Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 25.380
Filtrar
1.
Sci Rep ; 14(1): 5079, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429319

RESUMO

The differential diagnosis for optic atrophy can be challenging and requires expensive, time-consuming ancillary testing to determine the cause. While Leber's hereditary optic neuropathy (LHON) and optic neuritis (ON) are both clinically significant causes for optic atrophy, both relatively rare in the general population, contributing to limitations in obtaining large imaging datasets. This study therefore aims to develop a deep learning (DL) model based on small datasets that could distinguish the cause of optic disc atrophy using only fundus photography. We retrospectively reviewed fundus photographs of 120 normal eyes, 30 eyes (15 patients) with genetically-confirmed LHON, and 30 eyes (26 patients) with ON. Images were split into a training dataset and a test dataset and used for model training with ResNet-18. To visualize the critical regions in retinal photographs that are highly associated with disease prediction, Gradient-Weighted Class Activation Map (Grad-CAM) was used to generate image-level attention heat maps and to enhance the interpretability of the DL system. In the 3-class classification of normal, LHON, and ON, the area under the receiver operating characteristic curve (AUROC) was 1.0 for normal, 0.988 for LHON, and 0.990 for ON, clearly differentiating each class from the others with an overall total accuracy of 0.93. Specifically, when distinguishing between normal and disease cases, the precision, recall, and F1 scores were perfect at 1.0. Furthermore, in the differentiation of LHON from other conditions, ON from others, and between LHON and ON, we consistently observed precision, recall, and F1 scores of 0.8. The model performance was maintained until only 10% of the pixel values of the image, identified as important by Grad-CAM, were preserved and the rest were masked, followed by retraining and evaluation.


Assuntos
Aprendizado Profundo , Atrofia Óptica Hereditária de Leber , Disco Óptico , Neurite Óptica , Humanos , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Estudos Retrospectivos , Atrofia Óptica Hereditária de Leber/patologia , Neurite Óptica/patologia , Fotografação , Atrofia/patologia
2.
Acta Derm Venereol ; 104: adv27985, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38501841

RESUMO

Timely intervention reduces the risk of a poor prognosis in hand eczema, making early recognition of symptoms important in high-risk professions. However, limited data exist regarding the ability of cleaners and healthcare workers to recognize hand eczema. The aim of this study was to examine cleaners' and healthcare workers' ability to recognize hand eczema in clinical photographs and to assess the severity of the disease. Cleaners and healthcare workers completed a questionnaire consisting of 16 questions and participated in a structured interview referring to a validated photographic severity guide for chronic hand eczema, which comprised clinical photographs of hand eczema at varying levels of severity. Eighty cleaners and 201 healthcare workers (total N = 281) participated in the study. The rates of correctly identified hand eczema in clinical photographs (cleaners/ healthcare workers) were: 41.2%/57.7% (mild hand eczema), 81.2%/92.0% (moderate hand eczema), 85.0%/94.5% (severe hand eczema) and 82.5%/97.0% (very severe hand eczema). The proficiency of healthcare workers in recognizing hand eczema was significantly higher than that of cleaners. The results indicate that a large proportion of cleaners and healthcare workers fail to recognize mild hand eczema in clinical photographs. Healthcare workers had higher success rates in recognizing hand eczema in all severity categories. Symptom underestimation may lead to under-reporting of the true prevalence of hand eczema, with consequent loss of opportunities for prevention.


Assuntos
Dermatite Ocupacional , Eczema , Dermatoses da Mão , Humanos , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/prevenção & controle , Eczema/diagnóstico , Eczema/epidemiologia , Pessoal de Saúde , Fotografação , Inquéritos e Questionários , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/epidemiologia , Dermatoses da Mão/prevenção & controle
3.
J Safety Res ; 88: 31-40, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38485373

