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Saeidian J, Mahmoudi T, Riazi-Esfahani H, Montazeriani Z, Khodabande A, Zarei M, Ebrahimiadib N, Jafari B, Afzal Aghaei A, Azimi H, Khalili Pour E. Automated assessment of the smoothness of retinal layers in optical coherence tomography images using a machine learning algorithm. BMC Med Imaging 2023; 23:21. [PMID: 36732684 PMCID: PMC9896782 DOI: 10.1186/s12880-023-00976-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
Quantifying the smoothness of different layers of the retina can potentially be an important and practical biomarker in various pathologic conditions like diabetic retinopathy. The purpose of this study is to develop an automated machine learning algorithm which uses support vector regression method with wavelet kernel and automatically segments two hyperreflective retinal layers (inner plexiform layer (IPL) and outer plexiform layer (OPL)) in 50 optical coherence tomography (OCT) slabs and calculates the smoothness index (SI). The Bland-Altman plots, mean absolute error, root mean square error and signed error calculations revealed a modest discrepancy between the manual approach, used as the ground truth, and the corresponding automated segmentation of IPL/ OPL, as well as SI measurements in OCT slabs. It was concluded that the constructed algorithm may be employed as a reliable, rapid and convenient approach for segmenting IPL/OPL and calculating SI in the appropriate layers.
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Affiliation(s)
- Jamshid Saeidian
- grid.412265.60000 0004 0406 5813Faculty of Mathematical Sciences and Computer, Kharazmi University, No. 50, Taleghani Ave, Tehran, Iran
| | - Tahereh Mahmoudi
- grid.411705.60000 0001 0166 0922Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences and Research Center for Science and Technology in Medicine, Tehran, Iran
| | - Hamid Riazi-Esfahani
- grid.411705.60000 0001 0166 0922Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Montazeriani
- grid.411705.60000 0001 0166 0922Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences and Research Center for Science and Technology in Medicine, Tehran, Iran
| | - Alireza Khodabande
- grid.411705.60000 0001 0166 0922Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zarei
- grid.411705.60000 0001 0166 0922Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Ebrahimiadib
- grid.411705.60000 0001 0166 0922Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Behzad Jafari
- grid.411705.60000 0001 0166 0922Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Afzal Aghaei
- grid.412502.00000 0001 0686 4748Department of Computer Sciences, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hossein Azimi
- grid.412265.60000 0004 0406 5813Faculty of Mathematical Sciences and Computer, Kharazmi University, No. 50, Taleghani Ave, Tehran, Iran
| | - Elias Khalili Pour
- grid.411705.60000 0001 0166 0922Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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NASAL CROWDING AND NASAL TILTING OF THE MACULA AFTER EPIRETINAL MEMBRANE SURGERY. Retina 2022; 42:2284-2293. [DOI: 10.1097/iae.0000000000003606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Shah MS, Pradhan AK, Khalsa A, Kelgaonkar A. Mimickers of punctate inner retinal toxoplasmosis on optical coherence tomography. BMJ Case Rep 2022; 15:e251024. [PMID: 35728912 PMCID: PMC9214394 DOI: 10.1136/bcr-2022-251024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Miloni Suketu Shah
- Vitreo-retina, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
| | - Atish Kumar Pradhan
- Vitreo-retina, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
| | | | - Anup Kelgaonkar
- Vitreo-retina, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
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Disorganization of retinal inner layers: diagnostic and clinical characteristics. OPHTHALMOLOGY JOURNAL 2022. [DOI: 10.17816/ov104631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This review describes the current state of knowledge oт the phenomenon of disorganization of retinal inner layers. DRIL is characterized by alteration of microcirculation in retinal capillary plexuses detected with optical coherence tomography angiography, alteration of several inner layers of the retina with the inability to differentiate them on optical coherence tomography, and by an impact on the quality of vision. Disorganization of retinal inner layers occurs in a number of different vascular retinal disorders, which indicates its importance as a clinical biomarker and clinical significance. However, the literature data on disorganization of retinal inner layers are still limited, and questions about the pathogenesis of this disease warrant further investigations.
