抗vegf治疗下新生血管性年龄相关性黄斑变性视网膜液的定量评估

IF 2.3 Q2 OPHTHALMOLOGY Therapeutic Advances in Ophthalmology Pub Date : 2022-03-01 DOI:10.1177/25158414221083363
G. Reiter, U. Schmidt-Erfurth
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引用次数: 4

摘要

光学相干断层扫描(OCT)和抗血管内皮生长因子(VEGF)治疗已经彻底改变了视网膜世界。玻璃体内注射的数量在不断增加,新血管性年龄相关性黄斑变性(nAMD)的治疗主要是由OCT扫描检测到的黄斑液的定性评估驱动的。黄斑液的存在,特别是视网膜下液(SRF)和视网膜内液(IRF),已被用于触发临床试验和现实世界中的再治疗。然而,不同的读者或专家的评价之间可能存在很大的差异,特别是在这个过程中可能会遗漏少量的黄斑液。逐像素检测黄斑液使用整个OCT体积来计算视网膜液的精确体积。虽然这种逐像素液体检测的手动注释在临床环境中是不可行的,但人工智能(AI)能够通过提供不同视网膜隔室中黄斑液体的实时结果来克服这一障碍。定量体液评估已用于随机对照试验的各种事后分析,为抗vegf治疗方案提供了新的见解。尽管如此,人工智能算法在未来患者护理环境中的应用仍然有限。在这篇综述中,我们讨论了在抗vegf治疗期间定量液体评估在nAMD中的应用,并展望了人工智能定量支持下的新型患者护理形式。
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Quantitative assessment of retinal fluid in neovascular age-related macular degeneration under anti-VEGF therapy
The retinal world has been revolutionized by optical coherence tomography (OCT) and anti-vascular endothelial growth factor (VEGF) therapy. The numbers of intravitreal injections are on a constant rise and management in neovascular age-related macular degeneration (nAMD) is mainly driven by the qualitative assessment of macular fluid as detected on OCT scans. The presence of macular fluid, particularly subretinal fluid (SRF) and intraretinal fluid (IRF), has been used to trigger re-treatments in clinical trials and the real world. However, large discrepancies can be found between the evaluations of different readers or experts and especially small amounts of macular fluid might be missed during this process. Pixel-wise detection of macular fluid uses an entire OCT volume to calculate exact volumes of retinal fluid. While manual annotations of such pixel-wise fluid detection are unfeasible in a clinical setting, artificial intelligence (AI) is able to overcome this hurdle by providing real-time results of macular fluid in different retinal compartments. Quantitative fluid assessments have been used for various post hoc analyses of randomized controlled trials, providing novel insights into anti-VEGF treatment regimens. Nonetheless, the application of AI-algorithms in a prospective patient care setting is still limited. In this review, we discuss the use of quantitative fluid assessment in nAMD during anti-VEGF therapy and provide an outlook to novel forms of patient care with the support of AI quantifications.
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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
44
审稿时长
12 weeks
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