scholarly journals Machine-learning and Automatically Segmented Retinal Biomarkers Generate Spatial Heatmaps Predictive for Standard and Low Luminance Visual Acuity in Geographic Atrophy

2022 ◽  
Author(s):  
Konstantinos Balaskas ◽  
Sophie Glinton ◽  
Tiarnan Keenan ◽  
Livia Faes ◽  
Bart Liefers ◽  
...  
Keyword(s):  
Machine Learning ◽  
Visual Acuity ◽  
Pigment Epithelium ◽  
Clinical Care ◽  
Retinal Pigment ◽  
Model Performance ◽  
Geographic Atrophy ◽  
Imaging Biomarkers ◽  
Cross Sectional ◽  
Low Luminance

Abstract Objective: Predict visual function with machine-learning applied to automatically acquired quantitative imaging biomarkers in geographic atrophyDesign: Post-hoc analysis of data from a clinical trial and routine clinical care.Methods: Automated segmentation of OCT scans from 476 eyes (325 patients) with geographic atrophy. Machine learning modelling of resultant quantitative OCT (qOCT) biomarkers to predict cross-sectional visual acuity under both standard luminance (VA) and low luminance (LLVA) conditions.Main Outcome Measure: Correlation coefficient (R2) and mean absolute error (MAE) for cross-sectional VA and LLVA in Early Treatment Diabetic Retinopathy Study (ETDRS) letters.Results: Best-corrected VA under both standard luminance (R2 0.46 MAE 10.2 ETDRS letters) and low-luminance conditions (R2 0.25 MAE 12.1) could be predicted. The foveal region contributed the most (46.5%) toward model performance, with retinal pigment epithelium loss and outer retinal atrophy contributing the most (31.1%). For LLVA, however, features in the non-foveal regions were most important (74.5%), led by photoreceptor degeneration (38.9%).Conclusions: Our method of automatic qOCT segmentation demonstrates functional significance for vision in geographic atrophy, including LLVA. LLVA is itself predictive of geographic atrophy progression, implying that the predictive qOCT biomarkers provided by our model are also prognostic.

scholarly journals Hyperreflective Foci and Subretinal Fluid Are Potential Imaging Biomarkers to Evaluate Anti-VEGF Effect in Diabetic Macular Edema

2021 ◽  
Vol 12 ◽  
Author(s):  
Shiyue Qin ◽  
Chaoyang Zhang ◽  
Haifeng Qin ◽  
Hai Xie ◽  
Dawei Luo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Foveal Avascular Zone ◽  
Imaging Biomarkers ◽  
Hyperreflective Foci ◽  
Anti Vegf

Purpose: The aim was to investigate the effect and underlying mechanism of anti-vascular endothelial growth factor (anti-VEGF) in diabetic macular edema (DME) by optical coherence tomography angiography (OCTA).Methods: Twenty-five eyes in 18 treatment-naïve patients with DME were included. All eyes were imaged by OCTA at baseline and 1 week after monthly intravitreal aflibercept injection (IAI). Visual acuity was measured as best corrected visual acuity (BCVA). Additional parameters were evaluated by OCTA, including central macular thickness (CMT), the number of hyperreflective foci (HRF), foveal avascular zone (FAZ), vessel density (VD) in the deep capillary plexus (DCP), the en-face area of cystoid edema in DCP segmentation, and subretinal fluid (SRF) height.Results: The mean time between baseline and final follow-up by OCTA was 79.24 ± 38.15 (range, 28–163) days. Compared with baseline, BCVA was increased significantly after the 3rd IAI, while CMT was decreased significantly from the 1st IAI. SRF height and the area of cystoid edema in DCP segmentation were decreased significantly after the 2nd IAI compared with baseline. The number of HRF was decreased significantly after the 1st IAI (8.87 ± 9.38) compared with baseline (11.22 ± 10.63). However, FAZ’s area and perimeter as well as VD in DCP showed no significant changes post-treatment.Conclusion: Anti-VEGF is effective in treating DME, improving visual acuity and decreasing macular edema. The decreased HRF indicates anti-inflammatory effects of aflibercept to deactivate retinal microglia/macrophages. The decreased cystoid edema and SRF height indicated improved drainage function of Müller glial cells and retinal pigment epithelium after IAI.

