scholarly journals Choroidal Neovascularization Screening on OCT-Angiography Choriocapillaris Images by Convolutional Neural Networks

2021 ◽  
Vol 11 (19) ◽  
pp. 9313
Author(s):  
Kawther Taibouni ◽  
Alexandra Miere ◽  
Abdourahmane Samake ◽  
Eric Souied ◽  
Eric Petit ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Test Set ◽  
Non Invasive ◽  
Age Related ◽  
Wet Amd

Choroidal Neovascularization (CNV) is the advanced stage of Age-related Macular Degeneration (AMD), which is the leading cause of irreversible visual loss for elder people in developed countries. Optical Coherence Tomography Angiography (OCTA) is a recent non-invasive imaging technique widely used nowadays in diagnosis and follow-up of CNV. In this study, an automatic screening of CNV based on deep learning is performed using OCTA choriocapillaris images. CNV eyes (advanced wet AMD) are diagnosed among healthy eyes (no AMD) and eyes with drusen (intermediate AMD). An OCTA dataset of 1396 images is used to train and evaluate the model. A pre-trained convolutional neural network (CNN) is fine-tuned and validated on 80% of the dataset while the remaining 20% is used independently for predictions. The model can accurately detect CNV on the test set with an accuracy of 89.74%, precision of 0.96 and 0.99 area under the curve of the receiver operating characteristic. A good overall classification accuracy of 88.46% is obtained on a balanced test set. Detailed analysis of misclassified images shows that they are also considered ambiguous images for expert clinicians. This novel CNN-based application is truly a breakthrough to assist clinicians in the challenging task of screening for neovascular complications.

scholarly journals Outer retinal tubulation formation and clinical course of advanced age-related macular degeneration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alessandro Arrigo ◽  
Emanuela Aragona ◽  
Ottavia Battaglia ◽  
Andrea Saladino ◽  
Alessia Amato ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Müller Cells ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Advanced Age ◽  
Age Related ◽  
Dry Amd ◽  
Foveal Sparing ◽  
Wet Amd

AbstractOuter retinal tubulations (ORT) are a relatively new finding characterizing outer retinal atrophy. The main aim of the present study was to describe ORT development in advanced age-related macular degeneration (AMD) and to assess its relationship with disease’s severity. Patients with advanced AMD characterized either by macular neovascularization or geographic atrophy, showing signs of outer retinal disruption or retinal pigment epithelium atrophy on structural optical coherence tomography (OCT) at the inclusion examination were prospectively recruited. All the patients underwent complete ophthalmologic evaluation, structural OCT scans and fundus autofluorescence imaging. The planned follow-up was of 3-years. Main outcome measures were ORT prevalence, mechanism of ORT formation, mean time needed for complete ORT formation, best-corrected visual acuity (BCVA), definitely decreased autofluorescence (DDAF) area, questionably decreased autofluorescence (QDAF) area, retinal layer thickness, foveal sparing, number of intravitreal injections. We also assessed the possible role of external limiting membrane (ELM) and Müller cells in ORT pathogenesis. Seventy eyes (70 patients) were included; 43 showed dry AMD evolving to geographic atrophy, while 27 displayed the features of wet AMD. Baseline BCVA was 0.5 ± 0.5 LogMAR, decreasing to 0.9 ± 0.5 LogMAR at the 3-year follow-up (p < 0.01). We detected completely formed ORT in 26/70 eyes (37%), subdivided as follows: 20 eyes (77%) wet AMD and 6 eyes (23%) dry AMD (p < 0.01). ORT took 18 ± 8 months (range 3–35 months) to develop fully. We described the steps leading to ORT development, characterized by progressive involvement of, and damage to the photoreceptors, the ELM and the RPE. Eyes displaying ORT were associated with a smaller QDAF area, less retinal layers damage and lower rate of foveal sparing than eyes free of ORT (p < 0.01). We also described pigment accumulations simulating ORT, which were detected in 16/70 eyes (23%), associated with a greater loss of foveal sparing, increased DDAF area and smaller QDAF area at the 3-year follow-up (p < 0.01). In conclusion, this study provided a description of the steps leading to ORT development in AMD. ELM and Müller cells showed a role in ORT pathogenesis. Furthermore, we described a subtype of pigment hypertrophy mimicking ORT, evaluating its clinical utility.

