12/17/2023 0 Comments Glaucoma optical coherence tomography![]() Furthermore, the different SDOCT platforms are not standardized, and no true reference standard exists, making comparison of output across platforms challenging ( 14). Distinction of glaucoma from age-related changes affecting the thickness of the retinal nerve fiber layer on SDOCT is also critical to the accurate detection of glaucomatous progression over time ( 12, 13). The risk of overdiagnosis and treating false positives is thought to outweigh the possible benefit of early detection ( 4). Moreover, over 40% of SDOCT may be affected by segmentation errors, which can lead to false positives and negatives ( 9– 11). The large number of varied parameters and plots produced by a single SDOCT test also increases the risk of committing a type 1 error or diagnosing glaucoma when it is not truly present. Review of SDOCT imaging can also be complicated and time-consuming and clinicians can make errors when subjectively interpreting an array of different outputs produced by automated segmentation. Nevertheless, SDOCT is not currently recommended for population-based screening since the technology is expensive and requires skilled operators for image acquisition. Measurements of the disc and rim area, the cup-to-disc ratio, and Bruch’s membrane opening-minimum rim width (BMO-MRW) can provide additional microstructural evidence of early glaucomatous damage. SDOCT commercial software is not only able to segment and measure the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) ( 8), but also can be used to create 3-dimensional reconstructions of the optic nerve head (ONH), macula, and surrounding tissues. Spectral domain (SDOCT) has excellent repeatability ( 6), and it is highly accurate even for detection of early lesions prior to the onset of visual field loss ( 7). In recent years, however, OCT has risen to the forefront as the de facto diagnostic tool of choice for detecting the early onset of structural changes from glaucoma as well as its progression over time. Thus, there is increasing interest in improving diagnostic and screening technologies so that glaucoma can be detected and treated at an early stage before the onset of irreversible blindness.Ī number of diagnostic tests are employed in the clinical evaluation of glaucomatous optic neuropathy, including measurement of IOP and central corneal thickness, gonioscopy, visual field testing, fundus photography, and optical coherence tomography (OCT) ( 4). However, despite the availability of effective treatments to lower IOP and thus slow down the rate of disease progression, a majority of patients with glaucoma are unaware they have the disease until it is advanced since the early stages are relatively asymptomatic ( 5). The only known modifiable risk factor for glaucoma is elevated intraocular pressure (IOP) ( 3), which increases the risk of subsequent vision loss if left untreated ( 4). More than 76 million people were affected by glaucoma as of 2020, and it is projected to impact more than 111.8 million people by 2040, making it the most common cause of irreversible blindness worldwide ( 2). ![]() Glaucoma is a progressive optic neuropathy wherein retinal ganglion cell and retinal nerve fiber layer loss from optic nerve atrophy results in characteristic patterns of visual field loss ( 1). This review highlights ten years of contributions to glaucoma detection through advances in deep learning models trained utilizing OCT structural data and posits future directions for translation of these discoveries into the field of aging and the basic sciences. DL algorithms have also been trained utilizing OCT data to improve detection of glaucomatous damage on fundus photography, thus improving the potential utility of color photos which can be more easily collected in a wider range of clinical and screening settings. In recent years, development of novel deep learning (DL) algorithms has led to innovative advances and improvements in automated detection of glaucomatous damage and progression on OCT imaging. Microstructural evidence of glaucomatous damage to the optic nerve head and associated tissues can be visualized using optical coherence tomography (OCT). Glaucoma is a leading cause of progressive blindness and visual impairment worldwide. 4Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston Salem, NC, United States.3Wake Forest School of Medicine, Winston Salem, NC, United States.2Department of Internal Medicine, Gerontology, and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC, United States.1Department of Surgical Ophthalmology, Wake Forest School of Medicine, Winston Salem, NC, United States. ![]() ![]() Thompson 1,2* Aurelio Falconi 3 Rebecca M. ![]()
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