Correlation between morphology of optic disc determined by Heidelberg Retina Tomograph II and visual function in eyes with open-angle glaucoma

Omodaka, Kazuko; Nakazawa, Toru; Otomo, Takaaki; Nakamura, Masahiko; Fuse, Nobuo; Nishida, Kohji

doi:10.2147/opth.s9741

Cited by 7 publications

(7 citation statements)

References 38 publications

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“…We found that each of the 20 ONH topographical parameters output by our software had excellent reproducibility. We used these parameters to classify a group of glaucomatous eyes by optic disc type, and found that this classification correlated well with classifications based on a previous, HRT II-based method [ 11 ]. A stepwise analysis showed that the following 6 parameters were most useful for classifying the ONH: disc angle (horizontal), average cup depth, average rim to disc ratio (NS, NI), rim decentering ratio, and R/D ratio.…”

Section: Discussionmentioning

confidence: 71%

“…Measurement parameters of optic disc cupping have shown that it is significantly associated with glaucoma severity and that, interestingly, cupping precedes visual field loss. [ 10 , 11 ] Cupping is evident in high-tension glaucoma and also in normal-tension glaucoma, which is the most common type of glaucoma in Asia. In animal models, the intravitreal injection of endothelin has been found to induce retinal vessel constriction and subsequently enlarge existing cupping.…”

Section: Introductionmentioning

confidence: 99%

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OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

et al. 2016

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PurposeTo objectively classify the optic discs of open-angle glaucoma (OAG) patients into Nicolela's four disc types, i.e., focal ischemic (FI), myopic (MY), senile sclerotic (SS), and generalized enlargement (GE), with swept-source optical coherence tomography (SS-OCT).MethodsThis study enrolled 113 eyes of 113 OAG patients (mean age: 62.5 ± 12.6; Humphrey field analyzer-measured mean deviation: -9.4 ± 7.3 dB). Newly developed software was used to quantify a total of 20 optic disc parameters in SS-OCT (DRI OCT-1, TOPCON) images of the optic disc. The most suitable reference plane (RP) above the plane of Bruch’s membrane opening was determined by comparing, at various RP heights, the SS-OCT-measured rim parameters and spectral-domain OCT-measured circumpapillary retinal nerve fiber layer thickness (cpRNFLT), with Pearson's correlation analysis. To obtain a discriminant formula for disc type classification, a training group of 72 eyes of 72 OAG patients and a validation group of 60 eyes of 60 OAG patients were set up.ResultsCorrelation with cpRNFLT differed with disc type and RP height, but overall, a height of 120 μm minimized the influence of disc type. Six parameters were most significant for disc type discrimination: disc angle (horizontal), average cup depth, cup/disc ratio, rim-decentering ratio, average rim/disc ratio (upper and lower nasal). Classifying the validation group with these parameters returned an identification rate of 80.0% and a Cohen’s Kappa of 0.73.ConclusionOur new, objective SS-OCT-based method enabled us to classify glaucomatous optic discs with high reproducibility and accuracy.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

et al. 2016

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“… 22 Furthermore, the association between Heidelberg retina tomograph (HRT) II parameters and impaired visual fields was strong in patients with the generalized enlargement disc type but not in those with the focal ischemic disc type. 23 In addition, we found that patients with severe high-tension glaucoma had a significantly higher proportion of the generalized enlargement disc type of glaucoma. Thus, a study that evaluates patients by disc type may provide informative data.…”

Section: Introductionmentioning

confidence: 67%

“…Thirty-eight eyes from 38 Japanese adults aged > 40 years (mean age 62.7 ± 8.6 years) with glaucoma of the generalized enlargement disc type were studied. The generalized enlargement disc type was classified according to the system previously described by Nicolela and Drance 20 and in our publications 23 , 24 ( Figure 1 ). Patients were excluded from the study if they had glaucoma with other types of optic disc patterns, any other ocular diseases, systemic diseases affecting the visual field or blood flow, a history of intraocular surgery, or refractive errors (spherical equivalent up to −4 diopters [D]).…”

Section: Methodsmentioning

confidence: 99%

Association between optic nerve blood flow and objective examinations in glaucoma patients with generalized enlargement disc type

