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Tanikawa A, Maruyama K, Liu S, Mao Z, Wang Z, Shiraki N, Hashida N, Kawasaki R, Chan K, Nishida K. Unveiling Key Pathological Indicators for Disease Progression in Vogt Koyanagi Harada Disease and Sympathetic Ophthalmia Through Advanced Choroidal Volume Analysis. Ocul Immunol Inflamm 2024:1-9. [PMID: 38709183 DOI: 10.1080/09273948.2024.2337836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/27/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To evaluate the association between quantitative parameters derived from volume analysis of optical coherence tomography (OCT) data and disease worsening in Vogt-Koyanagi-Harada disease (VKHD) and sympathetic ophthalmia (SO). METHODS This retrospective study, conducted at Osaka University Hospital, employed swept-source OCT scans from patients diagnosed with VKHD or SO between October 2012 and January 2021. The choroidal vessel structure was segmented and visualized in three dimensions, generating quantitative vessel volume maps. Region-specific choroidal vessel volume (CVV), choroidal volume (CV), and vessel index (VI) were scrutinized for their potential correlation with disease severity. RESULTS Thirty-five eyes of 18 VKHD and 2 SO patient (8 females, 10 males) were evaluated. OCT-derived CVV maps revealed regional CV alterations in VKHD and SO patients. Two parameters, i.e. CV at 3- and 6-month follow-ups (p = 0.044, p = 0.040, respectively, with area under the ROC curve of 0.70) and CVV at 6 months (p = 0.046, area under the ROC curve of 0.71), were significantly higher in recurrent VKHD and SO compared to effectively treated cases. CONCLUSIONS The volume analysis of OCT images facilitates a three-dimensional visualization of choroidal alterations, which may serve as a reflection of disease severity in VKHD and SO patients. Furthermore, noninvasive initial CVV or CV measurements may serve as potential biomarkers for predicting disease recurrence in VKHD and SO.
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Affiliation(s)
- Akira Tanikawa
- Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazuichi Maruyama
- Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Department of Vision Informatics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
| | - Shiyi Liu
- Topcon Advanced Biomedical Imaging Laboratory, Oakland, New Jersey
| | - Zaixing Mao
- Topcon Advanced Biomedical Imaging Laboratory, Oakland, New Jersey
| | - Zhenguo Wang
- Topcon Advanced Biomedical Imaging Laboratory, Oakland, New Jersey
| | - Nobuhiko Shiraki
- Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Noriyasu Hashida
- Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Ryo Kawasaki
- Artificial Intelligence Center for Medical Research and Application, Osaka University Hospital, Suita, Osaka, Japan
- Graduate Scholl of Medicine/Division of Environmental Medicine and Population Science/Department of Social and Environmental Medicine, Osaka University, Suita, Osaka, Japan
| | - Kinpui Chan
- Topcon Advanced Biomedical Imaging Laboratory, Oakland, New Jersey
| | - Kohji Nishida
- Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
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Zhang W, Fine JL, Pei X, Cao Y, Liu Y, Yan J, Ban Z, Zhang T, Wei Y, Zhao X, Wang B, Zhao C, Zeng X. Characteristics and utility of high-resolution optical coherence microscopy images of endocervical canal lesions. Am J Clin Pathol 2024:aqae052. [PMID: 38704601 DOI: 10.1093/ajcp/aqae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/06/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVES To investigate optical coherence microscopy (OCM) imaging features and the application value of these high-resolution images for identifying endocervical canal lesions (ECLs), which is a clinical dilemma in cervical cancer screening programs. METHODS In total, 520 OCM images were obtained by scanning the cervical canal lesions with an ultra-high-resolution OCM system (204 specimens from 73 patients). The OCM morphologic characteristics of ECLs were observed and summarized, and then 3 researchers performed a diagnostic test of OCM images of cervical canal lesions. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, 95% confidence interval of each parameter, and interinvestigator agreement (κ) were calculated. RESULTS Normal endocervix, cysts, squamous metaplasia, high-grade squamous intraepithelial lesions involving glands, and invasive carcinoma had distinct OCM characteristics, which correlated well with corresponding H&E histologic sections. The accuracy, sensitivity, and specificity of the 3 researchers were 90.6%, 89.3% (95% CI, 86.5%-91.7%) and 91.6% (95% CI, 89.2%-93.5%), respectively. The positive predictive value was 90.1% (95% CI, 87.3%-92.4%), and the negative predictive value was 90.9% (95% CI, 88.5%-92.9%), with almost perfect agreement (κ = 0.874). CONCLUSIONS The application of the OCM system in cervical canal lesions is feasible and could help improve detection of occult ECLs in cervical cancer screening programs. This study lays the foundation for further research on OCM in cervical canal lesions in vivo, which also has a potential impact on projecting pathologic evaluation beyond what is currently possible, perhaps globally.
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Affiliation(s)
- Wei Zhang
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jeffrey L Fine
- Department of Pathology, UPMC Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, US
| | - Xiaoyin Pei
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yushan Cao
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yixuan Liu
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinxiang Yan
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhenying Ban
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ting Zhang
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Wei
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Baojin Wang
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chengquan Zhao
- Department of Pathology, UPMC Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, US
| | - Xianxu Zeng
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Padmanabhan A, Prabhu PB, Vidyadharan V, Tharayil HM. Retinal Nerve Fiber Layer Thickness in Patients with Schizophrenia and Its Relation with Cognitive Impairment. Indian J Psychol Med 2024; 46:238-244. [PMID: 38699767 PMCID: PMC11062300 DOI: 10.1177/02537176231223311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
Background Schizophrenia is a chronic severe mental illness with heterogeneous clinical presentation, course, and outcome. Cognitive impairment is one of its core features. Retinal nerve fiber layer (RNFL) imaging using OCT (optical coherence tomography) could provide easy access for in vivo imaging of the retina, rendering it as a "window to the brain." Studies done on schizophrenia have shown RNFL thinning. This study attempts to look into the association between cognitive impairment, disease duration, and RNFL abnormality in patients with schizophrenia using OCT. Methods Patients diagnosed with schizophrenia meeting DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria and who were confirmed to be in remission for at least six months clinically and scoring less than three on PANSS-8 (positive and negative symptom scale-8) remission scale were included. They were administered the Montreal Cognitive Assessment Scale (MoCA) for cognitive assessment. RNFL measures were taken using spectral domain-OCT. Variables were compared using Pearson's correlation test, one-way ANOVA test, and independent t-test as appropriate. Results A total of 36 patients were studied. MoCA scores and RNFL thickness showed a positive correlation. Patients with schizophrenia had reduced average RNFL thickness and reduced RNFL thickness in superior, inferior, and temporal quadrants. Average RNFL thickness, Superior and inferior quadrant RNFL thickness showed a positive correlation with MoCA scores. No correlation was obtained between macular volume, macular thickness, duration of illness, and MoCA scores. Conclusion Patients with schizophrenia have reduced average RNFL thickness. Patients with low MoCA scores have RNFL thinning.
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Affiliation(s)
- Anu Padmanabhan
- Dept. of Psychiatry, Government Medical College, Kozhikode, Kerala, India
| | - Padma B. Prabhu
- Dept. of Ophthalmology, Government Medical College, Kozhikode, Kerala, India
| | - Varsha Vidyadharan
- Dept. of Psychiatry, Government Medical College, Kozhikode, Kerala, India
| | - Harish M. Tharayil
- Dept. of Psychiatry, Government Medical College, Kozhikode, Kerala, India
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Boudriot E, Gabriel V, Popovic D, Pingen P, Yakimov V, Papiol S, Roell L, Hasanaj G, Xu S, Moussiopoulou J, Priglinger S, Kern C, Schulte EC, Hasan A, Pogarell O, Falkai P, Schmitt A, Schworm B, Wagner E, Keeser D, Raabe FJ. Signature of altered retinal microstructures and electrophysiology in schizophrenia spectrum disorders is associated with disease severity and polygenic risk. Biol Psychiatry 2024:S0006-3223(24)01262-9. [PMID: 38679358 DOI: 10.1016/j.biopsych.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/30/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Optical coherence tomography (OCT) and electroretinography (ERG) studies have revealed structural and functional retinal alterations in individuals with schizophrenia spectrum disorders (SSD). However, it remains unclear which specific retinal layers are affected, how the retina, brain, and clinical symptomatology are connected, and how alterations of the visual system are related to genetic disease risk. METHODS OCT, ERG, and brain magnetic resonance imaging (MRI) were applied to comprehensively investigate the visual system in a cohort of 103 patients with SSD and 130 healthy control individuals. The sparse partial least squares (SPLS) algorithm was used to identify multivariate associations between clinical disease phenotype and biological alterations of the visual system. The association of the revealed patterns with the individual polygenetic disease risk for schizophrenia was explored in a post hoc analysis. In addition, covariate-adjusted case-control comparisons were performed for each individual OCT and ERG parameter. RESULTS The SPLS analysis yielded a phenotype-eye-brain signature of SSD in which greater disease severity, longer duration of illness, and impaired cognition were associated with electrophysiological alterations and microstructural thinning of most retinal layers. Higher individual loading onto this disease-relevant signature of the visual system was significantly associated with elevated polygenic risk for schizophrenia. In case-control comparisons, patients with SSD had lower macular thickness, thinner retinal nerve fiber and inner plexiform layers, less negative a-wave amplitude, and lower b-wave amplitude. CONCLUSIONS This study demonstrates multimodal microstructural and electrophysiological retinal alterations in individuals with SSD that are associated with disease severity and individual polygenetic burden.
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Affiliation(s)
- Emanuel Boudriot
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Vanessa Gabriel
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Pauline Pingen
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Vladislav Yakimov
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), 80804 Munich, Germany
| | - Sergi Papiol
- Max Planck Institute of Psychiatry, 80804 Munich, Germany; Institute of Psychiatric Phenomics and Genomics, LMU Munich, 80336 Munich, Germany
| | - Lukas Roell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Genc Hasanaj
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; Evidence-based psychiatry and psychotherapy, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
| | - Simiao Xu
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Joanna Moussiopoulou
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Siegfried Priglinger
- Department of Ophthalmology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Christoph Kern
- Department of Ophthalmology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics, LMU Munich, 80336 Munich, Germany; Institute of Human Genetics, University Hospital, Faculty of Medicine, University of Bonn, 53127 Bonn, Germany; Department of Psychiatry and Psychotherapy, University Hospital, Faculty of Medicine, University of Bonn, 53127 Bonn, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany; German Center for Mental Health (DZPG), partner site Munich-Augsburg
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; Max Planck Institute of Psychiatry, 80804 Munich, Germany; German Center for Mental Health (DZPG), partner site Munich-Augsburg
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; Max Planck Institute of Psychiatry, 80804 Munich, Germany; German Center for Mental Health (DZPG), partner site Munich-Augsburg
| | - Benedikt Schworm
- Department of Ophthalmology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Elias Wagner
- Evidence-based psychiatry and psychotherapy, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany; Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, 80336 Munich, Germany; Munich Center for Neurosciences (MCN), LMU Munich, 82152 Planegg-Martinsried, Germany
| | - Florian J Raabe
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, 80336 Munich, Germany; Max Planck Institute of Psychiatry, 80804 Munich, Germany.
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Hu J, Wu S, Shi G, Fan J, Yu H, Chen S. Design of an endoscopic OCT probe based on piezoelectric tube with quartered outside electrodes. Front Bioeng Biotechnol 2024; 12:1391630. [PMID: 38725993 PMCID: PMC11080653 DOI: 10.3389/fbioe.2024.1391630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction: Optical coherence tomography (OCT) is a pivotal imaging modality in ophthalmology for real-time, in vivo visualization of retinal structures. To enhance the capability and safety of OCT, this study focuses on the development of a micro intraocular OCT probe. The demand for minimal invasiveness and precise imaging drives the need for advanced probe designs that can access tight and sensitive areas, such as the ocular sclera. Methods: A novel OCT probe was engineered using a piezoelectric tube with quartered electrodes to drive Lissajous scanning movements at the end of a single-mode fiber. This design allows the probe to enter the eyeball through a scleral opening. Structural innovation enables the outer diameter of the endoscopic OCT probe to be adjusted from 13G (2.41 mm) to 25G (0.51 mm), accommodating various imaging field sizes and ensuring compatibility with different scleral incisions. Results: The fabricated micro intraocular OCT probe successfully performed preliminary imaging experiments on in vivo fingers. The Lissajous scanning facilitated comprehensive coverage of the target area, enhancing the imaging capabilities. Discussion: The integration of a piezoelectric tube with quartered outside electrodes into the OCT probe design proved effective for achieving precise control over scanning movements and adaptability to different surgical needs. The design characteristics and practical applications demonstrated the probe's potential in clinical settings.
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Affiliation(s)
- Jinyuan Hu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Jiangsu Province Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Science, Suzhou, China
| | - Sujian Wu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Jiangsu Province Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Science, Suzhou, China
| | - Guohua Shi
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Jiangsu Province Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Science, Suzhou, China
| | - Jinyu Fan
- Jiangsu Province Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Science, Suzhou, China
| | - Haoyang Yu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Jiangsu Province Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Science, Suzhou, China
| | - Sixu Chen
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Jiangsu Province Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Science, Suzhou, China
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Nebbioso M, Franzone F, Milanese A, Artico M, Taurone S, La Cava M, Livani ML, Bonfiglio V, Vestri A. Psychophysical, electrofunctional, and morphological evaluation in naïve neovascular AMD patients treated with intravitreal anti-VEGF. Aging Med (Milton) 2024; 7:189-201. [PMID: 38725692 PMCID: PMC11077329 DOI: 10.1002/agm2.12296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/01/2024] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
Objectives The aim of this study was to investigate the retinal morpho-functional characteristics of patients with neovascular wet age-related macular degeneration (nAMD) treated with intravitreal injection (IV) of aflibercept (AFL). Methods The study was conducted on 35 patients previously diagnosed with type 1 nAMD who received a fixed-dosing regimen of aflibercept injections over 12 months. The goal was to assess trends in visual abilities over time by measuring visual acuity (VA), contrast sensitivity (CS), visual evoked potentials (VEPs), and spectral domain-optical coherence tomography (SD-OCT). The same psychophysical, electro-functional, and morphological tests administered at baseline (T0) were repeated 4 to 8 weeks after the last aflibercept injection (Tn), resulting in a total of six examinations. Results At Tn, all subjects exhibited improved VA for both far and near distances compared to values detected at T0. Similarly, VEP amplitude and latency values at Tn showed a greater P100 improvement than those observed at T0. Additionally, the CS examination at Tn demonstrated improvement, particularly at high spatial stimulation frequencies. The Tn SD-OCT results highlighted a reduction in macular thickness compared to T0 values. Conclusions This exploratory research indicates that intravitreal injections of AFL, following a fixed-dosing regimen, represent a valuable therapeutic approach for enhancing visual performance. This conclusion is supported by comprehensive statistical analysis of psychophysical, electro-functional, and morphological examinations within the same group of patients with nAMD, as demonstrated for the first time.
