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Karuntu JS, Nguyen XTA, Talib M, van Schooneveld MJ, Wijnholds J, van Genderen MM, Schalij-Delfos NE, Klaver CCW, Meester-Smoor MA, van den Born LI, Hoyng CB, Thiadens AAHJ, Bergen AA, van Nispen RMA, Boon CJF. Quality of life in patients with CRB1-associated retinal dystrophies: A longitudinal study. Acta Ophthalmol 2024; 102:469-477. [PMID: 37749859 DOI: 10.1111/aos.15769] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To assess the longitudinal vision-related quality of life among patients with CRB1-associated inherited retinal dystrophies. METHODS In this longitudinal questionnaire study, the National Eye Institute Visual Function Questionnaire (39 items, NEI VFQ-39) was applied at baseline, two-year follow-up, and 4-year follow-up in patients with pathogenic CRB1 variants. [Correction added on 20 November 2023, after first online publication: The preceding sentence has been updated in this version.] Classical test theory was performed to obtain subdomain scores and in particular 'near activities' and 'total composite' scores. The Rasch analysis based on previous calibrations of the NEI VFQ-25 was applied to create visual functioning and socio-emotional subscales. RESULTS In total, 22 patients with a CRB1-associated retinal dystrophy were included, […] with a median age of 25.0 years (interquartile range: 13-31 years) at baseline and mean follow-up of 4.0 ± 0.3 years. [Correction added on 20 November 2023, after first online publication: The preceding sentence has been updated in this version.] A significant decline at 4 years was observed for 'near activities' (51.0 ± 23.8 vs 35.4 ± 14.7, p = 0.004) and 'total composite' (63.0 ± 13.1 vs 52.0 ± 12.1, p = 0.001) subdomain scores. For the Rasch-scaled scores, the 'visual functioning' scale significantly decreased after 2 years (-0.89 logits; p = 0.012), but not at 4-year follow-up (+0.01 logits; p = 0.975). [Correction added on 20 November 2023, after first online publication: In the preceding sentence, "…after 4 years…" has been corrected to "…after 2 years…" in this version.] The 'socio-emotional' scale also showed a significant decline after 2 years (-0.78 logits, p = 0.033) and 4 years (-0.83 logits, p = 0.021). CONCLUSION In the absence of an intervention, a decline in vision-related quality of life is present in patients with pathogenic CRB1 variants at 4-year follow-up. Patient-reported outcome measures should be included in future clinical trials, as they can be a potential indicator of disease progression and treatment efficacy.
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Affiliation(s)
- Jessica S Karuntu
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Xuan-Thanh-An Nguyen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mays Talib
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mary J van Schooneveld
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan Wijnholds
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- The Netherlands Institute for Neuroscience (NIN-KNAW), Amsterdam, The Netherlands
| | - Maria M van Genderen
- Bartiméus, Diagnostic Centre for complex visual disorders, Zeist, The Netherlands
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
| | | | | | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Arthur A Bergen
- Department of Clinical Genetics, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Ruth M A van Nispen
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
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2
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Karuntu JS, Nguyen XT, Boon CJF. Correlations between the Michigan Retinal Degeneration Questionnaire and visual function parameters in patients with retinitis pigmentosa. Acta Ophthalmol 2023. [PMID: 38158751 DOI: 10.1111/aos.16601] [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: 06/05/2023] [Revised: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To validate the use of best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), low-luminance deficit (LLD; the difference between BCVA and LLVA), mean macular sensitivity and fixation stability as parameters of vision-related quality of life based on the novel Michigan Retinal Degeneration Questionnaire (MRDQ) in retinitis pigmentosa (RP) patients. METHODS In this prospective cross sectional study, 30 patients with RP (47% female) were included with a median age of 41.0 years (interquartile range: 24.1-58.3 years). BCVA, LLVA and LLD were measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Mesopic microperimetry was performed to measure mean macular sensitivity and fixation stability. Patients completed a Dutch translation of the MRDQ which results in an experienced disability (Θ-)score of seven domains. Spearman's rank correlation was used. RESULTS BCVA correlated significantly to the MRDQ domain of central vision (r = 0.657; p < 0.001) and colour vision (r = 0.524; p = 0.003). Lower LLVA significantly correlated to higher experienced disability in the MRDQ domains for central vision (=0.550; p = 0.002) and contrast sensitivity (r = 0.502; p = 0.005). LLD was significantly correlated to the MRDQ domains of scotopic function (r = -0.484; p = 0.007) and mesopic peripheral function (r = -0.533; p = 0.002). Lower mean macular sensitivity was significantly associated with high experienced disability in all domains except for photosensitivity. CONCLUSIONS The majority of the MRDQ domains is strongly associated with visual function parameters. These findings show that visual function measurements, especially LLVA, LLD and mean macular sensitivity on microperimetry, reflect vision-related quality of life and can be used as relevant outcome measures in clinical trials for RP.
