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Article ; Online: Does Retinal Ganglion Cell Loss Precede Visual Field Loss in Glaucoma?

Hood, Donald C

2019 Volume 28, Issue 11, Page(s) 945–951

Abstract: It is often said that substantial retinal ganglion cells are lost before glaucomatous damage is detected by standard automated perimetry. There are 4 key articles referenced to support this belief. To test the hypothesis that the 4 key articles are ... ...

Abstract	It is often said that substantial retinal ganglion cells are lost before glaucomatous damage is detected by standard automated perimetry. There are 4 key articles referenced to support this belief. To test the hypothesis that the 4 key articles are incorrectly cited, the publications in the first 6 months of 2019 that reference 1 or more of these 4 articles were examined. In particular, the degree to which the quotes from these 2019 publications accurately reflected the evidence in the 4 key articles was assessed. These quotes are inadequately supported by the data, and in some cases even by the conclusions found in the abstracts of the key articles. This is despite several review articles that have questioned the evidence in these key articles. Further, a case can be made that the evidence in the key articles better supports the opposite conclusion. That is, the data suggest that sensitivity loss can be seen on standard automated perimetry before retinal ganglion cells are missing.
MeSH term(s)	Glaucoma, Open-Angle/diagnosis ; Humans ; Intraocular Pressure/physiology ; Retinal Diseases/diagnosis ; Retinal Ganglion Cells/pathology ; Vision Disorders/diagnosis ; Vision Disorders/physiopathology ; Visual Field Tests ; Visual Fields/physiology
Language	English
Publishing date	2019-11-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	913494-3
ISSN	1536-481X ; 1057-0829
ISSN (online)	1536-481X
ISSN	1057-0829
DOI	10.1097/IJG.0000000000001380
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Article ; Online: Anatomical Features can Affect OCT Measures Used for Clinical Decisions and Clinical Trial Endpoints.

Hood, Donald C / La Bruna, Sol / Durbin, Mary / Lee, Chris / Hsiao, Yi S / De Moraes, Carlos G / Tsamis, Emmanouil

Translational vision science & technology

2024 Volume 13, Issue 4, Page(s) 27

Abstract: Purpose: To understand the association between anatomical parameters of healthy eyes and optical coherence tomography (OCT) circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements.: Methods: OCT cpRNFL thickness was obtained from ... ...

Abstract	Purpose: To understand the association between anatomical parameters of healthy eyes and optical coherence tomography (OCT) circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements. Methods: OCT cpRNFL thickness was obtained from 396 healthy eyes in a commercial reference database (RDB). The temporal quadrant (TQ), superior quadrant (SQ), inferior quadrant (IQ), and global (G) cpRNFL thicknesses were analyzed. The commercial OCT devices code these values based on percentiles (red, <1%; yellow, ≥1% and <5%), after taking age and disc area into consideration. Four anatomical parameters were assessed: fovea-to-disc distance, an estimate of axial length, and the locations of the superior and the inferior peaks of the cpRNFL thickness curve. Pearson correlation values were obtained for the parameters and the thickness measures of each of the four cpRNFL regions, and t-tests were performed between the cpRNFL thicknesses coded as abnormal (red or yellow, <5%) versus normal (≥5%). Results: For each of the four anatomical parameters, the correlation with the thickness of one or more of the TQ, SQ, IQ, and G regions exceeded the correlation with age or disc area. All four parameters were significantly (P < 0.001) associated with the abnormal cpRNFL values. The significant parameters were not the same for the different regions; for example, a parameter could be negatively correlated for the TQ but positively correlated with the SQ or IQ. Conclusions: In addition to age and disc area, which are used for inferences in normative databases, four anatomical parameters are associated with cpRNFL thickness. Translational relevance: Taking these additional anatomical parameters into consideration should aid diagnostic accuracy.
MeSH term(s)	Fovea Centralis ; Retina/diagnostic imaging ; Retinal Ganglion Cells ; Tomography, Optical Coherence/methods ; Clinical Trials as Topic ; Humans
Language	English
Publishing date	2024-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2674602-5
ISSN	2164-2591 ; 2164-2591
ISSN (online)	2164-2591
ISSN	2164-2591
DOI	10.1167/tvst.13.4.27
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Article ; Online: Improving our understanding, and detection, of glaucomatous damage: An approach based upon optical coherence tomography (OCT).