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Affiliation(s)
- Marcella Nebbioso
- Department of Sense Organs, Faculty of Medicine and OdontologySapienza University of RomeRomeItaly
| | - Federica Franzone
- Ophthalmic Hospital, Medicine and SurgeryUniversity of TurinTurinItaly
| | - Alberto Milanese
- Department of Public Health and Infectious DiseaseSapienza University of RomeRomeItaly
| | - Marco Artico
- Department of Sense Organs, Faculty of Medicine and OdontologySapienza University of RomeRomeItaly
| | - Samanta Taurone
- Department of Movement, Human and Health SciencesUniversity of Rome Foro ItalicoRomeItaly
| | - Maurizio La Cava
- Department of Sense Organs, Faculty of Medicine and OdontologySapienza University of RomeRomeItaly
| | | | - Vincenza Bonfiglio
- Department of Experimental Biomedicine and Clinical NeuroscienceUniversity of PalermoPalermoItaly
| | - Annarita Vestri
- Department of Public Health and Infectious DiseaseSapienza University of RomeRomeItaly
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Veeraraghavan S, Kidambi BR. "Full thickness calcium fracture by coronary intravascular lithotripsy on optical coherence tomography (OCT)" - cross it, crack it!! Acta Cardiol 2024; 79:252-253. [PMID: 38236664 DOI: 10.1080/00015385.2024.2304463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/06/2024] [Indexed: 04/18/2024]
Affiliation(s)
- Sriram Veeraraghavan
- Department of Cardiology, SRM Medical College and Research Centre, Potheri, Tamil Nadu, India
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Karn PK, Abdulla WH. Advancing Ocular Imaging: A Hybrid Attention Mechanism-Based U-Net Model for Precise Segmentation of Sub-Retinal Layers in OCT Images. Bioengineering (Basel) 2024; 11:240. [PMID: 38534514 DOI: 10.3390/bioengineering11030240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
This paper presents a novel U-Net model incorporating a hybrid attention mechanism for automating the segmentation of sub-retinal layers in Optical Coherence Tomography (OCT) images. OCT is an ophthalmology tool that provides detailed insights into retinal structures. Manual segmentation of these layers is time-consuming and subjective, calling for automated solutions. Our proposed model combines edge and spatial attention mechanisms with the U-Net architecture to improve segmentation accuracy. By leveraging attention mechanisms, the U-Net focuses selectively on image features. Extensive evaluations using datasets demonstrate that our model outperforms existing approaches, making it a valuable tool for medical professionals. The study also highlights the model's robustness through performance metrics such as an average Dice score of 94.99%, Adjusted Rand Index (ARI) of 97.00%, and Strength of Agreement (SOA) classifications like "Almost Perfect", "Excellent", and "Very Strong". This advanced predictive model shows promise in expediting processes and enhancing the precision of ocular imaging in real-world applications.
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Affiliation(s)
- Prakash Kumar Karn
- Department of Electrical, Computer and Software Engineering, The University of Auckland, Auckland 1010, New Zealand
| | - Waleed H Abdulla
- Department of Electrical, Computer and Software Engineering, The University of Auckland, Auckland 1010, New Zealand
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Shen Y, Wang X, Gu N, Liu Z, Rong J, Shen C, Zhang W, Chen P, Deng Y, Deng C, Ma S, Zhao Y, Zhao R, Shi B. Association between periprocedural myocardial injury and neointimal characteristics in patients with in-stent restenosis: an optical coherence tomography study. Cardiovasc Diagn Ther 2024; 14:5-17. [PMID: 38434558 PMCID: PMC10904304 DOI: 10.21037/cdt-23-390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/05/2024] [Indexed: 03/05/2024]
Abstract
Background The relationship between neointimal characteristics of in-stent restenosis (ISR) and periprocedural myocardial injury (PMI) remains unclear. Therefore, this study aimed to investigate the relationship between PMI and neointimal characteristics of ISR by using optical coherence tomography (OCT). Methods This was a retrospective study. We enrolled 140 patients diagnosed with ISR with normal baseline high-sensitivity troponin T (hs-cTnT) levels who underwent OCT and subsequent revascularization by means of drug-coated balloon (DCB) or drug-eluting stent (DES) between October 2018 and October 2022 in the Affiliated Hospital of Zunyi Medical University. Based on the 4th universal definition of myocardial infarction, patients whose hs-cTnT were increased five times above the upper reference limit (URL) after percutaneous coronary interventions (PCI) were deemed to PMI. The patients were subdivided into PMI (n=53) and non-PMI (n=87) groups. In the univariable analysis, variables in the baselines, angiography characteristics and OCT findings were analyzed with binary logistic regression. A P value of <0.2 was included in the multivariable model. Multivariable logistic regression analysis was used to identify the independent predictors of PMI. Results The prevalence of intra-intimal microvessels in patients with PMI was higher than in those without PMI (58.5% vs. 32.2%, P=0.003). The ratio of intra-stent plaque rupture (PR) was also higher in patients with PMI (60.4% vs. 40.2%, P=0.021). Multivariable logistic regression analysis showed that intra-intimal microvessels [odds ratio (OR): 3.193, 95% confidence interval (CI): 1.280-7.966; P=0.013] and intra-stent PR (OR: 2.124, 95% CI: 1.153-4.732; P=0.035) were independently associated with PMI. Conclusions Intra-intimal microvessels and intra-stent PR were independently associated with PMI. Accurate identification and recognition of intra-intimal microvessels and intra-stent PR may be helpful in preventing PMI.
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Affiliation(s)
- Youcheng Shen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xi Wang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ning Gu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhijiang Liu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jidong Rong
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Changyin Shen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Wei Zhang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Panke Chen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yi Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Chancui Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shuai Ma
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yongchao Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ranzun Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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10
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Chong YJ, Azzopardi M, Hussain G, Recchioni A, Gandhewar J, Loizou C, Giachos I, Barua A, Ting DSJ. Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review. Diagnostics (Basel) 2024; 14:122. [PMID: 38248000 PMCID: PMC10814678 DOI: 10.3390/diagnostics14020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Since its introduction, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and has now become an indispensable, noninvasive tool in daily practice. Most ophthalmologists are familiar with its use in the assessment and monitoring of retinal and optic nerve diseases. However, it also has important applications in the assessment of anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris, and has the potential to transform the clinical examination of these structures. In this review, we aim to provide a comprehensive overview of the potential clinical utility of anterior segment OCT (AS-OCT) for a wide range of anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. In addition, the clinical applications of AS-OCT (including epithelial mapping) in preoperative planning and postoperative monitoring for corneal and refractive surgeries are discussed.
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Affiliation(s)
- Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Modality Ophthalmology, Modality Partnership, Birmingham B19 1BP, UK;
| | - Matthew Azzopardi
- Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK;
| | - Gulmeena Hussain
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK;
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Jaishree Gandhewar
- New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK;
| | | | - Ioannis Giachos
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Ankur Barua
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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11
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Liu FJ, Chen Q, Cheng Y. Noninvasive carotid ultrasound for predicting vulnerable plaques of the coronary artery based on optical coherence tomography images. Quant Imaging Med Surg 2024; 14:316-324. [PMID: 38223065 PMCID: PMC10784012 DOI: 10.21037/qims-23-621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/20/2023] [Indexed: 01/16/2024]
Abstract
Background The risk factors for coronary and carotid plaque development are consistent. Coronary plaque rupture is a major cause of adverse cardiovascular events. Ultrasound can evaluate vulnerable carotid plaques and provide information for predicting vulnerable coronary plaques identified by optical coherence tomography (OCT). This study aimed to investigate the predictive role of non-invasive carotid ultrasound in OCT diagnosis of atherosclerotic vulnerable plaque. Methods A total of 70 participants, including 35 patients with and 35 without vulnerable coronary plaque, were enrolled in this case-control study at Beijing Anzhen Hospital from 2016 to 2021. The data of 70 patients with suspected coronary heart disease who had undergone OCT examination during percutaneous coronary intervention (PCI) surgery and completed carotid ultrasound examination within 3 days before PCI were analyzed retrospectively. According to the OCT diagnostic criteria for vulnerable plaques, the patients were divided into the vulnerable-plaque group and the stable-plaque group. Univariate and binary logistic regression analyses assessed risk factors for vulnerable coronary plaque. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive power of carotid plaque features. Results The univariate analysis demonstrated that the differences in high-sensitivity C-reactive protein levels and carotid plaque characteristics (irregular fibrous cap, heterogeneous plaque, hypoechoic plaque, plaque calcification, and a plaque thickness of greater than 3 mm) between the two groups were statistically significant. The logistic multivariate regression analysis revealed that an irregular fibrous cap of a carotid plaque [odds ratio (OR) =4.819; 95% confidence interval (CI): 1.106-22.867; P=0.048] and a hypoechoic plaque (OR =9.632; 95% CI: 2.138-43.384; P<0.05) were independent risk factors for predicting vulnerable plaques of the coronary artery. Conclusions Noninvasive carotid ultrasound is feasible and clinically valuable for predicting vulnerable and asymptomatic coronary plaques defined by OCT. With this method, adverse events can be diagnosed and treated in advance.
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Affiliation(s)
- Feng-Ju Liu
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Qing Chen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Yi Cheng
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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12
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Pfeiffer V, Gubser PA, Shang X, Lincke JB, Häner NU, Zinkernagel MS, Unterlauft JD. Functional and Morphological Outcomes after Trabeculectomy and Deep Sclerectomy-Results from a Monocentric Registry Study. Diagnostics (Basel) 2024; 14:101. [PMID: 38201410 PMCID: PMC10802181 DOI: 10.3390/diagnostics14010101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to compare the effectiveness of trabeculectomy (TE) and deep sclerectomy (DS) in lowering intraocular pressure (IOP) and thereby preserving visual field and peripapillary retinal nerve fiber layer (RNFL) tissue in primary open-angle glaucoma (POAG) cases. IOP, number of IOP-lowering medications, visual acuity, mean defect of standard automated perimetry, and mean peripapillary RNFL thickness were retrospectively collected and followed up for 3 years after surgery. TE was performed in 104 eyes and DS in 183 eyes. Age, gender, laterality, IOP, number of medications, visual acuity, perimetry mean defect, and peripapillary RNFL thickness were equally distributed at baseline. Mean IOP decreased from 23.8 ± 1.4 mmHg and 23.1 ± 0.4 mmHg to 13.4 ± 0.6 mmHg (p < 0.001) and 15.4 ± 0.7 mmHg (p = 0.001) in the TE and DS groups, respectively. Mean defect remained stable (TE: -11.5 ± 0.9 dB to -12.0 ± 1.1 (p = 0.090); DS: -10.5 ± 0.9 dB to -11.0 ± 1.0 dB (p = 0.302)), while mean peripapillary RNFL thickness showed further deterioration during follow-up (TE group: 64.4 ± 2.1 μm to 59.7 ± 3.5 μm (p < 0.001); DS group: 64.9 ± 1.9 μm to 58.4 ± 2.1 μm (p < 0.001)). Both TE and DS were comparably effective concerning postoperative reduction in IOP and medication. However, glaucoma disease further progressed during follow-up.
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Affiliation(s)
| | | | | | | | | | | | - Jan Darius Unterlauft
- University Eye Hospital, Inselspital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; (V.P.); (P.A.G.); (X.S.); (J.-B.L.); (N.U.H.); (M.S.Z.)
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13
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Ponugoti A, Ngo H, Stinnett S, Vajzovic L. Chronic Effects of e-Cigarette Aerosol Inhalation on Macular Perfusion Assessed Using OCT Angiography. J Vitreoretin Dis 2024; 8:21-28. [PMID: 38223771 PMCID: PMC10786087 DOI: 10.1177/24741264231205071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Purpose: To determine whether there are significant differences in the microvasculature and central retinal thickness (CRT) between e-cigarette users (user group) and age-matched nonusers (control group) using optical coherence tomography angiography (OCTA). Methods: In this prospective cross-sectional observational study, OCTA images were acquired of 52 eyes of 26 users and 25 eyes of 25 age-matched nonusers. Daily e-cigarette users with no ocular history were identified from provider information in the electronic medical record. A custom algorithm was used to calculate the foveal avascular zone (FAZ), vessel area density (VAD), and vessel length density (VLD). OCT software was used to calculate the foveal, superior, inferior, nasal, and temporal CRT. Generalized estimating equations using the Z-statistic were used to determine how the FAZ, VAD, VLD, and CRT parameters varied between groups and to assess the differential contribution of descriptive data in the user group. Results: No statistically significant difference was found between the user group and control group in the FAZ, superficial vascular complex (SVC) VAD, SVC VLD, or deep vascular complex (DVC) VAD. A statistically significant difference was found for DVC VLD (P = .002), with the user group having a slightly higher VLD on average. Superior, temporal, and inferior inner macular thicknesses were significantly thinner in the user group (P = .038, P = .012, and P = .035, respectively). Conclusions: Significant negative differences were found in CRT measures but not in retinal microvasculature parameters between e-cigarette users and nonusers. Decreased inferior, temporal, and superior inner macular thickness in e-cigarette users may show an early chronic structural effect that warrants further assessment of retinal effects as this population ages and continues to use e-cigarettes.
