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Liu H, Peng J, Zhang W, Zhang X, Gu VY, Yang Y, Xiao H, Yin J, Jiao D, Tian T, Zhao P. ANATOMIC OUTCOMES OF LENS-SPARING VITRECTOMY FOR STAGE 3 OR 4 FAMILIAL EXUDATIVE VITREORETINOPATHY. Retina 2024; 44:1538-1545. [PMID: 39167575 PMCID: PMC11332369 DOI: 10.1097/iae.0000000000004147] [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] [Indexed: 08/23/2024]
Abstract
PURPOSE To report the anatomic outcomes and retinal structure changes from lens-sparing vitrectomy (LSV) for eyes with Stage 3 or 4 familial exudative vitreoretinopathy (FEVR). METHODS Overall, 133 consecutive eyes of 119 patients with Stage 3 (51 eyes) or 4 (82 eyes) FEVR who underwent LSV between January 2012 and May 2023 were retrospectively reviewed. RESULTS One hundred twenty-nine eyes (97.0%) achieved traction relief through one LSV operation. The extent of retinal detachment improved in 98 eyes (73.7%), remained stable in 32 eyes (24.1%), and progressed in three eyes (2.3%). At long-term follow-up, 39 (29.3%) and 60 (45.1%) eyes had completely or partially reattached retina, respectively. The median change of venular angle was 3.6° (95% CI, 3.5-10.5; P < 0.001) and -9.9° (95% CI, -15.8 to -4.6; P < 0.001) for temporal and nasal vessels, respectively. The mean disk-fovea distance was 0.3 papillary diameter shorter (95% CI, -0.4 to -0.2; P < 0.001), and the mean temporal venular arcade distance was 0.02 papillary diameter larger (95% CI, -0.16 to 0.21; P = 0.361). CONCLUSION These results suggest that LSV can relieve vitreoretinal traction and reattach the retina in late-stage FEVR eyes. Improvements in temporal and nasal venular angle and disk-fovea distance reflect positive retinal structure changes for patients.
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Affiliation(s)
- Huanyu Liu
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Jie Peng
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Wenting Zhang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Xuerui Zhang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Victoria Y. Gu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yuan Yang
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Haodong Xiao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Jiawei Yin
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Dian Jiao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Tian Tian
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; and
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Mi X, Fang Y, Pu J, Chen W, Zhou Z, Qin M, Zhang R, Wang D, Yang Y, Peng C, Bian S, Jin M, Xu H, Jiao Y. Temporal vascular arcade angle in fundus image was associated with the rate of spherical equivalent refractive error and axial length changes in myopia children with young school age. Photodiagnosis Photodyn Ther 2024; 49:104305. [PMID: 39134251 DOI: 10.1016/j.pdpdt.2024.104305] [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: 06/17/2024] [Revised: 07/28/2024] [Accepted: 08/09/2024] [Indexed: 08/25/2024]
Abstract
PURPOSE To evaluate temporal vascular arcade angle and its influencing factors in myopic children. METHODS It was a retrospective study, we reviewed the records of 119 patients aged 6-10 years with myopia (spherical equivalent refractive error (SER) ≤ -0.05D) in the third year of follow-up in Beijing Hyperopia Reserve Research. We measured temporal vascular arcade angles on the fundus photographs and measured 3-year rate of spherical equivalent(D/year) and axial length (AXL) changes(mm/year). RESULTS Mean age at initial visit was 7.71±1.20 years and mean SER was -1.32±1.09D. Children were divided into two groups according to the refractive status of children at baseline: Myopia onset group (SER>-0.50D at baseline) (n = 107) and Myopia progression group (SER≤-0.50D at baseline) (n = 12). The mean SER in Myopia progression group was much smaller than Myopia onset group (P < 0.001) and mean AXL in Myopia progression group was much longer than Myopia onset group (P = 0.042). AXL (r=-0.320, P < 0.001), SER change rate (r=-0.209, P = 0.022) and AXL change rate (r=-0.232, P = 0.011) were associated with temporal vascular arcade angle in all participants. In Myopia onset group, AXL (r=-0.317, P < 0.001) and AXL change rate (r=-0.190, P = 0.05) were associated with temporal vascular arcade angle. There were no parameters were associated with temporal vascular arcade angle (all P > 0.05) in Myopia progression group. Only AXL (r=-0.306, P = 0.018) was associated with temporal vascular arcade angle in girls while AXL (r=-0.370, P = 0.004), SER change rate (r=-0.317, P = 0.013) and AXL change rate (r=-0.365, P = 0.004) were all associated with the Angle in boys. CONCLUSION Temporal vascular arcade angle was associated with the rate of SER and AXL changes in myopia onset children, and showed gender differences. These may suggest that lamina cribrosa location has different influencing factors in different genders and different stages of myopia development. Due to the small number of people in Myopia progression group, large sample size studies are still needed in the future.
