Pub Date : 2024-02-21DOI: 10.1186/s40942-024-00538-4
Venkatkrish M Kasetty, Pedro F Monsalve, Dhruv Sethi, Candice Yousif, Thomas Hessburg, Nitin Kumar, Abdualrahman E Hamad, Uday R Desai
Background: Scleral buckling is typically implemented to repair rhegmatogenous retinal detachments (RRD) in young patients. Therefore, there is limited data on post-pars plana vitrectomy (PPV) cataract formation in this cohort. We report the rates and risk factors of cataract progression after PPV for RRD repair in young eyes.
Methods: Retrospective single-center cohort study. Medical records of patients between the ages of 15 to 45 undergoing PPV for uncomplicated RRD between 2014 and 2020 were reviewed.
Results: Twenty-eight eyes from 26 patients met inclusion criteria. Cataracts developed in 20/28 (71%) eyes after PPV. After PPV, nuclear sclerotic cataract (NSC) rates were higher in patients above 35 (65%) compared to below 35 years (18%) (p = 0.024). Cataracts developed more frequently after macula-off RRDs (88%) compared to macula-on RRDs (50%) (p = 0.044) with NSC more common in macula-off detachments (p = 0.020). At postoperative month 2, all eyes with C3F8 gas developed cataracts compared to 59% of eyes with no gas (p = 0.040).
Conclusions: Cataract formation was common and frequent after PPV. After PPV, young eyes and macula-on detachments developed cataracts less frequently than older eyes and macula-off detachments. If appropriate, a shorter acting gas tamponade should be considered in young eyes to minimize cataract formation.
{"title":"Cataract progression after primary pars plana vitrectomy for uncomplicated rhegmatogenous retinal detachments in young adults.","authors":"Venkatkrish M Kasetty, Pedro F Monsalve, Dhruv Sethi, Candice Yousif, Thomas Hessburg, Nitin Kumar, Abdualrahman E Hamad, Uday R Desai","doi":"10.1186/s40942-024-00538-4","DOIUrl":"10.1186/s40942-024-00538-4","url":null,"abstract":"<p><strong>Background: </strong>Scleral buckling is typically implemented to repair rhegmatogenous retinal detachments (RRD) in young patients. Therefore, there is limited data on post-pars plana vitrectomy (PPV) cataract formation in this cohort. We report the rates and risk factors of cataract progression after PPV for RRD repair in young eyes.</p><p><strong>Methods: </strong>Retrospective single-center cohort study. Medical records of patients between the ages of 15 to 45 undergoing PPV for uncomplicated RRD between 2014 and 2020 were reviewed.</p><p><strong>Results: </strong>Twenty-eight eyes from 26 patients met inclusion criteria. Cataracts developed in 20/28 (71%) eyes after PPV. After PPV, nuclear sclerotic cataract (NSC) rates were higher in patients above 35 (65%) compared to below 35 years (18%) (p = 0.024). Cataracts developed more frequently after macula-off RRDs (88%) compared to macula-on RRDs (50%) (p = 0.044) with NSC more common in macula-off detachments (p = 0.020). At postoperative month 2, all eyes with C<sub>3</sub>F<sub>8</sub> gas developed cataracts compared to 59% of eyes with no gas (p = 0.040).</p><p><strong>Conclusions: </strong>Cataract formation was common and frequent after PPV. After PPV, young eyes and macula-on detachments developed cataracts less frequently than older eyes and macula-off detachments. If appropriate, a shorter acting gas tamponade should be considered in young eyes to minimize cataract formation.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.1186/s40942-024-00539-3
Ragukumar Venugopal, Anthony Vipin Das, Brijesh Takkar, Michael W Stewart, Raja Narayanan
Objective: To describe the demographics, clinical, and imaging characteristics, and visual outcomes in young patients with full-thickness traumatic macular hole (TMH).
Methods: This retrospective hospital-based study included patients with full-thickness TMH who presented between August 2010 and June 2021. Demographic data, clinical findings, and imaging characteristics were extracted from an electronic medical record system. Regression analyses were performed to determine significant associations among variables and to identify predictors of visual outcomes.
Results: 144 (0.005%) patients among 2,834,616 were diagnosed with Full thickness TMH. The majority of them were male (89.58%; odds ratio [OR] = 6.71) and the holes were unilateral. The mean age at presentation was 23.37 ± 8.19 years. Ball were the most common cause of injuries (22.22%), followed by stick (14.58%) and firecracker (12.50%). The mean LogMAR visual acuity (VA) at presentation was 1.18 ± 0.72, with 25.69% of eyes having VA < 20/400. The mean minimum hole diameter was 619.34 ± 336.16 μm. Sub-retinal fluid was present in 44.44%, followed by intraretinal fluid in 34.03% of eyes. Macular holes closed after vitrectomy in 66.67% of eyes, with mean final VA of 1.07 ± 0.85. Baseline VA was a strong predictor of final VA (R2 = 0.677; p = 0.000168).
Conclusion: Traumatic macular hole is a unilateral condition with significant visual impairment that is mainly seen in males during the third decade of life. Surgery is successful in most cases but improvements in VA are modest.
