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Novel Automated Approach to Predict the Outcome of Laser Peripheral Iridotomy for Primary Angle Closure Suspect Eyes Using Anterior Segment Optical Coherence Tomography

  • Patient Facing Systems
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Abstract

Develop an algorithm to predict the success of laser peripheral iridotomy (LPI) in primary angle closure suspect (PACS), using pre-treatment anterior segment optical coherence tomography (ASOCT) scans. A total of 116 eyes with PACS underwent LPI and time-domain ASOCT scans (temporal and nasal cuts) were performed before and 1 month after LPI. All the post-treatment scans were classified to one of the following categories: (a) both angles open, (b) one of two angles open and (c) both angles closed. After LPI, success is defined as one or more angles changed from close to open. In this proposed method, the pre and post-LPI ASOCT scans were registered at the corresponding angles based on similarities between the respective local descriptor features and random sample consensus technique was used to identify the largest consensus set of correspondences between the pre and post-LPI ASOCT scans. Subsequently, features such as correlation co-efficient (CC) and structural similarity index (SSIM) were extracted and correlated with the success of LPI. We included 116 eyes and 91 (78.44%) eyes fulfilled the criteria for success after LPI. Using the CC and SSIM index scores from this training set of ASOCT images, our algorithm showed that the success of LPI in eyes with narrow angles can be predicted with 89.7% accuracy, specificity of 95.2% and sensitivity of 36.4% based on pre-LPI ASOCT scans only. Using pre-LPI ASOCT scans, our proposed algorithm showed good accuracy in predicting the success of LPI for PACS eyes. This fully-automated algorithm could aid decision making in offering LPI as a prophylactic treatment for PACS.

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References

  1. Congdon, N., Wang, F., and Tielsch, J., Issues in the epidemiology and population-based screening of primary angle-closure glaucoma. Surv. Ophthalmol. 36:411–423, 1992.

    Article  PubMed  CAS  Google Scholar 

  2. Foster, P., Baasanhu, J., Alsbirk, P. H., Munkhbayar, D., Uranchimeg, D., and Johnson, G. J., Glaucoma in Mongolia: A population-based survey in Hovsgol province, northern Mongolia. Arch. Ophthalmol. 114:1235–1241, 1996.

    Article  PubMed  CAS  Google Scholar 

  3. Hu, Z., Zhao, J., and Dong, F., An epidemiological investigation of glaucoma in Beijing and Shun-Yi country. Chin J Ophthalmol 25:115–118, 1989.

    CAS  Google Scholar 

  4. Foster, P., and GJ, J., Glaucoma in China: How big is the problem? Br. J. Ophthalmol. 85:1277–1282, 2001.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Hu, Z., Zhao, J., and Dong, F., An epidemiological study of glaucoma in Shunyi County, Beijing [in Chinese]. Zhonghua Yan Ke Za Zhi 25:115–118, 1989.

