GPU-accelerated iterative method for FD-OCT image reconstruction with an image-level cross-domain regularizer.

The image reconstruction for Fourier-domain optical coherence tomography (FD-OCT) could be achieved by iterative methods, which offer a more accurate estimation than the traditional inverse discrete Fourier transform (IDFT) reconstruction. However, the existing iterative methods are mostly A-line-based and are developed on CPU, which causes slow reconstruction. Besides, A-line-based reconstruction makes the iterative methods incompatible with most existing image-level image processing techniques. In this paper, we proposed an iterative method that enables B-scan-based OCT image reconstruction, which has three major advantages: (1) Large-scale parallelism of the OCT dataset is achieved by using GPU acceleration. (2) A novel image-level cross-domain regularizer was developed, such that the image processing could be performed simultaneously during the image reconstruction; an enhanced image could be directly generated from the OCT interferogram. (3) The scalability of the proposed method was demonstrated for 3D OCT image reconstruction. Compared with the state-of-the-art (SOTA) iterative approaches, the proposed method achieves higher image quality with reduced computational time by orders of magnitude. To further show the image enhancement ability, a comparison was conducted between the proposed method and the conventional workflow, in which an IDFT reconstructed OCT image is later processed by a total variation-regularized denoising algorithm. The proposed method can achieve a better performance evaluated by metrics such as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), while the speed is improved by more than 30 times. Real-time image reconstruction at more than 20 B-scans per second was realized with a frame size of 4096 (axial) × 1000 (lateral), which showcases the great potential of the proposed method in real-world applications.

Stable complex conjugate artifact removal in OCT using circularly polarized light as reference.

In Fourier domain optical coherence tomography (FDOCT), the depth profile is mirrored about the zero delay between the sample and reference optical paths, limiting the imaging depth to half of the entire ranging space and undermining the optimal sensitivity window. We present a new method, to the best of our knowledge, to remove the complex conjugate artifact by using circularly polarized light as reference. Quadrature detection of the complex fringe is achieved by utilizing the intrinsic λ/4 delay between two polarization channels. We use passive broadband polarization optics to control the polarization state of the light in the reference and sample arms and a balanced polarization diversity detection unit to simultaneously detect phase-shifted fringes. We demonstrate a 40 dB artifact suppression ratio with a swept-source optical coherence tomography system. Our proposed method is immune to sample motion and laser phase noise, and imposes no restrictions to the source bandwidth, imaging speed, or computational power. In vivo images of the human finger, as well as the cornea and retina of a non-human primate, were demonstrated.

Effect of spectral leakage on the image formation of Fourier-domain optical coherence tomography.

We report on the investigation of spectral leakage's impact on the reconstruction of Fourier-domain optical coherence tomography (FD-OCT). We discuss the shift-variant nature introduced by the spectral leakage and develop a novel spatial-domain FD-OCT image formation model. A proof-of-concept phantom experiment is conducted to validate our model. Compared with previous models, the proposed framework could better describe the image formation process, especially when the fineness of the axial structure approaches the theoretical resolution limit.

Chip-based frequency comb sources for optical coherence tomography.

Optical coherence tomography (OCT) is a powerful interferometric imaging technique widely used in medical fields such as ophthalmology, cardiology and dermatology. Superluminescent diodes (SLDs) are widely used as light sources in OCT. Recently integrated chip-based frequency combs have been demonstrated in numerous platforms and the possibility of using these broadband chip-scale combs for OCT has been raised extensively over the past few years. However, the use of these chip-based frequency combs as light sources for OCT requires bandwidth and power compatibility with current OCT systems and have not been shown to date. Here we generate frequency combs based on chip-scale lithographically-defined microresonators and demonstrate its capability as a novel light source for OCT. The combs are designed with a small spectral line spacing of 0.21 nm which ensure imaging range comparable to commercial system and operated at non-phase locked regime which provide conversion efficiency of 30%. The comb source is shown to be compatible with a standard commercial spectral domain (SD) OCT system and enables imaging of human tissue with image quality comparable to the one achieved with tabletop commercial sources. The comb source also provides a path towards fully integrated OCT systems.

