Please join Dr. Tobias Else, as he presents, “Personalizing the Diagnosis of Glaucomatous Vision Loss and its Evolution Over Time.” The lecture will take place on October 30, 2018 as part of the Research Lecture Series in Lecture Hall 2. All are welcome to attend. One hour of Mass CE will be awarded. You are invited to join us for a light reception in Conference Room 1 following the lecture.
Abstract: Glaucoma is a disease of the optic nerve accompanied by visual field (VF) loss. While accurate VF loss diagnosis and the detection of its progression over time is of high relevance to clinical practitioners, VF measurements are known to be often unreliable and hard to interpret, and their quantitative description is often reduced to simple summary parameters, ignoring that glaucomatous VF loss follows characteristic and patient specific patterns. Here, we apply machine learning techniques to a dataset of around half a million VFs from domestic glaucoma services to objectively determine representative patterns of glaucomatous VF loss. Furthermore, we statistically investigate the evolution of these patterns over time and define patient-specific defect classes with the goal to individualize the diagnosis of glaucoma and its progression. Finally, we study parameters of retinal structure, such as retinal nerve fiber layer, appearance of the optic disc, or retinal vascularization, and parameters of eye anatomy, such as axial myopia, and their relationship to specific patterns of glaucomatous vision loss. We demonstrate how myopia and optic disc tilt and torsion may specifically bias structural glaucoma diagnosis. Furthermore, we show that vascularization parameters are specifically related to glaucomatous central vision loss. Myopia is shown to be an effect modifier of VF loss in glaucoma: While myopes do not have more severe VF loss, their individual loss patterns specifically differ from emmetropes.