Diagnostic Performance for Detection of Glaucomatous Structural Damage Using Pixelwise Analysis of Retinal Thickness Measurements.

Autor:	Yang H; Optic Nerve Head Research Laboratory, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Reynaud J; Optic Nerve Head Research Laboratory, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Sharpe GP; Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada., Jennings D; Optic Nerve Head Research Laboratory, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Albert C; Discoveries in Sight Research Laboratories, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Holthausen T; Discoveries in Sight Research Laboratories, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Jiang X; Optic Nerve Head Research Laboratory, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Demirel S; Discoveries in Sight Research Laboratories, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Mansberger SL; Discoveries in Sight Research Laboratories, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Nicolela MT; Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada., Gardiner SK; Discoveries in Sight Research Laboratories, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Chauhan BC; Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada., Burgoyne CF; Optic Nerve Head Research Laboratory, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States., Fortune B; Discoveries in Sight Research Laboratories, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, United States.
Jazyk:	angličtina
Zdroj:	Investigative ophthalmology & visual science [Invest Ophthalmol Vis Sci] 2024 Oct 01; Vol. 65 (12), pp. 17.
DOI:	10.1167/iovs.65.12.17
Abstrakt:	Purpose: To compare the diagnostic accuracy of thickness measurements of individual and combined macular retinal layers to discriminate 188 glaucomatous and 148 glaucoma suspect eyes from 362 healthy control (HC) eyes on a pixel-by-pixel basis. Methods: For this retrospective study, we manually corrected the segmentations of posterior pole optical coherence tomography (OCT) scans to determine the thickness of the nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), the ganglion cell complex (GCC), and the total neural retina (TR). For each eye, the total number of pixels with thickness values less than the fifth percentile of the HC distribution was used to create a receiver operating characteristic (ROC) curve for each layer and for layer combinations. Results: Using total abnormal pixel count criteria to discriminate glaucoma from HC eyes, the individual layers with the highest area under the ROC curve (AUC) were the NFL and GCL; IPL performance was significantly lower (P < 0.05). GCC had a significant higher AUC (94.3%) than individual the AUC of the NFL (92.3%) (P = 0.0231) but not higher than AUC of the GCL (93.4%) (P = 0.3487). The highest AUC (95.4%) and sensitivity (85.1%) at 95% specificity was found for the Boolean combination of NFL or GCL. The highest AUC is not significantly higher (P = 0.0882) than the AUC of the GCC but the highest sensitivity is significantly higher than the sensitivity of the GCC. This pattern was similar for discriminating between suspect and HC eyes (P = 0.0356). Conclusions: Using pixel-based methods, the diagnostic accuracy of NFL and GCL exceeded that of IPL and TR. GCC had equivalent performance as NFL and GCL. The specific spatial locations within the posterior pole that exhibit best performance vary depending on which layer is being assessed. Recognizing this dependency highlights the importance of considering multiple layers independently, as they offer complementary information for effective and comprehensive diagnosis.
Databáze:	MEDLINE
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