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Shao E, Liu C, Wang L, Song D, Guo L, Yao X, Xiong J, Wang B, Hu Y. Artificial intelligence-based detection of epimacular membrane from color fundus photographs. Sci Rep 2021; 11:19291. [PMID: 34588493 PMCID: PMC8481557 DOI: 10.1038/s41598-021-98510-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
Epiretinal membrane (ERM) is a common ophthalmological disorder of high prevalence. Its symptoms include metamorphopsia, blurred vision, and decreased visual acuity. Early diagnosis and timely treatment of ERM is crucial to preventing vision loss. Although optical coherence tomography (OCT) is regarded as a de facto standard for ERM diagnosis due to its intuitiveness and high sensitivity, ophthalmoscopic examination or fundus photographs still have the advantages of price and accessibility. Artificial intelligence (AI) has been widely applied in the health care industry for its robust and significant performance in detecting various diseases. In this study, we validated the use of a previously trained deep neural network based-AI model in ERM detection based on color fundus photographs. An independent test set of fundus photographs was labeled by a group of ophthalmologists according to their corresponding OCT images as the gold standard. Then the test set was interpreted by other ophthalmologists and AI model without knowing their OCT results. Compared with manual diagnosis based on fundus photographs alone, the AI model had comparable accuracy (AI model 77.08% vs. integrated manual diagnosis 75.69%, χ2 = 0.038, P = 0.845, McNemar’s test), higher sensitivity (75.90% vs. 63.86%, χ2 = 4.500, P = 0.034, McNemar’s test), under the cost of lower but reasonable specificity (78.69% vs. 91.80%, χ2 = 6.125, P = 0.013, McNemar’s test). Thus our AI model can serve as a possible alternative for manual diagnosis in ERM screening.
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Affiliation(s)
- Enhua Shao
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Congxin Liu
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Lei Wang
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Dan Song
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Libin Guo
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xuan Yao
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Jianhao Xiong
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Bin Wang
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Yuntao Hu
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
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Nagura K, Inoue T, Zhou HP, Obata R, Asaoka R, Arasaki R, Sato A, Nakamura K, Takeuchi M, Tanaka S, Yanagi Y, Maruyama-Inoue M, Kadonosono K. Association Between Retinal Artery Angle and Visual Function in Eyes With Idiopathic Epiretinal Membrane. Transl Vis Sci Technol 2021; 10:35. [PMID: 34448820 PMCID: PMC8399239 DOI: 10.1167/tvst.10.9.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose This study investigated the relationship between retinal artery angle and visual function in eyes with idiopathic epiretinal membrane (ERM). Methods Ultra-wide field fundus imaging was conducted to analyze ERM and normal contralateral eyes. In addition to the logMAR visual acuity (VA) measurement, the average of the vertical and horizontal metamorphopsia scores (Mave) was measured using m-Charts for each eye. We calculated the retinal artery angle (Yugami correlated angle [YCA]) in all the examined eyes using ImageJ software. The YCAs were then compared between the ERM and normal contralateral eyes. Additionally, the relationship between YCA and visual function was investigated in the ERM eyes. Results Data from 40 patients with ERM were analyzed. The mean age of the participants was 67.1 ± 8.1 years. The YCA was significantly smaller in the ERM eyes, compared with the contralateral eyes (P < 0.001, respectively; Wilcoxon signed rank test). Among age, axial length, YCAs, central retinal thickness (CRT), and central choroidal thickness (CCT), the optimal model for logMAR VA included age, YCA, and CRT. On the other hand, the optimal model for Mave included YCA and CCT. Conclusions The retinal artery angle may be useful for predicting visual function in eyes with ERM. Translational Relevance Our established quantitative measurements in fundus photography have potential clinical use in predicting visual function in ERM.
