Automatic segmentation of the borders of the pathological focus in the macular area of the retina to calculate the area of the pathological focus

Abstract Optical coherence tomography (OCT) is a modern, non-contact method of diagnostic examination that enables the visualization of various tissues of the human eye in a cross-sectional view at the microscopic level with the required morphological information. The software pre-installed in such devices contains many different tools for analyzing scans and has almost all the functionality necessary for the doctor to make a correct diagnosis. However, as time passes, more and more advanced methods of analyzing the images appear, which actualizes new tasks of developing additional software that can supplement and expand the functionality of the diagnostic equipment. This paper proposes an algorithm for automatic segmentation of the borders of a pathological focus in the macular area of the retina to calculate the area of the pathological focus, which together with other algorithms for analysis of morphometric parameters of the human eye, which are still under development, will be used for more accurate diagnosis of the stage of age-related macular degeneration.

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Patient Use of Dietary Supplements, Home Monitoring, or Genetic Testing for Nonneovascular Age-Related Macular Degeneration

Journal of VitreoRetinal Diseases ◽

10.1177/2474126421989228 ◽

2021 ◽

pp. 247412642198922

Author(s):

Brittany C. Tsou ◽

T.Y. Alvin Liu ◽

Jun Kong ◽

Susan B. Bressler ◽

J. Fernando Arevalo ◽

...

Keyword(s):

Genetic Testing ◽

Macular Degeneration ◽

Dietary Supplements ◽

Home Monitoring ◽

Cross Sectional Study ◽

Age Related Macular Degeneration ◽

Cross Sectional ◽

Supplement Use ◽

Age Related ◽

Disease Study

Purpose: This work evaluated the use and type of dietary supplements and home monitoring for nonneovascular age-related macular degeneration (AMD), as well as the prevalence of genetic testing among patients with AMD. Methods: A cross-sectional study was conducted of 129 participants older than 50 years who completed self-administered questionnaires regarding usage and type of dietary supplements and home monitoring, as well as the participants’ use of genetic testing for AMD. Results: Of 91 participants with AMD, 83 (91.2%) took vitamins, including 55 (60.4%) who used an Age-Related Eye Disease Study (AREDS) or AREDS2 formulation. Of 38 without AMD, 31 (81.6%) took vitamins (difference from participants with AMD = 9.6% [95% CI, 0%-23.2%]), including 2 on an AREDS formulation. Among 82 participants with AMD who were AREDS candidates (intermediate or advanced AMD in 1 or both eyes), 51 (62.2%; 95% CI, 51.7%-72.7%) took an AREDS or AREDS2 formulation, and 31 (37.8%) did not (5 were unsure). Additionally, 50 (61.0%; 95% CI, 50.4%-71.6%) AREDS candidates did some type of home monitoring. Only 1 (1.2%; 95% CI, 0%-3.6%) underwent genetic testing for AMD. Among 9 with AMD who were not AREDS candidates, 4 (44.4%) used an AREDS formulation, 4 (44.4%) did not, and 1 (11.1%) was unsure; only 1 (11.1%) of these 9 performed home monitoring. Conclusions: Despite similar results from past surveys and AREDS2 data supporting supplement use in 2013 and home monitoring in 2014, these findings suggest about one-third of AREDS candidates do not do so, providing further support for improving education regarding appropriate supplement and home monitoring usage. Genetic testing for AMD also appears infrequent.

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Association of Human Plasma Metabolomics with Delayed Dark Adaptation in Age-Related Macular Degeneration

Metabolites ◽

10.3390/metabo11030183 ◽

2021 ◽

Vol 11 (3) ◽

pp. 183

Author(s):

Kevin M Mendez ◽

Janice Kim ◽

Inês Laíns ◽

Archana Nigalye ◽

Raviv Katz ◽

...

