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Editors Selection IGR 11-3

Morphometry of the Optic Disc

Comment by Claude Burgoyne on:

24085 Optic disc morphology--rethinking shape, Sanfilippo PG; Cardini A; Hewitt AW et al., Progress in Retinal and Eye Research, 2009; 28: 227-248

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In this review article by Sanfilippo et al. (1000) the emerging field of biological morphometrics is reviewed and its implications for the clinical assessment of optic disc size and shape are clearly presented and discussed. In so doing, they argue that the application of 'geometric morphometrics', a branch of statistics that incorporates tools from geometry, biometrics and computer graphics in the quantitative analysis of biological forms, to clinical optic disc analysis is necessary to identify those relationships which are must predictive of susceptibility and are earliest altered by disease. I strongly recommend that all clinicians interested in the disc read this article, but in so doing, recognize that where these tools are likely to have their most important application is not to the features of the disc margin or cup but rather to the three-dimensional architecture of the neural and connective tissues of the optic nerve head. The current efforts of several research groups to use SDOCT imaging to define this architecture will lead to its incorporation into the kind of engineering finite element models being developed by Sigal and colleagues, that assess the shape of the prelaminar neural tissues, lamina cribrosa, scleral canal and peripapillary sclera separate from their position and thickness to predict risk. They will also be incorporated into neural networks to more sensitively and specifically detect the onset and progression of glaucomatous damage. Thus, I predict that it will be in the three dimensional assessment of the optic nerve head tissues rather than those that make up the disc margin and cup, alone, that these powerful new tools will have their most important application.

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