{"title":"Real-world experience of full-thickness traumatic macular hole among young patients.","authors":"Ragukumar Venugopal, Anthony Vipin Das, Brijesh Takkar, Michael W Stewart, Raja Narayanan","doi":"10.1186/s40942-024-00539-3","DOIUrl":"10.1186/s40942-024-00539-3","url":null,"abstract":"<p><strong>Objective: </strong>To describe the demographics, clinical, and imaging characteristics, and visual outcomes in young patients with full-thickness traumatic macular hole (TMH).</p><p><strong>Methods: </strong>This retrospective hospital-based study included patients with full-thickness TMH who presented between August 2010 and June 2021. Demographic data, clinical findings, and imaging characteristics were extracted from an electronic medical record system. Regression analyses were performed to determine significant associations among variables and to identify predictors of visual outcomes.</p><p><strong>Results: </strong>144 (0.005%) patients among 2,834,616 were diagnosed with Full thickness TMH. The majority of them were male (89.58%; odds ratio [OR] = 6.71) and the holes were unilateral. The mean age at presentation was 23.37 ± 8.19 years. Ball were the most common cause of injuries (22.22%), followed by stick (14.58%) and firecracker (12.50%). The mean LogMAR visual acuity (VA) at presentation was 1.18 ± 0.72, with 25.69% of eyes having VA < 20/400. The mean minimum hole diameter was 619.34 ± 336.16 μm. Sub-retinal fluid was present in 44.44%, followed by intraretinal fluid in 34.03% of eyes. Macular holes closed after vitrectomy in 66.67% of eyes, with mean final VA of 1.07 ± 0.85. Baseline VA was a strong predictor of final VA (R<sup>2</sup> = 0.677; p = 0.000168).</p><p><strong>Conclusion: </strong>Traumatic macular hole is a unilateral condition with significant visual impairment that is mainly seen in males during the third decade of life. Surgery is successful in most cases but improvements in VA are modest.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-15DOI: 10.1186/s40942-023-00512-6
Stavan V Shah, Sumit Randhir Singh, Amrish Selvam, Sanjana Harihar, Yash Parmar, Rubble Mangla, Supriya Arora, Kiran K Vupparaboina, Ramesh Venkatesh, Jay Chhablani
Purpose: To compare changes in the fibrous component of pigment epithelium detachment composition indices (PEDCI-F) in neovascular age-related macular degeneration (n-AMD) and polypoidal choroidal vasculopathy (PCV) over 12 months.
Methods: This was a retrospective chart review of treatment-naïve n-AMD and PCV eyes treated with anti-vascular endothelial growth factor (anti-VEGF) agents. Optical coherence tomography (OCT) images were recorded at baseline and at 3, 6, and 12 months. OCT images were processed by filtering followed by pigment epithelium detachment (PED) segmentation and analysis of PED lesion heterogeneity based on the composition (PEDCI-F).
Results: A total of 74 eyes with n-AMD (36) and PCV (38) were included. Overall, PEDCI-F increased minimally in both n-AMD and PCV groups (both p > 0.05). The majority, i.e., 58.3% and 60.5%, of n-AMD and PCV eyes, respectively, showed an increase in PEDCI-F at 12 months. An increase in PEDCI-F was associated with improved BCVA logMAR (n-AMD, r = -0.79; p < 0.001 and PCV, r = - 0.06; p = 0.74) and the need for fewer anti-VEGF injections (n-AMD, r = - 0.53; p < 0.001 and PCV, r = - 0.09; p = 0.58).
Conclusion: PEDCI-F increases in the majority of eyes with n-AMD and PCV through 12 months following treatment with anti-VEGF injections. This group had better visual acuity compared to the other subset with reduction in PEDCI-F requiring more anti-VEGF injections and worse visual acuity, possibly due to fibrovascular PED (FVPED) collapse and atrophy or a relative increase in other PEDCI constituents at 12 months.
{"title":"Comparison of pigment epithelium detachment composition indices between neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.","authors":"Stavan V Shah, Sumit Randhir Singh, Amrish Selvam, Sanjana Harihar, Yash Parmar, Rubble Mangla, Supriya Arora, Kiran K Vupparaboina, Ramesh Venkatesh, Jay Chhablani","doi":"10.1186/s40942-023-00512-6","DOIUrl":"10.1186/s40942-023-00512-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare changes in the fibrous component of pigment epithelium detachment composition indices (PEDCI-F) in neovascular age-related macular degeneration (n-AMD) and polypoidal choroidal vasculopathy (PCV) over 12 months.</p><p><strong>Methods: </strong>This was a retrospective chart review of treatment-naïve n-AMD and PCV eyes treated with anti-vascular endothelial growth factor (anti-VEGF) agents. Optical coherence tomography (OCT) images were recorded at baseline and at 3, 6, and 12 months. OCT images were processed by filtering followed by pigment epithelium detachment (PED) segmentation and analysis of PED lesion heterogeneity based on the composition (PEDCI-F).</p><p><strong>Results: </strong>A total of 74 eyes with n-AMD (36) and PCV (38) were included. Overall, PEDCI-F increased minimally in both n-AMD and PCV groups (both p > 0.05). The majority, i.e., 58.3% and 60.5%, of n-AMD and PCV eyes, respectively, showed an increase in PEDCI-F at 12 months. An increase in PEDCI-F was associated with improved BCVA logMAR (n-AMD, r = -0.79; p < 0.001 and PCV, r = - 0.06; p = 0.74) and the need for fewer anti-VEGF injections (n-AMD, r = - 0.53; p < 0.001 and PCV, r = - 0.09; p = 0.58).</p><p><strong>Conclusion: </strong>PEDCI-F increases in the majority of eyes with n-AMD and PCV through 12 months following treatment with anti-VEGF injections. This group had better visual acuity compared to the other subset with reduction in PEDCI-F requiring more anti-VEGF injections and worse visual acuity, possibly due to fibrovascular PED (FVPED) collapse and atrophy or a relative increase in other PEDCI constituents at 12 months.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.1186/s40942-024-00530-y
Verena Schöneberger, Jeany Q Li, Leonie Menghesha, Frank G Holz, Friederike Schaub, Tim U Krohne
Background: In vitrectomy for rhegmatogenous retinal detachment, long-acting gas tamponades (LGT) such as C3F8 or C2F6 may improve surgical success rate due to their prolonged effect compared to a short-acting gas tamponade (SGT) with SF6. On the other hand, SGT allow a significantly faster visual rehabilitation after surgery and may reduce the risk of gas-related complications. As comparative data in retinal detachment surgery is limited, we assessed the outcomes of vitrectomies using either LGT or SGT.
