1. Articles from jeffrey m. liebmann

    1-24 of 44 1 2 »
    1. Rationale and Development of an OCT-Based Method for Detection of Glaucomatous Optic Neuropathy

      Rationale and Development of an OCT-Based Method for Detection of Glaucomatous Optic Neuropathy

      A specific, sensitive and intersubjectively verifiable definition of disease for clinical care and research remains an important unmet need in the field of glaucoma. Using an iterative, consensus-building approach and employing pilot data, an optical coherence tomography (OCT)-based method to aid in the detection of glaucomatous optic neuropathy was sought to address this challenge. To maximize the chance of success, we utilized all available information from the OCT circle and cube scans, applied both quantitative and semi-quantitative data analysis methods, and aimed to limit the use of perimetry to cases where it is absolutely necessary. The outcome of this ...

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    2. Detecting glaucoma with only OCT: Implications for the clinic, research, screening, and AI development

      Detecting glaucoma with only OCT: Implications for the clinic, research, screening, and AI development

      A method for detecting glaucoma based only on optical coherence tomography (OCT) is of potential value for routine clinical decisions, for inclusion criteria for research studies and trials, for large-scale clinical screening, as well as for the development of artificial intelligence (AI) decision models. Recent work suggests that the OCT probability (p-) maps, also known as deviation maps, can play a key role in an OCT-based method. However, artifacts seen on the p-maps of healthy control eyes can resemble patterns of damage due to glaucoma. We document in section 2 that these glaucoma-like artifacts are relatively common and are probably ...

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    3. Individualized Glaucoma Change Detection Using Deep Learning Auto Encoder-Based Regions of Interest

      Individualized Glaucoma Change Detection Using Deep Learning Auto Encoder-Based Regions of Interest

      Purpose : To compare change over time in eye-specific optical coherence tomography (OCT) retinal nerve fiber layer (RNFL)-based region-of-interest (ROI) maps developed using unsupervised deep-learning auto-encoders (DL-AE) to circumpapillary RNFL (cpRNFL) thickness for the detection of glaucomatous progression. Methods : Forty-four progressing glaucoma eyes (by stereophotograph assessment), 189 nonprogressing glaucoma eyes (by stereophotograph assessment), and 109 healthy eyes were followed for ≥3 years with ≥4 visits using OCT. The San Diego Automated Layer Segmentation Algorithm was used to automatically segment the RNFL layer from raw three-dimensional OCT images. For each longitudinal series, DL-AEs were used to generate individualized eye-based ROI maps ...

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      Mentions: UCSD
    4. Predicting central 10 degrees visual field from peripapillary optical coherence tomography using deep learning approach

      Predicting central 10 degrees visual field from peripapillary optical coherence tomography using deep learning approach

      Purpose: To develop a deep learning (DL) simulation of standard automated perimetry (SAP) in the central 10 ° based on spectral domain optical coherence tomography (SD-OCT) retinal nerve fiber layer thickness (RNFLT). Methods : This study included 5352 pairs of SD-OCT and 10-2 SAP from 1365 eyes of 724 healthy, glaucoma suspect and glaucoma patients from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). Each pair of SD-OCT and 10-2 SAP was obtained within a 6-month duration. The dataset was randomly divided into training (65%), validation (15%), and test (20%) sets at the patient ...

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      Mentions: UCSD
    5. Global optical coherence tomography measures for detecting the progression of glaucoma have fundamental flaws

      Global optical coherence tomography measures for detecting the progression of glaucoma have fundamental flaws

      Objective To understand the problems involved in using global OCT measures for detecting progression in early glaucoma. Subjects/Methods Eyes from 76 patients and 28 healthy controls (HC) had a least two OCT scans at least 1 year apart. To determine the 95% confidence intervals (CI), 151 eyes (49 HC and 102 patients) had at least two scans within 6 months. All eyes had 24-2 mean deviation ≥-6dB. The average (global) thicknesses of the circumpapillary retinal nerve fibre layer (cRNFL), G ONH , and of the retinal ganglion cell layer plus inner plexiform layer (RGCLP), G mac , were calculated. Using quantile ...