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Epiretinal Membrane Peeling in Eyes with Retinal Vein Occlusion: Visual and Morphologic Outcomes. Ophthalmol Ther 2022; 11:661-675. [PMID: 35099781 PMCID: PMC8927570 DOI: 10.1007/s40123-022-00461-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/10/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction To evaluate the anatomical and functional outcomes of pars plana vitrectomy (PPV) and epiretinal membrane (ERM) peeling in patients with retinal vein occlusion (RVO) and secondary ERM. Methods Retrospective, multicenter study including patients with RVO and ERM who underwent PPV and ERM peeling with or without phacoemulsification. Demographic, clinical, surgical, and optical coherence tomography (OCT) features were recorded at the time of ERM peeling (baseline). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were longitudinally collected up to 36 months after surgery. Clinical factors associated with BCVA and CMT and disappearance of macular edema during follow-up were investigated. Results Twenty-one eyes of 21 patients with a median follow-up of 18 months were included. The BCVA improved significantly after ERM peeling (baseline vs. 24 months, p = 0.01). Absence of the external liming membrane/ellipsoid zone on OCT was associated with worse visual outcomes (regression estimate [95% confidence interval, CI] = 0.93 [0.39–1.48] logMAR, p = 0.004). Eyes with disorganization of the inner retinal layers at baseline had higher CMT values at each visit (regression estimate [95% CI] = 114.1 [78.9–219.4] μm, p = 0.004). Older age at the time of RVO (p = 0.03) and branch RVO (p = 0.04) were risk factors for persistent macular edema after ERM removal. Conclusion PPV and ERM removal provided encouraging functional and morphological results in eyes with RVO, with disappearance of macular edema in most eyes. The integrity of the outer retina and preservation of inner retinal segmentation were associated with better visual and anatomical outcomes after ERM removal, respectively. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00461-7.
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Abstract
PURPOSE The study aimed to evaluate fixation stability and position changes after epiretinal membrane (ERM) surgery. METHODS This is a retrospective study that included 60 consecutive eyes with idiopathic ERM. All patients received comprehensive ophthalmic examinations preoperatively and 1, 4, 10 months postoperatively. Main outcome measures included fixation stability and position, bivariate contour ellipse area (BCEA), and preferred retinal locus (PRL). RESULTS The number of patients with stable fixation as well as predominantly central fixation was increased significantly after ERM surgery (61.7% vs. 73.3%, P=0.001; 41.7% vs. 71.7%, P=0.037). The correlation analysis showed that the preoperative factors associated with improved postoperative fixation stability were a larger BCEA value (P<0.001), poorer visual acuity (P=0.002), advanced stage (P=0.002), thicker CFT (P=0.015), and a longer PRL-foveal distant (P=0.0025). As for improved fixation location, the associated preoperative factors were age (P=0.003), CFT (P=0.044) and PRL-foveal distant (P<0.001). CONCLUSION Our observations point to the changes of fixation parameters in patients after ERM surgery. We found that patients with preoperative unstable, eccentric fixation and poor BCVA can significantly benefit from the surgery. This result indicates that even in patients with severe macular damage, the ERM surgery still has great benefits in recovering visual function.
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Dimopoulos IS, Dollin M. Inner Retinal Morphology and Visual Outcomes in Idiopathic Epiretinal Membrane Surgery: A Retrospective Optical Coherence Tomography Study. JOURNAL OF VITREORETINAL DISEASES 2021; 5:488-494. [PMID: 37007173 PMCID: PMC9976143 DOI: 10.1177/2474126421989614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: Epiretinal membrane (ERM) is a common retinal finding for patients older than 50 years. Disorganization of the retinal inner layers (DRIL) has emerged as a novel predictor of poor visual acuity (VA) in eyes with inner retinal pathology. The aim of our study is to correlate preoperative DRIL with visual outcomes after ERM surgery. Methods: Medical records and optical coherence tomography (OCT) images of 81 pseudophakic patients who underwent treatment of idiopathic ERM were reviewed. Preoperative DRIL on OCT was correlated with VA at baseline and at 3 and 6 months after ERM surgery. DRIL was defined as the loss of distinction between the ganglion cell–inner plexiform layer complex, inner nuclear layer, and outer plexiform layer. DRIL severity was based on its extent within the central 2-mm region of a transfoveal B-scan (absent/mild: <one-third, severe: >one-third horizontal width). Results: Review of preoperative OCT showed severe DRIL in 41% and absent/mild DRIL in 59%. Severe DRIL was associated with worse baseline VA ( P < .001). Preoperative VA and DRIL status at baseline were both predictors of postoperative VA at follow-up time points ( P < .001). Severe DRIL was associated with significantly less improvement in VA at 6 months (–0.23 logMAR for absent/mild vs –0.14 for severe DRIL). Conclusions: Presence of severe preoperative DRIL correlates with worse baseline VA in patients with ERM and reduced VA improvement at 6 months. DRIL can be a strong predictor of long-term poor visual outcomes in ERM surgery.