Keyword(s):

Amino Acids ◽

Fatty Acid ◽

Macular Degeneration ◽

Dark Adaptation ◽

Ultra Performance Liquid Chromatography ◽

Cross Sectional Study ◽

Age Related Macular Degeneration ◽

Cross Sectional ◽

Age Related ◽

Vitreoretinal Disease

The purpose of this study was to analyze the association between plasma metabolite levels and dark adaptation (DA) in age-related macular degeneration (AMD). This was a cross-sectional study including patients with AMD (early, intermediate, and late) and control subjects older than 50 years without any vitreoretinal disease. Fasting blood samples were collected and used for metabolomic profiling with ultra-performance liquid chromatography–mass spectrometry (LC-MS). Patients were also tested with the AdaptDx (MacuLogix, Middletown, PA, USA) DA extended protocol (20 min). Two measures of dark adaptation were calculated and used: rod-intercept time (RIT) and area under the dark adaptation curve (AUDAC). Associations between dark adaption and metabolite levels were tested using multilevel mixed-effects linear modelling, adjusting for age, gender, body mass index (BMI), smoking, race, AMD stage, and Age-Related Eye Disease Study (AREDS) formulation supplementation. We included a total of 71 subjects: 53 with AMD (13 early AMD, 31 intermediate AMD, and 9 late AMD) and 18 controls. Our results revealed that fatty acid-related lipids and amino acids related to glutamate and leucine, isoleucine and valine metabolism were associated with RIT (p < 0.01). Similar results were found when AUDAC was used as the outcome. Fatty acid-related lipids and amino acids are associated with DA, thus suggesting that oxidative stress and mitochondrial dysfunction likely play a role in AMD and visual impairment in this condition.

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Cross-sectional study of the association between age-related macular degeneration and arthritis in the National Health and Nutrition Examination Survey 2005–2008

BMJ Open ◽

10.1136/bmjopen-2019-035805 ◽

2020 ◽

Vol 10 (12) ◽

pp. e035805

Author(s):

Zhuoting Zhu ◽

Huan Liao ◽

Sen Liu ◽

Jian Zhang ◽

Yifan Chen ◽

...

Keyword(s):

Macular Degeneration ◽

National Health ◽

Logistic Models ◽

Cross Sectional Study ◽

Age Related Macular Degeneration ◽

Nutrition Examination Survey ◽

Sectional Study ◽

Cross Sectional ◽

Health And Nutrition ◽

Age Related

ObjectiveTo explore the association between age-related macular degeneration (AMD) and arthritis in a representative sample of the US population.DesignPopulation-based, cross-sectional study.SettingThe National Health and Nutrition Examination Survey (NHANES) 2005–2008.ParticipantsA total of 4813 participants aged 40 years and older with available information on AMD and arthritis in the 2005–2008 NHANES.MethodsThe status and types of arthritis were obtained from questionnaires. Non-mydriatic fundus photographs were collected. The types of AMD were assessed using the modified Wisconsin Age-Related Maculopathy Grading Classification Scheme. The association between arthritis and AMD was evaluated using logistic regression models.ResultsAfter adjusting for covariates, participants with any or early AMD had significantly lower odds of having any type of arthritis (any AMD: OR=0.56, 95% CI: 0.36–0.86; early AMD: OR=0.55, 95% CI: 0.34–0.88) or osteoarthritis (OA) (any AMD: OR=0.43, 95% CI: 0.26–0.71; early AMD: OR=0.44, 95% CI: 0.25–0.76) compared with those without AMD. When considering AMD as the outcome, significant negative associations were also found between any arthritis or OA and any (any arthritis: OR=0.64, 95% CI: 0.43–0.94; OA: OR=0.52, 95% CI: 0.33–0.82) or early AMD (any arthritis: OR=0.61, 95% CI: 0.40–0.93; OA: OR=0.51, 95% CI: 0.31–0.86) in the multivariable logistic models. There was no significant association between different types of arthritis and late AMD.ConclusionsPeople with arthritis, especially those with OA, were less likely to have AMD compared with those without arthritis and vice versa. Further studies are needed to confirm this potential protective effect of arthritis and/or arthritis treatment on AMD and to explore the underlying mechanisms.

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SCARB1 rs5888 is associated with the risk of age-related macular degeneration susceptibility and an impaired macular area

Ophthalmic Genetics ◽

10.1080/13816810.2016.1203442 ◽

2016 ◽

Vol 38 (3) ◽

pp. 233-237 ◽

Cited By ~ 2

Author(s):

Daiva Stanislovaitiene ◽

Dalia Zaliuniene ◽

Algimantas Krisciukaitis ◽

Robertas Petrolis ◽

Alina Smalinskiene ◽

...

