Estimation of the Disc Damage Likelihood Scale in primary open-angle glaucoma: the Glaucoma Stereo Analysis Study

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Accurate assessment of optic nerve head (ONH) damage is crucial for glaucoma diagnosis and management.
• The Disc Damage Likelihood Scale (DDLS) is a grading system used to quantify glaucomatous ONH damage.

Purpose of the Study:

• To evaluate the association between the Disc Damage Likelihood Scale (DDLS) and various optic nerve head (ONH) morphological parameters.
• To assess the correlation of DDLS with clinical characteristics and visual field damage in glaucoma patients.
• To determine the utility of 3D ONH analysis in conjunction with DDLS for glaucoma assessment.

Main Methods:

• Cross-sectional multicenter study involving 187 eyes of 187 glaucoma patients.
• Stereo fundus photography and prototype analysis software used for ONH morphological parameter calculation.
• Spearman's rank correlation coefficient employed to analyze associations between DDLS, patient characteristics, and ONH parameters.

Main Results:

• DDLS showed positive correlations with intraocular pressure and visual field pattern standard deviation.
• DDLS demonstrated strong positive correlations with vertical and horizontal cup-to-disc ratios.
• A negative correlation was observed between DDLS and minimum rim-disc ratio, with higher DDLS in myopic glaucomatous discs.

Conclusions:

• The DDLS, when derived from 3D ONH analysis, correlates well with the severity of glaucomatous ONH damage.
• DDLS also shows a significant correlation with the extent of visual field damage.
• 3D ONH analysis combined with DDLS offers a robust method for assessing glaucoma progression.