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Paques M, Krivosic V, Castro-Farias D, Dulière C, Hervé D, Chaumette C, Rossant F, Taleb A, Lebenberg J, Jouvent E, Tadayoni R, Chabriat H. Early remodeling and loss of light-induced dilation of retinal small arteries in CADASIL. J Cereb Blood Flow Metab 2024:271678X241226484. [PMID: 38217411 DOI: 10.1177/0271678x241226484] [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] [Indexed: 01/15/2024]
Abstract
A major hurdle to therapeutic development in cerebral small vessel diseases is the lack of in-vivo method that can be used repeatedly for evaluating directly cerebral microvessels. We hypothesised that Adaptive Optics (AO), which allows resolution images up to 1-2 μm/pixel at retinal level, could provide a biomarker for monitoring vascular changes in CADASIL, a genetic form of such condition. In 98 patients and 35 healthy individuals, the wall to lumen ratio (WLR), outer and inner diameter, wall thickness and wall cross-sectional area were measured in a parapapillary and/or paramacular retinal artery. The ratio of vessel diameters before and after light flicker stimulations was also calculated to measure vasoreactivity (VR). Multivariate mixed-model analysis showed that WLR was increased and associated with a larger wall thickness and smaller internal diameter of retinal arteries in patients. The difference was maximal at the youngest age and gradually reduced with aging. Average VR in patients was less than half of that of controls since the youngest age. Any robust association was found with clinical or imaging manifestations of the disease. Thus, AO enables the detection of early functional or structural vascular alterations in CADASIL but with no obvious link to the clinical or imaging severity.
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Affiliation(s)
- Michel Paques
- Paris Eye Imaging Group, Clinical Investigation Center 1423, Quinze-Vingts Hospital, Sorbonne Université, INSERM, Paris, France
| | - Valérie Krivosic
- Paris Eye Imaging Group, Clinical Investigation Center 1423, Quinze-Vingts Hospital, Sorbonne Université, INSERM, Paris, France
- Ophthalmology Department, Hôpital Lariboisière, APHP and Université Paris-Cité, France
- Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, Paris, AP-HP, France
| | - Daniela Castro-Farias
- Paris Eye Imaging Group, Clinical Investigation Center 1423, Quinze-Vingts Hospital, Sorbonne Université, INSERM, Paris, France
| | - Cédric Dulière
- Paris Eye Imaging Group, Clinical Investigation Center 1423, Quinze-Vingts Hospital, Sorbonne Université, INSERM, Paris, France
| | - Dominique Hervé
- Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, Paris, AP-HP, France
- Translational Neurovascular Centre and Departement of Neurology, FHU NeuroVasc, Paris, France
| | - Céline Chaumette
- Paris Eye Imaging Group, Clinical Investigation Center 1423, Quinze-Vingts Hospital, Sorbonne Université, INSERM, Paris, France
| | | | - Abbas Taleb
- Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, Paris, AP-HP, France
| | - Jessica Lebenberg
- Translational Neurovascular Centre and Departement of Neurology, FHU NeuroVasc, Paris, France
- Université Paris-Cité, Inserm, NeuroDiderot, U1141, Paris, France
| | - Eric Jouvent
- Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, Paris, AP-HP, France
- Translational Neurovascular Centre and Departement of Neurology, FHU NeuroVasc, Paris, France
- Université Paris-Cité, Inserm, NeuroDiderot, U1141, Paris, France
| | - Ramin Tadayoni
- Paris Eye Imaging Group, Clinical Investigation Center 1423, Quinze-Vingts Hospital, Sorbonne Université, INSERM, Paris, France
- Ophthalmology Department, Hôpital Lariboisière, APHP and Université Paris-Cité, France
- Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, Paris, AP-HP, France
| | - Hugues Chabriat
- Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, Paris, AP-HP, France
- Translational Neurovascular Centre and Departement of Neurology, FHU NeuroVasc, Paris, France
- Université Paris-Cité, Inserm, NeuroDiderot, U1141, Paris, France
