Wang Bo, Gregston Alden P, Naithani Rizul, Alvarez Samuel, Sigireddi Rohini R, Freedman Sharon F
Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA.
Department of Ophthalmology, Duke University Medical Center, Durham, NC, US.
Sci Rep. 2025 Apr 12;15(1):12671. doi: 10.1038/s41598-025-96963-y.
Maldevelopment of Schlemm canal (SC) and trabecular meshwork (TM) is proposed in the pathogenesis of primary congenital glaucoma (PCG). This study aims to evaluate a semi-automated segmentation algorithm of SC and TM in pediatric patients scanned using overhead-mounted optical coherence tomography (OCT). Twenty-four children (33 eyes: 17 PCG, 16 normal), with mean age 1.3 ± 1.08 years, had anterior segment OCT imaging. Manual segmentation of SC and TM on individual B-scans represented the gold standard and was compared to semi-automated segmentation of the same structures. Intraclass correlation (ICC) compared the manual and semi-automated algorithm for several parameters: SC area (0.940), circularity (0.742), and aspect ratio (0.861); and TM thickness (0.807). Comparing eyes with PCG vs. normal, we found: (1) decreased SC area (4084 ± 4553µm vs. 7362 ± 3961µm, p = 0.008), (2) increased SC circularity (0.46 ± 0.15 vs. 0.36 ± 0.14, p = 0.011, 3) increased TM thickness (152 ± 43 μm vs. 110 ± 27 μm, p < 0.001) and 4) decreased SC aspect ratio (5.35 ± 2.51 vs. 7.06 ± 2.48, p = 0.012) in eyes with PCG. Semi-automated segmentation permits assessment of differences in SC and TM morphology in normal vs. PCG eyes. Further work is necessary to understand how SC and TM differ in these patients as well as other forms of childhood glaucoma.
原发性先天性青光眼（PCG）的发病机制被认为与施莱姆管（SC）和小梁网（TM）发育异常有关。本研究旨在评估一种半自动分割算法，用于对使用头顶式光学相干断层扫描（OCT）扫描的儿科患者的SC和TM进行分割。24名儿童（33只眼：17只PCG眼，16只正常眼），平均年龄1.3±1.08岁，接受了眼前节OCT成像。在个体B扫描上对SC和TM进行手动分割作为金标准，并与相同结构的半自动分割进行比较。组内相关系数（ICC）比较了手动和半自动算法在几个参数上的差异：SC面积（0.940）、圆度（0.742）和纵横比（0.861）；以及TM厚度（0.807）。比较PCG眼和正常眼，我们发现：（1）SC面积减小（4084±4553μm对7362±3961μm，p=0.008），（2）SC圆度增加（0.46±0.15对0.36±0.14，p=0.011），（3）TM厚度增加（152±43μm对110±27μm，p<0.001），以及（4）PCG眼中SC纵横比减小（5.35±2.51对7.06±2.48，p=0.012）。半自动分割允许评估正常眼与PCG眼中SC和TM形态的差异。有必要进一步开展工作，以了解这些患者以及其他形式儿童青光眼的SC和TM有何不同。
