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Only three healthy persons were excluded based on optic disc criteria (one with optic disc drusen, one with an optic disc hemorrhage and and one with a peripapillary membrane).
Patients were referred based on optic disc damage: focal or diffuse neuroretinal rim thinning, localised notching or nerve fibre layer defects.
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For example, [ 32, 69] detect glaucoma based on optic cup and disc segmentation, a small error in disc localization may propagate downstream and finally yield an error in detection.
Glaucoma was based on optic nerve damage attributed to glaucoma.
Our aim was to determine whether glaucoma subspecialists and neuro-ophthalmologists can distinguish these diagnoses on optic disc assessment alone.
The early efforts in retinal image analysis were focused on optic disc localization.
Three participants had one optic disc with disc drusen.
Neuroretinal rim assessment based on the clinical optic disc margin (DM) lacks a sound anatomic basis for 2 reasons: (1) The DM is not reliable as the outer border of rim tissue because of clinically and photographically invisible extensions of Bruch's membrane (BM) inside the DM and (2) nonaccountability of rim tissue orientation in the optic nerve head (ONH).
Second, our diabetic retinopathy grading was based on only two (optic disc and macular) fields rather than on seven fields of retinal photographs used by large trials such as the Early Treatment Diabetic Retinopathy Study ETDRSS).
The results of this analysis lead us to recommend that 'low risk' should be defined as referrals based on IOP only, optic disc only, VF only and IOP and VF, with all other referrals including any reference to a shallow anterior chamber angle better suited to a direct referral to secondary care.
Inclusion of tests from healthy individuals and glaucoma patients in further analyses was based on evaluation of the optic disc during fundus examination.
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