Tsamis Emmanouil

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

In section 5, the model helps account for the success of an AI deep learning model, which in turn validates our focus on the RNFL p-map.

Structure-Function Agreement Is Better Than Commonly Thought in Eyes With Early Glaucoma.

There is good agreement between structural and functional damage, even in eyes with confirmed early glaucomatous damage, if both 24-2 and 10-2 VFs are obtained, and abnormal locations on the VFs are compared to abnormal regions seen on OCT macular and disc scans.

An Automated Method for Assessing Topographical Structure-Function Agreement in Abnormal Glaucomatous Regions.

The method described here can automatically and objectively evaluate aS-aF agreement with a direct comparison of abnormal regions of function and structure.

Optical Coherence Tomography Can Be Used to Assess Glaucomatous Optic Nerve Damage in Most Eyes With High Myopia.

For most eyes with high myopia, there is sufficient information in OCT scans to allow for accurate diagnosis of GON.

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

A decision tree was devised for testing and implementation in clinical practice and research that can be used by reading centers, researchers, and clinicians.

OCT Circle Scans Can Be Used to Study Many Eyes with Advanced Glaucoma.

OCT scans can be used to assess and potentially follow the preserved regions of cpRNFL associated with the macula in eyes with advanced glaucoma if there is a preserved region on the 10-2 VF better…

The OCT RNFL Probability Map and Artifacts Resembling Glaucomatous Damage.

Glaucoma-like artifacts on RNFL p-maps are relatively common and can masquerade as arcuate and/or widespread/temporal damage.

Strategies to Improve Convolutional Neural Network Generalizability and Reference Standards for Glaucoma Detection From OCT Scans.

CNN generalizability can be improved with data augmentation, multiple input image modalities, and training on images with confident ratings.

Reasons why OCT Global Circumpapillary Retinal Nerve Fiber Layer Thickness is a Poor Measure of Glaucomatous Progression.

Local defects and segmentation errors are the primary reasons for the poor performance of cpRNFL thickness G metric.

Improving the Detection of Glaucoma and Its Progression: A Topographical Approach.

Together, the RNF bundle model and the automated structure-function method should improve the power of topographical methods for detecting glaucoma and its progression.

A Topographic Comparison of OCT Minimum Rim Width (BMO-MRW) and Circumpapillary Retinal Nerve Fiber Layer (cRNFL) Thickness Measures in Eyes With or Suspected Glaucoma.

Although BMO-MRW and cRNFL measures agreed in the majority of hemidiscs, they still disagreed in over 25% of the EG hemidiscs.

An Evaluation of a New 24-2 Metric for Detecting Early Central Glaucomatous Damage.

Neither the PSD(C24-2) nor the PSD(10-2) metric is good measure of early CD. Instead we recommend a topographic approach based upon OCT probability maps and a 10-2 VF.

Detection of Early Glaucomatous Damage: Performance of Summary Statistics From Optical Coherence Tomography and Perimetry.

OCT and VF metrics, single or in combinations, have only moderate sensitivity for eyes with early glaucoma.

A Model of Progression to Help Identify Macular Damage Due to Glaucoma.

Second, the patterns of progression predicted by the model suggest alternative end points for clinical trials. Finally, the model provides a heuristic for future research concerning the anatomic basis of glaucomatous damage.

The 24-2 Visual Field Guided Progression Analysis Can Miss the Progression of Glaucomatous Damage of the Macula Seen Using OCT.

In eyes with early glaucoma (i.e., 24-2 MD, > -6 dB) in this study, the 24-2 GPA missed progression seen using OCT and exhibited a relatively high rate of false positives.

The ICD-10 Glaucoma Severity Score Underestimates the Extent of Glaucomatous Optic Nerve Damage.

The ICD-10 system relies solely on damage seen on the 24-2 and as provides a 24-2 functional score rather than a "glaucoma" severity score.

A Pattern-Based OCT Metric for Glaucoma Detection.

The new metric outperformed other OCT metrics for detecting glaucomatous damage.

Progression of Early Glaucomatous Damage: Performance of Summary Statistics From Optical Coherence Tomography and Perimetry.