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Affiliation(s)
- Arathi Ponugoti
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Hoan Ngo
- School of Biomedical Engineering, International University–VNU HCMC, Ho Chi Minh City, Vietnam
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
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14
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van der Heide FCT, Steens ILM, Limmen B, Mokhtar S, van Boxtel MPJ, Schram MT, Köhler S, Kroon AA, van der Kallen CJH, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Webers CAB, van Greevenbroek MMJ, Koster A, van Sloten TT, Jansen JFA, Backes WH, Stehouwer CDA. Thinner inner retinal layers are associated with lower cognitive performance, lower brain volume, and altered white matter network structure-The Maastricht Study. Alzheimers Dement 2024; 20:316-329. [PMID: 37611119 PMCID: PMC10917009 DOI: 10.1002/alz.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION The retina may provide non-invasive, scalable biomarkers for monitoring cerebral neurodegeneration. METHODS We used cross-sectional data from The Maastricht study (n = 3436; mean age 59.3 years; 48% men; and 21% with type 2 diabetes [the latter oversampled by design]). We evaluated associations of retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer thicknesses with cognitive performance and magnetic resonance imaging indices (global grey and white matter volume, hippocampal volume, whole brain node degree, global efficiency, clustering coefficient, and local efficiency). RESULTS After adjustment, lower thicknesses of most inner retinal layers were significantly associated with worse cognitive performance, lower grey and white matter volume, lower hippocampal volume, and worse brain white matter network structure assessed from lower whole brain node degree, lower global efficiency, higher clustering coefficient, and higher local efficiency. DISCUSSION The retina may provide biomarkers that are informative of cerebral neurodegenerative changes in the pathobiology of dementia.
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Grants
- 31O.041 OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs
- Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI School for Public Health and Primary Care (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), Perimed (Järfälla, Sweden), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
- 916.19.074 VENI research
- 2018T025 Netherlands Organization for Scientific Research and the Netherlands Organization for Health Research and Development, and a Dutch Heart Foundation research
- 2021.81.004 Diabetes Fonds Fellowship
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15
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Apuzzo A, Gravina S, Panozzo G, Lattanzio R, Cicinelli MV, Bandello F. From diagnosis to prognosis: A paradigm shift for multimodal imaging in assessing diabetic macular edema. Eur J Ophthalmol 2024; 34:7-10. [PMID: 37649341 DOI: 10.1177/11206721231199149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Diabetic macular edema (DME) is one of the leading causes of visual impairment in patients with diabetes. Multimodal imaging (MMI) has allowed a shift from DME diagnosis to prognosis. Although there are no accepted guidelines, MMI may also lead to treatment customization. Several study groups have tried to identify structural biomarkers that can predict treatment response and long-term visual prognosis. The purpose of this editorial is to review currently proposed optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) biomarkers.
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Affiliation(s)
- Aurelio Apuzzo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Salvatore Gravina
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Giacomo Panozzo
- Ophthalmology, ESASO European School of Advances Studies in Ophthalmology, Lugano, Switzerland
- Ophthalmology, Clinica San Francesco, Verona, Italy
| | - Rosangela Lattanzio
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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16
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Heger KA, Waldstein SM. Artificial intelligence in retinal imaging: current status and future prospects. Expert Rev Med Devices 2024; 21:73-89. [PMID: 38088362 DOI: 10.1080/17434440.2023.2294364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The steadily growing and aging world population, in conjunction with continuously increasing prevalences of vision-threatening retinal diseases, is placing an increasing burden on the global healthcare system. The main challenges within retinology involve identifying the comparatively few patients requiring therapy within the large mass, the assurance of comprehensive screening for retinal disease and individualized therapy planning. In order to sustain high-quality ophthalmic care in the future, the incorporation of artificial intelligence (AI) technologies into our clinical practice represents a potential solution. AREAS COVERED This review sheds light onto already realized and promising future applications of AI techniques in retinal imaging. The main attention is directed at the application in diabetic retinopathy and age-related macular degeneration. The principles of use in disease screening, grading, therapeutic planning and prediction of future developments are explained based on the currently available literature. EXPERT OPINION The recent accomplishments of AI in retinal imaging indicate that its implementation into our daily practice is likely to fundamentally change the ophthalmic healthcare system and bring us one step closer to the goal of individualized treatment. However, it must be emphasized that the aim is to optimally support clinicians by gradually incorporating AI approaches, rather than replacing ophthalmologists.
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Affiliation(s)
- Katharina A Heger
- Department of Ophthalmology, Landesklinikum Mistelbach-Gaenserndorf, Mistelbach, Austria
| | - Sebastian M Waldstein
- Department of Ophthalmology, Landesklinikum Mistelbach-Gaenserndorf, Mistelbach, Austria
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17
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Peng J, Lu J, Zhuo J, Li P. Multi-Scale-Denoising Residual Convolutional Network for Retinal Disease Classification Using OCT. Sensors (Basel) 2023; 24:150. [PMID: 38203011 PMCID: PMC10781341 DOI: 10.3390/s24010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
Macular pathologies can cause significant vision loss. Optical coherence tomography (OCT) images of the retina can assist ophthalmologists in diagnosing macular diseases. Traditional deep learning networks for retinal disease classification cannot extract discriminative features under strong noise conditions in OCT images. To address this issue, we propose a multi-scale-denoising residual convolutional network (MS-DRCN) for classifying retinal diseases. Specifically, the MS-DRCN includes a soft-denoising block (SDB), a multi-scale context block (MCB), and a feature fusion block (FFB). The SDB can determine the threshold for soft thresholding automatically, which removes speckle noise features efficiently. The MCB is designed to capture multi-scale context information and strengthen extracted features. The FFB is dedicated to integrating high-resolution and low-resolution features to precisely identify variable lesion areas. Our approach achieved classification accuracies of 96.4% and 96.5% on the OCT2017 and OCT-C4 public datasets, respectively, outperforming other classification methods. To evaluate the robustness of our method, we introduced Gaussian noise and speckle noise with varying PSNRs into the test set of the OCT2017 dataset. The results of our anti-noise experiments demonstrate that our approach exhibits superior robustness compared with other methods, yielding accuracy improvements ranging from 0.6% to 2.9% when compared with ResNet under various PSNR noise conditions.
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Affiliation(s)
- Jinbo Peng
- State Key Laboratory of Digital Medical Engineering, School of Biomedical Engineering, Hainan University, Haiko 570228, China; (J.P.); (J.L.)
- Key Laboratory of Biomedical Engineering of Hainan Province, One Health Institute, Hainan University, Haiko 570228, China
- Research Unit of Multimodal Cross Scale Neural Signal Detection and Imaging, Chinese Academy of Medical Science, HUST-Suzhou Institute for Brainsmatics, Jiangsu Industrial Technology Research Institute (JITRI), Suzhou 215100, China
| | - Jinling Lu
- State Key Laboratory of Digital Medical Engineering, School of Biomedical Engineering, Hainan University, Haiko 570228, China; (J.P.); (J.L.)
- Key Laboratory of Biomedical Engineering of Hainan Province, One Health Institute, Hainan University, Haiko 570228, China
- Research Unit of Multimodal Cross Scale Neural Signal Detection and Imaging, Chinese Academy of Medical Science, HUST-Suzhou Institute for Brainsmatics, Jiangsu Industrial Technology Research Institute (JITRI), Suzhou 215100, China
- Britton Chance Center for Biomedical Photonics and MoE Key Laboratory for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Junjie Zhuo
- State Key Laboratory of Digital Medical Engineering, School of Biomedical Engineering, Hainan University, Haiko 570228, China; (J.P.); (J.L.)
- Key Laboratory of Biomedical Engineering of Hainan Province, One Health Institute, Hainan University, Haiko 570228, China
- Research Unit of Multimodal Cross Scale Neural Signal Detection and Imaging, Chinese Academy of Medical Science, HUST-Suzhou Institute for Brainsmatics, Jiangsu Industrial Technology Research Institute (JITRI), Suzhou 215100, China
| | - Pengcheng Li
- State Key Laboratory of Digital Medical Engineering, School of Biomedical Engineering, Hainan University, Haiko 570228, China; (J.P.); (J.L.)
- Key Laboratory of Biomedical Engineering of Hainan Province, One Health Institute, Hainan University, Haiko 570228, China
- Research Unit of Multimodal Cross Scale Neural Signal Detection and Imaging, Chinese Academy of Medical Science, HUST-Suzhou Institute for Brainsmatics, Jiangsu Industrial Technology Research Institute (JITRI), Suzhou 215100, China
- Britton Chance Center for Biomedical Photonics and MoE Key Laboratory for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
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18
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Zeppieri M, Marsili S, Enaholo ES, Shuaibu AO, Uwagboe N, Salati C, Spadea L, Musa M. Optical Coherence Tomography (OCT): A Brief Look at the Uses and Technological Evolution of Ophthalmology. Medicina (Kaunas) 2023; 59:2114. [PMID: 38138217 PMCID: PMC10744394 DOI: 10.3390/medicina59122114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
Medical imaging is the mainstay of clinical diagnosis and management. Optical coherence tomography (OCT) is a non-invasive imaging technology that has revolutionized the field of ophthalmology. Since its introduction, OCT has undergone significant improvements in image quality, speed, and resolution, making it an essential diagnostic tool for various ocular pathologies. OCT has not only improved the diagnosis and management of ocular diseases but has also found applications in other fields of medicine. In this manuscript, we provide a brief overview of the history of OCT, its current uses and diagnostic capabilities to assess the posterior segment of the eye, and the evolution of this technology from time-domain (TD) to spectral-domain (SD) and swept-source (SS). This brief review will also discuss the limitations, advantages, disadvantages, and future perspectives of this technology in the field of ophthalmology.
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Affiliation(s)
- Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Stefania Marsili
- Georgia Institute of Technology, School of Biological Sciences, Atlanta, GA 30332, USA
| | - Ehimare Samuel Enaholo
- Centre for Sight Africa, Nkpor, Onitsha 434109, Nigeria
- Africa Eye Laser Centre Ltd., Benin 300102, Nigeria
| | | | - Ngozi Uwagboe
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, 00142 Rome, Italy
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
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Latriglia F, Ogien J, Tavernier C, Fischman S, Suppa M, Perrot JL, Dubois A. Line-Field Confocal Optical Coherence Tomography (LC-OCT) for Skin Imaging in Dermatology. Life (Basel) 2023; 13:2268. [PMID: 38137869 PMCID: PMC10744435 DOI: 10.3390/life13122268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/09/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive optical imaging technique based on a combination of the principles of optical coherence tomography and reflectance confocal microscopy with line-field illumination, which can generate cell-resolved images of the skin in vivo. This article reports on the LC-OCT technique and its application in dermatology. The principle of the technique is described, and the latest technological innovations are presented. The technology has been miniaturized to fit within an ergonomic handheld probe, allowing for the easy access of any skin area on the body. The performance of the LC-OCT device in terms of resolution, field of view, and acquisition speed is reported. The use of LC-OCT in dermatology for the non-invasive detection, characterization, and therapeutic follow-up of various skin pathologies is discussed. Benign and malignant melanocytic lesions, non-melanocytic skin tumors, such as basal cell carcinoma, squamous cell carcinoma and actinic keratosis, and inflammatory and infectious skin conditions are considered. Dedicated deep learning algorithms have been developed for assisting in the analysis of LC-OCT images of skin lesions.
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Affiliation(s)
- Flora Latriglia
- DAMAE Medical, 75013 Paris, France
- Laboratoire Charles Fabry, Centre National de la Recherche Scientifique, Institut d’Optique Graduate School, Université Paris-Saclay, 91127 Palaiseau, France
| | | | | | | | - Mariano Suppa
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles (ULB), 1070 Anderlecht, Belgium
- Department of Dermatology, Jules Bordet Institute, Université Libre de Bruxelles (ULB), 1070 Anderlecht, Belgium
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), 75008 Paris, France;
| | - Jean-Luc Perrot
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), 75008 Paris, France;
- University Hospital of Saint-Etienne, 42100 Saint-Etienne, France
| | - Arnaud Dubois
- DAMAE Medical, 75013 Paris, France
- Laboratoire Charles Fabry, Centre National de la Recherche Scientifique, Institut d’Optique Graduate School, Université Paris-Saclay, 91127 Palaiseau, France
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20
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Pétursdóttir D, Åkerblom H, Holmström G, Larsson E. Central macular morphology and optic nerve fibre layer thickness in young adults born premature and screened for retinopathy of prematurity. Acta Ophthalmol 2023. [PMID: 37991127 DOI: 10.1111/aos.15814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/08/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To investigate central retinal morphology and optic retinal nerve fibre layer (RNFL) in prematurely born young adults and compare to term born controls. MATERIALS AND METHODS The participants were 59 prematurely born individuals, with a birthweight ≤1.500 g, and 44 term born controls, all 25-29 years of age. Visual acuity (VA) and contrast sensitivity (CS) were assessed. The retinal macular thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness and RNFL thickness were assessed with Cirrus optical coherence tomography (OCT). RESULTS Central macular thickness was increased (mean 26.7 μm) in prematurely born individuals compared to controls. The macular GC-IPL was thinner (mean 3.84 μm), also when excluding those with previous retinopathy of prematurity (ROP) and those with neurological complications. Gestational age at birth and previous treatment of ROP were risk factors for a thicker macula, however, not for reduced GC-IPL. The average peripapillary RNFL was thinner (mean 4.61 μm) in the prematurely born individuals, also when excluding those with previous ROP and/or neurological complications. Within the prematurely born group, treated ROP was correlated with increased average RNFL. Further, both better VA and CS were associated with thinner optic nerve RNFL and thicker average GC-IPL. CONCLUSION Macular and optic nerve morphology were influenced by premature birth as assessed with OCT in adult individuals. Gestational age at birth and treatment for ROP seemed to affect central macular thickness, and treated ROP affected the peripapillary RNFL. Thus, retinal sequelae remained in adulthood.
