scholarly journals Corneal Segmentation Analysis Increases Glaucoma Diagnostic Ability of Optic Nerve Head Examination, Heidelberg Retina Tomograph’s Moorfield’s Regression Analysis, and Glaucoma Probability Score

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
F. Saenz-Frances ◽  
L. Jañez ◽  
C. Berrozpe-Villabona ◽  
L. Borrego-Sanz ◽  
L. Morales-Fernández ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Open Angle Glaucoma ◽  
Characteristic Curve ◽  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Receiver Operator Characteristic Curve ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Segmentation Analysis

Purpose. To study whether a corneal thickness segmentation model, consisting in a central circular zone of 1 mm radius centered at the corneal apex (zone I) and five concentric rings of 1 mm width (moving outwards: zones II to VI), could boost the diagnostic accuracy of Heidelberg Retina Tomograph’s (HRT’s) MRA and GPS.Material and Methods. Cross-sectional study. 121 healthy volunteers and 125 patients with primary open-angle glaucoma. Six binary multivariate logistic regression models were constructed (MOD-A1, MOD-A2, MOD-B1, MOD-B2, MOD-C1, and MOD-C2). The dependent variable was the presence of glaucoma. In MOD-A1, the predictor was the result (presence of glaucoma) of the analysis of the stereophotography of the optic nerve head (ONH). In MOD-B1 and MOD-C1, the predictor was the result of the MRA and GPS, respectively. In MOD-B2 and MOD-C2, the predictors were the same along with corneal variables: central, overall, and zones I to VI thicknesses. This scheme was reproduced for model MOD-A2 (stereophotography along with corneal variables). Models were compared using the area under the receiver operator characteristic curve (AUC).Results. MOD-A1-AUC: 0.771; MOD-A2-AUC: 0.88; MOD-B1-AUC: 0.736; MOD-B2-AUC: 0.845; MOD-C1-AUC: 0.712; MOD-C2-AUC: 0.838.Conclusion. Corneal thickness variables enhance ONH assessment and HRT’s MRA and GPS diagnostic capacity.

Clinical relevance of protruded retinal layers in minimum rim width measurement of the optic nerve head

2018 ◽  
Vol 103 (10) ◽  
pp. 1401-1405
Author(s):  
Lucas A Torres ◽  
Faisal Jarrar ◽  
Glen P Sharpe ◽  
Donna M Hutchison ◽  
Eduardo Ferracioli-Oda ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Diagnostic Accuracy ◽  
Optic Nerve Head ◽  
Cross Sectional Study ◽  
Retinal Nerve Fibre Layer ◽  
Mean Deviation ◽  
Cross Sectional ◽  
Retinal Layers ◽  
Rnfl Thickness ◽  
Oct Imaging

Background/aimsOptical coherence tomography (OCT) imaging of the optic nerve head minimum rim width (MRW) has recently been shown to sometimes contain components besides extended retinal nerve fibre layer (RNFL). This study was conducted to determine whether excluding these components, termed protruded retinal layers (PRLs), from MRW increases diagnostic accuracy for detecting glaucoma.MethodsIn this cross-sectional study, we included 123 patients with glaucoma and 123 normal age-similar controls with OCT imaging of the optic nerve head (24 radial scans) and RNFL (circle scan). When present, PRLs were manually segmented, and adjusted MRW measurements were computed. We compared diagnostic accuracy of adjusted versus unadjusted MRW measurement. We also determined whether adjusted MRW correlates better with RNFL thickness compared with unadjusted MRW.ResultsThe median (IQR) visual field mean deviation of patients and controls was −4.4 (−10.3 to −2.1) dB and 0.0 (−0.6 to 0.8) dB, respectively. In the 5904 individual B-scans, PRLs were identified less frequently in patients (448, 7.6%) compared with controls (728, 12.3%; p<0.01) and were present most frequently in the temporal sector of both groups. Areas under the receiver operating characteristic curves and sensitivity values at 95% specificity indicated that PRL adjustment did not improve diagnostic accuracy of MRW, globally or temporally. Furthermore, adjusting MRW for PRL did not improve its correlation with RNFL thickness in either group.ConclusionWhile layers besides the RNFL are sometimes included in OCT measurements of MRW, subtracting these layers does not impact clinical utility.

scholarly journals Correlation between Corneal Elevation Topography and Perimetric Changes in Patients with Primary Open Angle Glaucoma

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Visual Field Examination ◽  
Cross Sectional ◽  
Control Subjects ◽  
Scheimpflug Imaging ◽  
Average Maximum ◽  
Grading Scale

