PallorMetrics: Software for Automatically Quantifying Optic Disc Pallor in Fundus Photographs, and Associations With Peripapillary RNFL Thickness

Samuel Gibbon (Lead / Corresponding author), Graciela Muniz-Terrera, Fabian S. L. Yii, Charlene Hamid, Simon Cox, Ian J. C. Maccormick, Andrew J. Tatham, Craig Ritchie, Emanuele Trucco, Baljean Dhillon, Thomas J. MacGillivray

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Abstract

Purpose: We sough to develop an automatic method of quantifying optic disc pallor in fundus photographs and determine associations with peripapillary retinal nerve fiber layer (pRNFL) thickness.

Methods: We used deep learning to segment the optic disc, fovea, and vessels in fundus photographs, and measured pallor. We assessed the relationship between pallor and pRNFL thickness derived from optical coherence tomography scans in 118 participants. Separately, we used images diagnosed by clinical inspection as pale (n = 45) and assessed how measurements compared with healthy controls (n = 46). We also developed automatic rejection thresholds and tested the software for robustness to camera type, image format, and resolution.

Results: We developed software that automatically quantified disc pallor across several zones in fundus photographs. Pallor was associated with pRNFL thickness globally (β = -9.81; standard error [SE] = 3.16; P < 0.05), in the temporal inferior zone (β = -29.78; SE = 8.32; P < 0.01), with the nasal/temporal ratio (β = 0.88; SE = 0.34; P < 0.05), and in the whole disc (β = -8.22; SE = 2.92; P < 0.05). Furthermore, pallor was significantly higher in the patient group. Last, we demonstrate the analysis to be robust to camera type, image format, and resolution.

Conclusions: We developed software that automatically locates and quantifies disc pallor in fundus photographs and found associations between pallor measurements and pRNFL thickness.

Translational Relevance: We think our method will be useful for the identification, monitoring, and progression of diseases characterized by disc pallor and optic atrophy, including glaucoma, compression, and potentially in neurodegenerative disorders.

Original languageEnglish
Article number20
Number of pages25
JournalTranslational Vision Science and Technology
Volume13
Issue number5
Early online date23 May 2024
DOIs
Publication statusPublished - May 2024

Keywords

  • Humans
  • Optic Disk/diagnostic imaging
  • Tomography, Optical Coherence/methods
  • Software
  • Male
  • Female
  • Middle Aged
  • Deep Learning
  • Nerve Fibers/pathology
  • Photography/methods
  • Adult
  • Retinal Ganglion Cells/pathology
  • Aged
  • Optic Nerve Diseases/diagnostic imaging
  • Fundus Oculi

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