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Valmaggia P, Cattin PC, Sandkühler R, Inglin N, Otto TP, Aumann S, Teussink MM, Spaide RF, Scholl HPN, Maloca PM. Time-Resolved Dynamic Optical Coherence Tomography for Retinal Blood Flow Analysis. Invest Ophthalmol Vis Sci 2024; 65:9. [PMID: 38837167 PMCID: PMC11160951 DOI: 10.1167/iovs.65.6.9] [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] [Received: 11/01/2023] [Accepted: 05/16/2024] [Indexed: 06/06/2024] Open
Abstract
Purpose Optical coherence tomography (OCT) representations in clinical practice are static and do not allow for a dynamic visualization and quantification of blood flow. This study aims to present a method to analyze retinal blood flow dynamics using time-resolved structural OCT. Methods We developed novel imaging protocols to acquire video-rate time-resolved OCT B-scans (1024 × 496 pixels, 10 degrees field of view) at four different sensor integration times (integration time of 44.8 µs at a nominal A-scan rate of 20 kHz, 22.4 µs at 40 kHz, 11.2 µs at 85 kHz, and 7.24 µs at 125 kHz). The vessel centers were manually annotated for each B-scan and surrounding subvolumes were extracted. We used a velocity model based on signal-to-noise ratio (SNR) drops due to fringe washout to calculate blood flow velocity profiles in vessels within five optic disc diameters of the optic disc rim. Results Time-resolved dynamic structural OCT revealed pulsatile SNR changes in the analyzed vessels and allowed the calculation of potential blood flow velocities at all integration times. Fringe washout was stronger in acquisitions with longer integration times; however, the ratio of the average SNR to the peak SNR inside the vessel was similar across all integration times. Conclusions We demonstrated the feasibility of estimating blood flow profiles based on fringe washout analysis, showing pulsatile dynamics in vessels close to the optic nerve head using structural OCT. Time-resolved dynamic OCT has the potential to uncover valuable blood flow information in clinical settings.
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Affiliation(s)
- Philippe Valmaggia
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Philippe C. Cattin
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Robin Sandkühler
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Nadja Inglin
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Basel, Switzerland
| | | | - Silke Aumann
- Heidelberg Engineering GmbH, Heidelberg, Germany
| | | | - Richard F. Spaide
- Vitreous Retina Macula Consultants of New York, New York, United States
| | - Hendrik P. N. Scholl
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Peter M. Maloca
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
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Richer E, Solano MM, Cheriet F, Lesk MR, Costantino S. Denoising OCT videos based on temporal redundancy. Sci Rep 2024; 14:6605. [PMID: 38503804 PMCID: PMC10951312 DOI: 10.1038/s41598-024-56935-0] [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] [Received: 09/29/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
The identification of eye diseases and their progression often relies on a clear visualization of the anatomy and on different metrics extracted from Optical Coherence Tomography (OCT) B-scans. However, speckle noise hinders the quality of rapid OCT imaging, hampering the extraction and reliability of biomarkers that require time series. By synchronizing the acquisition of OCT images with the timing of the cardiac pulse, we transform a low-quality OCT video into a clear version by phase-wrapping each frame to the heart pulsation and averaging frames that correspond to the same instant in the cardiac cycle. Here, we compare the performance of our one-cycle denoising strategy with a deep-learning architecture, Noise2Noise, as well as classical denoising methods such as BM3D and Non-Local Means (NLM). We systematically analyze different image quality descriptors as well as region-specific metrics to assess the denoising performance based on the anatomy of the eye. The one-cycle method achieves the highest denoising performance, increases image quality and preserves the high-resolution structures within the eye tissues. The proposed workflow can be readily implemented in a clinical setting.
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Affiliation(s)
- Emmanuelle Richer
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, QC, H3T 1J4, Canada
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada
| | - Marissé Masís Solano
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, H3T 1P1, Canada
| | - Farida Cheriet
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, QC, H3T 1J4, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, H3T 1P1, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, H1T 2M4, Canada.