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Affiliation(s)
- J S Karuntu
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - X T Nguyen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - C J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
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3
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Govers BM, van Huet RAC, El Kandoussi M, den Hollander AI, Keijser S, Klevering BJ. Risk factors and management of primary giant retinal tears. Acta Ophthalmol 2023. [PMID: 38146841 DOI: 10.1111/aos.16602] [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: 11/05/2022] [Revised: 10/13/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE To describe clinical characteristics and management in a large cohort of patients with retinal detachment due to a giant retinal tear (GRT). METHODS We performed a retrospective cohort study with 222 eyes of 206 patients with a primary and non-traumatic GRTs between 2005 and 2022. We analysed the relevant clinical and surgical data from these patients. RESULTS Eighty-six per cent (n = 177) of patients were male. We observed no relation between refractive error and GRT size (Spearman's rho: r = -0.018, p = 0.83). We achieved a primary and final treatment success in 77%, respectively 92%, of eyes. The final visual outcome was 20/40 or better in 65% and 36% of eyes in fovea-on and fovea-off GRTs respectively. Thirty-five per cent (n = 73) of patients developed a retinal detachment in the fellow eye. The median time until a retinal detachment in the fellow eye occurred after GRT was 20 months, and 10% developed within 1 month. A prediction model for the development of retinal detachment in the fellow eye resulted in a receiver operating characteristics curve with an area under the curve of 0.68 (95% CI: 0.57-0.78, p = 0.001). CONCLUSION We observed a highly significant gender imbalance in patients with a non-traumatic GRT. One third of patients developed a retinal detachment bilaterally. Ten per cent of fellow eye's retinal detachment that develop after GRT, occur within 1 month. Clinical parameters showed limited predictive value for a retinal detachment in the fellow eye. These findings suggest an underlying genetic factor.
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Affiliation(s)
- Birgit M Govers
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ramon A C van Huet
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mustapha El Kandoussi
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
- AbbVie, Genomics Research Centre, Cambridge, Massachusetts, USA
| | - Sander Keijser
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - B Jeroen Klevering
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
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4
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Govers BM, Keijser S, El Kandoussi M, van Overdam KA, Klevering BJ, Crama N. The effect of patient symptom awareness on the visual outcome in retinal detachment. Acta Ophthalmol 2023. [PMID: 38009800 DOI: 10.1111/aos.15815] [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: 05/26/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE To explore whether a patient's prior knowledge of the symptoms associated with rhegmatogenous retinal detachment (RRD) relates to the visual outcome after treatment. METHODS We performed a prospective survey study on 126 patients receiving treatment for primary RRD between March and July 2021. RESULTS Thirty-seven per cent (n = 47) of patients responded that they were aware of the RRD symptoms prior to the detachment. A history of RRD in the fellow eye or knowledge of family members treated for RRD was frequently reported as a reason for the patient's awareness of RRD symptoms. Patients aware of RRD symptoms presented significantly more often with an attached macula (χ2 , p = 0.002) and a better visual outcome following surgery (Mann-Whitney U, p = 0.028) compared to patients who were not aware of RRD-related symptoms. Among 76 patients with a myopic refractive error, only 15% (n = 11) indicated that they had been warned about the increased RRD risk related to myopia, suggesting that three-quarters of patients were not actively informed by their eye care professionals. CONCLUSION RRD symptom awareness is significantly related to a higher rate of macula-on RRDs and better visual outcomes after treatment. There is limited awareness of increased RRD risk in myopic RRD patients. These findings suggest that counselling individuals at high risk of RRD about related symptoms is inadequate and better counselling may improve visual outcomes following RRD treatment.
