Monitoring Of Retinal Diseases Research Articles

OCTA-ReVA: an open-source toolbox for comprehensive retinal vessel feature analysis in optical coherence tomography angiography.

Optical coherence tomography angiography (OCTA) has significantly advanced the study and diagnosis of eye diseases. However, current clinical OCTA systems and software tools lack comprehensive quantitative analysis capabilities, limiting their full clinical utility. This paper introduces the OCTA Retinal Vessel Analyzer (OCTA-ReVA), a versatile open-source platform featuring a user-friendly graphical interface designed for the automated extraction and quantitative analysis of OCTA features. OCTA-ReVA includes traditional established OCTA features based on binary vascular image processing, such as blood vessel density (BVD), foveal avascular zone area (FAZ-A), blood vessel tortuosity (BVT), and blood vessel caliber (BVC). Additionally, it introduces new features based on blood perfusion intensity processing, such as perfusion intensity density (PID), vessel area flux (VAF), and normalized blood flow index (NBFI), which provide deeper insights into retinal perfusion conditions. These additional capabilities are crucial for the early detection and monitoring of retinal diseases. OCTA-ReVA demystifies the intricate task of retinal vasculature quantification, offering a robust tool for researchers and clinicians to objectively evaluate eye diseases and enhance the precision of retinal health assessments.

OCTDL: Optical Coherence Tomography Dataset for Image-Based Deep Learning Methods

Optical coherence tomography (OCT) is a non-invasive imaging technique with extensive clinical applications in ophthalmology. OCT enables the visualization of the retinal layers, playing a vital role in the early detection and monitoring of retinal diseases. OCT uses the principle of light wave interference to create detailed images of the retinal microstructures, making it a valuable tool for diagnosing ocular conditions. This work presents an open-access OCT dataset (OCTDL) comprising over 2000 OCT images labeled according to disease group and retinal pathology. The dataset consists of OCT records of patients with Age-related Macular Degeneration (AMD), Diabetic Macular Edema (DME), Epiretinal Membrane (ERM), Retinal Artery Occlusion (RAO), Retinal Vein Occlusion (RVO), and Vitreomacular Interface Disease (VID). The images were acquired with an Optovue Avanti RTVue XR using raster scanning protocols with dynamic scan length and image resolution. Each retinal b-scan was acquired by centering on the fovea and interpreted and cataloged by an experienced retinal specialist. In this work, we applied Deep Learning classification techniques to this new open-access dataset.

Evaluation of a self-imaging OCT for remote diagnosis and monitoring of retinal diseases

ObjectivesTo evaluate the feasibility and accuracy of a portable, self-imaging optical coherence tomography (OCT) for measuring central subfield thickness (CST) and achieving diagnostic concordance for retinal lesions compared with clinic-based...

Reliability of Retinal Layer Annotation with a Novel, High-Resolution Optical Coherence Tomography Device: A Comparative Study.

Optical coherence tomography (OCT) enables in vivo diagnostics of individual retinal layers in the living human eye. However, improved imaging resolution could aid diagnosis and monitoring of retinal diseases and identify potential new imaging biomarkers. The investigational high-resolution OCT platform (High-Res OCT; 853 nm central wavelength, 3 µm axial-resolution) has an improved axial resolution by shifting the central wavelength and increasing the light source bandwidth compared to a conventional OCT device (880 nm central wavelength, 7 µm axial-resolution). To assess the possible benefit of a higher resolution, we compared the retest reliability of retinal layer annotation from conventional and High-Res OCT, evaluated the use of High-Res OCT in patients with age-related macular degeneration (AMD), and assessed differences of both devices on subjective image quality. Thirty eyes of 30 patients with early/intermediate AMD (iAMD; mean age 75 ± 8 years) and 30 eyes of 30 age-similar subjects without macular changes (62 ± 17 years) underwent identical OCT imaging on both devices. Inter- and intra-reader reliability were analyzed for manual retinal layer annotation using EyeLab. Central OCT B-scans were graded for image quality by two graders and a mean-opinion-score (MOS) was formed and evaluated. Inter- and intra-reader reliability were higher for High-Res OCT (greatest benefit for inter-reader reliability: ganglion cell layer; for intra-reader reliability: retinal nerve fiber layer). High-Res OCT was significantly associated with an improved MOS (MOS 9/8, Z-value = 5.4, p < 0.01) mainly due to improved subjective resolution (9/7, Z-Value 6.2, p < 0.01). The retinal pigment epithelium drusen complex showed a trend towards improved retest reliability in High-Res OCT in iAMD eyes but without statistical significance. Improved axial resolution of the High-Res OCT benefits retest reliability of retinal layer annotation and improves perceived image quality and resolution. Automated image analysis algorithms could also benefit from the increased image resolution.