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Affiliation(s)
- Xuejing Mi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Yuxin Fang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Jianing Pu
- Maternal and Child Health Hospital of Haidian District, Beijing, China
| | - Wei Chen
- Maternal and Child Health Hospital of Haidian District, Beijing, China
| | - Zhen Zhou
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Mengmeng Qin
- School of Geosciences and Surveying Engineering, China University of Mining and Technology-Beijing, Beijing 100083, China
| | - Ranran Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Dan Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Yanyan Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Chuzhi Peng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Shimeng Bian
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Mingrui Jin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Huaying Xu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Yonghong Jiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China.
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Peng Y, Zhu W, Chen Z, Shi F, Wang M, Zhou Y, Wang L, Shen Y, Xiang D, Chen F, Chen X. AFENet: Attention Fusion Enhancement Network for Optic Disc Segmentation of Premature Infants. Front Neurosci 2022; 16:836327. [PMID: 35516802 PMCID: PMC9063315 DOI: 10.3389/fnins.2022.836327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Retinopathy of prematurity and ischemic brain injury resulting in periventricular white matter damage are the main causes of visual impairment in premature infants. Accurate optic disc (OD) segmentation has important prognostic significance for the auxiliary diagnosis of the above two diseases of premature infants. Because of the complexity and non-uniform illumination and low contrast between background and the target area of the fundus images, the segmentation of OD for infants is challenging and rarely reported in the literature. In this article, to tackle these problems, we propose a novel attention fusion enhancement network (AFENet) for the accurate segmentation of OD in the fundus images of premature infants by fusing adjacent high-level semantic information and multiscale low-level detailed information from different levels based on encoder-decoder network. Specifically, we first design a dual-scale semantic enhancement (DsSE) module between the encoder and the decoder inspired by self-attention mechanism, which can enhance the semantic contextual information for the decoder by reconstructing skip connection. Then, to reduce the semantic gaps between the high-level and low-level features, a multiscale feature fusion (MsFF) module is developed to fuse multiple features of different levels at the top of encoder by using attention mechanism. Finally, the proposed AFENet was evaluated on the fundus images of preterm infants for OD segmentation, which shows that the proposed two modules are both promising. Based on the baseline (Res34UNet), using DsSE or MsFF module alone can increase Dice similarity coefficients by 1.51 and 1.70%, respectively, whereas the integration of the two modules together can increase 2.11%. Compared with other state-of-the-art segmentation methods, the proposed AFENet achieves a high segmentation performance.
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Affiliation(s)
- Yuanyuan Peng
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Weifang Zhu
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Zhongyue Chen
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Fei Shi
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Meng Wang
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Yi Zhou
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Lianyu Wang
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Yuhe Shen
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
| | - Daoman Xiang
- Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Feng Chen
- Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Xinjian Chen
- Analysis and Visualization Lab, School of Electronics and Information Engineering and Medical Image Processing, Soochow University, Suzhou, China
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
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Robust Detection and Modeling of the Major Temporal Arcade in Retinal Fundus Images. MATHEMATICS 2022. [DOI: 10.3390/math10081334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The Major Temporal Arcade (MTA) is a critical component of the retinal structure that facilitates clinical diagnosis and monitoring of various ocular pathologies. Although recent works have addressed the quantitative analysis of the MTA through parametric modeling, their efforts are strongly based on an assumption of symmetry in the MTA shape. This work presents a robust method for the detection and piecewise parametric modeling of the MTA in fundus images. The model consists of a piecewise parametric curve with the ability to consider both symmetric and asymmetric scenarios. In an initial stage, multiple models are built from random blood vessel points taken from the blood-vessel segmented retinal image, following a weighted-RANSAC strategy. To choose the final model, the algorithm extracts blood-vessel width and grayscale-intensity features and merges them to obtain a coarse MTA probability function, which is used to weight the percentage of inlier points for each model. This procedure promotes selecting a model based on points with high MTA probability. Experimental results in the public benchmark dataset Digital Retinal Images for Vessel Extraction (DRIVE), for which manual MTA delineations have been prepared, indicate that the proposed method outperforms existing approaches with a balanced Accuracy of 0.7067, Mean Distance to Closest Point of 7.40 pixels, and Hausdorff Distance of 27.96 pixels, while demonstrating competitive results in terms of execution time (9.93 s per image).
