International Journal of Retina and Vitreous最新文献

Purpose: To determine the associations between axial length (AL) and optical coherence tomography angiography (OCTA)-based eye-related parameters.

Methods: A prospective cross-sectional study of the right eye of 6953 individuals between the ages 50 and 97, with a range of AL from 19.1 to 31.7 mm was performed. Central subfield thickness (CST), foveal avascular zone (FAZ) and mean vessel density (mVD) were measured by OCTA. Associations between OCTA-based parameters, eye-related and systemic-related parameters were assessed using one-way ANCOVA, multivariable linear regression analysis and multiple regression analysis.

Results: AL and OCTA-based parameters were negatively correlated with age. Increased AL was associated with increased CST (ß=3.59), decreased FAZ (ß=0.02), and decreased mVD (ß=-0.4) (all p = 0.000). Better best corrected visual acuity (BCVA) was associated with larger FAZ (ß=-0.07) and higher mVD (ß=-3.160) (p = 0.002, p = 0.000). Hypertension and diabetes mellitus correlated with increased mVD (ß=0.5) and decreased mVD (ß=-0.18) respectively (p = 0.000, p = 0.023).

Conclusion: Increased AL is associated with lower mVD which may be a potential factor between myopia and poor BCVA.

Background: Cystoid macular edema (CME) is a leading cause of vision loss in patients with retinitis pigmentosa (RP). The present study was aimed to CME in patients with RP using deep learning (DL) models based on the analysis of the optical coherence tomography (OCT) images.

Methods: In this cross-sectional study, a total of 1,318 OCT scans of 296 eyes from RP patients were analyzed with scans grouped based on the presence (670 images) or absence (648 images) of CME. We used Spectral-Domain OCT (SD-OCT) to measure central foveal thickness and detect retinal abnormalities, including subclinical CME in the study groups. The dataset was stratified and divided into training and testing sets using a subject-wise split at an 80:20 ratio using the scikit-learn library. Resnet-34 and ResNet-18 model architectures were developed to automatically detect CME in RP patients, and their performance was evaluated and compared with other DL algorithms.

Results: Fine-tuning pretrained ResNet-34 and ResNet-18 models achieved an accuracy of 99.25%, 98.75%, F1-score of 99.26%, 98.77% and ROC of 99% and non-pretrained ResNet-34 and ResNet-18 achieved an accuracy of 80.64%, 82.13%, F1-score of 83.88%, 84.87% and ROC of 80%, 82% in detection of CME in RP patients.

Conclusion: This study was the first to apply DL algorithms to diagnose and manage CME in RP patients using OCT images. Pretrained ResNet models, particularly ResNet-34 with 99.25% accuracy, outperformed non-pretrained ResNet-34 with 80.64% accuracy. These results underscore the potential of pretrained models to aid in detection CME and supporting remote healthcare services.

Background: Swept-source OCT (SS-OCT) and OCT angiography (SS-OCTA) enable high-resolution assessment of retinal and choroidal biomarkers in diabetic macular edema (DME). However, prospective analyses of how these biomarkers correlate before and after anti-VEGF therapy in treatment-naïve eyes are limited. The aim of this study was to prospectively evaluate biomarker correlations following aflibercept treatment using state-of-the-art, high-resolution imaging with SS-OCT and SS-OCTA during 4 months of follow-up.

Methods: This was a prospective interventional case series that included 28 eyes from 25 treatment-naïve patients with DME. All eyes received three monthly intravitreal aflibercept injections. Patients were reassessed one month after the loading phase (4-month visit). The evaluated biomarkers included best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), vessel density (VD), and avascular area of the superficial plexus (AASP) and deep plexus (AADP). Pre- and posttreatment values were compared, and correlations were analyzed using Pearson's or Spearman's methods.

Results: Significant changes in BCVA (0.7250 ± 0.23 to 0.3957 ± 0.21; p < 0.000), CMT μm (339.04 ± 66.19 to 265.21 ± 55.75; p < 0.000), CCT μm (221.71 ± 69.69 to 209.07 ± 70.92; p < 0.000), VD (17.90 ± 7.82 to 15.35 ± 5.80; p < 0.038), AASP μm² (235,374 ± 91,299 to 157,326 ± 77,815; p < 0.000) and AADP μm² (1996,335 ± 1,000,047 to 362,161 ± 277,225; p < 0.000) were detected. Very high correlations were observed for the CCT pre vs CCT post (r = 0.98; p < 0.001), and AADP pre vs AADP reduction (r = -0.93; p < 0.001), high correlation: VD pre vs VD reduction (r = -0.72; p < 0.001. In total, 2 correlations were very high, 1 high, 4 moderate, and 9 were low; all the correlations were statistically significant.

Conclusions: Treatment-naïve DME eyes treated with aflibercept showed significant structural, vascular, and functional improvements, with several baseline biomarkers acting as potential predictive indicators of posttreatment outcomes. The very high correlation of CCT and AADP and the high correlation of VD suggest that SS-OCT and SS-OCTA can provide clinically useful information for identifying how patients will respond to treatment. These correlations support the role of SS-OCT and SS-OCTA not only as diagnostic tools but also as potential predictive indicators of therapeutic response, facilitating more personalized DME management in clinical practice. Notably, this is the first prospective study to evaluate correlations between SS-OCT and SS-OCTA biomarkers in naïve DME eyes treated with aflibercept.