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Affiliation(s)
- Dýrleif Pétursdóttir
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Reykjavík, Iceland
| | - Hanna Åkerblom
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research Västmanland, Hospital of Västmanland, Västerås, Sweden
| | - Gerd Holmström
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Eva Larsson
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
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21
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Nagy BI, Mohos B, Tzou CHJ. Imaging Modalities for Evaluating Lymphedema. Medicina (Kaunas) 2023; 59:2016. [PMID: 38004065 PMCID: PMC10673374 DOI: 10.3390/medicina59112016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/18/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages is mostly insufficient. Therefore-in many cases-surgical procedures, such as to restore lymph flow or excise lymphedema tissues, are the only ways to improve patients' quality of life. Imaging modalities: Lymphoscintigraphy (LS), near-infrared fluorescent (NIRF) imaging-also termed indocyanine green (ICG) lymphography (ICG-L)-ultrasonography (US), magnetic resonance lymphangiography (MRL), computed tomography (CT), photoacoustic imaging (PAI), and optical coherence tomography (OCT) are standardized techniques, which can be utilized in lymphedema diagnosis, staging, treatment, and follow-up. Conclusions: The combined use of these imaging modalities and self-assessment questionnaires deliver objective parameters for choosing the most suitable surgical therapy and achieving the best possible postoperative outcome.
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Affiliation(s)
- Bendeguz Istvan Nagy
- Department of Thoracic, Cardiac and Vascular Surgery, Westpfalz-Klinikum GmbH, 67655 Kaiserslautern, Germany
| | - Balazs Mohos
- Heart and Vascular Center, Semmelweis University, 1094 Budapest, Hungary
- Plastic and Reconstructive Surgery, Department of Surgery, County Hospital Veszprem, 8200 Veszprem, Hungary
- Balaton Private Clinic, 8200 Veszprem, Hungary
| | - Chieh-Han John Tzou
- Plastic and Reconstructive Surgery, Department of Surgery, Hospital of Divine Savior, 1060 Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria
- Lymphedema Center Vienna, TZOU MEDICAL., 1060 Vienna, Austria
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22
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Liu HC, Lin MH, Chang WC, Zeng RC, Wang YM, Sun CW. Rapid On-Site AI-Assisted Grading for Lung Surgery Based on Optical Coherence Tomography. Cancers (Basel) 2023; 15:5388. [PMID: 38001648 PMCID: PMC10670228 DOI: 10.3390/cancers15225388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
The determination of resection extent traditionally relies on the microscopic invasiveness of frozen sections (FSs) and is crucial for surgery of early lung cancer with preoperatively unknown histology. While previous research has shown the value of optical coherence tomography (OCT) for instant lung cancer diagnosis, tumor grading through OCT remains challenging. Therefore, this study proposes an interactive human-machine interface (HMI) that integrates a mobile OCT system, deep learning algorithms, and attention mechanisms. The system is designed to mark the lesion's location on the image smartly and perform tumor grading in real time, potentially facilitating clinical decision making. Twelve patients with a preoperatively unknown tumor but a final diagnosis of adenocarcinoma underwent thoracoscopic resection, and the artificial intelligence (AI)-designed system mentioned above was used to measure fresh specimens. Results were compared to FSs benchmarked on permanent pathologic reports. Current results show better differentiating power among minimally invasive adenocarcinoma (MIA), invasive adenocarcinoma (IA), and normal tissue, with an overall accuracy of 84.9%, compared to 20% for FSs. Additionally, the sensitivity and specificity, the sensitivity and specificity were 89% and 82.7% for MIA and 94% and 80.6% for IA, respectively. The results suggest that this AI system can potentially produce rapid and efficient diagnoses and ultimately improve patient outcomes.
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Affiliation(s)
- Hung-Chang Liu
- Section of Thoracic Surgery, Mackay Memorial Hospital, Taipei City 10449, Taiwan;
- Intensive Care Unit, Mackay Memorial Hospital, Taipei City 10449, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
- Department of Optometry, Mackay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan
| | - Miao-Hui Lin
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan; (M.-H.L.); (R.-C.Z.); (Y.-M.W.)
| | - Wei-Chin Chang
- Department of Pathology, Mackay Memorial Hospital, New Taipei City 25160, Taiwan;
- Department of Pathology, Taipei Medical University Hospital, Taipei City 11030, Taiwan
- Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11030, Taiwan
| | - Rui-Cheng Zeng
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan; (M.-H.L.); (R.-C.Z.); (Y.-M.W.)
| | - Yi-Min Wang
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan; (M.-H.L.); (R.-C.Z.); (Y.-M.W.)
| | - Chia-Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan; (M.-H.L.); (R.-C.Z.); (Y.-M.W.)
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan
- Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, Taipei City 11259, Taiwan
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23
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Borzanovic D, Ilic I, Nikolic D, Stojanovic I. Case Report: Optical coherence tomography to guide PCI of iatrogenic injury of the circumflex artery after minimally invasive mitral valve repair. Front Cardiovasc Med 2023; 10:1270541. [PMID: 37928763 PMCID: PMC10623148 DOI: 10.3389/fcvm.2023.1270541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
We present a case of a 42-year-old man who suffered an iatrogenic injury to his left circumflex (Cx) coronary artery after mitral valve (MV) repair surgery. After the patient suffered from myocardial infarction without ST-segment elevation following minimally invasive MV surgery, we performed repeated coronary angiography and optical coherence tomography (OCT), which revealed severe coronary stenosis of the dominant Cx caused by intramural hematoma. In addition, we proceeded with percutaneous coronary intervention and stent implantation.
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Affiliation(s)
- Dusan Borzanovic
- Department for Interventional Cardiology, Dedinje Cardiovascular Institute, Belgrade, Serbia
| | - Ivan Ilic
- Department for Interventional Cardiology, Dedinje Cardiovascular Institute, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dusan Nikolic
- Department for Interventional Cardiology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Ivan Stojanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia
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24
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Xenogiannis I, Pavlidis AN, Kaier TE, Rigopoulos AG, Karamasis GV, Triantafyllis AS, Vardas P, Brilakis ES, Kalogeropoulos AS. The role of intravascular imaging in chronic total occlusion percutaneous coronary intervention. Front Cardiovasc Med 2023; 10:1199067. [PMID: 37767372 PMCID: PMC10520251 DOI: 10.3389/fcvm.2023.1199067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Chronic total occlusions (CTOs) represent the most complex subset of coronary artery disease and therefore careful planning of CTO percutaneous coronary recanalization (PCI) strategy is of paramount importance aiming to achieve procedural success, and improve patient's safety and post CTO PCI outcomes. Intravascular imaging has an essential role in facilitating CTO PCΙ. First, intravascular ultrasound (IVUS), due to its higher penetration depth compared to optical coherence tomography (OCT), and the additional capacity of real-time imaging without need for contrast injection is considered the preferred imaging modality for CTO PCI. Secondly, IVUS can be used to resolve proximal cap ambiguity, facilitate wire re-entry when dissection and re-entry strategies are applied and most importantly to guide stent deployment and optimization post implantation. The role of OCT during CTO PCI is currently limited to stent sizing and optimization, however, due to its high spatial resolution, OCT is ideal for detecting stent edge dissections and strut malapposition. In this review, we describe the use of intravascular imaging for lesion crossing, plaque characterization and wire tracking, extra- or intra-plaque, and stent sizing and optimization during CTO PCI and summarize the findings of the major studies in this field.
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Affiliation(s)
- Iosif Xenogiannis
- Department of Cardiology, Mitera General Hospital, Hygeia HealthCare Group, Athens, Greece
- Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Antonis N. Pavlidis
- Department of Cardiology, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Thomas E. Kaier
- Department of Cardiology, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Angelos G. Rigopoulos
- Department of Cardiology, Mitera General Hospital, Hygeia HealthCare Group, Athens, Greece
| | - Grigoris V. Karamasis
- Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Panos Vardas
- Department of Cardiology, Mitera General Hospital, Hygeia HealthCare Group, Athens, Greece
| | - Emmanouil S. Brilakis
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, MN, United States
| | - Andreas S. Kalogeropoulos
- Department of Cardiology, Mitera General Hospital, Hygeia HealthCare Group, Athens, Greece
- Department of Cardiology, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
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25
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Rodriguez-Martinez AC, Higgins BE, Tailor-Hamblin V, Malka S, Cheloni R, Collins AM, Bladen J, Henderson R, Moosajee M. Foveal Hypoplasia in CRB1-Related Retinopathies. Int J Mol Sci 2023; 24:13932. [PMID: 37762234 PMCID: PMC10531165 DOI: 10.3390/ijms241813932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
The CRB1 gene plays a role in retinal development and its maintenance. When disrupted, it gives a range of phenotypes such as early-onset severe retinal dystrophy/Leber congenital amaurosis (EOSRD/LCA), retinitis pigmentosa (RP), cone-rod dystrophy (CORD) and macular dystrophy (MD). Studies in CRB1 retinopathies have shown thickening and coarse lamination of retinal layers resembling an immature retina. Its role in foveal development has not yet been described; however, this retrospective study is the first to report foveal hypoplasia (FH) presence in a CRB1-related retinopathy cohort. Patients with pathogenic biallelic CRB1 variants from Moorfields Eye Hospital, London, UK, were collected. Demographic, clinical data and SD-OCT analyses with FH structural grading were performed. A total of 15 (48%) patients had EOSRD/LCA, 11 (35%) MD, 3 (9%) CORD and 2 (6%) RP. FH was observed in 20 (65%; CI: 0.47-0.79) patients, all of whom were grade 1. A significant difference in BCVA between patients with FH and without was found (p = 0.014). BCVA continued to worsen over time in both groups (p < 0.001), irrespective of FH. This study reports FH in a CRB1 cohort, supporting the role of CRB1 in foveal development. FH was associated with poorer BCVA and abnormal retinal morphology. Nonetheless, its presence did not alter the disease progression.
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Affiliation(s)
- Ana Catalina Rodriguez-Martinez
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 1LE, UK
| | - Bethany Elora Higgins
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Vijay Tailor-Hamblin
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- UCL Experimental Psychology, London WC1H 0AP, UK
| | - Samantha Malka
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Riccardo Cheloni
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Alexander Mark Collins
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
| | - John Bladen
- King’s College Hospital NHS Foundation Trust, Strand, London WC2R 2LS, UK;
| | - Robert Henderson
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 1LE, UK
| | - Mariya Moosajee
- UCL Institute of Ophthalmology, London EC1V 9EL, UK; (A.C.R.-M.); (B.E.H.); (V.T.-H.); (S.M.); (R.C.); (A.M.C.); (R.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 1LE, UK
- The Francis Crick Institute, London NW1 1AT, UK
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26
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Huang X, He S, Wang J, Yang S, Wang Y, Ye X. Lesion detection with fine-grained image categorization for myopic traction maculopathy (MTM) using optical coherence tomography. Med Phys 2023; 50:5398-5409. [PMID: 37490302 DOI: 10.1002/mp.16623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Myopic traction maculopathy (MTM) are retinal disorder caused by traction force on the macula, which can lead to varying degrees of vision loss in eyes with high myopia. Optical coherence tomography (OCT) is an effective imaging technique for diagnosing, detecting and classifying retinopathy. MTM has been classified into different patterns by OCT, corresponding to different clinical strategies. PURPOSE We aimed to engineer a deep learning model that can automatically identify MTM in highly myopic (HM) eyes using OCT images. METHODS A five-class classification model was developed using 2837 OCT images from 958 HM patients. We adopted a ResNet-34 architecture to train the model to identify MTM: no MTM (class 0), extra-foveal maculoschisis (class 1), inner lamellar macular hole (class 2), outer foveoschisis (class 3), and discontinuity or detachment of foveal outer hyperreflective layers (class 4). An independent test set of 604 images from 173 HM patients was used to evaluate the model's performance. Classification performance was assessed according to the area under the curve (AUC), accuracy, sensitivity, specificity. RESULTS Our model exhibited a high training performance for classification (F1-score of 0.953; AUCs of 0.961 to 0.998). In test set, it achieved sensitivities (91.67%-97.78 %) and specificities (98.33%-99.17%) as good as, or better than, those of experienced clinicians. Heatmaps were generated to provide visual explanations. CONCLUSIONS We established a deep learning model for MTM classification using OCT images. This model performed equally well or better than retinal specialists and is suitable for large-scale screening and identifying MTM in HM eyes.
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Affiliation(s)
- Xingru Huang
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Shucheng He
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jun Wang
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shangchao Yang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yaqi Wang
- College of Media Engineering, Communication University of Zhejiang, Hangzhou, Zhejiang, China
| | - Xin Ye
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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27
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Yu YW, Lin CH, Lu CK, Wang JK, Huang TL. Automated Age-Related Macular Degeneration Detector on Optical Coherence Tomography Images Using Slice-Sum Local Binary Patterns and Support Vector Machine. Sensors (Basel) 2023; 23:7315. [PMID: 37687770 PMCID: PMC10489965 DOI: 10.3390/s23177315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023]
Abstract
Artificial intelligence has revolutionised smart medicine, resulting in enhanced medical care. This study presents an automated detector chip for age-related macular degeneration (AMD) using a support vector machine (SVM) and three-dimensional (3D) optical coherence tomography (OCT) volume. The aim is to assist ophthalmologists by reducing the time-consuming AMD medical examination. Using the property of 3D OCT volume, a modified feature vector connected method called slice-sum is proposed, reducing computational complexity while maintaining high detection accuracy. Compared to previous methods, this method significantly reduces computational complexity by at least a hundredfold. Image adjustment and noise removal steps are excluded for classification accuracy, and the feature extraction algorithm of local binary patterns is determined based on hardware consumption considerations. Through optimisation of the feature vector connection method after feature extraction, the computational complexity of SVM detection is significantly reduced, making it applicable to similar 3D datasets. Additionally, the design supports model replacement, allowing users to train and update classification models as needed. Using TSMC 40 nm CMOS technology, the proposed detector achieves a core area of 0.12 mm2 while demonstrating a classification throughput of 8.87 decisions/s at a maximum operating frequency of 454.54 MHz. The detector achieves a final testing classification accuracy of 92.31%.
