Optimization Strategies for Bruch's Membrane Opening Minimum Rim Area Calculation: Sequential versus Simultaneous...

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Accurate measurement of the optic nerve head (ONH) is crucial for diagnosing glaucoma.
• Spectral domain optical coherence tomography (SD-OCT) is a key technology for ONH imaging.
• Standard methods for calculating the Bruch's membrane opening (BMO) minimum rim area (MRA) may not be fully optimized.

Purpose of the Study:

• To compare a novel, simultaneously optimized continuous minimum rim surface parameter with the standard sequential minimization method for BMO-MRA calculation using SD-OCT.
• To evaluate the diagnostic performance of these parameters in differentiating glaucoma patients.

Main Methods:

• A case-control, cross-sectional study involving 704 eyes from 445 participants.
• SD-OCT of the ONH, visual field testing, and clinical examination were performed.
• Both globally and sector-wise optimized BMO-based minimum rim area (BMO-gMRA and BMO-MRA) were calculated and compared.

Main Results:

• Both BMO-MRA and BMO-gMRA showed strong correlation (r=0.995) and minimal difference (0.04 mm²).
• The area under the curve (AUC) for differentiating glaucoma was 0.873 for BMO-MRA and 0.866 for BMO-gMRA (P=0.004).
• The temporal inferior ONH sector demonstrated the highest AUC for glaucoma differentiation.

Conclusions:

• Optimization strategies for BMO-MRA calculation yield significantly different results.
• An additional adjacency constraint does not improve the diagnostic power of BMO-MRA.
• Global and temporal inferior BMO-MRA are the most effective parameters for differentiating glaucoma.