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Heidelberg Retina Tomograph 3 machine learning classifiers for glaucoma detection
  1. K A Townsend1,
  2. G Wollstein1,
  3. D Danks2,3,
  4. K R Sung1,
  5. H Ishikawa1,
  6. L Kagemann1,
  7. M L Gabriele1,
  8. J S Schuman1
  1. 1
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
  2. 2
    Department of Philosophy, Carnegie Mellon University, Pittsburgh, PA, USA
  3. 3
    Institute for Human and Machine Cognition, Pensacola, FL, USA
  1. Dr J S Schuman, UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, 203 Lothrop Street, Eye and Ear Institute, Suite 816, Pittsburgh, PA 15213, USA; schumanjs{at}


Aims: To assess performance of classifiers trained on Heidelberg Retina Tomograph 3 (HRT3) parameters for discriminating between healthy and glaucomatous eyes.

Methods: Classifiers were trained using HRT3 parameters from 60 healthy subjects and 140 glaucomatous subjects. The classifiers were trained on all 95 variables and smaller sets created with backward elimination. Seven types of classifiers, including Support Vector Machines with radial basis (SVM-radial), and Recursive Partitioning and Regression Trees (RPART), were trained on the parameters. The area under the ROC curve (AUC) was calculated for classifiers, individual parameters and HRT3 glaucoma probability scores (GPS). Classifier AUCs and leave-one-out accuracy were compared with the highest individual parameter and GPS AUCs and accuracies.

Results: The highest AUC and accuracy for an individual parameter were 0.848 and 0.79, for vertical cup/disc ratio (vC/D). For GPS, global GPS performed best with AUC 0.829 and accuracy 0.78. SVM-radial with all parameters showed significant improvement over global GPS and vC/D with AUC 0.916 and accuracy 0.85. RPART with all parameters provided significant improvement over global GPS with AUC 0.899 and significant improvement over global GPS and vC/D with accuracy 0.875.

Conclusions: Machine learning classifiers of HRT3 data provide significant enhancement over current methods for detection of glaucoma.

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  • Funding: Supported in part by NIH grants RO1-EY013178, P30-EY008098 (Bethesda, MD), The Eye and Ear Foundation (Pittsburgh) and an unrestricted grant from Research to Prevent Blindness (New York).

  • Competing interests: Dr Schuman receives royalties for intellectual property licensed by Massachusetts Institute of Technology to Carl Zeiss Meditec. Dr Wollstein received research funding from Carl Zeiss Meditec.

  • Ethics approval: The study was approved by the Institutional Review Board/Ethics Committee, and adhered to the Declaration of Helsinki and Health Insurance Portability and Accountability Act regulations.

  • Patient consent: Patient consent was obtained.

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