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Affiliation(s)
- B M Govers
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - S Keijser
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M El Kandoussi
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - K A van Overdam
- Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | - B J Klevering
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - N Crama
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
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Faraji Y, van Rijn JW, van Nispen RMA, van Rens GHMB, Melis-Dankers BJM, Koopman J, van Rijn LJ. TREYESCAN: configuration of an eye tracking test for the measurement of compensatory eye movements in patients with visual field defects. Sci Rep 2023; 13:20479. [PMID: 37993508 PMCID: PMC10665380 DOI: 10.1038/s41598-023-47470-5] [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: 07/12/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
The Traffic Eye Scanning and Compensation Analyzer (TREYESCAN) is introduced as an innovative eye tracking test designed to measure compensatory eye movements in individuals with visual field defects. The primary objective of the test is to quantitatively assess and analyze the compensatory eye movements employed by patients with visual field defects while viewing videos of various traffic scenes from the viewpoint of a driver of a passenger car. The filming process involved capturing a wide range of driving conditions and hazards, aiming to replicate real-world scenarios. Specific dynamic areas of interest within these scenes were selected and assessed by a panel of experts on medical and practical fitness to drive. Pilot measurements were conducted on a sample of 20 normally-sighted individuals during two different measurement sessions. The results provide valuable insights into how individuals without visual impairment view the dynamic scenes presented in the test. Moving forward, the TREYESCAN will be used in a case-control study involving glaucoma patients and control subjects, with the goal of further investigating and understanding the mechanisms employed by individuals with glaucoma to compensate for their visual field defects.
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Affiliation(s)
- Yasmin Faraji
- Department of Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Societal Participation & Health, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Joris W van Rijn
- Department of Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ruth M A van Nispen
- Department of Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Societal Participation & Health, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Ger H M B van Rens
- Department of Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Societal Participation & Health, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Bart J M Melis-Dankers
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - Jan Koopman
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - Laurentius J van Rijn
- Department of Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Department of Ophthalmology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Systems & Network Neurosciences, Amsterdam, The Netherlands.
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Tan ET, Kadhum A, Telleman MA, Treur A, Bruijning J, Loudon SE. How do parents experience patching or dichoptic action video gaming as amblyopia treatment? A qualitative study exploring treatment preferences and information needs to facilitate decision-making. Ophthalmic Physiol Opt 2023. [PMID: 37010918 DOI: 10.1111/opo.13132] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/10/2023] [Accepted: 03/14/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To explore parents' experiences, preferences and information needs when either patching treatment or dichoptic action video gaming is used as an amblyopia treatment for their child. METHODS A qualitative study was carried out on parents whose newly diagnosed amblyopic children participated in a randomised controlled trial (RCT) comparing the effects of dichoptic action video gaming versus patching. A purposive heterogenic sample was selected for an additional interview after the study period. Semi-structured interviews were conducted with one or both parents and transcribed verbatim, and a thematic analysis was performed. RESULTS Ten families agreed to participate: seven in the patching group and three in the gaming group. Two themes emerged from the data exploring experiences with treatment: (1) factors influencing compliance and (2) burden with treatment. Parents reported creating a routine which improved compliance with patching, as opposed to gaming where parents felt less need to conduct the treatment themselves as it was performed in the outpatient clinic. In both groups, parents experienced an information hiatus regarding the role of refractive error. In deciding the type of treatment to be used, parents preferred to deliberate the choice with the healthcare professional and discuss considerations resulting in shared decisions. The emerging themes were (1) effect and efficiency of treatment, (2) organisational aspects of treatments and (3) their child's traits. CONCLUSION This study provides insight into the experiences of parents whose children underwent different types of amblyopia therapy. Both treatments have their own advantages and disadvantages. For parents, the effectiveness and efficiency of treatment were the most important aspects when deciding the method of management. Parents wish to come to a well-informed, shared decision regarding the type of amblyopia treatment.
