Clinical Publications

TRITON

Early diagnosis of multiple sclerosis by OCT analysis using Cohen’s d method and a neural network as classifier

AUTHORS:

Garcia-Martin E, Ortiz M, Boquete L, Sánchez-Morla EM, Barea R, Cavaliere C, Vilades E, Orduna E, Rodrigo MJ.

PUBLICATION:

Computers in Biology and Medicine 129, 2021. PMID: 33302162 DOI: 10.1016/j.compbiomed.2020.104165

Study Purpose

To diagnose early-stage multiple sclerosis (MS) patients based on analysis of retinal layer thickness obtained by swept-source OCT (SS-OCT)

Overview

Study Design

Cross-sectional single center study

# of Eyes/
Patients

• Forty-eight eyes from 48 patients diagnosed with relapsing-remitting multiple sclerosis(RRMS). Forty-eight eyes from 48 healthy normal aged matched

Study Device

DRI Triton SS-OCT (Topcon, Tokyo, Japan)

Outcome Measures

• Determination of which zones in a 45×60 point grid differentiate the best between patient recordings and control subject recordings for the layers: RNFL, GCL+, GCL++, and full retina

Results

In all ocular layers analyzed, MS patients present lower thicknesses than controls.
The points selected in the GCL++ layer constitute 44.99% of the total macula, with points located in the area of the papillomacular bundle being the most numerous.
In the Retina, RNFL and GCL++ layers, an area with a higher density of discriminant points is detected in the inferonasal sector of the Macular area. (Figure)
Feed-forward network of 689 inputs showed the best results with a sensitivity = specificity = 0.98

IMOvifa reduced measurement time by

39%

Conclusions

The retinal layers evaluated in this study exhibited thinning, showing a horseshoe-like (or U zone) topographical distribution. • GCL++ turns out to be the most extensively affected layer with the highest number of discriminant points (44.99%). • The automatic segmentation of GCL++ from Triton would be the result of manual combination of RNFL and G CIPL from Spectralis. • The affectation of the ganglion cells is detected in the earlier stages of the disease and with shorter duration, absence of optic neuritis (ON) and lower expanded disability status scale (EDSS) values. • This study identifies the neuroretinal affectation of GCL++ as the first and more discriminant retinal layer in early-stage MS patients (disease duration < 9 months from initial symptoms)