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A Simple Subjective Evaluation of Enface OCT Reflectance Images Distinguishes Glaucoma From Healthy Eyes
Cheloni, Riccardo Dewsbery, S.D. Denniss, Jonathan
Cheloni, Riccardo
Dewsbery, S.D.
Denniss, Jonathan
Publication Date
2021-05-25
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© 2021 The Authors. This work is licensed under a Creative Commons Attribution (CC BY) 4.0 International License.
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Accepted for publication
2021-04-16
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Abstract
Purpose: We present a subjective approach to detecting glaucomatous defects in
enface images and assess its diagnostic performance. We also test the hypothesis that
if reflectivity changes precede thickness changes in glaucoma there should be reduced
correlation between the modalities in glaucoma compared to controls.
Methods: Twenty glaucoma participants and 20 age-matched controls underwent
high-resolution OCT scans of one eye. 4 μm-thick enface slabs were constructed through
the retina. Enface indices were depths of first gap in visible retinal nerve fiber bundles
(RNFBs) and last visible bundle, subjectively evaluated in six sectors of a 3.5 mm circle
around the optic disc. Retinal nerve fiber layer thickness (RNFLT) along the same circle
was extracted at angles corresponding to enface indices. Between-group differences
were tested by linear mixed models. Diagnostic performance was measured by partial
receiver operating characteristic area (pAUC).
Results: First gap and last visible bundle were closer to the inner limiting membrane in
glaucoma eyes (both P < 0.0001). Enface indices showed excellent diagnostic perfor mance (pAUCs 0.63–1.00), similar to RNFLT (pAUCs 0.63–0.95). Correlation between
enface and RNFLT parameters was strong in healthy (r = 0.81–0.92) and glaucoma eyes
(r = 0.73–0.80).
Conclusions: This simple subjective method reliably identifies glaucomatous defects
in enface images with diagnostic performance at least as good as existing thickness
indices. Thickness and reflectivity were similarly related in healthy and glaucoma eyes,
providing no strong evidence of reflectivity loss preceding thinning. Objective analyses
may realize further potential of enface OCT images in glaucoma.
Translational Relevance: Novel enface OCT indices may aid glaucoma diagnosis.
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Citation
Cheloni R, Dewsbery SD and Denniss J (2021) A Simple Subjective Evaluation of Enface OCT Reflectance Images Distinguishes Glaucoma From Healthy Eyes. Translational Vision Science And Technology. 10(6): 31.
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