scholarly journals Combined Hamartoma of the Retina and Retinal Pigment Epithelium in a Patient with Gorlin Syndrome: Spontaneous Partial Resolution of Traction Caused by Epiretinal Membrane

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
José L. Sánchez-Vicente ◽  
Miguel Contreras-Díaz ◽  
Trinidad Rueda ◽  
Enrique Rodríguez de la Rúa-Franch ◽  
Fredy E. Molina-Socola ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Epiretinal Membrane ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Spontaneous Resolution ◽  
Fundus Examination ◽  
Gorlin Syndrome ◽  
Clinical Context

Purpose. To describe the case of spontaneous resolution of epiretinal membrane in a patient with Combined Hamartoma of the Retina and Retinal Pigment Epithelium (CHR-RPE), in the clinical context of Gorlin Syndrome (GS).Methods. Observational case report of a 12-year-old female patient is presented. The diagnosis of CHRRPE was made by OCT and fundus examination, which showed a mound of disorganized tissue originating from retina and retinal pigment epithelium. Epiretinal membrane (EM) was also detected. Genetic study was performed to confirm the diagnosis of GS.Results. The patient was observed for 39 months, showing spontaneous resolution of the traction caused by the EM and improvement in visual acuity (VA), which was 20/80 at initial presentation, rising to 20/40 after follow-up period.Conclusions. The presence of EM in CHR-REP is a cause of reduction of visual acuity. Management of this condition is controversial; however, we would like to highlight that spontaneous resolution of the traction caused by EM is possible, resulting in recovery of VA.

scholarly journals Contrast sensitivity and visual acuity under low light conditions in macular telangiectasia type 2

2018 ◽  
Vol 103 (3) ◽  
pp. 398-403 ◽  
Author(s):  
Simone Müller ◽  
Tjebo F C Heeren ◽  
Roberto Bonelli ◽  
Marcus Fruttiger ◽  
Peter Charbel Issa ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Neutral Density Filter ◽  
Light Conditions ◽  
Low Light ◽  
Cross Sectional ◽  
Macular Telangiectasia ◽  
Low Luminance ◽  
Macular Telangiectasia Type 2

Background/AimMacular pigment optical density (MPOD) is centrally depleted early on in macular telangiectasia type 2 (MacTel). Contrast sensitivity (CS) might be related to MPOD, and thus impaired in early MacTel. The effect of low luminance was assessed on both CS and best corrected visual acuity (BCVA).MethodsThis is a cross-sectional study. Pelli-Robson charts were used for CS testing at 1 m in photopic (110 lux) and mesopic (1 lux) conditions. BCVA was tested with ETDRS charts and low luminance visual acuity (LLVA) with a 2.0 log unit neutral density filter. MPOD was obtained with dual-wavelength autofluorescence.ResultsOne hundred and three eyes of 52 patients with MacTel (mean±SD age 62.9±10.2, range 35–77) were compared with 34 healthy eyes of 17 controls (mean±SD age 65.2±7.4, range 53–78). CS was significantly lower in the eyes with MacTel. This impairment was higher in low light conditions (low light contrast sensitivity (LL-CS)). Eyes at the early stages of MacTel had significantly lower LL-CS than controls, but normal (photopic) CS. The results were similar but less pronounced for BCVA/LLVA. Decrease in CS was correlated with loss of MPOD.ConclusionsLow light conditions have a detrimental effect on visual performance in MacTel. Impaired CS might correlate with MPOD depletion as a pathognomonic finding in MacTel. Functional impairment might precede structural disintegration, indicating dysfunction at the cellular level. The applied tests might be useful as additional functional assessments in clinical routine and as outcome measures in future interventional clinical trials.