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Rossant F, Paques M. Normalization of series of fundus images to monitor the geographic atrophy growth in dry age-related macular degeneration. Comput Methods Programs Biomed 2021; 208:106234. [PMID: 34229997 DOI: 10.1016/j.cmpb.2021.106234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/28/2020] [Accepted: 06/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Age-related macular degeneration (ARMD) is a degenerative disease that affects the retina, and the leading cause of visual loss. In its dry form, the pathology is characterized by the progressive, centrifugal expansion of retinal lesions, called geographic atrophy (GA). In infrared eye fundus images, the GA appears as localized bright areas and its growth can be observed in series of images acquired at regular time intervals. However, illumination distortions between the images make impossible the direct comparison of intensities in order to study the GA progress. Here, we propose a new method to compensate for illumination distortion between images. METHODS We process all images of the series so that any two images have comparable gray levels. Our approach relies on an illumination/reflectance model. We first estimate the pixel-wise illumination ratio between any two images of the series, in a recursive way; then we correct each image against all the others, based on those estimates. The algorithm is applied on a sliding temporal window to cope with large changes in reflectance. We also propose morphological processing to suppress illumination artefacts. RESULTS The corrected illumination function is homogeneous in the series, enabling the direct comparison of grey-levels intensities in each pixel, and so the detection of the GA growth between any two images. To demonstrate that, we present numerous experiments performed on a dataset of 18 series (328 images), manually segmented by an ophthalmologist. First, we show that the normalization preprocessing dramatically increases the contrast of the GA growth areas. Secondly, we apply segmentation algorithms derived from Otsu's thresholding to detect automatically the GA total growth and the GA progress between consecutive images. We demonstrate qualitatively and quantitatively that these algorithms, although fully automatic, unsupervised and basic, already lead to interesting segmentation results when applied to the normalized images. Colored maps representing the GA evolution can be derived from the segmentations. CONCLUSION To our knowledge, the proposed method is the first one which corrects automatically and jointly the illumination inhomogeneity in a series of fundus images, regardless of the number of images, the size, shape and progression of lesion areas. This algorithm greatly facilitates the visual interpretation by the medical expert. It opens up the possibility of treating automatically each series as a whole (not just in pairs of images) to model the GA growth.
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Affiliation(s)
- Florence Rossant
- ISEP, Institut Supérieur d'Electronique de Paris, 10 rue de Vanves, 92130 Issy-les-Moulineaux, France.
| | - Michel Paques
- Clinical Investigation Center 1423, Quinze-Vingts Hospital, 28 rue de Charenton, 75012 Paris, France
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Royer C, Sublime J, Rossant F, Paques M. Unsupervised Approaches for the Segmentation of Dry ARMD Lesions in Eye Fundus cSLO Images. J Imaging 2021; 7:143. [PMID: 34460779 PMCID: PMC8404939 DOI: 10.3390/jimaging7080143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/29/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022] Open
Abstract
Age-related macular degeneration (ARMD), a major cause of sight impairment for elderly people, is still not well understood despite intensive research. Measuring the size of the lesions in the fundus is the main biomarker of the severity of the disease and as such is widely used in clinical trials yet only relies on manual segmentation. Artificial intelligence, in particular automatic image analysis based on neural networks, has a major role to play in better understanding the disease, by analyzing the intrinsic optical properties of dry ARMD lesions from patient images. In this paper, we propose a comparison of automatic segmentation methods (classical computer vision method, machine learning method and deep learning method) in an unsupervised context applied on cSLO IR images. Among the methods compared, we propose an adaptation of a fully convolutional network, called W-net, as an efficient method for the segmentation of ARMD lesions. Unlike supervised segmentation methods, our algorithm does not require annotated data which are very difficult to obtain in this application. Our method was tested on a dataset of 328 images and has shown to reach higher quality results than other compared unsupervised methods with a F1 score of 0.87, while having a more stable model, even though in some specific cases, texture/edges-based methods can produce relevant results.