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    6. Did the OCT Show Progression Since the Last Visit?

      Did the OCT Show Progression Since the Last Visit?

      Identifying progression is of fundamental importance to the management of glaucoma. It is also a challenge. The most sophisticated, and probably the most useful, commercially available clinical tool for identifying progression is the Guided Progression Analysis (GPA), which was initially developed to identify progression using 24-2 visual field tests. More recently it has been extended to retinal nerve fiber layer (RNFL) and ganglion cell + inner plexiform layer (GCIPL) thicknesses measured with optical coherence tomography (OCT). However, the OCT GPA requires a minimum of 3 tests to determine "possible loss (progression)" and a minimum of 4 tests to determine if the ...

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    7. Deep Learning Approaches Predict Glaucomatous Visual Field Damage from Optical Coherence Tomography Optic Nerve Head Enface Images and Retinal Nerve Fiber Layer Thickness Maps

      Deep Learning Approaches Predict Glaucomatous Visual Field Damage from Optical Coherence Tomography Optic Nerve Head Enface Images and Retinal Nerve Fiber Layer Thickness Maps

      Purpose To develop and evaluate a deep learning system for differentiating between eyes with and without glaucomatous visual field damage (GVFD) and predicting the severity of GFVD from spectral domain optical coherence tomography (SDOCT) optic nerve head images. Design Evaluation of a diagnostic technology Participants 9,765 visual field (VF)–SDOCT pairs collected from 1,194 participants with and without GVFD (1909 eyes). Methods Deep learning models were trained to use SDOCT retinal nerve fiber layer (RNFL) thickness maps, RNFL enface images, and confocal scanning laser ophthalmoscopy (CSLO) images to identify eyes with GVFD and predict quantitative VF mean deviation ...

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    8. OCT-Detected Optic Nerve Head Neural Canal Direction, Obliqueness and Minimum Cross-Sectional Area in Healthy Eyes

      OCT-Detected Optic Nerve Head Neural Canal Direction, Obliqueness and Minimum Cross-Sectional Area in Healthy Eyes

      Purpose To assess anterior scleral canal opening (ASCO) offset relative to Bruch’s membrane opening (BMO) (ASCO/BMO offset) so as to determine neural canal direction, obliqueness, and minimum cross-sectional area (NCMCA) in 362 healthy eyes. Design Cross-sectional study Methods After OCT optic nerve head (ONH) and retinal nerve fiber layer thickness (RNFLT) imaging, BMO and ASCO were manually segmented and planes, centroids, size and shape were calculated. Neural canal direction was defined by projecting the neural canal axis vector (connecting BMO and ASCO centroids) onto the BMO plane. Neural canal obliqueness was defined by the angle between the neural ...

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    9. Factors Influencing Optical Coherence Tomography Peripapillary Choroidal Thickness: A Multicenter Study

      Factors Influencing Optical Coherence Tomography Peripapillary Choroidal Thickness: A Multicenter Study

      Purpose : To quantify peripapillary choroidal thickness (PCT) and the factors that influence it in healthy participants who represent the racial and ethnic composition of the U.S. population. Methods : A total of 362 healthy participants underwent optical coherence tomography (OCT) enhanced depth imaging of the optic nerve head with a 24 radial B-scan pattern aligned to the fovea to Bruch's membrane opening axis. Bruch's membrane, anterior scleral canal opening (ASCO), and the anterior scleral surface were manually segmented. PCT was measured at 100, 300, 500, 700, 900, and 1100 μm from the ASCO globally and within 12 clock-hour ...