Methods: We retrospectively analyzed 533 eyes of 524 consecutive patients diagnosed with primary rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy (PVR) and treated by vitrectomy at two clinical sites. Depending on the site the patients presented at, they received either preferentially LGT (study site 1) or SGT (study site 2). Retinal re-detachment rates during a period of 6 months following surgery were analyzed.
Results: At study site 1, 254 of 278 eyes (91.4%) were treated by LGT (C3F8 72.3%; C2F6 19.1%), whereas at study site 2, 246 of 255 eyes (96.5%) received SGT (SF6). Rates of retinal re-detachment in the LGT- and SGT-treated groups were similar with 23 of 254 eyes (9.1%) and 24 of 246 eyes (9.8%), respectively (p = 0.9). Median time to re-detachment was 5.7 weeks in the LGT-treated group and 4.4 weeks in the SGT-treated group (p = 0.4).
Conclusion: In rhegmatogenous retinal detachment repair by vitrectomy, the use of SGT results in comparable rates of successful retinal re-attachment as LGT. Given the faster visual rehabilitation with SGT, these results suggest SGT as a sensible alternative to LGT in surgery of retinal detachment without PVR.
{"title":"Outcomes of short- versus long-acting gas tamponades in vitrectomy for rhegmatogenous retinal detachment.","authors":"Verena Schöneberger, Jeany Q Li, Leonie Menghesha, Frank G Holz, Friederike Schaub, Tim U Krohne","doi":"10.1186/s40942-024-00530-y","DOIUrl":"10.1186/s40942-024-00530-y","url":null,"abstract":"<p><strong>Background: </strong>In vitrectomy for rhegmatogenous retinal detachment, long-acting gas tamponades (LGT) such as C3F8 or C2F6 may improve surgical success rate due to their prolonged effect compared to a short-acting gas tamponade (SGT) with SF6. On the other hand, SGT allow a significantly faster visual rehabilitation after surgery and may reduce the risk of gas-related complications. As comparative data in retinal detachment surgery is limited, we assessed the outcomes of vitrectomies using either LGT or SGT.</p><p><strong>Methods: </strong>We retrospectively analyzed 533 eyes of 524 consecutive patients diagnosed with primary rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy (PVR) and treated by vitrectomy at two clinical sites. Depending on the site the patients presented at, they received either preferentially LGT (study site 1) or SGT (study site 2). Retinal re-detachment rates during a period of 6 months following surgery were analyzed.</p><p><strong>Results: </strong>At study site 1, 254 of 278 eyes (91.4%) were treated by LGT (C3F8 72.3%; C2F6 19.1%), whereas at study site 2, 246 of 255 eyes (96.5%) received SGT (SF6). Rates of retinal re-detachment in the LGT- and SGT-treated groups were similar with 23 of 254 eyes (9.1%) and 24 of 246 eyes (9.8%), respectively (p = 0.9). Median time to re-detachment was 5.7 weeks in the LGT-treated group and 4.4 weeks in the SGT-treated group (p = 0.4).</p><p><strong>Conclusion: </strong>In rhegmatogenous retinal detachment repair by vitrectomy, the use of SGT results in comparable rates of successful retinal re-attachment as LGT. Given the faster visual rehabilitation with SGT, these results suggest SGT as a sensible alternative to LGT in surgery of retinal detachment without PVR.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.1186/s40942-024-00532-w
Marwa Mahmoud Abdellah, Ahmed Ali Amer, Zeiad Hasan Eldaly, Mohamed Abdellatif Anber
Background: High myopia represents a health issue and leads to the development of complications that threaten vision. The study of macular changes in high myopia patients has undergone great advances with updated technology via new spectral optical coherence tomography (OCT) and Optical coherence tomography angiography (OCTA). Most of related studies have focused on the adults and additional studies need to investigate macular changes in children and adolescents. This study aimed to evaluate the changes in the macular structure by OCT and the macular vessel density in high myopia in children and adolescents by OCTA.
Methods: A cross-sectional comparative study. The population was divided into two groups: group 1 (4-11 years) and group 2 (12-18 years). The results were comparable to those of control study of the same age group. The two high myopia groups and the control groups were examined by macular OCT and OCTA to evaluate macular thickness and vessel density in the superficial and deep capillary plexuses.
