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Updated: Jan 29, 2026

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Objective Macular Asymmetry Metrics for Glaucoma Detection Using a Temporal Raphe-Based OCT Linearization Algorithm.

Takuhei Shoji1,2, Miho Seo1, Hisashi Ibuki1,2

  • 1Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-Machi, Iruma 350-0495, Saitama, Japan.

Journal of Clinical Medicine
|January 28, 2026
PubMed
Summary
This summary is machine-generated.

A new program quantifies macular asymmetry in glaucoma using spectral-domain OCT scans. Vertical and Quadrantal Asymmetry Scores show high accuracy in detecting glaucoma, outperforming retinal thickness measurements.

Keywords:
diagnosisganglion cell complexglaucomamacular asymmetryoptical coherence tomographytemporal raphe

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Glaucoma Research

Background:

  • Glaucoma diagnosis often relies on subjective assessments of retinal nerve fiber layer thickness.
  • Objective quantification of macular asymmetry in glaucoma remains a challenge.
  • Spectral-domain optical coherence tomography (SD-OCT) provides high-resolution cross-sectional retinal images.

Purpose of the Study:

  • To develop and validate an image linearization process and software for quantifying macular asymmetries in glaucoma.
  • To assess the clinical applicability of these tools in distinguishing glaucomatous from healthy eyes.
  • To compare the diagnostic accuracy of asymmetry scores with mean inner retinal thickness.

Main Methods:

  • A single-center, cross-sectional study involving 37 patients with unilateral open-angle glaucoma and their fellow healthy eyes.
  • Custom software was used to linearize SD-OCT images, align key anatomical landmarks (disc-fovea axis, temporal raphe).
  • Evaluated parameters included mean inner retinal thickness difference, Vertical Asymmetry Score, and Quadrantal Asymmetry Score.

Main Results:

  • Significant differences in mean inner retinal thickness, Vertical Asymmetry Score, and Quadrantal Asymmetry Score were observed between glaucomatous and healthy eyes (p < 0.001).
  • The Vertical Asymmetry Score (AUC = 0.967) and Quadrantal Asymmetry Score (AUC = 0.946) demonstrated superior accuracy in glaucoma detection compared to mean inner retinal thickness (AUC = 0.743).
  • The developed program successfully quantified macular asymmetries, showing promise for objective glaucoma assessment.

Conclusions:

  • The developed image linearization program and asymmetry scores offer a promising method for objective macular asymmetry quantification in glaucoma using SD-OCT.
  • These asymmetry metrics show significant potential as sensitive biomarkers for glaucoma detection.
  • Further external validation in diverse patient cohorts, including those with bilateral glaucoma, is recommended.