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Fernández-Vigo JI, Macarro-Merino A, De Moura-Ramos JJ, Alvarez-Rodriguez L, Burgos-Blasco B, Novo-Bujan J, Ortega-Hortas M, Fernández-Vigo JÁ. Comparative study of the glistening between four intraocular lens models assessed by OCT and deep learning. J Cataract Refract Surg 2024; 50:37-42. [PMID: 37702457 DOI: 10.1097/j.jcrs.0000000000001316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To evaluate the glistening in 4 different models of intraocular lenses (IOLs) using optical coherence tomography (OCT) and deep learning (DL). SETTING Centro Internacional de Oftalmología Avanzada (Madrid, Spain). DESIGN Cross-sectional study. METHODS 325 eyes were assessed for the presence and severity of glistening in 4 IOL models: ReSTOR+3 SN6AD1 (n = 41), SN60WF (n = 110), PanOptix TFNT (n = 128) and Vivity DFT015 (n = 46). The presence of glistening was analyzed using OCT, identifying the presence of hyperreflective foci (HRF) in the central area of the IOL. A manual and an original DL-based quantification algorithm designed for this purpose was applied. RESULTS Glistening was detected in 22 (53.7%) ReSTOR SN6AD1, 44 (40%) SN60WF, 49 (38.3%) PanOptix TFNT, and 4 (8.7%) Vivity DFT015 IOLs, when any grade was considered. In the comparison of the different types of IOLs, global glistening measured as total HRF was 17.3 ± 25.9 for the ReSTOR+3; 9.3 ± 15.7 for the SN60WF; 6.9 ± 10.5 for the PanOptix; and 1.2 ± 2.6 for the Vivity ( P < .05). There was excellent agreement between manual and DL-based quantification (≥0.829). CONCLUSIONS It is possible to quantify, classify and compare the glistening severity in different IOL models using OCT images in a simple and objective manner with a DL algorithm. In the comparative study, the Vivity presented the lowest severity of glistening.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- From the Centro Internacional de Oftalmología Avanzada, Madrid, Spain (J.I. Fernández-Vigo, Macarro-Merino, J.Á. Fernández-Vigo); Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain (J.I. Fernández-Vigo, Burgos-Blasco); Department of Computational, Centro de Investigacion CITIC, Universidade da Coruña, A Coruña, Spain (De Moura-Ramos, Alvarez-Rodriguez, Novo-Bujan, Ortega-Hortas); Department of Computational, VARPA Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain (De Moura-Ramos, Alvarez-Rodriguez, Novo-Bujan, Ortega-Hortas); Department of Ophthalmology, Universidad de Extremadura, Badajoz, Spain (J.Á. Fernández-Vigo)
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Stanojcic N, Hull CC, Mangieri E, Little N, O'Brart D. A new software for automated counting of glistenings in intraocular lenses in vivo. Int J Ophthalmol 2023; 16:1237-1242. [PMID: 37602355 PMCID: PMC10398534 DOI: 10.18240/ijo.2023.08.08] [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: 06/03/2022] [Accepted: 05/24/2023] [Indexed: 08/22/2023] Open
Abstract
AIM To assess the performance of a bespoke software for automated counting of intraocular lens (IOL) glistenings in slit-lamp images. METHODS IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software. The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading. A second set of 63 images, selected using randomised stratified sampling from 290 images, were used for software validation. The images were obtained using a previously described protocol. Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists. RESULTS A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set. Using this threshold value, only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images (κ=0.104, 95%CI, 0.040-0.168). Ten images (15.9%) had glistenings counts that agreed between the software and manual counting. There were 49 images (77.8%) where the software overestimated the number of glistenings. CONCLUSION The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application. Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement. The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.
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Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- Centre for Applied Vision Research, School of Health Sciences, University of London, London EC1V 0HB, UK
- King's College, London WC2R 2LS, UK
| | - Christopher C. Hull
- Centre for Applied Vision Research, School of Health Sciences, University of London, London EC1V 0HB, UK
| | | | | | - David O'Brart
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- King's College, London WC2R 2LS, UK
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Stanojcic N, Hull C, O'Brart D. Comment on Fernández-Vigo et al. Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J. Clin. Med. 2023, 12, 2351. J Clin Med 2023; 12:jcm12113685. [PMID: 37297881 DOI: 10.3390/jcm12113685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
We read with interest your article describing a new objective method for evaluating glistenings in intraocular lenses (IOLs) in vivo [...].
