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Maltsev DS, Kulikov AN, Burnasheva MA. Lattice Degeneration Imaging with Optical Coherence Tomography Angiography. J Curr Ophthalmol 2022; 34:379-383. [PMID: 36644475 PMCID: PMC9832459 DOI: 10.4103/joco.joco_94_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/16/2022] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose To describe a series of cases of lattice degeneration of the retina imaged with optical coherence tomography angiography (OCTA). Methods Four eyes of four patients were included and evaluated with green reflectance using a confocal scanning laser ophthalmoscopy and OCTA. In each case, the microcirculation of the retina and choriocapillaris within the lesion, as well as choroidal thickness beneath the lesion, were assessed. Results OCTA showed regional loss of retinal perfusion and rarefication of the choriocapillaris network within the lesion and the presence of venous collectors in the choroid beneath the lesion. The choroid was substantially thinner beneath the lesion compared to the adjacent normal region. Cross-sectional OCT scans showed retinal thinning, vitreal adhesion, atrophic holes, and subretinal fluid within the lesions. Conclusion Lattice degeneration is characterized by significant local changes in retinal and choroidal microcirculation which may play an important role in the pathophysiology of lattice degeneration.
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Affiliation(s)
- Dmitrii S. Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia,Address for correspondence: Dmitrii S. Maltsev, Department of Ophthalmology, Military Medical Academy, 21, Botkinskaya Str, St. Petersburg 194044, Russia. E-mail:
| | - Alexei N. Kulikov
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
| | - Maria A. Burnasheva
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
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2
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Muller J, Alonso-Caneiro D, Read SA, Vincent SJ, Collins MJ. Application of Deep Learning Methods for Binarization of the Choroid in Optical Coherence Tomography Images. Transl Vis Sci Technol 2022; 11:23. [PMID: 35157030 PMCID: PMC8857621 DOI: 10.1167/tvst.11.2.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose The purpose of this study was to develop a deep learning model for automatic binarization of the choroidal tissue, separating choroidal blood vessels from nonvascular stromal tissue, in optical coherence tomography (OCT) images from healthy young subjects. Methods OCT images from an observational longitudinal study of 100 children were used for training, validation, and testing of 5 fully semantic networks, which provided a binarized output of the choroid. These outputs were compared with ground truth images, generated from a local binarization technique after manually optimizing the analysis window size for each individual image. The performance was evaluated using accuracy and repeatability metrics. The methods were also compared with a fixed window size local binarization technique, which has been commonly used previously. Results The tested deep learning methods provided a good performance in terms of accuracy and repeatability. With the U-Net and SegNet networks showing >96% accuracy. All methods displayed a high level of repeatability relative to the ground truth. For analysis of the choroidal vascularity index (a commonly used metric derived from the binarized image), SegNet showed the closest agreement with the ground truth and high repeatability. The fixed window size showed a reduced accuracy compared to other methods. Conclusions Fully semantic networks such as U-Net and SegNet displayed excellent performance for the binarization task. These methods provide a useful approach for clinical and research applications of deep learning tools for the binarization of the choroid in OCT images. Translational Relevance Deep learning models provide a novel, robust solution to automatically binarize the choroidal tissue in OCT images.
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Affiliation(s)
- Joshua Muller
- Queensland University of Technology (QUT), Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - David Alonso-Caneiro
- Queensland University of Technology (QUT), Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Scott A. Read
- Queensland University of Technology (QUT), Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Stephen J. Vincent
- Queensland University of Technology (QUT), Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Michael J. Collins
- Queensland University of Technology (QUT), Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
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3
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Yazdani N, Ehsaei A, Hoseini-Yazdi H, Shoeibi N, Alonso-Caneiro D, Collins MJ. Wide-field choroidal thickness and vascularity index in myopes and emmetropes. Ophthalmic Physiol Opt 2021; 41:1308-1319. [PMID: 34487376 DOI: 10.1111/opo.12875] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To study regional variations in choroidal thickness (CT), luminal thickness and stromal thickness of the choroid, and choroidal vascularity index (CVI) in low myopic and emmetropic eyes using wide-field optical coherence tomography (OCT). METHODS Sixty-nine healthy young adults between 20 and 38 years of age participated in this study, including 40 low myopes (mean ± SD spherical equivalent (MSE) refractive error: -3.00 ± 1.39 D, range: -6.00 to -0.62 D) and 29 emmetropes (MSE: -0.05 ± 0.09 D, range: -0.25 to +0.12 D). Wide-field CT, luminal thickness, stromal thickness and CVI were measured across five eccentricities (fovea, parafovea, perifovea; near-periphery and periphery) and four quadrants (nasal, temporal, inferior and superior), in vertical and horizontal meridians, while controlling for a range of extraneous factors potentially influencing the CT. Custom-written software was used to segment and binarize the OCT images. RESULTS Wide-field CT, luminal thickness and stromal thickness, averaged across all participants, exhibited significant topographical variation, with the foveal (379 ± 8 µm, 200 ± 4 µm, 179 ± 4 µm, respectively) and peripheral (275 ± 8 µm, 161 ± 4 µm, 114 ± 4 µm, respectively) regions presenting the thickest and thinnest regions (all p < 0.001). Wide-field CVI showed a progressively higher percentage (greater vascularity) with increasing eccentricity from the fovea towards the periphery (p < 0.001). Macular CT and stromal choroidal thickness were significantly thinner in myopes compared to emmetropes (p < 0.05). Myopes (55.7 ± 0.3%) showed a slightly higher CVI compared with emmetropes (54.4 ± 0.4%) (p < 0.05). CONCLUSIONS Low myopia in young adults was associated with significant choroidal thinning across the macular, but not extramacular regions, with this decrease in choroidal thickness mostly attributed to thinning in the stromal component of the choroid, rather than the luminal (vascular) component.