Hood, Donald C

Progress in retinal and eye research

2016 Volume 57, Page(s) 46–75

Abstract: Although ophthalmologists are becoming increasingly reliant upon optical coherence tomography (OCT), clinicians who care for glaucoma patients are not taking full advantage of the potential of this powerful technology. First, we ask, how would one ... ...

Abstract	Although ophthalmologists are becoming increasingly reliant upon optical coherence tomography (OCT), clinicians who care for glaucoma patients are not taking full advantage of the potential of this powerful technology. First, we ask, how would one describe the nature of glaucomatous damage if only OCT scans were available? In particular, a schematic model of glaucomatous damage is developed in section 2, and the nature of glaucomatous damage seen on OCT scans described in the context of this model in section 3. In particular, we illustrate that local thinning of the circumpapillary retinal nerve fiber layer (cpRNFL) around the optic disc can vary in location, depth, and/or width, as well as homogeneity of damage. Second, we seek to better understand the relationship between the thinning of the cpRNFL and the various patterns of sensitivity loss seen on visual fields obtained with standard automated perimetry. In sections 4 and 5, we illustrate why one should expect a wide range of visual field patterns, and iilustrate why they should not be placed into discrete categories. Finally, section 6 describes how the clinician can take better advantage of the information in OCT scans. The approach is summarized in a single-page report, which can be generated from a single wide-field scan. The superiority of this approach, as opposed to the typical reliance on summary metrics, is described.
MeSH term(s)	Glaucoma/diagnosis ; Humans ; Intraocular Pressure ; Nerve Fibers/pathology ; Optic Disk/pathology ; Retinal Ganglion Cells/pathology ; Tomography, Optical Coherence/methods ; Visual Field Tests ; Visual Fields
Language	English
Publishing date	2016-12-22
Publishing country	England
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	1182683-6
ISSN	1873-1635 ; 1350-9462
ISSN (online)	1873-1635
ISSN	1350-9462
DOI	10.1016/j.preteyeres.2016.12.002
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Article ; Online: Imaging Glaucoma.

Hood, Donald C

Annual review of vision science

2015 Volume 1, Page(s) 51–72

Abstract: Optical coherence tomography (OCT) is changing the way glaucoma is studied and diagnosed. Glaucoma damages retinal ganglion cell (RGC) axons at the optic disc, and the resulting retrograde degeneration destroys the RGC bodies. OCT allows for a ... ...

Abstract	Optical coherence tomography (OCT) is changing the way glaucoma is studied and diagnosed. Glaucoma damages retinal ganglion cell (RGC) axons at the optic disc, and the resulting retrograde degeneration destroys the RGC bodies. OCT allows for a noninvasive measurement of both retinal nerve fiber (RNF) and RGC layer thickness. In this article, OCT techniques are described for studying the thinning of these layers due to glaucoma. We have learned that there is more damage to the macula (central ±8 deg) than previously thought, and a simple anatomical model provides an explanation for this finding. Further, OCT technology has led to improved understanding of the relationship between RGC and RNF layer loss and behavioral data. Finally, another imaging technique, adaptive optics, has allowed a better visualization and understanding of details that are often difficult or impossible to see with current OCT technology.
Language	English
Publishing date	2015-11-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2805730-2
ISSN	2374-4650 ; 2374-4642
ISSN (online)	2374-4650
ISSN	2374-4642
DOI	10.1146/annurev-vision-082114-035423
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Article ; Online: Glaucoma Detection Using Optical Coherence Tomography: Reviewing the Pitfalls of Comparison to Normative Data.

Leshno, Ari / De Moraes, Carlos Gustavo / Tsamis, Emmanouil / La Bruna, Sol / Cioffi, George A / Liebmann, Jeffrey M / Hood, Donald C

Journal of glaucoma

2023 Volume 33, Issue 2, Page(s) 65–77

Abstract: Prcis: Optical coherence tomography is essential in managing glaucoma. This review describes various artifacts that originate from using a normative database to compare the individual's scans. This is a review paper regarding artifacts in optical ... ...

Abstract	Prcis: Optical coherence tomography is essential in managing glaucoma. This review describes various artifacts that originate from using a normative database to compare the individual's scans. This is a review paper regarding artifacts in optical coherence tomography imaging for glaucoma arising from using a normative database as a reference for healthy retinal nerve fiber layer and ganglion cell layer.
MeSH term(s)	Humans ; Tomography, Optical Coherence/methods ; Intraocular Pressure ; Retinal Ganglion Cells ; Nerve Fibers ; Glaucoma/diagnosis
Language	English
Publishing date	2023-11-24
Publishing country	United States
Document type	Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	913494-3
ISSN	1536-481X ; 1057-0829
ISSN (online)	1536-481X
ISSN	1057-0829
DOI	10.1097/IJG.0000000000002337
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Article ; Online: Robust and Interpretable Convolutional Neural Networks to Detect Glaucoma in Optical Coherence Tomography Images.