RESUMO

INTRODUCTION: This research examines the effectiveness of point-to-point speed cameras in Thailand compared with spot speed camera enforcement, which is widely used in the country. METHOD: The evaluation includes the speed control's efficiency by observing the 85th percentile average speed of drivers on the road; the speed detection rate; conducting a comparison with spot speed camera enforcement; and a cost effectiveness analysis of this measure. RESULTS: After speed detection using point-to-point cameras were employed during which warning tickets were issued in many days of experiment, the 85th percentile average speed in the controlled area decreased by 10 km/hr, with a maximum decrease of 20 km/hr. When comparing the detection rate of the two camera models, point-to-point cameras could detect 95% of drivers' driving speed, with 45% of the detected drivers identified as speeding drivers, while spot speed cameras were only able to detect 10% to 20% of speeders. Drivers traveling through the area with point-to-point cameras were more likely to drive at a constant speed throughout the average speed detection area. PRACTICAL APPLICATIONS: The point-to-point camera system is determined to be quite cost-effective.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Humanos , Acidentes de Trânsito/prevenção & controle , Tailândia , Aplicação da Lei , Fotografação
4.
Accid Anal Prev ; 199: 107525, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38442631

RESUMO

Reduced speeds and increased speed compliance are crucial for achieving increased road traffic safety, cutting across most Safe System interventions. Speed cameras have been shown to be effective in increasing speed compliance and reducing the number of fatalities and seriously injured. The speed cameras system in Sweden is different compared to many other countries, spot speed cameras are almost always placed in series along a road stretch. The aim of this study is to investigate the effects of this system on mean speeds, speed compliance, and on the number of fatalities and seriously injured. Including 20 years of data, the study applies before-after analysis to 361 speed measurement spots, and Empirical Bayes before-after analysis with control to crash outcomes on 202 road sections. The results show a mean speed decrease of 3.5 km/h for all vehicles and road sections, 7.9 km/h at cameras and 3.0 km/h between cameras. Furthermore, follow-up measurements showed that the effects were maintained long-term. Speed compliance increased 16 %-units, 42 %-units at cameras and 13 %-units between cameras. Though larger effects can be seen at cameras, there are still substantial effects on the enforced road sections between cameras. The cameras had an average effect of 38.6 % on decreasing fatalities and may also suggest a decrease for seriously injured, though not statistically significant. This study also shows that for roads that received both a decreased speed limit from 90 to 80 km/h and speed cameras, the mean speeds were reduced by additionally 3.6 km/h compared to roads with unchanged limits of 90 km/h. The combined effect on fatalities and seriously injured was a reduction by 61.6 % and 33.4 %. In conclusion, the Swedish strategy with spot speed cameras in a series led to an increased speed compliance and a comprehensive reduction in mean speeds and of the number of fatalities.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Humanos , Acidentes de Trânsito/prevenção & controle , Teorema de Bayes , Fotografação , Suécia , Segurança
5.
Echocardiography ; 41(3): e15798, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38516863

RESUMO

Editing of 3D raw images acquired during transesophageal echocardiography could be similar to the post processing of raw images with digital software used in photography. 3D image editing in echocardiography is often underestimated in clinical practice, and people are satisfied with the first 3D image they are able to obtain during transesophageal examination. In fact, it is often believed to represent solely an aesthetic addition that does not change the information already obtained with 2D and baseline 3D. In reality, it represents a crucial moment to better understand the mechanisms of mitral pathology, avoiding artifacts and misjudgments. The importance of acquiring raw 3D images of the valve having all the necessary information (ring, the leaflet in toto, the right frame rate) allows us then to edit them making them more beautiful and clearer from the point of view of the information received. Nevertheless, by exclusively acquiring a raw 3D with all the necessary information, we can quickly finish the transesophageal examination, reducing its duration and discomfort for the patient, as well as the inherent risk of complications related to the procedure per se.


Assuntos
Ecocardiografia Tridimensional , Insuficiência da Valva Mitral , Humanos , Valva Mitral/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos , Fotografação
6.
Dental Press J Orthod ; 29(1): e2423285, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38451570

RESUMO

OBJECTIVE: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. METHODS: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). RESULTS: Individuals' mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. CONCLUSION: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established.