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    10. An Examination of the Frequency of Paravascular Defects and Epiretinal Membranes in Eyes With Early Glaucoma Using En-face Slab OCT Images

      An Examination of the Frequency of Paravascular Defects and Epiretinal Membranes in Eyes With Early Glaucoma Using En-face Slab OCT Images

      Purpose: To examine the frequency of paravascular defects (PDs) and macular epiretinal membranes (ERMs) in eyes categorized as having mild glaucoma or glaucoma suspect using en-face slab analysis of optical coherence tomography (OCT) scans. Materials and Methods: Fifty-seven glaucomatous eyes, 44 low-risk suspect eyes, and 101 healthy control eyes were included in the study. The 101 glaucomatous and suspect eyes had a mean deviation better than −6 dB on the 24-2 visual field, and a spherical refractive error between±6 D or axial length <26.5 mm. Two OCT-graders masked to eye classification identified ERMs and PDs on en-face slab ...

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    11. Hybrid Deep Learning on Single Wide-field Optical Coherence Tomography Scans Accurately Classifies Glaucoma Suspects

      Hybrid Deep Learning on Single Wide-field Optical Coherence Tomography Scans Accurately Classifies Glaucoma Suspects

      Purpose: Existing summary statistics based upon optical coherence tomographic (OCT) scans and/or visual fields (VFs) are suboptimal for distinguishing between healthy and glaucomatous eyes in the clinic. This study evaluates the extent to which a hybrid deep learning method (HDLM), combined with a single wide-field OCT protocol, can distinguish eyes previously classified as either healthy suspects or mild glaucoma. Methods: In total, 102 eyes from 102 patients, with or suspected open-angle glaucoma, had previously been classified by 2 glaucoma experts as either glaucomatous (57 eyes) or healthy/suspects (45 eyes). The HDLM had access only to information from a ...

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    12. Imaging Congenital Optic Disc Pits and Associated Maculopathy Using Optical Coherence Tomography

      Imaging Congenital Optic Disc Pits and Associated Maculopathy Using Optical Coherence Tomography

      Objective: To elucidate the anatomy of congenital optic disc pits with and without maculopathy using optical coherence tomography. Setting: All patients were examined, photographed, and scanned at the New York Eye and Ear Infirmary. Patients: Ten eyes of eight consecutive patients with congenital optic disc pits were studied. Three eyes had associated serous macular detachment (group 1), four had evidence of resolved detachment (group 2), and three had no clinical macular pathologic lesion (group 3). Methods: Optical coherence tomography, a new, noninvasive, noncontact, imaging technology capable of producing cross-sectional images of the retina in vivo with high resolution (<17 μm ...

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    13. Association of Glaucoma-Related, Optical Coherence Tomography–Measured Macular Damage With Vision-Related Quality of Life

      Association of Glaucoma-Related, Optical Coherence Tomography–Measured Macular Damage With Vision-Related Quality of Life

      Question What is the association of structural macular retinal ganglion cell plus inner plexiform layer (RGC+IPL) loss measured by spectral-domain optical coherence tomography (SD-OCT) with vision-related quality of life among individuals with primary open-angle glaucoma? Finding In this cross-sectional study of 214 eyes of 107 patients with glaucoma, diffuse macular RGC+IPL loss, as measured by SD-OCT, was associated with diminished vision-related quality of life.

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    14. Optic Nerve Head Drusen Prevalence and Associated Factors in Clinically Normal Subjects Measured Using Optical Coherence Tomography

      Optic Nerve Head Drusen Prevalence and Associated Factors in Clinically Normal Subjects Measured Using Optical Coherence Tomography

      Aim: The purpose of this study is to establish a normative database of subfoveal choroidal thickness (CT) in healthy young Indians using spectral domain optical coherence tomography (SD OCT). Evaluation and comparison of CT of central serous chorioretinopathy (CSC) and fellow eyes were also performed. Materials and Methods: This was a prospective, cross-sectional, and observational study. It included 112 normal eyes of 112 healthy volunteers who had no evidence of ocular or systemic disease, 84 CSC eyes with acute, treatment-naïve CSC, and 69 fellow eyes with no evidence of neurosensory detachment or pigment epithelium detachment on SD OCT. Complete ...

