Dataset Information

Automated Beta Zone Parapapillary Area Measurement to Differentiate Between Healthy and Glaucoma Eyes.

ABSTRACT: PURPOSE:To evaluate whether automated assessment of beta zone parapapillary atrophy (?PPA) area can differentiate between glaucomatous and healthy eyes of varying axial lengths (AL). DESIGN:Cross-sectional study. METHODS:?PPA was automatically identified in glaucoma and healthy eyes with enhanced-depth imaging optical coherence tomography (OCT) optic nerve head (ONH) radial B-scans. Associations with AL and the presence of glaucoma were assessed. Manually delineated ?PPA on individual OCT ONH B-scans of 35 eyes from the Diagnostic Innovations in Glaucoma Study served to validate the automated method. RESULTS:One hundred fifty-three glaucoma eyes (mean ± standard deviation) (visual field mean deviation, -5.0 ± 6.4 dB and mean AL, 25.1 ± 1.1 mm) and 73 healthy eyes (visual field mean deviation, 0.1 ± 1.4 dB and mean AL, 24.1 ± 1.1 mm) were included. In multivariable analysis, larger ?PPA area was significantly associated with a diagnosis of glaucoma after controlling for age, central corneal thickness, and AL. Moreover, in multivariable analysis, the odds of having glaucoma were doubled for each 0.2 mm2 larger ?PPA area. The age- and AL-adjusted area under the receiver operating characteristic curve (95% confidence interval) of ?PPA area for differentiating between glaucoma and healthy eyes was 0.75 (0.68-0.81). Agreement for the location of the Bruch membrane opening and the location of retinal pigment epithelium tips was stronger between the automated technique and each individual observer than it was between the 2 observers. CONCLUSIONS:Larger ?PPA area, as determined by automated OCT assessment, is significantly associated with a diagnosis of glaucoma, even after adjusting for age and AL, and may aid in differentiating healthy from glaucomatous eyes.

SUBMITTER: Manalastas PIC

PROVIDER: S-EPMC6173207 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Automated Beta Zone Parapapillary Area Measurement to Differentiate Between Healthy and Glaucoma Eyes.

Manalastas Patricia Isabel C PIC Belghith Akram A Weinreb Robert N RN Jonas Jost B JB Suh Min Hee MH Yarmohammadi Adeleh A Medeiros Felipe A FA Girkin Christopher A CA Liebmann Jeffrey M JM Zangwill Linda M LM

American journal of ophthalmology 20180509

<h4>Purpose</h4>To evaluate whether automated assessment of beta zone parapapillary atrophy (βPPA) area can differentiate between glaucomatous and healthy eyes of varying axial lengths (AL).<h4>Design</h4>Cross-sectional study.<h4>Methods</h4>βPPA was automatically identified in glaucoma and healthy eyes with enhanced-depth imaging optical coherence tomography (OCT) optic nerve head (ONH) radial B-scans. Associations with AL and the presence of glaucoma were assessed. Manually delineated βPPA on ...[more]

PMID: 29750949

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Project description:PurposeTo investigate the differences in the frequency of optic disc hemorrhage (DH) and prevalence of beta-zone parapapillary atrophy (βPPA) between individuals of African descent (AD) and European descent (ED).DesignProspective, multicenter, observational cohort.ParticipantsA total of 1950 eyes of 1172 participants of the African Descent and Glaucoma Evaluation Study (ADAGES).MethodsStereoscopic disc photographs of subjects with and without glaucomatous optic neuropathy (GON) followed during the first 13 years of the ADAGES underwent masked review searching for DH and βPPA. A total of 928 eyes (non-GON, 581; GON, 347) of 551 AD patients (non-GON, 334; GON, 217) and 1022 eyes (non-GON, 568; GON, 454) of 611 ED patients (non-GON, 334; GON, 277) were included. We compared the number of eyes with detected DH at any time during follow-up and eyes with βPPA between the AD and ED groups. The analyses were then adjusted for clinical parameters using multivariable logistic regression.Main outcome measuresDifferences in frequency of DH and prevalence of βPPA.ResultsA total of 9395 stereoscopic disc photographs were reviewed. More ED eyes experience DH than AD eyes (49/1022 [4.8%] vs. 10/928 eyes [1.1%], respectively; P < 0.001), whereas βPPA had higher prevalence in AD eyes (675 eyes [72%] vs. 659 eyes [64%]; P < 0.001). In the final multivariable model, after controlling for confounders, AD eyes were less likely to have at least 1 detected DH than ED eyes (odds ratio [OR], 0.21; 95% CI, 0.10-0.45; P < 0.001) but were more likely to have βPPA than ED eyes (OR, 1.55; 95% CI, 1.12-2.14; P = 0.008).ConclusionsSubjects of ED are at higher risk for developing DH compared with AD subjects, whereas AD subjects have greater prevalence of βPPA. These findings suggest that there are structural differences within the optic nerve complex between these groups. Further research is needed to determine whether racial differences in the frequency of DH and prevalence of βPPA affect the likelihood of glaucomatous progression.

