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Zeng Y, Gao S, Li Y, Marangoni D, De Silva T, Wong WT, Chew EY, Sun X, Li T, Sieving PA, Qian H. OCT Intensity of the Region between Outer Retina Band 2 and Band 3 as a Biomarker for Retinal Degeneration and Therapy. Bioengineering (Basel) 2024; 11:449. [PMID: 38790316 PMCID: PMC11118669 DOI: 10.3390/bioengineering11050449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Optical coherence tomography (OCT) is widely used to probe retinal structure and function. This study investigated the outer retina band (ORB) pattern and reflective intensity for the region between bands 2 and 3 (Dip) in three mouse models of inherited retinal degeneration (Rs1KO, TTLL5KO, RPE65KO) and in human AMD patients from the A2A database. OCT images were manually graded, and reflectivity signals were used to calculate the Dip ratio. Qualitative analyses demonstrated the progressive merging band 2 and band 3 in all three mouse models, leading to a reduction in the Dip ratio compared to wildtype (WT) controls. Gene replacement therapy in Rs1KO mice reverted the ORB pattern to one resembling WT and increased the Dip ratio. The degree of anatomical rescue in these mice was highly correlated with level of transgenic RS1 expression and with the restoration of ERG b-wave amplitudes. While the inner retinal cavity was significantly enlarged in dark-adapted Rs1KO mice, the Dip ratio was not altered. A reduction of the Dip ratio was also detected in AMD patients compared with healthy controls and was also positively correlated with AMD severity on the AMD score. We propose that the ORB and Dip ratio can be used as non-invasive early biomarkers for retina health, which can be used to probe therapeutic gene expression and to evaluate the effectiveness of therapy.
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Affiliation(s)
- Yong Zeng
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
| | - Shasha Gao
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yichao Li
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
| | - Dario Marangoni
- Section for Translational Research in Retinal and Macular Degeneration, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Tharindu De Silva
- Unit on Clinical Investigation of Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Wai T. Wong
- Section on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Emily Y. Chew
- Clinical Trials Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Xun Sun
- Neurobiology Neurodegeneration & Repair Laboratory (N-NRL), National Eye Institute, Bethesda, MD 20892, USA (T.L.)
| | - Tiansen Li
- Neurobiology Neurodegeneration & Repair Laboratory (N-NRL), National Eye Institute, Bethesda, MD 20892, USA (T.L.)
| | | | - Haohua Qian
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
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Lu SY, Zhang XJ, Wang YM, Yuan N, Kam KW, Chan PP, Tam PO, Yip WW, Young AL, Tham CC, Pang CP, Yam JC, Chen LJ. Association of SIX1-SIX6 polymorphisms with peripapillary retinal nerve fibre layer thickness in children. Br J Ophthalmol 2022:bjophthalmol-2021-319756. [PMID: 35017159 DOI: 10.1136/bjophthalmol-2021-319756] [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: 05/27/2021] [Accepted: 12/10/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Association of SIX1-SIX6 variants with peripapillary retinal nerve fibre layer (p-RNFL) thickness had been reported in adults. This study aimed to investigate these associations in children, with further explorations by spatial, age and sex stratifications. METHODS 2878 school children aged between 6 and 9 years were enrolled from the Hong Kong Children Eye Study. Three single-nucleotide polymorphisms (SNPs) at the SIX1-SIX6 locus were genotyped. The association of each SNP with p-RNFL thickness (including global and sectoral thickness) were evaluated using multiple linear regression. RESULTS SNPs rs33912345 (p=7.7×10-4) and rs10483727 (p=0.0013) showed significant associations with temporal-inferior p-RNFL thickness. The C allele of rs33912345 was associated with a thinner temporal-inferior p-RNFL by an average of 2.44 µm, while rs10483727-T was associated with a thinner temporal-inferior p-RNFL by 2.32 µm. The association with temporal-inferior p-RNFL was the strongest in the 8-9 year-old group for rs33912345 (p=5.2×10-4) and rs10483727 (p=3.3×10-4). Both SNPs were significantly associated with temporal-inferior p-RNFL thickness in boys (p<0.0017), but not in girls (p>0.05). In contrast, rs12436579-C (β=1.66; p=0.0059), but not rs33912345-C (β=1.31; p=0.052) or rs10483727-T (β=1.19; p=0.078), was nominally associated with a thicker nasal-inferior p-RNFL. CONCLUSIONS Both rs33912345 and rs10483727 at SIX1-SIX6 were associated with p-RNFL thickness in children, especially at the temporal-inferior sector, with age-dependent and sex-specific effects. SNP rs12436579 was associated with nasal-inferior p-RNFL thickness. Our findings suggested a role of SIX1-SIX6 in RNFL variation during neural retina development in childhood.
