Comparison between Automatic Segmentation of the Optical Disc by SD-OCT and Stereo Retinography
DOI:
https://doi.org/10.48560/rspo.23334Keywords:
Glaucoma, Retinoscopy, Tomography, Optical CoherenceAbstract
INTRODUCTION: The cup-to-disc (c/d) ratio, defined as the ratio of the optic disc cup and neuroretinal rim surfaces, is an important structural indicator for assuming glaucomatous damage and the historic landmark in the diagnosis and assessment of disease progression. We purpose to compare the automatic evaluation of the planimetric parameters of the optical disc by SD-OCT, with optic disc color fundus photographs (CFP) reviewed by two ophthalmologists with different experience levels.
METhODS: Observational and cross-sectional study including 64 eyes of patients followed up for glaucoma or suspected glaucoma (including ocular hypertension), who underwent stereoscopic CFP and evaluation by SD-OCT on the same day. We excluded patients with opaque media that can jeopardize image evaluation. Two graders, 1 glaucoma specialist (G1 - gold standard), and 1 ophthalmology resident (G2), blindly classified each stereo pair of CFP according to the vertical and horizontal cup-to-disk, among other qualitative parameters of the disk. The correlation between both was analyzed, as did with the OCT.
RESULTS: Graders differed by an average of 0.05 ± 0.09 (range -0.19-0.22) (p = 0.05) and 0.08 ± 0.11 (range -0.27-0.31) (p <0.01) in the vertical and horizontal ratio, respectively. The agreement between graders was Good (ICC = 0.82 and 0.81). G1 and G2 differed from OCT on 0.07(±0.01)/0.13(±0.02)/ and 0.03(±0.02)/0.06(±0.02)(vertical/horizontal). These differences were statistically significant (p <0.01), except for the vertical cup-to-disk ratio between G2 and OCT (p= 0.06). The mixed correlation between G1 and G2 with the OCT was Excellent (ICC = 0.91) for the vertical ratio, and Good (ICC=0.83) for the horizontal ratio. The difference in classification between G1 and OCT was not correlated with the disc area (B = 0.16, p = 0.15 nor with peripapillary atrophy ((B = -0.02, p=0.31).
CONCLUSION: In our study, we obtained a Good correlation in the optic disc analysis between a young ophthalmologist and a more experienced one, reassuring the importance of this classic sign in clinical practice. The OCT also obtained good reproducibility, with a possible increasing applicability in telemedicine. However, human evaluation maintains its clinical relevance, as it is more sensitive to anomalous discs and allowing a qualitative analysis of it.
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