scholarly journals Estimation of current and post-treatment retinal function in chronic central serous chorioretinopathy using artificial intelligence

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maximilian Pfau ◽  
Elon H. C. van Dijk ◽  
Thomas J. van Rijssen ◽  
Steffen Schmitz-Valckenberg ◽  
Frank G. Holz ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Absolute Error ◽  
Test Point ◽  
Post Treatment ◽  
Retinal Function ◽  
Patient Specific ◽  
Retinal Sensitivity ◽  
Chronic Central Serous Chorioretinopathy ◽  
Learning Software ◽  
Sd Oct

AbstractRefined understanding of the association of retinal microstructure with current and future (post-treatment) function in chronic central serous chorioretinopathy (cCSC) may help to identify patients that would benefit most from treatment. In this post-hoc analysis of data from the prospective, randomized PLACE trial (NCT01797861), we aimed to determine the accuracy of AI-based inference of retinal function from retinal morphology in cCSC. Longitudinal spectral-domain optical coherence tomography (SD-OCT) data from 57 eyes of 57 patients from baseline, week 6–8 and month 7–8 post-treatment were segmented using deep-learning software. Fundus-controlled perimetry data were aligned to the SD-OCT data to extract layer thickness and reflectivity values for each test point. Point-wise retinal sensitivity could be inferred with a (leave-one-out) cross-validated mean absolute error (MAE) [95% CI] of 2.93 dB [2.40–3.46] (scenario 1) using random forest regression. With addition of patient-specific baseline data (scenario 2), retinal sensitivity at remaining follow-up visits was estimated even more accurately with a MAE of 1.07 dB [1.06–1.08]. In scenario 3, month 7–8 post-treatment retinal sensitivity was predicted from baseline SD-OCT data with a MAE of 3.38 dB [2.82–3.94]. Our study shows that localized retinal sensitivity can be inferred from retinal structure in cCSC using machine-learning. Especially, prediction of month 7–8 post-treatment sensitivity with consideration of the treatment as explanatory variable constitutes an important step toward personalized treatment decisions in cCSC.

scholarly journals Long-Term Effects of Half-Time Photodynamic Therapy on Retinal Sensitivity in Eyes with Chronic Central Serous Chorioretinopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Takehito Iwase ◽  
Hirotaka Yokouchi ◽  
Masayasu Kitahashi ◽  
Mariko Kubota-Taniai ◽  
Takayuki Baba ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Retinal Sensitivity ◽  
Half Time ◽  
Long Term Effects ◽  
Chronic Central Serous Chorioretinopathy ◽  
Integrity Assessment ◽  
Minimum Angle ◽  
The Mean

The purpose of this study was to evaluate the long-term effects of half-time photodynamic therapy (PDT) on the retinal sensitivity in eyes with chronic central serous chorioretinopathy (CSC). Twenty-two eyes of 22 patients with chronic CSC were studied. PDT was applied with full-dose verteporfin and half-time laser duration. The best-corrected visual acuity (BCVA) and retinal sensitivity in the central 2 and 10 degrees were evaluated at the baseline, and at 12 and 24 months after the half-time PDT. The retinal sensitivity was determined by Macular Integrity Assessment microperimetry (MAIA, Centervue, Padova, Italy). The results showed that the mean retinal sensitivities in the central 2 and 10 degrees were significantly improved at 12 months (25.6±2.79 dB, median; 26.11 dB, 25.6±2.25 dB, median; 25.65 dB, respectively; P<0.001) and at 24 months (26.3±2.62 dB, median; 27.38 dB, 26.6±2.21 dB, median; 27.45 dB, respectively; P<0.001) after the treatment compared to that at the baseline (19.2±3.93 dB, median; 19.34 dB, 20.9±2.92 dB, median; 20.9 dB, respectively). The BCVA was also significantly improved from 0.18±0.19 median; 0.15 logarithm of the minimum angle of resolution (logMAR) units at the baseline to 0.07±0.15 median; 0 logMAR units at 12 months (P<0.001) and to 0.049±0.16 median; -0.039 logMAR units at 24 months (P<0.001). We conclude that half-time PDT results in a significant improvement of the mean central retinal sensitivity for at least 24 months in eyes with chronic CSC. Thus, half-time PDT is beneficial in resolving chronic CSC for a relatively long period.

scholarly journals The Effect of Selective Retina Therapy with Automatic Real-Time Feedback-Controlled Dosimetry for Chronic Central Serous Chorioretinopathy: A Randomized, Open-Label, Controlled Clinical Trial

