scholarly journals Detection of Diabetic Macular Edema in Optical Coherence Tomography Image Using an Improved Level Set Algorithm

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Wang ◽  
Wenping Zhang ◽  
Yanan Sun ◽  
Mudi Yao ◽  
Biao Yan
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Level Set ◽  
Diabetic Patients ◽  
Optical Coherence Tomography Image ◽  
Optical Coherence ◽  
Oct Image ◽  
Novel Algorithm

Diabetic macular edema (DME) is a major cause of visual loss in the patients with diabetic retinopathy. DME detection in Optical Coherence Tomography (OCT) image contributes to the early diagnosis of diabetic retinopathy and blindness prevention. Currently, DME detection in the OCT image mainly relies on the handwork by the experienced clinician. It is a laborious, time-consuming, and challenging work to organize a comprehensive DME screening for diabetic patients. In this study, we proposed a novel algorithm for the detection and segmentation of DME region in OCT image based on the K-means clustering algorithm and improved Selective Binary and Gaussian Filtering regularized level set (SBGFRLS) algorithm named as SBGFRLS-OCT algorithm. SBGFRLS-OCT algorithm was compared with the current level set algorithms, including C-V (Chan-Vese), GAC (geodesic active contour), and SBGFRLS, to estimate the performance of DME detection. SBGFRLS-OCT algorithm was also compared with the clinician to estimate the precision, sensitivity, and specificity of DME segmentation. Compared with C-V, GAC, and SBGFRLS algorithm, the SBGFRLS-OCT algorithm enhanced the accuracy and reduces the processing time of DME detection. Compared with manual DME segmentation, the SBGFRLS-OCT algorithm achieved a comparable precision (97.7%), sensitivity (91.8%), and specificity (99.2%). Collectively, this study presents a novel algorithm for DME detection in the OCT image, which can be used for mass diabetic retinopathy screening.

scholarly journals Fundus Fluorescein Angiography and Optical Coherence Tomography Angiography Findings in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 130-137
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Technique ◽  
Diabetic Patients ◽  
Type I ◽  
Optical Coherence

Diabetic retinopathy is an important public health issue as its prevalence has been increasing every year. It is one of the major causes of visual loss which can be preventable with early diagnosis and appropriate treatment. The fundus examination must be done in detail using mydriatics, and digital images must be recorded in all diabetic patients with special emphasis on the disease type (type I and type II), duration, and prognosis. Fluorescein angiography (FA) is a gold standard invasive retinal imaging technique for the diagnosis, monitoring, and evaluating the response of the treatment in diabetic patients, but FA has limitations due to possible side effects. Optical coherence tomography angiography (OCTA) is a recent, non-invasive, dye-free imaging technique that can be used in every visit. It has the capability to image all retinal and choroidal vascular layers (segmentation) and quantify macular ischemia in a short period of time which is beneficial for the patient, and the ophthalmologist. The aim of this review is to address the findings, advantages, and disadvantages of FA and OCTA in patients with diabetic retinopathy and diabetic macular edema.

scholarly journals Aqueous angiopoietin-like levels correlate with optical coherence tomography angiography metrics in diabetic macular edema

2021 ◽  
Vol 14 (12) ◽  
pp. 1888-1894
Author(s):  
Jie Yan ◽  
◽  
Ya-Zhou Qin ◽  
Xuan-Yu Qiu ◽  
Li Qin ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Suspension Array ◽  
Circularity Index