Aim: The aim of this study is to assess Scheimpflug topographic elevation maps in patients with POAG and correlate the results with their perimetric changes. Methods: This was an analytical observational cross-sectional study. The study included 130 eyes of 70 subjects which were divided into 78 eyes of 44 patients diagnosed with POAG and 52 eyes of 26 control subjects. Measurement of IOP, visual field examination in patients with POAG using Humphrey Field Analyzer (2003 Carl Zeiss Meditec), Germany were done. Subjects were scanned using TMS-5 topographer (Topographic Modeling System, version 5. Tomey Corp. Nagoya, Japan) to measure central corneal thickness, mean anterior keratometry, maximum anterior and posterior topographic elevation maps in the central 3, 5, and 7 mm. Results: 78 patients with POAG classified according to visual field deterioration using Hodapp-Anderson-Parrish grading scale into mild glaucoma 33 eyes, moderate glaucoma 19 eyes, severe glaucoma 26 eyes, and 52 eyes control were included in the study. The mean age of the patients with POAG was 57.82 ± 7.78 years; 22 eyes (50%) were male and 22 eyes (50%) were female. The average age of control subjects was 56.62 ± 8.48 years; 12 eyes (46.2%) were male and 14 eyes (53.8%) were female, average CCT was 530.3 ± 23.58 µm, average mean anterior keratometry (MAK) was 42.97 ± 1.42 D, average maximum anterior elevation (MAE) in 3,5 and 7mm zone was 5.31 ± 2.28, 12.10 ± 6.94 and 44.04 ± 21.99 µm respectively and average maximum posterior elevation (MPE) in 3,5 and 7mm zone was 8.46 ± 2.10, 19.90 ± 9.39 and 62.72 ± 28.82 µm respectively in patients with POAG, whereas average CCT was 543.0 ± 31.02µm, average MAK was 43.11 ± 1.73 D, average MAE in 3,5 and 7mm zone was 4.52 ± 1.97, 5.90 ± 2.71 and 27.19 ± 8.55 µm respectively. Conclusion: Evaluation of corneal elevation topography by scheimpflug imaging showed forward shifting of the anterior and posterior corneal surfaces in POAG.

scholarly journals Bruch’s membrane opening enlargement and its implication on the myopic optic nerve head

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mi Sun Sung ◽  
Min Young Heo ◽  
Hwan Heo ◽  
Sang Woo Park
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Lamina Cribrosa ◽  
Cross Sectional Study ◽  
Multivariate Regression Model ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Cross Sectional ◽  
Bruch’S Membrane Opening ◽  
Parapapillary Atrophy

AbstractWe examined the association between Bruch’s membrane opening (BMO) area and various ocular parameters and investigated the implication of BMO enlargement on the myopic optic nerve head. One hundred eighty-five myopic eyes were included in this cross-sectional study. Among the included eyes, 53 having axial lengths between 26 and 27 mm were further analyzed to investigate the association between BMO area and various ocular parameters. BMO area, BMO-minimum rim width (BMO-MRW), peripapillary choroidal thickness (pCT), width of β-parapapillary atrophy with and without Bruch’s membrane (PPA+BM and PPA−BM), and presence of lamina cribrosa (LC) defect were evaluated. We found that BMO area tended to increase with increasing axial length, but varied among the highly myopic eyes even though they had similar degrees of myopia. In the subgroup analysis of eyes with axial lengths between 26 and 27 mm, BMO area was highly variable and it significantly correlated with PPA−BM width and temporal-inferior, nasal-inferior, and nasal BMO-MRW and pCT. LC defects were more common in myopic eyes with enlarged BMO. A multivariate regression model revealed that higher intraocular pressure, enlarged BMO, and thinner BMO-MRW were associated with LC defects in highly myopic eyes. These findings should be considered when evaluating myopic eyes.

scholarly journals A predictive model for early diagnosis of keratoconus

2020 ◽  
Author(s):  
GRACIA CASTRO-LUNA ◽  
ANTONIO PÉREZ-RUEDA
Keyword(s):  
Logistic Regression ◽  
Predictive Model ◽  
Corneal Thickness ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Diagnostic Model ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Logistic Regression Models

