Regional Correlation Among Ganglion Cell Complex, Nerve Fiber Layer, and Visual Field Loss in Glaucoma

Le, Phuc Van; Tan, Ou; Chopra, Vikás; Francis, Brian A.; Ragab, Omar; Varma, Rohit; Huang, David

doi:10.1167/iovs.12-11388

Cited by 57 publications

(48 citation statements)

References 41 publications

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“…Linear regressions of global vascular parameters and vessel density inside disc were performed with C/D ratio, RNFL average thickness (lm), GCC average thickness (lm), FLV (%), GLV (%), VF MD (dB), and PSD (dB) for glaucomatous eyes. From a previously established relationship between regional RNFL and GCC loss with VF defects, [21][22][23] linear regressions of vascular parameters in T, ST, IT, N, SN, and IN sectors were performed with corresponding regional pattern deviation loss in the VF map (Fig. 3).…”

Section: Discussionmentioning

confidence: 99%

Discriminant Function of Optical Coherence Tomography Angiography to Determine Disease Severity in Glaucoma

Kumar

Anegondi

Chandapura

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Kumar RS, Anegondi N, Chandapura RS, et al. Discriminant function of optical coherence tomography angiography to determine disease severity in glaucoma. Invest Ophthalmol Vis Sci. 2016;57:6079-6088. DOI:10.1167/iovs.16-19984 PURPOSE. To determine the discriminant function of optical coherence tomography angiography (OCTA) by disease severity in glaucoma.METHODS. In this prospective, observational cross-sectional study, all subjects underwent visual fields, retinal nerve fiber layer (RNFL) measurements, and OCTA imaging. Local fractal analysis was applied to OCTA images (radial peripapillary capillaries [RPC] layer). Vessel density en face and inside the disc and spacing between large and small vessels were quantified. Stepwise logistic regression was performed and a glaucoma severity score (range, 0-1: 0, normal; 1, severe glaucoma) was developed by using global and regional (superotemporal [ST], inferotemporal [IT], temporal, superonasal [SN], inferonasal, and nasal) vascular parameters. Glaucoma severity score was compared with visual field and RNFL indices. RESULTS.One hundred ninety-nine eyes (112 subjects) with glaucoma (28 eyes preperimetric; 83 early, 43 moderate, and 45 severe glaucoma) and 74 normal (54 subjects) eyes were enrolled. Preperimetric and glaucomatous eyes had significantly altered (P < 0.001) global vascular parameters as compared to normal; regionally, ST, then SN and IT sectors (in that order) showed more change in glaucomatous eyes. Vascular parameters showed better discriminant ability (area under the curve [AUC], sensitivity, and specificity of 0.70, 69.2%, and 72.9%, respectively) than structural parameters between normal and preperimetric glaucomatous eyes. Vascular parameters had comparable AUC (P > 0.05) to visual fields for perimetric glaucoma. Glaucoma severity score identified preperimetric glaucoma and early glaucoma better than did visual fields.CONCLUSIONS. Vascular parameters could be a useful adjunct tool to evaluate/diagnose glaucoma. Longitudinal studies are needed to determine their use in early detection and prognostication.Keywords: optical coherence tomography, glaucoma, visual field, angiography G laucoma is the leading cause of irreversible blindness worldwide.1,2 It is characterized by progressive degeneration of the optic nerve and loss of retinal ganglion cells, with corresponding visual field (VF) defects on standard automated perimetry.1,2 While raised intraocular pressure (IOP) is currently the only known modifiable risk factor for glaucoma, there is evidence that vascular insufficiency in the optic nerve head (ONH) also plays an important role in the pathogenesis of glaucoma.3-5 Currently, a number of methods are available for measuring ONH perfusion.6-11 Fluorescein angiography is invasive. It provides only superficial ONH perfusion and not deep perfusion.6 Noninvasive methods such as laser Doppler flowmetry and laser speckle flowgraphy have demonstrated decreased ONH perfusion in glaucomatous eyes, but have moderate repeatability.8,10 Doppler O...

