Effect of Signal Intensity on Measurement of Ganglion Cell Complex and Retinal Nerve Fiber Layer Scans in Fourier-Domain Optical Coherence Tomography

Zhang, Xinbo; Iverson, Shawn M.; Tan, Ou; Huang, David

doi:10.1167/tvst.4.5.7

Cited by 55 publications

(48 citation statements)

References 30 publications

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“…The NFL regression further took into account the known effect of OCT signal strength (measured by SSI) on thickness measurement. 42 Taking out the aging adjustment increased the rate of detecting glaucoma progression by GCC and NFL thinning at the cost of decreased specificity. This increase in detection rate was statistically significant for both GCC and NFL in PG and GS/PPG group (P<0.001, P<0.001 for GCC, P=0.014, P < 0.001 for NFL).…”

Section: Resultsmentioning

confidence: 99%

“…The default analysis in this paper averaged measurements from 3 sets of OCT scans at each visit, accounted for the rate of normal age-related thinning in NFL and GCC, 43 and compensated for the effect of OCT signal strength variation on NFL measurements. 42 This differs from the standard clinical practice, where one OCT scan is made at each visit, and no compensation for signal strength or aging changes is made in the linear regression analysis software on the commercial RTVue OCT system software. Our analysis found that accounting for the change over time in NFL and GCC due to normal aging had significant effects on detecting progression; therefore it is desirable to adjust for aging effect when using the trend of NFL and GCC to define progression.…”

Section: Discussionmentioning

confidence: 99%

“…Only ONH scans with a signal strength index (SSI) above 37 and GCC scans above 42 were selected for analysis. 42 Measurements of qualified scans in the same visit were averaged. The macular GCC scan covered a 7 by 7 mm square area in the macula.…”

Section: Methodsmentioning

confidence: 99%

“…43 In case of NFL, the effect of the OCT signal strength index (SSI) on thickness measurement was also adjusted using a previously published linear regression analysis by 0.056 per SSI difference. 42 A number of variations on the method of progression analysis were investigated: 1) only the first scan was used for the analysis; 2) aging adjustment was not used; and 3) SSI adjustment was not used. These variations were compared to the default method to determine whether the effects were significant.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field

Zhang

Dastiridou

Francis

et al. 2017

American Journal of Ophthalmology

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Purpose To compare longitudinal glaucoma progression detection using optical coherence tomography (OCT) and visual field (VF). Design Validity assessment Method We analyzed subjects with more than 5 follow-up visits (every 6 months) in the multi-center Advanced Imaging for Glaucoma Study. Fourier-domain optical coherence tomography (OCT) was used to map the thickness of the peripapillary retinal nerve fiber layer (NFL) and ganglion cell complex (GCC). OCT-based progression detection was defined as a significant negative trend for either NFL or GCC. VF progression was reached if either the event or trend analysis reached significance. Result The analysis included 417 glaucoma suspect/pre-perimetric glaucoma (GS/PPG) eyes and 377 perimetric glaucoma (PG) eyes. In the GS/PPG group, progression was detect in 38.9% of eyes by OCT, significantly more (P<0.001) than the detection rate of 18.7% by VF. In severity-stratified analysis of PG eyes, OCT had significantly higher detection rate in early PG (49.7% vs. 32.0%, p=0.02), but not significantly different in moderate and advanced PG. The rate of NFL thinning declined dramatically in advanced PG, but GCC thinning rate remained relatively steady and allowed good progression detection even in advanced disease. The rate of false positive progression detection in permutated series was over 10% for VF trend analysis in both GS/PPG and PG group, while under 7% for both GCC and NFL. Conclusion OCT is a more sensitive than VF for the detection of progression in early glaucoma. While the value of NFL declines in advanced glaucoma, GCC appears to be a useful progression detector from early to advanced stages.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field

Zhang

Dastiridou

Francis

et al. 2017

American Journal of Ophthalmology

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121

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“…So far, no minimum image quality parameters for OCT-A CC measurements have been defined. Zhang et al [35] discussed the influence of SSI on image quality in OCT measurements using a Zeiss OCT instrument and concluded that a minimum of signal strength has to be reached to provide constant and reliable image quality. Cutoffs were defined at ≥ 37 SSI for retinal nerve fiber layer and ≥ 44 for ganglion cell complex measurements.…”

