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Burri C, Salzmann S, Wandel J, Hoffmann L, Považay B, Meier C, Frenz M. Real-time OCT feedback-controlled RPE photodisruption in ex vivo porcine eyes using 8 microsecond laser pulses. Biomed Opt Express 2023; 14:6328-6349. [PMID: 38420306 PMCID: PMC10898567 DOI: 10.1364/boe.503941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/24/2023] [Accepted: 11/12/2023] [Indexed: 03/02/2024]
Abstract
Selective retinal pigment epithelium (RPE) photodisruption requires reliable real-time feedback dosimetry (RFD) to prevent unwanted overexposure. In this study, optical coherence tomography (OCT) based RFD was investigated in ex vivo porcine eyes exposed to laser pulses of 8 µs duration (wavelength: 532 nm, exposure area: 90 × 90 µm2, radiant exposure: 247 to 1975 mJ/µm2). For RFD, fringe washouts in time-resolved OCT M-scans (central wavelength: 870 nm, scan rate: 85 kHz) were compared to an RPE cell viability assay. Statistical analysis revealed a moderate correlation between RPE lesion size and applied treatment energy, suggesting RFD adaptation to inter- and intraindividual RPE pigmentation and ocular transmission.
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Affiliation(s)
- Christian Burri
- optoLab, Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland
- Biomedical Photonics Group, Institute of Applied Physics, University of Bern, Bern, Switzerland
| | - Simon Salzmann
- optoLab, Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland
| | - Jasmin Wandel
- Institute for Optimisation and Data Analysis, Bern University of Applied Sciences, Burgdorf, Switzerland
| | - Leonie Hoffmann
- optoLab, Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland
| | - Boris Považay
- optoLab, Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland
| | - Christoph Meier
- optoLab, Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland
| | - Martin Frenz
- Biomedical Photonics Group, Institute of Applied Physics, University of Bern, Bern, Switzerland
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Suchand Sandeep CS, Khairyanto A, Aung T, Vadakke Matham M. Bessel Beams in Ophthalmology: A Review. Micromachines (Basel) 2023; 14:1672. [PMID: 37763835 PMCID: PMC10536271 DOI: 10.3390/mi14091672] [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: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023]
Abstract
The achievable resolution of a conventional imaging system is inevitably limited due to diffraction. Dealing with precise imaging in scattering media, such as in the case of biomedical imaging, is even more difficult owing to the weak signal-to-noise ratios. Recent developments in non-diffractive beams such as Bessel beams, Airy beams, vortex beams, and Mathieu beams have paved the way to tackle some of these challenges. This review specifically focuses on non-diffractive Bessel beams for ophthalmological applications. The theoretical foundation of the non-diffractive Bessel beam is discussed first followed by a review of various ophthalmological applications utilizing Bessel beams. The advantages and disadvantages of these techniques in comparison to those of existing state-of-the-art ophthalmological systems are discussed. The review concludes with an overview of the current developments and the future perspectives of non-diffractive beams in ophthalmology.
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Affiliation(s)
- C. S. Suchand Sandeep
- Centre for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Ahmad Khairyanto
- Centre for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - Murukeshan Vadakke Matham
- Centre for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
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Naseripour M, Mirshahi R, Kasraei H, Sedaghat A, Azimi F. Spotlight on Targeted Chemotherapy in Retinoblastoma: Safety, Efficacy, and Patient Outcomes. Onco Targets Ther 2022; 15:1545-1561. [PMID: 36579184 PMCID: PMC9792108 DOI: 10.2147/ott.s370878] [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: 08/02/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
As the most common primary intraocular malignancy of childhood, retinoblastoma (RB) has had a complex journey in its management, following a course from enucleation as the first life-saving treatment to numerous globe-salvaging therapies during the last century. Currently, this potentially lethal disease has achieved high survival rates owing to multidisciplinary management and the introduction of neoadjuvant and multimodal chemotherapy. Therefore, the goal of treatment is shifting toward conserving the globe and vision as much as possible. Up until recently, many advanced cases of RB were enucleated primarily; however, targeted chemotherapy via the ophthalmic artery and management of intraocular seeding by local administration of chemotherapeutic agents have revolutionized the globe-conserving therapies. The added benefit of avoiding systemic complications of cytotoxic drugs resulted in these methods gaining popularity, and they are becoming a main part of care in many referral centers. Initially, there were some safety concerns regarding these approaches; however, increasing experience has shown that these modalities are relatively safe procedures and many complications can be averted by changing the choice of the drug and using some prophylactic measures. It is hoped that, in the near future, with advances in early diagnosis and patient-targeted molecular therapies, as well as gene-editing techniques, the patient's vision can be saved even in advanced RB.