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Section: Discussionmentioning

confidence: 99%

Discriminant Function of Optical Coherence Tomography Angiography to Determine Disease Severity in Glaucoma

Kumar

Anegondi

Chandapura

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…Further confirmation that our method is as applicable to the patient population as it is to healthy individuals could be achieved by using low density macular cube data to compare the distributions in raphe orientation between the two groups. However, even this may produce unexpected results due to changes in raphe shape that apparently occur as glaucoma progresses [2,[8][9][10]14]. The most instructive approach to improve our understanding in the future will be measurement of the raphe orientation when the retina appears healthy, and tracking the raphe shape and/or orientation in the same patient as the disease progresses.…”

Section: Discussionmentioning

confidence: 99%

“…Both thickness [2,8,9] and intensity [11][12][13][14] of the RNFL have been used by other groups to estimate the orientation of the temporal raphe, and both are reasonable indicators since the apparent "missing" fibers at the raphe should reduce both thickness and intensity recorded by OCT at the level of the RNFL.…”

Section: Generation Of En Face Imagesmentioning

confidence: 99%

“…Hood et al located the axis of minimum RNFL thickness from 128 healthy eyes, reporting approximately horizontal orientation of the raphe despite a large physiological variation in the relative positions of the optic disc and fovea [2]. In glaucomatous eyes, Le et al, Amini et al and Kim et al have exploited characteristic patterns of glaucomatous damage coupled with measured visual field loss to infer the axis between superior and inferior fields, again relying on changes in thickness of particular layers measured with OCT [8][9][10]. Each of the above studies concluded that the temporal raphe is oriented roughly along a horizontal line.…”

Section: Introductionmentioning

confidence: 99%

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Automatic identification of the temporal retinal nerve fiber raphe from macular cube data

Bedggood¹,

Tanabe²,

McKendrick³

et al. 2016

Biomed. Opt. Express

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Abstract:We evaluated several approaches for automatic location of the temporal nerve fiber raphe from standard macular cubes acquired on a Heidelberg Spectralis OCT. Macular cubes with B-scan separation of 96-122 µm were acquired from 15 healthy participants, and "high density" cubes with scan separation of 11 µm were acquired from the same eyes. These latter scans were assigned to experienced graders for subjective location of the raphe, providing the ground truth by which to compare methods operating on the lower density data. A variety of OCT scan parameters and image processing strategies were trialed. Vertically oriented scans, purposeful misalignment of the pupil to avoid reflective artifacts, and the use of intensity as opposed to thickness of the nerve fiber layer were all critical to minimize error. The best performing approach "cFan" involved projection of a fan of lines from each of several locations across the foveal pit; in each fan the line of least average intensity was identified. The centroid of the crossing points of these lines provided the raphe orientation with an average error of 1.5° (max = 4.1°) relative to the human graders. The disc-fovea-raphe angle was 172.4 ± 2.3° (range = 168.5-176.2°), which agrees well with other published estimates.

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“…Thickness maps such as those of the NFL and ganglion cell complex have been shown to be informative in the diagnosis and management of diseases like glaucoma [22,23]. Because our segmentation approach is based on radial B-scans, scans which cover a larger area may require smaller increments during the resampling process to prevent undersampling at the edges of the scan.…”

Section: Discussionmentioning

confidence: 99%

Automated boundary detection of the optic disc and layer segmentation of the peripapillary retina in volumetric structural and angiographic optical coherence tomography

Zang

Gao

Hwang

et al. 2017

Biomed. Opt. Express

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Abstract:To improve optic disc boundary detection and peripapillary retinal layer segmentation, we propose an automated approach for structural and angiographic optical coherence tomography. The algorithm was performed on radial cross-sectional B-scans. The disc boundary was detected by searching for the position of Bruch's membrane opening, and retinal layer boundaries were detected using a dynamic programming-based graph search algorithm on each B-scan without the disc region. A comparison of the disc boundary using our method with that determined by manual delineation showed good accuracy, with an average Dice similarity coefficient 0.90 in healthy eyes and eyes with diabetic retinopathy and glaucoma. The layer segmentation accuracy in the same cases was on average less than one pixel (3.13 μm).

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Regional Correlation Among Ganglion Cell Complex, Nerve Fiber Layer, and Visual Field Loss in Glaucoma

Abstract: There are significant point-specific and regional correlations between GCC loss, NFL loss, and deficits on SAP. Using these different data sources together may improve our understanding of glaucomatous damage and aid in the management of patients with glaucoma.

Cited by 57 publications

References 41 publications

Discriminant Function of Optical Coherence Tomography Angiography to Determine Disease Severity in Glaucoma

Discriminant Function of Optical Coherence Tomography Angiography to Determine Disease Severity in Glaucoma

Automatic identification of the temporal retinal nerve fiber raphe from macular cube data

Automated boundary detection of the optic disc and layer segmentation of the peripapillary retina in volumetric structural and angiographic optical coherence tomography

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