Assuntos
Oclusão Dentária , Má Oclusão , Criança , Lactente , Humanos , Pré-Escolar , Estudos Prospectivos , Fotografação , Erupção Dentária
7.
Biomed Eng Online ; 23(1): 32, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38475784

RESUMO

PURPOSE: This study aimed to investigate the imaging repeatability of self-service fundus photography compared to traditional fundus photography performed by experienced operators. DESIGN: Prospective cross-sectional study. METHODS: In a community-based eye diseases screening site, we recruited 65 eyes (65 participants) from the resident population of Shanghai, China. All participants were devoid of cataract or any other conditions that could potentially compromise the quality of fundus imaging. Participants were categorized into fully self-service fundus photography or traditional fundus photography group. Image quantitative analysis software was used to extract clinically relevant indicators from the fundus images. Finally, a statistical analysis was performed to depict the imaging repeatability of fully self-service fundus photography. RESULTS: There was no statistical difference in the absolute differences, or the extents of variation of the indicators between the two groups. The extents of variation of all the measurement indicators, with the exception of the optic cup area, were below 10% in both groups. The Bland-Altman plots and multivariate analysis results were consistent with results mentioned above. CONCLUSIONS: The image repeatability of fully self-service fundus photography is comparable to that of traditional fundus photography performed by professionals, demonstrating promise in large-scale eye disease screening programs.


Assuntos
Serviços de Saúde Comunitária , Glaucoma , Humanos , Estudos Transversais , Estudos Prospectivos , China , Fotografação/métodos , Fundo de Olho
8.
Int Ophthalmol ; 44(1): 41, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38334896

RESUMO

Diabetic retinopathy (DR) is the leading global cause of vision loss, accounting for 4.8% of global blindness cases as estimated by the World Health Organization (WHO). Fundus photography is crucial in ophthalmology as a diagnostic tool for capturing retinal images. However, resource and infrastructure constraints limit access to traditional tabletop fundus cameras in developing countries. Additionally, these conventional cameras are expensive, bulky, and not easily transportable. In contrast, the newer generation of handheld and smartphone-based fundus cameras offers portability, user-friendliness, and affordability. Despite their potential, there is a lack of comprehensive review studies examining the clinical utilities of these handheld (e.g. Zeiss Visuscout 100, Volk Pictor Plus, Volk Pictor Prestige, Remidio NMFOP, FC161) and smartphone-based (e.g. D-EYE, iExaminer, Peek Retina, Volk iNview, Volk Vistaview, oDocs visoScope, oDocs Nun, oDocs Nun IR) fundus cameras. This review study aims to evaluate the feasibility and practicality of these available handheld and smartphone-based cameras in medical settings, emphasizing their advantages over traditional tabletop fundus cameras. By highlighting various clinical settings and use scenarios, this review aims to fill this gap by evaluating the efficiency, feasibility, cost-effectiveness, and remote capabilities of handheld and smartphone fundus cameras, ultimately enhancing the accessibility of ophthalmic services.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Oftalmopatias , Humanos , Retinopatia Diabética/diagnóstico , Smartphone , Fundo de Olho , Retina , Oftalmopatias/diagnóstico , Fotografação/métodos , Cegueira
9.
Nature ; 626(8001): 1049-1055, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38355800

RESUMO

Each year, people spend less time reading and more time viewing images1, which are proliferating online2-4. Images from platforms such as Google and Wikipedia are downloaded by millions every day2,5,6, and millions more are interacting through social media, such as Instagram and TikTok, that primarily consist of exchanging visual content. In parallel, news agencies and digital advertisers are increasingly capturing attention online through the use of images7,8, which people process more quickly, implicitly and memorably than text9-12. Here we show that the rise of images online significantly exacerbates gender bias, both in its statistical prevalence and its psychological impact. We examine the gender associations of 3,495 social categories (such as 'nurse' or 'banker') in more than one million images from Google, Wikipedia and Internet Movie Database (IMDb), and in billions of words from these platforms. We find that gender bias is consistently more prevalent in images than text for both female- and male-typed categories. We also show that the documented underrepresentation of women online13-18 is substantially worse in images than in text, public opinion and US census data. Finally, we conducted a nationally representative, preregistered experiment that shows that googling for images rather than textual descriptions of occupations amplifies gender bias in participants' beliefs. Addressing the societal effect of this large-scale shift towards visual communication will be essential for developing a fair and inclusive future for the internet.