An alternative electroretinography protocol for children: a study of diagnostic agreement and accuracy relative to ISCEV standard electroretinograms.

To assess the diagnostic accuracy and agreement between a paediatric electroretinography protocol used at Great Ormond Street Hospital (GOSH-ERG) and the 'gold standard' international protocol (ISCEV-ERG) in health and disease. Patient databases between 2010 and 2020 were screened to identify children with an ISCEV-ERG recorded within four years of a GOSH-ERG. Electroretinogram (ERG) component peak times and amplitudes were re-measured, and data were analysed in terms of absolute abnormality and proportional deviation from respective reference ranges. Abnormality was defined by the retinal system affected and by individual ERG a- and b-wave component analysis. A total of 59 patients were included: 38 patients had retinal disease defined by an abnormal ISCEV-ERG and 21 had normal ISCEV-ERGs. When absolute abnormality was defined by combined retinal systems, the GOSH-ERG showed an excellent overall sensitivity of 95% (accuracy 86%). Individual retinal systems showed good-excellent sensitivity (67%-100%) and specificity (68%-97%). Electroretinogram (ERG) component sensitivities ranged between 60% and 97% and specificities between 79% and 97% dependent upon the protocol step. The proportional relationship appeared mostly linear between protocols. Electroretinogram (ERG) morphology was comparable for both protocols in a range of retinal diseases including those with pathognomonic ERGs. We demonstrate the high diagnostic accuracy of a paediatric ERG protocol (GOSH-ERG) relative to ISCEV standard ERGs. The close proportional deviation and similar waveform morphology indicate ERGs from each protocol are similarly affected in disease. This encourages the use of the GOSH-ERG protocol in the screening, diagnosis and monitoring of retinal disease in children who are unable to comply with the rigorous ISCEV-ERG protocol.

NGF in Inflammatory and Neurodegenerative Diseases of the Eye: New Findings Supporting Neuroprotection and Proper Tissue Remodeling in Vitreoretinal Disorders.

Nerve growth factor (NGF) plays a crucial role in retinal disorders, as suggested by in vitro/in vivo models. The major effect embraces the neuroprotective activity on retinal ganglion cells (RGCs) undergoing degeneration, as observed in experimental diabetic retinopathy, age-related and diabetic macular degeneration, and some vitreoretinal diseases. Focused experiments suggested that locally applied NGF (intravitreal delivery) not only allowed the counteraction of RGC degeneration but also provided data for a whole retina restoration. The currently available retinal microsurgery allows the collection of human aqueous and more interesting vitreous (vitreal reflux) humors. The recent biomolecular analysis highlights the possibility to identify disease-associated biomarkers and allow the monitoring of retinal impairments with sustain to the retinal imaging. Coupled to other soluble mediators, NGF has been quantified in aqueous (slightly expressed) from diabetic retinopathy-suffering patients (cataract surgery) and vitreal reflux (significantly impaired) of diabetic macular degeneration-suffering patients (intravitreal surgery). Although the reasons of these NGF impairments are not fully comprehended, some retinal cells (glial cells, bipolar neurons, and RGCs) have been recognized partially responsible for these local changes.Taken together, the recent progress in the ocular microsurgeries might be associated with sampling of small amount of ocular humors, allowing the collection of biochemical information about diseased retina and the monitoring of treatment. The chance to detect NGF and likewise other neuroprotective or pro-/anti-inflammatory factors in these fluids would open to the possibility to identify biomarkers of early diagnosis or monitoring of retinal disease evolution/therapy (precision medicine).

CORRELATION BETWEEN MACULAR OEDEMA AND PERIPHERAL RETINAL ISCHAEMIA IN PATIENTS WITH DIABETIC RETINOPATHY

• Diabetic retinopathy is considered one of the commonest causes of vision loss among patients suffering diabetes and the leading cause of visual impairment. • Diabetic macular oedema is still a common cause of visual loss in patients suffering diabetic retinopathy in addition to vision-related quality of life in working-aged Americans. • Diabetic retinopathy is classified according to the presence or absence of abnormal new vessels as: Non-proliferative retinopathy and Proliferative retinopathy. • Retinal photography is used extensively to assist with diagnosis and monitoring of retinal diseases.• Wide-field fluorescein angiography images showed that diabetic nonperfusion areas are more frequently seen in the midperipheral regions than in the posterior pole. • Visualization of the peripheral retina using wide-field imaging has led to new era in the assessment of diabetic retinopathy.The aim of this work is to determine the correlation between macular oedema and peripheral retinal ischemia in patients with diabetic retinopathy.