    PubMed  CAS  Google Scholar 

  6. Casson, R., Newland, H. S., Muecke, J., McGovern, S., Abraham, L., Shein, W. K., Selva, D., and Aung, T., Prevalence of glaucoma in rural Myanmar: The Meiktila eye study. Br. J. Ophthalmol. 91:710–714, 2007.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Khor, C. C., Do, T., Jia, H., Nakano, M., George, R., Abu-Amero, K., Duvesh, R., Chen, L. J., Li, Z., Nongpiur, M. E., Perera, S. A., Qiao, C., Wong, H. T., Sakai, H., Barbosa de Melo, M., Lee, M. C., Chan, A. S., Azhany, Y., Dao, T. L. H., Ikeda, Y., Perez-Grossmann, R. A., Zarnowski, T., Day, A. C., Jonas, J. B., Tam, P. O. S., Tran, T. A., Ayub, H., Akhtar, F., Micheal, S., Chew, P. T. K., Aljasim, L. A., Dada, T., Luu, T. T., Awadalla, M. S., Kitnarong, N., Wanichwecharungruang, B., Aung, Y. Y., Mohamed-Noor, J., Vijayan, S., Sarangapani, S., Husain, R., Jap, A., Baskaran, M., Goh, D., Su, D. H., Wang, H., Yong, V. K., Yip, L. W., Trinh, T. B., Makornwattana, M., Nguyen, T. T., Leuenberger, E. U., Park, K. H., Wiyogo, W. A., Kumar, R. S., Tello, C., Kurimoto, Y., Thapa, S. S., Pathanapitoon, K., Salmon, J. F., Sohn, Y. H., Fea, A., Ozaki, M., Lai, J. S. M., Tantisevi, V., Khaing, C. C., Mizoguchi, T., Nakano, S., Kim, C. Y., Tang, G., Fan, S., Wu, R., Meng, H., Nguyen, T. T. G., Tran, T. D., Ueno, M., Martinez, J. M., Ramli, N., Aung, Y. M., Reyes, R. D., Vernon, S. A., Fang, S. K., Xie, Z., Chen, X. Y., Foo, J. N., Sim, K. S., Wong, T. T., Quek, D. T., Venkatesh, R., Kavitha, S., Krishnadas, S. R., Soumittra, N., Shantha, B., Lim, B. A., Ogle, J., de Vasconcellos, J. P. C., Costa, V. P., Abe, R. Y., de Souza, B. B., Sng, C. C., Aquino, M. C., Kosior-Jarecka, E., Fong, G. B., Tamanaja, V. C., Fujita, R., Jiang, Y., Waseem, N., Low, S., Pham, H. N., al-Shahwan, S., Craven, E. R., Khan, M. I., Dada, R., Mohanty, K., Faiq, M. A., Hewitt, A. W., Burdon, K. P., Gan, E. H., Prutthipongsit, A., Patthanathamrongkasem, T., Catacutan, M. A. T., Felarca, I. R., Liao, C. S., Rusmayani, E., Istiantoro, V. W., Consolandi, G., Pignata, G., Lavia, C., Rojanapongpun, P., Mangkornkanokpong, L., Chansangpetch, S., Chan, J. C. H., Choy, B. N. K., Shum, J. W. H., Than, H. M., Oo, K. T., Han, A. T., Yong, V. H., Ng, X. Y., Goh, S. R., Chong, Y. F., Hibberd, M. L., Seielstad, M., Png, E., Dunstan, S. J., Chau, N. V. V., Bei, J., Zeng, Y. X., Karkey, A., Basnyat, B., Pasutto, F., Paoli, D., Frezzotti, P., Wang, J. J., Mitchell, P., Fingert, J. H., Allingham, R. R., Hauser, M. A., Lim, S. T., Chew, S. H., Ebstein, R. P., Sakuntabhai, A., Park, K. H., Ahn, J., Boland, G., Snippe, H., Stead, R., Quino, R., Zaw, S. N., Lukasik, U., Shetty, R., Zahari, M., Bae, H. W., Oo, N. L., Kubota, T., Manassakorn, A., Ho, W. L., Dallorto, L., Hwang, Y. H., Kiire, C. A., Kuroda, M., Djamal, Z. E., Peregrino, J. I. M., Ghosh, A., Jeoung, J. W., Hoan, T. S., Srisamran, N., Sandragasu, T., Set, S. H., Doan, V. H., Bhattacharya, S. S., Ho, C. L., Tan, D. T., Sihota, R., Loon, S. C., Mori, K., Kinoshita, S., Hollander, A. I. ., Qamar, R., Wang, Y. X., Teo, Y. Y., Tai, E. S., Hartleben-Matkin, C., Lozano-Giral, D., Saw, S. M., Cheng, C. Y., Zenteno, J. C., Pang, C. P., Bui, H. T. T., Hee, O., Craig, J. E., Edward, D. P., Yonahara, M., Neto, J. M., Guevara-Fujita, M. L., Xu, L., Ritch, R., Liza-Sharmini, A. T., Wong, T. Y., al-Obeidan, S., Do, N. H., Sundaresan, P., Tham, C. C., Foster, P. J., Vijaya, L., Tashiro, K., Vithana, E. N., Wang, N., and Aung, T., Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma. Nat. Genet. 48(5):556–562, 2016.

    Article  PubMed  CAS  Google Scholar 

  8. Yip, J., and Foster, P., Ethnic differences in primary angle-closure glaucoma. Curr. Opin. Ophthalmol. 17:175–180, 2006.

    Article  PubMed  Google Scholar 

  9. Congdon, N., Quigley, H. A., Hung, P. T., Wang, T. H., and Ho, T. C., Screening techniques for angle-closure glaucoma in rural Taiwan. Acta Ophthalmol. Scand. 74:113–119, 1996.

    Article  PubMed  CAS  Google Scholar 

  10. Wang, J., and PT, C., What is the direct cost of treatment of acute primary angle closure glaucoma? The Singapore model. Clin. Exp. Ophthalmol. 32:578–583, 2004.

    Article  PubMed  Google Scholar 

  11. Sng, C. C., Aquino, M. C., Liao, J., Ang, M., Zheng, C., Loon, S. C., and Chew, P. T., Pretreatment anterior segment imaging during acute primary angle closure: Insights into angle closure mechanisms in the acute phase. Ophthalmology 121(1):119–125, 2014.