Chiba

Omodaka²,

Yokoyama³

et al. 2011

OPTH

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BackgroundThe purpose of this study was to investigate the correlations between microcirculation in the optic disc, average peripapillary retinal nerve fiber layer thickness cupping parameters, and visual field defects in glaucoma patients with the generalized enlargement disc type.MethodsA total of 38 eyes from 38 glaucoma patients with the generalized enlargement disc type were included. The microcirculation of the optic nerve head was examined with laser speckle flow graphy, and the mean blur rate in all areas, in vessel area, and in tissue area were calculated using the laser speckle flow graphy analyzer software. Average peripapillary retinal nerve fiber layer thickness was measured using Stratus optical coherence tomography, and cupping parameters were accessed using the Heidelberg retina tomograph. The mean deviation in the Humphrey field analyzer (30-2 SITA standard) was analyzed. The correlation between these parameters was evaluated using the Spearman rank correlation coefficient.ResultsThe correlation coefficient of mean blur rate in all optic disc area to the average peripapillary retinal nerve fiber layer thickness, vertical C/D, and mean deviation were r = 0.7546 (P < 0.0001), r = −0.6208 (P < 0.0001), and r = 0.6010 (P = 0.0001), respectively. The mean blur rate in tissue area of the optic disc showed r = 0.7305 (P < 0.0001), r = −0.6438 (P < 0.0001), and r = 0.6338 (P < 0.0001).ConclusionWe found that the mean blur rate in the optic disc was significantly correlated with the average peripapillary retinal nerve fiber layer thickness, vertical C/D, and mean deviation in patients with the generalized enlargement disc type of glaucoma. In particular, the mean blur rate in tissue area was more highly correlated than the vessel area with other results of examination in glaucoma patients with the generalized enlargement disc type.

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“…Moreover, the sample distribution of glaucoma types may have influenced the values of the ONH parameters. In a past study, we demonstrated the correlation between the severity of glaucomatous damage and different glaucomatous ONH types as classified by Nicolela's system [11] , [38] . Our report found that discs with generalized enlargement, i.e., those with a diffusely enlarged round cup without focal defects on the disc rim, had the highest correlation to MD.…”

Section: Discussionmentioning

confidence: 97%

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

et al. 2014

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PurposeThe Glaucoma Stereo Analysis Study (GSAS), a cross sectional multicenter collaborative study, used a stereo fundus camera to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients and investigated the relationships between these parameters and patient characteristics.Subjects and MethodsThe study included 187 eyes of 187 subjects with primary open angle glaucoma or normal tension glaucoma (male: female = 100: 87, age = 61±9 years). Stereo pairs of ONH photographs were made with a stereo fundus camera (nonmyd WX). ONH morphological parameters were calculated with prototype analysis software. In addition to 35 standard parameters, we defined three novel parameters: disc tilt angle, rim decentering, and the absolute value of rim decentering. The correlation between each parameter and patient characteristics was analyzed with Spearman's rank correlation coefficient.ResultsPatient characteristics included refractive error of −3.38±3.75 diopters, intraocular pressure (IOP) of 13.6±2.6 mmHg, and visual field mean deviation (MD) of −4.71±3.26 dB. Representative ONH parameters included a horizontal disc width of 1.66±0.28 mm, vertical disc width of 1.86±0.23 mm, disc area of 2.42±0.63 mm2, cup area of 1.45±0.57 mm2, and cup volume of 0.31±0.22 mm3. Correlation analysis revealed significant negative associations between vertical cup-to-disc ratio (0.82±0.08) and MD (r = −0.40, P<0.01) and between disc tilt angle (10.5±12.5 degrees) and refractive error (r = −0.36, P<0.01). Seventy-five percent of the eyes had a positive value for rim decentering (0.30±0.42), indicating that rim thinning manifested more often as an inferior lesion than a superior lesion.ConclusionWe used stereoscopic analysis to establish a database of ONH parameters, which may facilitate future studies of glaucomatous changes in ONH morphology.

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Correlation between morphology of optic disc determined by Heidelberg Retina Tomograph II and visual function in eyes with open-angle glaucoma

Cited by 7 publications

References 38 publications

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

Association between optic nerve blood flow and objective examinations in glaucoma patients with generalized enlargement disc type

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

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