Development of a nomogram using fundus photography to predict glaucoma progression in patients showing disc...

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Disc hemorrhage is a known risk factor for glaucoma progression.
• Accurate prediction of glaucoma progression is crucial for timely intervention.

Purpose of the Study:

• To develop and validate a nomogram for predicting glaucoma progression using fundus photography in patients with disc hemorrhage.
• To identify key prognostic factors associated with glaucoma progression in this patient cohort.

Main Methods:

• Retrospective review of medical records of open-angle glaucoma patients with disc hemorrhage (January 2010 - March 2018).
• Analysis of fundus photography to assess disc hemorrhage characteristics: proximal location, morphology, relationship to retinal nerve fiber layer defects, and angular extent.
• Multiple logistic regression analysis to identify prognostic factors and construct a predictive nomogram.

Main Results:

• Patients with glaucoma progression (n=52) showed significantly higher numbers of disc hemorrhage at the border of retinal nerve fiber layer defects and peripapillary disc hemorrhage compared to non-progressors (n=38).
• The developed nomogram, incorporating angular extent, location relative to retinal nerve fiber layer defects, and proximal location of disc hemorrhage, achieved an area under the receiver operating characteristic curve of 0.847.
• Key predictors identified included disc hemorrhage at the border of retinal nerve fiber layer defects (P=0.001) and peripapillary disc hemorrhage (P=0.008).

Conclusions:

• A nomogram utilizing fundus photography findings in patients with disc hemorrhage is a novel and accurate screening tool for predicting glaucoma progression.
• This nomogram can assist clinicians in making informed treatment decisions for glaucoma management.