Assessment of Scleral Contour Changes in High Myopia by Optical Coherence Tomography

Background/aimsTo apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images.MethodsIn this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four independent convolutional neural network (CNN) models to identify the following four vision-threatening conditions in high myopia: retinoschisis, macular hole, retinal detachment and pathological myopic choroidal neovascularisation. Focal Loss was used to address class imbalance, and optimal operating thresholds were determined according to the Youden Index.ResultsIn the independent test dataset, the areas under the receiver operating characteristic curves were high for all conditions (0.961 to 0.999). Our AI system achieved sensitivities equal to or even better than those of retina specialists as well as high specificities (greater than 90%). Moreover, our AI system provided a transparent and interpretable diagnosis with heatmaps.ConclusionsWe used OCT macular images for the development of CNN models to identify vision-threatening conditions in high myopia patients. Our models achieved reliable sensitivities and high specificities, comparable to those of retina specialists and may be applied for large-scale high myopia screening and patient follow-up.

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A meta-analysis of alterations in the retina and choroid in high myopia assessed by optical coherence tomography angiography

Ophthalmic Research ◽

10.1159/000517096 ◽

2021 ◽

Author(s):

Xiao-qin Wang ◽

Liu-zhi Zeng ◽

Ming Chen ◽

Long-qian Liu

Keyword(s):

Optical Coherence Tomography ◽

High Myopia ◽

Optical Coherence Tomography Angiography ◽

Meta Analysis ◽

Optical Coherence

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Geographic mapping of choroidal thickness in myopic eyes using 1050-nm spectral domain optical coherence tomography

Journal of Innovative Optical Health Sciences ◽

10.1142/s1793545815500121 ◽

2015 ◽

Vol 08 (04) ◽

pp. 1550012 ◽

Cited By ~ 8

Author(s):

Qinqin Zhang ◽

Maureen Neitz ◽

Jay Neitz ◽

Ruikang K. Wang

Keyword(s):

Optical Coherence Tomography ◽

High Myopia ◽

Choroidal Thickness ◽

Retinal Pigment ◽

Reduction Rate ◽

Radial Distance ◽

Spectral Domain ◽

Temporal Region ◽

Optical Coherence ◽

The Mean

Purpose: To provide a geographical map of choroidal thickness (CT) around the macular region among subjects with low, moderate and high myopia. Methods: 20 myopic subjects (n = 40 eyes) without other identified pathologies participated in this study: 20 eyes of ≤ 3 diopters (D) (low myopic), 10 eyes between -3 and -6D (moderate myopic), and 10 eyes of ≥ 6D (high myopic). The mean age of subjects was 30.2 years (± 7.6 years; range, 24 to 46 years). A 1050 nm spectral-domain optical coherence tomography (SD-OCT) system, operating at 120 kHz imaging rate, was used in this study to simultaneously capture 3D anatomical images of the choroid and measure intraocular length (IOL) in the subject. The 3D OCT images of the choroid were segmented into superior, inferior, nasal and temporal quadrants, from which the CT was measured, representing radial distance between the outer retinal pigment epithelium (RPE) layer and inner scleral border. Measurements were made within concentric regions centered at fovea centralis, extended to 5 mm away from fovea at 1 mm intervals in the nasal and temporal directions. The measured IOL was the distance from the anterior cornea surface to the RPE in alignment along the optical axis of the eye. Statistical analysis was performed to evaluate CT at each geographic region and observe the relationship between CT and the degree of myopia. Results: For low myopic eyes, the IOL was measured at 24.619 ± 0.016 mm. The CT (273.85 ± 49.01 μm) was greatest under fovea as is in the case of healthy eyes. Peripheral to the fovea, the mean CT decreased rapidly along the nasal direction, reaching a minimum of 180.65 ± 58.25μm at 5 mm away from the fovea. There was less of a change in thickness from the fovea in the temporal direction reaching a minimum of 234.25 ± 42.27 μm. In contrast to the low myopic eyes, for moderate and high myopic eyes, CTs were thickest in temporal region (where CT = 194.94 ± 27.28 and 163 ± 34.89 μm, respectively). Like the low myopic eyes, moderate and high myopic eyes had thinnest CTs in the nasal region (where CT = 100.84 ± 16.75 and 86.64 ± 42.6μm, respectively). High myopic eyes had the longest mean IOL (25.983 ± 0.021mm), while the IOL of moderate myopia was 25.413 ± 0.022 mm (**p < 0.001). The CT reduction rate was calculated at 31.28 μm/D (diopter) from low to moderate myopia, whilst it is 13.49 μm/D from moderate to high myopia. The similar tendency was found for the IOL reduction rate in our study: 0.265 mm/D from low to moderate myopia, and 0.137 mm/D from moderate to high myopia. Conclusion: The CT decreases and the IOL increases gradually with the increase of myopic condition. The current results support the theory that choroidal abnormality may play an important role in the pathogenesis of myopic degeneration.