Thakoor, Kaveri A / Koorathota, Sharath C / Hood, Donald C / Sajda, Paul

IEEE transactions on bio-medical engineering

2021 Volume 68, Issue 8, Page(s) 2456–2466

Abstract: Recent studies suggest that deep learning systems can now achieve performance on par with medical experts in diagnosis of disease. A prime example is in the field of ophthalmology, where convolutional neural networks (CNNs) have been used to detect ... ...

Abstract	Recent studies suggest that deep learning systems can now achieve performance on par with medical experts in diagnosis of disease. A prime example is in the field of ophthalmology, where convolutional neural networks (CNNs) have been used to detect retinal and ocular diseases. However, this type of artificial intelligence (AI) has yet to be adopted clinically due to questions regarding robustness of the algorithms to datasets collected at new clinical sites and a lack of explainability of AI-based predictions, especially relative to those of human expert counterparts. In this work, we develop CNN architectures that demonstrate robust detection of glaucoma in optical coherence tomography (OCT) images and test with concept activation vectors (TCAVs) to infer what image concepts CNNs use to generate predictions. Furthermore, we compare TCAV results to eye fixations of clinicians, to identify common decision-making features used by both AI and human experts. We find that employing fine-tuned transfer learning and CNN ensemble learning create end-to-end deep learning models with superior robustness compared to previously reported hybrid deep-learning/machine-learning models, and TCAV/eye-fixation comparison suggests the importance of three OCT report sub-images that are consistent with areas of interest fixated upon by OCT experts to detect glaucoma. The pipeline described here for evaluating CNN robustness and validating interpretable image concepts used by CNNs with eye movements of experts has the potential to help standardize the acceptance of new AI tools for use in the clinic.
MeSH term(s)	Artificial Intelligence ; Glaucoma/diagnostic imaging ; Humans ; Machine Learning ; Neural Networks, Computer ; Tomography, Optical Coherence
Language	English
Publishing date	2021-07-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	160429-6
ISSN	1558-2531 ; 0018-9294
ISSN (online)	1558-2531
ISSN	0018-9294
DOI	10.1109/TBME.2020.3043215
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Article ; Online: Monitoring Lesion Area Progression in Stargardt Disease: A Comparison of En Face Optical Coherence Tomography and Fundus Autofluorescence.

Greenstein, Vivienne C / Castillejos, David S / Tsang, Stephen H / Lee, Winston / Sparrow, Janet R / Allikmets, Rando / Birch, David G / Hood, Donald C

Translational vision science & technology

2023 Volume 12, Issue 5, Page(s) 2

Abstract: Purpose: To compare longitudinal changes in en face spectral domain-optical coherence tomography (SD-OCT) measurements of ellipsoid zone (EZ) and retinal pigment epithelium (RPE) loss to changes in the hypoautofluorescent and hyperautofluorescent (AF) ... ...

Abstract	Purpose: To compare longitudinal changes in en face spectral domain-optical coherence tomography (SD-OCT) measurements of ellipsoid zone (EZ) and retinal pigment epithelium (RPE) loss to changes in the hypoautofluorescent and hyperautofluorescent (AF) areas detected with short-wavelength (SW)-AF in ABCA4-associated retinopathy. Methods: SD-OCT volume scans were obtained from 20 patients (20 eyes) over 2.6 ± 1.2 years (range 1-5 years). The EZ, and RPE/Bruch's membrane boundaries were segmented, and en face slab images generated. SubRPE and EZ slab images were used to measure areas of atrophic RPE and EZ loss. These were compared to longitudinal measurements of the hypo- and abnormal AF (hypoAF and surrounding hyperAF) areas. Results: At baseline, the en face area of EZ loss was significantly larger than the subRPE atrophic area, and the abnormal AF area was significantly larger than the hypoAF area. The median rate of EZ loss was significantly greater than the rate of increase in the subRPE atrophic area (1.2 mm2/yr compared to 0.5 mm2/yr). The median rate of increase in the abnormal AF area was significantly greater than the increase in the hypoAF area (1.6 mm2/yr compared to 0.6 mm2/yr). Conclusions: En face SD-OCT can be used to quantify changes in RPE atrophy and photoreceptor integrity. It can be a complementary or alternative technique to SW-AF with the advantage of monitoring EZ loss. The SW-AF results emphasize the importance of measuring changes in the hypo- and abnormal AF areas. Translational relevance: The findings are relevant to the selection of outcome measures for monitoring ABCA4-associated retinopathy.
MeSH term(s)	Humans ; Stargardt Disease ; Tomography, Optical Coherence/methods ; Fluorescein Angiography/methods ; Fundus Oculi ; Retinal Diseases ; ATP-Binding Cassette Transporters
Chemical Substances	ABCA4 protein, human ; ATP-Binding Cassette Transporters
Language	English
Publishing date	2023-05-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2674602-5
ISSN	2164-2591 ; 2164-2591
ISSN (online)	2164-2591
ISSN	2164-2591
DOI	10.1167/tvst.12.5.2
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Article ; Online: Toward a Real-world Optical Coherence Tomography Reference Database: Optometric Practices as a Source of Healthy Eyes.

