IOVS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Uchida, H.
Right arrow Articles by Caprioli, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Uchida, H.
Right arrow Articles by Caprioli, J.

Investigative Ophthalmology & Visual Science, Vol 37, 2393-2401, Copyright © 1996 by Association for Research in Vision and Ophthalmology

ARTICLES AND REPORTS

Detection of structural damage from glaucoma with confocal laser image analysis

H Uchida, L Brigatti and J Caprioli
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut 06520, USA.

PURPOSE: To determine which structural optic nerve head parameters measured with confocal scanning laser image analysis that best discriminate between normal persons and those with glaucoma. METHODS: One randomly selected eye of 53 patients with early open-angle glaucoma (average visual field mean deviation = -4.8 dB) and of 43 age-, race-, and refractive error-matched normal subjects were studied. The performance of nine structural measures was evaluated with linear multivariate analysis and a neural network: cup area, cup to disc area ratio, rim area, height variation contour, cup volume, rim volume, cup shape measure, mean retinal nerve fiber layer thickness, and retinal nerve fiber layer cross-section area. A discriminant function was derived with two thirds of the sample and its discriminant power tested on the remaining one third. This was repeated twice so that the entire sample was used for training and testing. A neural network was trained and tested in the same way. Stereoscopic color optic nerve photographs of the same eyes were evaluated qualitatively by three experienced, masked observers. Receiver operating characteristic (ROC) curves of discriminant function, neural network results, and qualitative evaluation were plotted. Comparisons of the areas under the ROC curves were performed with nonparametric statistics. RESULTS: There were statistically significant differences between the normal and glaucoma groups for all measures (P < or = 0.007) except for height variation contour, mean retinal nerve fiber layer thickness, and retinal nerve fiber layer cross-section area. Cup shape measure provided the single best measure to distinguish between normal subjects and those with early glaucoma and had a diagnostic precision of 84%. Neural network diagnostic precision, when all measures were used, was 92% and decreased to 82% when cup shape measure was omitted. The area under the ROC curve when all measures were combined was 0.94; it was significantly lower (P = 0.04) when cup shape measure was omitted (area = 0.84). The area under the ROC curve for qualitative optic disc evaluation by experienced observers was 0.93. There was no statistically significant difference between qualitative evaluation and neural network performance (P = 0.80). CONCLUSIONS: Cup shape measure, the statistical third moment of the distribution of depth values of the optic nerve head obtained with confocal laser image analysis, can be used to discriminate between normal persons and those with early glaucomatous damage with high diagnostic precision.


This article has been cited by other articles:


Home page
 IOVSHome page
A. Ferreras, L. E. Pablo, D. F. Garway-Heath, P. Fogagnolo, and J. Garcia-Feijoo
Mapping Standard Automated Perimetry to the Peripapillary Retinal Nerve Fiber Layer in Glaucoma
Invest. Ophthalmol. Vis. Sci., July 1, 2008; 49(7): 3018 - 3025.
[Abstract] [Full Text] [PDF]

Home page
 Arch OphthalmolHome page
A. Ferreras, L. E. Pablo, A. B. Pajarin, J. M. Larrosa, V. Polo, and F. M. Honrubia
Logistic Regression Analysis for Early Glaucoma Diagnosis Using Optical Coherence Tomography
Arch Ophthalmol, April 1, 2008; 126(4): 465 - 470.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
F. A. Medeiros, D. Ng, L. M. Zangwill, P. A. Sample, C. Bowd, and R. N. Weinreb
The Effects of Study Design and Spectrum Bias on the Evaluation of Diagnostic Accuracy of Confocal Scanning Laser Ophthalmoscopy in Glaucoma
Invest. Ophthalmol. Vis. Sci., January 1, 2007; 48(1): 214 - 222.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
M.-L. Huang, H.-Y. Chen, and J.-C. Lin
Rule Extraction for Glaucoma Detection with Summary Data from StratusOCT
Invest. Ophthalmol. Vis. Sci., January 1, 2007; 48(1): 244 - 250.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
M. Shunmugam and A. Azuara-Blanco
The quality of reporting of diagnostic accuracy studies in glaucoma using the heidelberg retina tomograph.
Invest. Ophthalmol. Vis. Sci., June 1, 2006; 47(6): 2317 - 2323.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
M.-L. Huang and H.-Y. Chen
Development and Comparison of Automated Classifiers for Glaucoma Diagnosis Using Stratus Optical Coherence Tomography
Invest. Ophthalmol. Vis. Sci., November 1, 2005; 46(11): 4121 - 4129.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
C. Bowd, F. A. Medeiros, Z. Zhang, L. M. Zangwill, J. Hao, T.-W. Lee, T. J. Sejnowski, R. N. Weinreb, and M. H. Goldbaum
Relevance Vector Machine and Support Vector Machine Classifier Analysis of Scanning Laser Polarimetry Retinal Nerve Fiber Layer Measurements
Invest. Ophthalmol. Vis. Sci., April 1, 2005; 46(4): 1322 - 1329.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
C. K.-s. Leung, W.-m. Chan, Y.-l. Hui, W.-h. Yung, J. Woo, M.-k. Tsang, and K.-k. Tse
Analysis of Retinal Nerve Fiber Layer and Optic Nerve Head in Glaucoma with Different Reference Plane Offsets, Using Optical Coherence Tomography
Invest. Ophthalmol. Vis. Sci., March 1, 2005; 46(3): 891 - 899.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
C. E. Riva, T. Salgarello, E. Logean, A. Colotto, E. M. Galan, and B. Falsini
Flicker-Evoked Response Measured at the Optic Disc Rim Is Reduced in Ocular Hypertension and Early Glaucoma
Invest. Ophthalmol. Vis. Sci., October 1, 2004; 45(10): 3662 - 3668.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
L. M. Zangwill, K. Chan, C. Bowd, J. Hao, T.-W. Lee, R. N. Weinreb, T. J. Sejnowski, and M. H. Goldbaum
Heidelberg Retina Tomograph Measurements of the Optic Disc and Parapapillary Retina for Detecting Glaucoma Analyzed by Machine Learning Classifiers
Invest. Ophthalmol. Vis. Sci., September 1, 2004; 45(9): 3144 - 3151.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
C. A. Girkin, G. McGwin Jr, C. Long, J. DeLeon-Ortega, C. M. Graf, and A. W. Everett
Subjective and Objective Optic Nerve Assessment in African Americans and Whites
Invest. Ophthalmol. Vis. Sci., July 1, 2004; 45(7): 2272 - 2278.
[Abstract] [Full Text] [PDF]