Keyword(s):

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Macular Area ◽

Age Related

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Healthcare Cost of Stargardt Disease

10.1101/2020.01.22.20017962 ◽

2020 ◽

Author(s):

Kanza Aziz ◽

Bonnielin K. Swenor ◽

Joseph K. Canner ◽

Mandeep S. Singh

Keyword(s):

Macular Degeneration ◽

Healthcare Cost ◽

Financial Burden ◽

Age Related Macular Degeneration ◽

Administrative Claims ◽

Direct Healthcare Cost ◽

Stargardt Disease ◽

Cross Sectional ◽

Patient Cost ◽

Age Related

AbstractImportanceStargardt disease (SD) is the most common juvenile macular degeneration and a leading cause of uncorrectable childhood blindness. The progressive and incurable nature of this chronic condition entails a long-term financial burden on affected individuals. The economic costs of SD have not been characterized in detail.ObjectiveTo estimate the direct healthcare cost of SD.DesignCross-sectional analysis of healthcare claims.ParticipantsPatients with an ICD-9 diagnosis code of SD, non-exudative age-related macular degeneration (AMD), or bilateral sensorineural hearing loss (SHL).MethodsOutpatient administrative claims data from the IBM® MarketScan® Commercial Claims and Encounters Database from 2010 to 2014 were analyzed.Main Outcome MeasureAnnual per-patient direct healthcare cost.ResultsA total of 472,428 patients were analyzed (5,015 SD, 369,750 SHL and 97,663 AMD patients respectively). The payment per year of insurance coverage for SD (median: $105.58, IQR: $50.53-$218.71) was higher than that of SHL (median: $51.01, IQR: $25.66-$121.66, p <0.001) and AMD (median: $76.20, IQR: $38.00-$164.86, p <0.001). When adjusted for covariates, the annual payment for SD was $47.83 higher than SHL (p<0.001) and $17.34 higher than AMD (p<0.001).Conclusions and RelevanceThere is a significant direct healthcare cost associated with SD. The annual per-patient cost of SD was higher than SHL, another condition that causes sensory impairment in people of all ages, and nonexudative AMD which causes a similar pattern of visual loss that typically begins later in life. The total lifetime per-patient cost of SD may exceed that of nonexudative AMD.

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SUBCONJUNCTIVAL INJECTION

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.02.509 ◽

2017 ◽

Vol 24 (02) ◽

pp. 296-301

Author(s):

Faheem Ahmad ◽

Tayyab Mushtaq

Keyword(s):

Corneal Transplantation ◽

Disease Process ◽

Corneal Neovascularization ◽

Age Related Macular Degeneration ◽

University Hospital ◽

Subconjunctival Injection ◽

Rejection Reaction ◽

Human Eye ◽

Anti Vegf ◽

Age Related

Introduction: Normally the cornea in human eye is crystalline clear membranepresent in the anterior most portion of the eyeball. Regarding the various functions of thecornea in human eye it provides protection, clear vision, refractive media the visual systemand maintains itself as an immune privileged site. Neovascularization is mostly associated withan inflammation and always indicate a state of disease. Similarly Corneal Neovascularizationcan cause Graft rejection reaction after keratoplasty the different types of anti-VEGF agentsnow are used to prevent neovascular eye diseases. These different Anti-VEGF inhibitors areLucentis, Macugen and bevacizumab/Avastin and used in case of ocular neovascularization.Objectives: To determine the efficacy of subconjuctival injection of Avastin on patients havingcorneal neovascularization following keratoplasty. Settings: Department of OphthalmologyAllied Hospital, Faisalabad and Independent University Hospital, Faisalabad. Study Duration:The duration of study was 11-02-2015 to 11-07-2015. Results: A total of 86 cases fulfilling theinclusion/exclusion criteria were enrolled to determine the efficacy of subconjuctival injectionof Avastin on patients having corneal neovascularization following keratoplasty. Discussion:Regarding the success of Keratoplasty is determined by many factors especially avascularity ofcornea after surgery. Corneal neovasculrization is disease process secondary to various ocularinsults in which growth of vessels towards central cornea occur from the limbal vascular plexus.But now a days Bevacizumab/Avastin is commonly used in Ophthalmology as “off label” drug inthe treatment of Exudative age related macular degeneration as well as in diabetic retinopathy.Conclusion: We concluded that the frequency of efficacy of subconjuctival bevacizumab ishigher in patients having corneal neovascularization after corneal transplantation.