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Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, St Thomas' Hospital, London SE1 7EH, UK
- Cataract and Cornea Research Group, King's College London, Strand, London WC2R 2LS, UK
| | - Chris Hull
- Centre for Applied Vision Research, School of Health Sciences, University of London, London EC1V 0HB, UK
| | - David O'Brart
- Department of Ophthalmology, St Thomas' Hospital, London SE1 7EH, UK
- Cataract and Cornea Research Group, King's College London, Strand, London WC2R 2LS, UK
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Fernández-Vigo JI, Burgos-Blasco B, De-Pablo-Gómez-de-Liaño L, Sánchez-Guillén I, Albitre-Barca V, Fernández-Aragón S, Fernández-Vigo JÁ, Macarro-Merino A. Reply to Stanojcic et al. Comment on "Fernández-Vigo et al. Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J. Clin. Med. 2023, 12, 2351". J Clin Med 2023; 12:jcm12113686. [PMID: 37297882 DOI: 10.3390/jcm12113686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
We appreciate the comments made by Stanojcic et al. [...].
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain
| | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain
| | - Lucía De-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Inés Sánchez-Guillén
- Department of Ophthalmology, Hospital Perpetuo Socorro, 06010 Badajoz, Spain
- Centro Internacional de Oftalmología Avanzada, 06011 Badajoz, Spain
| | | | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Centro Internacional de Oftalmología Avanzada, 06011 Badajoz, Spain
- Department of Ophthalmology, Universidad de Extremadura, 06006 Badajoz, Spain
| | - Ana Macarro-Merino
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Centro Internacional de Oftalmología Avanzada, 06011 Badajoz, Spain
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Stanojcic N, Hull C, O'Brart DPS. Reply to letter from Drs. Piotr Kanclerz and Andrzej Grzybowski entitled "Glistenings might be associated with disability glare". Eur J Ophthalmol 2021; 32:NP347-NP348. [PMID: 34755575 PMCID: PMC8777313 DOI: 10.1177/11206721211059004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, 8945Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Christopher Hull
- School of Health Science, Division of Optometry and Visual Sciences, City University, London, UK
| | - David P S O'Brart
- Department of Ophthalmology, 8945Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
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Grzybowski A, Markeviciute A, Zemaitiene R. A narrative review of intraocular lens opacifications: update 2020. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1547. [PMID: 33313292 PMCID: PMC7729367 DOI: 10.21037/atm-20-4207] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The opacifications of intraocular lenses (IOLs) can significantly impact patients visual quality. Despite the identification of specific risk factors, manufacturing changes, opacifications are not eliminated. Likewise, more attention in recent studies was paid to possible new risk factors, however one of the most important purposes of the studies remains opacifications effect on visual performance, which could be disturbed in different aspects. The aim of this review is to discuss the main risk factors of IOLs opacification in particular IOL types, and its impact on vision quality. Different risk factors were discussed in the study, including the material of IOLs, the impact of the breakdown of blood-aqueous barrier (BAB), and certain surgeries that can be associated with opacification formation. Glistenings occur more often in a hydrophobic material, however, the changes in water content of the IOLs can significantly reduce the formation of glistenings. The studies showed a significant effect of intraocular injection of exogenous air or gas during Descemet-stripping endothelial keratoplasty, Descemet-stripping automated endothelial keratoplasty, Descemet membrane endothelial keratoplasty, and pars plana vitrectomy on calcification formation. It raises a concern, as the incidence of these surgeries is increasing. Visual acuity decreases significantly after the calcification in IOLs occurs, and it usually causes IOLs exchange. However, disability glare seems to be more affected in patients with IOLs, which were affected by glistenings than visual acuity. Disability glare is associated with increased levels of straylight, which was widely evaluated in recent studies and it was reported to be a susceptible measurement to detect the presence of IOLs pathology. For future researches, it should be noticed that disability glare and straylight are more appropriate in evaluating IOLs opacification effect on visual quality than visual acuity. While reviewing the main risk factors of IOLs opacifications particular attention must be paid on calcification occurrence in hydrophilic acrylic IOLs after surgeries with intraocular injection of exogenous air or gas.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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