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5
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Huang YP, Vadloori S, Kang EYC, Wu WC. Computer-Aided Detection of Retinopathy of Prematurity Severity in Preterm Infants via Measurement of Temporal Vessel Width and Angle. Front Pediatr 2022; 10:792724. [PMID: 35155307 PMCID: PMC8831837 DOI: 10.3389/fped.2022.792724] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Retinopathy of prematurity (ROP) is a retinal disorder that occurs in preterm infants with low birth weight and is the leading cause of preventable blindness in children. Early identification of high-risk patients and early diagnosis and timely treatment of ROP can substantially improve patients' visual outcomes. However, manual screening consumes both time and resources. Telescreening using retinal fundus images has the potential to reduce the burden engendered by the necessity of on-site screening. Recently, substantial progress has been made in using computer-aided diagnosis with retinal fundus images, and this approach has attracted considerable attention for the diagnosis of eye diseases. Abnormalities of and alterations in retinal blood vessels may relate to the occurrence and progression of ROP. In this study, we examined the hypothesis that ROP severity may be associated with the angle and width of arteries and veins. We computationally determined the artery-artery and vein-vein angles in the temporal quadrants-the temporal artery angle (TAA) and temporal vein angle (TVA)-under normal conditions and in different ROP stages. We also estimated retinal vessel width-temporal artery width (TAW) and temporal vein width (TVW)-by applying the Radon transform method to fundus images. Our results revealed significant decreases in TAA and TVA and increases in TAW and TVW with increasing ROP severity (all P < 0.0001).In addition, we observed positive TAA-TVA and TAW-TVW correlations (both P < 0.0001). The TAA was negatively correlated with the TAW (r = -0.162, P = 0.0314). These retinal vessel features may be useful in assisting ophthalmologists in the early detection of ROP and its progression.
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Affiliation(s)
- Yo-Ping Huang
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan.,Department of Electrical Engineering, National Penghu University of Science and Technology, Penghu, Taiwan.,Department of Information and Communication Engineering, Chaoyang University of Technology, Taichung, Taiwan
| | - Spandana Vadloori
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Eugene Yu-Chuan Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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6
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Feng X, Nan Y, Pan J, Zou R, Shen L, Chen F. Comparative study on optic disc features of premature infants and full-term newborns. BMC Ophthalmol 2021; 21:120. [PMID: 33676441 PMCID: PMC7936456 DOI: 10.1186/s12886-021-01833-6] [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: 05/23/2020] [Accepted: 01/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background To study optic disc features of premature infants and compare to that of term infants to explore the pattern and features of newborn optic disc development and provide the basis for the diagnosis of newborn optic disc disease. Methods This was a prospective clinical research. Newborns underwent newborn fundus disease screening from January 1st, 2016 to October 31st, 2016 in the neonatal ward of Ruian City Maternal and Child Health Hospital were selected. RetCam 3 Version6.1.25.0 Wide-Field Digital Pediatric Retinal Imaging System developed by Clarity Medical Systems, Inc was adopted to conduct fundus examination on both eyes, 130 degree wide-angle lens was used to film the images centering optic disc. Results For both premature infants and full-term newborns, vertical diameter of the optic disc to lateral diameter of the optic disc ratio was > 1, and the shape of the optic disc was a vertical oval. The difference of each optic disc parameter between premature infants and full-term newborns was not statistically significant (P > 0.05). There’s a difference of constitution of sclerotic ring type on optic disc between premature infants and full-term newborns. Among which, the proportion of single ring type and double ring type in premature infants was higher than that in full-term newborns (P < 0.05). The proportion of no ring type in full-term newborns was higher than that in premature infants (P < 0.05). The proportion of mixed type had no significant difference (P > 0.05) between premature infants and full-term newborns. Conclusions We found that The proportion of mature types (single ring type and double ring type) in full-term newborns was higher than that in premature infants. While there’s no statistical difference of the proportion of mixed types between premature infants and full-term newborns. Double ring type was a normal stage of the development of optic disc.