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Affiliation(s)
- Negareh Yazdani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.,Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nasser Shoeibi
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Madanagopalan VG, Shah K, Nagesha CK, Baskaran P. Peripheral retinal avascularity and capillary leakage in central serous chorioretinopathy. J Curr Ophthalmol 2019; 31:220-224. [PMID: 31317104 PMCID: PMC6611917 DOI: 10.1016/j.joco.2019.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/05/2019] [Accepted: 01/09/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To report a novel finding of peripheral retinal avascularity (PRA) and peripheral capillary leakage (PCL) on wide-field fluorescein angiography (WFA) in non-dependent quadrants, in eyes with bilateral chronic central serous chorioretinopathy (CSCR). Methods Forty six patients with bilateral CSCR were studied. Four patients had PRA and PCL, and 42 patients did not. The demographic profile, clinical findings, and imaging characteristics of the two groups were compared. Results There was no significant difference between those patients with and without PRA and PCL with respect to the demographic profile, clinical findings, and imaging characteristics. Laser photocoagulation to extrafoveal points of leakage seen on fluorescein angiography (FA) was sufficient to cause complete resolution of CSCR in these 4 patients. PRA areas were not treated. Conclusion The PRA and PCL in CSCR are novel findings, which have not been previously described.
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Affiliation(s)
| | - Karan Shah
- Aravind Eye Hospital and Postgraduate Institute, Pondicherry, India
| | - C K Nagesha
- Aravind Eye Hospital and Postgraduate Institute, Pondicherry, India
| | - Prabu Baskaran
- Aravind Eye Hospital and Postgraduate Institute, Pondicherry, India
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Nivison-Smith L, Milston R, Chiang J, Ly A, Assaad N, Kalloniatis M. Peripheral retinal findings in populations with macular disease are similar to healthy eyes. Ophthalmic Physiol Opt 2019; 38:584-595. [PMID: 30575075 DOI: 10.1111/opo.12589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE Recent evidence suggests several macular diseases are associated with peripheral retinal changes. This study investigated the number, type and management consequences of peripheral retinal findings detected in patients attending a referral only, eye-care clinic, the Centre for Eye Health(CFEH) with macular disease. METHODS Records of 537 patients attending CFEH for a macular assessment were included in the study. Subjects were classified as having age-related macular degeneration (AMD), epiretinal membrane (ERM), central serous chorioretinopathy (CSCR), inherited macular dystrophy or no macular disease. Data extracted included reason for referral, macular findings, peripheral findings (based on examination by ultra-widefield scanning laser ophthalmoscopy), diagnosis and management. RESULTS After age-matching, the number of peripheral findings in subjects with AMD, ERM or CSCR was not significant different to normal subjects. The most common finding for all cohorts were non-specific, degenerative changes such as drusen or pigmentation (61-72%) except inherited macular dystrophy subjects who had mostly vascular findings (30%; p < 0.05). Subjects with AMD and ERM with peripheral findings were significantly more likely to be reviewed or referred to an ophthalmologist than discharged back to their community eye care provider compared to subjects without findings. However only 8% of subjects had altered management based specifically on peripheral findings suggesting the macular findings in most subjects dictated their management. For those with a change, it was significant (upgrade to referral to an ophthalmologist). Peripheral findings also flagged 5% of subjects with vascular findings for referral to their general practitioner (GP). CONCLUSIONS Overall, the percentage and distribution of peripheral retinal findings in some macular diseases was similar to normal subjects. However, subjects with peripheral findings appeared to have significant differences in management. Considering some common findings, such as peripheral drusen may be relevant to AMD pathogenesis and therefore affect management of this disease, assessment of the peripheral retina should not be overlooked when the clinical focus is on the posterior pole.
