Imaging of a retinal pigment epithelium aperture using polarization-sensitive optical coherence tomography

Obata, Ryo; Yoshinaga, Akie; Yamamoto, Motoshi; Komatsu, Koichiro; Aoki, Nobuyori; Yamanari, Masahiro; Sugiyama, Satoshi; Minami, Takahiro; Azuma, Keiko; Inoue, Tatsuya; Aihara, Makoto; Kato, Satoshi

doi:10.1007/s10384-020-00787-4

Cited by 5 publications

(4 citation statements)

References 37 publications

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“…It also supports the findings of Toth et al who highlighted the benefits of multimodal imaging, on a functional level [36]. The implementation of PS-OCT could improve fibrosis detection and give insight into other AMD-related findings, such as RPE alterations [37,38]. However, before PS-OCT systems can be commercialized corresponding image-processing algorithms need to be created.…”

Section: Discussionsupporting

confidence: 80%

Structure-Function Correlation of Retinal Fibrosis in Eyes with Neovascular Age-Related Macular Degeneration

Schranz,

Sacu,

Reiter

et al. 2024

JCM

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Purpose: To assess retinal function in areas of presumed fibrosis due to neovascular age-related macular degeneration (nAMD), using multimodal imaging and structure-function correlation. Design: Cross-sectional observational study. Methods: 30 eyes of 30 consecutive patients with nAMD with a minimum history of one year of anti-vascular endothelial growth factor therapy were included. Each patient underwent microperimetry (MP), color fundus photography (CFP), standard spectral-domain-based OCT (SD-OCT), and polarization sensitive-OCT (PS-OCT) imaging. PS-OCT technology can depict retinal fibrosis based on its birefringence. CFP, SD-OCT, and PS-OCT were evaluated independently for the presence of fibrosis at the corresponding MP stimuli locations. MP results and morphologic findings in CFP, SD-OCT, and PS-OCT were co-registered and analyzed using mixed linear models. Results: In total, 1350 MP locations were evaluated to assess the functional impact of fibrosis according to a standardized protocol. The estimated means of retinal areas with signs of fibrosis were 12.60 db (95% confidence interval: 10.44–14.76) in CFP, 11.60 db (95% COI: 8.84–14.36) in OCT, and 11.02 db (95% COI 8.10–13.94) in PS-OCT. Areas evaluated as subretinal fibrosis in three (7.2 db) or two (10.1 db) modalities were significantly correlated with a lower retinal sensitivity than a subretinal fibrosis observed in only one (15.3 db) or none (23.3 db) modality (p < 0.001). Conclusions: CFP, SD-OCT and PS-OCT are all suited to detect areas of reduced retinal sensitivity related to fibrosis, however, a multimodal imaging approach provides higher accuracy in the identification of areas with low sensitivity in MP (i.e., impaired retinal function), and thereby improves the detection rate of subretinal fibrosis in nAMD.

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Section: Discussionsupporting

confidence: 80%

Structure-Function Correlation of Retinal Fibrosis in Eyes with Neovascular Age-Related Macular Degeneration

Schranz,

Sacu,

Reiter

et al. 2024

JCM

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“…It is possible that the decreased depolarization (discontinuous RPE entropy) might sharply detect RPE atrophy at the PED. We recently reported that there was a decrease in depolarization at the PED around the RPE aperture, which was mainly found in drusenoid PED eyes 30 . Retinal sensitivity was significantly decreased in the area surrounding the RPE aperture and was associated with the degree of depolarization, demonstrating the presence of RPE atrophy in the decreased depolarization area.…”

Section: Discussionmentioning

confidence: 90%

Assessment of macular function in patients with non-vascularized pigment epithelial detachment