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Prevalence and characteristics of macular atrophy in eyes with neovascular age-related macular degeneration. A study from a long-term observational dataset: the Fight Retinal Blindness! project

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315055 ◽

2019 ◽

Vol 104 (8) ◽

pp. 1064-1069

Author(s):

Vincent Daien ◽

Vuong Nguyen ◽

Rohan W Essex ◽

Robin Guymer ◽

Jennifer J Arnold ◽

...

Keyword(s):

Risk Factors ◽

Macular Degeneration ◽

Cross Sectional Study ◽

Age Related Macular Degeneration ◽

Vegf Inhibitors ◽

Cross Sectional ◽

Macular Atrophy ◽

Anti Vegf ◽

Age Related ◽

History Of

BackgroundTo assess the prevalence and characteristics associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.MethodsThis was a retrospective, cross-sectional study of nAMD eyes that commenced anti-VEGF between January 2006 and August 2016. MA (absent/extrafoveal/subfoveal) was graded by treating practitioners based on multimodal imaging from April 2016. The prevalence of MA over time and risk factors of MA were assessed.ResultsThe prevalence of MA in a cohort of 1689 eyes was 9.9% (22/222) in eyes within 1 year of starting treatment, 41.5% (71/171) after 5 years and 48.4% (30/62) after 9 years of treatment. Risk factors for subfoveal MA included the proportion of visits at which the lesion was graded as inactive ((adjusted OR (AOR) 3.72 for the highest vs lowest the quartile of frequency of inactive gradings (95% CI 2.33 to 6.07)), age (AOR 1.05 per year (95% CI 1.02 to 1.07)), baseline visual acuity (AOR 3.9 for ≤35 letters vs ≥70 letters (95% CI 2.4 to 6.4)) and the number of injections received (AOR 1.20 every 10 injections (95% CI 1.08 to 1.33)). Similar associations were observed with extrafoveal MA.ConclusionsThe risk of MA appeared to drop in eyes that had not developed it within 5 years. Low choroidal neovascularisation activity was by far the strongest predictor. We could not determine whether the increased prevalence of MA with time was due to anti-VEGF treatment or the natural history of the condition.

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The burden of ocular diseases in an underdeveloped village in Southwest Sumba, Eastern Indonesia, 2016

Medical Journal of Indonesia ◽

10.13181/mji.v26i4.1808 ◽

2018 ◽

Vol 26 (4) ◽

pp. 277-85 ◽

Cited By ~ 2

Author(s):

Ratna Sitompul ◽

Yeni D. Lestari ◽

Simon Siregar ◽

Asti Ayudianingrum ◽

Isfiyanto Isfiyanto ◽

...

Keyword(s):

Initial Step ◽

Cross Sectional Study ◽

Age Related Macular Degeneration ◽

Ocular Diseases ◽

Eye Care ◽

Public Health Action ◽

Cross Sectional ◽

Eastern Indonesia ◽

Care Services ◽

Age Related

Background: Prevalence estimates of ocular diseases in a given district are important to plan the programs of eye care services. This study aimed to describe the burden of ocular diseases as an initial step in improving eye care services in underdeveloped areas in Indonesia.Methods: A cross-sectional study was performed among residents of Perobatang Village in Southwest Sumba district in July 2016. Eye examinations were conducted by ophthalmologists, and visual acuity was measured by optometrists. Participants were provided with appropriate treatment according to diagnosis. Surgical services were offered two months after the examination.Results: After eximining a total of 667 of 1,459 (46%) residents, the result showed that the most frequent ocular problems were presbyopia (30.8%), cataract (12.8%), refractive error (11.3%), and pterygium (10.7%). The proportion of myopia was 5.9%, hyperopia was 5.0%, and astigmatism was 2.2%. Moreover, the proportion of blindness was 10%. Cataract caused blindness in 44 participants. Other causes of blindness included age-related macular degeneration, retinopathy, optic atrophy, glaucoma, retinal detachment and trauma.Conclusion: The burden of ocular problems in Perobatang Village, Southwest Sumba, Eastern Indonesia was high. These findings showed the importance of public health action from local government and non-governmental organizations to improve eye care services in Southwest Sumba district.