Phase-noise analysis of swept-source optical coherence tomography systems.

We propose a new model to characterize the phase noise in swept-source optical coherence tomography (SS-OCT). The new model explicitly incorporates scanning variability, timing jitter, and sample location in addition to intensity noise (shot noise). The model was analyzed and validated by using both Monte Carlo methods and experiments. We suggest that the proposed model can be used as a guideline for future SS-OCT experimental designs.

Visualization and tissue classification of human breast cancer images using ultrahigh-resolution OCT.

BACKGROUND AND OBJECTIVE: Breast cancer is one of the most common cancers, and recognized as the third leading cause of mortality in women. Optical coherence tomography (OCT) enables three dimensional visualization of biological tissue with micrometer level resolution at high speed, and can play an important role in early diagnosis and treatment guidance of breast cancer. In particular, ultra-high resolution (UHR) OCT provides images with better histological correlation. This paper compared UHR OCT performance with standard OCT in breast cancer imaging qualitatively and quantitatively. Automatic tissue classification algorithms were used to automatically detect invasive ductal carcinoma in ex vivo human breast tissue. STUDY DESIGN/MATERIALS AND METHODS: Human breast tissues, including non-neoplastic/normal tissues from breast reduction and tumor samples from mastectomy specimens, were excised from patients at Columbia University Medical Center. The tissue specimens were imaged by two spectral domain OCT systems at different wavelengths: a home-built ultra-high resolution (UHR) OCT system at 800 nm (measured as 2.72 µm axial and 5.52 µm lateral) and a commercial OCT system at 1,300 nm with standard resolution (measured as 6.5 µm axial and 15 µm lateral), and their imaging performances were analyzed qualitatively. Using regional features derived from OCT images produced by the two systems, we developed an automated classification algorithm based on relevance vector machine (RVM) to differentiate hollow-structured adipose tissue against solid tissue. We further developed B-scan based features for RVM to classify invasive ductal carcinoma (IDC) against normal fibrous stroma tissue among OCT datasets produced by the two systems. For adipose classification, 32 UHR OCT B-scans from 9 normal specimens, and 28 standard OCT B-scans from 6 normal and 4 IDC specimens were employed. For IDC classification, 152 UHR OCT B-scans from 6 normal and 13 IDC specimens, and 104 standard OCT B-scans from 5 normal and 8 IDC specimens were employed. RESULTS: We have demonstrated that UHR OCT images can produce images with better feature delineation compared with images produced by 1,300 nm OCT system. UHR OCT images of a variety of tissue types found in human breast tissue were presented. With a limited number of datasets, we showed that both OCT systems can achieve a good accuracy in identifying adipose tissue. Classification in UHR OCT images achieved higher sensitivity (94%) and specificity (93%) of adipose tissue than the sensitivity (91%) and specificity (76%) in 1,300 nm OCT images. In IDC classification, similarly, we achieved better results with UHR OCT images, featured an overall accuracy of 84%, sensitivity of 89% and specificity of 71% in this preliminary study. CONCLUSION: In this study, we provided UHR OCT images of different normal and malignant breast tissue types, and qualitatively and quantitatively studied the texture and optical features from OCT images of human breast tissue at different resolutions. We developed an automated approach to differentiate adipose tissue, fibrous stroma, and IDC within human breast tissues. Our work may open the door toward automatic intraoperative OCT evaluation of early-stage breast cancer. Lasers Surg. Med. 49:258-269, 2017. © 2017 Wiley Periodicals, Inc.

Ex vivo visualization of human ciliated epithelium and quantitative analysis of induced flow dynamics by using optical coherence tomography.