Results: OCT measurements of patients in group 1 revealed that central macular thickness was significantly lower in high myopia group than in the control group and measured 220.91 ± 27.87 μm and 258.23 ± 17.26 μm, respectively, (P < 0.0001). However, in group 2 the central macular thickness in the high myopia group and control group was 236.32 ± 27.76 μm and 247.09 ± 16.81 μm respectively, and the difference was not statistically significant (P = 0.09). The parafoveal macular thickness and the perifoveal macular quadrants thickness were significantly lower in high myopic children and high myopic adolescents (P < 0.0001) than age matched controls. The parafoveal and perifoveal vessel densities in the superficial and deep capillary plexuses were lower in the high myopia groups than in the age-matched controls in both groups with a few segment exceptions in group 1. The FAZ was significantly wider in group 1 than in the age-matched emmetropes (P = 0.02). The FAZ was wider in group 2 than controls, but the difference was not statistically significant, (P = 0.75).
Conclusion: High myopic children and adolescents have thinner macular thickness than comparable age-matched emmetropes and have less vessel density in superficial and deep capillary plexuses with a wider FAZ.
背景:高度近视是一个健康问题,会导致危及视力的并发症。随着新光谱光学相干断层扫描(OCT)和光学相干断层血管成像(OCTA)技术的更新,对高度近视患者黄斑变化的研究取得了重大进展。大多数相关研究都集中在成人身上,因此需要对儿童和青少年的黄斑变化进行更多研究。本研究旨在通过 OCT 评估儿童和青少年高度近视黄斑结构的变化,并通过 OCTA 评估黄斑血管密度:方法:横断面比较研究。研究对象分为两组:第一组(4-11 岁)和第二组(12-18 岁)。结果与同年龄组的对照研究结果相当。两组高度近视患者和对照组均接受了黄斑 OCT 和 OCTA 检查,以评估黄斑厚度以及浅层和深层毛细血管丛的血管密度:第 1 组患者的 OCT 测量结果显示,高度近视组的黄斑中心厚度明显低于对照组,分别为 220.91 ± 27.87 μm 和 258.23 ± 17.26 μm(P 结论:高度近视组的黄斑中心厚度明显低于对照组:高度近视儿童和青少年的黄斑厚度比年龄相当的外斜视儿童和青少年薄,浅层和深层毛细血管丛的血管密度较低,FAZ 较宽。
{"title":"Optical coherence tomography angiography of the macula of high myopia in children and adolescents.","authors":"Marwa Mahmoud Abdellah, Ahmed Ali Amer, Zeiad Hasan Eldaly, Mohamed Abdellatif Anber","doi":"10.1186/s40942-024-00532-w","DOIUrl":"10.1186/s40942-024-00532-w","url":null,"abstract":"<p><strong>Background: </strong>High myopia represents a health issue and leads to the development of complications that threaten vision. The study of macular changes in high myopia patients has undergone great advances with updated technology via new spectral optical coherence tomography (OCT) and Optical coherence tomography angiography (OCTA). Most of related studies have focused on the adults and additional studies need to investigate macular changes in children and adolescents. This study aimed to evaluate the changes in the macular structure by OCT and the macular vessel density in high myopia in children and adolescents by OCTA.</p><p><strong>Methods: </strong>A cross-sectional comparative study. The population was divided into two groups: group 1 (4-11 years) and group 2 (12-18 years). The results were comparable to those of control study of the same age group. The two high myopia groups and the control groups were examined by macular OCT and OCTA to evaluate macular thickness and vessel density in the superficial and deep capillary plexuses.</p><p><strong>Results: </strong>OCT measurements of patients in group 1 revealed that central macular thickness was significantly lower in high myopia group than in the control group and measured 220.91 ± 27.87 μm and 258.23 ± 17.26 μm, respectively, (P < 0.0001). However, in group 2 the central macular thickness in the high myopia group and control group was 236.32 ± 27.76 μm and 247.09 ± 16.81 μm respectively, and the difference was not statistically significant (P = 0.09). The parafoveal macular thickness and the perifoveal macular quadrants thickness were significantly lower in high myopic children and high myopic adolescents (P < 0.0001) than age matched controls. The parafoveal and perifoveal vessel densities in the superficial and deep capillary plexuses were lower in the high myopia groups than in the age-matched controls in both groups with a few segment exceptions in group 1. The FAZ was significantly wider in group 1 than in the age-matched emmetropes (P = 0.02). The FAZ was wider in group 2 than controls, but the difference was not statistically significant, (P = 0.75).</p><p><strong>Conclusion: </strong>High myopic children and adolescents have thinner macular thickness than comparable age-matched emmetropes and have less vessel density in superficial and deep capillary plexuses with a wider FAZ.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10845789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-04DOI: 10.1186/s40942-024-00535-7
Paula Basso Dias, Anna Carolina Badotti Linhares, Ana Barbara Dias Lopes Urzedo, Rony Carlos Preti, Leandro Cabral Zacharias, Leonardo Provetti Cunha, Mário Luiz Ribeiro Monteiro, Kenzo Hokazono
Purpose: Tuberous Sclerosis (TS) is a rare, multisystem genetic disease caused by mutations in the TSC1 and TSC2 genes, leading to abnormalities in cell differentiation and proliferation. This study aimed to evaluate the neural integrity of individuals with TS by using Optical Coherence Tomography (OCT) to examine the peripapillary retinal nerve fiber layer (RNFL) thickness and the macular thickness in patients with TS and to compare with healthy controls.
Methods: Peripapillary and macular OCT scans (Optopol Revo NX SD OCT) were performed on 41 eyes from 22 TS patients, divided into two groups based on the presence of retinal hamartomas, and compared to 20 eyes from a control group. The average peripapillary RNFL thickness was measured for each quadrant. The macular total thickness and ganglion cell layer (GCL) + inner plexiform layer (IPL) thickness were measured based on the Early Treatment Diabetic Retinopathy Study (ETDRS) map. All measurements were then compared between the groups and controls.