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Affiliation(s)
- Emily Tc Tan
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Aveen Kadhum
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marieke Aj Telleman
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annemieke Treur
- Department of Optometry and Orthoptics, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Janna Bruijning
- Institute for Allied Health Professions & Research Group Innovations in Preventive Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Sjoukje E Loudon
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
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7
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Faber S, Roepman R. A defective structural zipper in photoreceptors causes inherited blindness. PLoS Biol 2022; 20:e3001672. [PMID: 35714125 PMCID: PMC9205488 DOI: 10.1371/journal.pbio.3001672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This Primer explores a PLOS Biology study which uses ultrastructure expansion microscopy to study the inner scaffold of the photoreceptor connecting cilium, the location of multiple proteins implicated in inherited forms of progressive sight loss such as retinitis pigmentosa and Leber congenital amaurosis.
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Affiliation(s)
- Siebren Faber
- Department of Human Genetics and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ronald Roepman
- Department of Human Genetics and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- * E-mail:
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8
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Afanasyeva TAV, Schnellbach YT, Gibson TJ, Roepman R, Collin RWJ. OUP accepted manuscript. Hum Mol Genet 2022; 31:2560-2570. [PMID: 35253837 PMCID: PMC9396937 DOI: 10.1093/hmg/ddac057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 11/14/2022] Open
Abstract
Retinitis pigmentosa (RP) is a genetically heterogeneous form of inherited retinal disease that leads to progressive visual impairment. One genetic subtype of RP, RP54, has been linked to mutations in PCARE (photoreceptor cilium actin regulator). We have recently shown that PCARE recruits WASF3 to the tip of a primary cilium, and thereby activates an Arp2/3 complex which results in the remodeling of actin filaments that drives the expansion of the ciliary tip membrane. On the basis of these findings, and the lack of proper photoreceptor development in mice lacking Pcare, we postulated that PCARE plays an important role in photoreceptor outer segment disk formation. In this study, we aimed to decipher the relationship between predicted structural and function amino acid motifs within PCARE and its function. Our results show that PCARE contains a predicted helical coiled coil domain together with evolutionary conserved binding sites for photoreceptor kinase MAK (type RP62), as well as EVH1 domain-binding linear motifs. Upon deletion of the helical domain, PCARE failed to localize to the cilia. Furthermore, upon deletion of the EVH1 domain-binding motifs separately or together, co-expression of mutant protein with WASF3 resulted in smaller ciliary tip membrane expansions. Finally, inactivation of the lipid modification on the cysteine residue at amino acid position 3 also caused a moderate decrease in the sizes of ciliary tip expansions. Taken together, our data illustrate the importance of amino acid motifs and domains within PCARE in fulfilling its physiological function.
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Affiliation(s)
- Tess A V Afanasyeva
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, GA6525, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, GA6525, The Netherlands
| | - Yan-Ting Schnellbach
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, GA6525, The Netherlands
| | - Toby J Gibson
- Structural and Computational Biology Unit, European Molecular Biology Laboratory, Heidelberg 69117, Germany
| | - Ronald Roepman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, GA6525, The Netherlands
- Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, GA 6525, The Netherlands
| | - Rob W J Collin
- To whom correspondence should be addressed at: Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands. Tel: +31 243613750; Fax: +31 243668752;
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9
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Pfau M, van Dijk EHC, van Rijssen TJ, Schmitz-Valckenberg S, Holz FG, Fleckenstein M, Boon CJF. Estimation of current and post-treatment retinal function in chronic central serous chorioretinopathy using artificial intelligence. Sci Rep 2021; 11:20446. [PMID: 34650220 PMCID: PMC8516921 DOI: 10.1038/s41598-021-99977-4] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/30/2021] [Indexed: 01/13/2023] Open
Abstract