Kitano

Fujita

Asaoka

et al. 2021

Sci Rep

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Non-vascularized pigment epithelial detachments (PED) are usually associated with dry age-related macular degeneration (AMD). In this study, we aimed to investigate the correlation between visual function and morphologic parameters. Seventeen eyes of eleven patients with non-vascularized AMD were enrolled. In addition to conventional optical coherence tomography (OCT), polarization-sensitive optical coherence tomography (PS-OCT) measurements were performed by evaluating the regularity of retinal pigment epithelium (RPE) entropy within the PED area. Retinal sensitivity was measured with MP-3 microperimetry, and retinal sensitivities within (RSin) and outside (RSout) the PED area were calculated. The relationship between OCT parameters and visual function was analyzed. As a result, there was a significant difference between the RSin and RSout (p < 0.001, Wilcoxon signed rank test). Moreover, RSin was significantly related to logMAR VA (p = 0.033, linear mixed model). The regularity of RPE entropy was significantly related to visual acuity and RSin (p = 0.00038, p = 0.031, linear mixed model), although neither the height nor area of PED correlated with visual function. Our results suggest that retinal sensitivity is significantly deteriorated within the PED area and RPE entropy measured with PS-OCT was closely related to visual function in eyes with non-vascularized PED.

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“…These can be accessed online and offline as often as desired and used with any fundus camera. Cloud-based tele screening already provides promising prospects for future screening programs [18] . González-Gonzalo et al [19] also found correspondingly good functionality in RetCAD.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous screening and classification of diabetic retinopathy and age-related macular degeneration based on fundus photos—a prospective analysis of the RetCAD system

Skevas¹,

Levering²,

Engelberts³

et al. 2022

Int J Ophthalmol

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AIM: To assess the accuracy of an artificial intelligence (AI) based software (RetCAD, Thirona, The Netherlands) to identify and grade age-related macular degeneration (AMD) and diabetic retinopathy (DR) simultaneously based on fundus photos. METHODS: This prospective study included 1245 eyes of 630 patients attending an ophthalmology day-care clinic. Fundus photos were acquired and parallel graded by the RetCAD AI software and by an expert reference examiner for image quality, and staging of AMD and DR. Adjudication was provided by a second expert examiner in case of disagreement between the AI software and the reference examiner. Statistical analysis was performed on eye-level and on patient-level, by summarizing the individual image level-gradings into and eye-level or patient-level score, respectively. The performance of the RetCAD system was measured using receiver operating characteristics (ROC) analysis and sensitivity and specificity for both AMD and DR were reported. RESULTS: The RetCAD achieved an area under the ROC (Az) of 0.926 with a sensitivity of 84.6% at a specificity of 84.0% for image quality. On image level, the RetCAD software achieved Az values of 0.964 and 0.961 with sensitivity/specificity pairs of 98.2%/79.1% and 83.9%/93.3% for AMD and DR, respectively. On patient level, the RetCAD software achieved Az values of 0.960 and 0.948 with sensitivity/specificity pairs of 97.3%/73.3% and 80.0%/90.1% for AMD and DR, respectively. After adjudication by the second expert examiner sensitivity/specificity increases on patient-level to 98.6%/78.3% and 100.0%/92.3% for AMD and DR, respectively. CONCLUSION: The RetCAD offers very good sensitivity and specificity compared to manual grading by experts and is in line with that obtained by similar automated grading systems. The RetCAD AI software enables simultaneous grading of both AMD and DR based on the same fundus photos. Its sensitivity may be adjusted according to the desired acceptable sensitivity and specificity. Its simplicity cloud base integration allows cost-effective screening where routine expert evaluation may be limited.

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Imaging of a retinal pigment epithelium aperture using polarization-sensitive optical coherence tomography

Cited by 5 publications

References 37 publications

Structure-Function Correlation of Retinal Fibrosis in Eyes with Neovascular Age-Related Macular Degeneration

Structure-Function Correlation of Retinal Fibrosis in Eyes with Neovascular Age-Related Macular Degeneration

Assessment of macular function in patients with non-vascularized pigment epithelial detachment

Simultaneous screening and classification of diabetic retinopathy and age-related macular degeneration based on fundus photos—a prospective analysis of the RetCAD system

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