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Scan quality effect on glaucoma discrimination by glaucoma imaging devices
  1. Kyung Rim Sung1,
  2. Gadi Wollstein1,
  3. Joel S Schuman1,
  4. Richard A Bilonick1,
  5. Hiroshi Ishikawa1,
  6. Kelly A Townsend1,
  7. Larry Kagemann1,
  8. Michelle L Gabriele1,
  9. Advanced Imaging in Glaucoma Study group2
  1. 1 UPMC Eye Center, Eye and Ear Inst, Ophthalmol and Vis Sci Res Center, Dept Ophtalmol, Univ Pittsburg, United States;
  2. 2 Univ of Southern California, United States
  1. * Corresponding author; email: schumanjs{at}


Purpose: To evaluate, within ocular imaging scans of acceptable quality as determined by manufacturers’ guidelines, the effects of image quality on glaucoma discrimination capabilities.

Methods: One hundred and four healthy and 75 glaucomatous eyes from the Advanced Imaging in Glaucoma Study (AIGS) were imaged with GDx-VCC, HRT II, and StratusOCT. Quality score (QS≥8), pixel standard deviation (SD≤50), and signal strength (SS≥5) were used as quality parameter cutoffs, respectively. GDx nerve fiber indicator (NFI), and HRT Moorfields regression analysis (MRA) classifications and OCT mean retinal nerve fiber layer (RNFL) thickness were used as the discriminatory parameters. Logistic regression models were used to model the dichotomous clinical classification (healthy vs. glaucoma) as a function of image quality parameters and discriminatory parameters.

Results: Quality parameter covariates were statistically non¬-significant for GDx and HRT but had an inverse effect on OCT in predicting disease (higher SS had lower probability of glaucoma). Age was a significant covariate for GDx and HRT, but not OCT, while ethnicity and interaction between the image quality and the institute where scans were acquired were significant covariates in the OCT models.

Conclusion: Within scans considered to be acceptable based on the manufacturers’ recommended limits, scan quality does not affect the discriminating ability of global discriminatory parameters of GDx, HRT but have an effect on OCT measurements.

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