Project description:To characterize the rate and pattern of age-related and glaucomatous neuroretinal rim area changes in subjects of African and European descent.Prospective longitudinal study.Two hundred ninety-six eyes of 157 healthy subjects (88 patients of African descent and 69 of European descent) and 73 progressing glaucoma eyes of 67 subjects (24 patients of African descent and 43 of European descent) from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study were included.Global and sectoral rim areas were measured using confocal laser scanning ophthalmoscopy. Masked stereophotograph review determined progression of glaucomatous optic disc damage. The rates of absolute rim area loss and percentage rim area loss in healthy and progressing glaucomatous eyes were compared using multivariate, nested, mixed-effects models.Rate of rim area loss over time.The median follow-up time was 5.0 years (interquartile range, 2.0-7.4 years) for healthy eyes and 8.3 years (interquartile range, 7.5-9.9 years) for progressing glaucoma eyes. The mean rate of global rim area loss was significantly faster in progressing glaucomatous eyes compared with healthy eyes for both rim area loss (-10.2×10(-3) vs. -2.8×10(-3) mm(2)/year, respectively; P < 0.001) and percentage rim area loss (-1.1% vs. -0.2%/year, respectively; P < 0.001), but considerable overlap existed between the 2 groups. Sixty-three percent of progressing glaucoma eyes had a rate of change faster than the fifth quantile of healthy eyes. For both healthy and progressing eyes, the pattern of rim area loss and percentage rim area loss were similar, tending to be fastest in the superior temporal and inferior temporal sectors. The rate of change was similar in progressing eyes of patients of African or European descent.Compared with healthy eyes, the mean rate of global rim area loss was 3.7 times faster and the mean rate of global percentage rim area loss was 5.4 times faster in progressing glaucoma eyes. A reference database of healthy eyes can be used to help clinicians distinguish age-related rim area loss from rim area loss resulting from glaucoma.

Project description:Importance:?-zone parapapillary atrophy (?PPA) has been reported as a risk factor for glaucoma onset and progression. Previous studies have shown that the prevalence of ?PPA differs between individuals of African descent (AD) and European descent (ED). Objective:To test whether the association between the presence and progression of ?PPA vs visual field progression of glaucoma differs between these 2 ancestry groups. Design, Setting, and Participants:In a prospective, multicenter, longitudinal cohort study, 634 individuals (1090 eyes) enrolled in the African Descent and Evaluation Study (ADAGES) with a diagnosis of glaucomatous optic neuropathy (GON) or ocular hypertension (OHT) and at least 2 disc stereophotographs were included. Two graders masked to clinical and ancestry data reviewed and graded the baseline and last disc stereophotographs for the presence of ?PPA at baseline and ?PPA progression (development or enlargement). Mixed-effects linear models were tested with visual field mean deviation as a dependent variable and time (alone and with interaction terms) as independent variables. ADAGES enrollment began in January 2003 and ended in July 2006; follow-up ended in 2016. Exposures:Disc stereophotographs. Main Outcomes and Measures:Progression of ?PPA in AD and ED individuals. Results:In 634 patients, a total of 814 eyes of AD (395 eyes) and ED (419) patients with GON and 276 eyes of AD (106) and ED (170) patients with OHT who were enrolled in ADAGES were analyzed. There were 336 (53.0%) women in the study; mean (SD) age was 61.9 (12.7) years. In the OHT group, the association between ?PPA at baseline and visual field progression was not significantly different between AD and ED eyes (??=?0.071; 95% CI, -0.016 to 0.158; P?=?.11), nor was the association between ?PPA progression and visual field progression (??=?0.020; 95% CI, -0.465 to 0.506; P?=?.93). In the GON group, ED eyes with baseline ?PPA progressed faster than did AD eyes with baseline ?PPA (??=?-0.124; 95% CI, -0.241 to -0.007; P?=?.04), although the association between ?PPA progression and visual field progression did not differ significantly between race groups (??=?-0.101; 95% CI, -0.323 to 0.119; P?=?.37). Conclusions and Relevance:Race had a significant effect on the association between baseline ?PPA and rates of visual field progression in eyes with GON. Progression of ?PPA was not associated with faster visual field progression in either racial group.

Project description:PurposeTo evaluate optic nerve vascular density using swept source optical coherence tomography angiography (OCTA) in patients with early primary open angle glaucoma (POAG), pre-perimetric glaucoma and normal eyes.MethodsThis is a prospective, observational study including 56 eyes in total and divided into 3 groups; 20 eyes with mild POAG, 20 pre-perimetric glaucoma eyes, and 16 age-matched normal eyes as controls. The optic disc region was imaged by a 1050-nm-wavelength swept-source OCT system (DRI OCT Triton, TOPCON). Vessel density was assessed as the ratio of the area occupied by the vessels in 3 distinct regions: 1) within the optic nerve head; 2) in the 3 mm papillary region around the optic disc; and 3) in the peripapillary region, defined as a 700-μm-wide elliptical annulus around the disc. The potential associations between vessel density and structural, functional measures were analyzed.ResultsThere was a statistically significant difference for the peripapillary vessel density, optic nerve head vessel density, and papillary vessel density among all the groups (p<0.001). Control eyes showed a significant difference for all measured vessel densities compared to glaucomatous eyes (p values from 0.001 to 0.024). There was a statistically significant difference between control and pre-perimetric glaucoma eyes for peripapillary, optic nerve head and papillary vessel density values (p values from 0.001 to 0.007). The optic nerve head vessel density, superior and inferior papillary area vessel density (Pearson r = 0.512, 0.436, 0.523 respectively) were highly correlated with mean overall, superior and inferior RNFL thickness in POAG eyes (p = 0.04, p = 0.02 and p = 0.04 respectively). Multiple linear regression analysis of POAG group showed that optic nerve head vessel density in POAG group was more strongly linked to RNFL thickness than to any other variables.ConclusionsEyes with mild POAG could be differentiated from pre-perimetric glaucoma eyes, which also could be differentiated from normal eyes using OCTA-derived retinal vessel density measurements.

Dataset Information

Automated Beta Zone Parapapillary Area Measurement to Differentiate Between Healthy and Glaucoma Eyes.

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Automated Beta Zone Parapapillary Area Measurement to Differentiate Between Healthy and Glaucoma Eyes.

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