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    15. Characteristics and variations of in vivo Schlemm's canal and collector channel microstructures in enhanced-depth imaging optical coherence tomography

      Characteristics and variations of in vivo Schlemm's canal and collector channel microstructures in enhanced-depth imaging optical coherence tomography

      Background/aims To characterise in vivo Schlemm's canal (SC) and collector channels (CC) microstructures using enhanced-depth imaging (EDI) optical coherence tomography (OCT). Methods Serial horizontal EDI OCT B-scans (81 scans, 15×5° rectangle) were prospectively obtained in the nasal and temporal limbus. SC cross-sectional area (CSA) was measured by delineating its lumen in each B-scan. CCs connected to SC were counted. SC CSA and the number of CCs were compared between the nasal and temporal areas. Results Eleven eyes (11 normal subjects) were included (mean age, 28±5 years). SC and CCs were clearly demarcated in EDI OCT B-scans ...

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    16. Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

      Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

      Purpose To evaluate the relationship between intraocular pressure (IOP) and rates of retinal nerve fiber layer (RNFL) thickness change over time measured by spectral-domain (SD) optical coherence tomography (OCT). Design Observational cohort study. Participants The study involved 547 eyes of 339 patients followed up for an average of 3.9±0.9 years. Three hundred eight (56.3%) had a diagnosis of glaucoma and 239 (43.7%) were considered glaucoma suspects. Methods All eyes underwent imaging using the Spectralis SD OCT (Heidelberg Engineering GmbH, Heidelberg, Germany), along with IOP measurements and standard automated perimetry (SAP). Glaucoma progression was defined as ...

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      Mentions: UCSD
    17. Technology and the Glaucoma Suspect

      Technology and the Glaucoma Suspect

      Purpose : To determine and compare the diagnostic performance of spectral-domain optical coherence tomography (SD-OCT), stereoscopic disc photographs, and automated perimetry as assessed by a group of glaucoma specialists in differentiating individuals with early glaucoma from suspects. Methods : Forty-six eyes (46 patients) with suspicious optic nerves had previously undergone SD-OCT scans, 24-2 visual fields (VFs), and optic disc photographs. The average VF mean deviation was −1.97 ± 2.09 (SD) dB. Four glaucoma specialists examined the 138 individual diagnostic tests and classified the patient as likely glaucomatous or nonglaucomatous based on the results of a single test. The diagnostic performances of ...

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    18. Diagnostic Accuracy of the Spectralis and Cirrus Reference Databases in Differentiating between Healthy and Early Glaucoma Eyes

      Diagnostic Accuracy of the Spectralis and Cirrus Reference Databases in Differentiating between Healthy and Early Glaucoma Eyes

      Purpose To evaluate and compare the diagnostic accuracy of global and sector analyses for detection of early visual field (VF) damage using the retinal nerve fiber layer (RNFL) reference databases of the Spectralis (Heidelberg Engineering, Heidelberg, Germany) and Cirrus (Carl Zeiss Meditec, Dublin, CA) spectral-domain optical coherence tomography (SD OCT) devices. Methods Healthy subjects and glaucoma suspects from the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES) with at least 2 years of follow-up were included. Global and sectoral RNFL measures were classified as within normal limits, borderline (BL), and outside normal limits (ONL ...

