Comparing the Clinical Viability of Automated Fundus Image Segmentation Methods.

Recent methods for automatic blood vessel segmentation from fundus images have been commonly implemented as convolutional neural networks. While these networks report high values for objective metrics, the clinical viability of recovered segmentation masks remains unexplored. In this paper, we perform a pilot study to assess the clinical viability of automatically generated segmentation masks in the diagnosis of diseases affecting retinal vascularization. Five ophthalmologists with clinical experience were asked to participate in the study. The results demonstrate low classification accuracy, inferring that generated segmentation masks cannot be used as a standalone resource in general clinical practice. The results also hint at possible clinical infeasibility in experimental design. In the follow-up experiment, we evaluate the clinical quality of masks by having ophthalmologists rank generation methods. The ranking is established with high intra-observer consistency, indicating better subjective performance for a subset of tested networks. The study also demonstrates that objective metrics are not correlated with subjective metrics in retinal segmentation tasks for the methods involved, suggesting that objective metrics commonly used in scientific papers to measure the method's performance are not plausible criteria for choosing clinically robust solutions.

Analysis of the influence of type of diabetes mellitus on the development and type of glaucoma.

AIM: Main the goal of the research is to analyze the occurrence of glaucoma in patients with diabetes mellitus type 1 (DM type 1) and diabetes mellitus type 2 (DM type 2). PATIENTS AND METHODS: The study involved 140 patients, 34 with DM type 1 and 106 with DM type2. In relation to the type of glaucoma to the patients are divided into two groups: Primary and Secondary glaucoma. According to the stage of diabetic retinopathy (DR) patients were analyzed in three groups: non-proliferative, preproliferative and proliferative DR. Since ophthalmological parameters were analyzed: best corrected visual acuity (BCVA), intraocular pressure (IOP), visual field (VF) of computerized perimetry, excavatio optic nerve (E/D) by optic coherent tomography (OCT). RESULTS: Applying the test of quotient chance found that subjects with DM type 1 have a 5.94 times greater chance of developing secondary glaucoma, but is of primary (P <0.0001). In patients with DM type 2, where the chance of getting the subjects of secondary glaucoma 4.43 times larger than that of the primary (P = 0.0002). CONCLUSION: Patients with DM type have great chance of developing secondary glaucoma of the primary. Primary glaucoma more common in NPDR but secondary glaucoma more common in PDR.

Ocular findings in patient with primary familial pulmonary hypertension.

Exudative retinal detachment as subretinal fluid accumulation occurs due to chorioretinal eye disease (inflammation, infection, tumor, vascular abnormalities) and in systemic diseases too. The aim of this case report was to emphasize connection between the ophthalmological pathology and other systemic conditions. This is a case report of a 45-year old woman who suffered from pulmonary hypertension caused by many recurrent thromboembolic events. During one of eight previous hospitalizations she complained of blurred vision. Bilateral exudative detachment is diagnosed by an ophthalmologist. Parenteral steroids and acetazolamide provided quick recovery.

Acute posterior multifocal placoid pigment epitheliopathy-retinal "white dot syndrome".

Acute posterior multifocal placoid pigment epitheliopathy- APMPPE is an acquired idiopathic inflammatory disease of the chorioretina. This case report presents a typical clinical manifestation of a very rare condition: a twenty ive-year old female complained of a sudden bilateral decrease of vision. She reported lu-like symptoms and taking antibiotics therapy. Fundus examination revealed numerous discrete yellow-white lesions at posterior pole involving the macula. After a period of 7 days oral prednisone treatment she was completely recovered. Usage of steroids is recommended for treating APMPPE in cases where macula is involved and in recurrent cases.

[Tests of screening criteria for retinopathy of prematurity].

INTRODUCTION: Retinopathy of prematurity is a disease of the eye, i.e. the retinal blood vessels, which occurs exclusively in premature infants. The level of blindness in one country depends on the level of development of neonatal care and the opportunities to implement screening. The aim of this study was to examine the possibilities of changing screening criteria, provided that not a single child was left out from the survey. MATERIAL AND METHODS: A two-year prospective study, which was carried out in the period from January 1st 2007 to December 31st 2008, included 191 premature infants who were treated at the Institute for Child and Youth Healthcare of Vojvodina. RESULTS: Different inclusion criteria regarding body mass and gestational age were applied for screening retinopathy of prematurity and we assessed the coverage of the sample if certain screening criteria were applied. According to the results of the research, when the applied screening criterion was 37/2000, there was not a single case of a blind, prematurely born baby. DISCUSSION: Great migrations of population as well as big differences in characteristics of premature infants together with underlying multi-factor diseases besides retinopathy of prematurity send a warning signal to be very cautious. CONCLUSION: Although this study has given ground to shift the limits of screening, we will adhere to broad screening criteria.

The importance of timely ophthalmologic examination in preterm infants at risk of retinopathy occurrence.