Therapeutic effects of a novel siRNA-based anti-VEGF (siVEGF) nanoball for the treatment of choroidal neovascularization

Nanoscale ◽  
2017 ◽  
Vol 9 (40) ◽  
pp. 15461-15469 ◽  
Author(s):  
Na-Kyung Ryoo ◽  
Jihwang Lee ◽  
Hyunjoo Lee ◽  
Hye Kyoung Hong ◽  
Hyejin Kim ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Therapeutic Effects ◽  
Anti Vegf ◽  
Age Related

Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries and is characterized by the development of choroidal neovascularization (CNV).

Transpupillary Thermotherapy of Juxtafoveal Recurrent Choroidal Neovascularization

2003 ◽  
Vol 13 (5) ◽  
pp. 453-460 ◽  
Author(s):  
F. Cardillo Piccolino ◽  
C.M. Eandi ◽  
L. Ventre ◽  
R.C. Rigault De La Longrais ◽  
F.M. Grignolo
Keyword(s):  
Low Power ◽  
Choroidal Neovascularization ◽  
Laser Photocoagulation ◽  
Age Related Macular Degeneration ◽  
Retinal Damage ◽  
Transpupillary Thermotherapy ◽  
Age Related ◽  
Minute Duration ◽  
Conventional Laser

Purpose To evaluate the effectiveness of low power transpupillary thermotherapy (TTT) in treating juxtafoveal recurrent choroidal neovascularization (CNV) after laser photocoagulation in patients with age-related macular degeneration (ARMD). Methods Eight eyes of eight patients with ARMD and juxtafoveal recurrent CNV were treated with low power TTT, delivered using an 810-nm diode laser with 350 mW, 2.0 mm spot, and 1-minute duration. Visual acuity (VA) ranged from 20/100 to 20/50. Treatment effect was evaluated by fluorescein angiography, indocyanine green angiography, and VA measurements (Early Treatment Diabetic Retinopathy Study) at 1-week, 2-week, and monthly follow-up visits. Results NO retinal damage was visible ophthalmoscopically during treatment. At the first follow-up visit, seven eyes had obliteration of CNV and one eye required a second TTT application. VA was unchanged in six eyes, improved in one eye, and worsened in one eye. Recurrences occurred in all eyes between 1 and 7 months after TTT and were treated with photodynamic therapy (PDT). More than two PDT treatments were performed in each eye in the year after recurrence. Conclusions LOW power TTT is as able to close juxtafoveal recurrent CNV as is high power conventional laser photocoagulation but does not prevent recurrences. Further intervention with TTT in order to treat recurrences is under investigation.

scholarly journals Emerging Therapies for Wet-Form (Neovascular) Age-Related Macular Degeneration

2017 ◽  
pp. 235-240
Keyword(s):  
Macular Degeneration ◽  
Viral Vectors ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Vegf Inhibitors ◽  
Anti Vegf ◽  
Age Related ◽  
Emerging Therapies ◽  
Endothelial Growth Factor ◽  
Wet Amd

Age-related macular degeneration (AMD) is the most common cause of permanent visual loss in persons over 65 years of age in developed countries. Currently, intravitreal vascular endothelial growth factor (VEGF) inhibitors are the mainstay of the treatment for patients with wet AMD. Despite significant improvements in visual acuity since the beginning of these therapies, challenges in the treatment of wet AMD are still present. Therefore, there are ongoing researches such as sustained-release anti-VEGF therapy, novel generation anti-VEGF agents, viral vectors to modify genetic transcription, and combination therapies. In this review, it is aimed to discuss these emerging therapies.

Efficacy of Vitrectomy and Macular Hole Repair in Eyes With Dry Age-Related Macular Degeneration

2019 ◽  
Vol 3 (2) ◽  
pp. 94-98
Author(s):  
Omar M. Ismail ◽  
Lauren Mason ◽  
John O. Mason
Keyword(s):  
Macular Degeneration ◽  
Macular Hole ◽  
Age Related Macular Degeneration ◽  
Complication Rates ◽  
Age Related ◽  
Macular Holes ◽  
Pars Plana ◽  
Dry Amd ◽  
Wet Amd