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Affiliation(s)
- Xiaofen Feng
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan Nan
- Ruian Maternity and Child Care Hospital, Wenzhou, Zhejiang, China
| | - Jiandong Pan
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ruitao Zou
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lijun Shen
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Feng Chen
- School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Shin YI, Lee KM, Kim M, Oh S, Kim SH. Short foveo-disc distance in situs inversus of optic disc. Sci Rep 2020; 10:17740. [PMID: 33082477 PMCID: PMC7576120 DOI: 10.1038/s41598-020-74743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/06/2020] [Indexed: 12/01/2022] Open
Abstract
Situs inversus of optic disc (SIOD) is thought to be a congenital optic disc abnormality that is caused by dysversion of optic nerve insertion. SIOD, however, has many additional features that cannot be explained by abnormal optic-nerve-insertion directionality. In this study, we measured the distance between the fovea and disc in 22 eyes of 15 SIOD patients. For comparison, two control eyes were matched with each SIOD eye by age and axial length. The vertical distance between the temporal vascular arcades also was measured. The foveo-disc distance was shorter in the SIOD eyes than in the control eyes, while the inter-arcade distance did not differ. Further, we measured the circumpapillary retinal nerve fiber layer thickness, which showed nasal crowding of two humps in the SIOD eyes. This nasal crowding disappeared when we shifted the circle scan by the mean difference (465 μm) of the foveal-disc distance between the two groups. Our findings suggest that the optic disc was located closer to the fovea than it would have been normally. Thus, SIOD might reflect incomplete expansion of the posterior pole in the direction of the fovea-disc axis.
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Affiliation(s)
- Young In Shin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. .,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea.
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Tewari R, Chandra P, Agarwal R, Azad R. Posterior laser barrage in advancing retinopathy of prematurity: A prospective randomized study. Indian J Ophthalmol 2019; 67:866-870. [PMID: 31124504 PMCID: PMC6552574 DOI: 10.4103/ijo.ijo_1608_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To compare the outcomes of conventional laser photocoagulation versus additional posterior barrage laser in advanced stage 3 retinopathy of prematurity (ROP). Methods A total of 20 infants with bilateral symmetric zone 2 stage 3 advancing ROP were treated with conventional laser treatment followed by randomization of one eye to receive additional posterior retinal laser treatment. Disc-fovea and inter-arcade distance was measured. The patients were followed up prospectively for 3 months. Structural and functional outcomes and safety profile were analyzed. Results 18/20 (90%) eyes in the study group and 19/20 (95%) eyes in the control group achieved regression of disease. Faster and complete regression was observed at 4 weeks after posterior laser compared to the control group (P = 0.024). Disc-fovea and inter-arcade distance was comparable in both groups. Conclusion Additional posterior barrage laser is a safe technique that led to faster and more complete regression in eyes with advancing ROP. Final regression profile was comparable in both treatment modalities.
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Affiliation(s)
- Ruchir Tewari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Parijat Chandra
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh Agarwal
- Department of Pediatrics, Division of Neonatology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajvardhan Azad
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Oloumi F, Rangayyan RM, Ells AL. Computer-aided diagnosis of retinopathy in retinal fundus images of preterm infants via quantification of vascular tortuosity. J Med Imaging (Bellingham) 2016; 3:044505. [PMID: 28018938 PMCID: PMC5157208 DOI: 10.1117/1.jmi.3.4.044505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/18/2016] [Indexed: 11/14/2022] Open
Abstract
Retinopathy of prematurity (ROP), a disorder of the retina occurring in preterm infants, is the leading cause of preventable childhood blindness. An active phase of ROP that requires treatment is associated with the presence of plus disease, which is diagnosed clinically in a qualitative manner by visual assessment of the existence of a certain level of increase in the thickness and tortuosity of retinal vessels. The present study performs computer-aided diagnosis (CAD) of plus disease via quantitative measurement of tortuosity in retinal fundus images of preterm infants. Digital image processing techniques were developed for the detection of retinal vessels and measurement of their tortuosity. The total lengths of abnormally tortuous vessels in each quadrant and the entire image were then computed. A minimum-length diagnostic-decision-making criterion was developed to assess the diagnostic sensitivity and specificity of the values obtained. The area ([Formula: see text]) under the receiver operating characteristic curve was used to assess the overall diagnostic accuracy of the methods. Using a set of 19 retinal fundus images of preterm infants with plus disease and 91 without plus disease, the proposed methods provided an overall diagnostic accuracy of [Formula: see text]. Using the total length of all abnormally tortuous vessel segments in an image, our techniques are capable of CAD of plus disease with high accuracy without the need for manual selection of vessels to analyze. The proposed methods may be used in a clinical or teleophthalmological setting.