- Department of Ophthalmology, Université de Montréal, Montreal, QC, H3T 1P1, Canada.
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Thiéry AH, Braeu F, Tun TA, Aung T, Girard MJA. Medical Application of Geometric Deep Learning for the Diagnosis of Glaucoma. Transl Vis Sci Technol 2023; 12:23. [PMID: 36790820 PMCID: PMC9940771 DOI: 10.1167/tvst.12.2.23] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Purpose (1) To assess the performance of geometric deep learning in diagnosing glaucoma from a single optical coherence tomography (OCT) scan of the optic nerve head and (2) to compare its performance to that obtained with a three-dimensional (3D) convolutional neural network (CNN), and with a gold-standard parameter, namely, the retinal nerve fiber layer (RNFL) thickness. Methods Scans of the optic nerve head were acquired with OCT for 477 glaucoma and 2296 nonglaucoma subjects. All volumes were automatically segmented using deep learning to identify seven major neural and connective tissues. Each optic nerve head was then represented as a 3D point cloud with approximately 1000 points. Geometric deep learning (PointNet) was then used to provide a glaucoma diagnosis from a single 3D point cloud. The performance of our approach (reported using the area under the curve [AUC]) was compared with that obtained with a 3D CNN, and with the RNFL thickness. Results PointNet was able to provide a robust glaucoma diagnosis solely from a 3D point cloud (AUC = 0.95 ± 0.01).The performance of PointNet was superior to that obtained with a 3D CNN (AUC = 0.87 ± 0.02 [raw OCT images] and 0.91 ± 0.02 [segmented OCT images]) and with that obtained from RNFL thickness alone (AUC = 0.80 ± 0.03). Conclusions We provide a proof of principle for the application of geometric deep learning in glaucoma. Our technique requires significantly less information as input to perform better than a 3D CNN, and with an AUC superior to that obtained from RNFL thickness. Translational Relevance Geometric deep learning may help us to improve and simplify diagnosis and prognosis applications in glaucoma.
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Affiliation(s)
- Alexandre H. Thiéry
- Department of Statistics and Data Science, National University of Singapore, Singapore
| | - Fabian Braeu
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tin A. Tun
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Graduate Medical School, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Graduate Medical School, Singapore
| | - Michaël J. A. Girard
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Graduate Medical School, Singapore,Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
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Solano MM, Richer E, Cheriet F, Lesk MR, Costantino S. Mapping Pulsatile Optic Nerve Head Deformation Using OCT. OPHTHALMOLOGY SCIENCE 2022; 2:100205. [PMID: 36531582 PMCID: PMC9754981 DOI: 10.1016/j.xops.2022.100205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To develop a noninvasive technique to quantitatively assess the pulsatile deformation due to cardiac contractions of the optic nerve head (ONH). DESIGN Evaluation of a diagnostic test or technology. PARTICIPANTS Healthy subjects with no history of refractive surgery, divided into 2 cohorts on the basis of their axial length (AL). METHODS We present a noninvasive technique to quantitatively assess the pulsatile deformation of the ONH tissue by combining high-frequency OCT imaging and widely available image processing algorithms. We performed a thorough validation of the approach, numerically and experimentally, evaluating the sensitivity of the method to artificially induced deformation and its robustness to different noise levels. We performed deformation measurements in cohorts of healthy (n = 9) and myopic (n = 5) subjects in different physiological strain conditions by calculating the amplitude of tissue displacement in both the primary position and abduction. The head rotation was measured using a goniometer. During imaging in abduction, the head was rotated 40° ± 3°, and subjects were instructed to direct their gaze toward the OCT visual target. MAIN OUTCOME MEASURES Pulsatile tissue displacement maps. RESULTS The robustness of the method was assessed using artificial deformations and increasing noise levels. The results show acceptable absolute errors before the noise simulations grossly exaggerate image degradation. For the group of subjects with AL of < 25 mm (n = 9), the median pulsatile displacement of the ONH was 7.8 ± 1.3 μm in the primary position and 8.9 ± 1.2 μm in abduction. The Wilcoxon test showed a significant difference (P ≤ 0.005) between the 2 paired measures. Reproducibility was tested in 2 different sessions in 5 different subjects with the same intraocular pressure, and an intraclass correlation coefficient of 0.99 was obtained (P < 0.005). CONCLUSIONS The computational pipeline demonstrated good reproducibility and had the capacity to accurately map the pulsatile deformation of the optic nerve. In a clinical setting, we detected physiological changes in normal subjects supporting its translation potential as a novel biomarker for the diagnosis and progression of optic nerve diseases.
