advertisement
Editors Selection IGR 14-3
Clinical Examination Methods: Structure-function association in the papillomacular RNFL bundle
Comment by Laura Meliante & Anthony Khawaja on:
Retinal Optical Texture Analysis (ROTA) is a novel imaging approach that enhances traditional OCT-based assessment of the retinal nerve fibre layer (RNFL) by capturing optical texture changes along nerve fibre bundle trajectories. Unlike conventional RNFL thickness maps, ROTA combines reflectance and thickness data through nonlinear trans-formations to produce detailed visual representations of axonal integrity.1–3 This new algorithm may improve detection of glaucomatous damage in the macular region, where early structural changes are often subtle and easily overlooked.1
In this cross-sectional study of 841 eyes from 442 participants, the authors applied ROTA to visualize papillomacular and papillofoveal RNFL bundle defects and assessed their association with 10-2 and 24-2 visual field (VF) sensitivity loss. The cohort included 380 glaucoma eyes (45.2%), 317 glaucoma suspects (37.7%), and 144 controls (17.1%). Papillomacular defects were present in 92.1% of glaucoma eyes, with strong topographic concordance to abnormal 10-2 VF points on pattern deviation probability (PDP) maps (ORs reaching 38.60, 95% CI: 36.17, 41.18 at P < .01). In univariable analyses, this association exceeded that observed between ROTA-detected defects and the central 24-2 VF points (OR = 21.25, 95% CI: 19.22–23.49). In multivariable models including both predictors, ROTA remained more strongly associated with 10-2 abnormalities (OR = 22.21, 95% CI: 20.74–23.79) than central 24-2 test points (OR = 7.47, 95% CI: 6.93–8.06), highlighting its superior independent predictive value for detecting central glaucomatous damage. Perhaps most striking is how common even papillofoveal defects are in glaucoma (37.9%).
The authors present a biologically informed structure-function model that accounts for ganglion cell displacement and axonal bundle trajectories, supporting ROTA as a promising tool for identifying early macular damage
This study adds to the growing evidence that glaucoma has important effects on central vision, even early in the disease. The authors present a biologically informed structure-function model that accounts for ganglion cell displacement and axonal bundle trajectories, supporting ROTA as a promising tool for identifying early macular damage and guiding targeted 10-2 VF testing in eyes with papillomacular texture abnormalities.4 Longitudinal studies are needed to assess ROTA’s ability to detect pre-perimetric glaucoma and monitor disease progression.
References
- Leung CKS, Guo PY, Lam AKN. Retinal Nerve Fiber Layer Optical Texture Analysis: Involvement of the Papillomacular Bun-dle and Papillofoveal Bundle in Early Glaucoma. Ophthalmology. 2022;129(9):1043-1055.
- Leung CKS, Lam AKN, Weinreb RN, et al. Diagnostic assessment of glaucoma and non-glaucomatous optic neuropathies via optical texture analysis of the retinal nerve fibre layer. Nat Biomed Eng. 2022;6(5):593-604. doi:10.1038/S41551-021-00813-X
- Su CKY, Guo PY, Chan PPM, Lam AKN, Leung CKS. Retinal Nerve Fiber Layer Optical Texture Analysis: Detecting Axonal Fiber Bundle Defects in Patients with Ocular Hypertension. Ophthalmology. 2023;130(10):1080-1089. doi:10.1016/J. OPHTHA.2023.06.004
- Drasdo N, Millican CL, Katholi CR, Curcio CA. The length of Henle fibers in the human retina and a model of ganglion receptive field density in the visual field. Vision Res. 2007;47(22):2901-2911. doi:10.1016/J.VISRES.2007.01.007
Comments
The comment section on the IGR website is restricted to WGA#One members only. Please log-in through your WGA#One account to continue.Log-in through WGA#One