BACKGROUND AND OBJECTIVE: Cilia-driven mucociliary clearance is an important self-defense mechanism of great clinical importance in pulmonary research. Conventional light microscopy possesses the capability to visualize individual cilia and its beating pattern but lacks the throughput to assess the global ciliary activities and flow dynamics. Optical coherence tomography (OCT), which provides depth-resolved cross-sectional images, was recently introduced to this area. MATERIALS AND METHODS: Fourteen de-identified human tracheobronchial tissues are directly imaged by two OCT systems: one system centered at 1,300 nm with 6.5 µm axial resolution and 15 µm lateral resolution, and the other centered at 800 nm with 2.72 µm axial resolution and 5.52 µm lateral resolution. Speckle variance images are obtained in both cross-sectional and volumetric modes. After imaging, sample blocks are sliced along the registered OCT imaging plane and processed with hematoxylin and eosin (H&E) stain for comparison. Quantitative flow analysis is performed by tracking the path-lines of microspheres in a fixed cross-section. Both the flow rate and flow direction are characterized. RESULTS: The speckle variance images successfully segment the ciliated epithelial tissue from its cilia-denuded counterpart, and the results are validated by corresponding H&E stained sections. A further temporal frequency analysis is performed to extract the ciliary beat frequency (CBF) at cilia cites. By adding polyester microspheres as contrast agents, we demonstrate ex vivo imaging of the flow induced by cilia activities of human tracheobronchial samples. CONCLUSION: This manuscript presents an ex vivo study on human tracheobronchial ciliated epithelium and its induced mucous flow by using OCT. Within OCT images, intact ciliated epithelium is effectively distinguished from cilia-denuded counterpart, which serves as a negative control, by examining the speckle variance images. The cilia beat frequency is extracted by temporal frequency analysis. The flow rate, flow direction, and particle throughput are obtained through particle tracking. The availability of these quantitative parameters provides us with a powerful tool that will be useful for studying the physiology, pathophysiology and the effectiveness of therapies on epithelial cilia function, as well as serve as a diagnostic tool for diseases associated with ciliary dysmotility. Lasers Surg. Med. 49:270-279, 2017. © 2017 Wiley Periodicals, Inc.

Photonic crystal cavity-assisted upconversion infrared photodetector.

We describe an upconversion infrared photodetector assisted by a gallium phosphide photonic crystal nanocavity directly coupled to a silicon photodiode. The strongly cavity-enhanced second harmonic signal radiating from the gallium phosphide membrane can thus be efficiently collected by the silicon photodiode, which promises a high photoresponsivity of the upconversion detector as 0.81 A/W with the coupled power of 1W. The integrated upconversion photodetector also functions as a compact autocorrelator with sub-ps resolution for measuring pulse width and chirp.

High-contrast electrooptic modulation of a photonic crystal nanocavity by electrical gating of graphene.

We demonstrate high-contrast electro-optic modulation of a photonic crystal nanocavity integrated with an electrically gated monolayer graphene. A silicon air-slot nanocavity provides strong overlap between the resonant optical field and graphene. Tuning the Fermi energy of the graphene layer to 0.85 eV enables strong control of its optical conductivity at telecom wavelengths, which allows modulation of cavity reflection in excess of 10 dB for a swing voltage of only 1.5 V. The cavity resonance at 1570 nm is found to undergo a shift in wavelength of nearly 2 nm, together with a 3-fold increase in quality factor. These observations enable a cavity-enhanced determination of graphene's complex optical sheet conductivity at different doping levels. Our simple device demonstrates the feasibility of high-contrast, low-power, and frequency-selective electro-optic modulators in graphene-integrated silicon photonic integrated circuits.

The New Era of Retinal Imaging in Hypertensive Patients.

