Automated measurement of leakage on wide-field angiography in the assessment of retinal vasculitis

Venkat, Arthi; Sharma, Sumit

doi:10.1186/s12348-019-0193-8

Cited by 6 publications

(6 citation statements)

References 10 publications

(19 reference statements)

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“…Those studies focus on automated processing techniques for standardization and normalization of FFA images in patients with uveitis. 47 For retinal and choroidal lesions, autofluorescence and en face fundus images are now used in clinical trials to assess the level of inflammation. Other markers of inflammation used in clinical practice include macular edema, cells in vitreous, and vascular sheathing.…”

Section: Discussionmentioning

confidence: 99%

Label-Free Imaging of Inflammation at the Level of Single Cells in the Living Human Eye

Rui,

Zhang,

Lee

et al. 2024

Ophthalmology Science

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Section: Discussionmentioning

confidence: 99%

Label-Free Imaging of Inflammation at the Level of Single Cells in the Living Human Eye

Rui,

Zhang,

Lee

et al. 2024

Ophthalmology Science

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“…The amount of leakage in retinal vasculitis have been studied recently with development of automated leakage analysis of wide field fluorescein angiogram in uveitis patients. Those studies focus on automated processing techniques for standardization and normalization of fluorescein angiography images in patients with uveitis 41 . For retinal and choroidal lesions, autofluorescence and en face fundus images are now used in clinical trials to assess the level of inflammation.…”

Section: Discussionmentioning

confidence: 99%

Imaging the structure and dynamic activity of retinal microglia and macrophage-like cells in the living human eye

Rui

Lee

Zhang

et al. 2022

Preprint

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PurposeWe recently showed how a refined sequential detection pattern and image processing pipeline for multi-offset adaptive optics scanning light ophthalmoscopy (AOSLO) can increase the contrast of weakly scattering inner retinal structures, including microglia. However, sequential detection was still time-consuming, preventing dynamics from being monitored over short intervals (< 3 mins). Here we show that simultaneous fiber-bundle (FB) detection can overcomes this limitation to reveal the structure and dynamic activity of microglia and macrophage-like cells in healthy and diseased retinae.MethodsWe designed and implemented a custom 7-fiber optical FB with one central confocal fiber and six larger fibers for multi-offset detection in AOSLO at a single focal plane. We imaged the ganglion cell layer at several locations at multiple timepoints (from minutes to weeks) in 8 healthy participants and in 4 patients with ocular infections or inflammation, including ocular syphilis and posterior uveitis. Microglia and immune cells were manually segmented to quantify cell morphometry and motility.ResultsFiber-bundle detection reduced single acquisition time to 20-30 seconds, enabling imaging over larger areas and monitoring of dynamics over shorter intervals. Presumed microglia in healthy retinas had an average diameter of 12.8 μm and with a spectrum of morphologies including circular cells and elongated cells with visible processes. We also detected the somas of putative macroglia, potentially astrocytes, near the optic nerve head. Microglia moved slowly in normal eyes (0.02μm/sec, on average) but speed increased in patients with active infections or inflammation (up to 2.37μm/sec). Microglia activity was absent in a patient with chronic uveitis that was quiescent but apparent over short intervals in an active uveitis retina. In a patient with ocular syphilis imaged at multiple timepoints during treatment, macrophage-like cells containing granular internal structures were seen. Decreases in the quantity and motility of these immune cells were correlated with improvements to vision and other structural and systemic biomarkers.ConclusionsFB-AOSLO enable simplified optical setup with easy alignment and implementation. We imaged the fine-scale structure and dynamics of microglia and macrophage-like cells during active infection and inflammation in the living eye for the first time. In healthy eyes we also detected putative glia cell near the optic nerve head. FB-AOSLO offers promise as a powerful tool for detecting and monitoring retinal inflammation and infection in the living eye over short response to treatment.

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“…As highlighted, many of the current shortcomings of outcome measures are determined by the nature of the clinical assessment they are based on. The instrument-based automated methods for endpoint quantification reviewed herein may overcome many of these shortcomings, for example, are better reproducible and also more time and cost efficient compared to manual grading, especially for large studies or datasets [168]. Any development of automated quantification of, for example, intraocular inflammation, would benefit from precise definitions of imaging biomarkers present in uveitis as reviewed here.…”

Section: Discussionmentioning

confidence: 99%

Structural Endpoints and Outcome Measures in Uveitis

et al. 2021

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Most uveitis entities are rare diseases but, taken together, are responsible for 5–10% of worldwide visual impairment which largely affects persons of working age. As with many rare diseases, there is a lack of high-level evidence regarding its clinical management, partly due to a dearth of reliable and objective quantitative endpoints for clinical trials. This review provides an overview of available structural outcome measures for uveitis disease activity and damage in an anatomical order from the anterior to the posterior segment of the eye. While there is a multitude of available structural outcome measures, not all might qualify as endpoints for clinical uveitis trials, and thorough testing of applicability is warranted. Furthermore, a consensus on endpoint definition, standardization, and “core outcomes” is required. As stipulated by regulatory agencies, endpoints should be precisely defined, clinically important, internally consistent, reliable, responsive to treatment, and relevant for the respective subtype of uveitis. Out of all modalities used for assessment of the reviewed structural outcome measures, optical coherence tomography, color fundus photography, fundus autofluorescence, and fluorescein/indocyanine green angiography represent current “core modalities” for reliable and objective quantification of uveitis outcome measures, based on their practical availability and the evidence provided so far.

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Automated measurement of leakage on wide-field angiography in the assessment of retinal vasculitis

Cited by 6 publications

References 10 publications

Label-Free Imaging of Inflammation at the Level of Single Cells in the Living Human Eye

Label-Free Imaging of Inflammation at the Level of Single Cells in the Living Human Eye

Imaging the structure and dynamic activity of retinal microglia and macrophage-like cells in the living human eye

Structural Endpoints and Outcome Measures in Uveitis

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