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Affiliation(s)
- Shi Yao Lu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Nan Yuan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Poemen P Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China
| | - Pancy Os Tam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilson Wk Yip
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China .,Hong Kong Eye Hospital, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China .,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
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3
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Rao A, Vupparaboina KK, Padhy D, Raj N, Pradhan A, Goud A, Peguda HK, Jana S, Richariya A. Automated iris volume analysis and trabecular meshwork length using anterior segment optical coherence tomography - Application in pseudoexfoliation and pseudoexfoliation glaucoma. Indian J Ophthalmol 2021; 69:1815-1819. [PMID: 34146036 PMCID: PMC8374829 DOI: 10.4103/ijo.ijo_2403_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: The aim of this study was to evaluate differences in the iris and angle parameters in psuedoexfoliation syndrome (PXF) and pseudoexfoliation glaucoma (PXG) using anterior segment optical coherence tomography (ASOCT). Methods: Patients with PXF or PXG were compared using ASOCT with primary open-angle glaucoma POAG eyes as controls in this noninterventional comparative study conducted at a tertiary eye care center in East India. All angle parameters, TM length, and iris thickness were analyzed from the enhanced depth imaging (EDI) single scans obtained. Quadrant scans were used for the calculation of iris volume using a custom-built in-house software. In particular, the software performs multiple operations including edge detection, connected components, and thresholding to localize and segment the iris. Differences in the iris volume/thickness and TM length in PXF and PXG with POAG were analyzed. Results: A total of 225 eyes were included, which included 75 PXG and 98 PXF cases and 52 POAG with a mean age of 67 ± 9.7 years at presentation. The algorithm repeatability and reproducibility was also established with correlation coefficients more than 99% which was substantiated with Bland-Altman plots. The iris volume (calculated in 197 images of 225 eyes) did not differ significantly in PXF and PXG eyes, although both had significantly greater volume compared to POAG eyes. The iris volume or other angle parameters including TM length did not correlate with clinical variables such as IOP, age, or visual field indices. Conclusion: Iris parameters or TM length do not explain pathogenesis of glaucoma in pseudoexfoliation.
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Affiliation(s)
- Aparna Rao
- LV Prasad Eye Institute, Patia, Bhubaneswar, Orissa, India
| | | | | | - Niranjan Raj
- LV Prasad Eye Institute, Patia, Bhubaneswar, Orissa, India
| | - Amiya Pradhan
- LV Prasad Eye Institute, Patia, Bhubaneswar, Orissa, India
| | - Abilash Goud
- LV Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Soumya Jana
- LV Prasad Eye Institute, Hyderabad, Telangana, India
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Ye C, Wang X, Yu MCY, Shang X, Zhou K, Tao Y, Lu F, Liang Y. Progression of Macular Vessel Density in Primary Open-Angle Glaucoma: A Longitudinal Study. Am J Ophthalmol 2021; 223:259-266. [PMID: 33351744 DOI: 10.1016/j.ajo.2020.