Sensitivity and Specificity of Multimodal Imaging in Characterizing Drusen

Cozzi, Mariano; Monteduro, Davide; Parrulli, Salvatore; Corvi, Federico; Zicarelli, Federico; Corradetti, Giulia; Sadda, Srinivas R; Staurenghi, Giovanni

doi:10.1016/j.oret.2020.04.013

Cited by 17 publications

(12 citation statements)

References 28 publications

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“…[ 47 ] NIR and green FAF are recommended for detecting dots, whereas SLO pseudocolor is more useful for detecting ribbons. [ 48 ] SDD subtypes may have different outcomes. Eyes with dot SDD subtype had a 2.5-fold increased risk of developing neovascular AMD (NV-AMD), whereas eyes with ribbon SDD subtype had a 4.3-fold increased risk of developing GA.[ 49 ] Adaptive optic SLO has shed some light into the differences between the dot and ribbon subtypes.…”

Section: Subretinal Drusenoid Deposit Subtypesmentioning

confidence: 99%

Subretinal drusenoid deposits: An update

Monge

Araya²,

2022

Taiwan J Ophthalmol

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A wide spectrum of phenotypic manifestations characterizes age-related macular degeneration (AMD). Drusen is considered the hallmark of AMD and is located underneath the retinal pigment epithelium (RPE). In contrast, subretinal drusenoid deposits (SDDs), also known as reticular pseudodrusens, are located in the subretinal space, on top of the RPE. SDDs are poorly detected by clinical examination and color fundus photography. Multimodal imaging is required for their proper diagnosis. SDDs are topographically and functionally related to rods. SDDs cause a deep impairment in retinal sensitivity and dark adaptation. SDDs are dynamic structures that may grow, fuse with each other, or regress over time. An intermediate step in some eyes is the development of an acquired vitelliform lesion. The presence of SDD confers an eye a high risk for the development of late AMD. SDD leads to macular neovascularization, particularly type 3, geographic atrophy, and outer retinal atrophy.

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Section: Subretinal Drusenoid Deposit Subtypesmentioning

confidence: 99%

Subretinal drusenoid deposits: An update

Monge

Araya²,

2022

Taiwan J Ophthalmol

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“…Confocal scanning laser ophthalmoscopes (SLOs) are widely used to produce conventional reflectance monochromatic or multiwavelength fundus images. Some confocal SLOs have an additional retroillumination mode that can produce "pseudo-three-dimensional" (pseudo3D) images [1][2][3][4][5][6][7][8][9][10]. In their widely-used reflectance-mode (direct-mode), SLOs record images from light reflected directly back (retroreflected) from chorioretinal structures.…”

Section: Introductionmentioning

confidence: 99%

“…Retroillumination highlights and shades the boundaries of chorioretinal tissues and abnormalities, facilitating detection of small drusen, subretinal drusenoid deposits and subthreshold laser lesions [1][2][3][4][5][6][7][8][9][10]. It also facilitates identification of large-area chorioretinal irregularities not readily displayed in other en face retinal imaging modalities [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Scanning laser ophthalmoscopy retroillumination: applications and illusions

Mainster

Desmettre²,

Querques

et al. 2022

Int J Retin Vitr

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Scanning laser ophthalmoscopes (SLOs) are used widely for reflectance, fluorescence or autofluorescence photography and less commonly for retroillumination imaging. SLOs scan a visible light or near-infrared radiation laser beam across the retina, collecting light from each retinal spot as it’s illuminated. An SLO’s clinical applications, image contrast and axial resolution are largely determined by an aperture overlying its photodetector. High contrast, reflectance images are produced using small diameter, centered apertures (confocal apertures) that collect retroreflections and reject side-scattered veiling light returned from the fundus. Retroillumination images are acquired with annular on-axis or laterally-displaced off-axis apertures that capture scattered light and reject the retroreflected light used for reflectance imaging. SLO axial resolution is roughly 300 μm, comparable to macular thickness, so SLOs cannot provide the depth-resolved chorioretinal information obtainable with optical coherence tomography’s (OCT’s) 3 μm axial resolution. Retroillumination highlights and shades the boundaries of chorioretinal tissues and abnormalities, facilitating detection of small drusen, subretinal drusenoid deposits and subthreshold laser lesions. It also facilitates screening for large-area chorioretinal irregularities not readily identified with other en face retinal imaging modalities. Shaded boundaries create the perception of lesion elevation or depression, a characteristic of retroillumination but not reflectance SLO images. These illusions are not reliable representations of three-dimensional chorioretinal anatomy and they differ from objective OCT en face topography. SLO retroillumination has been a useful but not indispensable retinal imaging modality for over 30 years. Continuing investigation is needed to determine its most appropriate clinical roles in multimodal retinal imaging.

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“…Recently, a multimodal approach has been recommended to comprehensively visualise AMD and help determine the best clinical management based on structural disease markers 12 . For drusen, several advanced eye imaging modalities such as infrared imaging (IR) 23 , 24 , green scanning laser ophthalmoscopy 25 , fundus autofluorescence (FAF) 26 , 27 and OCT 27 – 29 have been shown to be useful in differentiating different drusen subtypes 27 , 30 and a multimodal approach is suggested for improved accuracy of AMD staging 31 , 32 . Comparison of drusen segmentation between OCT and en face retinal images also show different advantages to each modality with the former useful for detection of large drusen areas while color fundus photographs (CFPs) are superior in detecting subtle changes in drusen 21 , 22 .…”

Section: Introductionmentioning

confidence: 99%

Multispectral pattern recognition measures change in drusen area in age-related macular degeneration with high congruency to expert graders

Nam

Kalloniatis

et al. 2022

Sci Rep

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Drusen are a hallmark lesion of age-related macular degeneration (AMD) and changes in their area and/or volume are strongly associated with disease progression. Assessment of longitudinal change in drusen size in clinical practice however is limited to a single commercial tool or manual inspection by clinicians. In this study we analysed change in drusen area in 33 eyes with intermediate AMD across two separate visits using a novel technique known as multispectral pattern recognition for en face retinal images from various imaging modalities (infrared (815 nm), fundus autofluorescence (488 nm) and green (532 nm) scanning laser ophthalmoscopy). We found 91% (30/33 eyes) agreement in the direction of drusen change for multispectral pattern recognition relative to expert graders who graded eyes as having drusen progression, regression or being stable. Multispectral pattern recognition showed 100% sensitivity (22/22 eyes) and 73% specificity (8/11 eyes). In comparison, we found only 70% (23/33 eyes) agreement in the direction of drusen change with a commercially available change analysis software, the Cirrus Advanced RPE Analysis relative to expert graders, with a sensitivity 64% (14/22 eyes) and specificity of 82% (9/11 eyes). Total drusen area or amount of change between visits had no significant effect on agreement. This suggests multispectral pattern recognition can quantify longitudinal change in drusen area from multimodal imaging with greater congruency to expert graders than a commercially available platform based on a single imaging modality. Considering the association of drusen area and disease progression, this method could aid clinical assessment and monitoring of AMD.

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Sensitivity and Specificity of Multimodal Imaging in Characterizing Drusen

Cited by 17 publications

References 28 publications

Subretinal drusenoid deposits: An update

Subretinal drusenoid deposits: An update

Scanning laser ophthalmoscopy retroillumination: applications and illusions

Multispectral pattern recognition measures change in drusen area in age-related macular degeneration with high congruency to expert graders

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