scholarly journals Optical coherence tomography findings predictive of response to treatment in diabetic macular edema

2018 ◽  
Vol 46 (11) ◽  
pp. 4455-4464 ◽  
Author(s):  
Young Joo Cho ◽  
Dong Hyun Lee ◽  
Min Kim
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Serous Retinal Detachment ◽  
Intravitreal Bevacizumab ◽  
Internal Limiting Membrane ◽  
Response To Treatment ◽  
Optical Coherence ◽  
Sd Oct

Objective To evaluate the short-term efficacy of intravitreal bevacizumab (IVB) and posterior sub-tenon triamcinolone injections (PSTI) on the basis of spectral-domain optical coherence tomography (SD-OCT) patterns in diabetic macular edema (DME). Methods We retrospectively reviewed 73 eyes of 73 patients with DME. Based on the presence of serous retinal detachment (SRD), eyes were categorized into two groups, and either IVB or PSTI treatment was performed. Central macular thickness (CMT) and the degree of SRD were assessed preoperatively and 1 month postoperatively. The severity of intraretinal edema was approximated based on the distance from the external limiting membrane to the internal limiting membrane. Results In eyes with SRD, reduction of SRD was greater with IVB than with PSTI. Moreover, reduction of intraretinal edema was greater with PSTI than with IVB. In eyes without SRD, PSTI achieved greater CMT reduction, compared with IVB. Conclusions In DME patients with SRD, IVB achieved greater reduction of SRD, compared with PSTI; however, intraretinal edema responded more favorably to PSTI, regardless of the presence of SRD. Our results suggest that the classification of DME based on OCT findings may be useful to predict responses to IVB or PSTI treatments.

scholarly journals External limiting membrane: retinal structural barrier in diabetic macular edema

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sandeep Saxena ◽  
Levent Akduman ◽  
Carsten H. Meyer
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Barrier Effect ◽  
External Limiting Membrane ◽  
Ellipsoid Zone ◽  
Structural Barrier ◽  
Sd Oct

AbstractAdvances in spectral-domain optical coherence tomography (SD-OCT) technology have enhanced the understanding of external limiting membrane (ELM) and ellipsoid zone (EZ) in diabetic macular edema. An increase in VEGF has been demonstrated to be associated with sequential ELM and EZ disruption on SD-OCT. An intact ELM is a prerequisite for an intact EZ in DME. Anti-VEGF therapy leads to restoration of barrier effect of ELM. The ELM restores first followed by EZ restoration.

scholarly journals A Multitask Deep-Learning System to Classify Diabetic Macular Edema for Different Optical Coherence Tomography Devices: A Multicenter Analysis

2021 ◽  
Author(s):  
Fangyao Tang ◽  
Xi Wang ◽  
An-ran Ran ◽  
Carmen KM Chan ◽  
Mary Ho ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Deep Learning ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Three Dimensional ◽  
Learning System ◽  
Optical Coherence ◽  
Automated Classification

<a><b>Objective:</b></a> Diabetic macular edema (DME) is the primary cause of vision loss among individuals with diabetes mellitus (DM). We developed, validated, and tested a deep-learning (DL) system for classifying DME using images from three common commercially available optical coherence tomography (OCT) devices. <p><b>Research Design and Methods:</b> We trained and validated two versions of a multi-task convolution neural network (CNN) to classify DME (center-involved DME [CI-DME], non-CI-DME, or absence of DME) using three-dimensional (3D) volume-scans and two-dimensional (2D) B-scans respectively. For both 3D and 2D CNNs, we employed the residual network (ResNet) as the backbone. For the 3D CNN, we used a 3D version of ResNet-34 with the last fully connected layer removed as the feature extraction module. A total of 73,746 OCT images were used for training and primary validation. External testing was performed using 26,981 images across seven independent datasets from Singapore, Hong Kong, the US, China, and Australia. </p> <p><b>Results:</b> In classifying the presence or absence of DME, the DL system achieved area under the receiver operating characteristic curves (AUROCs) of 0.937 (95% CI 0.920–0.954), 0.958 (0.930–0.977), and 0.965 (0.948–0.977) for primary dataset obtained from Cirrus, Spectralis, and Triton OCTs respectively, in addition to AUROCs greater than 0.906 for the external datasets. For the further classification of the CI-DME and non-CI-DME subgroups, the AUROCs were 0.968 (0.940–0.995), 0.951 (0.898–0.982), and 0.975 (0.947–0.991) for the primary dataset and greater than 0.894 for the external datasets. </p> <p><b>Conclusion:</b> We demonstrated excellent performance with a DL system for the automated classification of DME, highlighting its potential as a promising second-line screening tool for patients with DM, which may potentially create a more effective triaging mechanism to eye clinics. </p>