AIM: To quantitatively detect aqueous levels of angiopoietin-like (ANGPTL)3, ANGPTL4, and ANGPTL6 and investigate their correlation with optical coherence tomography angiography (OCTA) findings in patients with diabetic macular edema (DME). METHODS: This cross-sectional study included 23 patients (27 eyes) with type 2 diabetes and 16 control subjects (20 eyes). All patients underwent OCTA imaging and ultra-wide field fundus photography. Diabetic patients were categorized into two groups according to the presence or absence of diabetic retinopathy (DME group, 14 patients, 16 eyes); and non-diabetic retinopathy (NDR) group, 9 patients, 11 eyes, respectively. Aqueous levels of ANGPTL3, ANGPTL4, and ANGPTL6 were assessed using suspension array technology, and foveal-centered 3×3 mm2 OCTA scans were automatically graded to determine the central, inner, and full vessel density (CVD, IVD, FVD); central, inner, and full perfusion density (CPD, IPD, FPD), foveal avascular zone (FAZ) area, FAZ perimeter, and FAZ circularity index (FAZ-CI) on superficial capillary plexuses. Additionally, central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were measured in a model of macular cube 512×128. RESULTS: Aqueous ANGPTL3 levels were not significantly different among the three groups (P>0.05). ANGPTL4 levels were significantly higher in the DME group than the control and NDR groups (P<0.0001 and P<0.001), while ANGPTL6 levels were significantly higher in the DME group than the control group (P<0.05). In the whole cohort, the aqueous ANGPTL3 levels correlated negatively with the IVD, FVD, IPD, and FPD, and positively with the CV and CAT. The aqueous ANGPTL4 levels correlated negatively with the CVD, IVD, FVD, CPD, IPD, and FPD, and positively with the FAZ perimeter, CST, CV, and CAT. The aqueous ANGPTL6 levels correlated negatively with the IVD, FVD, IPD, FPD, FAZ-CI and positively with CST, CV, CAT. CONCLUSION: ANGPTL4 and ANGPTL6 may be associated with vascular leakage in DME and may represent good targets for DME therapy. In addition, OCTA metrics may be useful for evaluating macular ischemia in DME.

Influence of the thickness and vascular density of the retina on its photosensitivity in diabetic macular edema

2021 ◽  
pp. 37-40
Author(s):  
D.D. Arzhukhanov ◽  
◽  
D.V. Petrachkov ◽  
A.G. Matyushchenko ◽  
◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Central Zone ◽  
Vascular Density ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Correlation Relationship ◽  
Functional Changes

Purpose: to study the effect of the thickness and vascular density of the retina on its photosensitivity in diabetic macular edema. Material and methods. 9 patients (13 eyes) aged from 26 to 79 years (average age 62.1 ± 16 years) with a diagnosis of diabetic retinopathy (DR), diabetic macular edema (DME) were examined. In addition to the standard ophthalmological examination, a complex of specialized research methods was performed, including microperimetry, optical coherence tomography (OCT) and OCT with angiography (OCT-angio) of the posterior segment of the eye. At the same time, the influence of morphometric parameters on functional changes in the retina in the corresponding segments with a diameter of 6 mm was analyzed. Results. The study was a high inverse correlation relationship in the majority of cases between the parameters of the relevant sectors according microperimetry and OCT and OCT-angio in central zone of diameter 1, 3 and 6 mm and a direct correlation between central retinal thickness by OCT diagnosis and the so-called parameter K, denoting the number of points with sensitivity below 24 dB according microperimetry with a high degree of confidence (p<0.01, p<0.05). Conclusion. According to the results of our study, a direct correlation was found between the vascular density of the superficial and deep capillary plexuses and the parameters of photosensitivity in patients with DME. At the same time, the relationship between the thickness and light sensitivity of the retina is inverse. Key words: diabetic retinopathy, diabetic macular edema, optical coherence tomography, microperimetry, angiography.

scholarly journals Large-cube 30° × 25° optical coherence tomography in diabetic macular edema

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Amir Mahdjoubi ◽  
Youcef Bousnina ◽  
Fatma-Samia Bendib ◽  
Faiza Bensmaine ◽  
Wafa Idlefqih ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Strong Association ◽  
Intravitreal Injections ◽  
Binary Logistic Regression Analysis ◽  
Optical Coherence ◽  
Retinal Edema ◽  
Baseline Visit