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Affiliation(s)
- Lisa Nivison-Smith
- Centre for Eye Health, University of New South Wales, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Rebecca Milston
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Jaclyn Chiang
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Angelica Ly
- Centre for Eye Health, University of New South Wales, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Nagi Assaad
- Centre for Eye Health, University of New South Wales, Sydney, Australia.,Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, University of New South Wales, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Rasheed MA, Singh SR, Invernizzi A, Cagini C, Goud A, Sahoo NK, Cozzi M, Lupidi M, Chhablani J. Wide-field choroidal thickness profile in healthy eyes. Sci Rep 2018; 8:17166. [PMID: 30464195 PMCID: PMC6249207 DOI: 10.1038/s41598-018-35640-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/07/2018] [Indexed: 01/15/2023] Open
Abstract
The introduction of wide field optical coherence tomography (WF-OCT) has provided newer insights in the imaging of peripheral choroid. We evaluated choroidal thickness (CT) and large choroidal vessel thickness (LCVT) of 20 eyes in horizontal and vertical meridians using WF-OCT. A high-definition line scan through the fovea in both horizontal and vertical meridian was captured in primary and extremes of gaze to obtain scans up to mid-equator. CT and LCVT measurements were done across predefined points in macular area and all quadrants. LCVT was calculated after identifying a large choroidal vessel near choroidoscleral interface. The main outcome measures were differences in CT and LCVT in macular and four quadrants. Mean CT (331.23 ± 76.34 µ) and LCVT (201.46 ± 54.31 µ) in vertical macular segment were significantly more than CT (245.79 ± 55.38 µ; p = 0.0002) and LCVT (150.48 ± 52.58 µ; p = 0.004) in horizontal macular segment. CT at peripheral points in all quadrants was significantly reduced as compared to subfoveal CT (all p values < 0.05) with maximum reduction in inferior quadrant (64.5%). Using linear regression, only quadrant had a significant effect on CT and LCVT (both p < 0.001). CT and LCVT are highest at the macular area with reduction towards the periphery. The contribution of LCVT to CT is less at the fovea compared to other peripheral points.
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Affiliation(s)
- Mohammed Abdul Rasheed
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, 34, India
| | - Sumit Randhir Singh
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, 34, India
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | - Carlo Cagini
- Department of Biochemical and Surgical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy
| | - Abhilash Goud
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, 34, India
| | - Niroj Kumar Sahoo
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, 34, India
| | - Mariano Cozzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | - Marco Lupidi
- Department of Biochemical and Surgical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy
| | - Jay Chhablani
- Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, 34, India.
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Yu L, Shao Y, Chai Y, Ye LH, Yang QC, Ye L, Yuan Q, Jiang N, Yi JL. Retinal microvasculature alteration in central serous chorioretinopathy. Mol Med Rep 2017; 17:2335-2340. [PMID: 29207100 PMCID: PMC5783478 DOI: 10.3892/mmr.2017.8126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 11/14/2017] [Indexed: 01/14/2023] Open
Abstract
The aim of the present study was to investigate the changes of retinal microvascular network in patients with central serous chorioretinopathy (CSCR). A total of fifteen patients (right eye) with CSCR and 15 normal controls (right eye) were recruited. We used optical coherence tomography angiography to scan 6×6 mm macular retinal blood flow images with the application of a series of customized image segmentation processing program software to obtain microvascular and macrovascular density, and compared the superficial microvascular (SMIR), superficial macrovascular ring (SMAR) and the superficial total microvascular (STMI) density between CSCR patients and control group. Using the annular partition (C1-C6) and quadrant partition methods on the macular, we compared the retinal vessel density changes. We also performed ROC analysis of superficial retinal microvessel density in CSCR retina to investigate the relationship between the microvascular density, the foveal thickness and visual acuity. The density of STMI and SMIR decreased in macular area in the patients with CSCR compared to the normal controls (P<0.05), while the density of SMAR did not change significantly. We found no significant difference in the density of SMIR with the quadrant partition method, whereas the annular partition method showed significantly decreased SMIR density only in the C1 region in patients with CSCR (P<0.05), with no significant difference observed in C2-C6 regions. The density of SMIR had the highest differentiation power in the CSCR group, whereas the density of SC1 ring had the lowest differentiation power by the annular method. The largest area under the ROC curves was 0.77. The correlation index of the SMIR density and visual acuity was −0.544, whereas macular thickness and visual acuity was −0.644 in the CSCR group. The density of STMI and SMIR were decreased in patients with CSCR, which might provide further understanding of the pathogenesis of CSCR.
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Affiliation(s)
- Li Yu
- Department of Opthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Yong Chai
- Department of Opthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Lin-Hong Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Qi-Chen Yang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian 361102, P.R. China
| | - Lei Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Nan Jiang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian 361102, P.R. China
| | - Jing-Lin Yi
- Department of Opthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Chronic Central Serous Chorioretinopathy in a Patient with Pigment Dispersion Syndrome: A Possible Correlation. Case Rep Ophthalmol Med 2017; 2017:5857041. [PMID: 29098100 PMCID: PMC5643050 DOI: 10.1155/2017/5857041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 08/23/2017] [Indexed: 11/23/2022] Open
Abstract
Chronic central serous chorioretinopathy (CSCR) is a progressive chorioretinopathy with widespread atrophic RPE abnormalities and serous retinal detachments (SRDs) present for 6 months or longer. We report a case of CSCR in a 38-year-old patient with Pigment Dispersion Syndrome (PDS). In the presented case of CSCR, the chronic course of the disease may in part be associated with an underlying generalized degenerative dysfunction of the pigmented cells of the eye on grounds of PDS. We suggest that a chronic course of disease may be suspected in the setting of CSCR with concurrent RPE pathology, such as what is found in PDS.
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