Abstract Background: The diagnosis of keratoconus in the early stages of the disease is necessary to initiate an early treatment of keratoconus. Furthermore to avoid possible refractive surgery that could produce ectasias. This study aims to describe the topographic, pachymetric and aberrometry characteristics in patients with keratoconus, subclinical keratoconus and normal corneas. Additionally to propose a diagnostic model of subclinical keratoconus based in binary logistic regression models Methods: The design was a cross-sectional study. It included 205 eyes from 205 patients distributed in 82 normal corneas, 40 subclinical keratoconus and 83 established keratoconus The rotary Scheimpflug camera (Pentacam® type) analyzed the topographic, pachymetric and aberrometry variables. It performed a descriptive and bivariate analysis of the recorded data. A diagnostic and predictive model of subclinical keratoconus was calculated with the statistically significant variables Results: Statistically significant differences were observed when comparing normal corneas with subclinical keratoconus/ in variables of the vertical asymmetry to 90º and the central corneal thickness. The binary logistic regression model included the minimal corneal thickness, the anterior coma to 90º and posterior coma to 90º. The model properly diagnosed 92% of cases Conclusions: The differential diagnosis between normal cases and subclinical keratoconus depends on the mínimum corneal thickness, the anterior coma to 90º and the posterior coma to 90º.

When Time is of the Essence: Preliminary Findings for a Quick Administration of the Dot Counting Test

2019 ◽  
Author(s):  
K Chase Bailey ◽  
Troy A Webber ◽  
Jacob I Phillips ◽  
Lindsay D R Kraemer ◽  
Janice C Marceaux ◽  
...  
Keyword(s):  
Classification Accuracy ◽  
Clinical Sample ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Receiver Operator Characteristic Curve ◽  
Performance Validity ◽  
Free Standing ◽  
Cross Sectional ◽  
Validity Measures ◽  
Sensitivity Specificity

Abstract Objective Performance validity research has emphasized the need for briefer measures and, more recently, abbreviated versions of established free-standing tests to minimize neuropsychological evaluation costs/time burden. This study examined the accuracy of multiple abbreviated versions of the Dot Counting Test (“quick” DCT) for detecting invalid performance in isolation and in combination with the Test of Memory Malingering Trial 1 (TOMMT1). Method Data from a mixed clinical sample of 107 veterans (80 valid/27 invalid per independent validity measures and structured criteria) were included in this cross-sectional study; 47% of valid participants were cognitively impaired. Sensitivities/specificities of various 6- and 4-card DCT combinations were calculated and compared to the full, 12-card DCT. Combined models with the most accurate 6- and 4-card combinations and TOMMT1 were then examined. Results Receiver operator characteristic curve analyses were significant for all 6- and 4-card DCT combinations with areas under the curve of .868–.897. The best 6-card combination (cards, 1-3-5-8-11-12) had 56% sensitivity/90% specificity (E-score cut-off, ≥14.5), and the best 4-card combination (cards, 3-4-8-11) had 63% sensitivity/94% specificity (cut-off, ≥16.75). The full DCT had 70% sensitivity/90% specificity (cut-off, ≥16.00). Logistic regression revealed 95% classification accuracy when 6-card or 4-card “quick” combinations were combined with TOMMT1, with the DCT combinations and TOMMT1 both emerging as significant predictors. Conclusions Abbreviated DCT versions utilizing 6- and 4-card combinations yielded comparable sensitivity/specificity as the full DCT. When these “quick” DCT combinations were further combined with an abbreviated memory-based performance validity test (i.e., TOMMT1), overall classification accuracy for identifying invalid performance was 95%.

scholarly journals A-227 Boston Naming Test as an Embedded Performance Validity Test: A Replication Study

2020 ◽  
Vol 35 (6) ◽  
pp. 1022-1022
Author(s):  
Abramson D ◽  
White D ◽  
Resch Z ◽  
Ovsiew G ◽  
Soble J
Keyword(s):  
Characteristic Curve ◽  
Area Under The Curve ◽  
High Specificity ◽  
Cross Sectional Study ◽  
Receiver Operator Characteristic Curve ◽  
Performance Validity ◽  
Boston Naming Test ◽  
Cross Sectional ◽  
Validity Test ◽  
Naming Test