2021 ◽  
Vol 10 (19) ◽  
pp. 4295
Author(s):  
Ji-young Lee ◽  
Min-hee Kim ◽  
Seung-hee Jeon ◽  
Seung-hoon Lee ◽  
Young-jung Roh
Keyword(s):  
Real Time ◽  
Central Serous Chorioretinopathy ◽  
Controlled Trial ◽  
Subretinal Fluid ◽  
Post Treatment ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Chronic Central Serous Chorioretinopathy ◽  
Selective Retina Therapy

This prospective randomized controlled trial evaluated the safety and efficacy of real-time feedback-controlled dosimetry (RFD)-guided selective retina therapy (SRT) in chronic central serous chorioretinopathy (CSC). Forty-four participants with chronic CSC were included and randomly assigned to the control group or SRT group. The SRT laser system with RFD-guidance was applied to cover the entire leakage area. If SRF remained at the 6-week follow-up visit, re-treatment and rescue SRT was performed for the SRT group and crossover group, respectively. The rate of complete resolution of subretinal fluid (SRF), mean SRF height, and mean retinal sensitivity were compared between the two groups at 6-weeks post-treatment. The complete SRF resolution rate in all SRT-treated eyes was evaluated at 12-weeks post-treatment. The rate of complete SRF resolution was significantly higher in the SRT group (63.6%) than in the control group (23.8%) at 6-weeks post-treatment (p = 0.020). The mean SRF height at 6 weeks after SRT was significantly lower in the SRT group (p = 0.041). Overall, SRT-treated eyes showed complete SRF resolution in 70.3% of eyes at 12-weeks post-treatment. RFD-guided SRT was safe and effective to remove SRF in chronic CSC patients during the 3-month follow-up period.

scholarly journals The Personalized Approach to the Chronic Central Serous Chorioretinopathy Treatment Based on the Navigated Micropulse Laser Technology

2019 ◽  
Vol 15 (4) ◽  
pp. 394-404
Author(s):  
P. L. Volodin ◽  
A. V. Doga ◽  
E. V. Ivanova ◽  
V. A. Pismenskaya ◽  
Iu. I. Kukharskaya ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Laser Treatment ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Retinal Sensitivity ◽  
Individual Selection ◽  
Chronic Central Serous Chorioretinopathy ◽  
Energy Parameters ◽  
Micropulse Laser ◽  
Selection Of

The Purpose— to develop the technology and to evaluate the clinical results of personalized laser treatment of patients with chronic central serous chorioretinopathy (CSC) in a micropulse mode with individual selection of energy parameters on the navigation system Navilas 577s.Patients and Methods. 19 patients (22 eyes) with CSC after micropulse laser treatment were analyzed. The initial best corrected visual acuity (BCVA) was 0.4 to 1.0. According to OCT, the height of the  detachment of the neurosensory retina varied from 83 to 259 microns. Retinal sensitivity of the central zone was from 20.2 to 29.7 dB. Before laser treatment were individually selected the optimal energy parameters for each patient. The treatment was performed on a Navilas 577s laser system. The follow-up were 1 and 3 months.Results. 1 month after treatment the positive dynamics of functional and anatomical results in all patients was observed. Mean BCVA increased in the group to 0.81 ± 0.04. The central retinal sensitivity raised on average in the group up to 25.7 ± 0.6 dB. After 3 months, mean BCVA was 0.96 ± 0.02. Mean central retinal sensitivity increased to 26.4 ± 0.57 dB. The study revealed a high correlation between visual acuity and the central retinal thickness (0.72) and medium correlation between foveal retinal sensitivity and central retinal thickness in fovea (0.60), respectively. The correlation among visual acuity, retinal sensitivity and the symptom’s duration of the disease is negative medium (-0.63) and significant (-0.72), respectively.Conclusions. The developed personalized technology of laser treatment of chronic central serous chorioretinopathy with a micropulse mode with an individual selection of energy parameters on the Navilas 577s navigation system showed high clinical efficiency and safety. It has been established that in the course of the longstanding duration of the disease irreversible changes in the chorioretinal complex structure occured, thinning of the foveal photoreceptors layer leading to a decrease in the central retinal sensitivity and visual acuity, which substantiate the necessity for early and maximally functional-saving treatment.

scholarly journals Anatomical Retinal Changes after Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
María Pilar Ruiz-del-Tiempo ◽  
Pilar Calvo ◽  
Antonio Ferreras ◽  
Jesús Leciñena ◽  
Luis Pablo ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Outer Nuclear Layer ◽  
Subretinal Fluid ◽  
Chronic Central Serous Chorioretinopathy ◽  
One Year ◽  
Mean Time ◽  
Sd Oct