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the rate of progression of macular vessel density (mVD) in primary open-angle glaucoma (POAG) and explore the relationship between the progression of mVD and macular ganglion cell-inner plexiform layer (mGCIPL) thickness and parapapillary retinal nerve fiber layer (pRNFL) thickness. DESIGN Prospective cohort study. METHODS In this study, 102 eyes with POAG were followed for 36.6 ± 6.4 months. The rates of progression were estimated by linear models. The agreement of progression detection among the 3 parameters was evaluated with Kappa statistics. The influence of baseline measurements on the rates of progression of mGCIPL thickness, pRNFL thickness, and mVD was investigated by linear mixed modeling. Kaplan-Meier survival analysis was adopted to calculate the survival probabilities. RESULTS The respective rate of progression by linear regression was -0.102 ± 0.054 μm/month, -0.160 ± 0.086 μm/month, and -0.199 ± 0.073 %/month for mGCIPL thickness, pRNFL thickness, and mVD. The agreement in detection of progression among them was poor with the Conger's Kappa coefficient of 0.098 (95% confidence interval: -0.025~0.220, P = .116). The significant factors influencing the rate of progression of mVD were baseline mGCIPL thickness, baseline pRNFL thickness, and baseline mVD (P ≤ .001), while baseline mVD was not a significant factor influencing the rates of progression of mGCIPL thickness and pRNFL thickness (P ≥ .659). Also, pRNFL thickness had a better survival probability compared with the other 2 parameters (P = .025). CONCLUSIONS The mGCIPL thickness, pRNFL thickness, and mVD decreased over time in POAG eyes. The rate of reduction of mVD was significantly influenced by the baseline measurements of mGCIPL thickness, pRNFL thickness, and mVD.
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Zhou R, Li F, Gao K, Zhang X. Smaller Anterior Chamber Volume Is Associated With Higher Risk of Intraocular Pressure Elevation After Laser Peripheral Iridotomy: A 1-Year Follow-Up Study. Asia Pac J Ophthalmol (Phila) 2020; 10:188-191. [PMID: 32925295 DOI: 10.1097/apo.0000000000000317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The aim of this study was to analyze the predictive value of swept-source optical coherence tomography (SS-OCT) derived anterior-segment volumetric parameters such as anterior chamber volume (ACV) in the long-term follow-up of primary angle closure disease (PACD). DESIGN Longitudinal observational study. METHODS In this single-center longitudinal observational study, PACD patients undergoing laser peripheral iridotomy (LPI) were recruited. Anterior segment images of the patients were captured using SS-OCT before LPI, and at 1 week, 1 month, 3 months, 6 months, and 1 year after LPI. Ninety eyes of 81 subjects were enrolled, and 72 eyes of 72 subjects finished the 1 year follow-up. Data of all the 81 subjects were included for analysis. Intraocular pressure (IOP) elevation was defined as IOP >21 mm Hg at any time point after LPI. The association between baseline trabecular-iris space area 750 μm from scleral spur (TISA750), ACV and iris volume (IV), and IOP elevation were analyzed using logistic regression. RESULTS Eighty-one subjects were included, 59 were female, and 22 were male, with a mean age of 60.98± 9.44 years. IOP elevation appeared in 14 eyes. Mean TISA750 was negatively associated with IOP elevation (OR = 0.94, P = 0.02). The correlation of TISA750 with IOP elevation varies across quadrants and there was only significant association in temporal TISA750 (OR = 0.98, P = 0.046), whereas in the other 3 quadrants, there was no significant association. Greater ACV was associated with lower risk of IOP elevation (OR = 0.80, P = 0.031), whereas IV was not associated with IOP elevation. CONCLUSIONS ACV is a reliable and accurate predictor for the outcome of PACD. Due to its 3-dimensional nature, the robustness of ACV is greater than traditional angle width parameters such as TISA750.
