Korean J Ophthalmol.  2019 Apr;33(2):103-112. 10.3341/kjo.2018.0060.

Clinical Efficacy of Custom-built Software for the Early Detection of Glaucoma: A Comparison of Axial-length and Major Retinal Artery Location Data

  • 1Department of Ophthalmology, Ajou University College of Medicine, Suwon, Korea.
  • 2Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. harryrho@gmail.com


To assess the clinical efficacy for early detection of glaucoma using custom-built image software visualizing translucent retinal nerve fiber layer thickness (RNFLT) that is graphed based on a normative database.
This prospective study was conducted using a normative database constructed with RNFLT data of 151 healthy Korean eyes. The reference lines of the mean, the lower 5%, and the lower 1% limit were visualized as a translucent RNFLT graph produced by our software after inputting each subject's major retinal artery position and overlaying the results onto the RNFLT measurements. Fifty-eight additional healthy control and 79 early-glaucoma eyes were collected for the validation group. If a subject's RNFLT graph was outside the reference line of the lower 1% limit, the graph was defined as abnormal. The lower 1% limit, which was generated by three criteria (criterion 1, built-in software; criterion 2, axial-length data; criterion 3, major retinal artery data), was used to address the difference of agreement with a standard answer.
For criteria 1, 2, and 3, the accuracy of our custom-built software was significantly higher than that of the manufacturer's database (kappa of 0.475 vs. 0.852 vs. 0.940; sensitivity of 62.0% vs. 91.1% vs. 97.5%, respectively) maintaining high specificity (87.9% vs. 94.8% vs. 96.6%, respectively).
The custom-built imaging software with the constructed RNFLT normative database showed high clinical efficiency for early detection of glaucoma with negligible user-related variability.


Axial length; Database; Glaucoma; Major retinal artery position; Optical coherence tomography

MeSH Terms

Nerve Fibers
Prospective Studies
Retinal Artery*
Sensitivity and Specificity
Tomography, Optical Coherence
Treatment Outcome*
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