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Akrobetu DY, Robbins CB, Ma JP, Soundararajan S, Quist MS, Stinnett SS, Moore KPL, Johnson KG, Liu AJ, Grewal DS, Fekrat S. Intrasession Repeatability of OCT Angiography Parameters in Neurodegenerative Disease. OPHTHALMOLOGY SCIENCE 2023; 3:100275. [PMID: 36950088 PMCID: PMC10025280 DOI: 10.1016/j.xops.2023.100275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/09/2023] [Accepted: 01/20/2023] [Indexed: 02/02/2023]
Abstract
Purpose To assess the intrasession repeatability of macular OCT angiography (OCTA) parameters in Alzheimer's disease (AD), mild cognitive impairment (MCI), Parkinson's disease (PD), and normal cognition (NC). Design Cross sectional study. Subjects Patients with a clinical diagnosis of AD, PD, MCI, or NC were imaged. Images with poor quality and of those with diabetes mellitus, glaucoma, or vitreoretinal disease were excluded from analysis. Methods Intervention or Testing All participants were imaged using the Zeiss Cirrus HD-5000 with AngioPlex (Carl Zeiss Meditec, Software Version 11.0.0.29946) and repeat OCTA images were obtained for both eyes. Perfusion density (PFD), vessel density (VD), and Foveal avascular zone (FAZ) area were measured from 3 × 3 mm and 6 × 6 mm OCTA images centered on the fovea using an ETDRS grid overlay. Main Outcome Measures Intraclass correlation coefficients were used to quantify repeatability of PFD, VD, and FAZ area measurements obtained from imaging. Results 3 × 3 mm scans of 22 AD, 40 MCI, 21 PD, and 26 NC participants and 6 × 6 mm scans of 29 AD, 44 MCI, 29 PD, and 30 NC participants were analyzed. Repeatability values ranged from 0.64 (0.49-0.82) for 6 × 6 mm PFD in AD participants to 0.87 (0.67-0.92) for 3 × 3 mm PFD in AD participants. No significant differences were observed in repeatability between NC participants and those with neurodegenerative disease. Conclusions Overall, similar OCTA repeatability was observed between NC participants and those with neurodegeneration. Regardless of diagnostic group, macular OCTA metrics demonstrated moderate to good repeatability. Financial Disclosures The authors have no proprietary or commercial interest in any materials discussed in this article.
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Key Words
- AD, Alzheimer's disease
- Alzheimer
- CI, confidence interval
- D, diopters
- FAZ, Foveal avascular zone
- ICC, intraclass correlation
- MCI, mild cognitive impairment
- MSE, mean square error
- Mild cognitive impairment
- NC, normal cognition
- OCTA
- OCTA, OCT angiography
- PD, Parkinson's disease
- PFD, Perfusion density
- Parkinson
- Repeatability
- SSI, strength signal index
- VD, vessel density
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Affiliation(s)
- Dennis Y Akrobetu
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Cason B Robbins
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Justin P Ma
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Srinath Soundararajan
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Michael S Quist
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Sandra S Stinnett
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Kathryn P L Moore
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Kim G Johnson
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Andy J Liu
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Dilraj S Grewal
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Sharon Fekrat
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
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Lee T, Rivera A, Brune M, Kundu A, Haystead A, Winslow L, Kundu R, Wisely CE, Robbins CB, Henao R, Grewal DS, Fekrat S. Convolutional Neural Network-Based Automated Quality Assessment of OCT and OCT Angiography Image Maps in Individuals With Neurodegenerative Disease. Transl Vis Sci Technol 2023; 12:30. [PMID: 37389540 PMCID: PMC10318591 DOI: 10.1167/tvst.12.6.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/04/2023] [Indexed: 07/01/2023] Open
Abstract
Purpose To train and test convolutional neural networks (CNNs) to automate quality assessment of optical coherence tomography (OCT) and OCT angiography (OCTA) images in patients with neurodegenerative disease. Methods Patients with neurodegenerative disease were enrolled in the Duke Eye Multimodal Imaging in Neurodegenerative Disease Study. Image inputs were ganglion cell-inner plexiform layer (GC-IPL) thickness maps and fovea-centered 6-mm × 6-mm OCTA scans of the superficial capillary plexus (SCP). Two trained graders manually labeled all images for quality (good versus poor). Interrater reliability (IRR) of manual quality assessment was calculated for a subset of each image type. Images were split into train, validation, and test sets in a 70%/15%/15% split. An AlexNet-based CNN was trained using these labels and evaluated with area under the receiver operating characteristic (AUC) and summaries of the confusion matrix. Results A total of 1465 GC-IPL thickness maps (1217 good and 248 poor quality) and 2689 OCTA scans of the SCP (1797 good and 892 poor quality) served as model inputs. The IRR of quality assessment agreement by two graders was 97% and 90% for the GC-IPL maps and OCTA scans, respectively. The AlexNet-based CNNs trained to assess quality of the GC-IPL images and OCTA scans achieved AUCs of 0.990 and 0.832, respectively. Conclusions CNNs can be trained to accurately differentiate good- from poor-quality GC-IPL thickness maps and OCTA scans of the macular SCP. Translational Relevance Since good-quality retinal images are critical for the accurate assessment of microvasculature and structure, incorporating an automated image quality sorter may obviate the need for manual image review.
