glaucoma

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Purpose: To identify whether optical coherence tomography (OCT) segmentation errors in retinal nerve fiber layer (RNFL) thickness measurements persist longitudinally. Methods: This was a cohort study. We used spectral domain OCT (Spectralis, Heidelberg Engineering, Heidelberg, Germany) to measure RNFL thickness in a 6-degree peripapillary circle, and exported the native 'automated segmentation only' results. In addition, we exported RNFL thickness results after 'manual refinement' to correct errors in the automated segmentation, and used the differences in these measurements as 'error' in segmentation. We used Bland-Altman plots and linear regression to determine the magnitude, location, and repeatability of RNFL thickness error in all twelve 30-degree sectors and compared the error at baseline to follow-up time points at 6 months, 2 years, 3 years, and 4 years. Results: We included 406 eyes from 213 participants. The 95% confidence interval for errors at baseline was −6.5 to +13.2μm. The correlation between the baseline error and the errors in the follow-up time periods were high (r > 0.5, p<0.001 for all). Automated segmentation had a smaller standard deviation of residuals from the longitudinal trend line when compared to manual refinement (1.56μm vs. 1.80μm, p<0.001), and a higher ability (p=0.009) to monitor progression using an analysis of a longitudinal signal-to-noise ratio. Conclusions: Errors in automated segmentation remain relatively stable, and baseline error is highly likely to persist in the same direction and magnitude in subsequent time periods. However, automated segmentation (without manual refinement) is more repeatable and may be more sensitive to glaucomatous progression. Future segmentation algorithms could exploit these findings to improve automated segmentation in the future.

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Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time

Nagarkatti-Gude

Gardiner²,

Fortune³

et al. 2019

Journal of Glaucoma

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“…In all three patients, HCQ had been used for >18 years. It is important to estimate the ocular effect of co-morbidities in the cohort analysed by Marshall et al Eyes with pathologies can also lead to increase in errors and misinterpretation of data from techniques such as SD-OCT-false-positive rates as high as 26.2% have been reported [3]. Marshall et al also report that the visual field tests were 'unreliable' (fixation losses, false positives and/or false negatives) in as many as onethird of their patients.…”

Section: To the Editormentioning

confidence: 99%

Hydroxychloroquine retinopathy—less than meets the eye

Pareek

Chandrashekara²,

Mehta

2020

Eye

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“…These have recently been outlined in more detail by Chen and Kardon. 3 First, comparisons to age-matched normative data do not fully account for important patientrelated factors. For example, myopes may have nerves which appear falsely small with corresponding pseudo-thinning of the RNFL.…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

Advances in Neuro-Ophthalmic Imaging

Bouffard

Prasad

2017

Semin Neurol

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Recent years have brought a rapid evolution of diagnostic imaging studies in neuro-ophthalmic practice. Optical coherence tomography (OCT) and several of its derivations (swept-source OCT, enhanced-depth imaging OCT, and OCT-angiography) are advancing diagnosis, and in some cases prognostication, in a variety of inflammatory, ischemic, and compressive optic neuropathies. These technologies hold potential in the laboratory as well, yielding insights into the mechanisms of a variety of neurological conditions. In addition, further developments in magnetic resonance imaging and ultrasonography techniques are shaping the approach to the diagnosis of giant cell arteritis.

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Avoiding Clinical Misinterpretation and Artifacts of Optical Coherence Tomography Analysis of the Optic Nerve, Retinal Nerve Fiber Layer, and Ganglion Cell Layer

Cited by 77 publications

References 69 publications

Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time

Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time

Hydroxychloroquine retinopathy—less than meets the eye

Advances in Neuro-Ophthalmic Imaging

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