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Dumitrescu OM, Zemba M, Brănișteanu DC, Pîrvulescu RA, Radu M, Stanca HT. Fundus Autofluorescence in Diabetic Retinopathy. J Pers Med 2024; 14:793. [PMID: 39201985 PMCID: PMC11355256 DOI: 10.3390/jpm14080793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 09/03/2024] Open
Abstract
Diabetic retinopathy is a leading cause of visual morbidity worldwide. Fundus autofluorescence is a rapid, non-invasive imaging modality that has gained increased popularity in recent years in the multimodal evaluation of diabetic retinopathy and, in particular, of diabetic macular oedema. Acquired using either a fundus camera or the confocal scanning laser ophthalmoscope, short-wavelength and near-infrared autofluorescence are the most used techniques in diabetic retinopathy. In diabetic macular oedema, short-wavelength autofluorescence, in its cystoid pattern, is useful for detecting cystoid macular oedema. Increased spot hyperautofluorescence in short-wavelength and granular changes in near-infrared autofluorescence correlate well with other imaging findings, indicating photoreceptor and retinal pigment epithelium damage and being associated with decreased visual acuity. While also being a marker of oxidative stress, increased short-wavelength autofluorescence in the setting of diabetic macular oedema appears to be a prognostic factor for poor visual outcome, even after the resolution of the intraretinal fluid. Autofluorescence also helps in the assessment of diabetic retinal pigment epitheliopathy and choroidopathy. Fundus autofluorescence is an evolving technology that will assist in gaining further insight into the pathophysiology of diabetic retinopathy and allow for a more comprehensive evaluation of these patients.
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Affiliation(s)
- Otilia-Maria Dumitrescu
- Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Mihail Zemba
- Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
- Department of Ophthalmology, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | | | - Ruxandra Angela Pîrvulescu
- Department of Ophthalmology, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Madalina Radu
- Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Horia Tudor Stanca
- Department of Ophthalmology, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
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Roy R, Chattree S, Kala U, Majumdar B, Desai J, Bhattacharya S, Sen A, Goel S, Thomas NR, Chowdhury M, Das K, Nigam E, Das D, Saurabh K. Multicolor imaging: Current clinical applications. Surv Ophthalmol 2024; 69:378-402. [PMID: 38122907 DOI: 10.1016/j.survophthal.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Multicolor (MC) imaging is an innovative pseudocolor fundus imaging modality based on confocal scanning laser ophthalmoscopy. It effectively scans the retina at different depths to create a composite image. The green reflectance image depicts the middle retinal while blue reflectance image provides images of the retinal surface. The infrared reflectance image depicts retinal structures at the level of outer retina and choroid. We systematically analyze published case reports, case series, and original articles on MC imaging where it has helped in discovering additional clinical features of retinal diseases not readily apparent on conventional color fundus photography and played a role in monitoring the response to treatment.
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Affiliation(s)
- Rupak Roy
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India.
| | - Surabhi Chattree
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Urvashi Kala
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Bristi Majumdar
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Janhavi Desai
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Sampurna Bhattacharya
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Ahana Sen
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | | | | | - Maitreyi Chowdhury
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Kalpita Das
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Eesh Nigam
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
| | - Debmalya Das
- Department of Vitreo Retina, Aditya Birla Sankara Nethralaya, 147, Mukundapur, E.M.Bypass, Kolkata 700099, West Bengal, India
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Venkatesh R, Handa A, Chitturi SP, Choudhary A, Prabhu V, Acharya I, Mangla R, Yadav NK, Chhablani J. Right-angled vessel characteristics in different stages of type 2 macular telangiectasia (MacTel). Eye (Lond) 2024; 38:1162-1167. [PMID: 38012385 PMCID: PMC11009321 DOI: 10.1038/s41433-023-02853-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 10/30/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE To study right-angled vessels (RAV) in disease progression and macular neovascularization in type 2 macular telangiectasia (MacTel) eyes. METHODS This retrospective image analysis study examined type 2 MacTel patients' multicolour® and OCT imaging records from January 2015 to March 2023. Age, gender, laterality, visual acuity, systemic disease, and follow-up duration were recorded. RAV characteristics were assessed using OCT and multicolour® images. This study examined RAV characteristics and type 2 MacTel disease stage. RESULTS In total, 270 eyes of 146 patients (97 females, 66%) with a mean age of 60.77 ± 9.34 years were studied. 153 (57%) eyes showed RAV. The non-proliferative stage of type 2 MacTel had either no RAV or a normal-calibre right-angled vein, while the proliferative stage had a right-angled artery and a dilated or normal-calibre RAV [p < 0.001]. RAV characteristics differed at the final follow-up (p < 0.001). 11 eyes transitioned from non-proliferative to proliferative after a median period of 26 months (range: 5-96 months). RAV characteristics changed from a normal calibre right-angled vein at presentation to a normal calibre vein and artery in 6 (55%) eyes and to a dilated vein and artery in 5 (45%) eyes respectively. CONCLUSION RAV characteristics may indicate type 2 MacTel stages. A right-angled artery in type 2 MacTel may indicate proliferative disease.