Assuntos
Ocupações , Fotografação , Sexismo , Mídias Sociais , Feminino , Humanos , Masculino , Ocupações/estatística & dados numéricos , Fotografação/estatística & dados numéricos , Fotografação/tendências , Opinião Pública , Sexismo/prevenção & controle , Sexismo/psicologia , Sexismo/estatística & dados numéricos , Sexismo/tendências , Mídias Sociais/estatística & dados numéricos , Mudança Social
11.
J Biomed Opt ; 29(Suppl 1): S11524, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38292055

RESUMO

Significance: Compressed ultrafast photography (CUP) is currently the world's fastest single-shot imaging technique. Through the integration of compressed sensing and streak imaging, CUP can capture a transient event in a single camera exposure with imaging speeds from thousands to trillions of frames per second, at micrometer-level spatial resolutions, and in broad sensing spectral ranges. Aim: This tutorial aims to provide a comprehensive review of CUP in its fundamental methods, system implementations, biomedical applications, and prospect. Approach: A step-by-step guideline to CUP's forward model and representative image reconstruction algorithms is presented with sample codes and illustrations in Matlab and Python. Then, CUP's hardware implementation is described with a focus on the representative techniques, advantages, and limitations of the three key components-the spatial encoder, the temporal shearing unit, and the two-dimensional sensor. Furthermore, four representative biomedical applications enabled by CUP are discussed, followed by the prospect of CUP's technical advancement. Conclusions: CUP has emerged as a state-of-the-art ultrafast imaging technology. Its advanced imaging ability and versatility contribute to unprecedented observations and new applications in biomedicine. CUP holds great promise in improving technical specifications and facilitating the investigation of biomedical processes.


Assuntos
Processamento de Imagem Assistida por Computador , Fotografação , Fotografação/métodos , Processamento de Imagem Assistida por Computador/métodos , Algoritmos
12.
J Prosthet Dent ; 131(2): 175-176, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38238214

RESUMO

Clinical documentation is critical in dental practices. Its influence reaches beyond diagnosis and treatment planning to patient education and evidence-based research. Historically, this documentation has relied mainly on photographic recordings. However, in the present era of rapid technical breakthroughs, a paradigm shift has occurred from photography to videography, driven by the transition from digital single-lens reflex (DSLR) cameras to mirrorless systems, which provide improved video capabilities. This article explores the technological journey from dental photography to videography, highlighting the need for revised and standardized clinical documenting methods to accommodate this changing landscape. It also includes a complete guide to maximizing the capabilities of mirrorless cameras and green screen technologies for the creation of high-quality video content. The essential element of protecting data privacy and security in the midst of these developments is also explored, providing a comprehensive view of the paradigm shift in dental clinical documentation.


Assuntos
Documentação , Fotografação , Humanos , Fotografia Dentária
13.
J Med Syst ; 48(1): 14, 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38227131

RESUMO

Many automated approaches have been proposed in literature to quantify clinically relevant wound features based on image processing analysis, aiming at removing human subjectivity and accelerate clinical practice. In this work we present a fully automated image processing pipeline leveraging deep learning and a large wound segmentation dataset to perform wound detection and following prediction of the Photographic Wound Assessment Tool (PWAT), automatizing the clinical judgement of the adequate wound healing. Starting from images acquired by smartphone cameras, a series of textural and morphological features are extracted from the wound areas, aiming to mimic the typical clinical considerations for wound assessment. The resulting extracted features can be easily interpreted by the clinician and allow a quantitative estimation of the PWAT scores. The features extracted from the region-of-interests detected by our pre-trained neural network model correctly predict the PWAT scale values with a Spearman's correlation coefficient of 0.85 on a set of unseen images. The obtained results agree with the current state-of-the-art and provide a benchmark for future artificial intelligence applications in this research field.


