Bruch Membrane Opening Detection Accuracy in Healthy Eyes and Eyes With Glaucoma With and Without Axial High Myopia in an American and Korean Cohort - PubMed (original) (raw)

doi: 10.1016/j.ajo.2021.11.030. Epub 2021 Dec 10.

James A Proudfoot 2, Christopher Bowd 2, Jade Dohleman 2, Mark Christopher 2, Akram Belghith 2, Suzanne M Vega 2, Keri Dirkes 2, Min Hee Suh 3, Jost B Jonas 4, Leslie Hyman 5, Massimo A Fazio 6, Ruti Sella 7, Natalie A Afshari 2, Robert N Weinreb 2, Linda M Zangwill 8

Affiliations

Bruch Membrane Opening Detection Accuracy in Healthy Eyes and Eyes With Glaucoma With and Without Axial High Myopia in an American and Korean Cohort

Jasmin Rezapour et al. Am J Ophthalmol. 2022 May.

Abstract

Purpose: To determine the predictors of Bruch membrane opening (BMO) location accuracy and the visibility of the BMO location in glaucoma and healthy individuals with and without axial high myopia.

Design: Cross-sectional study.

Methods: Healthy eyes and eyes with glaucoma from an American study and a Korean clinic population were classified into 2 groups: those with no axial high myopia (axial length [AL] <26 mm) and those with axial high myopia (AL ≥26 mm). The accuracy of the automated BMO location on optic nerve head Spectralis optical coherence tomography radial scans was assessed by expert reviewers.

Results: Four hundred thirty-eight non-highly myopic eyes (263 subjects) and 113 highly myopic eyes (81 subjects) were included. In healthy eyes with and without axial high myopia, 9.1% and 1.7% had indiscernible BMOs while 54.5% and 87.6% were accurately segmented, respectively. More than a third (36.4%) and 10.7% of eyes with indiscernible BMOs were manually correctable (respectively, P = .017). In eyes with glaucoma with and without high myopia, 15.0% and 3.2% had indiscernible BMOs, 55.0% and 38.2% were manually corrected, and 30.0% and 58.7% were accurately segmented without the need for manual correction (respectively, P = .005). Having axial high myopia, a larger AL, a larger BMO tilt angle, a lower BMO ovality index (more oval), and a glaucoma diagnosis were significant predictors of BMO location inaccuracy in multivariable logistic regression analysis.

Conclusions: As BMO location inaccuracy was 2.4 times more likely in eyes with high axial myopia regardless of diagnosis, optical coherence tomography images of high myopes should be reviewed carefully, and when possible, BMO location should be corrected before using optic nerve head scan results for the clinical management of glaucoma.

Copyright © 2021 Elsevier Inc. All rights reserved.

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Figures

Figure 1.

Figure 1.

Automatically accurate BMO location in A) a healthy non-highly myopic eye (AL=23.4mm) B) a healthy highly myopic eye (AL=26.1mm) C) a glaucoma non-highly myopic eye (AL=24.6mm) and D) a glaucoma highly myopic eye (AL=26.2mm) The image on the left presents a clinical photograph of the optic nerve head, the image in the middle an enface image of the OCT scan and the image on the right a radial B-scan of the OCT scan. The red dots illustrate the automatic correct BMO location, the red line the ILM segmentation and the blue arrows the BMO-MRW. Abbreviations: AL; axial length, BMO; Bruch’s membrane opening, MRW; minimum rim width, OCT; optical coherence tomography

Figure 2.

Figure 2.

Manually corrected BMO location (red dot) in A) a healthy non-highly myopic eye (AL=23.8mm) B) a healthy highly myopic eye (AL=27.2mm) C) a glaucoma non-highly myopic eye (AL=23.3mm) and D) a glaucoma highly myopic eye (AL=27.5mm). The image on the left presents a clinical photograph of the optic nerve head, the image in the middle an enface image of the OCT scan and the image on the right a radial B-scan of the OCT scan. The red dots illustrate the correct BMO location, the blue “m” stands for manually corrected, the yellow dots marked with an “a” illustrate the automatic inaccurate BMO location, the red line illustrates the ILM segmentation and the blue arrows the BMO-MRW. Abbreviations: AL; axial length, BMO; Bruch’s membrane opening, MRW; minimum rim width, OCT; optical coherence tomography

Figure 3.

Figure 3.

Indiscernible BMO in A) a healthy non-highly myopic eye (AL=25.5mm) B) a healthy highly myopic eye (29.1mm) C) a glaucoma non-highly myopic eye and (AL=23.6mm) D) a glaucoma highly myopic eye (AL=27.2mm). The image on the left presents a clinical photograph of the optic nerve head, the image in the middle an enface image of the OCT scan and the image on the right a radial B-scan of the OCT scan. The red dots illustrate the correct and incorrect automatically detected BMO locations. Incorrect BMO locations could not be manually corrected, the red line the ILM segmentation and the blue arrows the BMO-MRW. In Figure 3C the software did not provide automatic BMO locations in some scans, as in the illustrated example. Abbreviations: AL; axial length, BMO; Bruch’s membrane opening, MRW; minimum rim width, OCT; optical coherence tomography

Figure 4.

Figure 4.

Percentage of automatic accurate, manually corrected and indiscernible BMO in healthy eyes (left) and glaucoma eyes (right). No high myopia” is defined as axial length ≤26mm and high myopia as axial length >26mm. Abbreviations: BMO; Bruch’s membrane opening

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