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1.
Vestn Oftalmol ; 137(1): 60-67, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33610151

RESUMO

PURPOSE: To assess the influence of the frequency of retinal protective therapy courses on the indicators of regional hemodynamics of the eye. MATERIAL AND METHODS: The study included 17 patients (34 eyes) with a diagnosis of primary open-angle glaucoma (POAG), advanced stage. The patients were divided into 2 groups: the first group received a course of retinal protective therapy with Retinalamin every 3 months, the second group received a course of retinal protective therapy with Retinalamin every 6 months. All patients underwent standard ophthalmological examination including standard automatic perimetry according to the 24-2 program, optical coherence tomography angiography (OCT-A) of the macular area and optic disc. RESULTS: The comparison of hemodynamic parameters of all vascular plexuses of the retina at the beginning and at the end of the study, as well as intergroup comparison did not reveal any statistically significant differences (p>0.05). However, when studying the density and fractal dimension of the vascular bed, multidirectional trends were observed. Specifically, in the peripapillary region, there was a decrease in the length from 19.8 (1/mm) to 19.0 (1/mm) (p=0.37) and the density from 36.6% to 35.7% (p=0.63) of the vascular bed of the peripapillary capillary plexus of the retina in patients of the first group. In the superficial vascular plexus, the trend in the density of the vascular bed in both groups slightly changed (in group 1 - 38.1% and 38.3%, p=0.97; group 2 - 37.8% and 38.7%, p=0.46). The fractal dimension of the vascular bed in the first group tended to increase during treatment from 18.8 (1/mm) to 19.1 (1/mm) (p=0.5), while in the second group, on the contrary, it had tendency to decrease from 18.6 (1/mm) to 17.9 (1/mm) (p=0.63). In the deep vascular plexus, the density of the vascular bed trended to decrease in both groups, but in group 2 (42.5% and 42.4%, p=1.0) it was more pronounced than in the first group (42.5% and 42.6%, p=0.82). However, the fractal dimension of the vascular bed increased in group 1 (21.0 (1/mm) and 21.3 (1/mm), p=0.43) and showed a slight tendency to decrease in group 2 (21.5 (1/mm) and 21.0 (1/mm), p=0.86). CONCLUSION: The general trend of changes in hemodynamic parameters demonstrates a potential positive effect, especially in the data related to the deep vascular plexus.


Assuntos
Glaucoma de Ângulo Aberto , Disco Óptico , Angiografia , Angiofluoresceinografia , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Disco Óptico/diagnóstico por imagem , Projetos Piloto , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica
2.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462012

RESUMO

Morning glory disc anomaly (MGDA) is most commonly found in white females in childhood with reduced vision. One in two cases have been reported to develop maculopathy or posterior pole retinal detachment as they grow older. The pathophysiology of MGDA-associated maculopathy is not well understood.We describe a 31-year-old black woman, who presented with gradual reduction of vision in the right eye due to MGDA-associated maculopathy. We identified morphological characteristics of the optic disc and macula with multicolour and optical coherence tomography imaging.We speculate that the centripetal inner retina traction and cerebrospinal fluid pressure fluctuation play an important role in inner retinal fluid accumulation in the pathology of retinoschisis in MGDA. Further studies will shed some light of a potential cause-and-effect relationship between MGDA and retinoschisis.


Assuntos
Disco Óptico/anormalidades , Disco Óptico/diagnóstico por imagem , Doenças Retinianas/congênito , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Feminino , Humanos , Doenças Retinianas/patologia
3.
Zhonghua Yan Ke Za Zhi ; 56(11): 824-831, 2020 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-33152840

