Ametropia, retinal anatomy, and OCT abnormality patterns in glaucoma. 1. Impacts of refractive error and interartery angle

Tobias Elze; Neda Baniasadi; Qingying Jin; Hui Wang; Mengyu Wang

doi:10.1117/1.JBO.22.12.121713

15 December 2017 Ametropia, retinal anatomy, and OCT abnormality patterns in glaucoma. 1. Impacts of refractive error and interartery angle

Tobias Elze, Neda Baniasadi, Qingying Jin, Hui Wang, Mengyu Wang

Author Affiliations +

Funded by: Massachusetts Lions Foundation, US National Institutes of Health (NIH), National Eye Institute (NEI), NEI Core, Harvard Glaucoma Center of Excellence, China Scholarship Council, BrightFocus Foundation, Research to Prevent Blindness (RPB)

Journal of Biomedical Optics, Vol. 22, Issue 12, 121713 (December 2017). https://doi.org/10.1117/1.JBO.22.12.121713

Abstract

Retinal nerve fiber layer thickness (RNFLT) measured by optical coherence tomography (OCT) is widely used in clinical practice to support glaucoma diagnosis. Clinicians frequently interpret peripapillary RNFLT areas marked as abnormal by OCT machines. However, presently, clinical OCT machines do not take individual retinal anatomy variation into account, and according diagnostic biases have been shown particularly for patients with ametropia. The angle between the two major temporal retinal arteries (interartery angle, IAA) is considered a fundamental retinal ametropia marker. Here, we analyze peripapillary spectral domain OCT RNFLT scans of 691 glaucoma patients and apply multivariate logistic regression to quantitatively compare the diagnostic bias of spherical equivalent (SE) of refractive error and IAA and to identify the precise retinal locations of false-positive/negative abnormality marks. Independent of glaucoma severity (visual field mean deviation), IAA/SE variations biased abnormality marks on OCT RNFLT printouts at 36.7%/22.9% of the peripapillary area, respectively. 17.2% of the biases due to SE are not explained by IAA variation, particularly in inferonasal areas. To conclude, the inclusion of SE and IAA in OCT RNFLT norms would help to increase diagnostic accuracy. Our detailed location maps may help clinicians to reduce diagnostic bias while interpreting retinal OCT scans.

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Tobias Elze, Neda Baniasadi, Qingying Jin, Hui Wang, and Mengyu Wang "Ametropia, retinal anatomy, and OCT abnormality patterns in glaucoma. 1. Impacts of refractive error and interartery angle," Journal of Biomedical Optics 22(12), 121713 (15 December 2017). https://doi.org/10.1117/1.JBO.22.12.121713

Received: 30 July 2017; Accepted: 28 November 2017; Published: 15 December 2017

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