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Affiliation(s)
- Marissé Masís Solano
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Ophthalmology. Université de Montréal, Montreal, Quebec, Canada
| | - Emmanuelle Richer
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Farida Cheriet
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Mark R. Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Ophthalmology. Université de Montréal, Montreal, Quebec, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Ophthalmology. Université de Montréal, Montreal, Quebec, Canada
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Zhao Y, Hu G, Yan Y, Wang Z, Liu X, Shi H. Biomechanical analysis of ocular diseases and its in vitro study methods. Biomed Eng Online 2022; 21:49. [PMID: 35870978 PMCID: PMC9308301 DOI: 10.1186/s12938-022-01019-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/13/2022] [Indexed: 12/25/2022] Open
Abstract
Ocular diseases are closely related to the physiological changes in the eye sphere and its contents. Using biomechanical methods to explore the relationship between the structure and function of ocular tissue is beneficial to reveal the pathological processes. Studying the pathogenesis of various ocular diseases will be helpful for the diagnosis and treatment of ocular diseases. We provide a critical review of recent biomechanical analysis of ocular diseases including glaucoma, high myopia, and diabetes. And try to summarize the research about the biomechanical changes in ocular tissues (e.g., optic nerve head, sclera, cornea, etc.) associated with those diseases. The methods of ocular biomechanics research in vitro in recent years are also reviewed, including the measurement of biomechanics by ophthalmic equipment, finite element modeling, and biomechanical analysis methods. And the preparation and application of microfluidic eye chips that emerged in recent years were summarized. It provides new inspiration and opportunity for the pathogenesis of eye diseases and personalized and precise treatment.
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Foster WJ, Berg BW, Luminais SN, Hadayer A, Schaal S. Computational Modeling of Ophthalmic Procedures: Computational Modeling of Ophthalmic Procedures. Am J Ophthalmol 2022; 241:87-107. [PMID: 35358485 PMCID: PMC9444883 DOI: 10.1016/j.ajo.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/16/2022] [Accepted: 03/17/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To explore how finite-element calculations can continue to contribute to diverse problems in ophthalmology and vision science, we describe our recent work on modeling the force on the peripheral retina in intravitreal injections and how that force increases with shorter, smaller gauge needles. We also present a calculation that determines the location and stress on a retinal pigment epithelial detachment during an intravitreal injection, the possibility that stress induced by the injection can lead to a tear of the retinal pigment epithelium. BACKGROUND Advanced computational models can provide a critical insight into the underlying physics in many surgical procedures, which may not be intuitive. METHODS The simulations were implemented using COMSOL Multiphysics. We compared the monkey retinal adhesive force of 18 Pa with the results of this study to quantify the maximum retinal stress that occurs during intravitreal injections. CONCLUSIONS Currently used 30-gauge needles produce stress on the retina during intravitreal injections that is only slightly below the limit that can create retinal tears. As retina specialists attempt to use smaller needles, the risk of complications may increase. In addition, we find that during an intravitreal injection, the stress on the retina in a pigment epithelial detachment occurs at the edge of the detachment (found clinically), and the stress is sufficient to tear the retina. These findings may guide physicians in future clinical research. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Affiliation(s)
- William J Foster
- From the Department of Bioengineering (W.J.F.), Lewes Katz School of Medicine (B.W.B., S.N.L.), Temple University, Philadelphia, Pennsylvania, USA; Altasciences, Montréal, Québec, Canada (W.J.F.).