RESUMO

Objective: To analyze the characteristics of vessel density in the optic disc and macular area of patients with different phases of thyroid-associated ophthalmopathy (TAO) and their correlation with visual function. Methods: This case-control study was conducted at the Department of Ophthalmology of Peking Union Medical College Hospital between June 2019 and September 2019. TAO patients and healthy volunteers were included in the study. Patients with a clinical activity score greater than or equal to 3 points were categorized as active TAO. Dysthyroid optic neuropathy (DON) patients with a course less than 6 months were categorized as acute phase of DON, and those more than 6 months were in the chronic group. Healthy volunteers were in the control group. Each group included 12 subjects, with right eyes for analysis. There were 6 males and 6 females in each group. All participants underwent comprehensive ophthalmic examination including best corrected visual acuity and visual field examination for the mean defect (MD). Best corrected visual acuity was subsequently converted to logarithm of minimum angle of resolution (logMAR). Optical coherence tomography was used to measure the thickness of the retinal nerve fiber layer (RNFL) and retinal ganglion cell complex (GCC). Optical coherence tomography angiography was used to the peripapillary and macular vessel density. The differences in the vessel densities in the optic disc and macular area between groups and their correlation with different factors were analyzed. Analysis of variance, non-parametric Mann-Whitney U test and Spearman coefficient were conducted for statistical analysis. Results: There was no significant difference in age among the four groups (P>0.05). The logMAR of the acute DON group was 0.1 (0.0, 0.2), worse than the control group, which was 0.0 (0.0, 0.0) (U=114.000, P<0.05). The overall vessel densities of the optic disc in acute DON and chronic DON were significantly lower than the control group (54.70%±2.31% and 54.31%±3.65% vs. 57.54%±2.17%; t=3.104, 2.636; both P<0.05). The overall superficial vessel densities of the macular area in active TAO, acute DON and chronic DON were significantly lower than the control group (46.07%±3.06% and 42.26%±5.05% and 45.63%±3.87% vs. 49.34%±3.08%), and the differences were statistically significant (t=2.614, 4.147, 2.603; all P<0.05). There was no statistically significant difference in the size of the foveal avascular zone or the density of deep blood vessels in the macular area among the four groups (all P>0.05). In the active TAO period, there was no correlation between the MD value, RNFL thickness, GCC thickness and the vessel densities of the optic disc and macular area (all P>0.05). The vascular density of the whole layer of the optic disc in acute DON was negatively correlated with the MD value (r=-0.591, P<0.05) and positively correlated with the RNFL thickness and GCC thickness (r=0.595, 0.693; both P<0.05). In chronic DON, the overall capillary density of the optic disc was negatively correlated with the MD value (r=-0.673, P<0.05); the superficial overall blood vessel density of the macular area was positively correlated with the thickness of RNFL and GCC (r=0.732, 0.712;both P<0.01). Conclusions: In active TAO, only the blood supply to the superficial layer of the macular area is decreased. In the acute and chronic phases of DON, the blood supply to the superficial layer of the macular area and the optic disc is both reduced; the smaller the blood vessel density, the more severe the visual field defect, and the thinner the RNFL and GCC. (Chin J Ophthalmol, 2020, 56:824-831).


Assuntos
Oftalmopatia de Graves , Macula Lutea , Disco Óptico , Estudos de Casos e Controles , Estudos Transversais , Feminino , Oftalmopatia de Graves/diagnóstico por imagem , Humanos , Masculino , Disco Óptico/diagnóstico por imagem , Vasos Retinianos , Tomografia de Coerência Óptica
4.
PLoS One ; 15(10): e0239913, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002080

RESUMO

Optic-disc photography (ODP) has proven to be very useful for optic nerve evaluation in glaucoma. In real clinical practice, however, limited patient cooperation, small pupils, or media opacities can limit the performance of ODP. The purpose of this study was to propose a deep-learning approach for increased resolution and improved legibility of ODP by contrast, color, and brightness compensation. Each high-resolution original ODP was transformed into two counterparts: (1) down-scaled 'low-resolution ODPs', and (2) 'compensated high-resolution ODPs' produced via enhancement of the visibility of the optic disc margin and surrounding retinal vessels using a customized image post-processing algorithm. Then, the differences between these two counterparts were directly learned through a super-resolution generative adversarial network (SR-GAN). Finally, by inputting the high-resolution ODPs into SR-GAN, 4-times-up-scaled and overall-color-and-brightness-transformed 'enhanced ODPs' could be obtained. General ophthalmologists were instructed (1) to assess each ODP's image quality, and (2) to note any abnormal findings, at 1-month intervals. The image quality score for the enhanced ODPs was significantly higher than that for the original ODP, and the overall optic disc hemorrhage (DH)-detection accuracy was significantly higher with the enhanced ODPs. We expect that this novel deep-learning approach will be applied to various types of ophthalmic images.


