Evidence map›Paper›PMID 40921348›Full record

ArticleAmerican journal of ophthalmology2026

3D Structural Phenotype of the Optic Nerve Head in Glaucoma and Myopia-A Key to Improving Glaucoma Diagnosis in Myopic Populations.

Swati Sharma, Fabian A Braeu, Thanadet Chuangsuwanich, Tin A Tun, Quan V Hoang, Rachel Chong, Shamira A Perera, Ching-Lin Ho, Rahat Husain, Martin L Buist and 2 more

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Article in American journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Swati SharmaFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore.
Fabian A BraeuFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Singapore-MIT Alliance for Research and Technology (F.A.B.), Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Thanadet ChuangsuwanichDepartment of Ophthalmology (T.C., M.J.A.G.), Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.
Tin A TunFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Quan V HoangFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore; Yong Loo Lin School of Medicine (Q.V.H.), National University of Singapore, Singapore.
Rachel ChongFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Shamira A PereraFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Ching-Lin HoFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Rahat HusainFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Martin L BuistDepartment of Biomedical Engineering (M.L.B.), National University of Singapore, Singapore, Republic of Singapore.
Tin AungFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore.
Michaël J A GirardFrom the Singapore Eye Research Institute (S.S., F.A.B., T.A.T., Q.V.H., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School (F.A.B., T.A.T., R.C., S.A.P., C.-L.H., R.H., T.A., M.J.A.G.), Singapore; Department of Ophthalmology (T.C., M.J.A.G.), Emory University School of Medicine, Emory University, Atlanta, Georgia, USA; Department of Biomedical Engineering (M.J.A.G.), Georgia Institute of Technology/Emory University, Atlanta, Georgia, USA; Emory Empathetic AI for Health Institute (M.J.A.G.), Emory University, Atlanta, Georgia, USA. Electronic address: mgirard@ophthalmic.engineering.

Funding

P30-Core Grant for Vision Research Core CP30EY006360 · NEI · EMORY UNIVERSITY · PI NICKERSON, JOHN M · 1986 to 2025
$15.3M
AXON: Axonal biomechaniX to unveil injury mechanisms in glaucomatous Optic NeuropathyR01EY037299 · NEI · EMORY UNIVERSITY · PI Michael Girard, Ian A Sigal · 2025 to 2026
$1.2M
NEI NIH HHS P30 EY006360NEI NIH HHS R01 EY037299
6 · The paper itself

Abstract

purposeTo characterize the three-dimensional (3D) structural phenotypes of the optic nerve head (ONH) in patients with glaucoma, high myopia, and concurrent high myopia and glaucoma, and to evaluate their variations across these conditions.

designRetrospective cross-sectional study.

participantsA total of 685 optical coherence tomography (OCT) scans from 754 subjects of Singapore-Chinese ethnicity, including 256 healthy (H), 94 highly myopic (HM), 227 glaucomatous (G), and 108 highly myopic with glaucoma (HMG) cases.

methodsWe segmented the retinal and connective tissue layers from OCT volumes, and their boundary edges were converted into 3D point clouds. To classify the 3D point clouds into four ONH conditions, ie, H, HM, G, and HMG, a specialized ensemble network was developed, consisting of an encoder to transform high-dimensional input data into a compressed latent vector, a decoder to reconstruct point clouds from the latent vector, and a classifier to categorize the point clouds into the four ONH conditions. In addition, the network included an extension to reduce the latent vector to two dimensions for enhanced visualization.

main outcome measuresStructural variation in the ONH in H, HM, G, and HMG conditions.

resultsThe classification network achieved high accuracy, distinguishing H, HM, G, and HMG classes with a microaverage area under the receiver operating characteristic curve of 0.92 ± 0.03 on an independent test set. The decoder effectively reconstructed point clouds, achieving a Chamfer loss of 0.013 ± 0.002. Dimensionality reduction clustered ONHs into four distinct groups, revealing structural variations such as changes in retinal and connective tissue thickness, tilting and stretching of the disc and scleral canal opening, and alterations in optic cup morphology, including shallow or deep excavation, across the four conditions.

conclusionsThis study demonstrated that ONHs exhibit distinct structural signatures across H, HM, G, and HMG conditions. The findings further indicate that ONH morphology provides sufficient information for classification into distinct clusters, with principal components capturing unique structural patterns within each group. Future studies should seek to establish a connection between these structural patterns with the functional changes to enhance glaucoma diagnosis in myopic eyes.

Indexed as

GlaucomaImaging, Three-DimensionalMyopiaMyopia, DegenerativeOptic DiskAdultAgedCross-Sectional StudiesFemaleHumansIntraocular PressureMaleMiddle AgedNerve FibersPhenotypeRetinal Ganglion Cells

Identifiers

PMID40921348
PMCPMC12687752

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