Influence of Optic Disc Size on Identifying Glaucomatous Optic Neuropathy

Nixon, Gregory J.; Watanabe, Ronald; Sullivan-Mee, Michael; DeWilde, Anthony; Young, Lisa R.; Mitchell, G. Lynn

doi:10.1097/opx.0000000000001085

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…[9][10][11][12] However, it is crucial to acknowledge that not all modifications in the optic disc are indicative of glaucoma, as some alterations may be due to physiological factors or other ocular conditions. [13][14][15][16][17] Furthermore, diagnosing glaucomatous optic neuropathy (GON) is reliant on subjective and empirical assessments, which adds to the complexity of diagnosing glaucoma. 18 Color fundus photos (CFPs) are a valuable tool in ophthalmology as they allow for the visualization of lesion characteristics in a non-invasive, accessible, and cost-effective manner, making it a widely used method for large-scale detection.…”

Section: Introductionmentioning

confidence: 99%

Association of optic disc parameters and glaucoma incidence based on automated segmentation, evidence from the UK Biobank

Zhu,

He,

Shi

et al. 2023

Preprint

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ObjectiveTo assess the correlation between glaucoma incidence and optic disc parameters obtained through an automated deep learning (DL) algorithm segmentation.Methods and AnalysisWe obtained eligible fundus photographs and corresponding participant data from the UK Biobank. To accurately assess the optic disc parameters and their relationship with glaucoma incidence using Cox proportional hazard regression models, we developed a DL algorithm that automatically segmented the optic disc and cup and calculated various parameters including the vertical cup-to-disc ratio (VCDR), ovality index, cup-to-disc area ratio, rim area, disc area, and disc rotation from the fundus photos. We performed two logistic regression models, with model A comprising sociodemographic and health covariates and model B including additional ophthalmic features. Receiver operating characteristic curves (ROC) and areas under the curve (AUC) were plotted and calculated for each model to evaluate their performance.ResultsA total of 44,376 subjects with fundus photos were included in our study. After a median follow-up of 10.1 years, 354 incident glaucoma were documented. Subjects with larger VCDR had a higher risk of incident glaucoma; the HR (95% CI) was 2.05 (1.57-2.66) in the multivariable-adjusted model (p<0.001). The results remain significant in the sensitivity analysis that excluded fundus photographs with “Reject” quality. After adding the optic disc parameters into the regression model A, the AUC increased by 4.2% to 78.6%.ConclusionThe VCDR calculated by automatic optic disc segmentation model shows potential as a biomarker for evaluating the risk of glaucoma.What is already known on this topicGlaucoma is a worldwide leading cause of irreversible vision loss, and its early diagnosis is of great necessity.What this study addsData from the UK Biobank shows the optic disc parameters and their relationship with glaucoma incidence.We develop a DL-based algorithm for optic disc segmentation in Color fundus photos and validate its efficacy in glaucoma prediction.How this study might affect research, practice or policyThe VCDR calculated using an automatic optic disc segmentation based on a DL model can serve as a biomarker to predict the incidence of glaucoma.

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Section: Introductionmentioning

confidence: 99%

Association of optic disc parameters and glaucoma incidence based on automated segmentation, evidence from the UK Biobank

Zhu,

He,

Shi

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In glaucoma, fundus photos provide the vertical optic nerve cup-to-disc ratio (vCDR), which quantifies the relationship between the cup (the central depression on the optic nerve head) and the disc (the entire optic nerve head) which enlarges as the disease progresses. Interpretation of these photos, however, can be difficult to reproduce among even expert specialists, and exhibit high rates of inter-observer variability [6][7][8], as well as being subject to observer bias (e.g., the tendency to under-call optic neuropathy in small optic discs while overcalling disease in physiologically large discs [9]). Therefore, the development and application of an AI tool to classify GON could greatly enhance fundus photography's utility as a population-based screening tool.…”

Section: Introductionmentioning

confidence: 99%

Multi-Dataset Comparison of Vision Transformers and Convolutional Neural Networks for Detecting Glaucomatous Optic Neuropathy from Fundus Photographs

Hwang,

Chen,

Han

et al. 2023

Bioengineering

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Glaucomatous optic neuropathy (GON) can be diagnosed and monitored using fundus photography, a widely available and low-cost approach already adopted for automated screening of ophthalmic diseases such as diabetic retinopathy. Despite this, the lack of validated early screening approaches remains a major obstacle in the prevention of glaucoma-related blindness. Deep learning models have gained significant interest as potential solutions, as these models offer objective and high-throughput methods for processing image-based medical data. While convolutional neural networks (CNN) have been widely utilized for these purposes, more recent advances in the application of Transformer architectures have led to new models, including Vision Transformer (ViT,) that have shown promise in many domains of image analysis. However, previous comparisons of these two architectures have not sufficiently compared models side-by-side with more than a single dataset, making it unclear which model is more generalizable or performs better in different clinical contexts. Our purpose is to investigate comparable ViT and CNN models tasked with GON detection from fundus photos and highlight their respective strengths and weaknesses. We train CNN and ViT models on six unrelated, publicly available databases and compare their performance using well-established statistics including AUC, sensitivity, and specificity. Our results indicate that ViT models often show superior performance when compared with a similarly trained CNN model, particularly when non-glaucomatous images are over-represented in a given dataset. We discuss the clinical implications of these findings and suggest that ViT can further the development of accurate and scalable GON detection for this leading cause of irreversible blindness worldwide.

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Risk Factors for Open-angle Glaucoma in Persons of Latin American Descent

Wurster

Harris

González

et al. 2019

Journal of Glaucoma

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Purpose: The aim of this paper is to concisely summarize what is currently known about OAG among persons of LAD in the United States for the purpose of improving individualized care and highlighting areas requiring further study. Materials and Methods: Review of relevant literature was performed through PubMed and Google Scholar from October 1978 through November 11, 2019. Results: As the Latin American population grows within the United States, it is predicted that by 2050, men of LAD will make up the largest demographic group with OAG. Persons of LAD experience a greater increase in OAG prevalence per decade of life compared with persons of African descent and may have unique risk factors. In particular, those with African ancestry and hypertension are at greater risk of elevated intraocular pressure (IOP). Maximum IOP, variability in IOP, and diabetes are also important considerations. Unique anatomic and physiological characteristics such as scleral tensile strain, longer axial length, thin corneas, and corneal hysteresis may play a role in this population’s unique risk for the development and progression of OAG. Conclusions: OAG represents a growing concern among persons of LAD in the United States; however, information on specific risk factors in this population currently remains limited. Studies should be designed to investigate the LAD population and their respective structural, vascular, and social risk factors for the development and progression of OAG to assist clinicians in improving outcomes for this growing population.

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Influence of Optic Disc Size on Identifying Glaucomatous Optic Neuropathy

Cited by 3 publications

References 24 publications

Association of optic disc parameters and glaucoma incidence based on automated segmentation, evidence from the UK Biobank

Association of optic disc parameters and glaucoma incidence based on automated segmentation, evidence from the UK Biobank

Multi-Dataset Comparison of Vision Transformers and Convolutional Neural Networks for Detecting Glaucomatous Optic Neuropathy from Fundus Photographs

Risk Factors for Open-angle Glaucoma in Persons of Latin American Descent

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