Assuntos
Aprendizado Profundo , Glaucoma/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Disco Óptico/diagnóstico por imagem , Fotografação/métodos , Humanos , Processamento de Imagem Assistida por Computador/normas , Limite de Detecção , Fotografação/normas
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1540-1543, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018285

RESUMO

This paper proposes a new method for automatic detection of glaucoma from stereo pair of fundus images. The basis for detecting glaucoma is using the optic cup-to-disc area ratio, where the surface area of the optic cup is segmented from the disparity map estimated from the stereo fundus image pair. More specifically, we first estimate the disparity map from the stereo image pair. Then, the optic disc is segmented from one of the stereo image. Based upon the location of the optic disc, we perform an active contour segmentation on the disparity map to segment the optic cup. Thereafter, we can compute the optic cup-to-disc area ratio by dividing the area (i.e. the total number of pixels) of the segmented optic cup region to that of the segmented optic disc region. Our experimental results using the available test dataset shows the efficacy of our proposed approach.


Assuntos
Glaucoma , Disco Óptico , Algoritmos , Fundo de Olho , Glaucoma/diagnóstico por imagem , Humanos , Disco Óptico/diagnóstico por imagem
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1832-1835, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018356

RESUMO

Glaucoma is a progressive optic neuropathy that leads to loss of retinal ganglion cells and thinning of retinal nerve fiber layer (RNFL). Circumpapillary RNFL thickness measurements have been used for glaucoma diagnostic and monitoring purposes. However, manual measurement of the RNFL thickness is tedious and subjective. We proposed and evaluated the performance of automated RNFL segmentation from OCT images using a state-of-the-art deep learning-based model. Circumpapillary OCT scans were extracted from volumetric OCT scans using a high-resolution swept-source OCT device. Manual annotation was performed on the extracted scans and used for training and evaluation. The results show that the accuracy and diagnostic performance is comparable to manual assessment, and the potential application of deep learning-based approach in such segmentation.


Assuntos
Disco Óptico , Doenças do Nervo Óptico , Humanos , Fibras Nervosas , Disco Óptico/diagnóstico por imagem , Células Ganglionares da Retina , Tomografia de Coerência Óptica
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1976-1979, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018390

RESUMO

In this paper, we proposed and validated a probability distribution guided network for segmenting optic disc (OD) and optic cup (OC) from fundus images. Uncertainty is inevitable in deep learning, as induced by different sensors, insufficient samples, and inaccurate labeling. Since the input data and the corresponding ground truth label may be inaccurate, they may actually follow some potential distribution. In this study, a variational autoencoder (VAE) based network was proposed to estimate the joint distribution of the input image and the corresponding segmentation (both the ground truth segmentation and the predicted segmentation), making the segmentation network learn not only pixel-wise information but also semantic probability distribution. Moreover, we designed a building block, namely the Dilated Inception Block (DIB), for a better generalization of the model and a more effective extraction of multi-scale features. The proposed method was compared to several existing state-of-the-art methods. Superior segmentation performance has been observed over two datasets (ORIGA and REFUGE), with the mean Dice overlap coefficients being 96.57% and 95.81% for OD and 88.46% and 88.91% for OC.