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Affiliation(s)
- Faraz Oloumi
- University of Calgary, Department of Electrical and Computer Engineering, Schulich School of Engineering, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Rangaraj M. Rangayyan
- University of Calgary, Department of Electrical and Computer Engineering, Schulich School of Engineering, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Anna L. Ells
- University of Calgary, Department of Electrical and Computer Engineering, Schulich School of Engineering, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
- University of Calgary, Division of Ophthalmology, Department of Surgery, Cumming School of Medicine, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
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10
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Oloumi F, Rangayyan RM, Ells AL. Computer-aided diagnosis of proliferative diabetic retinopathy via modeling of the major temporal arcade in retinal fundus images. J Digit Imaging 2014; 26:1124-30. [PMID: 23579735 DOI: 10.1007/s10278-013-9592-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Monitoring the openness of the major temporal arcade (MTA) and how it changes over time could facilitate diagnosis and treatment of proliferative diabetic retinopathy (PDR). We present methods for user-guided semiautomated modeling and measurement of the openness of the MTA based on Gabor filters for the detection of retinal vessels, morphological image processing, and a form of the generalized Hough transform for the detection of parabolas. The methods, implemented via a graphical user interface, were tested with retinal fundus images of 11 normal individuals and 11 patients with PDR in the present pilot study on potential clinical application. A method of arcade angle measurement was used for comparative analysis. The results using the openness parameters of single- and dual-parabolic models as well as the arcade angle measurements indicate areas under the receiver operating characteristics of A z = 0.87, 0.82, and 0.80, respectively. The proposed methods are expected to facilitate quantitative analysis of the architecture of the MTA, as well as assist in detection and diagnosis of PDR.
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Affiliation(s)
- Faraz Oloumi
- Department of Electrical and Computer Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada, T2N 1N4
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Oloumi F, Rangayyan RM, Ells AL. Computer-aided diagnosis of proliferative diabetic retinopathy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:1438-41. [PMID: 23366171 DOI: 10.1109/embc.2012.6346210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Monitoring the openness of the major temporal arcade (MTA) and how it changes over time could facilitate improved diagnosis and timely treatment of proliferative diabetic retinopathy (PDR). We present methods for user-guided modeling and measurement of the openness of the MTA based on a form of the generalized Hough transform for the detection of parabolas, and to compare it with a method of arcade angle measurement. The methods, implemented via a graphical user interface, were tested with retinal fundus images of 10 normal individuals and 15 patients with PDR. The results using the openness parameters of single- and dual-parabolic models as well as the arcade angle measurements indicate areas under the receiver operating characteristics of A(z)= 0.94, 0.87, and 0.84, respectively. The proposed methods should facilitate improved quantitative analysis of the architecture of the MTA, as well as assist in detection, diagnosis, and improved treatment of PDR.
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Affiliation(s)
- Faraz Oloumi
- Department of Electrical and Computer Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
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Wilson CM, Ells AL, Fielder AR. The challenge of screening for retinopathy of prematurity. Clin Perinatol 2013; 40:241-59. [PMID: 23719308 DOI: 10.1016/j.clp.2013.02.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Screening for retinopathy of prematurity (ROP) and the optimum treatment of sight-threatening disease requires detailed understanding of the infants at risk and timely identification. Despite a plethora of guidelines, not all populations and situations are adequately covered, so that what should be preventable visual disability still occurs. This article considers the design of screening guidelines and the possibility of a global guideline, although in certain parts of the world manpower for ROP screening is not available. Algorithms linked to the increase in weight of preterm infants over time may refine the number of babies needing to undergo treatment.
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Affiliation(s)
- Clare M Wilson
- Department of Visual Neuroscience, UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK.
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O'Connor AR, Wilson CM, Fielder AR. Ophthalmological problems associated with preterm birth. Eye (Lond) 2008; 21:1254-60. [PMID: 17914427 DOI: 10.1038/sj.eye.6702838] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
As survival of preterm infants improves, the long-term care of consequent ophthalmic problems is an expanding field. Preterm birth can inflict a host of challenges on the developing ocular system, resulting in the visual manifestations of varied significance and pathological scope. The ophthalmic condition most commonly associated with preterm birth is retinopathy of prematurity, which has the potential to result in devastating vision loss. However, the visual compromise from increased incidence of refractive errors, strabismus, and cerebral vision impairment has significant impact on visual function, which also has influence on other developmental aspects including psychological and educational. In this review, the normal ocular development is discussed, aiming to exemplify the impact of early exteriorisation on one of the more naive organs of prematurity. This is then related to the incidence and visual consequences of many types of deficit, including refractive error, strabismus, and loss of visual function in preterm populations, with comparisons to term infant studies. Often these conditions are linked with causal and resultant factors being impossible to segregate, but the common factor of increased rates of all types of ophthalmic deficits demonstrates that children born prematurely are indeed premature for life.
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Affiliation(s)
- A R O'Connor
- Division of Orthoptics, University of Liverpool, Liverpool, UK
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