Home page
 Arch OphthalmolHome page
L. M. Zangwill, R. N. Weinreb, C. C. Berry, A. R. Smith, K. A. Dirkes, A. L. Coleman, J. R. Piltz-Seymour, J. M. Liebmann, G. A. Cioffi, G. Trick, et al.
Racial Differences in Optic Disc Topography: Baseline Results From the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study
Arch Ophthalmol, January 1, 2004; 122(1): 22 - 28.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Ophthalmol.Home page
Y-W Lan, D B Henson, and A J Kwartz
The correlation between optic nerve head topographic measurements, peripapillary nerve fibre layer thickness, and visual field indices in glaucoma
Br. J. Ophthalmol., September 1, 2003; 87(9): 1135 - 1141.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
C. A. Girkin, G. McGwin Jr, S. F. McNeal, and J. DeLeon-Ortega
Racial Differences in the Association between Optic Disc Topography and Early Glaucoma
Invest. Ophthalmol. Vis. Sci., August 1, 2003; 44(8): 3382 - 3387.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
C. Bowd, K. Chan, L. M. Zangwill, M. H. Goldbaum, T.-W. Lee, T. J. Sejnowski, and R. N. Weinreb
Comparing Neural Networks and Linear Discriminant Functions for Glaucoma Detection Using Confocal Scanning Laser Ophthalmoscopy of the Optic Disc
Invest. Ophthalmol. Vis. Sci., November 1, 2002; 43(11): 3444 - 3454.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
M. J. Greaney, D. C. Hoffman, D. F. Garway-Heath, M. Nakla, A. L. Coleman, and J. Caprioli
Comparison of Optic Nerve Imaging Methods to Distinguish Normal Eyes from Those with Glaucoma
Invest. Ophthalmol. Vis. Sci., January 1, 2002; 43(1): 140 - 145.
[Abstract] [Full Text] [PDF]

Home page
 Arch OphthalmolHome page
B. C. Chauhan, T. A. McCormick, M. T. Nicolela, and R. P. LeBlanc
Optic Disc and Visual Field Changes in a Prospective Longitudinal Study of Patients With Glaucoma: Comparison of Scanning Laser Tomography With Conventional Perimetry and Optic Disc Photography
Arch Ophthalmol, October 1, 2001; 119(10): 1492 - 1499.
[Abstract] [Full Text] [PDF]

Home page
 Arch OphthalmolHome page
L. M. Zangwill, C. Bowd, C. C. Berry, J. Williams, E. Z. Blumenthal, C. A. Sanchez-Galeana, C. Vasile, and R. N. Weinreb
Discriminating Between Normal and Glaucomatous Eyes Using the Heidelberg Retina Tomograph, GDx Nerve Fiber Analyzer, and Optical Coherence Tomograph
Arch Ophthalmol, July 1, 2001; 119(7): 985 - 993.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Ophthalmol.Home page
M. Harju and E. Vesti
Scanning laser ophthalmoscopy of the optic nerve head in exfoliation glaucoma and ocular hypertension with exfoliation syndrome
Br. J. Ophthalmol., March 1, 2001; 85(3): 297 - 303.
[Abstract] [Full Text]