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Affiliation(s)
- Ramesh Venkatesh
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India.
| | - Ashit Handa
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Sai Prashanti Chitturi
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Ayushi Choudhary
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Vishma Prabhu
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Isha Acharya
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Rubble Mangla
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Naresh Kumar Yadav
- Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA
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Chandran K, Giridhar A, Desai S, Gopalakrishnan M, Indu VP, Sivaprasad S. Relevance of multicolor imaging, its component channels, and fundus autofluorescence in describing macular telangiectasia type-2 (MacTel) lesion characteristics. Indian J Ophthalmol 2024; 72:S125-S134. [PMID: 38131554 PMCID: PMC10833168 DOI: 10.4103/ijo.ijo_78_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/05/2023] [Accepted: 09/29/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE The aim of the study was to describe imaging characteristics and detection rates of phenotypic features in macular telangiectasia type-2 (MacTel) on multicolor (MC), blue reflectance (BR), green reflectance (GR), infrared reflectance (IR), and fundus autofluorescence (FAF) and to evaluate sensitivity, specificity, and predictive values across modalities. METHODS In this monocentric observational study, 282 eyes of 148 patients with MacTel underwent color fundus photograph, MC, BR, GR, IR, FAF, spectral-domain optical coherence tomography (SD-OCT), OCT-angiography (OCT-A), and fundus fluorescein angiography (FFA). Grading was done by two graders qualitatively and quantitatively for the presence of the following prespecified MacTel findings [crystals, right-angle vessels (RAVs), plaques, subretinal neovascularization (SRNV), and MacTel area]. Across each imaging modality, the detection rate of RAVs and SRNV was compared with reference standard OCT-A (RAVs and SRNV) and FFA (SRNV), whereas that of plaques was compared with reference standard SD-OCT. RESULTS MC identified overall MacTel characteristics in 92.7% of eyes. Regarding the presence, number, and quadrants of RAVs and the presence and number of crystals, MC and GR had superior detection rates as well as the highest sensitivity and negative predictive value. Retinal plaques were better detected using FAF (97%), followed by MC (88%). In proliferative MacTel, SRNV was identified in 86% and 79% of eyes on MC and IR, respectively. While BR clearly delineated MacTel area in 100% eyes, FAF was able to ascertain a larger area of involvement in proliferative MacTel. CONCLUSION The findings demonstrate the ability of MC, its component channels, and FAF to describe MacTel characteristics qualitatively and quantitatively.
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Affiliation(s)
- Kiran Chandran
- Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, Kerala, India
- SSM Eye Research Foundation, Giridhar Eye Institute, Cochin, Kerala, India
| | - Anantharaman Giridhar
- Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, Kerala, India
- SSM Eye Research Foundation, Giridhar Eye Institute, Cochin, Kerala, India
| | - Sachin Desai
- Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, Kerala, India
| | | | - V P Indu
- Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, Kerala, India
| | - Sobha Sivaprasad
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom
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Wylęgała A, Wozniak P, Sędziak-Marcinek B, Bolek B, Szkodny D, Wylęgała E. Retro-Mode in NIDEK Mirante: A Comparative Analysis with Other Imaging Modalities for AMD and CSR. Diagnostics (Basel) 2023; 13:2846. [PMID: 37685384 PMCID: PMC10486949 DOI: 10.3390/diagnostics13172846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Retro-mode is a novel technique capable of creating pseudo-3D images of the retina. However, its clinical utility remains unknown. This study aimed to evaluate the Nidek Mirante multimodal imaging platform for ocular assessment in patients with various retinal conditions. METHODS A total of 115 participants with central serous chorioretinopathy (CSR) and age-related macular degeneration (AMD) were included. Two experienced graders independently evaluated the images, and statistical analysis was performed to assess interclass correlation coefficients (ICC) between graders and modalities; Results: For CSR detection, retro-mode demonstrated exceptionally high ICC rates (ICC = 1; 100%), while color and autofluorescence (FAF) showed moderate coefficients (0.69 and 0.78, respectively). The detection of pigment epithelial detachment was high across all methods, with only retro-mode deviated right (DR) allowing detection in 69% of cases, while retro-mode DR and deviated left (DL) achieved 100% detection. FAF-green achieved a 95% detection rate. In detecting retinal atrophy, most modalities demonstrated high detection rates, with the lowest detection rates offered by retro-mode DL (ICC = 0.85) and DR (ICC = 0.89), while retro-mode ring aperture offered 0.97. Infra-red and fluorescein angiography imaging offered the highest detection rates among the tested modalities, with 97% and 100%, respectively. CONCLUSION Retro-mode showed promise for comprehensive ocular evaluation and diagnosis, with certain imaging modalities demonstrating higher accuracy in detecting specific retinal features.
