Abstract
Background: Laguna-ONhE is an application for the colorimetric analysis of optic nerve images, which topographically assesses the cup and the presence of haemoglobin. Its latest version has been fully automated with five deep learning models. In this paper, perimetry in combination with Laguna-ONhE or Cirrus-OCT was evaluated. Methods: The morphology and perfusion estimated by Laguna ONhE were compiled into a “Globin Distribution Function” (GDF). Visual field irregularity was measured with the usual pattern standard deviation (PSD) and the threshold coefficient of variation (TCV), which analyses its harmony without taking into account age-corrected values. In total, 477 normal eyes, 235 confirmed, and 98 suspected glaucoma cases were examined with Cirrus-OCT and different fundus cameras and perimeters. Results: The best Receiver Operating Characteristic (ROC) analysis results for confirmed and suspected glaucoma were obtained with the combination of GDF and TCV (AUC: 0.995 and 0.935, respectively. Sensitivities: 94.5% and 45.9%, respectively, for 99% specificity). The best combination of OCT and perimetry was obtained with the vertical cup/disc ratio and PSD (AUC: 0.988 and 0.847, respectively. Sensitivities: 84.7% and 18.4%, respectively, for 99% specificity). Conclusion: Using Laguna ONhE, morphology, perfusion, and function can be mutually enhanced with the methods described for the purpose of glaucoma assessment, providing early sensitivity.
Highlights
Glaucoma is a disease with a relatively high incidence, estimated between 2.09% and5.82% of the adult population [1]
globin distribution function (GDF) presented a sensitivity higher than the rim area for 95.0% (p = 0.0121) and 99.0% specificities (p = 0.0131), which was higher than the rest of the perimetric indices and optical coherence tomograph (OCT) (p < 0.0001)
The Laguna ONhE method arose from the observation of differences in RGB frequency histograms of optic disc structures when analysing colour photographs of the optic nerve, as can be seen in Figure 6 of our first publication [4]
Summary
Glaucoma is a disease with a relatively high incidence, estimated between 2.09% and. 5.82% of the adult population [1]. Its diagnosis in early stages is difficult due to its almost asymptomatic onset and controversy of criteria regarding its initial signs. Intraocular pressure is an important pathogenesis factor; while not the only one, it is currently the only one that can be targeted for treatment. Many other factors seem to have an influence on the disease: genetic, morphological, vasospasm, intracranial pressure, tissue thickness and morphology, sleep apnoea, etc. Visual field assessment and optic nerve head examination were the main diagnostic procedures. Examples are the scanning laser polarimeter (GDx), the Heidelberg retina tomograph (HRT) and the optical coherence tomograph (OCT), which is
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