Abstract Background To evaluate the contribution of large-cube 30° × 25° optical coherence tomography (OCT) in the characterization of diabetic macular edema (DME) by assessing its extent and the presence of additional retinal edemas and to evaluate the factors that influenced their occurrence. Methods This retrospective study enrolled patients with diabetes who presented with retinal edema detected by horizontal large-cube 30° × 25° (8.7 × 7.3 mm) OCT. Two individualized areas were selected from the thickness map: the area within the 6-mm Early Treatment of Diabetic Retinopathy Study (ETDRS) grid, and that outside the ETDRS grid. Retinal edemas located within the ETDRS grid were designated as “main DME” and those located outside the ETDRS grid were designated as “peripheral retinal edemas.” For each area, OCT features were assessed while the extent of the main DME and the presence of peripheral retinal oedema were analysed in the area outside the ETDRS grid. Finally, part of included eyes was followed by the same protocol, of which a part benefited from intravitreal injections. Results Peripheral events were detected outside the ETDRS area in 279 eyes (74.4%) of the 375 eyes of the 218 patients included in this study: an extension of the main DME outside ETDRS grid in 177 eyes (47.2%) and/or the presence of peripheral retinal edemas in 207 eyes (55.2%). The analysis of associations between main DME and peripheral retinal edemas patterns did not find an association for retinal cyst localization (P = 0.42) while a week association was found fort cyst size (Cramer’s V = 0.188, p = 0.028). Nevertheless, a moderate association was found for the presence of microaneurysms (Cramer’s V = 0.247, p < 0.001) and strong association for hard exudates (Cramer’s V = 0.386, p < 0.001), The binary logistic regression analysis retained the following influencing factors of the occurrence of peripheral events: advanced DR stage (Odds ratio OR = 2.19, p = 0.03), diffuse DME (OR = 7.76, p < 0.001) and its location in outer fields (OR = 7.09, p = 0.006). Likewise, the extension of the main DME outside the ETDRS area in was influenced by the same factors in addition to CMT (OR = 0.98, p = 0.004) while the presence of peripheral retinal edema was influenced by the same factors except the outer location of the Main DME. Finally, from the 94 eyes treated by intravitreal injections, extension of the main DME outside the ETDRS grid was detected in 54 eyes (56.44%) at baseline visit and still remained detectable in 37 eyes (39.36%) after treatment initiation. Conclusions Large-cube 30° × 25° OCT allowed for more precise assessment of DME extension and better detection of retinal thickening mainly in the advanced stages of diabetic retinopathy with significant DME whether at the baseline visit or during follow-up. The combination of this protocol with a wider ETDRS grid would enhance DME detection and topography.

scholarly journals Correlating the patterns of Diabetic macular edema, Optical Coherence Tomography Biomarkers and Grade of Diabetic Retinopathy With Stage of Renal Disease

2021 ◽  
Author(s):  
Manisha Agarwal ◽  
Mani Sachdeva ◽  
Shalin Shah ◽  
Rajiv Raman ◽  
Padmaja Kumari Rani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Cross Sectional Study ◽  
Optical Coherence ◽  
Morphological Pattern ◽  
Cross Sectional ◽  
Ckd Stage ◽  
Morphological Patterns

Abstract PurposeTo correlate Optical coherence tomography (OCT) based morphological patterns of diabetic macular edema (DME), prognostic biomarkers and grade of diabetic retinopathy (DR) in patients with various stages of chronic kidney disease (CKD) secondary to diabetes. DesignMulticentric retrospective cross-sectional study conducted at seven centres across India.MethodsData from medical records of patients with DME and CKD was entered in a common excel sheet across all seven centers. Staging of CKD was based on estimated glomerular filtration rate (eGFR). ResultsThe most common morphological pattern of DME was cystoid pattern (42%) followed by the mixed pattern (31%). The proportion of different morphological patterns did not significantly vary across various CKD stages (p=0.836). Presence of external limiting membrane-ellipsoid zone (ELM-EZ) defects (p<0.001) and foveal sub-field thickness (p=0.024) showed a direct correlation with the stage of CKD which was statistically significant. Presence of hyper reflective dots (HRD) and disorganization of inner retinal layers (DRIL) showed no significant correlation with the stage of CKD. Sight threatening DR was found to increase from 70% in CKD stage-3 to 82% in stage-4 and 5 of CKD and this was statistically significant (p=0.03).ConclusionsCystoid morphological pattern followed by mixed type was the most common pattern of DME on OCT found in patients suffering from stage 3 to 5 of CKD. However, the morphological patterns of DME did not significantly vary across various CKD stages. ELM-EZ defects may be considered as an important OCT biomarker for advanced stage of CKD.

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