Regression Analysis of Optical Coherence Tomography Disc Variables for Glaucoma Diagnosis

the Advanced Imaging for Glaucoma Study Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

PURPOSE:: To report diagnostic accuracy of optical coherence tomography (OCT) disc variables using both time-domain (TD) and Fourier-domain (FD) OCT, and to improve the use of OCT disc variable measurements for glaucoma diagnosis through regression analyses that adjust for optic disc size and axial length–based magnification error. DESIGN:: Observational, cross-sectional. PARTICIPANTS:: In total, 180 normal eyes of 112 participants and 180 eyes of 138 participants with perimetric glaucoma from the Advanced Imaging for Glaucoma Study. METHODS:: Diagnostic variables evaluated from TD-OCT and FD-OCT were: disc area, rim area, rim volume, optic nerve head volume, vertical cup-to-disc ratio (CDR), and horizontal CDR. These were compared with overall retinal nerve fiber layer thickness and ganglion cell complex. Regression analyses were performed that corrected for optic disc size and axial length. Area-under-receiver-operating curves (AUROC) were used to assess diagnostic accuracy before and after the adjustments. An index based on multiple logistic regression that combined optic disc variables with axial length was also explored with the aim of improving diagnostic accuracy of disc variables. MAIN OUTCOME MEASURE:: Comparison of diagnostic accuracy of disc variables, as measured by AUROC. RESULTS:: The unadjusted disc variables with the highest diagnostic accuracies were: rim volume for TD-OCT (AUROC=0.864) and vertical CDR (AUROC=0.874) for FD-OCT. Magnification correction significantly worsened diagnostic accuracy for rim variables, and while optic disc size adjustments partially restored diagnostic accuracy, the adjusted AUROCs were still lower. Axial length adjustments to disc variables in the form of multiple logistic regression indices led to a slight but insignificant improvement in diagnostic accuracy. CONCLUSIONS:: Our various regression approaches were not able to significantly improve disc-based OCT glaucoma diagnosis. However, disc rim area and vertical CDR had very high diagnostic accuracy, and these disc variables can serve to complement additional OCT measurements for diagnosis of glaucoma.

Original languageEnglish (US)
JournalJournal of Glaucoma
DOIs
StateAccepted/In press - Feb 19 2016

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Optical Coherence Tomography
Glaucoma
Regression Analysis
Optic Disk
Logistic Models
Nerve Fibers
Ganglia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Regression Analysis of Optical Coherence Tomography Disc Variables for Glaucoma Diagnosis. / the Advanced Imaging for Glaucoma Study Group.

In: Journal of Glaucoma, 19.02.2016.

Research output: Contribution to journalArticle

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title = "Regression Analysis of Optical Coherence Tomography Disc Variables for Glaucoma Diagnosis",
abstract = "PURPOSE:: To report diagnostic accuracy of optical coherence tomography (OCT) disc variables using both time-domain (TD) and Fourier-domain (FD) OCT, and to improve the use of OCT disc variable measurements for glaucoma diagnosis through regression analyses that adjust for optic disc size and axial length–based magnification error. DESIGN:: Observational, cross-sectional. PARTICIPANTS:: In total, 180 normal eyes of 112 participants and 180 eyes of 138 participants with perimetric glaucoma from the Advanced Imaging for Glaucoma Study. METHODS:: Diagnostic variables evaluated from TD-OCT and FD-OCT were: disc area, rim area, rim volume, optic nerve head volume, vertical cup-to-disc ratio (CDR), and horizontal CDR. These were compared with overall retinal nerve fiber layer thickness and ganglion cell complex. Regression analyses were performed that corrected for optic disc size and axial length. Area-under-receiver-operating curves (AUROC) were used to assess diagnostic accuracy before and after the adjustments. An index based on multiple logistic regression that combined optic disc variables with axial length was also explored with the aim of improving diagnostic accuracy of disc variables. MAIN OUTCOME MEASURE:: Comparison of diagnostic accuracy of disc variables, as measured by AUROC. RESULTS:: The unadjusted disc variables with the highest diagnostic accuracies were: rim volume for TD-OCT (AUROC=0.864) and vertical CDR (AUROC=0.874) for FD-OCT. Magnification correction significantly worsened diagnostic accuracy for rim variables, and while optic disc size adjustments partially restored diagnostic accuracy, the adjusted AUROCs were still lower. Axial length adjustments to disc variables in the form of multiple logistic regression indices led to a slight but insignificant improvement in diagnostic accuracy. CONCLUSIONS:: Our various regression approaches were not able to significantly improve disc-based OCT glaucoma diagnosis. However, disc rim area and vertical CDR had very high diagnostic accuracy, and these disc variables can serve to complement additional OCT measurements for diagnosis of glaucoma.",
author = "{the Advanced Imaging for Glaucoma Study Group} and Richter, {Grace M.} and Xinbo Zhang and O. Tan and Francis, {Brian A.} and Vikas Chopra and Greenfield, {David S.} and Rohit Varma and Schuman, {Joel S.} and David Huang",
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AU - the Advanced Imaging for Glaucoma Study Group

AU - Richter, Grace M.

AU - Zhang, Xinbo

AU - Tan, O.

AU - Francis, Brian A.

AU - Chopra, Vikas

AU - Greenfield, David S.

AU - Varma, Rohit

AU - Schuman, Joel S.

AU - Huang, David

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N2 - PURPOSE:: To report diagnostic accuracy of optical coherence tomography (OCT) disc variables using both time-domain (TD) and Fourier-domain (FD) OCT, and to improve the use of OCT disc variable measurements for glaucoma diagnosis through regression analyses that adjust for optic disc size and axial length–based magnification error. DESIGN:: Observational, cross-sectional. PARTICIPANTS:: In total, 180 normal eyes of 112 participants and 180 eyes of 138 participants with perimetric glaucoma from the Advanced Imaging for Glaucoma Study. METHODS:: Diagnostic variables evaluated from TD-OCT and FD-OCT were: disc area, rim area, rim volume, optic nerve head volume, vertical cup-to-disc ratio (CDR), and horizontal CDR. These were compared with overall retinal nerve fiber layer thickness and ganglion cell complex. Regression analyses were performed that corrected for optic disc size and axial length. Area-under-receiver-operating curves (AUROC) were used to assess diagnostic accuracy before and after the adjustments. An index based on multiple logistic regression that combined optic disc variables with axial length was also explored with the aim of improving diagnostic accuracy of disc variables. MAIN OUTCOME MEASURE:: Comparison of diagnostic accuracy of disc variables, as measured by AUROC. RESULTS:: The unadjusted disc variables with the highest diagnostic accuracies were: rim volume for TD-OCT (AUROC=0.864) and vertical CDR (AUROC=0.874) for FD-OCT. Magnification correction significantly worsened diagnostic accuracy for rim variables, and while optic disc size adjustments partially restored diagnostic accuracy, the adjusted AUROCs were still lower. Axial length adjustments to disc variables in the form of multiple logistic regression indices led to a slight but insignificant improvement in diagnostic accuracy. CONCLUSIONS:: Our various regression approaches were not able to significantly improve disc-based OCT glaucoma diagnosis. However, disc rim area and vertical CDR had very high diagnostic accuracy, and these disc variables can serve to complement additional OCT measurements for diagnosis of glaucoma.

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