Assuntos
Glaucoma , Disco Óptico , Animais , Fundo de Olho , Fundo Gástrico , Disco Óptico/diagnóstico por imagem , Probabilidade
8.
PLoS One ; 15(9): e0238983, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32956372

RESUMO

The optic disc(OD) and the optic cup(OC) segmentation is an key step in fundus medical image analysis. Previously, FCN-based methods have been proposed for medical image segmentation tasks. However, the consecutive convolution and pooling operations usually hinder dense prediction tasks which require detailed spatial information, such as image segmentation. In this paper, we propose a network called Recurrent Fully Convolution Network(RFC-Net) for automatic joint segmentation of the OD and the OC, which can captures more high-level information and subtle edge information. The RFC-Net can minimize the loss of spatial information. It is mainly composed of multi-scale input layer, recurrent fully convolutional network, multiple output layer and polar transformation. In RFC-Net, the multi-scale input layer constructs an image pyramid. We propose four recurrent units, which are respectively applied to RFC-Net. Recurrent convolution layer effectively ensures feature representation for OD and OC segmentation tasks through feature accumulation. For each multiple output image, the multiple output cross entropy loss function is applied. To better balance the cup ratio of the segmented image, the polar transformation is used to transform the fundus image from the cartesian coordinate system to the polar coordinate system. We evaluate the effectiveness and generalization of the proposed method on the DRISHTI-GS1 dataset. Compared with the original FCN method and other state-of-the-art methods, the proposed method achieves better segmentation performance.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Disco Óptico/diagnóstico por imagem , Imagem Óptica/métodos , Algoritmos , Bases de Dados Genéticas , Olho/diagnóstico por imagem , Olho/embriologia , Fundo de Olho , Glaucoma , Humanos , Menisco , Redes Neurais de Computação
9.
PLoS One ; 15(8): e0237796, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804983

RESUMO

PURPOSE: To characterize changes in the retinal nerve fiber layer (RNFL) and peripapillary vessel density (VD) at the site of disc hemorrhage (DH) in nonglaucomatous eyes. MATERIALS AND METHODS: This retrospective cross-sectional study included nonglaucomatous eyes diagnosed with unilateral DH. The change of DH was recorded using disc photography. Both anatomical data and functional visual field (VF) data were collected using optical coherence tomography angiography and Humphrey VF examination. RESULTS: Sixteen patients were included with average follow-up duration of 95 months. Almost half of DH episodes was initially presented at the inferotemporal area of the optic disc. Pigment formation at the previous DH site after resolution was noted in 12.5% of eyes. Sectoral radial peripapillary VD at the DH site was significantly lower in DH eyes than in the control group; however, the sectoral RNFL thickness at the DH site was not significantly decreased. Progression of the VF defect corresponding to the DH site was found in 81.3% of eyes despite regular use of antiglaucoma agents. The mean change in the VF mean deviation was -0.64 dB/year in DH eyes. CONCLUSION: During long follow-up periods, decreased peripapillary VD at the DH site and progression of the VF defect corresponding to the DH site were detected in nonglaucomatous eyes. Retinal pigmentation with an RNFL defect is a clue for DH, although RNFL showed no significant change. Antiglaucoma treatment may not prevent the deterioration of visual function.


Assuntos
Doenças do Nervo Óptico/complicações , Hemorragia Retiniana/complicações , Vasos Retinianos/patologia , Transtornos da Visão/etiologia , Idoso , Estudos Transversais , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico/diagnóstico por imagem , Disco Óptico/fisiopatologia , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/fisiopatologia , Retina/diagnóstico por imagem , Retina/patologia , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/fisiopatologia , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Transtornos da Visão/fisiopatologia , Testes de Campo Visual/estatística & dados numéricos , Campos Visuais/fisiologia
10.
PLoS One ; 15(8): e0237858, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822382

RESUMO

The main objective of the study was to analyze deviations in retinal nerve fiber layer (RNFL) thickness measurements caused by the displacement of circular optic disc optical coherence tomography scans. High-density radial scans of the optic nerve heads of cynomolgus monkeys were acquired. The retinal nerve fiber layer was manually segmented, and a surface plot of the discrete coordinates was generated. From this plot, the RNFL thicknesses were calculated and compared between accurately centered and intentionally displaced circle scans. Circle scan displacement caused circumpapillary retinal nerve fiber layer thickness deviations of increasing magnitude with increasing center offset. As opposed to the human eye, horizontal displacement resulted in larger RNFL thickness deviations than vertical displacement in cynomolgus monkeys. Acquisition of high-density radial scans allowed for the mathematical reconstruction and modelling of the nerve fiber layer and extrapolation of its thickness. Accurate and strictly repeatable circle scan placement is critical to obtain reproducible values, which is essential for longitudinal studies.


