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. 2017 Aug 1;58(10):4310–4317.
doi: 10.1167/iovs.17-21961.

Vertical Macular Asymmetry Measures Derived From SD-OCT for Detection of Early Glaucoma

Farideh Sharifipour  1   2 , Esteban Morales  1 , Ji Woong Lee  1   3 , JoAnn Giaconi  1 , Abdelmonem A Afifi  4 , Fei Yu  1   4 , Joseph Caprioli  1 , Kouros Nouri-Mahdavi  1
Affiliations

Vertical Macular Asymmetry Measures Derived From SD-OCT for Detection of Early Glaucoma

Farideh Sharifipour et al. Invest Ophthalmol Vis Sci. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Invest Ophthalmol Vis Sci. 2017 Sep 1;58(11):4799. doi: 10.1167/iovs.17-22948a. Invest Ophthalmol Vis Sci. 2017. PMID: 28973336 Free PMC article. No abstract available.

Abstract

Purpose: To test the hypothesis that vertical asymmetry in macular ganglion cell/inner plexiform layer (GCIPL) thickness can improve detection of early glaucoma.

Methods: Sixty-nine normal eyes and 101 glaucoma eyes had macular imaging with spectral-domain optical coherence tomography (OCT; 200 × 200 cube). The resulting GCIPL thickness matrix was grouped into a 20 × 20 superpixel array and superior superpixels were compared to their inferior counterparts. A global asymmetry index (AI) was defined as the grand mean of the asymmetry ratios. To measure local asymmetry, the corresponding thickness measurements of three rows above and below the horizontal raphe were compared individually and in combinations. Global and local AIs were compared to the best-performing GCIPL thickness parameters with area under the receiver operating curves (AUC) and sensitivity/specificities.

Results: Age or axial length did not influence AIs in normal subjects (P ≥ 0.08). Global and local AIs were significantly higher in the glaucoma group compared to normal eyes. Minimum (AUC = 0.962, 95% confidence interval [CI]: 0.936-0.989) and inferotemporal thickness (AUC = 0.944, 95% CI: 0.910-0.977; P = 0.122) performed best for detection of early glaucoma. The AUC for global AI was 0.851 (95% CI: 0.792-0.909) compared to 0.916 (95% CI: 0.874-0.958) for the best local AI. Combining minimum or inferotemporal GCIPL thickness and the best local AI led to higher partial AUCs (0.088 and 0.085, 90% specificity, P = 0.120 and 0.130, respectively) than GCIPL thickness measures.

Conclusions: Macular vertical thickness asymmetry measures did not perform better than sectoral or minimum GCIPL thickness for detection of early glaucoma. Combining local asymmetry parameters with the best sectoral GCIPL thickness measures enhanced this task.

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Figures

Figure 1
Figure 1
The 200 × 200 macular cube (Carl Zeiss Meditec, Inc.) consists of 40,000 A-scan measurements that were clustered into a 20 × 20 grid of superpixels centered on the fovea. Local asymmetry measures were defined based on comparison of the GCIPL thickness on the three corresponding pairs of rows above and below the temporal horizontal raphe including four or eight temporal columns, both individually and in combination. The best performing local asymmetry parameter was the one incorporating the three rows above and below the temporal raphe consisting of eight superpixels.
Figure 2
Figure 2
Receiver operating characteristic curves comparing glaucoma diagnostic capabilities of the best local asymmetry index, global asymmetry index, inferotemporal, and minimal GCIPL thicknesses, and combination of the best local asymmetry and regional GCIPL thickness measures.
See this image and copyright information in PMC

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