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Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time.

ABSTRACT: PRéCIS:: There are errors in automated segmentation of the retinal nerve fiber layer (RNFL) in glaucoma suspects or patients with mild glaucoma that appear to persist over time; however, automated segmentation has greater repeatability than manual segmentation. PURPOSE:To identify whether optical coherence tomography (OCT) segmentation errors in RNFL thickness measurements persist longitudinally. METHODS:This was a cohort study. We used spectral domain OCT (Spectralis) to measure RNFL thickness in a 6-degree peripapillary circle, and exported the native "automated segmentation only" results. In addition, we exported RNFL thickness results after "manual refinement" to correct errors in the automated segmentation, and used the differences in these measurements as "error" in segmentation. We used Bland-Altman plots and linear regression to determine the magnitude, location, and repeatability of RNFL thickness error in all twelve 30-degree sectors and compared the error at baseline to follow-up time points at 6 months, 2 years, 3 years, and 4 years. RESULTS:We included 406 eyes from 213 participants. The 95% confidence interval for errors at baseline was -6.5 to +13.2??m. The correlation between the baseline error and the errors in the follow-up time periods were high (r>0.5, P<0.001 for all). Automated segmentation had a smaller SD of residuals from the longitudinal trend line when compared to manual refinement (1.56 vs. 1.80??m, P<0.001), and a higher ability (P=0.009) to monitor progression using an analysis of a longitudinal signal-to-noise ratio. CONCLUSIONS:Errors in automated segmentation remain relatively stable, and baseline error is highly likely to persist in the same direction and magnitude in subsequent time periods. However, automated segmentation (without manual refinement) is more repeatable and may be more sensitive to glaucomatous progression. Future segmentation algorithms could exploit these findings to improve automated segmentation in the future.

SUBMITTER: Nagarkatti-Gude N

PROVIDER: S-EPMC6499633 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time.

Nagarkatti-Gude Nisha N Gardiner Stuart K SK Fortune Brad B Demirel Shaban S Mansberger Steven L SL

Journal of glaucoma 20190501 5

PRéCIS:: There are errors in automated segmentation of the retinal nerve fiber layer (RNFL) in glaucoma suspects or patients with mild glaucoma that appear to persist over time; however, automated segmentation has greater repeatability than manual segmentation.<h4>Purpose</h4>To identify whether optical coherence tomography (OCT) segmentation errors in RNFL thickness measurements persist longitudinally.<h4>Methods</h4>This was a cohort study. We used spectral domain OCT (Spectralis) to measure R ...[more]

PMID: 30855415

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Project description:To evaluate the relationship between intraocular pressure (IOP) and rates of retinal nerve fiber layer (RNFL) thickness change over time measured by spectral-domain (SD) optical coherence tomography (OCT).Observational cohort study.The study involved 547 eyes of 339 patients followed up for an average of 3.9±0.9 years. Three hundred eight (56.3%) had a diagnosis of glaucoma and 239 (43.7%) were considered glaucoma suspects.All eyes underwent imaging using the Spectralis SD OCT (Heidelberg Engineering GmbH, Heidelberg, Germany), along with IOP measurements and standard automated perimetry (SAP). Glaucoma progression was defined as a result of "Likely Progression" from the Guided Progression Analysis software for SAP. Linear mixed models were used to investigate the relationship between average IOP during follow-up and rates of RNFL thickness change, while taking into account potential confounding factors such as age, race, corneal thickness, and baseline disease severity.The association between IOP and rates of global and sectorial RNFL thickness loss measured by SD OCT.Forty-six eyes (8.4%) showed progression on SAP during follow-up. Rates of global RNFL thickness change in eyes that progressed by SAP were faster than in those that did not progress (-1.02 vs. -0.61 ?m/year, respectively; P = 0.002). For progressing eyes, each 1-mmHg higher average in IOP during follow-up was associated with an additional average loss of 0.20 ?m/year (95% confidence interval [CI]: 0.08 to 0.31 ?m/year; P < 0.001) of global RNFL thickness versus only 0.04 ?m/year (95% CI: 0.01 to 0.07 ?m/year; P = 0.015) for nonprogressing eyes. The largest associations between IOP and rates of RNFL change were seen for measurements from the temporal superior and temporal inferior sectors, whereas the smallest association was seen for measurements from the nasal sector.Higher levels of IOP during follow-up were associated with faster rates of RNFL loss over time measured by SD OCT. These findings support the use of SD OCT RNFL thickness measurements as biomarkers for the evaluation of the efficacy of IOP-lowering therapies to slow down the rate of disease progression.

Dataset Information

Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time.

Publications

Optical Coherence Tomography Segmentation Errors of the Retinal Nerve Fiber Layer Persist Over Time.

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