Parra-Blesa Alfonso, Sanchez-Alberca Alfredo, Garcia-Medina Jose Javier
Department of Ophthalmology, Policlínica Baza, 18800 Baza (Granada), Spain.
CEINDO, San Pablo CEU University, 28668 Madrid, Spain.
J Clin Med. 2020 May 19;9(5):1530. doi: 10.3390/jcm9051530.
Primary open-angle glaucoma (POAG) is considered one of the main causes of blindness. Detection of POAG at early stages and classification into evolutionary stages is crucial to blindness prevention.
1001 patients were enrolled, of whom 766 were healthy subjects and 235 were ocular hypertensive or glaucomatous patients in different stages of the disease. Spectral domain optical coherence tomography (SD-OCT) was used to determine Bruch's membrane opening-minimum rim width (BMO-MRW) and the thicknesses of peripapillary retinal nerve fibre layer (RNFL) rings with diameters of 3.0, 4.1 and 4.7 mm centred on the optic nerve. The BMO-MRW rim and RNFL rings were divided into seven sectors (G-T-TS-TI-N-NS-NI). The k-means algorithm and linear discriminant analysis were used to classify patients into disease stages.
We defined four glaucoma stages and provided a new model for classifying eyes into these stages, with an overall accuracy greater than 92% (88% when including healthy eyes). An online application was also implemented to predict the probability of glaucoma stage for any given eye.
We propose a new objective algorithm for classifying POAG into clinical-evolutionary stages using SD-OCT.
原发性开角型青光眼（POAG）被认为是失明的主要原因之一。早期检测POAG并将其分类为不同的发展阶段对于预防失明至关重要。
招募了1001名患者，其中766名是健康受试者，235名是处于疾病不同阶段的高眼压症或青光眼患者。使用光谱域光学相干断层扫描（SD-OCT）来确定布鲁赫膜开口最小边缘宽度（BMO-MRW）以及以视神经为中心、直径分别为3.0、4.1和4.7 mm的视乳头周围视网膜神经纤维层（RNFL）环的厚度。BMO-MRW边缘和RNFL环被分为七个扇区（G-T-TS-TI-N-NS-NI）。使用k均值算法和线性判别分析将患者分类为不同的疾病阶段。
我们定义了四个青光眼阶段，并提供了一种将眼睛分类到这些阶段的新模型，总体准确率大于92%（包括健康眼睛时为88%）。还实施了一个在线应用程序来预测任何给定眼睛处于青光眼阶段的概率。
我们提出了一种使用SD-OCT将POAG分类为临床发展阶段的新客观算法。