Hood, Donald C / Durbin, Mary / Lee, Chris / Gomide, Gabriel / La Bruna, Sol / Chaglasian, Michael / Tsamis, Emmanouil

Optometry and vision science : official publication of the American Academy of Optometry

2023 Volume 100, Issue 8, Page(s) 499–506

Abstract: Significance: The reports from optical coherence tomography (OCT) instruments depend on a reference database (RDB) of healthy eyes. Although these RDBs tend to be relatively small, they are time consuming and expensive to obtain. A larger RDB should ... ...

Abstract	Significance: The reports from optical coherence tomography (OCT) instruments depend on a reference database (RDB) of healthy eyes. Although these RDBs tend to be relatively small, they are time consuming and expensive to obtain. A larger RDB should improve our ability to screen for diseases such as glaucoma. Purpose: To explore the feasibility of developing a large RDB from OCT scans obtained by optometrists as part of their pre-test gathering of information, we tested the hypothesis that these scans are of sufficient quality for an RDB and contain a relatively low base rate of glaucoma and other pathologies (OPs). Methods: Optical coherence tomography widefield (12 × 9 mm) scans from 400 eyes of 400 patients were randomly selected from a data set of more than 49,000 scans obtained from four optometry sites. Based on a commercial OCT report and a previously validated reading center method, two OCT graders categorized eyes as unacceptable to use for RDB, healthy (H), optic neuropathy consistent with glaucoma (ON-G), glaucoma suspect, or OPs. Results: Overall, 29 (7.25%) of the eyes were graded unacceptable. Of the remaining 371 eyes, 352 (94.9%) were graded H. Although, for one site, 7.4% of the eligible eyes were graded ON-G, the average for the other three sites was 1.4%. Adjustments of the reading center criteria resulted in exclusion of more than half of these ON-G and OP eyes. Conclusions: The OCT scans obtained from optometry practices as part of their pre-test regimen are of sufficient quality for an RDB and contain a relatively low base rate of glaucoma and OPs. With the suggested exclusion criteria, the scans from optometry practices that are primarily involved in refraction and medical screening services should yield a large, real-world RDB with improved specificity and a base rate of glaucoma and/or OPs comparable with existing RDB.
MeSH term(s)	Humans ; Tomography, Optical Coherence/methods ; Optometry ; Visual Field Tests/methods ; Visual Fields ; Glaucoma/diagnosis ; Retinal Ganglion Cells/pathology ; Intraocular Pressure
Language	English
Publishing date	2023-07-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1001706-9
ISSN	1538-9235 ; 1040-5488
ISSN (online)	1538-9235
ISSN	1040-5488
DOI	10.1097/OPX.0000000000002049
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Article ; Online: Radial thinning ineffective at increasing large sugar pine survival

Hood, Sharon M. / Schaupp, Willis C. / Goheen, Donald J.

Forest Ecology and Management. 2022 Sept., v. 520 p.120351-

2022

Abstract: White pines (Pinus, subgenus Strobus) in North America are highly vulnerable to the native mountain pine beetle (Dendroctonus ponderosae), invasive white pine blister rust (Cronartium ribicola), and consequences of altered disturbance regimes, with sugar ...