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    19. Improving Glaucoma Detection Using Spatially Correspondent Clusters of Damage and by Combining Standard Automated Perimetry and Optical Coherence Tomography

      Improving Glaucoma Detection Using Spatially Correspondent Clusters of Damage and by Combining Standard Automated Perimetry and Optical Coherence Tomography

      PURPOSE. To improve the detection of glaucoma, techniques for assessing local patterns of damage and for combining structure and function were developed. METHODS. Standard automated perimetry (SAP) and frequency-domain optical coherence tomography (fdOCT) data, consisting of macular retinal ganglion cell plus inner plexiform layer (mRGCPL) as well as macular and optic disc retinal nerve fiber layer (mRNFL and dRNFL) thicknesses, were collected from 52 eyes of 52 healthy controls and 156 eyes of 96 glaucoma suspects and patients. In addition to generating simple global metrics, SAP and fdOCT data were searched for contiguous clusters of abnormal points and converted to ...

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    20. The Locations of Circumpapillary Glaucomatous Defects Seen on Frequency-Domain OCT Scans

      The Locations of Circumpapillary Glaucomatous Defects Seen on Frequency-Domain OCT Scans

      Purpose. To examine the locations of local glaucomatous damage around the optic disc as seen in the circumpapillary retinal nerve fiber layer (RNFL) on frequency domain optical coherence tomography (fdOCT). Methods. Optic disc fdOCT volume scans from 54 healthy control eyes and 114 patient eyes, classified as suspected or mild glaucoma, were analyzed. All patient eyes had 24-2 visual fields (VFs) with mean deviations better than −5.5 dB. By hand-correcting automated segmentation, the RNFL thickness profile was obtained for a circumpapillary circle. RNFL defects were defined as regions where the patient's RNFL thickness fell below the 99% confidence ...

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    21. Enhanced Depth Imaging Optical Coherence Tomography of Optic Nerve Head Drusen

      Enhanced Depth Imaging Optical Coherence Tomography of Optic Nerve Head Drusen

      Objective To assess the value of enhanced depth imaging optical coherence tomography (EDI OCT) in diagnosing and evaluating optic nerve head drusen (ONHD) compared with conventional diagnostic methods. Design Prospective, comparative, cross-sectional study. Participants Thirty-four patients with clinically visible or suspected ONHD in either eye based on dilated optic disc examination or optic disc stereophotography and without ocular comorbidity. Methods Spectral-domain OCT of the optic nerve head in both conventional (non-EDI) and EDI modes, ultrasound B-scan, and standard automated perimetry were performed on both eyes of all participants. Main Outcome Measures Detection and findings of ONHD between EDI OCT and ...

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    22. Understanding Disparities Among Diagnostic Technologies in Glaucoma

      Understanding Disparities Among Diagnostic Technologies in Glaucoma

      Objective To investigate causes of disagreement among 3 glaucoma diagnostic techniques: standard automated achromatic perimetry (SAP), the multifocal visual evoked potential technique (mfVEP), and optical coherence tomography (OCT). Methods In a prospective cross-sectional study, 138 eyes of 69 patients with glaucomatous optic neuropathy were tested using SAP, the mfVEP, and OCT. Eyes with the worse and better mean deviations (MDs) were analyzed separately. If the results of 2 tests were consistent for the presence of an abnormality in the same topographic site, that abnormality was considered a true glaucoma defect. If a third test missed that abnormality (false-negative result), the ...

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    23. The Nature of Macular Damage in Glaucoma as Revealed by Averaging Optical Coherence Tomography Data

      The Nature of Macular Damage in Glaucoma as Revealed by Averaging Optical Coherence Tomography Data

      Purpose: To better understand the nature of glaucomatous damage, especially to the macula, the inner retinal thickness maps obtained with frequency domain optical coherence tomography (fdOCT) were averaged. Methods: Frequency domain optical coherence tomography macular and optic disc cube scans were obtained from 54 healthy eyes and 156 eyes with glaucomatous optic neuropathy. A manually corrected algorithm was used for layer segmentation. Patients' eyes were grouped both by mean deviation (MD) and hemifield classification using standard categories and 24-2 (6° grid) visual fields (VFs). To obtain average difference maps, the thickness of retinal nerve fiber (RNF) and retinal ganglion cell ...

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