Origins of Ghost Drusen: A follow-up Analysis

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000011
Author(s):  
Caroline Bottin ◽  
Olivia Zambrowski ◽  
Giuseppe Querques ◽  
Salomon Yves Cohen ◽  
Mayer Srour ◽  
...  
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Geographic Atrophy ◽  
Primary Lesion ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Soft Drusen ◽  
Initial Lesions ◽  
Sd Oct

Purpose Ghost drusen (GD) are pyramidal or dome-shaped retinal pigment epithelium elevations observed in some geographic atrophy (GA) areas in the context of age-related macular degeneration (AMD). The purpose was to investigate the first morphologic features preceding GD on spectral-domain optical coherence tomography (SD-OCT) on patients with GA associated with AMD. Methods A retrospective observational study was performed on a series of patients with GA that had at least 3 years of follow-up. Using the follow-up tool of SD-OCT, we tracked the initial lesions that could lead to GD. Results Among 442 patients with GA, 37 had well defined GD (8%). We included the 17/37 patients (31 eyes) with at least 3 years of follow-up for analysis, which led to a total of 582 counted GD. Most GD were already present at the first visit, and remained stable. However, on 13 of the 582 analyzed GD (2.2%), soft drusen were shown as the initial lesion, which progressively turned into GD. Conclusions GD were observed in less than 10% of eyes with GA. None of the ghost drusen turned into another shaped lesion, suggesting that GD is a possible final stage of evolution. In a few cases, large drusen were shown as the primary lesion that progressed into GD.

scholarly journals Early Detection of Incipient Retinal Pigment Epithelium Atrophy Overlying Drusen with Fundus Autofluorescence vs. Spectral Domain Optical Coherence Tomography

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Anabel Rodríguez ◽  
Marc Biarnés ◽  
Rosa M. Coco-Martin ◽  
Anna Sala-Puigdollers ◽  
Jordi Monés
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Median Time ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Geographic Atrophy ◽  
Optical Coherence ◽  
Rpe Atrophy ◽  
Sd Oct

Purpose. This study aims to find out which tool, fundus autofluorescence (FAF) or spectral domain optical coherence tomography (SD-OCT), is more sensitive in detecting retinal pigment epithelium (RPE) demise overlying drusen and can, therefore, help predict geographic atrophy (GA) appearance in Age-Related Macular Degeneration (AMD). Methods. A single-site, retrospective, observational, longitudinal study was conducted. Patients with intermediate AMD (iAMD) (large (>125 μm) or intermediate (63–125 μm) drusen with hyper/hypopigmentation) with a minimum follow-up of 18 months were included. Drusen with overlying incipient RPE atrophy were identified on SD-OCT defined as choroidal hypertransmission or nascent geographic atrophy (nGA). These selected drusen were, then, traced backwards in time to determine if incipient RPE atrophy overlying drusen was observed on FAF (well-demarcated region of absence of autofluorescence) before, simultaneously, or after having detected the first signs of incipient RPE atrophy on SD-OCT. The number of drusen in which signs of incipient RPE atrophy was detected earlier using FAF or SD-OCT was compared. The time elapsed from the identification with the more sensitive method to the other was recorded and analyzed. Results. One hundred and thirty-three drusen in 22 eyes of 22 patients were included. Of these, 112 (84.2%) drusen showed choroidal hypertransmission and 21(15.8%) nGA. Early signs of atrophy overlying drusen were found simultaneously on SD-OCT and FAF in 52 cases (39.1%, 95% CI 30.8–47.9%), earliest on FAF in 51 (38.3%, 95% CI 30.0–47.2%) and first on SD-OCT in 30 (22.6%, 95% CI 15.8–30.6%; p<0.05). Statistically significant differences were found between both techniques (p=0.005), with FAF detecting it earlier than SD-OCT. When RPE atrophy was found first on FAF, the median time to diagnosis with SD-OCT was 6.6 months (95% CI 5.5 to 8.6), while if detection occurred earlier on SD-OCT, the median time until identification with FAF was 12.6 months (95% CI 6.0 to 23.4; p=0.0003). Conclusions. In iAMD cases in which early atrophy overlying drusen is not detected simultaneously in FAF and SD-OCT, FAF was significantly more sensitive. Nevertheless, a multimodal approach is recommended and required to evaluate these patients.