Optical Coherence Tomography Features During the Evolution of Serous Retinal Detachment in Patients with Diabetic Macular Edema

2008 ◽  
Vol 145 (2) ◽  
pp. 289-296.e1 ◽  
Author(s):  
David Gaucher ◽  
Clemence Sebah ◽  
Ali Erginay ◽  
Belkacem Haouchine ◽  
Ramin Tadayoni ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Serous Retinal Detachment ◽  
Optical Coherence

Effect of Intravitreal Bevacizumab Based on Optical Coherence Tomography Patterns of Diabetic Macular Edema

2011 ◽  
Vol 226 (3) ◽  
pp. 138-144 ◽  
Author(s):  
Moosang Kim ◽  
Pyung Lee ◽  
Younggyun Kim ◽  
Seung-Young Yu ◽  
Hyung-Woo Kwak
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Optical Coherence

scholarly journals Discrepancies between Spectral Domain Optical Coherence Tomography and Fluorescein Angiography in Detecting Uveitic Macular Edema

Folia Medica ◽  
2016 ◽  
Vol 57 (3-4) ◽  
pp. 207-215 ◽  
Author(s):  
Vesela T. Mitkova-Hristova ◽  
Marieta I. Konareva-Kostianeva ◽  
Arsenia M. Balian ◽  
Nina S. Stoyanova ◽  
Maria A. Semerdzhieva
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Serous Retinal Detachment ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Uveitic Macular Edema ◽  
Highly Sensitive ◽  
Sd Oct ◽  
Rule Out

AbstractAIM: To compare spectral-domain optical coherence tomography (SD-OCT) with fluorescein angiography (FA) in detecting macular edema in patients with uveitis and analyse discrepancies in the findings obtained by the two methods. METHODS: The study included 133 eyes from 117 patients with uveitis that had SD-OCT (RTVue-100/ Optovue) and FA (Topcon TRC 50DX) scans performed to detect or rule out macular edema. RESULTS: Macular edema was found in 57 (42.9%) of the 133 surveyed eyes. In 37 eyes (27.8%) macular edema was confirmed by both imaging methods. In 17 eyes (12.8%) macular edema was detected on SD-OCT but not on FA;in 15 eyes of these the edema was diffuse, and in 2 eyes - serous retinal detachment was verified in the macular area. Focal macular edema was detected on FA in three eyes (2.3%) in which SD-OCT showed normal finding. In 76 eyes (57.1%) no pathological changes in the macula were observed on both SD-OCT and FA. Kappa coefficient was 0.675 at p < 0.001. The agreement rate between the two methods calculated using Kendall’s tau-b was 0.693 at p < 0.001. CONCLUSION: Fluorescein angiography and spectral domain optical coherence tomography are highly sensitive methods used in detecting macular edema in patients with uveitis, but they might fail to be efficient in this if used independently. Optical coherence tomography is a more informative method, especially in diagnosing diffuse macular edema.

scholarly journals Evaluation of Changes in Macular Perfusion Detected by Optical Coherence Tomography Angiography following 3 Intravitreal Monthly Bevacizumab Injections for Diabetic Macular Edema in the IMPACT Study

