PLoS ONE (Jan 2016)

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients.

  • Naoko Takada,
  • Kazuko Omodaka,
  • Tsutomu Kikawa,
  • Airi Takagi,
  • Akiko Matsumoto,
  • Yu Yokoyama,
  • Yukihiro Shiga,
  • Kazuichi Maruyama,
  • Hidetoshi Takahashi,
  • Masahiro Akiba,
  • Toru Nakazawa

DOI
https://doi.org/10.1371/journal.pone.0160226
Journal volume & issue
Vol. 11, no. 8
p. e0160226

Abstract

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PURPOSE:To objectively classify the optic discs of open-angle glaucoma (OAG) patients into Nicolela's four disc types, i.e., focal ischemic (FI), myopic (MY), senile sclerotic (SS), and generalized enlargement (GE), with swept-source optical coherence tomography (SS-OCT). METHODS:This study enrolled 113 eyes of 113 OAG patients (mean age: 62.5 ± 12.6; Humphrey field analyzer-measured mean deviation: -9.4 ± 7.3 dB). Newly developed software was used to quantify a total of 20 optic disc parameters in SS-OCT (DRI OCT-1, TOPCON) images of the optic disc. The most suitable reference plane (RP) above the plane of Bruch's membrane opening was determined by comparing, at various RP heights, the SS-OCT-measured rim parameters and spectral-domain OCT-measured circumpapillary retinal nerve fiber layer thickness (cpRNFLT), with Pearson's correlation analysis. To obtain a discriminant formula for disc type classification, a training group of 72 eyes of 72 OAG patients and a validation group of 60 eyes of 60 OAG patients were set up. RESULTS:Correlation with cpRNFLT differed with disc type and RP height, but overall, a height of 120 μm minimized the influence of disc type. Six parameters were most significant for disc type discrimination: disc angle (horizontal), average cup depth, cup/disc ratio, rim-decentering ratio, average rim/disc ratio (upper and lower nasal). Classifying the validation group with these parameters returned an identification rate of 80.0% and a Cohen's Kappa of 0.73. CONCLUSION:Our new, objective SS-OCT-based method enabled us to classify glaucomatous optic discs with high reproducibility and accuracy.