Abstract Objective The Boston Naming Test (BNT) has recently been proposed as an embedded performance validity test (PVT) with high specificity/low sensitivity; however, this has not been replicated. This study therefore aimed to cross-validate findings in a mixed clinical neuropsychiatric sample. Method This cross-sectional study of 136 primary monolingual English-speaking patients who completed the BNT during outpatient evaluation was 57% female/43% male, 38% Caucasian, 39% African American, 16% Hispanic, and 6% Asian with mean age of 47.7 years (SD = 16.6) and mean education of 14.0 years (SD = 2.7). In total, 109/136 (80%) were classified as valid and 27/136 (20%) as invalid based on 4 independent criterion PVTs. Results Respective mean BNT raw/T-scores were 49.5 (SD = 9.2)/45.3 (SD = 10.9) for the valid group and 45.8 (SD = 8.2)/41.1 (SD = 7.8) for the invalid group. Analyses of variance fell just above significance for both BNT raw F(1, 134) = 3.75, p = .05 and T-scores F(1, 134) = 3.55, p = .06. Receiver operator characteristic curve analysis for the raw score was significant, with an area under the curve (AUC) of .67 (p &lt; .01) and an optimal cutoff of ≤ 35 (4% specificity/90% sensitivity). BNT raw scores remained significant after removing bilingual participants, (AUC = .68; p &lt; .01), with identical psychometric properties. In contrast, analysis of BNT T-scores (AUC = .61; p = .08) were nonsignificant. Conclusions Overall, results showed that the BNT cannot psychometrically distinguish valid versus invalid performance and therefore has questionable utility as a PVT in a mixed clinical setting. Findings contribute to a growing literature base cautioning against the indiscriminate use of measures of actual cognitive ability as validity indicators, particularly in populations with cognitive impairment.

scholarly journals Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Fariba Ghassemi ◽  
Sahar Berijani ◽  
Ramak Roohipoor ◽  
Masoumeh Mohebbi ◽  
Ameneh Babeli ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Blood Perfusion ◽  
Cross Sectional Study ◽  
Vascular Density ◽  
Optical Coherence ◽  
Cross Sectional

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.

scholarly journals Optic Nerve Sonography in the Diagnostic Evaluation of Pseudopapilledema and Raised Intracranial Pressure: A Cross-Sectional Study

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Masoud Mehrpour ◽  
Fatemeh Oliaee Torshizi ◽  
Shooka Esmaeeli ◽  
Salameh Taghipour ◽  
Sahar Abdollahi
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Head ◽  
Cross Sectional Study ◽  
Optic Disk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nerve Sheath ◽  
Nerve Sonography ◽  
Optic Nerve Sonography

Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination.Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes.Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100% for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90% for the right eye and 87% for the left eye.Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage.

scholarly journals Diagnostic validity of optic nerve head colorimetric assessment and optical coherence tomography angiography in patients with glaucoma

2020 ◽  
pp. bjophthalmol-2020-316455
Author(s):  
Carmen Mendez-Hernandez ◽  
Surina Wang ◽  
Paula Arribas-Pardo ◽  
Liseth Salazar-Quiñones ◽  
Noemi Güemes-Villahoz ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Open Angle Glaucoma ◽  
Vessel Density ◽  
Diagnostic Validity ◽  
Optical Coherence ◽  
Open Angle ◽  
Cross Sectional

Background/AimsThe aim of this study was to assess the optic nerve head (ONH) and macular vessel density with optical coherence tomography angiography (OCT-A) and the ONH haemoglobin (ONH Hb) amount with Laguna ONhE program in open-angle glaucoma (OAG) patients.MethodsIn this prospective observational cross-sectional study, 67 OAG patients and 41 healthy age-sex frequency matched subjects were examined with OCT-A and retinal photos. The circumpapillary (wcpVD), optic nerve head (iVD) and macular (wmVD) capillary vessel density of OCT-A and ONH colorimetric assessment to determine the ONH Hb amount using the Laguna ONhE program were evaluated.ResultsSignificant differences between normal subjects and glaucoma patients in the wcpVD (22.18±3.42 vs 16.03±2.89%; p<0.001), iVD (18.31±5.56 vs 12.52±4.67%; p<0.001), wmVD (15.60±2.34 vs 13.34±2.32%; p<0.001) and amount of ONH Hb (71.10±1.67 vs 68.86±2.46%; p<0.001) and in the papillary cup (68.14±5.25 vs 64.77±5.08%; p=0.001) were found. The Laguna ONhE glaucoma discriminant function (GDF) index had a negative value in the OAG patients and normal values in healthy subjects (−18.76±13.31 vs 7.98±14.09; p<0.001). The area under the receiver operating characteristic (ROC) curve (AUROC) for discriminating between healthy and glaucomatous eyes was highest for wcpVD (0.93; 95% CI 0.86 to 0.97, p<0.0001), followed by GDF (0.92; 95% CI 0.86 to 0.97, p<0.0001), iVD (0.79; 95% CI 0.70 to 0.86; p<0.0001) and ONH Hb (0.78; 95% CI 0.69 to 0.85, p<0.0001). Pair wise comparisons showed that the AUROC of wcpVD (0.93) was not significantly different than GDF (0.92) (p=0.855).ConclusionLaguna ONhE program and OCT-A have similar diagnostic validity in open-angle glaucoma patients.

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