    Article  PubMed  Google Scholar 

  12. Sng, C. C., Singh, M., Chew, P. T., Ngo, C. S., Zheng, C., Tun, T. A., See, J. L., Ang, M., Loon, S. C., and Aung, T., Quantitative assessment of changes in trabeculectomy blebs after laser suture lysis using anterior segment coherence tomography. J. Glaucoma 21(5):313–317, 2012.

    Article  PubMed  Google Scholar 

  13. Sng, C. C., Allen, J. C., Nongpiur, M. E., Foo, L.-L., Zheng, Y., Cheung, C. Y., He, M., Friedman, D. S., Wong, T. Y., and And Aung, T., Associations of iris structural measurements in a Chinese population: The Singapore Chinese eye study. Invest. Ophthalmol. Vis. Sci. 54(4):2829–2835, 2013.

    Article  PubMed  Google Scholar 

  14. Sng, C. C., and Barton, K., Mechanism and management of angle closure in uveitis. Curr. Opin. Ophthalmol. 26(2):121–127, 2015.

    Article  PubMed  Google Scholar 

  15. Liu, L., Deconstructing the mechanisms of angle closure with anterior segment optical coherence tomography. Clin. Exp. Ophthalmol. 39(7):614–622, 2011.

    Article  PubMed  Google Scholar 

  16. Shabana, N., Aquino, M. C., See, J., Ce, Z., Tan, A. M., Nolan, W. P., Hitchings, R., Young, S. M., Loon, S. C., Sng, C. C., Wong, W., and Chew, P. T., Quantitative evaluation of anterior chamber parameters using anterior segment optical coherence tomography in primary angle closure mechanisms. Clin. Exp. Ophthalmol. 40(8):792–801, 2012.

    Article  PubMed  Google Scholar 

  17. Nongpiur, M. E., Ku, J. Y., and Aung, T., Angle closure glaucoma: A mechanistic review. Curr. Opin. Ophthalmol. 22(2):96–101, 2011.

    Article  PubMed  Google Scholar 

  18. Kwon, J., Sung, K. R., Han, S., Moon, Y. J., and Shin, J. W., Sub-classification of primary angle closure using anterior segment optical coherence tomography and ultrasound bio-microscopic parameters. Ophthalmology 124(7):1039–1047, 2017.

    Article  PubMed  Google Scholar 

  19. Bai, X., Issac Niwas, S., Lin, W., Ju, B.-F., Kwoh, C. K., Wang, L., Sng, C. C., Aquino, M. C., and Chew, P. T. K., Learning ECOC code matrix for multiclass classification with application to Glaucoma diagnosis. J. Med. Syst. 40(4):1–10, 2016.

    Article  Google Scholar 

  20. Issac Niwas, S., Lin, W., Bai, X., Kwoh, C. K., Sng, C. C., Aquino, M. C., and Chew, P. T. K., Reliable feature selection for automated angle closure mechanism detection. J. Med. Syst. 39(3):1–10, 2015.

    Google Scholar 

  21. Issac Niwas, S., Lin, W., Kwoh, C. K., Jay Kuo, C. C., Sng, C. C., Aquino, M. C., and Chew, P. T. K., Cross-examination for angle-closure Glaucoma feature detection. IEEE J. Biomed. Health Inform. 20(1):343–354, 2016.

    Article  Google Scholar 

  22. Issac Niwas, S., Lin, W., Bai, X., Kwoh, C. K., Jay Kuo, C. C., Sng, C. C., Aquino, M. C., and Chew, P. T. K., Automated anterior segment OCT image analysis for angle closure Glaucoma mechanisms classification. Comput. Methods Prog. Biomed. 130:65–75, 2016.

    Article  Google Scholar 

  23. Niwas, S. I., Jakhetiya, V., Lin, W., Kwoh, C. K., Sng, C. C., Aquino, M. C., Victor, K., and Chew, P. T. K., Complex wavelet based quality assessment for AS-OCT images with application to angle closure Glaucoma diagnosis. Comput. Methods Prog. Biomed. 130:13–21, 2016.

    Article  Google Scholar 

  24. Wang, N., Ouyang, J., Zhou, W. et al., Multiple patterns of angle closure mechanisms in primary angle closure glaucoma in Chinese. Zhonghua Yan Ke Za Zhi 36(1):46–51, 45, 46, 2000.