2020 ◽  
Vol 2020 ◽  
pp. 1-14 ◽  
Author(s):  
Ayman G. Elnahry ◽  
Ahmed A. Abdel-Kader ◽  
Karim A. Raafat ◽  
Khaled Elrakhawy
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Intravitreal Bevacizumab ◽  
Vascular Density ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Macular Area ◽  
The Impact

Objective. To evaluate macular perfusion changes following intravitreal bevacizumab injections for diabetic macular edema (DME) using spectral domain optical coherence tomography angiography (SD-OCTA). Methods. This study was a prospective noncomparative interventional case series. Treatment naïve patients with DME underwent full ophthalmological examination and SD-OCTA scanning at baseline and after 3 intravitreal bevacizumab injections. Both the 6 × 6 and 3 × 3 mm macular scan protocols were used. Pretreatment and posttreatment OCTA images were automatically aligned using a commercially available retina alignment software (i2k Align Retina software); then the fractal dimension (FD), vascular density (VD), and skeleton VD changes were obtained at the full retinal thickness (Full) and superficial (SCP) and deep (DCP) capillary plexuses after processing images using a semiautomated program. The foveal avascular zone (FAZ) was manually measured and FD was calculated using the FracLac plugin of ImageJ. Results. Forty eyes of 26 patients were included. Following injections, there were an 8.1% increase in FAZ, 1.3% decrease in FD-Full and FD-SCP, 1.9% decrease in FD-DCP, 8% decrease in VD-Full, 9.1% decrease in VD-SCP, 10.6% decrease in VD-DCP, 13.3% decrease in skeleton VD-Full, 12.5% decrease in skeleton VD-SCP, and 16.3% decrease in skeleton VD-DCP in the 6 × 6 mm macular area and a 2.6% decrease in FD-Full, 3.4% decrease in FD-SCP, 11.5% decrease in VD-Full, 14.3% decrease in VD-SCP, and 25.1% decrease in skeleton VD-SCP in the 3 × 3 mm macular area which were all statistically significant p<0.05. Using univariate and multivariate analysis, the pretreatment FD, VD, and skeleton VD at each capillary layer significantly negatively correlated with the change in FD, VD, and skeleton VD at the corresponding capillary layer, respectively p<0.05. Conclusion. OCTA is a useful noninvasive tool for quantitative evaluation of macular perfusion changes following DME treatment. This trial is registered with NCT03246152.

scholarly journals Role of Inflammation in Classification of Diabetic Macular Edema by Optical Coherence Tomography

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yoo-Ri Chung ◽  
Young Ho Kim ◽  
Seong Jung Ha ◽  
Hye-Eun Byeon ◽  
Chung-Hyun Cho ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Microstructural Analysis ◽  
Optical Coherence ◽  
Therapeutic Approaches ◽  
Technical Developments ◽  
Abnormal Accumulation

Diabetic macular edema (DME) is the abnormal accumulation of fluid in the subretinal or intraretinal spaces in the macula in patients with diabetic retinopathy and leads to severely impaired central vision. Technical developments in retinal imaging systems have led to many advances in the study of DME. In particular, optical coherence tomography (OCT) can provide longitudinal and microstructural analysis of the macula. A comprehensive review was provided regarding the role of inflammation using OCT-based classification of DME and current and ongoing therapeutic approaches. In this review, we first describe the pathogenesis of DME, then discuss the classification of DME based on OCT findings and the association of different types of DME with inflammation, and finally describe current and ongoing therapeutic approaches using OCT-based classification of DME. Inflammation has an important role in the pathogenesis of DME, but its role appears to differ among the DME phenotypes, as determined by OCT. It is important to determine how the different DME subtypes respond to intravitreal injections of steroids, antivascular endothelial growth factor agents, and other drugs to improve prognosis and responsiveness to treatment.

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