Assuntos
Disco Óptico/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Animais , Feminino , Macaca fascicularis , Masculino , Modelos Biológicos , Fibras Nervosas/ultraestrutura , Disco Óptico/anatomia & histologia , Retina
12.
PLoS One ; 15(8): e0236819, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817645

RESUMO

AIMS: To examine the relationship between baseline structural characteristics of the optic nerve head (ONH) and retinal nerve fiber layer (RNFL) and functional disease progression in patients with open-angle glaucoma (OAG) over 5 years. METHODS: 112 OAG patients were prospectively examined at baseline and every 6 months over a period of five years. Structural glaucomatous changes were examined with optical coherence tomography (OCT) and Heidelberg retinal tomography-III (HRT-III), and functional disease progression with automated perimetry (Humphrey visual fields). Cox proportional hazard models were used to assess the relationship between baseline structural measurements and functional disease progression. RESULTS: From baseline over a 5-year period, statistically significant increases were found in OCT disc (D) area (p<0.001), cup (C) area (p<0.001), C/D area ratio (p<0.001), C/D horizontal ratio (p<0.001), C/D vertical ratio (p = 0.018), and a decrease in superior RNFL thickness (p = 0.008). Statistically significant increases were found in HRT-III C volume (p = 0.021), C/D area ratio (p = 0.046), mean C depth (p = 0.036), C shape (p = 0.008), and height variation contour (p = 0.020). Functional disease progression was detected in 37 of the 112 patients (26 of European descent and 11 of African descent; 33%). A statistically significant shorter time to functional progression was seen in patients with larger baseline OCT D area (p = 0.008), C area (p = 0.003), thicker temporal RNFL (p = 0.003), and in patients with a larger HRT-III C area (p = 0.004), C/D area ratio (p = 0.004), linear C/D ratio (p = 0.007), C shape (p = 0.032), or smaller rim area (p = 0.039), rim volume (p = 0.005), height variation contour (p = 0.041), mean RNFL thickness (p<0.001), or RNFL cross-sectional area (p = 0.002). CONCLUSION: Baseline ONH and RNFL structural characteristics were associated with a significantly shorter time to functional glaucomatous progression and visual field loss through the five-year period in OAG patients.


Assuntos
Cegueira/diagnóstico , Glaucoma de Ângulo Aberto/patologia , Fibras Nervosas/fisiologia , Disco Óptico/fisiopatologia , Idoso , Cegueira/etiologia , Complicações do Diabetes/patologia , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/complicações , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Modelos de Riscos Proporcionais , Estudos Prospectivos , Retina/diagnóstico por imagem , Retina/fisiopatologia , Tomografia de Coerência Óptica , Testes de Campo Visual
14.
PLoS One ; 15(7): e0235621, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32678824

RESUMO

PURPOSE: This observational case series was to determine long term optic disc changes in eyes with large cup to disc ratio (CDR) and compare the changes induced by myopic shift during childhood with normal control eyes. METHODS: Children under 15 years of age who developed myopia with serial optic disc photographs and spectral domain (SD)-optical coherence tomography (OCT) images with a minimal interval of three years were evaluated. Children with average CDR ≥ 0.6 on SD-OCT were classified as having large CDR. The ratios of vertical disc diameter (VDD), horizontal disc diameter (HDD), and maximum peripapillary atrophy (PPA) width (PPW) were measured to quantify morphologic changes of optic discs and SD-OCT parameters, such as peripapillary retinal nerve fiber layer (RNFL) thickness and macular ganglion cell and inner plexiform layer (GCIPL) thickness were measured. RESULTS: Of the 82 eyes (82 patients) analyzed, 42 eyes had large CDR and 40 eyes were normal controls. The mean age and refractive error at initial examination were not different between groups (P = 0.33, P = 0.76, respectively). The changes in HDD/VDD and PPW/VDD ratios during follow-up showed no significant difference among the groups (P = 0.45, P = 0.62, respectively). No statistical significance was found in changes in RNFL and GCIPL thickness between the two groups (P = 0.74, P = 0.79, respectively). CONCLUSIONS: Children with enlarged CDR showed changes in optic disc morphology and RNFL/GCIPL thickness similar to normal children during myopic shift.