    PubMed  Google Scholar 

  25. Lee, R. Y., Kasuga, T., Cui, Q. N., Porco, T. C., Huang, G., He, M., and Lin, S. C., Association between baseline iris thickness and prophylactic laser peripheral iridotomy outcomes in primary angle-closure suspects. Ophthalmology 121(6):1194–1202, 2014.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Huang, G., Gonzalez, E., Lee, R., Osmonavic, S., Leeungurasatien, T., He, M., and Lin, S. C., Anatomic predictors for anterior chamber angle opening after laser peripheral iridotomy in narrow angle eyes. Curr. Eye Res. 37(7):575–582, 2012.

    Article  PubMed  Google Scholar 

  27. Zebardast, N., Kavitha, S., Krishnamurthy, P., Friedman, D. S., Nongpiur, M. E., Aung, T., Quigley, H. A., Ramulu, P. Y., and Venkatesh, R., Changes in anterior segment morphology and predictors of angle widening after laser Iridotomy in south Indian eyes. Ophthalmology 123(12):2519–2526, 2016.

    Article  PubMed  Google Scholar 

  28. Lee, K. S., Sung, K. R., Kang, S. Y., Cho, J. W., Kim, D. Y., and Kook, M. S., Residual anterior chamber angle closure in narrow-angle eyes following laser peripheral iridotomy: Anterior segment optical coherence tomography quantitative study. Jpn. J. Ophthalmol. 55(3):213–219, 2011.

    Article  PubMed  Google Scholar 

  29. He, M., Friedman, D. S., Ge, J., Huang, W., Jin, C., Lee, P. S., Khaw, P. T., and Foster, P. J., Laser peripheral iridotomy in primary angle-closure suspects: Biometric and gonioscopic outcomes: The Liwan eye study. Ophthalmology 114(3):494–500, 2007.

    Article  PubMed  Google Scholar 

  30. Foster, P. J., Buhrmann, R., Quigley, H. A., and Johnson, G. J., The definition and classification of glaucoma in prevalence surveys. Br. J. Ophthalmol. 86(2):238–242, 2002.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Scheie, H., Width and pigmentation of the angle of the anterior chamber; a system of grading by gonioscopy. AMA Arch Ophthalmol 58:510–512, 1957.

    Article  PubMed  CAS  Google Scholar 

  32. Spaeth, G., The normal development of the human anterior chamber angle: A new system of descriptive grading. Trans Ophthalmol Soc UK 91:709–739, 1971.

    PubMed  CAS  Google Scholar 

  33. Hajnal, J., Hill, D., Neuman, M., Oatridge, A., Clarkson, M., Bell, D., Collins, L., Hawkes, D., Rueckert, D., Paulsen, K., Miga, M., Zijdenos, A., Paus, T., Fitzpatrick, J., Pietrzyk, U., Hill, D., Bydder, G., Jarosz, J., Lemieux, L., Jenkinson, M., Smith, S., Bailey, a., Edwards, P., Penney, G., and Evans, A. (Eds). Medical image registration. Boca Raton: CRC Press, 2001.

  34. Szeliski, R., Image alignment and stitching: a tutorial, foundations and trends. R. O in Computer Graphics and Vision 2(1):1–104, 2006.

  35. Lu, Y., Gao, K., Zhang, T., and Xu, T., A novel image registration approach via combining local features and geometric invariants. PLoS ONE 13(1):e0190383, 2018. https://doi.org/10.1371/journal.pone.0190383.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Guryanov, F., and Krylov, A., Fast medical image registration using bidirectional empirical mode decomposition. Signal Process. Image Commun. 59:12–17, 2017. https://doi.org/10.1016/j.image.2017.04.003.

  37. Le Folgoc, L., Delingette, H., Criminisi, A., and Ayache, N., Sparse Bayesian registration of medical images for self-tuning of parameters and spatially adaptive Parametrization of displacements. Med. Image Anal. 36:79–97, 2017.

    Article  PubMed  Google Scholar 

  38. Ferrante, E., and Paragios, N., Slice-to-volume medical image registration: a survey. Med. Image Anal. 9:101–123, 2017.

    Article  Google Scholar 

  39. McLaughlin, R., Hipwell, J., Hawkes, D., Noble, A., Byrne, J. and Cox, T., A comparison of intensity-based registration and feature-based registration for neuro-interventions, Proc. MICCAI, LNCS, Springer-Verlag, 2002; 2489, p. 517–524

  40. Alvén, J., Norlén, A., Enqvist, O., and Kahl, F., Überatlas: robust speed-up of feature-based registration and multi-atlas segmentation. In: Paulsen, R., and Pedersen, K. (Eds.), Image analysis. SCIA 2015. Lecture Notes in Computer Science. Vol. 9127. Cham: Springer, 2015.