Results: The TS group showed significantly reduced RNFL thickness and macular thickness when compared to the control group. Specifically, patients with retinal hamartomas exhibited an even more pronounced thinning of both RNFL and macular thickness.
Conclusions: These findings suggest that TS patients undergo significant changes in retinal neurodevelopment and experience axonal loss. This finding may have significant prognostic utility regarding central nervous system degeneration in TS, particularly among patients with retinal hamartomas. OCT may serve as a valuable tool for assessing axonal structural abnormalities in TS patients.
{"title":"Optical coherence tomography detection of retinal neural loss in patients with tuberous sclerosis.","authors":"Paula Basso Dias, Anna Carolina Badotti Linhares, Ana Barbara Dias Lopes Urzedo, Rony Carlos Preti, Leandro Cabral Zacharias, Leonardo Provetti Cunha, Mário Luiz Ribeiro Monteiro, Kenzo Hokazono","doi":"10.1186/s40942-024-00535-7","DOIUrl":"10.1186/s40942-024-00535-7","url":null,"abstract":"<p><strong>Purpose: </strong>Tuberous Sclerosis (TS) is a rare, multisystem genetic disease caused by mutations in the TSC1 and TSC2 genes, leading to abnormalities in cell differentiation and proliferation. This study aimed to evaluate the neural integrity of individuals with TS by using Optical Coherence Tomography (OCT) to examine the peripapillary retinal nerve fiber layer (RNFL) thickness and the macular thickness in patients with TS and to compare with healthy controls.</p><p><strong>Methods: </strong>Peripapillary and macular OCT scans (Optopol Revo NX SD OCT) were performed on 41 eyes from 22 TS patients, divided into two groups based on the presence of retinal hamartomas, and compared to 20 eyes from a control group. The average peripapillary RNFL thickness was measured for each quadrant. The macular total thickness and ganglion cell layer (GCL) + inner plexiform layer (IPL) thickness were measured based on the Early Treatment Diabetic Retinopathy Study (ETDRS) map. All measurements were then compared between the groups and controls.</p><p><strong>Results: </strong>The TS group showed significantly reduced RNFL thickness and macular thickness when compared to the control group. Specifically, patients with retinal hamartomas exhibited an even more pronounced thinning of both RNFL and macular thickness.</p><p><strong>Conclusions: </strong>These findings suggest that TS patients undergo significant changes in retinal neurodevelopment and experience axonal loss. This finding may have significant prognostic utility regarding central nervous system degeneration in TS, particularly among patients with retinal hamartomas. OCT may serve as a valuable tool for assessing axonal structural abnormalities in TS patients.</p><p><strong>Trial registration number: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-03DOI: 10.1186/s40942-024-00534-8
Andreas Abou Taha, Sebastian Dinesen, Anna Stage Vergmann, Jakob Grauslund
Diabetes is a prevalent global concern, with an estimated 12% of the global adult population affected by 2045. Diabetic retinopathy (DR), a sight-threatening complication, has spurred diverse screening approaches worldwide due to advances in DR knowledge, rapid technological developments in retinal imaging and variations in healthcare resources.Many high income countries have fully implemented or are on the verge of completing a national Diabetic Eye Screening Programme (DESP). Although there have been some improvements in DR screening in Africa, Asia, and American countries further progress is needed. In low-income countries, only one out of 29, partially implemented a DESP, while 21 out of 50 lower-middle-income countries have started the DR policy cycle. Among upper-middle-income countries, a third of 59 nations have advanced in DR agenda-setting, with five having a comprehensive national DESP and 11 in the early stages of implementation.Many nations use 2-4 fields fundus images, proven effective with 80-98% sensitivity and 86-100% specificity compared to the traditional seven-field evaluation for DR. A cell phone based screening with a hand held retinal camera presents a potential low-cost alternative as imaging device. While this method in low-resource settings may not entirely match the sensitivity and specificity of seven-field stereoscopic photography, positive outcomes are observed.Individualized DR screening intervals are the standard in many high-resource nations. In countries that lacks a national DESP and resources, screening are more sporadic, i.e. screening intervals are not evidence-based and often less frequently, which can lead to late recognition of treatment required DR.The rising global prevalence of DR poses an economic challenge to nationwide screening programs AI-algorithms have showed high sensitivity and specificity for detection of DR and could provide a promising solution for the future screening burden.In summary, this narrative review enlightens on the epidemiology of DR and the necessity for effective DR screening programs. Worldwide evolution in existing approaches for DR screening has showed promising results but has also revealed limitations. Technological advancements, such as handheld imaging devices, tele ophthalmology and artificial intelligence enhance cost-effectiveness, but also the accessibility of DR screening in countries with low resources or where distance to or a shortage of ophthalmologists exists.
