Automated assessment of the optic nerve head on stereo disc photographs,” Invest

Purpose—To develop automated software for optic nerve head (ONH) quantitative assessment from stereoscopic disc photographs and to evaluate its performance in comparison with human expert assessment. Methods—A fully automated system, including three-dimensional ONH modeling, disc margin detection, cup margin detection, and calculation of stereometric ONH parameters, was developed and tested. One eye each from 54 subjects (23 healthy, 17 suspected glaucoma, and 14 glaucoma) was enrolled. The majority opinion of three experts defined disc and cup margins on the disc photographs was used for comparison. Seven ONH parameters, disc area, rim area, rim volume, cup area, cup volume, cup-to-disc (C/D) area ratio, and vertical C/D ratio, were computed based on both machine- and expert-defined margins and compared between the methods. Results—All automated ONH measurements showed good correlation with the expert defined margins (Pearson r = 0.90, disc area; 0.56, rim area; 0.78, rim volume; 0.88, cup area; 0.93, cup volume; 0.69, C/D area ratio; and 0.67, vertical C/D ratio; all P ≤ 0.0001). No statistically significant difference was found in the glaucoma-discriminating ability of all seven ON