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Affiliation(s)
- Adam Wylęgała
- Health Promotion and Obesity Management, Pathophysiology Department, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Przemysław Wozniak
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Bogumiła Sędziak-Marcinek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Bartłomiej Bolek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Dominika Szkodny
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
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Venkatesh R, Agrawal S, Reddy NG, Mutalik D, Mishra P, Yadav NK, Chhablani J. Visual function correlates with foveal slope, retinal and choroidal thickness on optical coherence tomography in type 2 Macular Telangiectasia. Semin Ophthalmol 2021; 37:524-530. [PMID: 34965178 DOI: 10.1080/08820538.2021.2022166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To correlate the foveal slope angle (FSA), retinal (RT) and choroidal (CT) thickness measured using optical coherence tomography (OCT) across different stages of type 2 macular telangiectasia (MacTel) with best-corrected visual acuity (BCVA). METHODS A cross-sectional study of 182 gradable quality macular OCT images of 49 patients with type 2 MacTel was carried out. RT was measured on the Spectralis OCT machine from ETDRS (Early Treatment Diabetic Retinopathy Study) retinal thickness map and later used for calculating FSA. RT and CT were measured at 500-µm intervals up to 1500 µm from foveal centre manually. The change in RT, CT and FSA across five stages of type 2 MacTel was assessed. The measurements were correlated with BCVA. RESULTS The FSA, RT and CT were calculated quadrantwise and stagewise. The FSA and RT showed a significant negative correlation with disease stage and BCVA (p < .05) in all four quadrants. No significant correlation was noted between CT and BCVA. Multivariate linear regression analysis identified the temporal FSA to correlate best with BCVA. CONCLUSION BCVA correlates best with temporal FSA. Smaller the temporal FSA, poorer the vision.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | - Sameeksha Agrawal
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | | | - Deepashri Mutalik
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | - Pranjal Mishra
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | | | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, Pittsburg, PA, USA
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Venkatesh R, Reddy NG, Agrawal S, Pereira A, Mutalik D, Mishra P, Yadav NK, Chhablani J. Functional relevance of macular telangiectasia (MacTel) area on multicolour imaging in type 2 MacTel. Eur J Ophthalmol 2021; 32:2368-2374. [PMID: 34488467 DOI: 10.1177/11206721211044625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To analyse the correlation between area of macular telangiectasia (MacTel) involvement on multicolour (MC) imaging, disease stages and visual acuity in type 2 MacTel. METHODS In this retrospective analysis of MC images, confirmed cases of type 2 MacTel were graded into different disease stages as per Gass and Blodi and Yannuzzi et al classification systems. The 'MacTel area' was calculated by marking the outer boundary of an area with abnormally increased reflectivity to confocal blue wavelength light. At every follow-up visit, best-corrected visual acuity, MacTel area and stage of disease on the MC image was documented. Analyses between disease stage, MacTel area and visual acuity was carried out. RESULTS In total, 92 eyes of 49 patients were included in the study. The mean age was 59.6 ± 8.96 years. About 182 high-quality gradable MC images were available for analysis. There was a statistically significant difference in the visual acuity (p < 0.001) and area of involvement (p < 0.001) in the non-proliferative and proliferative type 2 MacTel groups. An increase in disease severity stage statistically correlated positively with Mactel area (r = 0.544; p < 0.001) and logMAR visual acuity (r = 0.329; p < 0.001). Over time, there was a significant increase in area of MacTel involvement (p = 0.012) with an associated decrease in the visual acuity (p = 0.023). CONCLUSION The MacTel area measured on MC imaging showed a strong positive correlation with disease stage and a negative correlation with visual acuity. This could serve as a useful biomarker in clinical trials and understanding the natural history of the disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Gong R, Han R, Guo J, Liu W, Xu G. Quantitative evaluation of hard exudates in diabetic macular edema by multicolor imaging and their associations with serum lipid levels. Acta Diabetol 2021; 58:1161-1167. [PMID: 33811294 DOI: 10.1007/s00592-021-01697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