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Affiliation(s)
- Yao-Wen Yu
- Department of Electrical Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
| | - Cheng-Hung Lin
- Department of Electrical Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
| | - Cheng-Kai Lu
- Department of Electrical Engineering, National Taiwan Normal University, Taipei City 106, Taiwan;
| | - Jia-Kang Wang
- Department of Electrical Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Tzu-Lun Huang
- Department of Electrical Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
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28
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Gernert JA, Böhm L, Starck M, Buchka S, Kümpfel T, Kleiter I, Havla J. Inner Retinal Layer Changes Reflect Changes in Ambulation Score in Patients with Primary Progressive Multiple Sclerosis. Int J Mol Sci 2023; 24:12872. [PMID: 37629053 PMCID: PMC10454007 DOI: 10.3390/ijms241612872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
The establishment of surrogate markers to detect disability progression in persons with multiple sclerosis (PwMS) is important to improve monitoring of clinical deterioration. Optical coherence tomography (OCT) could be such a tool. However, sufficient longitudinal data of retinal neuroaxonal degeneration as a marker of disease progression exist only for PwMS with a relapsing-remitting course (RRMS) so far. In contrast, longitudinal data of retinal layers in patients with primary-progressive MS (PPMS) are inconsistent, and the association of OCT parameters with ambulatory performance in PwMS has rarely been investigated. We aimed to investigate the relative annual rates of change in retinal layers in PwMS (RRMS and PPMS) compared with healthy controls (HC) using OCT and to evaluate their association with ambulatoryfunctionalscore (AS) worsening in PPMS. A retrospective analysis of a longitudinal OCT dataset of the retinal layers of PwMS and HC from two MS centers in Germany was performed. Walking ability was measured over a standardized distance of 500 m, and changes during the observation period were categorized using the AS and the expanded disability status scale (EDSS). 61 HC with 121 eyes and 119 PwMS (PPMS: 57 patients with 108 eyes; RRMS: 62 patients with 114 eyes) were included. The median follow-up time for PwMS was 3 years. The relative annual change of pRNFL (peripapillary retinal nerve fiber layer) and INL (inner nuclear layer) was significantly different in PwMS compared with HC. RRMS and PPMS subgroups did not differ in the annual atrophy rates. In patients with PPMS, worsening of the AS was significantly associated with increased thinning of the TMV (total macular volume), GCIP (ganglion cell and inner plexiform layer), and ONPL (outer nuclear and outer plexiform layer) (all p-value < 0.05, r > 0.30). For every -0.1% decrease in the TMV, GCIP, and ONPL, the risk of a deterioration in the AS increased by 31% (hazard ratio (HR): 1.309), 11% (HR: 1.112), and 16% (HR: 1.161), respectively. In addition, worsening EDSS in PPMS was significantly associated with the relative annual atrophy rates of pRNFL, TMV, and GCIP (all p-value < 0.05). Disability progression in PPMS can be measured using OCT, and increasing annual atrophy rates of the inner retinal layers are associated with worsening ambulation. OCT is a robust and side-effect-free imaging tool, making it suitable for routine monitoring of PwMS.
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Affiliation(s)
- Jonathan A. Gernert
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Luise Böhm
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Michaela Starck
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, 82335 Berg, Germany
| | - Stefan Buchka
- Institute of Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
- Biomedical Center and University Hospital, Ludwig-Maximilians-Universität München, 82152 Planegg-Martinsried, Germany
| | - Ingo Kleiter
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, 82335 Berg, Germany
- Department of Neurology, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
- Biomedical Center and University Hospital, Ludwig-Maximilians-Universität München, 82152 Planegg-Martinsried, Germany
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Zhao GL, Li RZ, Pang YH, Wang XQ, Wei JF, Zhou Z. Diagnostic value of 3D Optical Coherence Tomography Multimode Images in the Diagnosis of Acute Central Serous Chorioretinopathy. Curr Med Imaging 2023:CMIR-EPUB-133377. [PMID: 37537936 DOI: 10.2174/1573405620666230804093929] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/21/2023] [Accepted: 07/08/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Spectral-Domain Optical Coherence Tomography (SD-OCT) provides non-invasive, high-speed, high-resolution, three-dimensional cross-section imaging of the macula. OBJECTIVES This study aimed to investigate the diagnostic value of the multimodal imaging technique of three-dimension (3D) optical coherence tomography (OCT) (3D-OCT) for the diagnosis and characterization of acute central serous chorioretinopathy (CSC). METHODS In this prospective clinical study 3D-OCT examinations of 82 cases with acute CSC were performed on the macular area, and the image characteristics were analyzed. Our study included a total of 87 eyes from 82 cases of CSC patients, 67 males and 15 females (mean age ± standard deviation (SD): 42.89 ±7.80 years old; age range: 27 to 56 years old. The 3D-OCT images were evaluated for the presence of subretinal fluid, subretinal space, fluctuation of the internal limiting membrane (ILM), folds of retinal pigment epithelial (RPE), retinal pigment epithelium detachment (PED), and flat irregular PED. The foveal thickness was measured using the manual caliper of OCT software. RESULTS The OCT B-scan images showed 87 (100%) eyes had exudative retinal detachment (ERD), 38 (44%) had flat irregular PED, 36 (41%) had PED, 8 (9%) had subretinal turbidity structure, 2 (2%) had subretinal dot-like precipitates, 1 (1%) had focal choroidal excavation (FCE), and 1 (1%) eye had fluctuation of internal limiting membrane (FI). In the ILM-RPE thickness map, all eyes had a round or round like regular uniform domes. Fifty-seven (66%) domes were limited in the examination area and 30 (44%) domes were beyond the scope of this examination and only a partial section of the dome could be observed. In the en-face image, all eyes had a round or round-like black figure that corresponded with domes in the ILM-RPE thickness map. In RPE surface, 76 (87%) eyes had a shallow plate depression, 71(82%) had small focal uplift, and 1 (1%) eye had a focal concave feature. CONCLUSIONS In the OCT ILM-RPE thickness, en-face image, and RPE surface maps, acute CSC exhibited specific imaging characteristics that can be helpful for reliable diagnosis and differential diagnosis of CSC.
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Affiliation(s)
- Gui-Ling Zhao
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, 524001, China
| | - Rui-Zhuang Li
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, 524001, China
| | - Yan-Hua Pang
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, 524001, China
| | - Xiu-Qin Wang
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, 524001, China
| | - Jin-Fen Wei
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, 524001, China
| | - Zhou Zhou
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue, Xiashan District, Zhanjiang, 524001, China
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Muñoz-Ortiz T, Alayeto I, Lifante J, Ortgies DH, Marin R, Martín Rodríguez E, Iglesias de la Cruz MDC, Lifante-Pedrola G, Rubio-Retama J, Jaque D. 3D Optical Coherence Thermometry Using Polymeric Nanogels. Adv Mater 2023; 35:e2301819. [PMID: 37352307 DOI: 10.1002/adma.202301819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/04/2023] [Indexed: 06/25/2023]
Abstract
In nanothermometry, the use of nanoparticles as thermal probes enables remote and minimally invasive sensing. In the biomedical context, nanothermometry has emerged as a powerful tool where traditional approaches, like infrared thermal sensing and contact thermometers, fall short. Despite the strides of this technology in preclinical settings, nanothermometry is not mature enough to be translated to the bedside. This is due to two major hurdles: the inability to perform 3D thermal imaging and the requirement for tools that are readily available in the clinics. This work simultaneously overcomes both limitations by proposing the technology of optical coherence thermometry (OCTh). This is achieved by combining thermoresponsive polymeric nanogels and optical coherence tomography (OCT)-a 3D imaging technology routinely used in clinical practice. The volume phase transition of the thermoresponsive nanogels causes marked changes in their refractive index, making them temperature-sensitive OCT contrast agents. The ability of OCTh to provide 3D thermal images is demonstrated in tissue phantoms subjected to photothermal processes, and its reliability is corroborated by comparing experimental results with numerical simulations. The results included in this work set credible foundations for the implementation of nanothermometry in the form of OCTh in clinical practice.
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Affiliation(s)
- Tamara Muñoz-Ortiz
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física de Materiales, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- Instituto Nicolás Cabrera, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
| | - Idoia Alayeto
- Departamento de Química en Ciencias Farmacéuticas, Facultad de Farmacia, Plaza de Ramón y Cajal, s/n, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - José Lifante
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo 2, Madrid, 28029, Spain
- nanomaterials for BioImaging Group (nanoBIG), Instituto Ramón y Cajal de Investigación Sanitaria, Ctra de Colmenar Viejo Km 9,100, Madrid, 28034, Spain
| | - Dirk H Ortgies
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física de Materiales, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- Instituto Nicolás Cabrera, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- nanomaterials for BioImaging Group (nanoBIG), Instituto Ramón y Cajal de Investigación Sanitaria, Ctra de Colmenar Viejo Km 9,100, Madrid, 28034, Spain
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física Aplicada, Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, 28049, Spain
| | - Riccardo Marin
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física de Materiales, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- Instituto Nicolás Cabrera, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física Aplicada, Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, 28049, Spain
| | - Emma Martín Rodríguez
- Instituto Nicolás Cabrera, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- nanomaterials for BioImaging Group (nanoBIG), Instituto Ramón y Cajal de Investigación Sanitaria, Ctra de Colmenar Viejo Km 9,100, Madrid, 28034, Spain
- Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, Madrid, 28049, Spain
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física Aplicada, Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, 28049, Spain
| | - María Del Carmen Iglesias de la Cruz
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo 2, Madrid, 28029, Spain
| | - Ginés Lifante-Pedrola
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física de Materiales, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
| | - Jorge Rubio-Retama
- Departamento de Química en Ciencias Farmacéuticas, Facultad de Farmacia, Plaza de Ramón y Cajal, s/n, Universidad Complutense de Madrid, Madrid, 28040, Spain
- nanomaterials for BioImaging Group (nanoBIG), Instituto Ramón y Cajal de Investigación Sanitaria, Ctra de Colmenar Viejo Km 9,100, Madrid, 28034, Spain
| | - Daniel Jaque
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física de Materiales, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- Instituto Nicolás Cabrera, Facultad de Ciencias, Universidad Autónoma de Madrid, C/ Francisco Tomás y Valiente 7, Madrid, 28049, Spain
- nanomaterials for BioImaging Group (nanoBIG), Instituto Ramón y Cajal de Investigación Sanitaria, Ctra de Colmenar Viejo Km 9,100, Madrid, 28034, Spain
- nanomaterials for BioImaging Group (nanoBIG), Departamento de Física Aplicada, Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, 28049, Spain
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Yang D, Wang W, Yuan Z, Liang Y. Information-Rich Multi-Functional OCT for Adult Zebrafish Intra- and Extracranial Imaging. Bioengineering (Basel) 2023; 10:856. [PMID: 37508883 PMCID: PMC10375992 DOI: 10.3390/bioengineering10070856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
The zebrafish serves as a valuable animal model for both intra- and extracranial research, particularly in relation to the brain and skull. To effectively investigate the development and regeneration of adult zebrafish, a versatile in vivo imaging technique capable of showing both intra- and extracranial conditions is essential. In this paper, we utilized a high-resolution multi-functional optical coherence tomography (OCT) to obtain rich intra- and extracranial imaging outcomes of adult zebrafish, encompassing pigmentation distribution, tissue-specific information, cranial vascular imaging, and the monitoring of traumatic brain injury (TBI). Notably, it is the first that the channels through the zebrafish cranial suture, which may have a crucial function in maintaining the patency of the cranial sutures, have been observed. Rich imaging results demonstrated that a high-resolution multi-functional OCT system can provide a wealth of novel and interpretable biological information for intra- and extracranial studies of adult zebrafish.
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Affiliation(s)
- Di Yang
- Tianjin Key Laboratory of Micro-Scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, Tianjin 300350, China
| | - Weike Wang
- Tianjin Key Laboratory of Micro-Scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, Tianjin 300350, China
| | - Zhuoqun Yuan
- Tianjin Key Laboratory of Micro-Scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, Tianjin 300350, China
| | - Yanmei Liang
- Tianjin Key Laboratory of Micro-Scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, Tianjin 300350, China
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Hu M, Wu B, Lu D, Xie J, Chen Y, Yang Z, Dai W. Two-step hierarchical neural network for classification of dry age-related macular degeneration using optical coherence tomography images. Front Med (Lausanne) 2023; 10:1221453. [PMID: 37547613 PMCID: PMC10403700 DOI: 10.3389/fmed.2023.1221453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Purpose The aim of this study is to apply deep learning techniques for the development and validation of a system that categorizes various phases of dry age-related macular degeneration (AMD), including nascent geographic atrophy (nGA), through the analysis of optical coherence tomography (OCT) images. Methods A total of 3,401 OCT macular images obtained from 338 patients admitted to Shenyang Aier Eye Hospital in 2019-2021 were collected for the development of the classification model. We adopted a convolutional neural network (CNN) model and introduced hierarchical structure along with image enhancement techniques to train a two-step CNN model to detect and classify normal and three phases of dry AMD: atrophy-associated drusen regression, nGA, and geographic atrophy (GA). Five-fold cross-validation was used to evaluate the performance of the multi-label classification model. Results Experimental results obtained from five-fold cross-validation with different dry AMD classification models show that the proposed two-step hierarchical model with image enhancement achieves the best classification performance, with a f1-score of 91.32% and a kappa coefficients of 96.09% compared to the state-of-the-art models. The results obtained from the ablation study demonstrate that the proposed method not only improves accuracy across all categories in comparison to a traditional flat CNN model, but also substantially enhances the classification performance of nGA, with an improvement from 66.79 to 81.65%. Conclusion This study introduces a novel two-step hierarchical deep learning approach in categorizing dry AMD progression phases, and demonstrates its efficacy. The high classification performance suggests its potential for guiding individualized treatment plans for patients with macular degeneration.