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Affiliation(s)
- Terry Lee
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Alexandra Rivera
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Pratt School of Engineering, Duke University, Durham, NC, USA
| | - Matthew Brune
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Pratt School of Engineering, Duke University, Durham, NC, USA
| | - Anita Kundu
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Alice Haystead
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Pratt School of Engineering, Duke University, Durham, NC, USA
| | - Lauren Winslow
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Pratt School of Engineering, Duke University, Durham, NC, USA
| | - Raj Kundu
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Pratt School of Engineering, Duke University, Durham, NC, USA
| | - C. Ellis Wisely
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Cason B. Robbins
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Ricardo Henao
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
- Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA
| | - Dilraj S. Grewal
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Sharon Fekrat
- iMIND Study Group, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
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Ryu CK, Lim HB, Kim JY. Symmetry of Peripapillary-Optical Coherence Tomography Angiography Parameters between Dominant and Non-dominant Eyes in Normal Eyes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.11.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To assess whether optical coherence tomography (OCT) measurements and peripapillary microvascular parameters measured via optical coherence tomography angiography (OCTA) were similar between the dominant and non-dominant eyes of normal subjects.Methods: We retrospectively analyzed spectral domain OCT and OCTA data on healthy Koreans. The “hole-in-the-card” technique was used to determine ocular dominance. The perfusion density (PD) and flux index (FI) of the peripapillary 4.5 × 4.5-mm area were measured via OCTA. Central macular, peripapillary retinal nerve fiber layer, and macular ganglion cell-inner plexiform layer thicknesses were measured with the aid of spectral-domain OCT. The OCT and OCTA data of dominant and non-dominant eyes were compared.Results: A total of 84 eyes of 42 healthy subjects were analyzed. The average age was 27.3 ± 5.63 years. Twenty-eight subjects (66.7%) were right eye-dominant and 14 (33.3%) left eye-dominant. None of the central macular (260.00 ± 14.16 μm, 258.71 ± 15.18 μm, <i>p</i> = 0.183), macular ganglion cell-inner plexiform layer (82.02 ± 5.07 μm, 82.43 ± 5.60 μm, <i>p</i> = 0.460), or peripapillary retinal nerve fiber layer thickness (99.36 ± 9.27 μm, 97.90 ± 9.46 μm, <i>p</i> = 0.091) differed between the eyes; neither did any OCTA-assessed microvascular parameter.Conclusions: No OCT or OCTA parameter differed between dominant and non-dominant eyes. No parameter identified ocular dominance.
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Robbins CB, Grewal DS, Thompson AC, Soundararajan S, Yoon SP, Polascik BW, Scott BL, Fekrat S. Identifying Peripapillary Radial Capillary Plexus Alterations in Parkinson's Disease Using OCT Angiography. Ophthalmol Retina 2021; 6:29-36. [PMID: 33713852 DOI: 10.1016/j.oret.2021.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare radial peripapillary capillary (RPC) plexus vascular parameters and retinal nerve fiber layer (RNFL) thickness between those with Parkinson's disease (PD) and controls. DESIGN Prospective, cross-sectional study. PARTICIPANTS A total of 151 eyes of 81 PD participants and 514 eyes of 266 controls. METHODS Participants underwent OCT angiography (OCTA) imaging using the Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss AG). Capillary perfusion density (CPD) and capillary flux index (CFI) were assessed using a 4.5 × 4.5-mm peripapillary scan, and RNFL thickness was assessed using a 200 × 200-μm optic nerve cube OCT scan. Hoehn and Yahr clinical staging for PD was determined by an experienced movement disorders specialist. Generalized estimating equations adjusted for age and sex were used for analysis. MAIN OUTCOME MEASURES Differences in RNFL thickness, CPD, and CFI as assessed using multivariable generalized estimating equations between individuals with PD and controls. RESULTS After adjustment for age and sex, average CPD (0.446% ± 0.018% vs. 0.439% ± 0.017%, P < 0.001) and CFI (0.434 ± 0.031 vs. 0.426 ± 0.036, P = 0.008) were significantly higher in PD eyes. Average RNFL thickness was similar between groups (PD 89.71 ± 10.45 μm vs. control 88.20 ± 10.33 μm, P = 0.19). Significant correlations between Hoehn and Yahr stage and OCTA parameters were not observed. The OCTA parameters were not significantly different between eyes of the same patient. CONCLUSIONS Increased peripapillary microvascular density and flux were detected in a large cohort of individuals with PD compared with controls after adjusting for age and sex; however, RNFL thickness was similar between groups. Peripapillary OCTA parameters may not correlate with the severity of PD. OCTA may serve as a noninvasive method to identify novel biomarkers for the early diagnosis of PD; as such, this methodology deserves further investigation.
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Affiliation(s)
- Cason B Robbins
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Dilraj S Grewal
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Atalie C Thompson
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Srinath Soundararajan
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Stephen P Yoon
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Bryce W Polascik
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Burton L Scott
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Sharon Fekrat
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
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