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Affiliation(s)
- Clément Royer
- ISEP-School of Digital Engineers, 92130 Issy-Les-Moulineaux, France
| | - Jérémie Sublime
- ISEP-School of Digital Engineers, 92130 Issy-Les-Moulineaux, France
- LIPN-CNRS UMR 7030, LaMSN-Université Sorbonne Paris Nord, 93210 St Denis, France
| | - Florence Rossant
- ISEP-School of Digital Engineers, 92130 Issy-Les-Moulineaux, France
| | - Michel Paques
- Clinical Imaging Center 1423, Quinze-Vingts Hospital, INSERM-DGOS Clinical Investigation Center, 75012 Paris, France
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Bakker E, Dikland FA, van Bakel R, Andrade De Jesus D, Sánchez Brea L, Klein S, van Walsum T, Rossant F, Farías DC, Grieve K, Paques M. Adaptive optics ophthalmoscopy: a systematic review of vascular biomarkers. Surv Ophthalmol 2021; 67:369-387. [PMID: 34090882 DOI: 10.1016/j.survophthal.2021.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 12/02/2020] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 12/28/2022]
Abstract
Retinal vascular diseases are a leading cause for blindness and partial sight certifications. By applying adaptive optics (AO) to conventional imaging modalities, the microstructures of the retinal vasculature can be observed with high spatial resolution, hence offering a unique opportunity for the exploration of the human microcirculation. The objective of this systematic review is to describe the current state of retinal vascular biomarkers imaged by AO flood illumination ophthalmoscopy (FIO) and AO scanning laser ophthalmoscopy (SLO). A literature research was conducted in the PubMed and Scopus databases on July 9, 2020. From 217 screened studies, 42 were eligible for this review. All studies underwent a quality check regarding their content. A meta-analysis was performed for the biomarkers reported for the same pathology in at least three studies using the same modality. The most frequently studied vascular biomarkers were the inner diameter (ID), outer diameter (OD), parietal thickness (PT), wall cross-sectional area (WCSA), and wall-to-lumen ratio (WLR). The applicability of AO vascular biomarkers has been mostly explored in systemic hypertension using AO FIO and in diabetes using AO SLO. The result of the meta-analysis for hypertensive patients showed that WLR, PT, and ID were significantly different when compared to healthy controls, while WCSA was not (P < 0.001, P = 0.002, P < 0.001, and P = 0.070, respectively). The presented review shows that, although a substantial number of retinal vascular biomarkers have been explored in AO en face imaging, further clinical research and standardization of procedures is needed to validate such biomarkers for the longitudinal monitoring of arterial hypertension and other diseases.
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Affiliation(s)
- Elise Bakker
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands
| | - Felix Anne Dikland
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands
| | - Roan van Bakel
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands
| | - Danilo Andrade De Jesus
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
| | - Luisa Sánchez Brea
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Theo van Walsum
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Florence Rossant
- ISEP, Institut Supérieur d'Electronique de Paris, Issy-les-Moulineaux, France
| | - Daniela Castro Farías
- Paris Eye Imaging Group, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS Clinical Investigation Center, Paris, France
| | - Kate Grieve
- Paris Eye Imaging Group, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS Clinical Investigation Center, Paris, France
| | - Michel Paques
- Paris Eye Imaging Group, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS Clinical Investigation Center, Paris, France
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Errera MH, Laguarrigue M, Rossant F, Koch E, Chaumette C, Fardeau C, Westcott M, Sahel JA, Bodaghi B, Benesty J, Paques M. High-Resolution Imaging of Retinal Vasculitis by Flood Illumination Adaptive Optics Ophthalmoscopy: A Follow-up Study. Ocul Immunol Inflamm 2020; 28:1171-1180. [PMID: 31573376 DOI: 10.1080/09273948.2019.1646773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose: To monitor perivascular sheathing during the course of retinal vasculitis by flood illumination adaptive optics ophthalmoscopy (AOO). Methods: Perivenous sheathing and venous diameters were quantitatively analyzed by semi-automatic segmentation of AOO images in 12 eyes of treatment-naive patients with retinal vasculitis. Results: The width of venous sheathing ranged from 45 to 225 µm (mean 101.0 µm ± 54.3). In 10 cases, the underlying vein showed focal narrowing (mean ± SD 14% ± 10). Focal narrowing of arteries was also present in one eye. At presentation, width of sheathing and vessel diameters were not correlated with fluorescein leakage. During follow-up, 5 eyes showed an increase in vein diameter or resolution of narrowing and in 10 eyes a thinning of vascular sheathing was observed (p= .003). Conclusions: Perivenous sheathing may be quantitatively analyzed and monitored by AOO. AOO may therefore contribute to monitor vascular sheathing during posterior uveitis.