Refined understanding of the association of retinal microstructure with current and future (post-treatment) function in chronic central serous chorioretinopathy (cCSC) may help to identify patients that would benefit most from treatment. In this post-hoc analysis of data from the prospective, randomized PLACE trial (NCT01797861), we aimed to determine the accuracy of AI-based inference of retinal function from retinal morphology in cCSC. Longitudinal spectral-domain optical coherence tomography (SD-OCT) data from 57 eyes of 57 patients from baseline, week 6-8 and month 7-8 post-treatment were segmented using deep-learning software. Fundus-controlled perimetry data were aligned to the SD-OCT data to extract layer thickness and reflectivity values for each test point. Point-wise retinal sensitivity could be inferred with a (leave-one-out) cross-validated mean absolute error (MAE) [95% CI] of 2.93 dB [2.40-3.46] (scenario 1) using random forest regression. With addition of patient-specific baseline data (scenario 2), retinal sensitivity at remaining follow-up visits was estimated even more accurately with a MAE of 1.07 dB [1.06-1.08]. In scenario 3, month 7-8 post-treatment retinal sensitivity was predicted from baseline SD-OCT data with a MAE of 3.38 dB [2.82-3.94]. Our study shows that localized retinal sensitivity can be inferred from retinal structure in cCSC using machine-learning. Especially, prediction of month 7-8 post-treatment sensitivity with consideration of the treatment as explanatory variable constitutes an important step toward personalized treatment decisions in cCSC.
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Affiliation(s)
- Maximilian Pfau
- Department of Ophthalmology, University of Bonn, Bonn, Germany
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Thomas J van Rijssen
- Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology, University of Bonn, Bonn, Germany
- John A. Moran Eye Center, University of Utah, Utah, USA
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands.
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
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10
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Wagstaff EL, Heredero Berzal A, Boon CJF, Quinn PMJ, ten Asbroek ALMA, Bergen AA. The Role of Small Molecules and Their Effect on the Molecular Mechanisms of Early Retinal Organoid Development. Int J Mol Sci 2021; 22:7081. [PMID: 34209272 PMCID: PMC8268497 DOI: 10.3390/ijms22137081] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 12/12/2022] Open
Abstract
Early in vivo embryonic retinal development is a well-documented and evolutionary conserved process. The specification towards eye development is temporally controlled by consecutive activation or inhibition of multiple key signaling pathways, such as the Wnt and hedgehog signaling pathways. Recently, with the use of retinal organoids, researchers aim to manipulate these pathways to achieve better human representative models for retinal development and disease. To achieve this, a plethora of different small molecules and signaling factors have been used at various time points and concentrations in retinal organoid differentiations, with varying success. Additions differ from protocol to protocol, but their usefulness or efficiency has not yet been systematically reviewed. Interestingly, many of these small molecules affect the same and/or multiple pathways, leading to reduced reproducibility and high variability between studies. In this review, we make an inventory of the key signaling pathways involved in early retinogenesis and their effect on the development of the early retina in vitro. Further, we provide a comprehensive overview of the small molecules and signaling factors that are added to retinal organoid differentiation protocols, documenting the molecular and functional effects of these additions. Lastly, we comparatively evaluate several of these factors using our established retinal organoid methodology.
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Affiliation(s)
- Ellie L. Wagstaff
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam (UvA), 1105 AZ Amsterdam, The Netherlands;
| | - Andrea Heredero Berzal
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam (UvA), 1105 AZ Amsterdam, The Netherlands; (A.H.B.); (C.J.F.B.)
| | - Camiel J. F. Boon
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam (UvA), 1105 AZ Amsterdam, The Netherlands; (A.H.B.); (C.J.F.B.)
- Department of Ophthalmology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Peter M. J. Quinn
- Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia Stem Cell Initiative, Departments of Ophthalmology, Pathology & Cell Biology, Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center—New York-Presbyterian Hospital, New York, NY 10032, USA;
| | | | - Arthur A. Bergen
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam (UvA), 1105 AZ Amsterdam, The Netherlands;
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam (UvA), 1105 AZ Amsterdam, The Netherlands; (A.H.B.); (C.J.F.B.)
- Netherlands Institute for Neuroscience (NIN-KNAW), 1105 BA Amsterdam, The Netherlands
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