ABSTRACT: Structural and functional alterations in the microcirculation by systemic hypertension can cause significant organ damage at the eye, heart, brain, and kidneys. As the retina is the only tissue in the body that allows direct imaging of small vessels, the relationship of hypertensive retinopathy signs with development of disease states in other organs have been extensively studied; large-scale epidemiological studies using fundus photography and advanced semi-automated analysis software have reported the association of retinopathy signs with hypertensive end-organ damage includes the following: stroke, dementia, and coronary heart disease. Although yielding much useful information, the vessels assessed from fundus photographs remain limited to the larger retinal arterioles and venules, and abnormalities observed may not be that of the earliest changes. Newer imaging modalities such as optical coherence tomography angiography and adaptive optics technology, which allow a greater precision in the structural quantification of retinal vessels, including capillaries, may facilitate the assessment and management of these patients. The advent of deep learning technology has also augmented the utility of fundus photographs to help create diagnostic and risk stratification systems. Particularly, deep learning systems have been shown in several large studies to be able to predict multiple cardiovascular risk factors, major adverse cardiovascular events within 5 years, and presence of coronary artery calcium, from fundus photographs alone. In the future, combining deep learning systems with the imaging precision offered by optical coherence tomography angiography and adaptive optics could pave way for systems that are able to predict adverse clinical outcomes even more accurately.

Multi-Scale Reconstruction of Undersampled Spectral-Spatial OCT Data for Coronary Imaging Using Deep Learning.

Coronary artery disease (CAD) is a cardiovascular condition with high morbidity and mortality. Intravascular optical coherence tomography (IVOCT) has been considered as an optimal imagining system for the diagnosis and treatment of CAD. Constrained by Nyquist theorem, dense sampling in IVOCT attains high resolving power to delineate cellular structures/features. There is a trade-off between high spatial resolution and fast scanning rate for coronary imaging. In this paper, we propose a viable spectral-spatial acquisition method that down-scales the sampling process in both spectral and spatial domain while maintaining high quality in image reconstruction. The down-scaling schedule boosts data acquisition speed without any hardware modifications. Additionally, we propose a unified multi-scale reconstruction framework, namely Multiscale-Spectral-Spatial-Magnification Network (MSSMN), to resolve highly down-scaled (compressed) OCT images with flexible magnification factors. We incorporate the proposed methods into Spectral Domain OCT (SD-OCT) imaging of human coronary samples with clinical features such as stent and calcified lesions. Our experimental results demonstrate that spectral-spatial down-scaled data can be better reconstructed than data that are down-scaled solely in either spectral or spatial domain. Moreover, we observe better reconstruction performance using MSSMN than using existing reconstruction methods. Our acquisition method and multi-scale reconstruction framework, in combination, may allow faster SD-OCT inspection with high resolution during coronary intervention.

A multi-regression approach to improve optical coherence tomography diagnostic accuracy in multiple sclerosis patients without previous optic neuritis.

BACKGROUND: Optical coherence tomography (OCT) is a retinal imaging system that may improve the diagnosis of multiple sclerosis (MS) persons, but the evidence is currently equivocal. To assess whether compensating the peripapillary retinal nerve fiber layer (pRNFL) thickness for ocular anatomical features as well as the combination with macular layers can improve the capability of OCT in differentiating non-optic neuritis eyes of relapsing-remitting MS patients from healthy controls. METHODS: 74 MS participants (n = 129 eyes) and 84 age- and sex-matched healthy controls (n = 149 eyes) were enrolled. Macular ganglion cell complex (mGCC) thickness was extracted and pRNFL measurement was compensated for ocular anatomical factors. Thickness measurements and their corresponding areas under the receiver operating characteristic curves (AUCs) were compared between groups. RESULTS: Participants with MS showed significantly thinner mGCC, measured and compensated pRNFL (p ≤ 0.026). Compensated pRNFL achieved better performance than measured pRNFL for MS differentiation (AUC, 0.75 vs 0.80; p = 0.020). Combining macular and compensated pRNFL parameters provided the best discrimination of MS (AUC = 0.85 vs 0.75; p < 0.001), translating to an average improvement in sensitivity of 24 percent for differentiation of MS individuals. CONCLUSION: The capability of OCT in MS differentiation is made more robust by accounting OCT scans for individual anatomical differences and incorporating information from both optic disc and macular regions, representing markers of axonal damage and neuronal injury, respectively.