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Affiliation(s)
- Marie-Hélène Errera
- Ophthalmology Department, Quinze-Vingts Hospital, INSERM-DHOS CIC 1423 , Paris, France.,Sorbonne Universités , Paris, France.,DHU ViewRestore , Paris, France
| | | | | | - Edouard Koch
- Ophthalmology Department, Quinze-Vingts Hospital, INSERM-DHOS CIC 1423 , Paris, France.,Sorbonne Universités , Paris, France
| | - Céline Chaumette
- Ophthalmology Department, Quinze-Vingts Hospital, INSERM-DHOS CIC 1423 , Paris, France.,Sorbonne Universités , Paris, France
| | - Christine Fardeau
- Ophthalmology Department, Pitié-Salpêtrière Hospital, Sorbonne Universités , Paris, France
| | - Mark Westcott
- Department of Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, Biomedical Research Centre, UCL Institute of Ophthalmology , London, UK
| | - José-Alain Sahel
- Ophthalmology Department, Quinze-Vingts Hospital, INSERM-DHOS CIC 1423 , Paris, France.,Sorbonne Universités , Paris, France.,DHU ViewRestore , Paris, France
| | - Bahram Bodaghi
- DHU ViewRestore , Paris, France.,Ophthalmology Department, Pitié-Salpêtrière Hospital, Sorbonne Universités , Paris, France
| | - Jonathan Benesty
- Ophthalmology Department, Quinze-Vingts Hospital, INSERM-DHOS CIC 1423 , Paris, France.,Sorbonne Universités , Paris, France.,DHU ViewRestore , Paris, France
| | - Michel Paques
- Ophthalmology Department, Quinze-Vingts Hospital, INSERM-DHOS CIC 1423 , Paris, France.,Sorbonne Universités , Paris, France.,DHU ViewRestore , Paris, France
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Julien L, Ventre J, Lagrée PY, Ramkhelawon A, Rossant F, Atlan M, Paques M, Fullana JM. Retinal micro-vascular network: data and model. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1812854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- L. Julien
- Institut Jean Le Rond d’Alembert, CNRS, Sorbonne Université, Paris, France
- Unité d'Imagerie à Haute Résolution, Hôpital des Quinze-Vingts, Paris, France
| | - J. Ventre
- Institut Jean Le Rond d’Alembert, CNRS, Sorbonne Université, Paris, France
| | - P.-Y Lagrée
- Institut Jean Le Rond d’Alembert, CNRS, Sorbonne Université, Paris, France
| | - A. Ramkhelawon
- Institut Jean Le Rond d’Alembert, CNRS, Sorbonne Université, Paris, France
| | - F. Rossant
- Unité d'Imagerie à Haute Résolution, Hôpital des Quinze-Vingts, Paris, France
| | - M. Atlan
- Unité d'Imagerie à Haute Résolution, Hôpital des Quinze-Vingts, Paris, France
| | - M. Paques
- Unité d'Imagerie à Haute Résolution, Hôpital des Quinze-Vingts, Paris, France
| | - J.-M. Fullana
- Institut Jean Le Rond d’Alembert, CNRS, Sorbonne Université, Paris, France
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Dupont G, Kalinicheva E, Sublime J, Rossant F, Pâques M. Analyzing Age-Related Macular Degeneration Progression in Patients with Geographic Atrophy Using Joint Autoencoders for Unsupervised Change Detection. J Imaging 2020; 6:57. [PMID: 34460650 PMCID: PMC8321155 DOI: 10.3390/jimaging6070057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/06/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022] Open
Abstract
Age-Related Macular Degeneration (ARMD) is a progressive eye disease that slowly causes patients to go blind. For several years now, it has been an important research field to try to understand how the disease progresses and find effective medical treatments. Researchers have been mostly interested in studying the evolution of the lesions using different techniques ranging from manual annotation to mathematical models of the disease. However, artificial intelligence for ARMD image analysis has become one of the main research focuses to study the progression of the disease, as accurate manual annotation of its evolution has proved difficult using traditional methods even for experienced practicians. In this paper, we propose a deep learning architecture that can detect changes in the eye fundus images and assess the progression of the disease. Our method is based on joint autoencoders and is fully unsupervised. Our algorithm has been applied to pairs of images from different eye fundus images time series of 24 ARMD patients. Our method has been shown to be quite effective when compared with other methods from the literature, including non-neural network based algorithms that still are the current standard to follow the disease progression and change detection methods from other fields.