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Affiliation(s)
- Rouxi Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Chua J, Kadziauskienė A, Wong D, Ašoklis R, Lesinskas E, Quang ND, Chong R, Tan B, Girard MJA, Mari JM, Crowston JG, Aung T, Schmetterer L. One year structural and functional glaucoma progression after trabeculectomy. Sci Rep 2020; 10:2808. [PMID: 32071369 PMCID: PMC7029027 DOI: 10.1038/s41598-020-59792-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/04/2020] [Indexed: 02/07/2023] Open
Abstract
We evaluated the changes in visual field mean deviation (VF MD) and retinal nerve fibre layer (RNFL) thickness in glaucoma patients undergoing trabeculectomy. One hundred patients were examined with VF and spectral-domain optical coherence tomography (OCT) before trabeculectomy and 4 follow-up visits over one year. Linear mixed models were used to investigate factors associated with VF and RNFL. VF improved during the first 3 months of follow-up (2.55 ± 1.06 dB/year) and worsened at later visits (−1.14 ± 0.29 dB/year). RNFL thickness reduced by −4.21 ± 0.25 µm/year from 1st month of follow-up. Eyes with an absence of initial VF improvement (β = 0.64; 0.30–0.98), RNFL thinning (β = 0.15; 0.08–0.23), increasing intraocular pressure (IOP; β = −0.11; −0.18 to −0.03) and severe glaucoma (β = −10.82; −13.61 to −8.02) were associated with VF deterioration. Eyes with VF deterioration (β = 0.19; 0.08–0.29), increasing IOP (β = −0.09; −0.17 to −0.01), and moderate (β = −6.33; −12.17 to −0.49) or severe glaucoma (β = −19.58; −24.63 to −14.52) were associated with RNFL thinning. Changes in RNFL structure and function occur over a 1-year follow-up period after trabeculectomy. Early VF improvement is more likely to occur in patients with mild/moderate glaucoma, whereas those with severe glaucoma show greater decline over one year. Our findings indicate that progression is observable using OCT, even in late-stage glaucoma.
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Affiliation(s)
- Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Aistė Kadziauskienė
- Clinic of Ears, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Eye Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Damon Wong
- SERI-NTU Advanced Ocular Engineering (STANCE) Program, Singapore, Singapore.,Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rimvydas Ašoklis
- Clinic of Ears, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Eye Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Eugenijus Lesinskas
- Clinic of Ears, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Eye Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Nguyen Duc Quang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Rachel Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE) Program, Singapore, Singapore
| | - Michaël J A Girard
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Jean Martial Mari
- GePaSud Laboratory, University of French Polynesia, Tahiti, French Polynesia
| | - Jonathan G Crowston
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore. .,Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. .,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. .,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
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Sarhan A, Rokne J, Alhajj R. Glaucoma detection using image processing techniques: A literature review. Comput Med Imaging Graph 2019; 78:101657. [PMID: 31675645 DOI: 10.1016/j.compmedimag.2019.101657] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/02/2019] [Accepted: 09/09/2019] [Indexed: 11/26/2022]
Abstract
The term glaucoma refers to a group of heterogeneous diseases that cause the degeneration of retinal ganglion cells (RGCs). The degeneration of RGCs leads to two main issues: (i) structural changes to the optic nerve head as well as the nerve fiber layer, and (ii) simultaneous functional failure of the visual field. These two effects of glaucoma may lead to peripheral vision loss and, if the condition is left to progress it may eventually lead to blindness. No cure for glaucoma exists apart from early detection and treatment by optometrists and ophthalmologists. The degeneration of RGCs is normally detected from retinal images which are assessed by an expert. These retinal images also provide other vital information about the health of an eye. Thus, it is essential to develop automated techniques for extracting this information. The rapid development of digital images and computer vision techniques have increased the potential for analysis of eye health from images. This paper surveys current approaches to detect glaucoma from 2D and 3D images; both the limitations and possible future directions are highlighted. This study also describes the datasets used for retinal analysis along with existing evaluation algorithms. The main topics covered by this study may be enumerated as follows.