Purpose. To evaluate anatomical retinal changes measured by spectral-domain optical coherence tomography (SD-OCT), after applying photodynamic therapy (PDT) for treatment of chronic central serous chorioretinopathy (CSC). Methods. A retrospective analysis was conducted on 43 patients (48 eyes) with chronic CSC treated with PDT. Visual acuity (VA), central retinal thickness (CRT), outer nuclear layer (ONL) thickness, subretinal fluid (SRF), and photoreceptor ellipsoid zone (EZ) measured by SD-OCT were collected at baseline and at 3, 6, and 12 months after PDT. Differences between normally distributed variables were calculated by a paired-sample t-test; p<0.05 was considered statistically significant. Results. Mean age was 50 ± 9.8 years. Mean time from diagnosis to PDT was 12.5 months. Baseline VA was 0.51 ± 0.24 and significantly improved (p<0.001) to 0.74 ± 0.26 one year after PDT. CRT and SRF significantly decreased (p<0.001) at 3, 6, and 12 months after treatment. ONL thickness and EZ did not significantly change at any point during follow-up. Conclusions. Not significant changes were found in the ONL or EZ 12 months after PDT.

scholarly journals Inferred retinal sensitivity in recessive Stargardt disease using machine learning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Philipp L. Müller ◽  
Alexandru Odainic ◽  
Tim Treis ◽  
Philipp Herrmann ◽  
Adnan Tufail ◽  
...  
Keyword(s):  
Machine Learning ◽  
Surrogate Marker ◽  
Absolute Error ◽  
Retinal Function ◽  
Regulatory Agencies ◽  
Retinal Sensitivity ◽  
Stargardt Disease ◽  
Spatially Resolved ◽  
Psychophysical Testing ◽  
Macular Diseases

AbstractSpatially-resolved retinal function can be measured by psychophysical testing like fundus-controlled perimetry (FCP or ‘microperimetry’). It may serve as a performance outcome measure in emerging interventional clinical trials for macular diseases as requested by regulatory agencies. As FCP constitute laborious examinations, we have evaluated a machine-learning-based approach to predict spatially-resolved retinal function (’inferred sensitivity’) based on microstructural imaging (obtained by spectral domain optical coherence tomography) and patient data in recessive Stargardt disease. Using nested cross-validation, prediction accuracies of (mean absolute error, MAE [95% CI]) 4.74 dB [4.48–4.99] were achieved. After additional inclusion of limited FCP data, the latter reached 3.89 dB [3.67–4.10] comparable to the test–retest MAE estimate of 3.51 dB [3.11–3.91]. Analysis of the permutation importance revealed, that the IS&OS and RPE thickness were the most important features for the prediction of retinal sensitivity. ’Inferred sensitivity’, herein, enables to accurately estimate differential effects of retinal microstructure on spatially-resolved function in Stargardt disease, and might be used as quasi-functional surrogate marker for a refined and time-efficient investigation of possible functionally relevant treatment effects or disease progression.

OCTA characterisation of microvascular retinal alterations in patients with central serous chorioretinopathy

2020 ◽  
Vol 104 (10) ◽  
pp. 1453-1457 ◽  
Author(s):  
Marco Battista ◽  
Enrico Borrelli ◽  
Mariacristina Parravano ◽  
Francesco Gelormini ◽  
Massimiliano Tedeschi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Spectral Domain ◽  
Foveal Avascular Zone ◽  
Optical Coherence ◽  
Vascular Changes ◽  
Chronic Central Serous Chorioretinopathy ◽  
Avascular Zone ◽  
Sd Oct

PurposeThis study aimed to describe the characteristics of microvascular retinal alterations in eyes with chronic central serous chorioretinopathy (CSC) employing optical coherence tomography angiography (OCTA) analysis.MethodsWe collected data from 472 eyes with chronic CSC from 336 patients who had OCTA obtained. Each OCTA image was graded by two readers to assess the presence of microvascular retinal alterations, including regions of vascular rarefaction/retinal hypoperfusion, enlargement of the foveal avascular zone (FAZ) and presence of telangiectasias or microaneurysms. Volume spectral domain optical coherence tomography (SD-OCT) scans were obtained through the macula and the OCT was correlated with the OCTA findings in eyes with retinal vascular alterations.ResultsOCTA displayed microvascular retinal alterations in 18 out of 474 eyes (3.6%) from 14 patients (13 male and 1 female; mean±SD age was 54.7±11.1 years). One eye displayed the presence of retinal telangiectasias, while 17 out of 18 eyes were graded as having areas of retinal vascular rarefactions, and 3 out of 17 eyes were also characterised by an enlargement of the FAZ. The parafoveal region was the location most involved by retinal vascular changes (66,7%), followed by foveal (22,2%) and perifoveal (11.1%) regions, respectively.ConclusionAlthough CSC is known to represent a choroidal disorder, retinal vascular alterations may be present in these eyes and OCTA may represent a useful tool to identify and describe them.