Assuntos
Inteligência Artificial , Benchmarking , Humanos , Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Fotografação
14.
J Drugs Dermatol ; 23(1): 1311-1318, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38206150

RESUMO

BACKGROUND: AbobotulinumtoxinA (aboBoNT-A) is useful for the treatment of platysmal banding. This study evaluated the efficacy and safety of a standardized 2-staged injection technique using high doses of AboBoNT-A for treating platysmal banding. METHODS: This was a randomized, double-blinded, dose-ranging prospective study. Subjects included adults with moderate-to-severe platysmal bands (grade 3 or 4 on the validated 5-point photographic scale), who received either 120 U (Cohort 1) or 180 U (Cohort 2) of aboBoNT-A, followed by an optional 90 U touch-up. The relatively higher on-label concentration of aboBoNT-A was used (1.5 mL/300 units) to reduce the volume injected and the risk of spread to adjacent muscles. Subjects were followed for 5 months, with safety and efficacy endpoints evaluated by the Investigator Live Assessment (ILA) and Subject Live Assessment (SLA). RESULTS: Twenty women were included in the analysis. Cohort 1 and Cohort 2 had 100% and 90% responder rates (achieved grade 1 or 2) during maximal contraction at month 1 with ILA. Cohort 2 had more subjects with 2 or greater grade improvement at maximal contraction using both ILA and SLA. Cohort 2 also had longer time to loss of grade 1 or 2 at maximal contraction compared with Cohort 1. No major adverse reactions occurred, but 3 subjects experienced transient positional neck weakness. CONCLUSION: We demonstrate a standardized 2-stage injection technique using aboBoNT-A for effectively treating moderate-to-severe platysmal banding. We used relatively higher doses while maintaining a good safety profile by using the more concentrated on-label volume of reconstitution for aboBoNT-A and by including a touch-up. J Drugs Dermatol. 2024;23(1):1311-1318.     doi:10.36849/JDD.7537.


Assuntos
Toxinas Botulínicas Tipo A , Adulto , Feminino , Humanos , Toxinas Botulínicas Tipo A/efeitos adversos , Fotografação , Estudos Prospectivos , Método Duplo-Cego
15.
Head Face Med ; 20(1): 7, 2024 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-38267982

RESUMO

BACKGROUND: New 3D technologies for superficial soft tissue changes, especially in plastic and reconstructive surgical procedures, can improve the planning and documentation of facial surgeries. The purpose of this study was to compare and determine the applicability and feasibility of three different 3D-photography systems in clinical practice imaging the nose. METHODS: A total of 16 healthy non-operated noses were included in this prospective study. A plaster model of each nose was produced, digitized, and converted to a .stl mesh (= ground truth model). Three-dimensional images of each nose were then taken using Artec Space Spider (gold standard), Planmeca ProFace®, and the Bellus3D Dental Pro application. All resulting .stl files were aligned to the ground truth model using MeshLab software, and the root mean square error (RMSE), mean surface distance (MSD), and Hausdorff distance (HD) were calculated. RESULTS: The Artec Space Spider 3D-photography system showed significantly better results compared to the two other systems in regard to RMSE, MSD, and HD (each p < 0.001). There was no significant difference between Planmeca ProFace® and Bellus3D Dental Pro in terms of RMSE, MSD, and HD. Overall, all three camera systems showed a clinically acceptable deviation to the reference model (range: -1.23-1.57 mm). CONCLUSIONS: The three evaluated 3D-photography systems were suitable for nose imaging in the clinical routine. While Artec Space Spider showed the highest accuracy, the Bellus3D Dental Pro app may be the most feasible option for everyday clinical use due to its portability, ease of use, and low cost. This study presents three different systems, allowing readers to extrapolate to other systems when planning to introduce 3D photography in the clinical routine.


