Localized glaucomatous change detection within the proper orthogonal decomposition framework
Abstract
PURPOSE. To detect localized glaucomatous structural changes using proper orthogonal decomposition (POD) framework with false-positive control that minimizes confirmatory followups, and to compare the results to topographic change analysis (TCA). METHODS. We included 167 participants (246 eyes) with >4 Heidelberg Retina Tomograph (HRT)-II exams from the Diagnostic Innovations in Glaucoma Study; 36 eyes progressed by stereo-photographs or visual fields. All other patient eyes (n = 210) were non-progressing. Specificities were evaluated using 21 normal eyes. Significance of change at each HRT superpixel between each follow-up and its nearest baseline (obtained using POD) was estimated using mixed-effects ANOVA. Locations with significant reduction in retinal height (red pixels) were determined using Bonferroni, Lehmann- Romano Κ-family-wise error rate (Κ-FWER), and Benjamini- Hochberg false discovery rate (FDR) type I error control procedures. Observed positive rate (OPR) in each follow-up was calculated as a ratio of number of red pixels within disk to disk size. Progression by POD was defined as one or more follow-ups with OPR greater than the anticipated false-positive rate. TCA was evaluated using the recently proposed liberal, moderate, and conservative progression criteria. RESULTS. Sensitivity in progressors, specificity in normals, and specificity in non-progressors, respectively, were POD-Bonferroni = 100%, 0%, and 0%; POD Κ-FWER 1/4 78%, 86%, and 43%; POD-FDR = 78%, 86%, and 43%; POD Κ-FWER with retinal height change ≥50 lm 1/4 61%, 95%, and 60%; TCA-liberal = 86%, 62%, and 21%; TCA-moderate1/453%, 100%, and 70%; and TCA-conservative = 17%, 100%, and 84%. CONCLUSIONS. With a stronger control of type I errors, Κ-FWER in POD framework minimized confirmatory follow-ups while providing diagnostic accuracy comparable to TCA. Thus, POD with Κ-FWER shows promise to reduce the number of confirmatory follow-ups required for clinical care and studies evaluating new glaucoma treatments. © 2012 The Association for Research in Vision and Ophthalmology, Inc.
Publication Title
Investigative Ophthalmology and Visual Science
Recommended Citation
Balasubramanian, M., Kriegman, D., Bowd, C., Holst, M., Weinreb, R., Sample, P., & Zangwill, L. (2012). Localized glaucomatous change detection within the proper orthogonal decomposition framework. Investigative Ophthalmology and Visual Science (7), 3615-3628. https://doi.org/10.1167/iovs.11-8847
