New technique to visualize retinal axon fiber bundles for early diagnosis of optic neuropathy

A research team led by the Department of Ophthalmology, Li Ka-shing, The University of Hong Kong The Faculty of Medicine (HKUMed) School of Medicine, in collaboration with the Chinese University of Hong Kong School of Medicine (CU Medicine) and local and international partners, has developed a new technique, ROTA (Retinal Nerve Layer Optical Texture Analysis), to reveal the optical properties of retinal axonal fiber bundles Textures and tracks. ROTA outperformed current clinical standards with a 15.0% to 28.4% increase in sensitivity in detecting early optic nerve damage in glaucoma, the leading cause of irreversible blindness. The research has been published in

Nature Biomedical Engineering .

Glaucoma is the most common neurodegenerative disease. The clinical diagnosis of glaucoma is based on the measurement of retinal nerve fiber layer (RNFL) thickness, usually obtained with non-invasive digital imaging devices, but optical coherence tomography (OCT), false positives and false negatives are common, which allows clinical interpretation even for glaucoma For experts, the discovery of OCT is also difficult. This is supported by a meta-analysis that reported that at 90%–95% specificity, the optimal OCT parameters were only 65%–75% sensitive for detecting abnormal RNFL thickness.

ROTA is a patented algorithm that integrates RNFL thickness and RNFL reflectance measurements obtained from standard OCT scans values ​​to discern the optical texture and trajectory of axonal fiber bundles and reveal RNFL defects. ROTA can detect focal RNFL defects missed by standard clinical tests.

Compared with OCT, ROTA can improve the detection sensitivity of early optic nerve damage in glaucoma by 15-22% . At 95% specificity, the sensitivity of ROTA for early glaucoma detection was 97.3%-98.4%, which was 15.0%-28.4% higher than the current clinical standard. The HKU Faculty of Medicine is collaborating with the University of California, San Diego (UCSD) to apply ROTA to research and patient care, and patients can find ROTA applications at the HKU Eye Center and the Southern District Hong Kong Eye Survey.

In a diagnostic study of 177 healthy individuals and 363 glaucoma patients at CUHK Eye Center , ROTA obtained significantly higher sensitivity and specificity than conventional OCT RNFL thickness analysis for detecting glaucoma. In addition, ROTA is able to identify axonal fiber tract damage in optic neuritis, ischemic optic neuropathy, and compressive optic neuropathy.

“We are delighted to cooperate with Zhongda Pharma to develop ROTA, which due to its high sensitivity and specificity, is suitable for glaucoma Early detection and timely treatment of the disease have brought new hope,” said Professor Christopher Leung Ki-shun, Chair of the Center and Clinical Professor. Department of Ophthalmology, Faculty of Medicine, Faculty of Medicine, The University of Hong Kong. “Our next steps include enrolling patients from Queen Mary Hospital, Grantham Hospital and Hong Kong Eye Hospital for a longitudinal study to examine the effectiveness of ROTA in detecting glaucoma progression, as well as working with OCT industry partners for deployment in clinical care ROTA. In addition, the University of Hong Kong Eye Centre welcomes patients with a suspected glaucoma diagnosis to undergo ROTA evaluation.”

Prof. Tam Chi-yung Ho Sin-wah, Head of the Department of Ophthalmology and Visual Sciences and Professor of Ophthalmology and Visual Sciences, Faculty of Medicine, CUHK said, “If not diagnosed and treated early, glaucoma can lead to irreversible vision loss. In Hong Kong, about 25% of the Blindness is caused by glaucoma, and there are more than 100,000 glaucoma patients with different degrees of visual impairment. It is crucial to realize the progress of early diagnosis and detection of glaucoma through advanced imaging technology. I am glad that ROTA is a collaboration between CUHK Medicine and HKU Medicine developed and now ready for clinical use.”

ROTA supports a highly sensitive and specific technology, To advance the diagnosis of glaucoma and optic neuropathy. ROTA will be deployed on the Advanced Neural and Glaucoma Imaging Network (ANGI Network), a network of ophthalmologists, neuro-ophthalmologists and clinical researchers around the world.