Retina-The Journal of Retinal and Vitreous Diseases最新文献

Purpose: To determine the feasibility of developing an artificial intelligence (AI) algorithm based on optical coherence tomography (OCT) images as an automated screening tool for diagnosing retinal thinning in children with sickle cell disease (SCD).

Methods: This retrospective consecutive series included children with SCD who had an ophthalmic examination at a Pediatric Tertiary Care Hospital, including OCT imaging between January 1998 and August 2022. Three different machine learning algorithms were evaluated: logistic regression, K-Nearest Neighbors (KNN), and random forest.

Results: A total of 348 OCT scans from 174 eyes of 87 patients (54% males) were included. Using the original data set, KNN algorithm outperformed both the random forest and logistic regression algorithms when using two OCT scans per patient. However, with cross-validation, this model's accuracy dropped to 77.11%. When duplicating the data set's values, the random forest algorithm performed best, demonstrating the highest accuracy after cross-validation of 96.0%, AUC, sensitivity, specificity, and a F1 score all reaching 1, when using one OCT scan per patient.

Conclusion: AI-based analysis of OCT imaging is a promising tool in the early detection of sickle cell maculopathy in the pediatric population.

Purpose: To detect retinal photoreceptors and arterioles alterations among individuals with diabetes mellitus (DM) and nonproliferative diabetic retinopathy (DR) at cellular resolution.

Methods: Thirty subjects were recruited in the Guangdong Diabetic Retinopathy Multiple-omics Study. Adaptive optics scanning laser ophthalmoscopy was adopted for image acquisition. An AI-based algorithm conducted quantitative analyses of photoreceptor morphology, including cone density, spacing, and regularity. Vessel morphology (inner diameter, outer diameter, wall thickness, wall-to-lumen ratio) was manually assessed. The arteriolar index ratio was derived to assess arteriolar remodeling. Generalized estimating equation was used to compare the differences of inner diameter, outer diameter, wall thickness, wall-to-lumen ratio, and the arteriolar index ratio among healthy control, DM, and DR groups.

Results: Thirty patients, consisting of 9 healthy controls, 11 with DM, and 10 with DR, were evaluated (mean [SD] age, 66.33 [7.02]). A significant reduction in photoreceptor cell density in macular areas correlated with the presence of DM ( P = 0.033) and DR ( P = 0.006). Notably, a significant increase of the wall thickness was observed. These variations were pronounced in the arteriole segments of diabetic patients ( P < 0.001) and escalated with the presence of DR ( P = 0.018). Accounting for wall-to-lumen ratio, the DR group showed a significantly larger ratio comparing to control group ( P = 0.011). The arteriolar index ratio in small retinal arterioles differed significantly among DR ( P < 0.001), DM ( P = 0.024), and control groups.

Conclusion: Adaptive optics scanning laser ophthalmoscopy imaging showed delineating retinal photoreceptor and arteriolar alterations throughout DR progression, potentially serving as a predictive measure for anatomical or functional retinal changes in patients with DM and DR.

Purpose: To describe a novel Optical Coherence Tomography (OCT) finding called "scolex sign" in cases of central serous chorioretinopathy(CSCR).

Methods: This retrospective multicenter study included CSCR patients with serous pigment epithelial detachments(PED) greater than 100µm, with or without subretinal fluid(SRF). Eyes showing a distinct hyperreflective focus on the PED wall(scolex sign) were analyzed. An equal number of age-matched controls with PEDs but without the scolex sign were included. Multimodal imaging data were reviewed. A subgroup analysis based on SRF status was also performed.

Results: Of 291 eyes with large serous PEDs, 52 eyes exhibited the "scolex sign" and were compared to 52 age-matched controls. Baseline characteristics including gender, systemic comorbidities, best recorded visual acuity(BRVA) and OCT parameters were similar in both the groups. However eyes with "scolex" sign exhibited more number of central PEDs and shorter distance from foveal centre. On follow-up, eyes with "scolex" sign showed a higher rate of PED flattening and SRF resolution trended to be higher compared to controls.

Conclusion: The "scolex" sign represents a novel, benign OCT feature seen in a subset of CSCR cases. While not associated with poorer outcomes or adverse sequalae, it may reflect ongoing reparative changes, indicating a resolving stage of the disease.

Purpose: To compare anatomical and functional outcomes as well as postoperative complication rates between cryotherapy and illuminated endolaser retinopexy in chandelier-assisted scleral buckling (CASB) for rhegmatogenous retinal detachment (RRD).

Methods: This retrospective study included 63 eyes from 63 patients treated with CASB between January 2021 and January 2024. Group 1 (n=31) underwent retinopexy with cryotherapy, while Group 2 (n=32) received illuminated endolaser through the same cannula as the chandelier light. All surgeries were performed using a noncontact wide-angle viewing system (WAVS) by a single experienced vitreoretinal surgeon. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), swept-source OCT, and postoperative complications.

Results: Mean BCVA improved significantly in both groups. In Group 1, BCVA improved from 1.39 ± 0.74 logMAR (approx. Snellen 20/490) to 1.01 ± 0.63 (20/204), p<0.001. In Group 2, BCVA improved from 1.50 ± 0.67 (20/632) to 1.14 ± 0.66 (20/276), p<0.001. Final BCVA (p=0.21) and retinal reattachment rates (p=0.67) were similar. However, cystoid macular edema occurred significantly more in Group 1 (19.3%) than in Group 2 (3.1%) (p=0.04). Rates of epiretinal membrane, cataract, and IOP elevation did not differ significantly (p>0.05). No buckle exposure or infection was observed.

Conclusion: Both techniques are effective for CASB. Endolaser provides a lower risk of CME and enhanced surgical precision, suggesting it may be a favorable option in selected cases.