| | - Brian W Berg
- From the Department of Bioengineering (W.J.F.), Lewes Katz School of Medicine (B.W.B., S.N.L.), Temple University, Philadelphia, Pennsylvania, USA
| | - Steven N Luminais
- From the Department of Bioengineering (W.J.F.), Lewes Katz School of Medicine (B.W.B., S.N.L.), Temple University, Philadelphia, Pennsylvania, USA
| | - Amir Hadayer
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (A.H.)
| | - Shlomit Schaal
- Department of Ophthalmology, University of Massachusetts Medical School, Worcester, Massachusetts, USA (S.S.)
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Son DY, Kwon HB, Lee DS, Jin HW, Jeong JH, Kim J, Choi SH, Yoon H, Lee MH, Lee YJ, Park KS. Changes in physiological network connectivity of body system in narcolepsy during REM sleep. Comput Biol Med 2021; 136:104762. [PMID: 34399195 DOI: 10.1016/j.compbiomed.2021.104762] [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: 05/06/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Narcolepsy is marked by pathologic symptoms including excessive daytime drowsiness and lethargy, even with sufficient nocturnal sleep. There are two types of narcolepsy: type 1 (with cataplexy) and type 2 (without cataplexy). Unlike type 1, for which hypocretin is a biomarker, type 2 narcolepsy has no adequate biomarker to identify the causality of narcoleptic phenomenon. Therefore, we aimed to establish new biomarkers for narcolepsy using the body's systemic networks. METHOD Thirty participants (15 with type 2 narcolepsy, 15 healthy controls) were included. We used the time delay stability (TDS) method to examine temporal information and determine relationships among multiple signals. We quantified and analyzed the network connectivity of nine biosignals (brainwaves, cardiac and respiratory information, muscle and eye movements) during nocturnal sleep. In particular, we focused on the differences in network connectivity between groups according to sleep stages and investigated whether the differences could be potential biomarkers to classify both groups by using a support vector machine. RESULT In rapid eye movement sleep, the narcolepsy group displayed more connections than the control group (narcolepsy connections: 24.47 ± 2.87, control connections: 21.34 ± 3.49; p = 0.022). The differences were observed in movement and cardiac activity. The performance of the classifier based on connectivity differences was a 0.93 for sensitivity, specificity and accuracy, respectively. CONCLUSION Network connectivity with the TDS method may be used as a biomarker to identify differences in the systemic networks of patients with narcolepsy type 2 and healthy controls.
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Affiliation(s)
- Dong Yeon Son
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea; Integrated Major in Innovative Medical Science, College of Medicine, Seoul National University, Seoul, 03080, South Korea
| | - Hyun Bin Kwon
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea
| | - Dong Seok Lee
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea
| | - Hyung Won Jin
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, 03080, South Korea
| | - Jong Hyeok Jeong
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea; Integrated Major in Innovative Medical Science, College of Medicine, Seoul National University, Seoul, 03080, South Korea
| | - Jeehoon Kim
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, 03080, South Korea
| | - Sang Ho Choi
- School of Computer and Information Engineering, Kwangwoon University, Seoul, 01897, South Korea
| | - Heenam Yoon
- Department of Human-Centered Artificial Intelligence, Sangmyung University, Seoul, 03016, South Korea
| | - Mi Hyun Lee
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, 03080, South Korea
| | - Yu Jin Lee
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, 03080, South Korea
| | - Kwang Suk Park
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, 03080, South Korea; Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, 03080, South Korea.
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