scholarly journals Influence of the foveal curvature on myopic macular complications

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Un Chul Park ◽  
Dae Joong Ma ◽  
Woon Hyung Ghim ◽  
Hyeong Gon Yu
Keyword(s):  
Refractive Error ◽  
Axial Length ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Cross Sectional Study ◽  
Optical Coherence Tomography Image ◽  
Cross Sectional ◽  
Curvature Index ◽  
Tomography Image ◽  
And Control

AbstractIn this cross-sectional study, we investigated whether a foveal curvature affects the development of two major myopic macular complications, myopic traction maculopathy (MTM) and myopic choroidal neovascularization (mCNV). In high myopic eyes (axial length ≥ 26.5 mm, refractive error ≤ −6 diopters) with posterior staphyloma, three different parameters of foveal curvature (staphyloma height, coefficient a, and curvature index) calculated based on the retinal pigment epithelium hyperreflective line in spectral domain optical coherence tomography image were compared among the MTM (72 eyes), mCNV (58 eyes), and control (69 eyes) group. The three curvature parameters showed a significant correlation with each other (all P’s < 0.001). The axial length, refractive error, and staphyloma types were comparable among the groups, but the means of all three curvature parameters were significantly greater in the MTM group compared to the mCNV and control groups (all P’s < 0.001). Furthermore, the curvature parameters had a significant correlation with myopic severity in the MTM group, but not in the other groups. These results suggest that a steeper change of foveal curvature plays a role in the development of MTM but not mCNV in high myopes.

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

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.

Diagnosis and treatment of peripheral exudative haemorrhagic chorioretinopathy

2019 ◽  
Vol 104 (6) ◽  
pp. 874-878 ◽  
Author(s):  
Sarah Vandefonteyne ◽  
Jean-Pierre Caujolle ◽  
Laurence Rosier ◽  
John Conrath ◽  
Gabriel Quentel ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Multimodal Imaging ◽  
Chart Review ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Choroidal Melanoma ◽  
Endothelial Growth Factor

PurposePeripheral exudative haemorrhagic chorioretinopathy (PEHCR) is a rare disorder that is often misdiagnosed. The aim of this study was to better characterise PEHCR and to assess treatment options.Material and methodsRetrospective multicentric chart review.ResultsOf 84 eyes (69 patients) with PEHCR referred between 2005 and 2017, the most common referral diagnosis was choroidal melanoma (41.3%). Bilateral involvement was found in 21.7% of cases. Haemorrhagic retinal pigment epithelium detachment was the most common peripheral lesion (53.6%). Maculopathy was associated with peripheral lesions in 65.8% of cases. PEHCR lesions were mostly heterogeneous (58.8%) on B-scan ultrasonography. Choroidal neovascularisation was found in 10 eyes (26.3%) out of 38 eyes that underwent fluorescein angiography. Polyps were observed in 14 eyes (58.3%) out of 24 eyes that underwent indocyanine green angiography. Fifty-one eyes were treated (62.2%). Intravitreal injections (IVTI) of antivascular endothelial growth factor (VEGF) were the most used treatment (36.6%) before laser photocoagulation, photodynamic therapy, vitrectomy and cryotherapy. Only vitrectomy improved visual acuity. Most lesions (65.6%) regressed at the last follow-up visit.ConclusionIn case of PEHCR, multimodal imaging is useful to avoid misdiagnosis, to characterise PEHCR lesions and to guide treatment strategies. Regression of PEHCR lesions was observed in two-thirds of the patients. Vitrectomy improved visual acuity. More than a third of patients underwent anti-VEGF IVTI. Further studies are needed to assess IVTI’s efficacy.

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