Multimodal AI-based modeling of glaucoma progression: a 3PM-guided approach integrating structural, functional, and...

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Data Science

Background:

• Glaucoma is a leading cause of irreversible blindness globally.
• High inter-individual variability in glaucoma progression necessitates predictive, preventive, and personalized medicine (3PM) strategies.
• Effective patient stratification is crucial for protecting individuals from disease advancement.

Purpose of the Study:

• To develop and validate a personalized, multimodal predictive modeling framework for primary open-angle glaucoma (POAG).
• To integrate structural, functional, and vascular biomarkers for individualized risk stratification of POAG progression rates.
• To enhance patient management through precise prediction of disease trajectory.

Main Methods:

• Longitudinal monitoring (≥36 months) of POAG patients at various stages.
• Comprehensive multimodal data collection: optical coherence tomography (OCT), OCT angiography (OCT-A), automated perimetry, biomechanical assessments.
• Predictive modeling using Ranked Partial Least Squares Discriminant Analysis (Ranked PLS-DA) with Procrustes Cross-Validation.

Main Results:

• Developed models with up to 27 parameters for early and 20 for advanced POAG, achieving high prognostic accuracy (AUC up to 0.90).
• Identified key predictive biomarkers varying by disease stage: RNFL thickness, microvascular dropout, vascular density, and corneal hysteresis in early POAG; age, ganglion cell complex thickness, macular thickness, and perfusion parameters in advanced POAG.
• Demonstrated the framework's ability to classify slow, moderate, and rapid glaucoma progression rates.

Conclusions:

• The multimodal predictive modeling framework enables accurate risk stratification and personalized glaucoma management.
• Clinical application involves initial profiling, regular recalibration, and adaptive treatment strategies for improved visual outcomes.
• This 3PM approach optimizes resource utilization and enhances patient protection against disease progression.