Risk of Normal Tension Glaucoma Progression From Automated Baseline Retinal-Vessel Caliber Analysis: A Prospective Cohort Study.

Autor: Lin TPH; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Hong Kong Eye Hospital, Hong Kong, China., Hui HYH; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China., Ling A; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China., Chan PP; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Hong Kong Eye Hospital, Hong Kong, China; Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, the Chinese University of Hong Kong(P.P.C., C.C.T., C.Y.C.), Hong Kong, China., Shen R; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China., Wong MOM; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Hong Kong Eye Hospital, Hong Kong, China., Chan NCY; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (N.C.Y.C.), Hong Kong, China., Leung DYL; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Department of Ophthalmology, Hong Kong Sanatorium and Hospital (D.Y.L.L.), Hong Kong, China., Xu D; School of Computing, National University of Singapore (D.X., M.L.L., W.H.), Singapore., Lee ML; School of Computing, National University of Singapore (D.X., M.L.L., W.H.), Singapore., Hsu W; School of Computing, National University of Singapore (D.X., M.L.L., W.H.), Singapore., Wong TY; Singapore Eye Research Institute, Singapore National Eye Centre (T.Y.W.), Singapore; Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School (T.Y.W.), Singapore; Tsinghua Medicine, Tsinghua University (T.Y.W.), Beijing, China., Tham CC; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Hong Kong Eye Hospital, Hong Kong, China; Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, the Chinese University of Hong Kong(P.P.C., C.C.T., C.Y.C.), Hong Kong, China. Electronic address: clemtham@cuhk.edu.hk., Cheung CY; From the Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong (T.P.H.L., H.Y.H.H., A.L., P.P.C., R.S., M.O.M.W., N.C.Y.C., D.Y.L.L., C.C.T., C.Y.C.), Hong Kong, China; Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, the Chinese University of Hong Kong(P.P.C., C.C.T., C.Y.C.), Hong Kong, China. Electronic address: carolcheung@cuhk.edu.hk.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2023 Mar; Vol. 247, pp. 111-120. Date of Electronic Publication: 2022 Oct 09.
DOI: 10.1016/j.ajo.2022.09.015
Abstrakt: Purpose: To determine the relationship between baseline retinal-vessel calibers computed by a deep-learning system and the risk of normal tension glaucoma (NTG) progression.
Design: Prospective cohort study.
Methods: Three hundred and ninety eyes from 197 patients with NTG were followed up for at least 24 months. Retinal-vessel calibers (central retinal arteriolar equivalent [CRAE] and central retinal venular equivalent [CRVE]) were computed from fundus photographs at baseline using a previously validated deep-learning system. Retinal nerve fiber layer (RNFL) thickness and visual field (VF) were evaluated semiannually. The Cox proportional-hazards model was used to evaluate the relationship of baseline retinal-vessel calibers to the risk of glaucoma progression.
Results: Over a mean follow-up period of 34.36 ± 5.88 months, 69 NTG eyes (17.69%) developed progressive RNFL thinning and 22 eyes (5.64%) developed VF deterioration. In the multivariable Cox regression analysis adjusting for age, gender, intraocular pressure, mean ocular perfusion pressure, systolic blood pressure, axial length, standard automated perimetry mean deviation, and RNFL thickness, narrower baseline CRAE (hazard ratio per SD decrease [95% confidence interval], 1.36 [1.01-1.82]) and CRVE (1.35 [1.01-1.80]) were associated with progressive RNFL thinning and narrower baseline CRAE (1.98 [1.17-3.35]) was associated with VF deterioration.
Conclusion: In this study, each SD decrease in the baseline CRAE or CRVE was associated with a more than 30% increase in the risk of progressive RNFL thinning and a more than 90% increase in the risk of VF deterioration during the follow-up period. Baseline attenuation of retinal vasculature in NTG eyes was associated with subsequent glaucoma progression. High-throughput deep-learning-based retinal vasculature analysis demonstrated its clinical utility for NTG risk assessment.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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