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Affiliation(s)
| | | | - Jérémie Sublime
- ISEP, DaSSIP Team, 92130 Issy-Les-Moulineaux, France
- Université Paris 13, LIPN - CNRS UMR 7030, 93430 Villetaneuse, France
| | | | - Michel Pâques
- Clinical Imaging Center 1423, Quinze-Vingts Hospital, INSERM-DGOS Clinical Investigation Center, 75012 Paris, France
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Gallo A, Chaigneau E, Jublanc C, Rosenbaum D, Mattina A, Paques M, Rossant F, Girerd X, Leban M, Bruckert E. IGF-1 is an independent predictor of retinal arterioles remodeling in subjects with uncontrolled acromegaly. Eur J Endocrinol 2020; 182:375-383. [PMID: 31972545 DOI: 10.1530/eje-19-0390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 01/23/2020] [Indexed: 11/08/2022]
Abstract
CONTEXT Cardiovascular disease is one of the main causes of morbidity in active acromegaly due to the increased prevalence of risk factors and arterial consequences of increased growth hormone levels. No in vivo study has evaluated the consequences of acromegaly on the retinal microvasculature. OBJECTIVE The aim of this study was to identify in vivo the presence of morphological alterations of retinal arterioles in subjects with acromegaly. PATIENTS AND METHODS Single-center retrospective study of a cohort of 60 subjects with acromegaly, matched to 60 controls, who were referred for adaptive optics camera (AOC) from September 2014 to December 2016. Of the subjects with acromegaly, 19 had an active disease (AD) and 41 a controlled disease (CD) based on the IGF1 ratio (IGF1r). Retinal arteriolar remodeling was previously assessed using adaptive optics camera (AOC) in order to measure wall-to-lumen ratio (WLR), wall thickness (WT), internal diameter (ID) and wall cross sectional area (WCSA). RESULTS WLR was significantly higher in AD subjects compared to CD subjects and controls (AD: 0.311 ± 0.06, CD: 0.279 ± 0.04, controls: 0.281 ± 0.04, P = 0.031). A significant positive correlation was observed between WLR and IGF-1r (R2 = 0.215, P < 0.001), even after adjustment for gender, age, systolic blood pressure (SBP) and the presence of dopamine agonist treatment (R2 = 0.406, P < 0.001). Retinal arteriolar anatomical indices were comparable between CD and controls. CONCLUSION Active acromegaly is associated with the presence of small retinal arteriolar remodeling. These results provide new perspectives to better stratify cardiovascular risk and consequently optimize treatment in acromegaly.
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Affiliation(s)
- Antonio Gallo
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, INSERM 1146, CNRS 7371, Laboratoire d'imagerie Biomédicale, Paris, France
| | - Emmanuelle Chaigneau
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
| | - Christel Jublanc
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
| | - David Rosenbaum
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
| | - Alessandro Mattina
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
| | - Michel Paques
- Département d'Ophtalmologie, Hôpital des Quinze-Vingts, Centre d'Investigation Clinique INSERM-DHOS 1423, Institut de la Vision, Sorbonne Universités, CNRS, Paris, France
| | | | - Xavier Girerd
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
| | - Monique Leban
- Laboratory of Endocrine Biochemistry, University Hospital Pitié-Salpêtrière, APHP, Paris, France
| | - Eric Bruckert
- Department of Endocrinology, Metabolism and Cardiovascular Prevention, University Hospital Pitié-Salpêtrière, APHP, Sorbonne University Paris, Paris, France
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Abstract
Optical coherence tomography (OCT), which is routinely used in ophthalmology, enables transverse optical imaging of the retina and, hence, the identification of the different neuronal layers. Directional OCT (D-OCT) extends this technology by acquiring sets of images at different incidence angles of the light beam. In this way, reflectance properties of photoreceptor substructures are highlighted, enabling physicians to study their orientation, which is potentially an interesting biomarker for retinal diseases. Nevertheless, commercial OCT devices equipped to automate D-OCT acquisition do not yet exist, meaning that physicians manually deviate the light beam to acquire a set of D-OCT images sequentially. Therefore, the intensities in the stack of images are not directly comparable, and a normalization step is required before differential analysis. In this paper, we present advanced image processing methods to perform differential analysis of a set of D-OCT images and extract the angle-dependent retinal substructures. Our approach relies on a robust and accurate normalization algorithm followed by a classification that is spatially regularized. We also propose a robust color representation that facilitates interpretation of D-OCT data in general, by detecting and highlighting angle-dependent structures in healthy and diseased eyes. Experimental results show evidence of photoreceptor disarray in a variety of retinal diseases, demonstrating the potential medical interest of the approach.