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Affiliation(s)
- Min Hu
- Changsha Aier Eye Hospital, Changsha, China
| | - Bin Wu
- Department of Retina, Shenyang Aier Excellence Eye Hospital, Shenyang, China
| | - Di Lu
- Department of Retina, Shenyang Aier Optometry Hospital, Shenyang, China
| | - Jing Xie
- Changsha Aier Eye Hospital, Changsha, China
| | - Yiqiang Chen
- Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Zhikuan Yang
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Weiwei Dai
- Changsha Aier Eye Hospital, Changsha, China
- Anhui Aier Eye Hospital, Anhui Medical University, Hefei, China
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Nozaki M, Ando R, Kimura T, Kato F, Yasukawa T. The Role of Laser Photocoagulation in Treating Diabetic Macular Edema in the Era of Intravitreal Drug Administration: A Descriptive Review. Medicina (Kaunas) 2023; 59:1319. [PMID: 37512130 PMCID: PMC10385537 DOI: 10.3390/medicina59071319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: This study aimed to elucidate the role of laser photocoagulation therapy in the treatment of diabetic macular edema (DME) as an alternative to, or in conjunction with, the first-line treatment, anti-vascular endothelial growth factor (VEGF). Materials and Methods: A comprehensive literature search to identify studies that evaluated the efficacy of laser photocoagulation therapy in the management of DME was performed. The relevant findings of the efficacy of focal/grid laser therapy from data in randomized, controlled trials were synthesized, and the potential of new laser technologies, such as navigated laser systems, pattern scan lasers, and subthreshold lasers, was explored. The usefulness of multimodal imaging-guided laser therapy was also evaluated, with a focus on the potential contribution to anti-VEGF therapy. Results: Focal laser photocoagulation targeting microaneurysms remains an effective therapeutic approach to chronic refractory edema, despite the widespread use of anti-VEGF therapy. To achieve the best possible treatment outcomes, precise identification of microaneurysms is essential. This requires the use of multimodal imaging-guided, highly accurate, minimally invasive coagulation techniques. Subthreshold laser therapy can also reduce the frequency of anti-VEGF injections and minimize treatment burden. Conclusions: Further studies are needed to determine the optimal timing and settings for laser photocoagulation therapy and the potential of new laser technologies in the management of DME. Nevertheless, laser photocoagulation therapy plays an important role in the management of DME, in conjunction with anti-VEGF therapy.
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Affiliation(s)
- Miho Nozaki
- Department of Ophthalmology, Laser Eye Center, Nagoya City University East Medical Center, Nagoya 464-8547, Japan
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Ryota Ando
- Department of Ophthalmology, Laser Eye Center, Nagoya City University East Medical Center, Nagoya 464-8547, Japan
| | - Toshiya Kimura
- Department of Ophthalmology, Laser Eye Center, Nagoya City University East Medical Center, Nagoya 464-8547, Japan
| | - Fusae Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
- Department of Ophthalmology, Toyota Kosei Hospital, Toyota 470-0396, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
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Kowalik-Jagodzińska M, Sobol M, Turno-Kręcicka A. A Comparison of Observational Studies on Subfoveal Choroidal Thickness Measured with OCT according to the Level of Thyroid Eye Disease Activity-Systematic Review and Meta-Analysis. J Clin Med 2023; 12:4720. [PMID: 37510836 PMCID: PMC10380986 DOI: 10.3390/jcm12144720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
This study aims to systematise subfoveal choroidal thickness (SFCT) measured using optical coherence tomography (OCT) in patients with different severities of thyroid eye disease (TED) compared with healthy subjects. The PubMed, Web of Science and Scopus databases were searched for the following terms: ((Graves' ophthalmopathy) OR (thyroid eye disease) OR (Graves' orbitopathy) OR (thyroid-associated orbitopathy)) AND (choroidal thickness) AND ((optical coherence tomography) OR (OCT)). The pool of papers was narrowed down to articles published until 31 January 2023 (26, 26 and 96 papers, respectively). Twenty-five (25) articles were taken into consideration, which were original papers and included the choroidal thickness measurements among TED patients in their results. Finally, eight papers were included in the comparative analysis of the SFCT parameter in TED patients and a group of healthy controls, and seven papers in the comparative analysis of the same parameter between active and inactive TED patients. The mean value of the difference between the TED group and the healthy group was 38.79 μm, with a confidence interval (CI) from 0.09 to 77.49 μm (p = 0.0495). The mean difference between the active TED group and inactive TED group was 38.02 μm, with a CI from 8.62 to 67.42 μm (p = 0.0113). All the results were statistically significant.
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Affiliation(s)
| | - Maria Sobol
- Department of Biophysics Physiology and Pathophysiology, Medical University of Warsaw, 02-004 Warszawa, Poland
| | - Anna Turno-Kręcicka
- Department of Ophthalmology, Wroclaw Medical University, 50-367 Wrocław, Poland
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Kao CC, Hsieh HM, Chang YC, Chu HC, Yang YH, Sheu SJ. Optical Coherence Tomography Assessment of Macular Thickness in Alzheimer's Dementia with Different Neuropsychological Severities. J Pers Med 2023; 13:1118. [PMID: 37511731 PMCID: PMC10381874 DOI: 10.3390/jpm13071118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
This retrospective case-control study aimed to investigate associations between disease severity of Alzheimer's dementia (AD) and macular thickness. Data of patients with AD who were under medication (n = 192) between 2013 and 2020, as well as an age- and sex-matched control group (n = 200) with normal cognitive function, were included. AD patients were divided into subgroups according to scores of the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Macular thickness was analyzed via the Early Treatment Diabetic Retinopathy Study (ETDRS) grid map. AD patients had significant reductions in full macula layers, including inner circle, outer inferior area, and outer nasal area of the macula. Similar retinal thinning was noted in ganglion cells and inner plexiform layers. Advanced AD patients (MMSE score < 18 or CDR ≥ 1) showed more advanced reduction of macular thickness than the AD group (CDR = 0.5 or MMSE ≥ 18), indicating that severe cognitive impairment was associated with thinner macular thickness. Advanced AD is associated with significant macula thinning in full retina and inner plexiform layers, especially at the inner circle of the macula. Macular thickness may be a useful biomarker of AD disease severity. Retinal imaging may be a non-invasive, low-cost surrogate for AD.
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Affiliation(s)
- Chia-Chen Kao
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Ophthalmology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Yo-Chen Chang
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Ophthalmology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, Taiwan
| | - Hui-Chen Chu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Post-Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Shwu-Jiuan Sheu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Ophthalmology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Fink E, Celikovic S, Rehrl J, Sacher S, Alberto Afonso Urich J, Khinast J. Prediction of Dissolution Performance of Uncoated Solid Oral Dosage Forms via Optical Coherence Tomography. Eur J Pharm Biopharm 2023:S0939-6411(23)00175-3. [PMID: 37423415 DOI: 10.1016/j.ejpb.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 07/11/2023]
Abstract
Real-time prediction of the dissolution behavior of solid oral dosage forms is an important research topic. Although methods such as Terahertz and Raman can provide measurements that can be linked to the dissolution performance, they typically require a longer time off-line for analysis. In this paper, we present a novel strategy for analyzing uncoated compressed tablets by means of optical coherence tomography (OCT). Using OCT, which is fast and in-line capable, makes it possible to predict the dissolution behavior of tablets based on images. In our study, OCT images were obtained of individual tablets from differently produced batches. Differences between tablets or batches in these images were hardly visible to the human eye. Advanced image analysis metrics were developed to quantify the light scattering behavior captured by the OCT probe and depicted in the OCT images. Detailed investigations assured the repeatability and robustness of the measurements. A correlation between these measurements and the dissolution behavior was established. A tree-based machine learning model was used to predict the amount of dissolved active pharmaceutical ingredient (API) at certain time points for each immediate-release tablet. Our results indicate that OCT, which is a non-destructive and real-time technology, can be used for in-line monitoring of tableting processes.
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Affiliation(s)
- Elisabeth Fink
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse, 13, 8010 Graz, Austria.
| | - Selma Celikovic
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse, 13, 8010 Graz, Austria; Institute of Automation and Control, Graz University of Technology, Inffeldgasse 21/B/I, 8010 Graz, Austria
| | - Jakob Rehrl
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse, 13, 8010 Graz, Austria
| | - Stephan Sacher
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse, 13, 8010 Graz, Austria
| | | | - Johannes Khinast
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse, 13, 8010 Graz, Austria; Institute of Process and Particle Engineering, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria
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Xiaodong L, Xuejun X, Xiaojuan S, Yu H, Mingchao X. Characterization of peripheral blood inflammatory indicators and OCT imaging biological markers in diabetic retinopathy with or without nephropathy. Front Endocrinol (Lausanne) 2023; 14:1160615. [PMID: 37465123 PMCID: PMC10351984 DOI: 10.3389/fendo.2023.1160615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/13/2023] [Indexed: 07/20/2023] Open
Abstract
Objective To observe the distribution characteristics of peripheral blood inflammatory indexes and retinal macular area optical coherence tomography (OCT) imaging biomarkers in patients with diabetic retinopathy (DR) with or without diabetic nephropathy (DN), in order to seek clinical biomarkers that can predict the development of DR and DN. Methods A total of 169 inpatients with DR who visited the ophthalmology department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from October 2020 to June 2022 and had complete clinical data were collected, and the patients with DR were divided into two major groups, DR and DR/DN, according to whether they had DN, and then further divided into four subgroups, Non-proliferative DR(NPDR), proliferative DR(PDR), NPDR/DN and PDR/DN, according to the stage of DR. The distribution characteristics of peripheral blood inflammatory indexes [Neutrophil to lymphocyte ratio(NLR) and Platelet to neutrophil ratio(PLR)], renal function indexes [Cystatin-C(CYS-C), Creatinine(Crea), Uric acid(UA)and Urinary albumin to creatinine ratio(UACR)] and OCT imaging indexes [Hyperreflective foci(HRF), Disorgnization of retinal inner layers(DRIL), Outer retinal tubulations(ORTs), Central retinal thickness(CRT), Retinal nerve fiber layer(RNFL) and Ganglion cell layer(GCL)] were analyzed between the above subgroups. Results There was no difference between DR and DR/DN groups in terms of gender, family history of diabetes, duration of diabetes and Body mass index(BMI) (P>0.05), the mean age of the DR/DN group was significantly lower than that of the DR group (P<0.05), and the proportion of the DR/DN group with a history of hypertension was significantly higher than that of the DR group (P<0.05); there was no significant difference in hemoglobin A1C(HbA1c) between DR and DR/DN groups (P>0.05). (P>0.05), Hemoglobin(HGB) was significantly higher in the DR group than in the DR/DN group (P <0.05), NLR, PLR, Crea, UA and CYS-C were significantly higher in the DR/DN group than in the DR group (P<0.05); there was no significant difference in the comparison of HRF, DRIL, ORTs positive rate and CRT between the DR and DR/DN groups (P>0.05). RNFL and GCL thickness were significantly lower in the DR/DN group than in the DR group (P<0.05); history of hypertension (OR=2.759), NLR (OR=1.316), PLR (OR=1.009), Crea (OR=1.018), UA (OR=1.004), CYS-C (OR=3.742) were the independent (OR=0.951), age (OR=0.951), HGB (OR=0.976), RNFL (OR=0.909) and GCL (OR=0.945) were independent protective factors for DR/DN; RNFL (OR=0.899) and GCL (OR=0.935) were independent protective factors for NPDR/DN, RNFL (OR=0.852) and GCL (OR=0.928) were independent protective factors for PDR/DN. ROC curve analysis showed that the area under the curve (AUC) for CYS-C, PLR, Crea, UA and the combination of the four indicators to predict DR/DN were 0.717, 0.625, 0.647, 0.616 and 0.717, respectively. Conclusions (1) Low age combined with hypertension HGB, NLR, PLR, CYS-C, Crea and UA may be serum biological markers for predicting DN in DR; meanwhile, PLR, CYS-C, Crea, UA and the combination of the four indicators can be used for risk assessment and adjunctive diagnosis of DN in DR combined with hypertension. (2) The RNFL and GCL thickness in the temporal aspect of the central macular sulcus may be imaging biological markers for predicting DN in DR; meanwhile, GCL thickness may have important value for risk prediction and diagnosis of DN in combination with DR.
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Affiliation(s)
- Li Xiaodong
- Department of Ophthalmology, The First Affiliated Hospital of Guizhou University of Chinese Medicine, Chengdu, China
- Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xie Xuejun
- Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Su Xiaojuan
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - He Yu
- Department of Ophthalmology, Chengdu First People’s Hospital, Chengdu, China
| | - Xu Mingchao
- Traditional Chinese Medicine Hospital of Meishan, Meishan, China
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Zeiger E, Jakob A, Dalla Pozza R, Fischer M, Tengler A, Ulrich SM, Arnold L, Weismann CG, Schulze-Neick I, Haas NA, Pattathu J. Evaluation of the diagnostic and prognostic potential of optical coherence tomography (OCT) of the pulmonary arteries during standardised right heart catheterisation in patients with pulmonary hypertension: a cross-sectional single-centre experience. Cardiovasc Diagn Ther 2023; 13:453-464. [PMID: 37405017 PMCID: PMC10315434 DOI: 10.21037/cdt-22-421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/03/2023] [Indexed: 07/06/2023]
Abstract
Background Pulmonary hypertension (PH) is diagnosed based on an invasive evaluation of the mean pulmonary artery (PA) pressure. The morphological assessment of the pulmonary arteries was only recently not feasible. With the advent of optical coherence tomography (OCT)-imaging, an accessible tool allows to study PA morphology longitudinally. The primary hypothesis was that OCT distincts the PA structure of PH patients from control subjects. The secondary hypothesis was that PA wall thickness (WT) correlates with the progression of PH. Methods This is a retrospective monocentric study of 28 paediatric patients with (PH group) and without PH (control group) who had undergone cardiac catheterisation including OCT imaging of the PA branches. OCT parameters analysed were WT and the quotient of WT and diameter (WT/DM) and those were compared between the PH group and the control group. In addition, the OCT parameters were aligned with the haemodynamic parameters to evaluate the potential of OCT as a risk factor for patients with PH. Results WT and WT/DM in the PH group were significantly higher compared to the control group {WT: 0.150 [0.230, range (R): 0.100-0.330] vs. 0.100 [0.050, R: 0.080-0.130] mm, P<0.001; WT/DM: 0.06 [0.05] vs. 0.03 [0.01], P=0.006}. There were highly significant correlations between WT and WT/DM with the haemodynamic parameters mean pulmonary arterial pressure (mPAP) [Spearman correlation coefficient (rs) =0.702, P<0.001; rs=0.621, P<0.001], systolic pulmonary arterial pressure (sPAP) (rs=0.668, P<0.001; rs=0.658, P<0.001) and WT and pulmonary vascular resistance (PVR) (rs=0.590, P=0.02). Also, there was a significant correlation between WT and WT/DM and the risk factors quotient of mPAP and mean systemic arterial pressure (mSAP) (mPAP/mSAP) (rs=0.686, P<0.001; rs=0.644, P<0.001) and pulmonary vascular resistance index (PVRI) (rs=0.758, P=0.002; rs=0.594, P=0.02). Conclusions OCT can detect significant differences in WT of the PA in patients with PH. Furthermore, the OCT parameters correlate significantly with haemodynamic parameters and risk factors for patients with PH. More investigations are required to evaluate to what extent the impact of OCT can contribute to the clinical care of children with PH.