Assuntos
Imageamento Tridimensional , Procedimentos de Cirurgia Plástica , Estudos Prospectivos , Fotografação , Nariz/diagnóstico por imagem
16.
Indian J Ophthalmol ; 72(Suppl 2): S280-S296, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38271424

RESUMO

PURPOSE: To compare the quantification of intraretinal hard exudate (HE) using en face optical coherence tomography (OCT) and fundus photography. METHODS: Consecutive en face images and corresponding fundus photographs from 13 eyes of 10 patients with macular edema associated with diabetic retinopathy or Coats' disease were analyzed using the machine-learning-based image analysis tool, "ilastik." RESULTS: The overall measured HE area was greater with en face images than with fundus photos (en face: 0.49 ± 0.35 mm2 vs. fundus photo: 0.34 ± 0.34 mm2, P < 0.001). However, there was an excellent correlation between the two measurements (intraclass correlation coefficient [ICC] = 0.844). There was a negative correlation between HE area and central macular thickness (CMT) (r = -0.292, P = 0.001). However, HE area showed a positive correlation with CMT in the previous several months, especially in eyes treated with anti-vascular endothelial growth factor (VEGF) therapy (CMT 3 months before: r = 0.349, P = 0.001; CMT 4 months before: r = 0.287, P = 0.012). CONCLUSION: Intraretinal HE can be reliably quantified from either en face OCT images or fundus photography with the aid of an interactive machine learning-based image analysis tool. HE area changes lagged several months behind CMT changes, especially in eyes treated with anti-VEGF injections.


Assuntos
Retinopatia Diabética , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Estudos Retrospectivos , Técnicas de Diagnóstico Oftalmológico , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/complicações , Fotografação/métodos , Exsudatos e Transudatos/metabolismo
17.
BMC Med Inform Decis Mak ; 24(1): 25, 2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38273286

RESUMO

BACKGROUND: The epiretinal membrane (ERM) is a common retinal disorder characterized by abnormal fibrocellular tissue at the vitreomacular interface. Most patients with ERM are asymptomatic at early stages. Therefore, screening for ERM will become increasingly important. Despite the high prevalence of ERM, few deep learning studies have investigated ERM detection in the color fundus photography (CFP) domain. In this study, we built a generative model to enhance ERM detection performance in the CFP. METHODS: This deep learning study retrospectively collected 302 ERM and 1,250 healthy CFP data points from a healthcare center. The generative model using StyleGAN2 was trained using single-center data. EfficientNetB0 with StyleGAN2-based augmentation was validated using independent internal single-center data and external datasets. We randomly assigned healthcare center data to the development (80%) and internal validation (20%) datasets. Data from two publicly accessible sources were used as external validation datasets. RESULTS: StyleGAN2 facilitated realistic CFP synthesis with the characteristic cellophane reflex features of the ERM. The proposed method with StyleGAN2-based augmentation outperformed the typical transfer learning without a generative adversarial network. The proposed model achieved an area under the receiver operating characteristic (AUC) curve of 0.926 for internal validation. AUCs of 0.951 and 0.914 were obtained for the two external validation datasets. Compared with the deep learning model without augmentation, StyleGAN2-based augmentation improved the detection performance and contributed to the focus on the location of the ERM. CONCLUSIONS: We proposed an ERM detection model by synthesizing realistic CFP images with the pathological features of ERM through generative deep learning. We believe that our deep learning framework will help achieve a more accurate detection of ERM in a limited data setting.


Assuntos
Aprendizado Profundo , Membrana Epirretiniana , Humanos , Membrana Epirretiniana/diagnóstico por imagem , Estudos Retrospectivos , Técnicas de Diagnóstico Oftalmológico , Fotografação/métodos
18.
Diabetes Care ; 47(2): 304-319, 2024 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-38241500

