Is it Myopia or Glaucoma? Clinical Tools to Identify the Disease

• Applicant: Dr. Jasmin Rezapour
• Subject Area: Ophthalmology
• Term: from 2019 to 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 422530480

• Final Report Year: 2021

Final Report Abstract

This project demonstrated that the anatomy of glaucoma eyes with axial myopia differed significantly from glaucoma eyes without axial myopia. Compared to glaucoma eyes without high myopia, axial highly myopic eyes: had a smaller BMO ovality index (were more oval) - had larger BMO tilt angle - had no differences in BMO rotation angle - had no differences in global peripapillary RNFL and BMO-MRW thickness, except for the temporal and superonasal sector, respectively - had a lower peripapillary and macular vessel density - had thinner peripapillary and macular choroidal thickness - had similar global and sectoral GCIPL and GCC thickness values - had a higher rate of BMO segmentation inaccuracy rates. Furthermore, automatic OCT scan based BMO ovality index and rotation angle measurements can not be compared to optic disc photograph clinical disk margin based measurements of those parameters. This project contributed important data to objectively characterize morphological characteristics of glaucomatous optic discs with and without axial myopia. The results are useful to evaluate parameters that might be useful to diagnose and monitor glaucoma in myopic eyes. Because ganglion cell-related macular thickness measurements were strongly associated with VFMD but did not vary with axial length, GCIPL and GCC showed promise for detecting glaucoma in myopic eyes. Furthermore, our results suggest that peripapillary RNFL and BMO-MRW glaucoma measurements in highly myopic eyes should be interpreted with caution, as the pattern varies with axial length and OCT scans need to be evaluated for BMO segmentation inaccuracies. Inaccurate BMO segmentation impacts BMO-MRW measurements, but also the peripapillary RNFL measurements based on OCT radial scans and may lead to false positive glaucoma diagnosis in highly myopic eyes. Future work including healthy high myopic eyes is underway and promises identification of the most appropriate diagnostic tools to differentiate between myopic eyes with and without glaucoma.

Publications

• Effects of Study Population, Labeling and Training on Glaucoma Detection Using Deep Learning Algorithms. Translational vision science & technology. 2020;9(2):27
  Christopher, Mark; Nakahara, Kenichi; Bowd, Christopher; Proudfoot, James A.; Belghith, Akram; Goldbaum, Michael H.; Rezapour, Jasmin; Weinreb, Robert N.; Fazio, Massimo A.; Girkin, Christopher A.; Liebmann, Jeffrey M.; De Moraes, Gustavo; Murata, Hiroshi; Tokumo, Kana; Shibata, Naoto; Fujino, Yuri; Matsuura, Masato; Kiuchi, Yoshiaki; Tanito, Masaki; ... & Zangwill, Linda M.
  
• GLANCE: Visual Analystics for Monitoring Glaucoma Progression. Eurographics Visual Computing Biology and Medicine. 2020
  Van den Brandt A, Christopher M, Zangwill LM, Rezapour J, Bowd C, Baxter SL, Welsbie DS, Camp A, Moghimi, S, Do JL, Weinreb RN, Snijders CCP, Westenberg MA
  
• Long-Term Reproducibility of Optical Coherence Tomography Angiography in Healthy, and Stable Glaucoma Eyes – BJO 2021
  Nishida, Takashi; Moghimi, Sasan; Hou, Huiyuan; Proudfoot, James A.; Chang, Aimee C.; David, Ryan Caezar C.; Kamalipour, Alireza; El-Nimri, Nevin; Rezapour, Jasmin; Bowd, Christopher; Zangwill, Linda M. & Weinreb, Robert N.
  
• Macular thickness and vessel density in glaucoma eyes with and without high myopia. ARVO 2021 annual meeting
  Rezapour, Jasmin; Bowd, Christopher; Dohleman, Jade; Belghith, Akram; Proudfoot, James A.; Christopher, Mark; Hyman, Leslie; Jonas, Jost B.; Penteado, Rafaella C.; Moghimi, Sasan; Hou, Huiyuan; Fazio, Massimo A.; Weinreb, Robert N. & Zangwill, Linda M.
  
• Optical Coherence Tomography Angiography Artifacts in Glaucoma. Ophthalmology 2021
  Kamalipour, Alireza; Moghimi, Sasan; Hou, Huiyuan; Penteado, Rafaella C.; Oh, Won Hyuk; Proudfoot, James A.; El-Nimri, Nevin; Ekici, Eren; Rezapour, Jasmin; Zangwill, Linda M.; Bowd, Christopher & Weinreb, Robert N.
  
• Superficial and Deep Macula Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes. JOG. 2021; 15(3)
  El-Nimri, Nevin W.; Manalastas, Patricia Isabel C.; Zangwill, Linda M.; Proudfoot, James A.; Bowd, Christopher; Hou, Huiyuan; Moghimi, Sasan; Penteado, Rafaella C.; Rezapour, Jasmin; Ekici, Eren; Shoji, Takuhei; Ghahari, Elham; Yarmohammadi, Adeleh & Weinreb, Robert N.
  
• The influence of axial myopia on optic disc characteristics of glaucoma eyes. Scientific reports 2021;11:8854
  Rezapour, Jasmin; Bowd, Christopher; Dohleman, Jade; Belghith, Akram; Proudfoot, James A.; Christopher, Mark; Hyman, Leslie; Jonas, Jost B.; Fazio, Massimo A.; Weinreb, Robert N. & Zangwill, Linda M.
  
• Bruch’s membrane opening detection accuracy in healthy and glaucoma eyes with and without high myopia in an American and Korean cohort. AJO 2021
  Rezapour, Jasmin; Proudfoot, James A.; Bowd, Christopher; Dohleman, Jade; Christopher, Mark; Belghith, Akram; Vega, Suzanne M.; Dirkes, Keri; Suh, Min Hee; Jonas, Jost B.; Hyman, Leslie; Fazio, Massimo A.; Sella, Ruti; Afshari, Natalie A.; Weinreb, Robert N. & Zangwill, Linda M.