  41. Bay, H., Ess, A., Tuytelaars, T., and Gool, L. V., SURF: Speeded up robust features. Comput. Vis. Image Underst. 110:346–359, 2008.

    Article  Google Scholar 

  42. Fischler, M. A., and Robert, C. B., Random sample consensus: A paradigm for model fitting with applications to image analysis and automated cartography. Commun. ACM 24:381–395, 1981.

    Article  Google Scholar 

  43. Hall, M., Correlation-based feature selection for machine learning, PhD Thesis, Department of Computer Science, Waikato University, New Zealand, 1999.

  44. Thomas, R., Parikh, R., Muliyil, J., and Kumar, R. S., Five-year risk of progression of primary angle closure to primary angle closure glaucoma: A population-based study. Acta Ophthalmol. Scand. 81(5):480–485, 2003.

    Article  PubMed  Google Scholar 

  45. Ang, L. P., Aung, T., and Chew, P. T., Acute primary angle closure in an Asian population: Long-term outcome of the fellow eye after prophylactic laser peripheral iridotomy. Ophthalmology 107(11):2092–2096, 2000.

    Article  PubMed  CAS  Google Scholar 

  46. Sun, X., Dai Y, Chen Y, Yu, D. Y., Cringle, S. J., Chen, J., Kong, X., Wang, X., and Jiang, C., Primary angle closure glaucoma: What we know and what we don’t know. Prog. Retin. Eye Res. 57:26–45, 2017.

  47. Vijaya, L., Asokan, R., Panday, M., and George, R., Is prophylactic laser peripheral iridotomy for primary angle closure suspects a risk factor for cataract progression? The Chennai eye disease incidence study. Br. J. Ophthalmol. 101(5):665–670, 2017.

    Article  PubMed  Google Scholar 

  48. Wang, P. X., Koh, V. T., and Loon, S. C., Laser iridotomy and the corneal endothelium: A systemic review. Acta Ophthalmol. 92(7):604–616, 2014.

    Article  PubMed  Google Scholar 

  49. Foo, L. L., Nongpiur, M. E., Allen, J. C., Perera, S. A., Friedman, D. S., He, M., Cheng, C. Y., Wong, T. Y., and Aung, T., Determinants of angle width in Chinese Singaporeans. Ophthalmology 119(2):278–282, 2012.

    Article  PubMed  Google Scholar 

  50. Ang, B. C., Nongpiur, M. E., Aung, T., Mizoguchi, T., and Ozaki, M., Changes in Japanese eyes after laser peripheral iridotomy: An anterior segment optical coherence tomography study. Clin. Exp. Ophthalmol. 44(3):159–165, 2016.

    Article  PubMed  Google Scholar 

  51. Sung, K. R., Lee, K. S., and Hong, J. W., Baseline anterior segment parameters associated with the long-term outcome of laser peripheral Iridotomy. Curr. Eye Res. 40(11):1128–1133, 2015.

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by (1) National Medical Research Council New Investigator Grant No: NIG10Nov019 and (2) National Medical Research Council Clinician-Scientist Individual Research Grant New Investigator Grant No: CNIG14Nov017.

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Authors and Affiliations

  1. Department of Ophthalmology, National University Hospital, Singapore, 119074, Singapore

    Victor Koh, Maria Cecilia D. Aquino, Paul T. Chew & Chelvin Sng

  2. School of Computer Science and Engineering, Nanyang Technological University (NTU), Singapore, 639798, Singapore

    Issac Niwas Swamidoss

  3. Singapore Eye Research Institute, Singapore, 168751, Singapore

    Chelvin Sng

  4. Department of Glaucoma, Moorfields Eye Hospital, London, UK

    Chelvin Sng

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  1. Victor Koh
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Correspondence to Chelvin Sng.

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Koh, Victor: The author declare that he has no conflict of interest. Issac Niwas Swamidoss: The author declare that he has no conflict of interest. Aquino, Maria Cecilia D: The author declare that she has no conflict of interest. Chew, Paul T: The author declare that he has no conflict of interest. Sng, Chelvin: The author has conflict of interest since she has received the consultant fees and research funding from Glaukos and consultant fees from Allergan.

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Koh, V., Swamidoss, I., Aquino, M.C.D. et al. Novel Automated Approach to Predict the Outcome of Laser Peripheral Iridotomy for Primary Angle Closure Suspect Eyes Using Anterior Segment Optical Coherence Tomography. J Med Syst 42, 107 (2018). https://doi.org/10.1007/s10916-018-0960-3

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