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A more recent version of this article appeared on June 1, 2008
 (Investigative Ophthalmology and Visual Science. )
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-1229
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Article

Automated Assessment of Optic Nerve Head on Stereo Disc Photographs

Juan Xu 1, Hiroshi Ishikawa 2*, Gadi Wollstein 1, Rick Bilonick 1, Kyung R Sung 1, Larry Kagemann 2, Kelly A Townsend 1, and Joel S. Schuman 2

1 Ophthalmology, UPMC Eye Center, Pittsburgh, Pennsylvania, United States
2 Ophthalmology, UPMC Eye Center, Pittsburgh, Pennsylvania, United States; Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, Pennsylvania, United States

* To whom correspondence should be addressed. E-mail: ishikawah{at}upmc.edu.


  Abstract

Purpose: To develop automated software for optic nerve head (ONH) quantitative assessment from stereoscopic disc photographs and to evaluate its performance in comparison with human expert assessment. Methods: A fully automated system, including three-dimensional ONH modeling, disc margin detection, cup margin detection and calculation of stereometric ONH parameters, was developed and tested. One eye each from a cohort of 54 subjects (23 healthy, 17 glaucoma suspect, and 14 glaucomatous eyes) from the University of Pittsburgh Medical Center Eye Center with a comprehensive ocular examination, visual field test and stereoscopic disc photographs was enrolled. The majority opinion of three expert defined disc and cup margins on the disc photographs was compared with the automatically generated ONH measurements. Seven ONH parameters, disc area, rim area, rim volume, cup area, cup volume, cup-to-disc (C/D) area ratio and vertical C/D ratio, were computed based on both machine and expert defined margins and compared between the methods. Results: All automated ONH measurements showed good correlations with the expert defined margins (Pearson r: 0.90 (disc area), 0.56 (rim area), 0.78 (rim volume), 0.88 (cup area), 0.93 (cup volume), 0.69 (C/D area ratio), and 0.67 (vertical C/D ratio) all pless double equals0.0001). No statistically significant difference was found in glaucoma discriminating ability for all the seven ONH parameters (pgreater double equals0.21). Conclusions: The automated ONH analysis method provides an objective and quantitative ONH evaluation using widely available stereo disc photographs.

Key Words: optic nerve head, image analysis, glaucoma, optic disc, glaucoma posterior segment






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