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Affiliation(s)
- Masood Naseripour
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran,Correspondence: Masood Naseripour, Department of Ophthalmology, Iran University of Medical Sciences (IUMS), Rassoul Akram Hospital, Niayesh Ave, 14455-364, Tehran, Iran, Fax +98 21 66509162, Email
| | - Reza Mirshahi
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hengameh Kasraei
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ahad Sedaghat
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Azimi
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Khan NC, Perera C, Dow ER, Chen KM, Mahajan VB, Mruthyunjaya P, Do DV, Leng T, Myung D. Predicting Systemic Health Features from Retinal Fundus Images Using Transfer-Learning-Based Artificial Intelligence Models. Diagnostics (Basel) 2022; 12:diagnostics12071714. [PMID: 35885619 PMCID: PMC9322827 DOI: 10.3390/diagnostics12071714] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/02/2022] Open
Abstract
While color fundus photos are used in routine clinical practice to diagnose ophthalmic conditions, evidence suggests that ocular imaging contains valuable information regarding the systemic health features of patients. These features can be identified through computer vision techniques including deep learning (DL) artificial intelligence (AI) models. We aim to construct a DL model that can predict systemic features from fundus images and to determine the optimal method of model construction for this task. Data were collected from a cohort of patients undergoing diabetic retinopathy screening between March 2020 and March 2021. Two models were created for each of 12 systemic health features based on the DenseNet201 architecture: one utilizing transfer learning with images from ImageNet and another from 35,126 fundus images. Here, 1277 fundus images were used to train the AI models. Area under the receiver operating characteristics curve (AUROC) scores were used to compare the model performance. Models utilizing the ImageNet transfer learning data were superior to those using retinal images for transfer learning (mean AUROC 0.78 vs. 0.65, p-value < 0.001). Models using ImageNet pretraining were able to predict systemic features including ethnicity (AUROC 0.93), age > 70 (AUROC 0.90), gender (AUROC 0.85), ACE inhibitor (AUROC 0.82), and ARB medication use (AUROC 0.78). We conclude that fundus images contain valuable information about the systemic characteristics of a patient. To optimize DL model performance, we recommend that even domain specific models consider using transfer learning from more generalized image sets to improve accuracy.
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Affiliation(s)
- Nergis C. Khan
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - Chandrashan Perera
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
- Department of Ophthalmology, Fremantle Hospital, Perth, WA 6004, Australia
| | - Eliot R. Dow
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - Karen M. Chen
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - Vinit B. Mahajan
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - Prithvi Mruthyunjaya
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - Diana V. Do
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - Theodore Leng
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
| | - David Myung
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA; (N.C.K.); (C.P.); (E.R.D.); (K.M.C.); (V.B.M.); (P.M.); (D.V.D.); (T.L.)
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
- Correspondence: ; Tel.: +1-650-724-3948
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Lyu X, Jajal P, Tahir MZ, Zhang S. Fractal dimension of retinal vasculature as an image quality metric for automated fundus image analysis systems. Sci Rep 2022; 12:11868. [PMID: 35831401 DOI: 10.1038/s41598-022-16089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Automated fundus screening is becoming a significant programme of telemedicine in ophthalmology. Instant quality evaluation of uploaded retinal images could decrease unreliable diagnosis. In this work, we propose fractal dimension of retinal vasculature as an easy, effective and explainable indicator of retinal image quality. The pipeline of our approach is as follows: utilize image pre-processing technique to standardize input retinal images from possibly different sources to a uniform style; then, an improved deep learning empowered vessel segmentation model is employed to extract retinal vessels from the pre-processed images; finally, a box counting module is used to measure the fractal dimension of segmented vessel images. A small fractal threshold (could be a value between 1.45 and 1.50) indicates insufficient image quality. Our approach has been validated on 30,644 images from four public database.
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