Assuntos
Miopia/diagnóstico por imagem , Miopia/patologia , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Tomografia de Coerência Óptica , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Tamanho do Órgão , Fatores de Tempo
15.
PLoS One ; 15(5): e0232785, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469871

RESUMO

BACKGROUND: Alzheimer's disease (AD) pathology precedes symptoms and its detection can identify at-risk individuals who may benefit from early treatment. Since the retinal nerve fiber layer (RNFL) is depleted in established AD, we tested whether its thickness can predict whether cognitively healthy (CH) individuals have a normal or pathological cerebrospinal fluid (CSF) Aß42 (A) and tau (T) ratio. METHODS: As part of an ongoing longitudinal study, we enrolled CH individuals, excluding those with cognitive impairment and significant ocular pathology. We classified the CH group into two sub-groups, normal (CH-NAT, n = 16) or pathological (CH-PAT, n = 27), using a logistic regression model from the CSF AT ratio that identified >85% of patients with a clinically probable AD diagnosis. Spectral-domain optical coherence tomography (OCT) was acquired for RNFL, ganglion cell-inner plexiform layer (GC-IPL), and macular thickness. Group differences were tested using mixed model repeated measures and a classification model derived using multiple logistic regression. RESULTS: Mean age (± standard deviation) in the CH-PAT group (n = 27; 75.2 ± 8.4 years) was similar (p = 0.50) to the CH-NAT group (n = 16; 74.1 ± 7.9 years). Mean RNFL (standard error) was thinner in the CH-PAT group by 9.8 (2.7) µm; p < 0.001. RNFL thickness classified CH-NAT vs. CH-PAT with 87% sensitivity and 56.3% specificity. CONCLUSIONS: Our retinal data predict which individuals have CSF biomarkers of AD pathology before cognitive deficits are detectable with 87% sensitivity. Such results from easy-to-acquire, objective and non-invasive measurements of the RNFL merit further study of OCT technology to monitor or screen for early AD pathology.


Assuntos
Doença de Alzheimer/genética , Peptídeos beta-Amiloides/genética , Disfunção Cognitiva/genética , Proteínas tau/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Amiloidose/líquido cefalorraquidiano , Amiloidose/diagnóstico por imagem , Amiloidose/genética , Amiloidose/patologia , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/líquido cefalorraquidiano , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/metabolismo , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Disco Óptico/metabolismo , Disco Óptico/patologia , Retina/diagnóstico por imagem , Retina/metabolismo , Retina/patologia , Células Ganglionares da Retina/metabolismo , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica , Proteínas tau/líquido cefalorraquidiano
16.
Invest Ophthalmol Vis Sci ; 61(5): 9, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32392317

RESUMO

Purpose: To compare lamina cribrosa (LC) morphology in patients with normal tension glaucoma (NTG) and autosomal-dominant optic atrophy (ADOA). Methods: This cross-sectional study matched 24 patients diagnosed with ADOA (24 eyes) by age and retinal nerve fiber layer thickness with 48 patients diagnosed with NTG (48 eyes) by age with 48 healthy controls (48 eyes). Optic nerve heads were scanned by enhanced-depth imaging (EDI) optical coherence tomography (OCT). The LC curvature index (LCCI) and LC depth (LCD) on B-scan images obtained using EDI-OCT were measured at seven locations spaced equidistantly across the vertical optic disc diameter and compared among the NTG, ADOA, and control groups. Results: Mean LCCI and LCD were significantly greater in NTG than in ADOA and healthy eyes (P < 0.001 each) but did not differ significantly in ADOA and healthy eyes. Conclusions: NTG eyes have a more posteriorly curved and deeper LC than ADOA and healthy eyes. This finding provides insight into the role of LC morphology in NTG and provides a clinical clue to distinguish between NTG and ADOA.


