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Abstract #100508 Published in IGR 23-1
Diagnostic accuracy of macular thickness map and texture en-face images for detecting glaucoma in eyes with axial high myopia
Bowd C; Belghith A; Rezapour J; Christopher M; Hyman L; Jonas JB; Weinreb RN; Zangwill LMAmerican Journal of Ophthalmology 2022; 242: 26-35
PURPOSE: To evaluate the diagnostic accuracy of a novel optical coherence tomography (OCT) texture-based en-face image analysis, called SALSA-Texture, that requires segmentation of only one retinal layer for glaucoma detection in eyes with axial high myopia, and to compare to standard macular ganglion cell-inner plexiform layer (GCIPL) thickness, macular retinal nerve fiber layer (mRNFL) thickness, and ganglion cell complex (GCC) thickness maps. DESIGN: Comparison of diagnostic approaches. METHODS: Cross-sectional data were collected from 92 primary open-angle glaucoma (POAG) eyes and 44 healthy eyes with axial high myopia (axial length > 26 mm). OCT texture en-face images, developed using SALSA-Texture to model the spatial arrangement patterns of the pixel intensities in a region, were generated from 70-μm slabs just below the vitreal border of the inner limiting membrane (ILM). Areas under the receiver operating curves (AUROC) and areas under the precision recall curves (AUPRC) adjusted for both eyes, AL, age, disc area and image quality were used to compare different approaches. RESULTS: The best parameter-adjusted AUROCs (95% CI) for differentiating between healthy and glaucoma high myopic eyes were 0.92 (0.88, 0.94) for texture en-face images, 0.88 (0.86, 0.91) for macular RNFL thickness, 0.87 (0.83, 0.89) for macula GCIPL thickness, and 0.87 (0.84, 0.89) for GCC thickness. A subset analysis of highly advanced myopic eyes (axial length ≥ 27 mm, 38 glaucomatous eyes and 22 healthy eyes) showed the best AUROC was 0.92 (0.89, 0.94) for texture en-face images compared to 0.86 (0.84, 0.88) for macular GCIPL, 0.86 (0.84, 0.88) GCC and 0.84 (0.81, 0.87) for RNFL thickness (p ≤ 0.02 compared to texture for all comparisons). CONCLUSION: The current results suggest that our novel en-face texture-based analysis method can improve on most investigated macular tissue thickness measurements for discriminating between highly myopic glaucomatous and highly myopic healthy eyes. While further investigation is needed, texture en-face images show promise for improving the detection of glaucoma in eyes with high myopia where traditional retinal layer segmentation often is challenging.
Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States.
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