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Affiliation(s)
- Koichi Nagura
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan.,Department of Ophthalmology, National Defense Medical College Hospital, Saitama, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan.,Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Han Peng Zhou
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryo Obata
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.,Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan.,Seirei Christopher University, Shizuoka, Japan
| | - Rei Arasaki
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
| | - Akinori Sato
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
| | - Kentaro Nakamura
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
| | - Masaru Takeuchi
- Department of Ophthalmology, National Defense Medical College Hospital, Saitama, Japan
| | - Shin Tanaka
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
| | - Yasuo Yanagi
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
| | - Maiko Maruyama-Inoue
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
| | - Kazuaki Kadonosono
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Kanagawa, Japan
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Shimizu H, Asaoka R, Omoto T, Fujino Y, Mitaki S, Onoda K, Nagai A, Yamaguchi S, Tanito M. Prevalence of Epiretinal Membrane among Subjects in a Health Examination Program in Japan. Life (Basel) 2021; 11:life11020093. [PMID: 33513873 PMCID: PMC7912057 DOI: 10.3390/life11020093] [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] [Received: 01/09/2021] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
The prevalence of an epiretinal membrane (ERM) was elucidated using a dataset from a health examination program database in Japan. From the cohort database, 5042 eyes of 2552 subjects were included. The presence of an ERM, cellophane macular reflex (CMR), or preretinal macular fibrosis (PMF) was detected using color fundus photographs, and crude and age-standardized prevalence were obtained. To further assess the possible risk factors of ERM, background parameters were compared between ERM+ and − groups, and multiple logistic regression analysis was performed. ERM was detected in fundus photographs of 275 eyes (eye-based prevalence of 5.5%) from 217 subjects (subject-based prevalence of 8.5%). CMR was detected in 169 eyes (3.4%) of 138 subjects (5.4%), and PMF was detected in 106 eyes (2.1%) of 97 subjects (3.8%). By univariate analyses, compared with ERM− eyes or subjects, higher Scheie’s H grade (p < 0.0001), S grade (p < 0.0001), and glaucoma prevalence (p = 0.0440) were found in ERM+ eyes, and older age (p < 0.0001), more frequent histories of hypertension (p = 0.0033) and hyperlipidemia (p = 0.0441), and more frequent uses of medication for hypertension (p = 0.0034) and hyperlipidemia (p = 0.0074), shorter body height (p = 0.0122), and higher systolic blood pressure (p = 0.0078), and thicker intimal medial thickness (p = 0.0318) were found in ERM+ subjects. By multivariate analyses, older age (p < 0.0001, estimate = 0.05/year) was the only significant factor of ERM prevalence. Age-standardized prevalence of ERM was calculated to be 2.4%, 6.7%, and 13.3% for all ages, subjects older than 40 years, and subjects older than 65 years, respectively. We reported the prevalence of ERM and its subclasses in Japanese subjects. Since its prevalence is remarkably high in older subjects, an ERM can be seen as an important cause of visual impairment in Japan and in areas of the world where individuals live to an advanced age.
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Affiliation(s)
- Hiroshi Shimizu
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan; (R.A.); (Y.F.)
| | - Takashi Omoto
- Department of Ophthalmology, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Yuri Fujino
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan; (R.A.); (Y.F.)
| | - Shingo Mitaki
- Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (S.M.); (A.N.); (S.Y.)
| | - Keiichi Onoda
- Faculty of Psychology, Otemon Gakuin University, Ibaraki 567-8502, Japan;
| | - Atsushi Nagai
- Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (S.M.); (A.N.); (S.Y.)
| | - Shuhei Yamaguchi
- Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (S.M.); (A.N.); (S.Y.)
| | - Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
- Correspondence: ; Tel.: +81-853-20-2284
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Foreman J, Keel S, McGuinness MB, Crowston JG, Taylor HR, Dirani M. Prevalence and associations of non-retinopathy ocular conditions among older Australians with self-reported diabetes: The National Eye Health Survey. Int J Ophthalmol 2020; 13:1642-1651. [PMID: 33078117 DOI: 10.18240/ijo.2020.10.20] [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: 02/20/2020] [Accepted: 06/30/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the prevalence and associations of non-retinopathy ocular conditions among older Australian adults with diabetes. METHODS Multistage random-cluster sampling was used to select 3098 non-indigenous Australians aged 50y or older (46.4% male) and 1738 indigenous Australians aged 40y or older (41.1% male) from all levels of geographic remoteness in Australia. Participants underwent a standardised questionnaire to ascertain diabetes history, and a clinical examination to identify eye disease. We determined the prevalence of uncorrected refractive error, visually significant cataract, cataract surgery, age-related macular degeneration, glaucoma, ocular hypertension, retinal vein occlusion and epiretinal membrane among those with and without self-reported diabetes. RESULTS Participants with self-reported diabetes had a higher prevalence of cataract surgery than those without diabetes (28.8% vs 16.9%, OR 1.78, 95%CI: 1.35-2.34 among non-indigenous Australians, and 11.3% vs 5.2%, OR 1.62, 95%CI: 1.22-2.14 among indigenous Australians). Diabetic retinopathy (DR) increased the odds of cataract surgery among self-reported diabetic indigenous and non-indigenous Australians (OR 1.89, P=0.004 and OR 2.33, P<0.001 respectively). Having diabetes for ≥20y and having vision-threatening DR increased the odds of cataract surgery among indigenous Australians with diabetes (OR 3.73, P=0.001 and 7.58, P<0.001, respectively). CONCLUSION Most non-retinopathy ocular conditions are not associated with self-reported diabetes. However, to account for Australia's worsening diabetes epidemic, interventions to reduce the impact of diabetes-related blindness should include increased cataract surgery services.