Section: Signal Strengthmentioning

confidence: 99%

Comparison of Choriocapillaris Flow Measurements between Two Optical Coherence Tomography Angiography Devices

et al. 2017

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Purpose: To evaluate choriocapillaris (CC) perfusion in healthy subjects using 2 different optical coherence tomography angiography (OCT-A) devices. Procedures: Macular OCT-A imaging (36 eyes of 36 subjects) was performed using Optovue AngioVue and Zeiss AngioPlex devices. CC decorrelation signal index was assessed, and CC data were analyzed regarding intra-device variability, inter-device correlation, age, signal strength, and fields of view. Results: The intra-device variability of CC measurements in the 3 × 3 mm² field was 5.3 and 2.6% (Angiovue and Angioplex, coefficients of variation; 6 × 6 mm²: 8.0 and 2.8%, respectively). Mean CC decorrelation signal index in 3 × 3 mm² was 104.3 ± 6.7 (Angiovue) and 81.3 ± 9.2 (Angioplex) (6 × 6 mm²: 95.6 ± 8.1, 81.1 ± 6.5) with high correlation between both devices (3 × 3 mm²: p = 0.0053; 6 × 6 mm²: p = 0.0139). CC decorrelation signal index in 3 × 3 mm² was significantly higher in subjects aged ≤58 years compared to subjects aged ≥59 years (Angiovue: 107.3 ± 3.6, 101.3 ± 7.7, p = 0.0156; Angioplex: 84.6 ± 7.6, 78.0 ± 9.5, p = 0.0371). Signal strength was 64.6 ± 8.9 (Angiovue) and 9.5 ± 0.8 (Angioplex). Conclusion: Both devices showed low intra-device variability and a high inter-device correlation. CC decorrelation signal index was negatively correlated with advancing age.

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Genetic and Environmental Factors Associated With the Ganglion Cell Complex in a Healthy Aging British Cohort

et al. 2017

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IMPORTANCE Measurement of ganglion cell complex (GCC) thickness may be more sensitive than current methods for glaucoma diagnosis and research. However, little is known about the factors influencing GCC thickness in the general population.OBJECTIVES To investigate the heritability of and factors associated with GCC thickness in a healthy aging population. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional twin study was conducted from August 27, 2014, to March 31, 2016, among 1657 participants of white British ancestry from the TwinsUK study cohort without ocular pathologic conditions. Heritability analyses were conducted in 1432 twins (426 monozygous and 290 dizygous pairs). Association analyses were performed using univariable and multivariable stepwise linear regression models, taking family structure into account. Heritability analyses were conducted using maximum likelihood structural equation twin modeling. MAIN OUTCOMES AND MEASURESParameters measured included GCC thickness, autorefraction, intraocular pressure, blood pressure, body mass index, and cholesterol, creatinine, glucose, insulin, triglycerides, and urea levels. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease formula. RESULTS Among the 1657 participants (mean [SD] age, 56.0 [15.3] years; 89.5% women and 10.5% men), the mean [SD] inner GCC thickness was 96.0 [7.6] μm (95% CI, 95.1-96.2). In multivariable modeling, the mean inner GCC thickness was associated with advancing age (β, -0.14; P < .001), increased body mass index (β, -0.15; P = .001), spherical equivalent (β, 0.70; P < .001), and higher estimated glomerular filtration rate (β, 0.03; P = .02). A 1-U increase in age or body mass index was associated with a 0.14-μm and 0.15-μm decrease in GCC thickness, respectively (P < .001), while a 1-U increase in spherical equivalent or estimated glomerular filtration rate was associated with a 0.70-μm (P < .001) and 0.03-μm (P = .02) increase in GCC thickness, respectively. Ganglion cell complex thickness was not associated with sex, intraocular pressure, or diabetes. Age-adjusted GCC thickness was highly heritable, with additive genetic effects explaining 81% (95% CI, 78%-84%) of phenotypic variance and individual environmental factors explaining the remaining 19% (95% CI, 16%-22%).CONCLUSIONS AND RELEVANCE Ganglion cell complex thickness appears to be highly heritable and further genetic analysis may help identify new biological pathways for glaucoma. The results suggest it may be important to account for age, body mass index, refractive error, and sex when using GCC thickness as a diagnostic tool. Replication of their results is required, as is further research to explain the association between renal function and GCC thickness.

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Effect of Signal Intensity on Measurement of Ganglion Cell Complex and Retinal Nerve Fiber Layer Scans in Fourier-Domain Optical Coherence Tomography

Cited by 55 publications

References 30 publications

Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field

Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field

Comparison of Choriocapillaris Flow Measurements between Two Optical Coherence Tomography Angiography Devices

Genetic and Environmental Factors Associated With the Ganglion Cell Complex in a Healthy Aging British Cohort

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