Although relying solely on metrics is not recommended for clinical purposes, in situations requiring very high specificity and precision, combinations of OCT-OCT metrics can be used.

Distinguishing Healthy From Glaucomatous Eyes With Optical Coherence Tomography Global Circumpapillary Retinal Nerve Fiber Thickness in the Bottom 5th Percentile.

Quantitative metrics can distinguish between most of the healthy and glaucomatous eyes with low global cpRNFL thickness. However, even the most successful metric, RMS cpRNFL, missed some glaucomatous eyes.

Did the OCT Show Progression Since the Last Visit?

Instead of relying on the GPA analysis or summary statistics, one needs to evaluate RNFL and ganglion cell+inner plexiform layer probability maps and circumpapillary OCT B-scan images.

A Deep Learning Model for Glaucoma Detection Outperforms Conventional Metrics.

The DLM achieved high specificity and sensitivity and outperformed conventional metrics.

A Deep Learning Model Detects Glaucoma Based on an OCT Report, but Where Should the Clinician Look to Identify Glaucomatous Damage?

Although the DLM heat maps are flagging clinically meaningful elements of the report, in their existing form, they are not optimal for guiding the clinician to relevant locations of damage.

Glaucoma Detection Using Optical Coherence Tomography: Reviewing the Pitfalls of Comparison to Normative Data.

This review describes various artifacts that originate from using a normative database to compare the individual's scans.

Detecting Established Glaucoma Using OCT Alone: Utilizing an OCT Reading Center in a Real-World Clinical Setting.

An OCT-based reading center is able to identify eyes with established glaucoma using OCT alone with high sensitivity and specificity.

Local Glaucomatous Defects of the Circumpapillary Retinal Nerve Fiber Layer Show a Variety of Patterns of Progression.

All eyes showed a widening and deepening of the ROP, but a variety of different patterns of progressive cRNFL loss.

Diagnostic Accuracy of Smart Supra Perimetry in Comparison With Standard Automated Perimetry in the Detection of Early Glaucoma.

The SS supra-threshold test was faster and had equivalent diagnostic accuracy to the SITA standard 24-2 threshold test in early/suspect glaucoma.

Test of a Retinal Nerve Fiber Bundle Trajectory Model Using Eyes With Glaucomatous Optic Neuropathy.

The arcuate model performed well in predicting the borders of arcuate patterns seen on RNFL p-maps. It also predicted the associated abnormal regions of the cpRNFL thickness plots.

The Role of Intraocular Pressure and Systemic Hypertension in the Progression of Glaucomatous Damage to the Macula.

Macular structural and functional parameters are more sensitive to IOP in terms of glaucomatous progression when compared with more conventional parameters.

Larger Real-World OCT Reference Database Improves Accuracy of Glaucoma Flagging Using Summary Metrics.

There is a difference in the eyes flagged, and this difference is largely due to the greater size of the RW-RDB.

Nicotinamide and Pyruvate in Open-Angle Glaucoma: A Randomized Controlled Trial on Neuroprotection-Design and Methodology.

This novel trial design may deliver valuable data on the neuroprotective potential of nicotinamide and pyruvate supplementation in glaucoma and improve our understanding of optimal study design for longitudinal randomized clinical trials focused on glaucoma neuroprotection.

Perimetry Testing in the 10th Decade of Life.

A total of 3951 VF tests were collected from 289 patients (530 eyes) who met the inclusion criteria.

A Morphologic Model of Glaucomatous Damage to the Macular Ganglion Cell Layer in Myopic Eyes.

The proposed model of glaucomatous damage patterns in macula GCL is applicable to myopic eyes, even with coexisting macular pathology. In cases deviating from the model, clinicians are advised to seek causes besides glaucoma.

Understanding Patterns of Preserved Retinal Ganglion Cell Layer in Advanced Glaucoma as Seen With Optical Coherence Tomography.

All eyes with advanced glaucoma had damage to the critically important central, donut-shaped GCL region.

Improving glaucoma staging in clinical practice by combining the ICD-10 glaucoma severity classification system and optical coherence tomography.

Combining OCT and VF data provides better staging of glaucoma severity than VF data alone.