Abstract	White pines (Pinus, subgenus Strobus) in North America are highly vulnerable to the native mountain pine beetle (Dendroctonus ponderosae), invasive white pine blister rust (Cronartium ribicola), and consequences of altered disturbance regimes, with sugar pine (Pinus lambertiana) being among the most in peril. Radial thinning treatments reflect an effort to balance the needs of late seral, high forest cover for some wildlife species with the desire to also promote habitat for species requiring higher light and lower competition, as well as to create heterogenous forest structure that can be more resilient to wildfire and drought. We examined 16-year effects of three radial thinning treatments that cleared approximately 0.017 ha to 0.05 ha around focal large sugar pines on reducing tree mortality and increasing sugar pine recruitment relative to untreated, control trees. Thinning treatments by order of increasing intensity included a compressed radius treatment which removed all trees and shrubs to 3 m from the crown edge, an extended radius with large tree retention treatment which removed trees <64 cm DBH and shrubs to 7.6 m from the crown edge, and an extended radius treatment which removed all trees and shrubs to 7.6 m outside of the crown edge. None of the three radial thinning treatments tested reduced mortality relative to the control, and mountain pine beetle caused the most mortality across the four treatments. However, mortality trended lower in the extended radius with retention treatment (19% compared to 30-37%) and was the only treatment where no mortality from wind or insects other than mountain pine beetle occurred. For trees that survived through the 16-year monitoring period, only trees in the extended radius treatment experienced increased growth above pre-treatment values and higher presence of sugar pine seedlings. Our results show no clear benefit was derived from the radial thinning treatments tested. While radial thinning may be a useful tool when used in conjunction with other silvicultural prescriptions that create heterogeneous stands and landscapes with a variety of forest structures, it seems unlikely that employing only radial thinning will meet restoration efforts that aim to decrease large tree mortality. This study highlights the value of long-term monitoring in the continual effort to develop new treatments that are effective at increasing forest resilience.
Keywords	Cronartium ribicola ; Dendroctonus ponderosae ; Pinus lambertiana ; administrative management ; drought ; forest ecology ; forests ; habitats ; mortality ; sugars ; tree mortality ; trees ; white pine blister rust ; wildfires ; wildlife ; wind ; North America ; Crop tree release ; Free thinning ; Daylighting ; Northwest Forest Plan ; Adaptive management
Language	English
Dates of publication	2022-09
Publishing place	Elsevier B.V.
Document type	Article ; Online
ZDB-ID	751138-3
ISSN	0378-1127
ISSN	0378-1127
DOI	10.1016/j.foreco.2022.120351
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Understanding Patterns of Preserved Retinal Ganglion Cell Layer in Advanced Glaucoma as seen with OCT.

Sun, Anna J / Gomide, Gabriel / Tsamis, Emmanouil / Mao, Grace / Leshno, Ari / La Bruna, Sol / Liebmann, Jeffrey M / De Moraes, Gustavo / Hood, Donald C

Journal of glaucoma

2024

Abstract: Precis: Using OCT, eyes with advanced glaucoma were found to have a wide range of patterns of damage that were consistent with the natural history of progression based upon a model of macular progression.: Purpose: To understand the patterns of ... ...

Abstract	Precis: Using OCT, eyes with advanced glaucoma were found to have a wide range of patterns of damage that were consistent with the natural history of progression based upon a model of macular progression. Purpose: To understand the patterns of preserved retinal ganglion cells in eyes with advanced glaucoma using OCT and a model of progression of the central macula. Methods: OCT GCL thickness was measured in 94 eyes with advanced glaucoma, defined as glaucomatous eyes with a 24-2 MD (mean deviation) worse than -12 dB. A commercial report supplied the GCL thickness in 6 sectors of the thick, donut-shaped GCL region around the fovea. For each eye, the 6 sectors were coded as green (within normal limits, WNL), yellow (≤5th, ≥1st percentile), or red (<1st percentile). Results: In all 94 eyes, one or more of the 6 sectors of the donut were abnormal (red or yellow), while all 6 sectors were red in 52 (55%) of the eyes. On the other hand, 33 eyes had one or more sectors WNL (green). While the pattern of donut damage varied widely across these 33 eyes, 61 of the 66 hemiretinas were consistent with a temporal-to-nasal progression of damage within each hemiretina as predicted by our model. Conclusion: All eyes with advanced glaucoma had damage to the critically important central, donut-shaped GCL region. This region showed a wide range of patterns of damage, but these patterns were consistent with the natural history of progression based upon a model of macular progression. These results have implications for the clinical identification of macular progression, as well as for inclusion criteria for clinical trials seeking to preserve central macular function.
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	913494-3
ISSN	1536-481X ; 1057-0829
ISSN (online)	1536-481X
ISSN	1057-0829
DOI	10.1097/IJG.0000000000002399
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