Assuntos
Glaucoma de Baixa Tensão/diagnóstico por imagem , Atrofia Óptica Autossômica Dominante/diagnóstico por imagem , Disco Óptico/diagnóstico por imagem , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica
17.
Int J Comput Assist Radiol Surg ; 15(7): 1205-1213, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32445127

RESUMO

PURPOSE: The cup-to-disc ratio (CDR), a clinical metric of the relative size of the optic cup to the optic disc, is a key indicator of glaucoma, a chronic eye disease leading to loss of vision. CDR can be measured from fundus images through the segmentation of optic disc and optic cup . Deep convolutional networks have been proposed to achieve biomedical image segmentation with less time and more accuracy, but requires large amounts of annotated training data on a target domain, which is often unavailable. Unsupervised domain adaptation framework alleviates this problem through leveraging off-the-shelf labeled data from its relevant source domains, which is realized by learning domain invariant features and improving the generalization capabilities of the segmentation model. METHODS: In this paper, we propose a WGAN domain adaptation framework for detecting optic disc-and-cup boundary in fundus images. Specifically, we build a novel adversarial domain adaptation framework that is guided by Wasserstein distance, therefore with better stability and convergence than typical adversarial methods. We finally evaluate our approach on publicly available datasets. RESULTS: Our experiments show that the proposed approach improves Intersection-over-Union score for optic disc-and-cup segmentation, Dice score and reduces the root-mean-square error of cup-to-disc ratio, when we compare it with direct transfer learning and other state-of-the-art adversarial domain adaptation methods. CONCLUSION: With this work, we demonstrate that WGAN guided domain adaptation obtains a state-of-the-art performance for the joint optic disc-and-cup segmentation in fundus images.


Assuntos
Aprendizado Profundo , Fundo de Olho , Glaucoma/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Disco Óptico/diagnóstico por imagem , Imagem Óptica/métodos , Humanos
18.
Am J Ophthalmol ; 218: 105-119, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32445702

RESUMO

PURPOSE: To measure the magnitude and direction of anterior scleral canal opening (ASCO) offset relative to the Bruch membrane opening (BMO) (ASCO/BMO offset) to characterize neural canal obliqueness and minimum cross-sectional area (NCMCA) in 69 highly myopic and 138 healthy, age-matched, control eyes. DESIGN: Cross-sectional study. METHODS: Using optical coherence tomography (OCT) scans of the optic nerve head (ONH), BMO and ASCO were manually segmented and their centroids and size and shape were calculated. ASCO/BMO offset magnitude and direction were measured after projecting the ASCO/BMO centroid vector onto the BMO plane. Neural canal axis obliqueness was defined as the angle between the ASCO/BMO centroid vector and the vector perpendicular to the BMO plane. NCMCA was defined by projecting BMO and ASCO points onto a plane perpendicular to the neural canal axis and measuring their overlapping area. RESULTS: ASCO/BMO offset magnitude was greater (highly myopic eyes 264.3 ± 131.1 µm; healthy control subjects 89.0 ± 55.8 µm, P < .001, t test) and ASCO centroid was most frequently nasal relative to BMO centroid (94.2% of eyes) in the highly myopic eyes. BMO and ASCO areas were significantly larger (P < .001, t test), NCMCA was significantly smaller (P < .001), and all 3 were significantly more elliptical (P ≤ .001) in myopic eyes. Neural canal obliqueness was greater in myopic (65.17° ± 14.03°) compared with control eyes (40.91° ± 16.22°; P < .001, t test). CONCLUSIONS: Our data suggest that increased temporal displacement of BMO relative to the ASCO, increased BMO and ASCO area, decreased NCMCA, and increased neural canal obliqueness are characteristic components of ONH morphology in highly myopic eyes.


