Subretinal pseudocysts: A novel OCT finding in diabetic macular edema

Directional analysis of intensity changes for determining the existence of cyst in optical coherence tomography images

Diabetic retinopathy (DR) is an important cause of blindness in people with the long history of diabetes. DR is caused due to the damage to blood vessels in the retina. One of the most important manifestations of DR is the formation of fluid-filled regions between retinal layers. The evaluation of stage and transcribed drugs can be possible through the analysis of retinal Optical Coherence Tomography (OCT) images. Therefore, the detection of cysts in OCT images and the is of considerable importance. In this paper, a fast method is proposed to determine the status of OCT images as cystic or non-cystic. The method consists of three phases which are pre-processing, boundary pixel determination and post-processing. After applying a noise reduction method in the pre-processing step, the method finds the pixels which are the boundary pixels of cysts. This process is performed by finding the significant intensity changes in the vertical direction and considering rectangular patches around the candidate pixels. The patches are verified whether or not they contain enough pixels making considerable diagonal intensity changes. Then, a shadow omission method is proposed in the post-processing phase to extract the shadow regions which can be mistakenly considered as cystic areas. Then, the pixels extracted in the previous phase that are near the shadow regions are removed to prevent the production of false positive cases. The performance of the proposed method is evaluated in terms of sensitivity and specificity on real datasets. The experimental results show that the proposed method produces outstanding results from both accuracy and speed points of view.

Challenges in Diabetic Macular Edema Management: An Expert Consensus Report

Purpose

This paper aimed to present daily-practice recommendations for the management of diabetic macular edema (DME) patients based on available scientific evidence and the clinical experience of the consensus panel.

Methods

A group of Spanish retina experts agreed to discuss different aspects related with the clinical management of DME patients.

Results

Panel was mainly focused on therapeutic objectives in DME management; definition terms; and role of biomarkers as prognostic and predictive factors to intravitreal treatment response. The panel recommends to start DME treatment as soon as possible in those eyes with a visual acuity less than 20/25 (always according to the retina unit capacity). Naïve patient was defined, in a strict manner, as a patient who, up to that moment, had never received any treatment. A refractory DME patient may be defined as the one who did not achieve a complete resolution of the disease, regardless of the treatment administered. Different optical coherence tomography biomarkers, such as disorganization of the retinal inner layers, hyperreflective dots, and cysts, have been identified as prognostic factors.

Conclusion

This document has sought to lay down a set of recommendations and to identify key issues that may be useful for the daily management of DME patients.