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Bottin C, Grieve K, Rossant F, Pedinielli A, Mrejen S, Paques M. DIRECTIONAL VARIABILITY OF FUNDUS REFLECTANCE IN ACUTE MACULAR NEURORETINOPATHY: EVIDENCE FOR A CONTRIBUTION OF THE STILES-CRAWFORD EFFECT. Retin Cases Brief Rep 2018; 12 Suppl 1:S19-S24. [PMID: 29369084 DOI: 10.1097/icb.0000000000000701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To document directional reflectivity of fundus lesions in a case of acute macular neuroretinopathy. METHODS Case report. Clinical and imaging data from a patient with acute macular neuroretinopathy were reviewed. Imaging comprised infrared scanning laser ophthalmoscopy, optical coherence tomography and flood-illumination adaptive optics images acquired through different entry pupils in the cardinal directions (approximately 2° eccentricity). RESULTS The patient reported acute bilateral paracentral scotoma revealing dark, wedge-shaped macular plaques which by optical coherence tomography were associated with focal loss of the visibility of the cone outer segment tip and inner/outer segment lines. Comparing scanning laser ophthalmoscopy images taken at different entry points in the pupil showed that macular plaques varied from hyporeflectance to isoreflectance. Cone counts by flood-illumination adaptive optics within plaques and optical coherence tomography features of the cone outer segment tip showed also a strong directional variability, peaking at near-normal values. Within each modality, fusion images showed that directional variability covered most of macular plaques. CONCLUSION The characteristic fundus abnormalities of acute macular neuroretinopathy may show a strong directional variability. Our findings suggest that the Stiles-Crawford effect may be an important factor in signs and symptoms of acute macular neuroretinopathy.
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Affiliation(s)
- Caroline Bottin
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
| | - Kate Grieve
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
- Université Pierre et Marie Curie-Paris 6, Paris, France
| | | | | | - Sarah Mrejen
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
| | - Michel Paques
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
- Université Pierre et Marie Curie-Paris 6, Paris, France
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Miloudi C, Rossant F, Bloch I, Chaumette C, Leseigneur A, Sahel JA, Meimon S, Mrejen S, Paques M. The Negative Cone Mosaic: A New Manifestation of the Optical Stiles-Crawford Effect in Normal Eyes. Invest Ophthalmol Vis Sci 2016; 56:7043-50. [PMID: 26523388 DOI: 10.1167/iovs.15-17022] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The purpose of this study was to describe a previously unreported manifestation of the optical Stiles-Crawford effect (oSCE) in normal eyes. METHODS In a cohort of 50 normal subjects, the directional reflectance of cones in the retinal periphery was explored by flood-illuminated adaptive optics (FIAO) and optical coherence tomography (OCT). RESULTS In 32 eyes (64%), off-axis FIAO images of the retinal periphery (∼15-20° from the fovea) showed variably sized patches of hyporeflective dots (called here negative mosaic) coexisting with hyperreflective (positive) cones. In nine cases, shifting the entry pupil toward the optical axis restored the positive cone mosaic, with a point-by-point correspondence between positive and negative mosaics. Rods remained hyperreflective around negative and positive cones. These changes were paralleled by changes of the OCT reflectance of the cone outer segment tips and, to a lesser extent, of the inner/outer segment limit. CONCLUSIONS By en face FIAO imaging of the retina, the contrast of cones over rods may be strongly dependent on the entry pupil to such an extent that their reflectance is lower than that of rods. We hypothesized that the negative cone mosaic aspect results from the differential Stiles-Crawford effect of cones and rods. Cone reflectance by en face FIAO parallels the reflectance from the cone outer segment tip line and to a lesser extent of the inner/outer segment limit by OCT. Taking this into account, the oSCE is of importance for the interpretation of high-resolution images of photoreceptors. (ClinicalTrials.gov number, NCT01546181.)
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Affiliation(s)
- Chahira Miloudi
- Quinze-Vingts Hospital Departement Hospitalo-Universitaire SightMaintain, Institut National de la Recherche Medicale (INSERM)-Direction de l'Hospitalisation et de l'Organisation des Soins CIC 1423, Paris, France 2Alten Corporation, Boulogne Billancourt, F
| | | | - Isabelle Bloch
- Institut Mines Telecom, Telecom ParisTech, Centre National de la Recherche Scientifique Laboratoire Traitement et Communication de l'Information, Paris, France
| | - Céline Chaumette
- Quinze-Vingts Hospital Departement Hospitalo-Universitaire SightMaintain, Institut National de la Recherche Medicale (INSERM)-Direction de l'Hospitalisation et de l'Organisation des Soins CIC 1423, Paris, France
| | - Alexandre Leseigneur
- Quinze-Vingts Hospital Departement Hospitalo-Universitaire SightMaintain, Institut National de la Recherche Medicale (INSERM)-Direction de l'Hospitalisation et de l'Organisation des Soins CIC 1423, Paris, France
| | - José-Alain Sahel