Evaluation of different OCT systems in quantitative imaging of human Schlemm's canal.

We examined the performance of human Schlemm's canal (SC) imaging using different OCT devices: CIRRUS 5000 (840 nm, spectral-domain (SD)-OCT), PLEX Elite 9000 (1060 nm, swept-source (SS)-OCT) and CASIA SS-1000 (1310 nm, SS-OCT), and analyzed potential impact factors on visualization and the quantitative assessment of SC morphology in a pilot study. Ten healthy subjects were imaged using three OCT devices by a single experienced operator on the same day. Each eye underwent two cubic scans by each device, one on nasal and the other on temporal quadrant. The B-scan showing the largest SC was manually selected for processing. Four quantitative metrics, including one morphological metric as cross-sectional area (CSA), and three performance metrics as contrast, continuity, and coverage, were derived from the datasets. Repeated-measures ANOVA was used to investigate the difference between these parameters from the three devices (P < 0.05). We found the CSA measured from CIRRUS was significantly larger than PLEX, followed by CASIA. The contrast was highest in CIRRUS, followed by PLEX and CASIA. The coverage was also higher in CIRRUS as compared to PLEX and CASIA. No significant difference was seen in the continuity from the three devices. In summary, we showed the measurements from the three devices were not interchangeable.

A multi-regression framework to improve diagnostic ability of optical coherence tomography retinal biomarkers to discriminate mild cognitive impairment and Alzheimer's disease.

BACKGROUND: Diagnostic performance of optical coherence tomography (OCT) to detect Alzheimer's disease (AD) and mild cognitive impairment (MCI) remains limited. We assessed whether compensating the circumpapillary retinal nerve fiber layer (cpRNFL) thickness for multiple demographic and anatomical factors as well as the combination of macular layers improves the detection of MCI and AD. METHODS: This cross-sectional study of 62 AD (n = 92 eyes), 108 MCI (n = 158 eyes), and 55 cognitively normal control (n = 86 eyes) participants. Macular ganglion cell complex (mGCC) thickness was extracted. Circumpapillary retinal nerve fiber layer (cpRNFL) measurement was compensated for several ocular factors. Thickness measurements and their corresponding areas under the receiver operating characteristic curves (AUCs) were compared between the groups. The main outcome measure was OCT thickness measurements. RESULTS: Participants with MCI/AD showed significantly thinner measured and compensated cpRNFL, mGCC, and altered retinal vessel density (p < 0.05). Compensated RNFL outperformed measured RNFL for discrimination of MCI/AD (AUC = 0.74 vs 0.69; p = 0.026). Combining macular and compensated cpRNFL parameters provided the best detection of MCI/AD (AUC = 0.80 vs 0.69; p < 0.001). CONCLUSIONS AND RELEVANCE: Accounting for interindividual variations of ocular anatomical features in cpRNFL measurements and incorporating macular information may improve the identification of high-risk individuals with early cognitive impairment.

Relationship of Quantitative Retinal Capillary Network and Myocardial Remodeling in Systemic Hypertension.

Background This study examined the associations between quantitative optical coherence tomography angiography (OCTA) parameters and myocardial abnormalities as documented on cardiovascular magnetic resonance imaging in patients with systemic hypertension. Methods and Results We conducted a cross-sectional study of 118 adults with hypertension (197 eyes). Patients underwent cardiovascular magnetic resonance imaging and OCTA (PLEX Elite 9000, Carl Zeiss Meditec). Associations between OCTA parameters (superficial and deep retinal capillary density) and adverse cardiac remodeling (left ventricular mass, remodeling index, interstitial fibrosis, global longitudinal strain, and presence of left ventricular hypertrophy) were studied using multivariable linear regression analysis with generalized estimating equations. Of the 118 patients with hypertension enrolled (65% men; median [interquartile range] age, 59 [13] years), 29% had left ventricular hypertrophy. After adjusting for age, sex, systolic blood pressure, diabetes, and signal strength of OCTA scans, patients with lower superficial capillary density had significantly higher left ventricular mass (ß=-0.150; 95% CI, -0.290 to -0.010), higher interstitial volume (ß=-0.270; 95% CI, -0.535 to -0.0015), and worse global longitudinal strain (ß=-0.109; 95% CI, -0.187 to -0.032). Lower superficial capillary density was found in patients with hypertension with replacement fibrosis versus no replacement fibrosis (16.53±0.64 mm-1 versus 16.96±0.64 mm-1; P=0.003). Conclusions We showed significant correlations between retinal capillary density and adverse cardiac remodeling markers in patients with hypertension, supporting the notion that the OCTA could provide a non-invasive index of microcirculation alteration for vascular risk stratification in people with hypertension.