Home page
 Br. J. Ophthalmol.Home page
D S Kamal, D F Garway-Heath, R A Hitchings, and F W Fitzke
Use of sequential Heidelberg retina tomograph images to identify changes at the optic disc in ocular hypertensive patients at risk of developing glaucoma
Br. J. Ophthalmol., September 1, 2000; 84(9): 993 - 998.
[Abstract] [Full Text]

Home page
 Br. J. Ophthalmol.Home page
B.-S. Ahn and C. Kee
Ability of a confocal scanning laser ophthalmoscope (TopSS) to detect early glaucomatous visual field defect
Br. J. Ophthalmol., August 1, 2000; 84(8): 852 - 855.
[Abstract] [Full Text]

Home page
 IOVSHome page
A. Colotto, B. Falsini, T. Salgarello, G. Iarossi, M. E. Galan, and L. Scullica
Photopic Negative Response of the Human ERG: Losses Associated with Glaucomatous Damage
Invest. Ophthalmol. Vis. Sci., July 1, 2000; 41(8): 2205 - 2211.
[Abstract] [Full Text]

Home page
 IOVSHome page
N. V. Swindale, G. Stjepanovic, A. Chin, and F. S. Mikelberg
Automated Analysis of Normal and Glaucomatous Optic Nerve Head Topography Images
Invest. Ophthalmol. Vis. Sci., June 1, 2000; 41(7): 1730 - 1742.
[Abstract] [Full Text]

Home page
 IOVSHome page
J. B. Jonas, A. Bergua, P. Schmitz–Valckenberg, K. I. Papastathopoulos, and W. M. Budde
Ranking of Optic Disc Variables for Detection of Glaucomatous Optic Nerve Damage
Invest. Ophthalmol. Vis. Sci., June 1, 2000; 41(7): 1764 - 1773.
[Abstract] [Full Text]

Home page
 Br. J. Ophthalmol.Home page
M. Iester, J. B Jonas, C. Y Mardin, and W. M Budde
Discriminant analysis models for early detection of glaucomatous optic disc changes
Br. J. Ophthalmol., May 1, 2000; 84(5): 464 - 468.
[Abstract] [Full Text]

Home page
 IOVSHome page
T. Salgarello, A. Colotto, B. Falsini, L. Buzzonetti, L. Cesari, G. Iarossi, and L. Scullica
Correlation of Pattern Electroretinogram with Optic Disc Cup Shape in Ocular Hypertension
Invest. Ophthalmol. Vis. Sci., August 1, 1999; 40(9): 1989 - 1997.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Ophthalmol.Home page
D F Garway-Heath, D Poinoosawmy, G Wollstein, A Viswanathan, D Kamal, L Fontana, and R A Hitchings
Inter- and intraobserver variation in the analysis of optic disc images: comparison of the Heidelberg retina tomograph and computer assisted planimetry
Br. J. Ophthalmol., June 1, 1999; 83(6): 664 - 669.
[Abstract] [Full Text]

Home page
 Br. J. Ophthalmol.Home page
D S Kamal, A C Viswanathan, D F Garway-Heath, R A Hitchings, D Poinoosawmy, and C Bunce
Detection of optic disc change with the Heidelberg retina tomograph before confirmed visual field change in ocular hypertensives converting to early glaucoma
Br. J. Ophthalmol., March 1, 1999; 83(3): 290 - 294.
[Abstract] [Full Text]

Home page
 Br. J. Ophthalmol.Home page
J. B Jonas, W. M Budde, and P. Lang
Neuroretinal rim width ratios in morphological glaucoma diagnosis
Br. J. Ophthalmol., December 1, 1998; 82(12): 1366 - 1371.
[Abstract] [Full Text]

Home page
 Arch OphthalmolHome page
R. N. Weinreb
Assessment of Optic Disc Topography for Diagnosing and Monitoring Glaucoma
Arch Ophthalmol, September 1, 1998; 116(9): 1229 - 1231.
[Full Text] [PDF]

Home page
 Arch OphthalmolHome page
Y. H. Yucel, N. Gupta, M. W. Kalichman, A. P. Mizisin, W. Hare, M. de Souza Lima, L. Zangwill, and R. N. Weinreb
Relationship of Optic Disc Topography to Optic Nerve Fiber Number in Glaucoma
Arch Ophthalmol, April 1, 1998; 116(4): 493 - 497.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Ophthalmol.Home page
J. B Jonas, C. Y Mardin, and A. E Gründler
Comparison of measurements of neuroretinal rim area between confocal laser scanning tomography and planimetry of photographs
Br. J. Ophthalmol., April 1, 1998; 82(4): 362 - 366.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the Association for Research in Vision and Ophthalmology