糖尿病是全球普遍关注的问题,预计到 2045 年,全球将有 12% 的成年人患上糖尿病。糖尿病视网膜病变(DR)是一种威胁视力的并发症,由于糖尿病知识的进步、视网膜成像技术的飞速发展以及医疗资源的差异,全球范围内的筛查方法多种多样。尽管非洲、亚洲和美洲国家在糖尿病筛查方面取得了一些进步,但仍需取得进一步进展。在低收入国家中,29 个国家中只有 1 个国家部分实施了 DESP,而在 50 个中低收入国家中,21 个国家已经开始了 DR 政策周期。在中上收入国家中,59 个国家中有三分之一的国家在制定 DR 议程方面取得了进展,其中 5 个国家制定了全面的国家 DESP,11 个国家处于实施的早期阶段。许多国家使用 2-4 个视野的眼底图像,与传统的 7 个视野的 DR 评估相比,其灵敏度为 80-98%,特异性为 86-100%,已被证明是有效的。使用手持式视网膜照相机进行手机筛查是一种潜在的低成本成像设备。虽然这种方法在低资源环境中可能无法完全达到七视场立体摄影的灵敏度和特异性,但仍能观察到积极的结果。在缺乏国家 DESP 和资源的国家,筛查更为零散,即筛查间隔没有循证医学证据,筛查频率通常较低,这可能导致需要治疗的 DR 识别较晚。DR 在全球的流行率不断上升,给全国范围内的筛查计划带来了经济挑战。在全球范围内,现有 DR 筛查方法的发展取得了可喜的成果,但也暴露出了局限性。手持成像设备、远程眼科和人工智能等技术的进步不仅提高了成本效益,还使资源匮乏或距离眼科医生较远或眼科医生短缺的国家更容易获得 DR 筛查。
{"title":"Present and future screening programs for diabetic retinopathy: a narrative review.","authors":"Andreas Abou Taha, Sebastian Dinesen, Anna Stage Vergmann, Jakob Grauslund","doi":"10.1186/s40942-024-00534-8","DOIUrl":"10.1186/s40942-024-00534-8","url":null,"abstract":"<p><p>Diabetes is a prevalent global concern, with an estimated 12% of the global adult population affected by 2045. Diabetic retinopathy (DR), a sight-threatening complication, has spurred diverse screening approaches worldwide due to advances in DR knowledge, rapid technological developments in retinal imaging and variations in healthcare resources.Many high income countries have fully implemented or are on the verge of completing a national Diabetic Eye Screening Programme (DESP). Although there have been some improvements in DR screening in Africa, Asia, and American countries further progress is needed. In low-income countries, only one out of 29, partially implemented a DESP, while 21 out of 50 lower-middle-income countries have started the DR policy cycle. Among upper-middle-income countries, a third of 59 nations have advanced in DR agenda-setting, with five having a comprehensive national DESP and 11 in the early stages of implementation.Many nations use 2-4 fields fundus images, proven effective with 80-98% sensitivity and 86-100% specificity compared to the traditional seven-field evaluation for DR. A cell phone based screening with a hand held retinal camera presents a potential low-cost alternative as imaging device. While this method in low-resource settings may not entirely match the sensitivity and specificity of seven-field stereoscopic photography, positive outcomes are observed.Individualized DR screening intervals are the standard in many high-resource nations. In countries that lacks a national DESP and resources, screening are more sporadic, i.e. screening intervals are not evidence-based and often less frequently, which can lead to late recognition of treatment required DR.The rising global prevalence of DR poses an economic challenge to nationwide screening programs AI-algorithms have showed high sensitivity and specificity for detection of DR and could provide a promising solution for the future screening burden.In summary, this narrative review enlightens on the epidemiology of DR and the necessity for effective DR screening programs. Worldwide evolution in existing approaches for DR screening has showed promising results but has also revealed limitations. Technological advancements, such as handheld imaging devices, tele ophthalmology and artificial intelligence enhance cost-effectiveness, but also the accessibility of DR screening in countries with low resources or where distance to or a shortage of ophthalmologists exists.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.1186/s40942-024-00537-5
Tereza Kanadani, Neiffer Rabelo, Denise Takahashi, Lucas Magalhães, Michel Farah
Purpose: To evaluate the structural and functional changes in eyes with neovascular age related macular degeneration (nAMD) in a real-world setting, using Treat and Extend protocol (T&E), comparing four antiangiogenic agents.
Methods: Prospective, observational, case series study performed in 131 patients with the exudative form of nAMD. Patients were randomly assigned into four groups according to the antiangiogenic agent. During the first year, all eyes received at least 3 monthly intravitreal injections of antiangiogenic agents, and afterwards, were submitted to the T&E.
Results: There was statistically significant difference (p < 0.05) between pre- and post-treatment in the best corrected visual acuity measurements by drug used. Patients who used aflibercept had significantly fewer injections than patients using the other drugs (mean = 9.03). No significant difference was observed between the drugs bevacizumab, ranibizumab and ziv-aflibercept. With regard to biomarkers, patients who used aflibercept and had lower baseline central retinal thickness, absence of hyperreflective foci and no subretinal hyperreflective material had the lowest number of injections.
Conclusion: Results indicate that over 2 years, Intravitreal aflibercept on T&E provided better visual and anatomical improvements when compared to other drugs used in this study with significantly fewer injections.