Comparison of retinal vessel diameter measurements from swept-source OCT angiography and adaptive optics ophthalmoscope.

BACKGROUND/IMS: To compare the retinal vessel diameter measurements obtained from the swept-source optical coherence tomography angiography (OCTA; Plex Elite 9000, Carl Zeiss Meditec, USA) and adaptive optics ophthalmoscope (AOO; RTX1, Imagine Eyes, France). METHODS: Fifteen healthy subjects, 67% women, mean age (SD) 30.87 (6.19) years, were imaged using OCTA and AOO by a single experienced operator on the same day. Each eye was scanned using two OCTA protocols (3×3 mm2 and 9×9 mm2) and two to five AOO scans (1.2×1.2 mm2). The OCTA and AOO scans were scaled to the same pixel resolution. Two independent graders measured the vessel diameter at the same location on the region-of-interest in the three coregistered scans. Differences in vessel diameter measurements between the scans were assessed. RESULTS: The inter-rater agreement was excellent for vessel diameter measurement in both OCTA protocols (ICC=0.92) and AOO (ICC=0.98). The measured vessel diameter was widest from the OCTA 3×3 mm2 (55.2±16.3 µm), followed by OCTA 9×9 mm2 (54.7±14.3 µm) and narrowest by the AOO (50.5±15.6 µm; p<0.001). Measurements obtained from both OCTA protocols were significantly wider than the AOO scan (OCTA 3×3 mm2: mean difference Δ=4.7 µm, p<0.001; OCTA 9×9 mm2: Δ=4.2 µm, p<0.001). For vessels >45 µm, it appeared to be larger in OCTA 3×3 mm2 scan than the 9×9 mm2 scan (Δ=1.9 µm; p=0.005), while vessels <45 µm appeared smaller in OCTA 3×3 mm2 scan (Δ=-1.3 µm; p=0.009) CONCLUSIONS: The diameter of retinal vessels measured from OCTA scans were generally wider than that obtained from AOO scans. Different OCTA scan protocols may affect the vessel diameter measurements. This needs to be considered when OCTA measures such as vessel density are calculated.

The Application of Optical Coherence Tomography Angiography in Systemic Hypertension: A Meta-Analysis.

Objective: Multiple studies have compared various optical coherence tomography angiography (OCTA) parameters in participants with systemic hypertension vs. controls and have presented discordant findings. We conducted a meta-analysis to pool together data from different studies to generate an overall effect size and find out whether OCTA parameter(s) significantly differed in participants with systemic hypertension as compared to controls. Methods: We conducted a literature search through a search of electronic databases to identify studies before 19 June 2021, which compared OCTA parameters in non-diabetic participants with systemic hypertension vs. controls. If the OCTA parameter had a minimum number of 3 studies that analyzed it, the mean difference between participants with systemic hypertension and controls were analyzed using a random-effects model. Results: We identified 11 eligible studies. At the macula, 9 studies analyzed vessel density at the superficial capillary plexus (SVD), 7 analyzed vessel density at the deep capillary plexus (DVD), and 6 analyzed the area of the superficial foveal avascular zone (FAZ). Participants with systemic hypertension had significantly lower SVD (standardized mean difference [SMD], -0.50 [-0.70, -0.30], P < 0.00001, I 2 = 63%), lower DVD (SMD, -0.38 [-0.64, -0.13], P = 0.004, I 2 = 67%) and larger superficial FAZ (SMD, 0.32 [0.04, 0.61], P = 0.020, I 2 = 77%). Conclusion: The eyes of people with systemic hypertension have robustly lower superficial and deep vascular densities at the macula when compared to control eyes. Our results suggest that OCTA can provide information about pre-clinical microvascular changes from systemic hypertension.