RESUMO

BACKGROUND: Diabetic macular edema (DME) is the leading cause of vision loss in people with diabetes. Application of artificial intelligence (AI) in interpreting fundus photography (FP) and optical coherence tomography (OCT) images allows prompt detection and intervention. PURPOSE: To evaluate the performance of AI in detecting DME from FP or OCT images and identify potential factors affecting model performances. DATA SOURCES: We searched seven electronic libraries up to 12 February 2023. STUDY SELECTION: We included studies using AI to detect DME from FP or OCT images. DATA EXTRACTION: We extracted study characteristics and performance parameters. DATA SYNTHESIS: Fifty-three studies were included in the meta-analysis. FP-based algorithms of 25 studies yielded pooled area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity of 0.964, 92.6%, and 91.1%, respectively. OCT-based algorithms of 28 studies yielded pooled AUROC, sensitivity, and specificity of 0.985, 95.9%, and 97.9%, respectively. Potential factors improving model performance included deep learning techniques, larger size, and more diversity in training data sets. Models demonstrated better performance when validated internally than externally, and those trained with multiple data sets showed better results upon external validation. LIMITATIONS: Analyses were limited by unstandardized algorithm outcomes and insufficient data in patient demographics, OCT volumetric scans, and external validation. CONCLUSIONS: This meta-analysis demonstrates satisfactory performance of AI in detecting DME from FP or OCT images. External validation is warranted for future studies to evaluate model generalizability. Further investigations may estimate optimal sample size, effect of class balance, patient demographics, and additional benefits of OCT volumetric scans.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Edema Macular , Humanos , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/complicações , Edema Macular/diagnóstico por imagem , Edema Macular/etiologia , Inteligência Artificial , Tomografia de Coerência Óptica/métodos , Fotografação/métodos
19.
Klin Monbl Augenheilkd ; 241(1): 75-83, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38242135

RESUMO

Cataract is among the leading causes of visual impairment worldwide. Innovations in treatment have drastically improved patient outcomes, but to be properly implemented, it is necessary to have the right diagnostic tools. This review explores the cataract grading systems developed by researchers in recent decades and provides insight into both merits and limitations. To this day, the gold standard for cataract classification is the Lens Opacity Classification System III. Different cataract features are graded according to standard photographs during slit lamp examination. Although widely used in research, its clinical application is rare, and it is limited by its subjective nature. Meanwhile, recent advancements in imaging technology, notably Scheimpflug imaging and optical coherence tomography, have opened the possibility of objective assessment of lens structure. With the use of automatic lens anatomy detection software, researchers demonstrated a good correlation to functional and surgical metrics such as visual acuity, phacoemulsification energy, and surgical time. The development of deep learning networks has further increased the capability of these grading systems by improving interpretability and increasing robustness when applied to norm-deviating cases. These classification systems, which can be used for both screening and preoperative diagnostics, are of value for targeted prospective studies, but still require implementation and validation in everyday clinical practice.


Assuntos
Catarata , Cristalino , Facoemulsificação , Humanos , Estudos Prospectivos , Fotografação/métodos , Catarata/diagnóstico , Acuidade Visual , Facoemulsificação/métodos
20.
Med Biol Eng Comput ; 62(2): 449-463, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37889431

RESUMO

Recently, fundus photography (FP) is being increasingly used. Corneal curvature is an essential factor in refractive errors and is associated with several pathological corneal conditions. As FP-based examination systems have already been widely distributed, it would be helpful for telemedicine to extract information such as corneal curvature using FP. This study aims to develop a deep learning model based on FP for corneal curvature prediction by categorizing corneas into steep, regular, and flat groups. The EfficientNetB0 architecture with transfer learning was used to learn FP patterns to predict flat, regular, and steep corneas. In validation, the model achieved a multiclass accuracy of 0.727, a Matthews correlation coefficient of 0.519, and an unweighted Cohen's κ of 0.590. The areas under the receiver operating characteristic curves for binary prediction of flat and steep corneas were 0.863 and 0.848, respectively. The optic nerve and its peripheral areas were the main focus of the model. The developed algorithm shows that FP can potentially be used as an imaging modality to estimate corneal curvature in the post-COVID-19 era, whereby patients may benefit from the detection of abnormal corneal curvatures using FP in the telemedicine setting.


Assuntos
COVID-19 , Aprendizado Profundo , Humanos , Técnicas de Diagnóstico Oftalmológico , Córnea/diagnóstico por imagem , Fotografação
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...