# Personalizing Glaucoma Diagnosis by Disease Specific Patterns and Individual Eye Anatomy

> **NIH NIH R01** · SCHEPENS EYE RESEARCH INSTITUTE · 2021 · $448,282

## Abstract

Project Summary/Abstract
Glaucoma is a disease of the optic nerve which is accompanied by visual ﬁeld (VF) loss. While accurate VF loss
diagnosis and the detection of its progression over time is of high relevance to clinical practitioners as it indicates
the initiation of or change in ocular therapy, there is no consensus on objective measures for this purpose, and
VF measurements are known to be often unreliable. The main objective of this project is to develop clinically
applicable measures to improve the diagnosis of glaucomatous VF loss and of its progression by two approaches:
First, the identiﬁcation of representative loss patterns and their progression, achieved by large-scale, customized
bioinformatical procedures applied to data from glaucoma patients from nine clinical centers and second, the
inclusion of eye and patient speciﬁc personalized parameters. In total, 480,486 VFs, are available for this project.
One major aim is to develop novel diagnostic indices based on computationally identiﬁed evolution patterns of
VF loss, particularly (1) an index that denotes the probability of glaucomatous vision loss and (2) an index that
assigns probabilities to a VF that follow-up measurements will be in a certain defect class. The indices will
be statistically evaluated on separate VF samples and compared to existing approaches. Routinely available
patient speciﬁc parameters which are candidates to impact glaucomatous vision loss are patient ethnicity, type of
glaucoma, spherical equivalent (SE) of refractive error and the location of the blind spot relative to ﬁxation. The
effect of these parameters on the vision loss patterns will be systematically studied. The impact of their inclusion
in the novel diagnostic indices and their potential improvement on glaucoma diagnosis will be quantiﬁed on a
separate data set. A further aim is the calculation of a spatial map speciﬁc to a measured VF that represents the
preferred VF locations of future defects as well as their reliability as an aid to event-based progression diagnosis.
A second major objective is the investigation of the relationship of VF loss and individual parameters related
to retinal structure, based on retinal nerve ﬁber layer thickness (RNFLT) measurements around the optic disc.
The inter-relationship of representative patterns of RNFLT and its decrease over time with trajectories of major
retinal arteries, SE, and blind spot location is systematically studied, and the impact on patterns of VF loss
is quantitatively analyzed with the goal to improve the interpretation of existing VF loss and to predict future
glaucomatous vision loss. Main contributions of the project with relevance to clinical practice are publicly available
open-source software implementations of new diagnostic indices and maps, enhanced by individual functional
and structural parameters, and a detailed and personalized model for the relationship between retinal structure
and glaucomatous vision loss.

## Key facts

- **NIH application ID:** 10245094
- **Project number:** 5R01EY030575-03
- **Recipient organization:** SCHEPENS EYE RESEARCH INSTITUTE
- **Principal Investigator:** Tobias Elze
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $448,282
- **Award type:** 5
- **Project period:** 2019-09-30 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10245094

## Citation

> US National Institutes of Health, RePORTER application 10245094, Personalizing Glaucoma Diagnosis by Disease Specific Patterns and Individual Eye Anatomy (5R01EY030575-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10245094. Licensed CC0.

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