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Article: Sector-Based Regression Strategies to Reduce Refractive Error-Associated Glaucoma Diagnostic Bias When Using OCT and OCT Angiography

TitleSector-Based Regression Strategies to Reduce Refractive Error-Associated Glaucoma Diagnostic Bias When Using OCT and OCT Angiography
Authors
Issue Date15-Sep-2023
PublisherAssociation for Research in Vision and Ophthalmology
Citation
Translational Vision Science and Technology, 2023, v. 12, n. 9, p. 10 How to Cite?
Abstract

Purpose: This cross-sectional study aimed to investigate the sectoral variance of optical coherence tomography (OCT) and OCT angiography (OCTA) glaucoma diagnostic parameters across eyes with varying degrees of refractive error.

Methods: Healthy participants, including individuals with axial ametropia, enrolled in the Hong Kong FAMILY cohort were imaged using the Avanti/AngioVue OCT/OCTA system. The OCT and OCTA parameters obtained include peripapillary nerve fiber layer thickness (NFLT), peripapillary nerve fiber layer plexus capillary density (NFLP-CD), and macular ganglion cell complex thickness (GCCT). Sectoral measurements of NFLT, NFLP-CD, and GCCT were based on sectors and hemispheres.

Results: A total of 1339 eyes from 791 participants were stratified based on spherical equivalent refraction: high myopia (<−6 D), low myopia (−6 D to −1 D), emmetropia (−1 D to 1 D), and hyperopia (>1 D). Multivariable broken stick regression models, accounting for age, sex, and signal strength, showed that all NFLT sectors except temporally, the inferior GCCT hemisphere, and half of the NFLP-CD sectors were more affected by ametropia-related covariates than the corresponding global parameters. As expected, the false-positive rates in those sectors were elevated. Finally, sector-specific axial length (AL) and spherical equivalent (SE) adjustments helped reduce the elevated false-positive rates.

Conclusions: The effect of optical magnification is even more prominent among sectors than the global parameters. AL- and SE-based adjustments should be individualized to each sector to mitigate this magnification bias effectively.

Translational Relevance: Identifying sectoral differences among diagnostic parameters and adopting these sector-based adjustments into commercial OCT systems will hopefully reduce false-positive rates related to refractive error.


Persistent Identifierhttp://hdl.handle.net/10722/331950
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiu, Keke-
dc.contributor.authorYou, Qi Sheng-
dc.contributor.authorChen, Aiyin-
dc.contributor.authorChoi, Dongseok-
dc.contributor.authorWhite, Elizabeth-
dc.contributor.authorChan, Jonathan C H-
dc.contributor.authorChoy, Bonnie N K-
dc.contributor.authorShih, Kendrick C-
dc.contributor.authorWong, Jasper K W-
dc.contributor.authorNg, Alex L K-
dc.contributor.authorCheung, Janice J C-
dc.contributor.authorNi, Michael Y-
dc.contributor.authorLai, Jimmy S M-
dc.contributor.authorLeung, Gabriel M-
dc.contributor.authorWong, Ian Y H-
dc.contributor.authorHuang, David-
dc.contributor.authorTan, Ou-
dc.date.accessioned2023-09-28T04:59:49Z-
dc.date.available2023-09-28T04:59:49Z-
dc.date.issued2023-09-15-
dc.identifier.citationTranslational Vision Science and Technology, 2023, v. 12, n. 9, p. 10-
dc.identifier.urihttp://hdl.handle.net/10722/331950-
dc.description.abstract<p><strong>Purpose</strong>: This cross-sectional study aimed to investigate the sectoral variance of optical coherence tomography (OCT) and OCT angiography (OCTA) glaucoma diagnostic parameters across eyes with varying degrees of refractive error.</p><p><strong>Methods</strong>: Healthy participants, including individuals with axial ametropia, enrolled in the Hong Kong FAMILY cohort were imaged using the Avanti/AngioVue OCT/OCTA system. The OCT and OCTA parameters obtained include peripapillary nerve fiber layer thickness (NFLT), peripapillary nerve fiber layer plexus capillary density (NFLP-CD), and macular ganglion cell complex thickness (GCCT). Sectoral measurements of NFLT, NFLP-CD, and GCCT were based on sectors and hemispheres.</p><p><strong>Results</strong>: A total of 1339 eyes from 791 participants were stratified based on spherical equivalent refraction: high myopia (<−6 D), low myopia (−6 D to −1 D), emmetropia (−1 D to 1 D), and hyperopia (>1 D). Multivariable broken stick regression models, accounting for age, sex, and signal strength, showed that all NFLT sectors except temporally, the inferior GCCT hemisphere, and half of the NFLP-CD sectors were more affected by ametropia-related covariates than the corresponding global parameters. As expected, the false-positive rates in those sectors were elevated. Finally, sector-specific axial length (AL) and spherical equivalent (SE) adjustments helped reduce the elevated false-positive rates.</p><p><strong>Conclusions</strong>: The effect of optical magnification is even more prominent among sectors than the global parameters. AL- and SE-based adjustments should be individualized to each sector to mitigate this magnification bias effectively.</p><p><strong>Translational Relevance</strong>: Identifying sectoral differences among diagnostic parameters and adopting these sector-based adjustments into commercial OCT systems will hopefully reduce false-positive rates related to refractive error.</p>-
dc.languageeng-
dc.publisherAssociation for Research in Vision and Ophthalmology-
dc.relation.ispartofTranslational Vision Science and Technology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleSector-Based Regression Strategies to Reduce Refractive Error-Associated Glaucoma Diagnostic Bias When Using OCT and OCT Angiography-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1167/tvst.12.9.10-
dc.identifier.scopuseid_2-s2.0-85171328375-
dc.identifier.volume12-
dc.identifier.issue9-
dc.identifier.spage10-
dc.identifier.eissn2164-2591-
dc.identifier.isiWOS:001103195600010-
dc.identifier.issnl2164-2591-

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