{"title":"Comparison of antiangiogenic agents (ranibizumab, aflibercept, bevacizumab and ziv-aflibercept) in the therapeutic response to the exudative form of age-related macular degeneration according to the treat-and-extend protocol- true head-to-head study.","authors":"Tereza Kanadani, Neiffer Rabelo, Denise Takahashi, Lucas Magalhães, Michel Farah","doi":"10.1186/s40942-024-00537-5","DOIUrl":"10.1186/s40942-024-00537-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the structural and functional changes in eyes with neovascular age related macular degeneration (nAMD) in a real-world setting, using Treat and Extend protocol (T&E), comparing four antiangiogenic agents.</p><p><strong>Methods: </strong>Prospective, observational, case series study performed in 131 patients with the exudative form of nAMD. Patients were randomly assigned into four groups according to the antiangiogenic agent. During the first year, all eyes received at least 3 monthly intravitreal injections of antiangiogenic agents, and afterwards, were submitted to the T&E.</p><p><strong>Results: </strong>There was statistically significant difference (p < 0.05) between pre- and post-treatment in the best corrected visual acuity measurements by drug used. Patients who used aflibercept had significantly fewer injections than patients using the other drugs (mean = 9.03). No significant difference was observed between the drugs bevacizumab, ranibizumab and ziv-aflibercept. With regard to biomarkers, patients who used aflibercept and had lower baseline central retinal thickness, absence of hyperreflective foci and no subretinal hyperreflective material had the lowest number of injections.</p><p><strong>Conclusion: </strong>Results indicate that over 2 years, Intravitreal aflibercept on T&E provided better visual and anatomical improvements when compared to other drugs used in this study with significantly fewer injections.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.1186/s40942-024-00528-6
Po Hsiang Shawn Yuan, Arman Athwal, Mena Shalaby, Andrew Mehnert, Dao-Yi Yu, Rony C Preti, Marinko Sarunic, Eduardo V Navajas
Background: Diabetic retinopathy (DR) is a leading cause of blindness and involves retinal capillary damage, microaneurysms, and altered blood flow regulation. Optical coherence tomography angiography (OCTA) is a non-invasive way of visualizing retinal vasculature but has not been used extensively to study blood flow heterogeneity. The purpose of this study is to detect and quantify blood flow heterogeneity utilizing en-face swept source OCTA in patients with DR.
Methods: This is a prospective clinical study which examined patients with either type 1 or 2 diabetes mellitus. Each included eye was graded clinically as no DR, mild DR, or moderate-severe DR. Ten consecutive en face 6 × 6 mm foveal SS-OCTA images were obtained from each eye using a PLEX Elite 9000 (Zeiss Meditec, Dublin, CA). Built-in fixation-tracking, follow-up functions were utilized to reduce motion artifacts and ensure same location imaging in sequential frames. Images of the superficial and deep vascular complexes (SVC and DVC) were arranged in temporal stacks of 10 and registered to a reference frame for segmentation using a deep neural network. The vessel segmentation was then masked onto each stack to calculate the pixel intensity coefficient of variance (PICoV) and map the spatiotemporal perfusion heterogeneity of each stack.
Results: Twenty-nine eyes were included: 7 controls, 7 diabetics with no DR, 8 mild DR, and 7 moderate-severe DR. The PICoV correlated significantly and positively with DR severity. In patients with DR, the perfusion heterogeneity was higher in the temporal half of the macula, particularly in areas of capillary dropout. PICoV also correlates as expected with the established OCTA metrics of perfusion density and vessel density.
Conclusion: PICoV is a novel way to analyze OCTA imaging and quantify perfusion heterogeneity. Retinal capillary perfusion heterogeneity in both the SVC and DVC increased with DR severity. This may be related to the loss of retinal capillary perfusion autoregulation in diabetic retinopathy.
背景:糖尿病视网膜病变(DR)是导致失明的主要原因,涉及视网膜毛细血管损伤、微动脉瘤和血流调节改变。光学相干断层血管成像(OCTA)是一种无创的视网膜血管成像方法,但尚未广泛用于研究血流异质性。本研究的目的是利用面扫源 OCTA 对 DR 患者的血流异质性进行检测和量化:这是一项前瞻性临床研究,研究对象为 1 型或 2 型糖尿病患者。每只纳入研究的眼睛都被临床分级为无 DR、轻度 DR 或中重度 DR。使用 PLEX Elite 9000(Zeiss Meditec,Dublin,CA)获得了每只眼睛十张连续的正面 6 × 6 毫米眼窝 SS-OCTA 图像。利用内置的定点跟踪和随访功能减少运动伪影,并确保在连续帧中进行相同位置成像。浅层和深层血管复合体(SVC 和 DVC)的图像按 10 张的时间堆叠排列,并注册到参考帧上,以便使用深度神经网络进行分割。然后将血管分割结果掩盖在每个堆栈上,计算像素强度方差系数(PICoV),并绘制每个堆栈的时空灌注异质性图:结果:共纳入 29 只眼睛:结果:共纳入 29 只眼睛:7 只对照组、7 只无 DR 的糖尿病患者、8 只轻度 DR 和 7 只中重度 DR。PICoV与DR严重程度呈显著正相关。在 DR 患者中,黄斑颞半部分的灌注异质性较高,尤其是在毛细血管脱落的区域。PICoV 与已有的 OCTA 指标(灌注密度和血管密度)也有预期的相关性:结论:PICoV 是分析 OCTA 成像和量化灌注异质性的一种新方法。SVC和DVC的视网膜毛细血管灌注异质性随着DR的严重程度而增加。这可能与糖尿病视网膜病变导致的视网膜毛细血管灌注自动调节功能丧失有关。
{"title":"Retinal capillary perfusion heterogeneity in diabetic retinopathy detected by optical coherence tomography angiography.","authors":"Po Hsiang Shawn Yuan, Arman Athwal, Mena Shalaby, Andrew Mehnert, Dao-Yi Yu, Rony C Preti, Marinko Sarunic, Eduardo V Navajas","doi":"10.1186/s40942-024-00528-6","DOIUrl":"10.1186/s40942-024-00528-6","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a leading cause of blindness and involves retinal capillary damage, microaneurysms, and altered blood flow regulation. Optical coherence tomography angiography (OCTA) is a non-invasive way of visualizing retinal vasculature but has not been used extensively to study blood flow heterogeneity. The purpose of this study is to detect and quantify blood flow heterogeneity utilizing en-face swept source OCTA in patients with DR.