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Affiliation(s)
- Joshua Foreman
- Centre for Eye Research Australia, the Royal Victorian Eye & Ear Hospital, Victoria 3002, Melbourne, Australia.,Ophthalmology, Department of Surgery, the University of Melbourne, Victoria 3010, Melbourne, Australia
| | - Stuart Keel
- Centre for Eye Research Australia, the Royal Victorian Eye & Ear Hospital, Victoria 3002, Melbourne, Australia.,Ophthalmology, Department of Surgery, the University of Melbourne, Victoria 3010, Melbourne, Australia
| | - Myra B McGuinness
- Centre for Eye Research Australia, the Royal Victorian Eye & Ear Hospital, Victoria 3002, Melbourne, Australia.,Ophthalmology, Department of Surgery, the University of Melbourne, Victoria 3010, Melbourne, Australia
| | - Jonathan G Crowston
- Centre for Eye Research Australia, the Royal Victorian Eye & Ear Hospital, Victoria 3002, Melbourne, Australia.,Ophthalmology, Department of Surgery, the University of Melbourne, Victoria 3010, Melbourne, Australia
| | - Hugh R Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, the University of Melbourne, Victoria 3010, Melbourne, Australia
| | - Mohamed Dirani
- Centre for Eye Research Australia, the Royal Victorian Eye & Ear Hospital, Victoria 3002, Melbourne, Australia.,Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore
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Song JH, Moon KY, Jang S, Moon Y. Comparison of MultiColor fundus imaging and colour fundus photography in the evaluation of epiretinal membrane. Acta Ophthalmol 2019; 97:e533-e539. [PMID: 30565886 DOI: 10.1111/aos.13978] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/28/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare MultiColor fundus imaging (MC) and colour fundus photography (CFP) for the evaluation of epiretinal membrane (ERM). METHODS In this retrospective study, 192 eyes (181 patients) that underwent vitrectomy for ERM were imaged using Spectralis optical coherence tomography (for MC) and AFC-210 digital camera (for CFP) 1 week before vitrectomy. Two investigators independently determined the rate of delineability and ERM area for each modality. RESULTS The intergrader agreement rates for delineability were very high for both image modalities. The rate of delineability of ERM (%) was higher for MC than for CFP, for both investigators [70.8% versus 52.6% and 73.4% versus 53.6% (both p -)]. Epiretinal membrane (ERM) area measurement showed high agreement between investigators for MC (p = 0.466) but differed significantly between the investigators for CFP (p -). The ERM area determined on MC was significantly wider than that on CFP for both investigators (p - for investigator 1 and p - for investigator 2). CONCLUSION The ERM area is more clearly detectable and widely demarcated in MC than in CFP images. MultiColor imaging (MC) may be more sensitive and accurate for early detection of ERM and ERM area measurement.
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Affiliation(s)
- Ji Hun Song
- Department of Ophthalmology Ajou University School of Medicine Suwon Korea
| | - Ka Young Moon
- Department of Ophthalmology Ajou University School of Medicine Suwon Korea
| | - Seran Jang
- Department of Ophthalmology Ajou University School of Medicine Suwon Korea
| | - YeoRae Moon
- Office of Biostatistics Ajou University School of Medicine Suwon Korea
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