Purpose: The purpose of this article is to examine the efficacy of macular hole repair in eyes with coexisting dry age-related macular degeneration (AMD). Methods: A retrospective analysis was performed of charts of 25 patients (27 eyes) diagnosed with mild to moderate dry AMD who underwent macular hole repair via 25-gauge pars plana vitrectomy between 2014 and 2016. Data of interest included anatomic failure rates, complication rates, and best-corrected visual acuity (BCVA) preoperatively, and at 1 month, 3 months, 6 months, and 12 months postoperatively. When available, data at each patient’s most recent visit were also analyzed. Results: Macular hole repair resulted in a statistically significant ( P < .05) visual improvement postoperatively, with BCVA increasing from 20/141 preoperatively to 20/33 1 year postoperatively. Mean BCVA at most recent visit was 20/41. Mean duration of follow-up was 13 months (range, 1-39 months). One of 27 (3.7%) macular holes failed to close after vitrectomy. One of 27 eyes (3.7%) progressed from dry to wet AMD. Four of 27 additional eyes (18.5%) were noted to have worsening of their AMD on exam over the course of follow-up. Conclusions: Macular hole repair in patients with coexisting dry AMD leads to a significant improvement in visual performance and has a low risk of failure or complication.

scholarly journals Forum ophthalmicum – how to take control over accumulation of diagnostic data from macular OCT with benefit for both doctor and patient?

2021 ◽  
Vol 8 (3) ◽  
pp. 160-165
Author(s):  
Dorota Maria Kaczmarek
Keyword(s):  
Treatment Effectiveness ◽  
Age Related Macular Degeneration ◽  
Single Patient ◽  
Anatomical Changes ◽  
Age Related ◽  
Diagnostic Time ◽  
Precise Analysis ◽  
Effectiveness Assessment ◽  
Wet Amd

Wet age-related macular degeneration (wet AMD) is a disease which requires regular diagnostic tests such as macular optical coherent tomography which is extremely important both in diagnosis and disease monitoring. With constant aging of the population, we are dealing with an increasing incidence rate of AMD, which makes it even more important to have a tool allowing for quick and precise analysis of anatomical changes in macular region, particularly in the current complicated epidemiological situation when diagnostic time should be used most efficiently to plan the follow-up treatment. Forum® software allows for the precise analysis of many tests performed in a single patient and combining it with treatment effectiveness assessment which substantially accelerates the diagnostics.

scholarly journals Choroidal neovascularization activity and structure by optical coherence tomography angiography in age related macular degeneration

2021 ◽  
Vol 6 (6-1) ◽  
pp. 12-18
Author(s):  
M. A. Kovalevskaya ◽  
O. A. Pererva
Keyword(s):  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Vascular System ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Type I ◽  
Neovascular Amd ◽  
Anti Vegf ◽  
Age Related

Background. In economically developed countries, age-related macular degeneration (AMD) is the leading cause of visual disability among the population of the older age group. The main criterion for the anti-VEGF treatment of neovascular AMD is the activity of choroidal neovascularization (CNV), which is determined by its confi guration. The search for optimal criteria for quantifying the state of the macular region in order to decide on the appointment of anti-VEGF therapy continues.Aim: improving the effi ciency of diagnosis and treatment of AMD based on the assessment of the configuration of vascular system on the “Key to Diagnosis II” platform.Material and methods. The study included 341 patients: 64 % (218 patients, 267 eyes) with non-neovascular AMD, 36 % (123 patients, 174 eyes) – with neovascular AMD. 56 patients (58 eyes) had active type I CNV. Group 1A – active CNV before treatment (9 patients, 9 eyes), group 1B – non-active CNV after treatment with antiVEGF (9 patients, 9 eyes); control group – 10 patients (10 eyes) without AMD. Analysis of OCT-angio images of choriocapillaries included the isolation of CNV, its area, fractal dimension (Df) and the complexity of the vascular system (CVS) counting.Results. Group 1A: Df – 1.5871 ± 0.05, CVS – 2.29 ± 0.29, area – 11734 ± 4866; group 1B: Df – 1.6462 ± 0.08, CVS – 1.65 ± 0.18, area – 6797 ± 3818; control: Df – 1.9167 ± 0.06, CVS – 1, area – 0. Significant differences were found for CVS (p = 0.0003). Df correlates with the CNV area (p = 0.7) and is probably an unreliable parameter due to incomplete visualization of active CNV.Conclusions. CVS is a quantitative biomarker for determining the activity of type 1 CNV in patients with AMD and can serve as a parameter for convolutional neural networks training for automated analysis of OCT angiography images based on the “Key to Diagnosis II” platform

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