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Affiliation(s)
- Emilie Zeiger
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - André Jakob
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Robert Dalla Pozza
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Fischer
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Anja Tengler
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Sarah M. Ulrich
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Leonie Arnold
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Constance G. Weismann
- Department of Clinical Sciences, Pediatric Cardiology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Ingram Schulze-Neick
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Nikolaus A. Haas
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Joseph Pattathu
- Department of Paediatric Cardiology and Paediatric Intensive Care, University Hospital, Ludwig-Maximilians-University, Munich, Germany
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Hassan E, Elmougy S, Ibraheem MR, Hossain MS, AlMutib K, Ghoneim A, AlQahtani SA, Talaat FM. Enhanced Deep Learning Model for Classification of Retinal Optical Coherence Tomography Images. Sensors (Basel) 2023; 23:5393. [PMID: 37420558 DOI: 10.3390/s23125393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 07/09/2023]
Abstract
Retinal optical coherence tomography (OCT) imaging is a valuable tool for assessing the condition of the back part of the eye. The condition has a great effect on the specificity of diagnosis, the monitoring of many physiological and pathological procedures, and the response and evaluation of therapeutic effectiveness in various fields of clinical practices, including primary eye diseases and systemic diseases such as diabetes. Therefore, precise diagnosis, classification, and automated image analysis models are crucial. In this paper, we propose an enhanced optical coherence tomography (EOCT) model to classify retinal OCT based on modified ResNet (50) and random forest algorithms, which are used in the proposed study's training strategy to enhance performance. The Adam optimizer is applied during the training process to increase the efficiency of the ResNet (50) model compared with the common pre-trained models, such as spatial separable convolutions and visual geometry group (VGG) (16). The experimentation results show that the sensitivity, specificity, precision, negative predictive value, false discovery rate, false negative rate accuracy, and Matthew's correlation coefficient are 0.9836, 0.9615, 0.9740, 0.9756, 0.0385, 0.0260, 0.0164, 0.9747, 0.9788, and 0.9474, respectively.
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Affiliation(s)
- Esraa Hassan
- Faculty of Artificial Intelligence, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
| | - Samir Elmougy
- Department of Computer Science, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt
| | - Mai R Ibraheem
- Department of Information Technology, Faculty of Computers and information, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
| | - M Shamim Hossain
- Research Chair of Pervasive and Mobile Computing, Department of Software Engineering, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia
| | - Khalid AlMutib
- Department of Software Engineering, College of Computer and Information Sciences, King Saud University, Riyadh 11574, Saudi Arabia
| | - Ahmed Ghoneim
- Research Chair of Pervasive and Mobile Computing, Department of Software Engineering, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia
| | - Salman A AlQahtani
- Research Chair of Pervasive and Mobile Computing, Department of Computer Engineering, College of Computer and Information Sciences, King Saud University, Riyadh 11574, Saudi Arabia
| | - Fatma M Talaat
- Faculty of Artificial Intelligence, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
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Liu HC, Lin MH, Ting CH, Wang YM, Sun CW. Intraoperative application of optical coherence tomography for lung tumor. J Biophotonics 2023; 16:e202200344. [PMID: 36755475 DOI: 10.1002/jbio.202200344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 06/07/2023]
Abstract
On-site instant determination of benign or malignant tumors for deciding the types of resection is crucial during pulmonary surgery. We designed a portable spectral-domain optical coherence tomography (SD-OCT) system to do real-time scanning intraoperatively for the distinction of fresh tumor specimens in the lung. A total of 12 ex vivo lung specimens from six patients were enrolled. Three patients were diagnosed with invasive adenocarcinoma (IA), while the others were benign. After OCT-imaged reconstruction, we compared the qualitative morphology of OCT and histology among malignant, benign, and normal tissues. In addition, through analysis of the quantitative data, a discrete difference in optical attenuation coefficients around the junctional surface was shown by our data processing. This study demonstrated a feasible OCT-assisted resection guide by a rapid on-site tumor diagnosis. The results indicate that future deep learning of OCT-captured image systems able to improve diagnostic and therapeutic efficiency is warranted.
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Affiliation(s)
- Hung-Chang Liu
- Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
| | - Miao-Hui Lin
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - Ching-Heng Ting
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
- Department of Pathology, Mackay Memorial Hospital, New Taipei City, Taiwan
| | - Yi-Min Wang
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - Chia-Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Kuppuraj RL, Srividya N, Mathangi S, Pandian AJ, Adithya V, Rajiv R. Phenotypic heterogeneity in family members of patients with retinitis pigmentosa. Indian J Ophthalmol 2023; 71:2504-2511. [PMID: 37322671 PMCID: PMC10418025 DOI: 10.4103/ijo.ijo_1853_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/04/2022] [Accepted: 03/27/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose To describe the phenotypic variations in family members of patients with retinitis pigmentosa (RP) with different modes of inheritance and to assess the ocular abnormalities in RP families. Methods A descriptive analysis of three types of inheritance of RP was carried out, where 64 family members were examined at a tertiary eye care center, South India. They underwent comprehensive eye examination, fundus photography, fundus autofluorescence (FAF), full-field electroretinogram (FFERG), and spectral domain optical coherence tomography (SD-OCT). Analysis was performed between mild and severe forms of abnormalities to delineate retinal structural and functional defects in RP families. Results The mean age was 38.55 ± 17.95 years. Males were 48.4%. In autosomal recessive and X-linked recessive groups, 74.2% and 77.3%, respectively, were asymptomatic, whereas in autosomal dominant group, 27.3% were asymptomatic. The proportion of the cases with abnormalities in all three groups was higher on ERG (59.6%), followed by OCT (57.5%), visual acuity (43.7%), peripheral FAF (23.5%), and macular FAF (11.8%). However, these abnormalities and the clinical pictures of the family members had no statistical difference across the three groups of inheritance. Conclusion Structural and functional retinal alterations were noted in four out of five asymptomatic members, suggesting the need for careful screening of RP families and the pressing need for pre-test (genetic) counseling.
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Affiliation(s)
| | - Neriyanuri Srividya
- Department of Optometry and Vision Sciences, The University of Melbourne, Victoria, Australia
| | - Sathyaprasath Mathangi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Arunacahalam Jayamuruga Pandian
- Central Inter-Disciplinary Research Facility, Sri Balaji Vidyapeeth [Deemed to be University], SBV-Mahatma Gandhi Medical College and Research Institute Campus, Pondicherry, India
| | - Verma Adithya
- Department of Ophthalmology and Visual Sciences, University of Louisville, KY, USA
| | - Raman Rajiv
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Rodríguez-Robles F, Verdú-Monedero R, Berenguer-Vidal R, Morales-Sánchez J, Sellés-Navarro I. Analysis of the Asymmetry between Both Eyes in Early Diagnosis of Glaucoma Combining Features Extracted from Retinal Images and OCTs into Classification Models. Sensors (Basel) 2023; 23:4737. [PMID: 37430650 DOI: 10.3390/s23104737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 07/12/2023]
Abstract
This study aims to analyze the asymmetry between both eyes of the same patient for the early diagnosis of glaucoma. Two imaging modalities, retinal fundus images and optical coherence tomographies (OCTs), have been considered in order to compare their different capabilities for glaucoma detection. From retinal fundus images, the difference between cup/disc ratio and the width of the optic rim has been extracted. Analogously, the thickness of the retinal nerve fiber layer has been measured in spectral-domain optical coherence tomographies. These measurements have been considered as asymmetry characteristics between eyes in the modeling of decision trees and support vector machines for the classification of healthy and glaucoma patients. The main contribution of this work is indeed the use of different classification models with both imaging modalities to jointly exploit the strengths of each of these modalities for the same diagnostic purpose based on the asymmetry characteristics between the eyes of the patient. The results show that the optimized classification models provide better performance with OCT asymmetry features between both eyes (sensitivity 80.9%, specificity 88.2%, precision 66.7%, accuracy 86.5%) than with those extracted from retinographies, although a linear relationship has been found between certain asymmetry features extracted from both imaging modalities. Therefore, the resulting performance of the models based on asymmetry features proves their ability to differentiate healthy from glaucoma patients using those metrics. Models trained from fundus characteristics are a useful option as a glaucoma screening method in the healthy population, although with lower performance than those trained from the thickness of the peripapillary retinal nerve fiber layer. In both imaging modalities, the asymmetry of morphological characteristics can be used as a glaucoma indicator, as detailed in this work.
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Affiliation(s)
- Francisco Rodríguez-Robles
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena, 30202 Cartagena, Spain
| | - Rafael Verdú-Monedero
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena, 30202 Cartagena, Spain
| | - Rafael Berenguer-Vidal
- Departamento de Ciencias Politécnicas, Universidad Católica de Murcia (UCAM), 30107 Guadalupe, Spain
| | - Juan Morales-Sánchez
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena, 30202 Cartagena, Spain
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Gende M, de Moura J, Fernández-Vigo JI, Martínez-de-la-Casa JM, García-Feijóo J, Novo J, Ortega M. Robust multi-view approaches for retinal layer segmentation in glaucoma patients via transfer learning. Quant Imaging Med Surg 2023; 13:2846-2859. [PMID: 37179949 PMCID: PMC10167471 DOI: 10.21037/qims-22-959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/10/2023] [Indexed: 03/11/2023]
Abstract
Background Glaucoma is the leading global cause of irreversible blindness. Glaucoma patients experience a progressive deterioration of the retinal nervous tissues that begins with a loss of peripheral vision. An early diagnosis is essential in order to prevent blindness. Ophthalmologists measure the deterioration caused by this disease by assessing the retinal layers in different regions of the eye, using different optical coherence tomography (OCT) scanning patterns to extract images, generating different views from multiple parts of the retina. These images are used to measure the thickness of the retinal layers in different regions. Methods We present two approaches for the multi-region segmentation of the retinal layers in OCT images of glaucoma patients. These approaches can extract the relevant anatomical structures for glaucoma assessment from three different OCT scan patterns: circumpapillary circle scans, macular cube scans and optic disc (OD) radial scans. By employing transfer learning to take advantage of the visual patterns present in a related domain, these approaches use state-of-the-art segmentation modules to achieve a robust, fully automatic segmentation of the retinal layers. The first approach exploits inter-view similarities by using a single module to segment all of the scan patterns, considering them as a single domain. The second approach uses view-specific modules for the segmentation of each scan pattern, automatically detecting the suitable module to analyse each image. Results The proposed approaches produced satisfactory results with the first approach achieving a dice coefficient of 0.85±0.06 and the second one 0.87±0.08 for all segmented layers. The first approach produced the best results for the radial scans. Concurrently, the view-specific second approach achieved the best results for the better represented circle and cube scan patterns. Conclusions To the extent of our knowledge, this is the first proposal in the literature for the multi-view segmentation of the retinal layers of glaucoma patients, demonstrating the applicability of machine learning-based systems for aiding in the diagnosis of this relevant pathology.
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Affiliation(s)
- Mateo Gende
- VARPA Group, A Coruña Biomedical Research Institute (INIBIC), University of A Coruña, A Coruña, Spain
- CITIC Research Centre, University of A Coruña, A Coruña, Spain
| | - Joaquim de Moura
- VARPA Group, A Coruña Biomedical Research Institute (INIBIC), University of A Coruña, A Coruña, Spain
- CITIC Research Centre, University of A Coruña, A Coruña, Spain
| | | | | | | | - Jorge Novo
- VARPA Group, A Coruña Biomedical Research Institute (INIBIC), University of A Coruña, A Coruña, Spain
- CITIC Research Centre, University of A Coruña, A Coruña, Spain
| | - Marcos Ortega
- VARPA Group, A Coruña Biomedical Research Institute (INIBIC), University of A Coruña, A Coruña, Spain
- CITIC Research Centre, University of A Coruña, A Coruña, Spain
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Schittkowski MP, Naxer S, Elabbasy M, Herholz L, Breitling V, Finglas A, Gärtner J, Schlotawa L. Multiple Sulfatase Deficiency from an Ophthalmologist's Perspective-Case Report and Literature Review. Children (Basel) 2023; 10:children10030595. [PMID: 36980153 PMCID: PMC10047279 DOI: 10.3390/children10030595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
Multiple sulfatase deficiency (MSD) is an extremely rare autosomal recessively inherited disease with a prevalence of 1:500.000 caused by mutations on the sulfatase-modifying-Factor 1 gene (SUMF1). MSD is most specifically characterised by a combination of developmentally retarded psychomotoric functions, neurodegeneration that entails the loss of many already acquired abilities, and by ichthyosis. Other symptoms include those associated with mucopolysaccharidosis, i.e., facial dysmorphy, dwarfism, and hepatosplenomegaly. In 50-75% of all MSD-affected patients, functional or structural ocular damage is likely. MSD seldom affects the anterior segment of the eye. The main pathology these patients present is a highly conspicuous tapetoretinal degeneration, similar to severe Retinitis pigmentosa, that leads to blindness at an early age. An initially five-year-old boy with MSD, genetically verified at his first examination in our opthalmology department (SUMF1 mutations c.776A>T, p.Asn259Ile; c.797A>T, p.Pro266Leu; c.836A>T, p.Ala279Val), and a 4, 5 year regular follow-up are described. The patient had some visual potential ("tunnel view"), which deteriorated dramatically after his fifth birthday. We observed no evidence of worsening retinal involvement in this patient in spite of his progressively worsening clinical symptoms, extending to total blindness/no light perception. OCT revealed that the outer retinal layers containing photoreceptors were diseased; the ellipsoid zone was only partially discernible and the outer nuclear layer appeared to be thinned out. The inner nuclear layer, ganglion cell layer, and retinal nerve fibre layer were indistinguishable. These anomalies are indicative of a severe pathology within the retina's inner layers. Characteristic anomalies in the fundus should stimulate clinicians to suspect a case of MSD in their differential diagnosis, and thus to order thorough genetic and paediatric diagnostics.