scholarly journals Macular Integrity Assessment and Fixation Analysis in Chronic Central Serous Chorioretinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Dolar-Szczasny ◽  
Anna Święch-Zubilewicz ◽  
Jerzy Mackiewicz
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Serous Retinal Detachment ◽  
Retinal Sensitivity ◽  
Chronic Central Serous Chorioretinopathy ◽  
Cross Sectional ◽  
Integrity Assessment ◽  
Visual Status ◽  
Fixation Stability ◽  
The Mean ◽  
And Control

Purpose. To investigate retinal sensitivity characteristics associated with morphologic changes in the eyes exhibiting chronic central serous chorioretinopathy (CSC), using macular integrity assessment (MAIA) microperimetry. Methods. A retrospective, cross-sectional, observational study was constructed. The eyes of patients classified as chronic CSC, according to the onset of subjective symptoms with serous retinal detachment, as confirmed by optical coherence tomography examination, were included in the study. Retinal sensitivity and fixation were analyzed by performing microperimetry examinations using the MAIA instrument. Results. We reviewed microperimetry examinations of 15 eyes of 15 patients (age: 28–51 years) with chronic CSC and mean best-corrected visual acuity of −0.2 logMAR units. The mean retinal integrity in the chronic CSC group was 49.0 ± 27.6, which was significantly different from the control eyes. The mean average threshold in the eyes with chronic CSC was 24.7 ± 5.8 dB, which also was significantly different from the control eyes. Fixation stability was significantly different between the CSC and control eyes for the P1 parameter (90.1 ± 13.7 versus 99.3 ± 1.5), and for the P2 parameter (97.4 ± 4.0 versus 100.0 ± 0.0). Conclusion. New microperimetry technology may provide valuable information regarding the visual status of chronic CSC cases. Our findings suggest that retinal sensitivity and fixation stability in chronic CSC eyes may serve as useful indicators for assessing the effectiveness of clinical treatments.

Microperimetric changes and fixation stability status after half-dose photodynamic therapy for chronic central serous chorioretinopathy

2019 ◽  
Vol 30 (5) ◽  
pp. 1053-1060 ◽  
Author(s):  
Samet Gulkas ◽  
Ozlem Sahin
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Retinal Sensitivity ◽  
Central Macular Thickness ◽  
Chronic Central Serous Chorioretinopathy ◽  
Corrected Visual Acuity ◽  
Half Dose ◽  
Fixation Stability ◽  
Best Corrected Visual Acuity

Purpose: The aim of this study was to evaluate the effect of half-dose verteporfin photodynamic therapy on central retinal sensitivity, status of fixation stability, and choroidal thickness in patients with chronic central serous chorioretinopathy. Methods: In total, 22 eyes of 22 patients with chronic central serous chorioretinopathy were enrolled, and all the eyes received indocyanine green angiography-guided half-dose verteporfin photodynamic therapy. Best-corrected visual acuity, contrast sensitivity, and retinal sensitivity in the central 10° and status of the fixation stability are assessed by MAIA microperimetry, and optical coherence tomography findings (central macular thickness and subfoveal choroidal thickness) were evaluated at baseline and 1, 3, and 6 months after the half-dose verteporfin photodynamic therapy. Results: Subretinal fluid was completely resolved in 9 eyes at 1 month and in 17 eyes at 3 months. There was recurrence in two eyes at 6 months and five of the eyes had a persistent subretinal fluid through all the time points. Best-corrected visual acuity, contrast sensitivity, and retinal sensitivity improved significantly 6 months after half-dose verteporfin photodynamic therapy. Fixation stability did not change in either follow-up visit. Central macular thickness and subfoveal choroidal thickness decreased significantly at 6 months of the visits compared to baseline. There was not any systemic and ocular side effect after the treatment. Conclusion: This study shows that there is significant improvement in best-corrected visual acuity, contrast sensitivity, and retinal sensitivity after half-dose verteporfin photodynamic therapy. The status of fixation stability remained unchanged in the eyes with chronic central serous chorioretinopathy after half-dose verteporfin photodynamic therapy. Furthermore, half-dose verteporfin photodynamic therapy is also effective in decreasing central macular thickness and subfoveal choroidal thickness.

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