- Quinze-Vingts Hospital Departement Hospitalo-Universitaire SightMaintain, Institut National de la Recherche Medicale (INSERM)-Direction de l'Hospitalisation et de l'Organisation des Soins CIC 1423, Paris, France
| | - Serge Meimon
- Office National d'Etudes et de Recherches Aéronautiques, Châtillon, France
| | - Sarah Mrejen
- Quinze-Vingts Hospital Departement Hospitalo-Universitaire SightMaintain, Institut National de la Recherche Medicale (INSERM)-Direction de l'Hospitalisation et de l'Organisation des Soins CIC 1423, Paris, France
| | - Michel Paques
- Quinze-Vingts Hospital Departement Hospitalo-Universitaire SightMaintain, Institut National de la Recherche Medicale (INSERM)-Direction de l'Hospitalisation et de l'Organisation des Soins CIC 1423, Paris, France
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Paques M, Brolly A, Benesty J, Lermé N, Koch E, Rossant F, Bloch I, Girmens JF. Venous Nicking Without Arteriovenous Contact: The Role of the Arteriolar Microenvironment in Arteriovenous Nickings. JAMA Ophthalmol 2015; 133:947-50. [PMID: 25997175 DOI: 10.1001/jamaophthalmol.2015.1132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Arteriovenous nickings (AVNs) in the retina are the cause of retinal vein occlusions and are also surrogates of cerebrovascular aging. The prevalent mechanistic model of AVNs stating that arteries crush veins remains somewhat unchallenged despite the lack of evidence other than fundus photographs. Here, we observed that venous nicking may be observed in the absence of physical contact with an arteriole. OBSERVATIONS This observational study, conducted from January 2013 to September 2014, included 7 patients showing remodeling of a venous segment close to a retinal arteriole without arteriovenous overlap were imaged by adaptive optics imaging. Affected venous segments showed a variable association of nicking, narrowing, deviation, and opacification. Venous segments were deviated toward the arterioles in 6 of the 7 cases. The degree of venous narrowing ranged from 40% to 77%, while at these sites, the width of the intervascular space ranged from 16 µm to 42 µm. Similar features were identified in typical AVNs. CONCLUSIONS AND RELEVANCE Arteriovenous nickings do not necessarily involve an arteriovenous compression. Instead, the topology of venous changes suggests a retractile process originating in the intervascular space. These findings have important implications for the understanding of retinal vein occlusions and of cerebrovascular aging.
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Affiliation(s)
- Michel Paques
- Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS CIC 1423, Paris, F-75012 and Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Aurélie Brolly
- Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS CIC 1423, Paris, F-75012 and Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Jonathan Benesty
- Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS CIC 1423, Paris, F-75012 and Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Nicolas Lermé
- Institut Supérieur d'Electronique de Paris, Paris, France
| | - Edouard Koch
- Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS CIC 1423, Paris, F-75012 and Université Pierre et Marie Curie-Paris 6, Paris, France
| | | | - Isabelle Bloch
- Institut Mines Telecom, Telecom ParisTech, CNRS LTCI, Paris, France
| | - Jean-François Girmens
- Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS CIC 1423, Paris, F-75012 and Université Pierre et Marie Curie-Paris 6, Paris, France
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Audo I, Gocho K, Rossant F, Mohand-Saïd S, Loquin K, Bloch I, Sahel JA, Paques M. Functional and high-resolution retinal imaging monitoring photoreceptor damage in acute macular neuroretinopathy. Graefes Arch Clin Exp Ophthalmol 2015; 254:855-64. [PMID: 26344727 DOI: 10.1007/s00417-015-3136-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 04/20/2015] [Revised: 07/30/2015] [Accepted: 08/10/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To report functional and high-resolution retinal imaging abnormalities, including adaptive optics (AO) throughout the course of acute macular neuroretinopathy (AMNR). METHODS Two female patients (four eyes) with a diagnosis of AMNR were observed at the Clinical Investigation Center, CHNO des Quinze-Vingts, Paris, France. The patients underwent detailed ophthalmic examination including best-corrected visual acuity, slit-lamp examination, kinetic and static perimetry, full-field and multifocal electroretinogram, infrared reflectance, autofluorescence imaging and spectral-domain optical coherence tomography (SD-OCT) and AO fundus imaging at presentation and during follow-up. RESULTS Both cases showed concomitant loss of integrity of the outer retinal structures on SD-OCT, and marked abnormalities on AO imaging with disruption of the visibility of the cone mosaic. In the first case, photoreceptor damage was seen to progress during several weeks before healing. In both cases, there were persistent morphological abnormalities of photoreceptors 1 year after onset. CONCLUSION This study further highlights the value of AO fundus imaging to facilitate detection, mapping, and monitoring of damage to the cone outer segments during AMNR. In particular, residual damage to the cone mosaic can be precisely documented.
