Differentiation of glaucomatous optic discs with different appearances using optic disc topography parameters: The Glaucoma Stereo Analysis Study

• Published in: PloS one 2017-02, Vol.12 (2), p.e0169858-e0169858
• Main Authors: Tanito, Masaki, Nitta, Koji, Katai, Maki, Kitaoka, Yasushi, Yokoyama, Yu, Omodaka, Kazuko, Nakazawa, Toru
• Format: Article
• Language: English
• Subjects: Acuity; Aged; Biology and Life Sciences; Cameras; Defects; Diagnosis; Diagnosis, Differential; Discrimination; Engineering and Technology; Enlargement; Eye (anatomy); Female; Fluorescein Angiography; Glaucoma; Glaucoma - diagnostic imaging; Glaucoma - pathology; Height variations; Hospitals; Humans; Intraocular pressure; Ischemia; Male; Medicine; Medicine and Health Sciences; Middle Aged; Nitric oxide; Open-angle glaucoma; Optic disc; Optic Disk - pathology; Optic nerve; Optics; Patients; People and Places; Physical Sciences; ROC Curve; Social Sciences; Tomography; Topography; University graduates; Visual acuity; Visual discrimination
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0169858

The Glaucoma Stereo Analysis Study (GSAS) is a multicenter collaborative study of the characteristics of glaucomatous optic disc morphology using a stereo fundus camera. Using GSAS dataset, the formulas for predicting different glaucomatous optic disc appearances were established. The GSAS dataset containing three-dimensionally-analyzed optic disc topographic parameters from 187 eyes with primary open-angle glaucoma was assessed with discrimination analyses to obtain formulas predictive of glaucomatous optic disc appearances: focal ischemic (FI); generalized enlargement (GE), myopic glaucomatous (MY), and senile sclerotic (SS). Using 38 optic disc parameters-substituted discrimination analyses with a stepwise forward-selection method, six parameters (temporal and nasal rim-disc ratios, mean cup depth, height variation contour, disc tilt angle, and rim decentering absolute) were selected into the formulas. The area under the receiver operating characteristic curves for predicting the four disc types with established formulas were 0.88, 0.91, 0.93, and 0.86 for FI, MY, SS, and GE, respectively. Age, visual acuity, refractive error, glaucoma (normal or high-tension glaucoma), and baseline intraocular pressure differed significantly among the four optic disc types, suggesting the appearances represent different clinical glaucoma phenotypes. Using six optic disc topographic parameters obtained by stereo fundus camera, the GSAS classification formulas predicted and quantified each component of different optic disc appearances in each eye and provided a novel parameter to describe glaucomatous optic disc characteristics.