Combining information from 3 anatomic regions in the diagnosis of glaucoma with time-domain optical coherence tomography

Mingwu Wang, Ake Tzu Hui Lu, Rohit Varma, Joel S. Schuman, David S. Greenfield, David Huang

    Research output: Contribution to journalArticle

    Abstract

    PURPOSE: To improve the diagnosis of glaucoma by combining time-domain optical coherence tomography (TD-OCT) measurements of the optic disc, circumpapillary retinal nerve fiber layer (RNFL), and macular retinal thickness. PATIENTS AND METHODS: Ninety-six age-matched normal and 96 perimetric glaucoma participants were included in this observational, cross-sectional study. Or-logic, support vector machine, relevance vector machine, and linear discrimination function were used to analyze the performances of combined TD-OCT diagnostic variables. RESULTS: The area under the receiver-operating curve (AROC) was used to evaluate the diagnostic accuracy and to compare the diagnostic performance of single and combined anatomic variables. The best RNFL thickness variables were the inferior (AROC=0.900), overall (AROC=0.892), and superior quadrants (AROC=0.850). The best optic disc variables were horizontal integrated rim width (AROC=0.909), vertical integrated rim area (AROC=0.908), and cup/disc vertical ratio (AROC=0.890). All macular retinal thickness variables had AROCs of 0.829 or less. Combining the top 3 RNFL and optic disc variables in optimizing glaucoma diagnosis, support vector machine had the highest AROC, 0.954, followed by or-logic (AROC=0.946), linear discrimination function (AROC=0.946), and relevance vector machine (AROC=0.943). All combination diagnostic variables had significantly larger AROCs than any single diagnostic variable. There are no significant differences among the combination diagnostic indices. CONCLUSIONS: With TD-OCT, RNFL and optic disc variables had better diagnostic accuracy than macular retinal variables. Combining top RNFL and optic disc variables significantly improved diagnostic performance. Clinically, or-logic classification was the most practical analytical tool with sufficient accuracy to diagnose early glaucoma.

    Original languageEnglish (US)
    Pages (from-to)129-135
    Number of pages7
    JournalJournal of Glaucoma
    Volume23
    Issue number3
    DOIs
    StatePublished - Mar 2014

    Keywords

    • Glaucoma
    • Image processing
    • Imaging
    • Optical coherence tomography

    ASJC Scopus subject areas

    • Ophthalmology

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