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Comparison between Widefield Optical Coherence Tomography Devices in Eyes with High Myopia

Diagnostics ◽

10.3390/diagnostics11040658 ◽

2021 ◽

Vol 11 (4) ◽

pp. 658

Author(s):

Federico Corvi ◽

Federico Zicarelli ◽

Matteo Airaldi ◽

Salvatore Parrulli ◽

Mariano Cozzi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

High Myopia ◽

Cross Sectional Study ◽

Horizontal Line ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Image Artifact ◽

Control Subjects ◽

And Control

Background: To compare four different optical coherence tomography (OCT) devices for visualization of retinal and subretinal layers in highly myopic eyes. Methods: In this prospective, observational, cross-sectional study, consecutive patients with high myopia and control subjects were imaged by four OCT devices: Spectralis OCT2, PlexElite 2.0 100 kHz, PlexElite 2.0 200 kHz and the Canon Xephilio OCT-S1. The acquisition protocol for comparison consisted of single vertical and horizontal line scans centered on the fovea. Comparison between the devices in the extent of visible retina, presence of conjugate image or mirror artifacts, visibility of the sclerochoroidal interface and retrobulbar tissue. Results: 30 eyes with high myopia and 30 control subjects were analyzed. The visualized RPE length was significantly different between the OCT devices with Xephilio OCT-S1 imaging the largest extent (p < 0.0001). The proportion of eyes with conjugate image artifact was significantly higher with the Spectralis OCT (p < 0.0001), and lower with the PlexElite 200 kHz (p < 0.0001). No difference in visibility of the sclerochoroidal interface was noted among instruments. The retrobulbar tissue was visible in a higher proportion of eyes using swept-source PlexElite 100 kHz and 200 kHz (p < 0.007) compared to the other devices. Conclusions: In highly myopic eyes, the four OCT devices demonstrated significant differences in the extent of the retina imaged, in the prevalence of conjugate image artifact, and in the visualization of the retrobulbar tissue.

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Analysis of Peripapillary Geometric Characters in High Myopia Using Swept-Source Optical Coherence Tomography

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.15-17510 ◽

2016 ◽

Vol 57 (1) ◽

pp. 137 ◽

Cited By ~ 6

Author(s):

Tomoko Asai ◽

Yasushi Ikuno ◽

Masahiro Akiba ◽

Tsutomu Kikawa ◽

Shinichi Usui ◽

...

Keyword(s):

Optical Coherence Tomography ◽

High Myopia ◽

Optical Coherence ◽

Swept Source

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Investigation of Macular Choroidal Thickness and Blood Flow Change by Optical Coherence Tomography Angiography After Posterior Scleral Reinforcement

Frontiers in Medicine ◽

10.3389/fmed.2021.658259 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zheng Zhang ◽

Yue Qi ◽

Wenbin Wei ◽

Zi-Bing Jin ◽

Wen Wang ◽

...

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

High Myopia ◽

Choroidal Thickness ◽

Optical Coherence Tomography Angiography ◽

Pathologic Myopia ◽

Optical Coherence ◽

Short Period ◽

Posterior Scleral Reinforcement

Purpose: This work aimed to study the effect of posterior scleral reinforcement (PSR) on choroidal thickness (CT) and blood flow.Methods: This study included 25 eyes of 24 patients with high myopia ( ≤ -6.0 dioptres or axial length ≥ 26.0 mm) who underwent PSR surgery. All patients completed the 1-month follow-up visit. Myopic macular degeneration (MMD) was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification based on color fundus photographs. Swept-source optical coherence tomography angiography (SSOCTA) was performed to investigate CT, choroidal perfusion area (CPA), and choriocapillaris perfusion area (CCPA) change following PSR surgery.Results: The distribution of MMD categories was 9 (36.0%) in category 1, 10 (40.0%) in category 2, and 6 (24.0%) in category 3 or 4. MMD severity was strongly correlated with CT (all P < 0.01) and CPA (all P < 0.04). Postoperative CT at each sector increased significantly at 1 week's follow-up, compared to preoperative measures (all P < 0.05). Postoperative CPA at subfoveal, superior, inferior, and nasal sectors also increased significantly 1 week after PSR surgery (all P < 0.05). Moreover, the increased CT, CPA, and CCPA remain after PSR surgery at 1 month's follow-up, but the difference was not statistically significant.Conclusions: We demonstrated that the CT and choroidal blood flow increased significantly in patients with high myopia who underwent PSR surgery in a short period of time. In addition, the CT and CPA were independently associated with MMD. However, whether the transient improvement of the choroidal circulation could prevent long-term progression of high myopia warrants further study in the future.

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The Association between Macular Thickness and Axial Length in Myopic Eyes

BioMed Research International ◽

10.1155/2019/8913582 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yeon Woong Chung ◽

Moon Young Choi ◽

Jung-sub Kim ◽

Jin-woo Kwon

Keyword(s):

Optical Coherence Tomography ◽

Axial Length ◽

High Myopia ◽

Polynomial Regression ◽

Macular Thickness ◽

Optical Coherence ◽

Regression Analyses ◽

Foveal Thickness ◽

P Values ◽

The Relationship

Purpose. To investigate the relationship between macular thickness and axial length (AL) in myopic eyes. Methods. We included 441 myopic eyes in this study and measured macular thickness at the fovea and in other macular regions, using optical coherence tomography. We got thickness difference indices (TDIs) which by definition are the values of thickness difference obtained by subtracting the foveal thickness from that of each macula sector to evaluate macular contour. We then analyzed the relationships between AL and foveal thickness and AL and the TDIs of each macular sector. Results. In polynomial regression analyses, foveal thickness slope was relatively flat up to an AL of 25.5 mm and began to rise from 25.5–26.0 mm. The TDIs were also relatively flat up to AL of 25.5mm and started to show steepened negative slopes from around AL of 25.5 mm. When grouping myopia participants as high myopia or non-high myopia based on AL of 25.5mm, all macular indices of the high myopia group showed significant correlation with AL (all p values <0.01). But all indices of non-high myopia group had no significant correlation with AL. Conclusions. Average macular thickness profiles showed that appreciable changes started at an AL of 25.5mm.

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