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Affiliation(s)
- Isabelle Audo
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France. .,INSERM, U968, Paris, 75012, France. .,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France. .,CNRS, UMR_7210, Paris, 75012, France. .,Département de Génétique, Curie/CHNO des Quinze-Vingts, Centre de Recherche Institut de la Vision, UMR S 968 Inserm / Université Pierre et Marie, 17, rue Moreau, 75012, Paris, France.
| | - Kiyoko Gocho
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,Ophthalmology, Nippon Medical University, Chiba Hokusoh Hospital, Inzai, Japan
| | | | - Saddek Mohand-Saïd
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,INSERM, U968, Paris, 75012, France.,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France.,CNRS, UMR_7210, Paris, 75012, France
| | - Kevin Loquin
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | | | - José-Alain Sahel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,INSERM, U968, Paris, 75012, France.,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France.,CNRS, UMR_7210, Paris, 75012, France.,Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Académie des Sciences-Institut de France, Paris, 75006, France
| | - Michel Paques
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,INSERM, U968, Paris, 75012, France.,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France.,CNRS, UMR_7210, Paris, 75012, France
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Rosenbaum D, Koch E, Girerd X, Rossant F, Pâques M. [Imaging of retinal arteries with adaptative optics, feasibility and reproducibility]. Ann Cardiol Angeiol (Paris) 2013; 62:184-8. [PMID: 23773704 DOI: 10.1016/j.ancard.2013.04.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 04/25/2013] [Accepted: 04/27/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Adaptative optic is a new non-invasive imaging technique that allows to measure arterioles wall thickness and diameter with a resolution near two microns. Our objectives were to evaluate the feasibility and the reproducibility of this technique in untreated hypertensive patients. DESIGN AND METHODS In 23 naive hypertensive patients and in 14 normotensives, the internal diameter (ID) and the wall thickness of the superior temporal artery were automatically measured. Those measurements were made on a temporal artery segment and led to determine a whole vessel cross sectional area (WCSA) and a wall to lumen ratio (WLR). Intra-observer reproducibility was evaluated by realizing three consecutive measurements in 14 subjects. Inter-observer reproducibility was assessed by two independent readers in 17 patients. Variation coefficient was calculated as SD/mean values. A comparison of retinal parameters was made between normal and hypertensive subjects. RESULTS Inter-observer reproducibility indicated a variation coefficient of 1.3% for ID, 3.7% for the WCSA and 3.2% for the WLR. Intra-observer reproducibility indicated a variation coefficient of 3.2% for the WLR. Arterial remodeling was present in hypertensive patients at baseline with a significantly increased WLR as compared to normal subjects (0.32 ± 0.04 vs. 0.26 ± 0.04; P<0.05), both population having the same ID. CONCLUSION Adaptative optics is feasible and reproducible technique. The possibility of a direct and non-invasive assessment of retinal arterioles must assess the attractions in this technique in hypertensive patients' care.
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Affiliation(s)
- D Rosenbaum
- Unité de prévention des maladies cardiovasculaire, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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Paques M, Koch E, Girerd X, Rossant F, Rosenbaum D, Benesty J, Sahel J, Chaumet-Riffaud P. P2.01 HIGH RESOLUTION IMAGING OF SMALL ARTERIES IN THE HUMAN RETINA DURING HYPERTENSIVE RETINOPATHY. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Tick S, Rossant F, Ghorbel I, Gaudric A, Sahel JA, Chaumet-Riffaud P, Paques M. Foveal Shape and Structure in a Normal Population. ACTA ACUST UNITED AC 2011; 52:5105-10. [PMID: 21803966 DOI: 10.1167/iovs.10-7005] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Sarah Tick
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France
| | | | | | - Alain Gaudric
- the Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; and
| | - José-Alain Sahel
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Philippe Chaumet-Riffaud
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France; the 5Centre Hospitalier de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris Sud
| | - Michel Paques
- From the Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris 6, Paris, France
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Rossant F, Badellino M, Chavillon A, Bloch I, Paques M. A Morphological Approach for Vessel Segmentation in Eye Fundus Images, with Quantitative Evaluation. J Med Imaging Hlth Inform 2011. [DOI: 10.1166/jmihi.2011.1006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tick S, Rossant F, Girmens J, Sahel J, Mohand-Said S, Paques M. 289 Étude de la variabilité de la segmentation maculaire dans une population de sujets normaux OCT haute résolution (OCT-HR). J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73412-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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