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Affiliation(s)
- Michael P Schittkowski
- Section for Strabismus and Neuroophthalmology, Department of Ophthalmology, University Medical Centre Goettingen; Robert-Koch-Str. 40, 37085 Goettingen, Germany
| | - Sabine Naxer
- Section for Strabismus and Neuroophthalmology, Department of Ophthalmology, University Medical Centre Goettingen; Robert-Koch-Str. 40, 37085 Goettingen, Germany
| | - Mohamed Elabbasy
- Section for Strabismus and Neuroophthalmology, Department of Ophthalmology, University Medical Centre Goettingen; Robert-Koch-Str. 40, 37085 Goettingen, Germany
| | - Leonie Herholz
- Division for Neuropaediatrics, Department of Paediatrics and Adolescent Medicine, University Medical Centre Goettingen, 37075 Goettingen, Germany
| | - Vivian Breitling
- Division for Neuropaediatrics, Department of Paediatrics and Adolescent Medicine, University Medical Centre Goettingen, 37075 Goettingen, Germany
| | | | - Jutta Gärtner
- Division for Neuropaediatrics, Department of Paediatrics and Adolescent Medicine, University Medical Centre Goettingen, 37075 Goettingen, Germany
| | - Lars Schlotawa
- Division for Neuropaediatrics, Department of Paediatrics and Adolescent Medicine, University Medical Centre Goettingen, 37075 Goettingen, Germany
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Grines CL, Tummala PE. Calcified coronary nodule: Tip of the iceberg on a road full of thorns. Catheter Cardiovasc Interv 2023; 101:959-960. [PMID: 36934405 DOI: 10.1002/ccd.30638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/20/2023]
Affiliation(s)
- Cindy L Grines
- Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA
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Chang JJ, Chen C, Chang J, Koka S, Jokerst JV. A narrative review of imaging tools for imaging subgingival calculus. Front Oral Maxillofac Med 2023; 5:4. [PMID: 37829152 PMCID: PMC10569434 DOI: 10.21037/fomm-21-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Background and Objective The conventional method of detecting subgingival calculus involves using a periodontal probe to sense tactile differences on the dental root surface. Although efficient, this method can result in false positives and false negatives. This literature review explores alternative detection techniques that can detect subgingival calculus with improved accuracy and consistency. The accumulation of dental calculus below the gingival margin can foster periodontitis-inducing bacterial growth. Conventional methods of locating subgingival calculus are often inaccurate and highly dependent on clinician skill. This literature review evaluates techniques used to improve the accuracy of imaging and detecting subgingival calculus. Methods Google Scholar, PubMed and PubMed Central databases were searched for peer-reviewed original articles evaluating subgingival calculus imaging and detection techniques. A total of 46 relevant articles ranging from 1981 to 2021 were included. Key Content and Findings This narrative review discusses the subgingival calculus detection and imaging capabilities of periodontal endoscopy in an in vivo study and of optical coherence tomography (OCT), fluorescence spectroscopy, and differential reflectometry in in vitro settings. Each technique has unique benefits and limitations that distinguishes it from the others. Conclusions In vitro studies have revealed that techniques including periodontal endoscopy, OCT, fluorescence spectroscopy, or differential reflectometry allow for a more accurate diagnosis of subgingival calculus deposits in comparison to detection via periodontal probing. Despite the improved results, the common limitations of these techniques include longer operation times and expensive equipment. Further studies are needed to transition these imaging and detection methods to clinical environments.
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Affiliation(s)
- Jason J. Chang
- Department of Biological Sciences, University of California, San Diego, CA, USA
| | - Casey Chen
- Division of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Joe Chang
- Division of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Sreenivas Koka
- School of Dentistry, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jesse V. Jokerst
- Material Science and Engineering Program, University of California, San Diego, CA, USA
- Department of Bioengineering, University of California, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, CA, USA
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Lotz-Havla AS, Christmann T, Parhofer KG, Maier EM, Havla J. Optical Coherence Tomography: Retinal Imaging Contributes to the Understanding of Brain Pathology in Classical Galactosemia. J Clin Med 2023; 12. [PMID: 36902816 DOI: 10.3390/jcm12052030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
It remains unresolved whether central nervous system involvement in treated classical galactosemia (CG) is a progressive neurodegenerative process. This study aimed to investigate retinal neuroaxonal degeneration in CG as a surrogate of brain pathology. Global peripapillary retinal nerve fibre layer (GpRNFL) and combined ganglion cell and inner plexiform layer (GCIPL) were analysed in 11 CG patients and 60 controls (HC) using spectral-domain optical coherence tomography. Visual acuity (VA) and low-contrast VA (LCVA) were acquired to test visual function. GpRNFL and GCIPL did not differ between CG and HC (p > 0.05). However, in CG, there was an effect of intellectual outcome on GCIPL (p = 0.036), and GpRNFL and GCIPL correlated with neurological rating scale scores (p < 0.05). A single-case follow-up analysis showed GpRNFL (0.53-0.83%) and GCIPL (0.52-0.85%) annual decrease beyond the normal aging effect. VA and LCVA were reduced in CG with intellectual disability (p = 0.009/0.006), likely due to impaired visual perception. These findings support that CG is not a neurodegenerative disease, but that brain damage is more likely to occur early in brain development. To clarify a minor neurodegenerative component in the brain pathology of CG, we propose multicenter cross-sectional and longitudinal studies using retinal imaging.
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Bennett JL, Fujihara K, Kim HJ, Marignier R, O'Connor KC, Sergott RC, Traboulsee A, Wiendl H, Wuerfel J, Zamvil SS, Anania VG, Buffels R, Künzel T, Lekkerkerker AN, Lennon-Chrimes S, Pittock SJ. SAkuraBONSAI: Protocol design of a novel, prospective study to explore clinical, imaging, and biomarker outcomes in patients with AQP4-IgG-seropositive neuromyelitis optica spectrum disorder receiving open-label satralizumab. Front Neurol 2023; 14:1114667. [PMID: 36873431 PMCID: PMC9982113 DOI: 10.3389/fneur.2023.1114667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/26/2023] [Indexed: 02/19/2023] Open
Abstract
Background Neuromyelitis optica spectrum disorder (NMOSD) is a rare, autoimmune disease of the central nervous system that produces acute, unpredictable relapses causing cumulative neurological disability. Satralizumab, a humanized, monoclonal recycling antibody that targets the interleukin-6 receptor, reduced NMOSD relapse risk vs. placebo in two Phase 3 trials: SAkuraSky (satralizumab ± immunosuppressive therapy; NCT02028884) and SAkuraStar (satralizumab monotherapy; NCT02073279). Satralizumab is approved to treat aquaporin-4 IgG-seropositive (AQP4-IgG+) NMOSD. SAkuraBONSAI (NCT05269667) will explore fluid and imaging biomarkers to better understand the mechanism of action of satralizumab and the neuronal and immunological changes following treatment in AQP4-IgG+ NMOSD. Objectives SAkuraBONSAI will evaluate clinical disease activity measures, patient-reported outcomes (PROs), pharmacokinetics, and safety of satralizumab in AQP4-IgG+ NMOSD. Correlations between imaging markers (magnetic resonance imaging [MRI] and optical coherence tomography [OCT]) and blood and cerebrospinal fluid (CSF) biomarkers will be investigated. Study design SAkuraBONSAI is a prospective, open-label, multicenter, international, Phase 4 study that will enroll approximately 100 adults (18-74 years) with AQP4-IgG+ NMOSD. This study includes two patient cohorts: newly diagnosed, treatment-naïve patients (Cohort 1; n = 60); and inadequate responders to recent (<6 months) rituximab infusion (Cohort 2; n = 40). Satralizumab monotherapy (120 mg) will be administered subcutaneously at Weeks 0, 2, 4, and Q4W thereafter for a total of 92 weeks. Endpoints Disease activity related to relapses (proportion relapse-free, annualized relapse rate, time to relapse, and relapse severity), disability progression (Expanded Disability Status Scale), cognition (Symbol Digit Modalities Test), and ophthalmological changes (visual acuity; National Eye Institute Visual Function Questionnaire-25) will all be assessed. Peri-papillary retinal nerve fiber layer and ganglion cell complex thickness will be monitored using advanced OCT (retinal nerve fiber layer and ganglion cell plus inner plexiform layer thickness). Lesion activity and atrophy will be monitored by MRI. Pharmacokinetics, PROs, and blood and CSF mechanistic biomarkers will be assessed regularly. Safety outcomes include the incidence and severity of adverse events. Conclusions SAkuraBONSAI will incorporate comprehensive imaging, fluid biomarker, and clinical assessments in patients with AQP4-IgG+ NMOSD. SAkuraBONSAI will provide new insights into the mechanism of action of satralizumab in NMOSD, while offering the opportunity to identify clinically relevant neurological, immunological, and imaging markers.
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Affiliation(s)
- Jeffrey L. Bennett
- Programs in Neuroscience and Immunology, Departments of Neurology and Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kazuo Fujihara
- Department of Multiple Sclerosis Therapeutics, Fukushima Medical University School of Medicine, Multiple Sclerosis and Neuromyelitis Optica Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, Japan
| | - Ho Jin Kim
- Department of Neurology, National Cancer Center, Goyang, Republic of Korea
| | - Romain Marignier
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Kevin C. O'Connor
- Departments of Neurology and Immunobiology, Yale University School of Medicine, New Haven, CT, United States
| | - Robert C. Sergott
- Annesley EyeBrain Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, United States
| | - Anthony Traboulsee
- Department of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada
| | - Heinz Wiendl
- Department of Neurology, University of Muenster, Münster, Germany
| | - Jens Wuerfel
- Medical Image Analysis Centre (MIAC AG) and University of Basel, Basel, Switzerland
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Scott S. Zamvil
- Department of Neurology and Program in Immunology, University of California, San Francisco, San Francisco, CA, United States
| | | | | | | | | | | | - Sean J. Pittock
- Department of Neurology, Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States
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Pang Y, Tan Z, Chen X, Liao Z, Yang X, Zhong Q, Huang B, Zhong Q, Zhong J, Mo W. Evaluation of preoperative visual pathway impairment in patients with non-functioning pituitary adenoma using diffusion tensor imaging coupled with optical coherence tomography. Front Neurosci 2023; 17:1057781. [PMID: 36845438 PMCID: PMC9947395 DOI: 10.3389/fnins.2023.1057781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
Objective Optic chiasma compression and associated visual impairment induced by a non-functioning pituitary adenoma (NFPA) is commonly assessed by the optic disk and retina but is inadequate to understand the entire visual pathway impairment. We aim to evaluate the use of optical coherence tomography (OCT) coupled with diffusion tensor imaging (DTI) for the preoperative evaluation of visual pathway impairment. Methods Fifty-three patients with NFPA (categorized into mild and heavy compression subgroups) were subjected to OCT to calculate the thickness of the circumpapillary retinal nerve fiber layer (CP-RNFL), macular ganglion cell complex (GCC), macular ganglion cell layer (GCL), and macular inner plexus layer (IPL), as well as to DTI to calculate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values. Results Compared to mild compression, heavy compression caused decreased FA value, increased ADC value of several segments of the visual pathway, thin temporal CP-RNFL, and quadrant macular GCC, IPL, and GCL. Average CP-RNFL thickness, inferior-macular inner-ring IPL and GCC thicknesses, inferior CP-RNFL thickness, and superior CP-RNFL thickness were the best indicators of the impairment of the optic nerve, optic chiasma, optic tract, and optic radiation, respectively. Conclusion DTI and OCT parameters can effectively evaluate visual pathway impairment and are beneficial for the objective preoperative evaluation of visual pathway impairment in patients with NFPA.
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Affiliation(s)
- Yanhua Pang
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zhi Tan
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xinxin Chen
- Teaching and Research Center of Medical Communication Science, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zhihui Liao
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xin Yang
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qin Zhong
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Baqi Huang
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qianshuo Zhong
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jingxiang Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China,Department of Ophthalmology, The Sixth Affiliated Hospital of Jinan University, Guangzhou, China,*Correspondence: Jingxiang Zhong,
| | - Wei Mo
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China,Wei Mo,
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Szabelska P, Mędrzycka J, Brydak-Godowska J, Różycki R, Gołębiewska J. Focal Choroidal Excavation: Epidemiology, Clinical Characteristics and Multimodal Imaging Findings. Diagnostics (Basel) 2023; 13:diagnostics13040602. [PMID: 36832090 PMCID: PMC9954964 DOI: 10.3390/diagnostics13040602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Focal choroidal excavation (FCE) is one of the pachychoroid spectrum diseases. It may be an isolated lesion or associated with other ophthalmological disorders. The aim of the study was to present the epidemiology, clinical features and multimodal imaging findings in FCE. METHODS This is a case series of 14 consecutive patients with a diagnosis of FCE, confirmed by multimodal imaging, from a review of the 5076 optical coherence tomography (OCT) scans in 2538 patients. Choroidal thickness (CT) was measured under the fovea and in the area of maximum choroidal thickening in the affected eye and under the fovea in the fellow eye. RESULTS The mean age of the subjects was 40 ± 13.58 years. FCE occurred unilaterally and was an isolated lesion in all cases. The fellow eye did not show any macular pathology in all patients. Twelve eyes presented conforming FCEs and two non-conforming FCEs. In 79% of cases, FCE was subfoveal. The mean maximum CT was 390 μm in the affected eye with the presence of pachyvessels. A total of 13 patients were asymptomatic, while one patient reported a visual disturbance due to neovascularization secondary to FCE. Of all the multimodal imaging techniques, optical coherence tomography (OCT) provided the most important data in the diagnosis of FCE. CONCLUSIONS Our study confirmed that FCE is a rare ocular condition, but it may be more common in Caucasian population than previously known. Multimodal imaging methods, mainly OCT, are crucial in FCE diagnostics. Further studies are needed to expand the available knowledge about its etiology and clinical course.
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Affiliation(s)
- Paulina Szabelska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Justyna Mędrzycka
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Joanna Brydak-Godowska
- Department of Ophthalmology, Infant Jesus Clinical Hospital, University Clinical Center, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Radosław Różycki
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Joanna Gołębiewska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
- Correspondence:
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