Novel Optical Coherence Tomography Method Detects Glaucoma in Eyes With High Axial Myopia

Retinal scan testing for glaucoma
Retinal scan testing for glaucoma. 3D scan of the retina of an eye in a patient being tested for glaucoma. The retina is the light-sensitive layer at the back of the eye responsible for vision. Glaucoma is a build-up of pressure inside the eye causing blurring and blindness. The technique used to scan the retina here is optical coherence tomography (OCT) using a confocal scanning laser ophthalmoscope (SLO) device. These results are from a machine from the Optovue company. For the machine in use, see images C028/1546 and C028/1547.
This novel technique requires the segmentation of only 1 retinal layer in order to detect glaucoma.

A novel, en-face optical coherence tomography (OCT) method known as SALSA-Texture can discriminate between highly myopic glaucomatous and healthy eyes, according to research published in the American Journal of Ophthalmology. The method requires segmentation of only 1 retinal layer in order to detect glaucoma.  

Researchers compared cross-sectional data from 92 eyes with primary open-angle glaucoma (POAG) and 41 healthy eyes with axial high myopia. They found that the best parameter-adjusted areas under the receiver operating characteristics (AUROCs) for differentiating between glaucomatous and healthy high myopic eyes were the following: 0.92 for texture en-face images (95% CI, 0.86-0.91), 0.88 for macular retinal nerve fiber layer (RNFL) thickness (95% CI, 0.86-0.91), 0.87 for macular ganglion cell-inner plexiform layer (GCIPL) thickness (95% CI, 0.83-0.89), and 0.87 for ganglion cell complex (GCC) thickness (95% CI, 0.84-0.89). In highly myopic eyes (axial length ≥ 27 mm), they found that the best AUROC was 0.92 for texture en-face images compared with 0.86 for macular GCIPL, 0.86 for GCC, and 0.84 for RNFL thickness (P ≤.02 for all).

“The texture-based en-face image analysis described herein shows improved discrimination between glaucoma and healthy axial highly myopic eyes,” according to the researchers. “While further investigation is needed, the current methodology shows promise for improving the detection of glaucoma in eyes with high myopia where traditional retinal layer segmentation becomes more challenging.”

Study limitations include a small sample size and age differences between experimental arms.


Bowd C, Belghith A, Rezapour J, et al. Diagnostic accuracy of macular thickness map and texture en-face images for detecting glaucoma in eyes with axial high myopia. Am J Ophthalmol. Published online May 2, 2022. doi:10.1016/j.ajo.2022.04.019