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Multimodal Screening of Glaucoma Improves Sensitivity and Specificity

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Teleophthalmology in Preventive Medicine

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Abstract

Glaucoma is defined by morphologic changes in the optic nerve head and irreversible restriction of the visual field. Consequently, early glaucoma detection includes consideration of the morphology of the optic disc as well as measurements of the functional integrity of the visual system. Sensory tests with frequency doubling technology (FDT) perimetry and structural measurements with the Heidelberg Retina Tomograph (HRT) are able to deliver numerous parameters with diagnostic power for glaucoma detection. We aim to develop a diagnostic setup with classification rules for combined analysis of parameters from these techniques. For this task, “random forests” were learned on subjects of the Erlangen glaucoma registry with all information of the tests. With this automated classification method, we successfully combined the FDT and HRT parameters for glaucoma identification. The usage of separate training and test data from two independent study populations enables us to provide an adequately tested diagnostic tool for glaucoma detection in a heterogenous population. The feasibility of machine learning for medical diagnostic assistance could be demonstrated in an Internet-based application. The trained classifier can be used for telemedicine, diagnosis, and research via the World Wide Web.

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Acknowledgments

The authors thank Sylvia Rühl for skilful technical assistance; Professor G. Michelson, Professor A. Jünemann, Professor C. Mardin, and Dr. Lämmer for classification of the patients; Dipl. Ing. Dr. F. Lauterwald for implementation of the database; and Professor B. Lausen for help in statistical questions. The development of the “Erlangen Glaucoma Registry” was supported by DFG grant SFB 539. The authors have no commercial interest in the equipment used in this work.

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Authors and Affiliations

  1. Department of Ophthalmology, University Eye Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

    Folkert K. Horn PhD

  2. Universitäts-Augenklinik, Schwabachanlage 6, D-91054, Erlangen, Germany

    Folkert K. Horn PhD

  3. Department of Ophthalmology, University Medical Center Erlangen, Erlangen, Germany

    Folkert K. Horn PhD

  4. Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, D-91054, Germany

    Werner Adler PhD

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  1. Folkert K. Horn PhD
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Correspondence to Folkert K. Horn PhD .

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  1. Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany

    Georg Michelson

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Horn, F.K., Adler, W. (2015). Multimodal Screening of Glaucoma Improves Sensitivity and Specificity. In: Michelson, G. (eds) Teleophthalmology in Preventive Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44975-2_3

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  • DOI: https://doi.org/10.1007/978-3-662-44975-2_3

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