Ultrawide field, distortion-corrected ocular shape estimation with MHz optical coherence tomography (OCT).

Ocular deformation may be associated with biomechanical alterations in the structures of the eye, especially the cornea and sclera in conditions such as keratoconus, congenital glaucoma, and pathological myopia. Here, we propose a method to estimate ocular shape using an ultra-wide field MHz swept-source optical coherence tomography (SS-OCT) with a Fourier Domain Mode-Locked (FDML) laser and distortion correction of the images. The ocular biometrics for distortion correction was collected by an IOLMaster 700, and localized Gaussian curvature was proposed to quantify the ocular curvature covering a field-of-view up to 65°×62°. We achieved repeatable curvature shape measurements (intraclass coefficient = 0.88 ± 0.06) and demonstrated its applicability in a pilot study with individuals (N = 11) with various degrees of myopia.

Full circumferential morphological analysis of Schlemm's canal in human eyes using megahertz swept source OCT.

We performed full circumferential imaging of the Schlemm's canal (SC) of two human eyes using a Fourier domain mode-lock laser (FDML) based 1.66-MHz SS-OCT prototype at 1060 nm. Eight volumes with overlapping margins were acquired around the limbal area with customized raster scanning patterns designed to fully cover the SC while minimizing motion artifacts. The SC was segmented from the volumes using a semi-automated active contour segmentation algorithm, whose mean dice similarity coefficient was 0.76 compared to the manual segmentation results. We also reconstructed three-dimensional (3D) renderings of the 360° SC by stitching the segmented SCs from the volumetric datasets. Quantitative metrics of the full circumferential SC were provided, including the mean and standard deviation (SD) of the cross-sectional area (CSA), the maximum CSA, the minimum and maximum SC opening width, and the number of collector channels (CC) stemming from the SC.

Factors affecting the diagnostic performance of circumpapillary retinal nerve fibre layer measurement in glaucoma.

BACKGROUND/AIMS: To identify factors that influence the diagnostic performance of circumpapillary retinal nerve fibre layer (RNFL) thickness measurements in the detection of primary open-angle glaucoma (POAG). METHODS: 1592 eyes from 1076 healthy controls and 758 eyes from 502 patients with POAG underwent optical coherence tomography (OCT) imaging to assess RNFL parameters. Visual field (VF) mean deviation (MD) from standard automated perimetry was used to indicate severity in subjects with glaucoma. RESULTS: RNFL thickness significantly decreased with age (ρ=-0.10 to -0.16, p<0.001) and increased with spherical equivalent (SE) refractive error (ρ=0.23-0.29, p<0.001) in healthy and glaucoma groups but showed a significant reduction with SE (ρ=-0.20, p<0.001) in the temporal RNFL of healthy subjects. RNFL measurements significantly decreased with VF MD (ρ=0.08-0.53, p<0.05) in subjects with POAG. When healthy subjects and subjects with glaucoma were matched to subgroups within a factor, significant differences in area under the curve (AUC) between subgroups were only found with SE AUCs increased significantly with disease severity, particularly in the global, inferior and superior measurements (p<0.001). Overall, the diagnostic performance of the inferior and global RNFL measurements were found to be more resilient to different factors. CONCLUSION: Diagnostic accuracy in glaucoma was influenced by SE but could be mitigated by using controls with similar refractive characteristics. Increasing disease severity led to significantly better diagnostic accuracy. These factors should be considered when using OCT for glaucoma diagnosis in practice.