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Pattern of blindness in a community based hospital of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v5i1.7822 ◽

2013 ◽

Vol 5 (1) ◽

pp. 50-56

Author(s):

R Sharma ◽

S Marasini ◽

BP Nepal

Keyword(s):

Age Related Macular Degeneration ◽

Easy Access ◽

Retinal Diseases ◽

Access To Health Services ◽

Community Based ◽

Cross Sectional ◽

Age Related ◽

Access To Health ◽

Disease Pattern ◽

The Mean

Introduction: Because of the availability of modern health facilities and moderately easy access to health services in the last 25 years, the blindness due to cataract and trachoma is expected to decline in Nepal. So it is felt that the causes of blindness need to be revised. Objective: To regroup the disease pattern leading to permanent blindness in patients attending a suburban multidisciplinary community-based hospital of Nepal. Materials and methods: A cross-sectional, descriptive study was conducted in patients attending Dhulikhel hospital over a period of 12 months, from March 2010. Only the patients with best corrected visual acuity of < 3/60 were enrolled in the study. A detailed ocular examination was carried out. Results: A total of 76 eyes of 58 patients were analyzed. Of all, 32 were male (55.2 %). The mean age of the patients was 43.03 ± 22.98, with a range of 7 years to 84 years. Retinal diseases had the higher prevalence (23, 39.7 %) followed by amblyopia (10, 17.2 %) and corneal diseases (9, 15.51 %). Anisometropic amblyopia (3.94 %) was the commonest type of amblyopia. Retinitis pigmentosa (9.21 %) and age-related macular degeneration (7.89 %) were common retinal diseases whereas anterior staphyloma (5.26 %) and leucoma (3.94 %) were common corneal diseases. Other important and rare causes of blindness included ethambutol-induced optic neuropathy and vitelliform dystrophy. Conclusion: Periodic collection of statistics on the relative frequency of the causes of blindness is important in socioeconomically developing nations like Nepal. This helps to revise the pattern of blinding diseases so that priorities can be redefined. Nepal J Ophthalmol 2013; 5(9):50-56 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7822

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Association between central retinal thickness and low luminance visual acuity in early age-related macular degeneration

European Journal of Ophthalmology ◽

10.1177/1120672120968740 ◽

2020 ◽

pp. 112067212096874

Author(s):

María Cinta Puell ◽

Francisco Javier Hurtado-Ceña ◽

María Jesús Pérez-Carrasco ◽

Inés Contreras

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Retinal Thickness ◽

Central Area ◽

Age Related Macular Degeneration ◽

Central Retinal Thickness ◽

Cross Sectional ◽

Age Related ◽

Low Luminance ◽

Sd Oct

Purpose/Aim: To examine whether central retinal thickness (CRT) is related to mesopic visual acuity (VA) and low luminance deficit (LLD, difference between photopic and mesopic VA) in eyes with early and intermediate age-related macular degeneration (AMD). Materials and Methods: In a cross-sectional study, 50 pseudophakic subjects older than 63 years were divided into three groups (no AMD, early AMD and intermediate AMD). Spectral domain optical coherence tomography (SD-OCT) was used to measure CRT in the 1 mm-central-area. Best-corrected distance VA was measured under photopic or mesopic luminance conditions and LLD calculated. Subjects were stratified by VA impairment to compare CRTs across these groups. Relationships were examined by stepwise multiple linear regression. Results: No significant differences in mean CRT, photopic and mesopic VA or LLD were detected between the groups no AMD, early AMD and intermediate AMD. However, mean CRTs were 20 microns and 18 microns thicker in the eyes with impaired mesopic VA (> 0.3 logMAR) and impaired LLD (⩾ 0.3 logMAR) compared to the eyes with non-impaired VA or LLD respectively (both p < 0.01). CRT and mesopic pupil size were independent predictors of mesopic VA ( p = 0.001). CRT emerged as the only independent predictor of LLD ( p = 0.004). Conclusions: Increased CRT was linked to worse retinal function when measured under mesopic conditions in eyes without AMD and eyes with early to intermediate AMD. SD-OCT imaging combined with VA measurements under low luminance conditions could be a useful tool to detect early AMD.

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