BACKGROUND/AIM: Retinopathy of prematurity (ROP) is a multifactorial disease in premature infants. The aim of this study was to determine the incidence of ROP in children treated at the Center of Neonatology, Pediatric Clinic, Clinical Center in Kragujevac, Serbia. METHODS: The study covered all children with birth weight below 2,000 g and/or gestational age below the 37th week, who from June 2006 to December 2009 underwent ophthalmological examination for ROP. The results of fundoscopy were classified in accordance with the International Classification of ROP. The treatment of infants and those with ROP was conducted in accordance with the early treatment of ROP study recommendations. We analyzed gestational age, birth weight and postconceptional age in two groups: healthy infants and those with severe form of ROP. Statistical analysis was performed using the SPSS 16. RESULTS: A total of 478 children met the criteria of screening for ROP. Severe stage of ROP, which required laser treatment, had 102 (21.3%) children. Out of the infants with severe ROP 14 (13.7%) of the infants with APD had aggressive posterior disease, while two (0.4%) remained blind. The differences in the mean values of gestational age between the healthy and the children with severe form of the disease were statistically significant (p < 0.0005). The mean value of gestational age for the healthy children was 33.33 +/- 2.28 weeks and for the seek infants 30.66 +/- 2.79 weeks. The mean value of the weight in healthy children was 1.981 +/- 407 g, and in sick children 1.535 +/- 434 g which was statistically significant (p < 0.0005). Multivariate binary logistic regression showed that the occurrence of the disease depends on body weight and gestational age. CONCLUSION: The incidence of severe forms of ROP was 21.3%. Aggressive form of ROP was present in 13.7% of the children. The cut-off value for body weight was 1.740 g, and for gestational age 32.5 weeks.

Factors given by birth and oxygen therapy in relation to development of retinopathy of prematurity.

INTRODUCTION: Retinopathy of prematurity is a disease of the eye which affects the blood vessels of the retina and represents the most important cause of blindness and low vision in children worldwide. There are many risk factors given by birth and parameters of general health status that may influence this disease. The aim of this study was to investigate the significance of the factors given by birth and use of oxygen in relation to the development of premature retinopathy. MATERIAL AND METHODS: A two-year-long prospective study was done at the Institute for Child and Youth Health Care of Vojvodina. In this study the following parameters were examined: weight, gestational age as a factor given by birth and parameters of oxygenotherapy--the number of days on oxygenotherapy and the number of days of mechanical ventilation. The findings on the eye fundus were also taken into consideration. RESULTS: The test results suggest that the gestational age is the most important factor given by birth which determines the possibility of development of premature retinopathy. CONCLUSION: In fact, the most important risk factor for the development of premature retinopathy is premature birth.

Unilateral optic nerve aplasia associated with microphthalmos.

INTRODUCTION: Optic nerve aplasia is a rare developmental anomaly characterised by the congenital absence of the optic nerve, central retinal vessels and retinal ganglion cells that is seen most often in a unilaterally malformed eye. CASE REPORT: We reported a girl with a very rare anomaly of the eye, unilateral aplasia of the optic nerve and microphthalmia. We carried out a complete ophthalmological examination, A- and B-scan ultrasonography, magnetic resonance imaging (MRI) of the orbit and brain, pediatrician, neurological examinations and karyotype determination. The examined child was a third child from the third regular pregnancy, born at term (39 GS, BM 3100 g). Family ocular history was negative. The right corneal diameter was 7.5 mm and left 10 mm. On dilated fundus examination, the right eye showed the absence of op tic nerve and central retinal vessels. B-scan echography showed a small right globe (axial length 13.80 mm), normal size left globe (axial length 18.30 mm) and the absence of optic nerve on the right eye. Physical and neurological findings and karyotype was normal. MRI of the orbits and brain marked asymmetry of globe size and unilateral absence of the optic nerve. The patient is under the control of a competent ophthalmologist and prosthetic. CONCLUSION: Further aesthetic and functional development of a young person is the primary goal in tracking this rare congenital optic nerve anomalies in the malformed eye.

Analysis of risk factors in the development of retinopathy of prematurity.

INTRODUCTION: Retinopathy of prematurity (ROP) is a multifactorial disease that occurs most frequently in very small and very sick preterm infants, and it has been identified as the major cause of childhood blindness. OBJECTIVE: The aim of this study was to evaluate ROP incidence and risk factors associated with varying degrees of illness. METHODS: The study was conducted at the Centre for Neonatology, Paediatric Clinic of the Clinical Centre Kragujevac, Serbia, in the period from June 2006 to December 2008. Ophthalmologic screening was performed in all children with body weight lower than 2000 g or gestational age lower than 36 weeks. We analyzed eighteen postnatal and six perinatal risk factors and the group correlations for each of the risk factors. RESULTS: Out of 317 children that were screened, 56 (17.7%) developed a mild form of ROP, while 68 (21.5%) developed a severe form. Univariate analysis revealed a large number of statistically significant risk factors for the development of ROP, especially the severe form. Multivariate logistical analysis further separated two independent risk factors: small birth weight (p = 0.001) and damage of central nervous system (p = 0.01). Independent risk factors for transition from mild to severe forms of ROP were identified as: small birth weight (p = 0.05) and perinatal risk factors (p = 0.02). CONCLUSION: Small birth weight and central nervous system damage were risk factors for the development of ROP, perinatal risk factors were identified as significant for transition from mild to severe form of ROP.

Hyperpolarized xenon in NMR and MRI.

Hyperpolarized gases have found a steadily increasing range of applications in nuclear magnetic resonance (NMR) and NMR imaging (MRI). They can be regarded as a new class of MR contrast agent or as a way of greatly enhancing the temporal resolution of the measurement of processes relevant to areas as diverse as materials science and biomedicine. We concentrate on the properties and applications of hyperpolarized xenon. This review discusses the physics of producing hyperpolarization, the NMR-relevant properties of 129Xe, specific MRI methods for hyperpolarized gases, applications of xenon to biology and medicine, polarization transfer to other nuclear species and low-field imaging.