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Affiliation(s)
| | - Michael Dollin
- University of Ottawa Eye Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
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Chatzistergiou V, Papasavvas I, Ambresin A, Pournaras JAC. Prediction of Post-operative Visual Outcome in Patients with Idiopathic Epiretinal Membrane. Ophthalmologica 2021; 244:535-542. [PMID: 34062549 DOI: 10.1159/000517193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/30/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - Ioannis Papasavvas
- RétinElysée, Lausanne, Switzerland
- Clinique de Montchoisi Centre C, Lausanne, Switzerland
| | - Aude Ambresin
- RétinElysée, Lausanne, Switzerland
- Clinique de Montchoisi Centre C, Lausanne, Switzerland
- University of Lausanne (UNIL), Faculty of Biology and Medicine, Lausanne, Switzerland
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Bemme S, Heins A, Lauermann P, Storch MW, Khattab MH, Hoerauf H, Feltgen N, van Oterendorp C. Reliability of Subjective Assessment of Spectral-Domain OCT Pathologic Features by Multiple Raters in Retinal Vein Occlusion. OPHTHALMOLOGY SCIENCE 2021; 1:100031. [PMID: 36249305 PMCID: PMC9562329 DOI: 10.1016/j.xops.2021.100031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
Purpose Design Participants Methods Main Outcome Measures Results Conclusions
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Affiliation(s)
- Sebastian Bemme
- Correspondence: Sebastian Bemme, MD, Department of Ophthalmology, University Medical Center Göttingen, Robert-Koch-Str, 4037075 Göttingen, Germany.
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Liu Z, Tao QQ, Li XR, Zhang XM. Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with macular edema secondary to uveitis. Int J Ophthalmol 2021; 14:725-731. [PMID: 34012888 DOI: 10.18240/ijo.2021.05.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/26/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the correlation between disorganization of the retinal inner layers (DRIL) and best-corrected visual acuity (BCVA) in patients with uveitis and macular edema (UME) who underwent systemic treatment using optical coherence tomography (OCT). METHODS A retrospective clinical study of 23 patients (30 eyes) with DRIL and 23 patients (31 eyes) without DRIL secondary to UME were included. All patients underwent comprehensive ophthalmic examinations at baseline, 3, 6, and 12mo after local and systemic treatment. The OCT-based parameters included foveal center point thickness (FCPT), mean thickness (MT), and diameters of DRIL in horizontal and vertical directions. BCVA and OCT-based parameters were compared between the two groups. The relationship between each OCT parameter and BCVA was evaluated using linear correlation and regression analysis. RESULTS At the initial visit, the mean baseline FCPT was 441.03±128.68 µm in the eyes with DRIL and 337.26±99.31 µm in the eyes without DRIL (P=0.001). No significant differences were observed in MT (P=0.357). The mean size of transverse and vertical diameters of DRIL was 684.07±267.51 and 267.07±104.61 µm at baseline, respectively. There was significant improvement in BCVA and OCT-based parameters at 3, 6, and 12mo in all cases (P<0.001 for each timepoint). In addition, significant differences were detected in BCVA and OCT parameters between eyes with and without DRIL at each time point (P<0.01 for each timepoint). A greater DRIL range at baseline was associated with a worse baseline BCVA (transverse diameter of DRIL: r=0.875, P<0.001; vertical diameter of DRIL: r=0.622, P<0.001). The transverse diameter of baseline DRIL was found to be significantly correlated with the final BCVA (P=0.003). CONCLUSION The improvement in BCVA is associated with DRIL in patients with UME. DRIL is an easy-to-determine and robust imaging biomarker that could help predict BCVA prognosis in eyes with UME.
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Affiliation(s)
- Zheng Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.,Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China
| | - Qing-Qin Tao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Xiao-Rong Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Xiao-Min Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
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[Optical coherence tomography biomarkers in epimacular membranes and vitreomacular traction syndrome]. Ophthalmologe 2021; 118:308-319. [PMID: 33688969 DOI: 10.1007/s00347-021-01349-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 10/21/2022]
Abstract
Using high-resolution imaging, such as optical coherence tomography (OCT), the different layers of the retina as well as the vitreoretinal interface and its alterations can be very clearly differentiated. This includes the morphological characteristics of tractive maculopathies, such as epiretinal gliosis and vitreomacular traction syndrome. Additionally, structural alterations of the various layers of the neurosensory retina as a result of traction due to these pathologies can be demarcated. The latter have been investigated in clinical trials and evaluated as OCT biomarkers with respect to their prognostic and predictive value. In this review we would like to present and discuss various OCT biomarkers in the context of epimacular membranes and vitreomacular traction syndrome.
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Chatziralli I, Chatzirallis A, Kazantzis D, Dimitriou E, Machairoudia G, Theodossiadis G, Parikakis E, Theodossiadis P. Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy. Ophthalmologica 2021; 244:213-217. [PMID: 33465770 DOI: 10.1159/000514538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). METHODS Participants in this study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time points (6 weeks and 6, 12, and 24 months). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors affecting the long-term postoperative visual outcome 24 months after PPV for RRD. RESULTS Increasing age, duration of RD of more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption, and external limiting membrane disruption were significantly associated with a worse BVCA. BCVA was not associated with gender, lens status, the location of breaks, the gas tamponade agent used in PPV, the presence of subretinal fluid, and intraretinal fluid. CONCLUSIONS It is important to determine predictive factors for visual outcomes in order to inform patients about their prognosis and help in the decision-making process for patient management.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
| | | | | | - Eleni Dimitriou
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
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