AIMS To quantify hard exudates (HEs) by multicolor imaging (MCI) and traditional color fundus photography (CFP) in diabetic macular edema (DME), and study their associations with serum lipid levels. METHODS Observational study. DME patients with HEs were recruited. The HE area and location both by MCI and CFP were measured by ImageJ software. Multivariate regression models were used to analyze the associations of serum lipid levels with the total HE area and HE location. RESULTS Sixty-two patients (74 eyes) were enrolled to quantify HEs in DME. The total HE area by MCI was larger than that by CFP (P = 0.004), and the distance between the fovea and the nearest HE by MCI was shorter than that by CFP (P = 0.003). The percentage of patients with HEs involving the central macula by MCI was significantly higher than that by CFP (P < 0.001). Furthermore, 62 eyes of 62 patients were included to analyze the associations of HE parameters with serum lipid levels. In both MCI and CFP, the HE areas were positively associated with triglyceride level (P = 0.016, P = 0.022, respectively). HEs involving the central macula were positively associated with triglyceride and low-density cholesterol levels in MCI (P = 0.028, P = 0.046, respectively), while no significant association was found between serum lipid levels and HE location in CFP. CONCLUSIONS MCI is superior to traditional CFP for the detection of HEs and the analysis of associations between HEs and serum lipid levels in DME.
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Affiliation(s)
- Ruowen Gong
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China
| | - Ruyi Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China
| | - Jingli Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China
| | - Wei Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China.
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China.
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Pauleikhoff L, Heeren TFC, Gliem M, Lim E, Pauleikhoff D, Holz FG, Clemons T, Balaskas K, Egan CA, Charbel Issa P. Fundus Autofluorescence Imaging in Macular Telangiectasia Type 2: MacTel Study Report Number 9. Am J Ophthalmol 2021; 228:27-34. [PMID: 33775659 DOI: 10.1016/j.ajo.2021.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the role of fundus autofluorescence (FAF) imaging in the diagnosis of macular telangiectasia type 2 (MacTel) and to describe disease-associated FAF patterns and their origin. DESIGN Cross-sectional multicenter study METHODS: FAF images were collected from the multicenter MacTel Natural History Observation and Registry Study. In a first qualitative approach, common FAF phenotypes were defined and correlated with multimodal imaging. We then evaluated how many eyes showed FAF changes, and temporal vs nasal asymmetry of FAF changes was graded. Finally, 100 eyes of MacTel patients and 100 control eyes (50 normal eyes and 50 eyes with other macular diseases) were combined and 2 masked graders assessed the presence of MacTel based on FAF images alone. RESULTS The study included 807 eyes of 420 patients (33 eyes were excluded owing to poor image quality). Loss of macular pigment, cystoid spaces, pigment plaques, neovascular membranes, and ectatic vascular changes commonly caused characteristic changes on FAF images. All MacTel patients had macular FAF changes in at least 1 eye. In 95% of eyes, these changes were more pronounced temporally than nasally. Common FAF patterns were increased (60%) and mixed/decreased FAF (38%) and/or visibility of vascular changes such as blunted vessels or ectatic capillaries (79%). Based on those features, high diagnostic performance was achieved for detection of the disease based on FAF alone (Youden index up to 0.91). CONCLUSIONS The study demonstrates that MacTel is consistently associated with disease-specific changes on FAF imaging. Those changes are typically more pronounced in the temporal parafovea.