Lessons learned from quantitative fundus autofluorescence.

Quantitative fundus autofluorescence (qAF) is an approach that is built on a confocal scanning laser platform and used to measure the intensity of the inherent autofluorescence of retina elicited by short-wavelength (488 nm) excitation. Being non-invasive, qAF does not interrupt tissue architecture, thus allowing for structural correlations. The spectral features, cellular origin and topographic distribution of the natural autofluorescence of the fundus indicate that it is emitted from retinaldehyde-adducts that form in photoreceptor cells and accumulate, under most conditions, in retinal pigment epithelial cells. The distributions and intensities of fundus autofluorescence deviate from normal in many retinal disorders and it is widely recognized that these changing patterns can aid in the diagnosis and monitoring of retinal disease. The standardized protocol employed by qAF involves the normalization of fundus grey levels to a fluorescent reference installed in the imaging instrument. Together with corrections for magnification and anterior media absorption, this approach facilitates comparisons with serial images and images acquired within groups of patients. Here we provide a comprehensive summary of the principles and practice of qAF and we highlight recent efforts to elucidate retinal disease processes by combining qAF with multi-modal imaging.

Visible-light optical coherence tomography-based multimodal system for quantitative fundus autofluorescence imaging.

Quantitative fundus autofluorescence imaging with simultaneous visible-light optical coherence tomography-based multimodal technology has potential significant impact on the diagnosis and monitoring the progression of retinal diseases.

Spotlight on fundus autofluorescence.

Fundus autofluorescence (FAF) imaging is based on the fluorescence from ocular endogenous fluorophores located in the retinal pigment epithelium and choroid, mainly lipofuscin and melanin. It is a noninvasive technique that provides information about the spatial distribution of lipofuscin/melanin and retinal pigment epithelium health status. An overview about the fluorophores responsible for FAF imaging and the usefulness of FAF imaging in the noninvasive assessment and monitoring of retinal diseases, such as age-related macular degeneration, diabetic retinopathy, diabetic macular edema, central serous chorioretinopthy, retinitis pigmentosa and retinal dystrophies, are discussed in this review.

In vivo cell‐scale imaging of the human retina by adaptive optics

AbstractDiagnosis and monitoring of retinal diseases, the most important causes of blindness in developed countries, is largely based on accurate imaging of the retina. We have been using a flood imaging, commercially available AO camera (rtx1 from ImagineEye) to examine a variety of retinal diseases. Geographic atrophy can be detected at a very early stage under the form of patches of depigmented RPE filled with numerous clumps of melanin. Time‐lapse imaging show the progression of atrophy at a very small spatial and temporal scale, as well as the motion of melanin clumps within and outside atrophic areas. Diabetic microaneurysms can be distinguished from hemorrages. Epiretinal membranes can be observed under the form of small star‐like hyperreflective spots. Finally, parietal remodelling of small arteries following arterial hypertension can be detected, which may provide a novel quantitative biomarker. To sum up, while AO imaging was originally used for photoreceptor imaging, its scope is now extending. AO fundus imaging will probably establish itself as a reference methodology for early detection and monitoring of a variety of retinal diseases.

Optical Coherence Tomography in the Diagnosis and Monitoring of Retinal Diseases

Optical coherence tomography (OCT) allows the visualization of the retinal microarchitecture as cross-sectional or tomographic volumetric data. The usefulness of OCT in the management of various retinal diseases is validated by the possibility to allow early diagnosis and to help in the decision-making process. OCT is applied by two main methods: time domain (TD-OCT) and spectral domain (SD-OCT). The advantages of SD-OCT over TD-OCT are significant improvement of the image axial resolution, decreased acquisition times, reduction of motion artifacts, increased area of retinal sampling, and the possibility to create topographic maps by the three-dimensional evaluation of tissues. OCT is the most precise method to measure the central macular thickness (which is the most important practical parameter) in vivo. It has been demonstrated that there are differences in the retinal thickness measurements between OCT models, explained by the higher axial and transverse resolutions of the newer devices. Further research has led to significant improvements in OCT technology represented by ultrahigh resolution OCT (UHR-OCT), swept source OCT (SS-OCT), enhanced depth imaging OCT (EDI-OCT), and adaptive optics. Technological progress in OCT imaging offered new perspectives for better understanding the retinal diseases, opening new avenues for the fundamental and clinical research. This is a review of the data in the literature concerning the evolution of OCT technology in the field of retinal imaging.