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Affiliation(s)
- Abdullah Sarhan
- Department of Computer Science, University of Calgary, Calgary, AB, Canada.
| | - Jon Rokne
- Department of Computer Science, University of Calgary, Calgary, AB, Canada
| | - Reda Alhajj
- Department of Computer Science, University of Calgary, Calgary, AB, Canada; Department of Computer Engineering, Istanbul Medipol University, Istanbul, Turkey
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Li F, Zhou R, Gao K, Jin L, Zhang X. Volumetric parameters-based differentiation of narrow angle from open angle and classification of angle configurations: an SS-OCT study. Br J Ophthalmol 2019; 104:92-97. [PMID: 31036585 DOI: 10.1136/bjophthalmol-2018-313386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/02/2019] [Accepted: 02/26/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND To evaluate the diagnostic ability of volumetric parameters to differentiate narrow angle from open angle and distinguish different configurations of narrow angle. METHODS The current study was composed of two parts. In the first part, with gonioscopy as reference standard, we tested power of each parameter to differentiate narrow angle from open angle. In the second part, we evaluated the efficacy of different parameters to distinguish angle configurations which were subclassified into type 1 (pupillary block) and type 2 (non-pupillary block and multiple mechanisms) based on ultrasound biomicroscopy (UBM) images. RESULTS In part 1, the training set was composed of 117 narrow-angle eyes and 60 open-angle eyes, and the validation set included 38 narrow-angle eyes and 37 open-angle eyes. Anterior chamber volume (ACV) outperformed all the other parameters with an area under the curve (AUC) of 0.988. The sensitivity and specificity of the cut-off value 98.1 mm3 in the validation set were 90.0% and 97.1%, respectively. In part 2, training set was composed of 96 eyes of 88 patients with primary angle-closure disease, with 49 diagnosed as type 1 and 47 as type 2 configuration. 32 eyes were used for validation. A model comprised of iris volume (IV), iris thickness (IT) 2000 µm from the scleral spur and angle open distance (AOD) 750 µm from the scleral spur was found to have an AUC of 0.793 (95% CI, 0.695 to 0.870). Sensitivity and specificity of the model were 82.6% and 77.8% respectively in the validation set. CONCLUSIONS With ACV, we can detect patients with narrow angle from open angle faster and more easily than AOD and anterior chamber depth. Then, for patients with narrow angle, the combination of IV, IT and AOD750 measured by swept-source optical coherence tomography could further classify configurations of angle closure compared with UBM.
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Affiliation(s)
- Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Rouxi Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Kai Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
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Li F, Yu K, Zhang L, Gao K, Chen X, Zhang X. Automatic Assessment of Biometric Parameters in Optic Nerve Head Area by "Zhongshan ONH Calculator (ZOC)". Curr Eye Res 2018; 44:551-557. [PMID: 30582375 DOI: 10.1080/02713683.2018.1563703] [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: 10/27/2022]
Abstract
PURPOSE To test the repeatability and reproducibility of the Zhongshan ONH Calculator (ZOC) software in terms of selected optic nerve head (ONH) parameters commonly used in clinical research of glaucoma. MATERIALS AND METHODS Forty-two horizontal single-line scans were selected to test the repeatability and reproducibility of the ZOC software. Clinically relevant 2D parameters of the ONH area were selected to test repeatability of ZOC, including length of BMO, minimum rim thickness on both sides (RIML and RIMR), optic cup depth (OCD), and depth of the anterior surface of the LC (ALCD). RESULTS Intraobserver test showed higher the intra-class correlation coefficient (ICC) of BMO ((0.991 vs. 0.777), RIML (0.988 vs. 0.890), RIMR (0.972 vs. 0.846), OCD (0.997 vs. 0.992), and ALCD (0.993 vs. 0.949) by single researcher using ZOC software than manual measurement. BA analysis showed acceptable agreement between automatic and manual measurements. SDs and limits of agreement (95% CI) of BMO, RIML, RIMR, OCD, and ALCD were 0.05 (-0.13, 0.07), 0.03 (-0.05, 0.05), 0.03 (-0.06, 0.07), 0.015 (-0.035, 0.024), and 0.04 (-0.07, 0.08), respectively. CONCLUSION This study presented the design and development of software for the automatic measurement of OCT images of ONH area with good reproducibility. In the future, with advances of OCTs and improvements to the resolution of the LC, ZOC will become a powerful tool in glaucoma research.