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Affiliation(s)
- Laurenz Pauleikhoff
- From the Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Eye Center, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Tjebo F C Heeren
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Martin Gliem
- From the Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Ernest Lim
- From the Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | | | - Catherine A Egan
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Peter Charbel Issa
- From the Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
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Song J, Zheng Y, Wang J, Zakir Ullah M, Jiao W. Multicolor image classification using the multimodal information bottleneck network (MMIB-Net) for detecting diabetic retinopathy. OPTICS EXPRESS 2021; 29:22732-22748. [PMID: 34266030 DOI: 10.1364/oe.430508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Multicolor (MC) imaging is an imaging modality that records confocal scanning laser ophthalmoscope (cSLO) fundus images, which can be used for the diabetic retinopathy (DR) detection. By utilizing this imaging technique, multiple modal images can be obtained in a single case. Additional symptomatic features can be obtained if these images are considered during the diagnosis of DR. However, few studies have been carried out to classify MC Images using deep learning methods, let alone using multi modal features for analysis. In this work, we propose a novel model which uses the multimodal information bottleneck network (MMIB-Net) to classify the MC Images for the detection of DR. Our model can extract the features of multiple modalities simultaneously while finding concise feature representations of each modality using the information bottleneck theory. MC Images classification can be achieved by picking up the combined representations and features of all modalities. In our experiments, it is shown that the proposed method can achieve an accurate classification of MC Images. Comparative experiments also demonstrate that the use of multimodality and information bottleneck improves the performance of MC Images classification. To the best of our knowledge, this is the first report of DR identification utilizing the multimodal information bottleneck convolutional neural network in MC Images.
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Pole C, Ameri H. Fundus Autofluorescence and Clinical Applications. J Ophthalmic Vis Res 2021; 16:432-461. [PMID: 34394872 PMCID: PMC8358768 DOI: 10.18502/jovr.v16i3.9439] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/01/2021] [Indexed: 12/20/2022] Open
Abstract
Fundus autofluorescence (FAF) has allowed in vivo mapping of retinal metabolic derangements and structural changes not possible with conventional color imaging. Incident light is absorbed by molecules in the fundus, which are excited and in turn emit photons of specific wavelengths that are captured and processed by a sensor to create a metabolic map of the fundus. Studies on the growing number of FAF platforms has shown each may be suited to certain clinical scenarios. Scanning laser ophthalmoscopes, fundus cameras, and modifications of these each have benefits and drawbacks that must be considered before and after imaging to properly interpret the images. Emerging clinical evidence has demonstrated the usefulness of FAF in diagnosis and management of an increasing number of chorioretinal conditions, such as age-related macular degeneration, central serous chorioretinopathy, retinal drug toxicities, and inherited retinal degenerations such as retinitis pigmentosa and Stargardt disease. This article reviews commercial imaging platforms, imaging techniques, and clinical applications of FAF.
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Affiliation(s)
- Cameron Pole
- Retina Division, USC Roski Eye Institute, Keck School of Medicine, University of South California, Los Angeles, CA, USA
| | - Hossein Ameri
- Retina Division, USC Roski Eye Institute, Keck School of Medicine, University of South California, Los Angeles, CA, USA
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Terasaki H, Sonoda S, Tomita M, Sakamoto T. Recent Advances and Clinical Application of Color Scanning Laser Ophthalmoscope. J Clin Med 2021; 10:jcm10040718. [PMID: 33670287 PMCID: PMC7917686 DOI: 10.3390/jcm10040718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
Scanning laser ophthalmoscopes (SLOs) have been available since the early 1990s, but they were not commonly used because their advantages were not enough to replace conventional color fundus photography. In recent years, color SLOs have improved significantly, and the colored SLO images are obtained by combining multiple SLO images taken by lasers of different wavelengths. A combination of these images of different lasers can create an image that is close to that of the real ocular fundus. One advantage of the advanced SLOs is that they can obtain images with a wider view of the ocular fundus while maintaining a high resolution even through non-dilated eyes. The current SLOs are superior to the conventional fundus photography in their ability to image abnormal alterations of the retina and choroid. Thus, the purpose of this review was to present the characteristics of the current color SLOs and to show how that can help in the diagnosis and the following of changes after treatments. To accomplish these goals, we will present our findings in patients with different types of retinochoroidal disorders.
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Affiliation(s)
- Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (S.S.); (M.T.); (T.S.)
- Correspondence: ; Tel.: +81-99-275-5402; Fax: +81-99-265-4894
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (S.S.); (M.T.); (T.S.)
- Kagoshima Sonoda Eye & Plastic Surgery Clinic, Kagoshima 890-0053, Japan
| | - Masatoshi Tomita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (S.S.); (M.T.); (T.S.)
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (S.S.); (M.T.); (T.S.)
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