Analysis of GDx-VCC polarimetry data by Wavelet-Fourier analysis across glaucoma stages

The purpose of this study was to apply shape-based analysis techniques of retinal nerve fiber layer (RNFL) thickness to GDx-VCC (variable corneal and lens compensator; Laser Diagnostic Technologies, Inc., San Diego, CA) polarimetry data and to evaluate the techniques' ability to detect glaucoma in its earliest stages. Wavelet-based (wavelet-Fourier analysis [WFA]), Fourier-based (fast Fourier analysis [FFA]), and several previous variations of shape-based analysis were considered, as well as the standard metric nerve fiber indicator (NFI), and all were compared as a function of disease stage.

GDx-VCC scans of one eye of each of 67 patients with glaucoma and each of 67 healthy age-matched subjects provided RNFL thickness estimates at a fixed distance from the optic disc. Severity of disease was graded according to the Glaucoma Staging System and also by mean deviation (MD) from standard automated perimetry. WFA, FFA, and NFI procedures were performed including the following variations: use of signed or unsigned phase, inclusion of interocular or intraocular asymmetry of analysis parameters, and combination of features by principle components analysis or Wilks lambda. Independent samples (k-fold variation) were used for training and testing. Sensitivity, specificity, and receiver operating characteristic (ROC) area were obtained.

Classification performance of WFA (ROC = 0.978) was significantly better than FFA (ROC = 0.938) and NFI (ROC = 0.900). This difference was largest for the earliest stages of glaucoma. Shape-based analysis methods performed better than NFI overall. Adding between-eye asymmetry measures helped FFA but not WFA.

Shape-based analysis, and WFA in particular, makes an important improvement in detecting earliest glaucoma with polarimetry.