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Affiliation(s)
- Fei Li
- a Zhongshan Ophthalmic Center, the State Key Laboratory of Ophthalmology , Sun Yat-sen University , Guangzhou , China
| | - Kai Yu
- b School of Electronics and Information Engineering , Soochow University , Suzhou , China
| | - Lichun Zhang
- b School of Electronics and Information Engineering , Soochow University , Suzhou , China
| | - Kai Gao
- a Zhongshan Ophthalmic Center, the State Key Laboratory of Ophthalmology , Sun Yat-sen University , Guangzhou , China
| | - Xinjian Chen
- b School of Electronics and Information Engineering , Soochow University , Suzhou , China
| | - Xiulan Zhang
- a Zhongshan Ophthalmic Center, the State Key Laboratory of Ophthalmology , Sun Yat-sen University , Guangzhou , China
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Ramirez AI, de Hoz R, Salobrar-Garcia E, Salazar JJ, Rojas B, Ajoy D, López-Cuenca I, Rojas P, Triviño A, Ramírez JM. The Role of Microglia in Retinal Neurodegeneration: Alzheimer's Disease, Parkinson, and Glaucoma. Front Aging Neurosci 2017; 9:214. [PMID: 28729832 PMCID: PMC5498525 DOI: 10.3389/fnagi.2017.00214] [Citation(s) in RCA: 306] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/16/2017] [Indexed: 12/12/2022] Open
Abstract
Microglia, the immunocompetent cells of the central nervous system (CNS), act as neuropathology sensors and are neuroprotective under physiological conditions. Microglia react to injury and degeneration with immune-phenotypic and morphological changes, proliferation, migration, and inflammatory cytokine production. An uncontrolled microglial response secondary to sustained CNS damage can put neuronal survival at risk due to excessive inflammation. A neuroinflammatory response is considered among the etiological factors of the major aged-related neurodegenerative diseases of the CNS, and microglial cells are key players in these neurodegenerative lesions. The retina is an extension of the brain and therefore the inflammatory response in the brain can occur in the retina. The brain and retina are affected in several neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), and glaucoma. AD is an age-related neurodegeneration of the CNS characterized by neuronal and synaptic loss in the cerebral cortex, resulting in cognitive deficit and dementia. The extracellular deposits of beta-amyloid (Aβ) and intraneuronal accumulations of hyperphosphorylated tau protein (pTau) are the hallmarks of this disease. These deposits are also found in the retina and optic nerve. PD is a neurodegenerative locomotor disorder with the progressive loss of dopaminergic neurons in the substantia nigra. This is accompanied by Lewy body inclusion composed of α-synuclein (α-syn) aggregates. PD also involves retinal dopaminergic cell degeneration. Glaucoma is a multifactorial neurodegenerative disease of the optic nerve, characterized by retinal ganglion cell loss. In this pathology, deposition of Aβ, synuclein, and pTau has also been detected in retina. These neurodegenerative diseases share a common pathogenic mechanism, the neuroinflammation, in which microglia play an important role. Microglial activation has been reported in AD, PD, and glaucoma in relation to protein aggregates and degenerated neurons. The activated microglia can release pro-inflammatory cytokines which can aggravate and propagate neuroinflammation, thereby degenerating neurons and impairing brain as well as retinal function. The aim of the present review is to describe the contribution in retina to microglial-mediated neuroinflammation in AD, PD, and glaucomatous neurodegeneration.
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Affiliation(s)
- Ana I. Ramirez
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid (UCM)Madrid, Spain
| | - Rosa de Hoz
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid (UCM)Madrid, Spain
| | - Elena Salobrar-Garcia
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid (UCM)Madrid, Spain
| | - Juan J. Salazar
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid (UCM)Madrid, Spain
| | - Blanca Rojas
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid (UCM)Madrid, Spain
| | - Daniel Ajoy
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
| | - Inés López-Cuenca
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
| | - Pilar Rojas
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Servicio de Oftalmología, Hospital Gregorio MarañónMadrid, Spain
| | - Alberto Triviño
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid (UCM)Madrid, Spain
| | - José M. Ramírez
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo. Universidad Complutense de MadridMadrid, Spain
- Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid (UCM)Madrid, Spain
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