</p><p><strong>Methods: </strong>This is a prospective clinical study which examined patients with either type 1 or 2 diabetes mellitus. Each included eye was graded clinically as no DR, mild DR, or moderate-severe DR. Ten consecutive en face 6 × 6 mm foveal SS-OCTA images were obtained from each eye using a PLEX Elite 9000 (Zeiss Meditec, Dublin, CA). Built-in fixation-tracking, follow-up functions were utilized to reduce motion artifacts and ensure same location imaging in sequential frames. Images of the superficial and deep vascular complexes (SVC and DVC) were arranged in temporal stacks of 10 and registered to a reference frame for segmentation using a deep neural network. The vessel segmentation was then masked onto each stack to calculate the pixel intensity coefficient of variance (PICoV) and map the spatiotemporal perfusion heterogeneity of each stack.</p><p><strong>Results: </strong>Twenty-nine eyes were included: 7 controls, 7 diabetics with no DR, 8 mild DR, and 7 moderate-severe DR. The PICoV correlated significantly and positively with DR severity. In patients with DR, the perfusion heterogeneity was higher in the temporal half of the macula, particularly in areas of capillary dropout. PICoV also correlates as expected with the established OCTA metrics of perfusion density and vessel density.</p><p><strong>Conclusion: </strong>PICoV is a novel way to analyze OCTA imaging and quantify perfusion heterogeneity. Retinal capillary perfusion heterogeneity in both the SVC and DVC increased with DR severity. This may be related to the loss of retinal capillary perfusion autoregulation in diabetic retinopathy.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To study the role of artificial intelligence (AI) to identify key risk factors for diabetic retinopathy (DR) screening and develop recommendations based on clinician and large language model (LLM) based AI platform opinions for newly detected diabetes mellitus (DM) cases.
Methods: Five clinicians and three AI applications were given 20 AI-generated hypothetical case scenarios to assess DR screening timing. We calculated inter-rater agreements between clinicians, AI-platforms, and the "majority clinician response" (defined as the maximum number of identical responses provided by the clinicians) and "majority AI-platform" (defined as the maximum number of identical responses among the 3 distinct AI). Scoring was used to identify risk factors of different severity. Three, two, and one points were given to risk factors requiring screening immediately, within a year, and within five years, respectively. After calculating a cumulative screening score, categories were assigned.
Results: Clinicians, AI platforms, and the "majority clinician response" and "majority AI response" had fair inter-rater reliability (k value: 0.21-0.40). Uncontrolled DM and systemic co-morbidities required immediate screening, while family history of DM and a co-existing pregnancy required screening within a year. The absence of these risk factors required screening within 5 years of DM diagnosis. Screening scores in this study were between 0 and 10. Cases with screening scores of 0-2 needed screening within 5 years, 3-5 within 1 year, and 6-12 immediately.
Conclusion: Based on the findings of this study, AI could play a critical role in DR screening of newly diagnosed DM patients by developing a novel DR screening score. Future studies would be required to validate the DR screening score before it could be used as a reference in real-life clinical situations.
{"title":"Recommendations for initial diabetic retinopathy screening of diabetic patients using large language model-based artificial intelligence in real-life case scenarios.","authors":"Nikhil Gopalakrishnan, Aishwarya Joshi, Jay Chhablani, Naresh Kumar Yadav, Nikitha Gurram Reddy, Padmaja Kumari Rani, Ram Snehith Pulipaka, Rohit Shetty, Shivani Sinha, Vishma Prabhu, Ramesh Venkatesh","doi":"10.1186/s40942-024-00533-9","DOIUrl":"10.1186/s40942-024-00533-9","url":null,"abstract":"<p><strong>Purpose: </strong>To study the role of artificial intelligence (AI) to identify key risk factors for diabetic retinopathy (DR) screening and develop recommendations based on clinician and large language model (LLM) based AI platform opinions for newly detected diabetes mellitus (DM) cases.</p><p><strong>Methods: </strong>Five clinicians and three AI applications were given 20 AI-generated hypothetical case scenarios to assess DR screening timing. We calculated inter-rater agreements between clinicians, AI-platforms, and the \"majority clinician response\" (defined as the maximum number of identical responses provided by the clinicians) and \"majority AI-platform\" (defined as the maximum number of identical responses among the 3 distinct AI). Scoring was used to identify risk factors of different severity. Three, two, and one points were given to risk factors requiring screening immediately, within a year, and within five years, respectively. After calculating a cumulative screening score, categories were assigned.</p><p><strong>Results: </strong>Clinicians, AI platforms, and the \"majority clinician response\" and \"majority AI response\" had fair inter-rater reliability (k value: 0.21-0.40). Uncontrolled DM and systemic co-morbidities required immediate screening, while family history of DM and a co-existing pregnancy required screening within a year. The absence of these risk factors required screening within 5 years of DM diagnosis. Screening scores in this study were between 0 and 10. Cases with screening scores of 0-2 needed screening within 5 years, 3-5 within 1 year, and 6-12 immediately.</p><p><strong>Conclusion: </strong>Based on the findings of this study, AI could play a critical role in DR screening of newly diagnosed DM patients by developing a novel DR screening score. Future studies would be required to validate the DR screening score before it could be used as a reference in real-life clinical situations.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}