Assuntos
Segmento Anterior do Olho/patologia , Lâmina Basilar da Corioide/patologia , Miopia Degenerativa/patologia , Disco Óptico/patologia , Esclera/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/diagnóstico por imagem , Disco Óptico/diagnóstico por imagem , Tomografia de Coerência Óptica
19.
Invest Ophthalmol Vis Sci ; 61(4): 41, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32343781

RESUMO

Purpose: To measure the ex vivo pressure-induced strain response of the human optic nerve head and analyze for variations with glaucoma diagnosis and optic nerve axon damage. Methods: The posterior sclera of 16 eyes from 8 diagnosed glaucoma donors and 10 eyes from 6 donors with no history of glaucoma were inflation tested between 5 and 45 mm Hg. The optic nerve from each donor was examined for degree of axon loss. The posterior volume of the lamina cribrosa (LC) was imaged with second harmonic generation and analyzed using volume correlation to calculate LC strains between 5 and 10 and 5 and 45 mm Hg. Results: Eye length and LC area were larger in eyes diagnosed with glaucoma (P ≤ 0.03). Nasal-temporal EXX and circumferential Eθθ strains were lower in the LC of diagnosed glaucoma eyes at 10 mm Hg (P ≤ 0.05) and 45 mm Hg (P ≤ 0.07). EXX was smaller in the LC of glaucoma eyes with <25% axon loss compared with undamaged normal eyes (P = 0.01, 45 mm Hg). In general, the strains were larger in the peripheral than central LC. The ratio of the maximum principal strain Emax in the peripheral to central LC was larger in glaucoma eyes with >25% axon loss than in glaucoma eyes with milder damage (P = 0.004, 10 mm Hg). Conclusions: The stiffness of the LC pressure-strain response was greater in diagnosed glaucoma eyes and varied with glaucomatous axon damage. Lower LC strains in glaucoma eyes with milder damage may represent baseline biomechanical behavior that contributes to axon loss, whereas greater LC strain and altered radial LC strain variation in glaucoma eyes with more severe damage may be caused by glaucoma-related remodeling.


Assuntos
Glaucoma/diagnóstico por imagem , Glaucoma/fisiopatologia , Imageamento Tridimensional , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Estresse Mecânico , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Humanos , Técnicas In Vitro , Masculino , Valores de Referência , Esclera/diagnóstico por imagem , Esclera/patologia , Manejo de Espécimes
20.
Am J Ophthalmol ; 217: 91-103, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32298653

RESUMO

PURPOSE: To use optical coherence tomography (OCT) to 3-dimensionally characterize the optic nerve head (ONH) in peripapillary scleral bowing in non-highly myopic healthy eyes. DESIGN: Cross-sectional, multicenter study. METHODS: A total of 362 non-highly myopic (+6 diopters [D] > spherical equivalent > -6D) eyes of 362 healthy subjects from 20-90 years old underwent OCT ONH radial B-scan imaging. Bruch's membrane (BM), BM opening (BMO), anterior scleral canal opening (ASCO), and the peripapillary scleral surface were segmented. BMO and ASCO planes were fit, and their centroids, major axes, ovality, areas and offsets were determined. Peripapillary scleral bowing was characterized by 2 parameters: peripapillary scleral slope (ppSS) of 3 anterior peripapillary scleral segments (0-300, 300-700, and 700-1,000 µm from the ASCO centroid); and ASCO depth relative to a peripapillary scleral reference plane (ASCOD-ppScleral). Peripapillary choroidal thickness (ppCT) was calculated relative to the ASCO as the minimum distance between the anterior scleral surface and BM. RESULTS: Both ppSS and ASCOD-ppScleral ranged from slightly inward through profoundly outward in direction. Both parameters increased with age and were independently associated with decreased ppCT. CONCLUSIONS: In non-highly myopic healthy eyes, outward peripapillary scleral bowing achieved substantial levels, was markedly increased with age, and was independently associated with decreased peripapillary choroidal thickness. These findings provide a normative foundation for characterizing this anatomy in cases of high myopia and glaucoma and in eyes with optic disc tilt, torsion, and peripapillary atrophy.


Assuntos
Envelhecimento/fisiologia , Corioide/diagnóstico por imagem , Imageamento Tridimensional/métodos , Pressão Intraocular/fisiologia , Disco Óptico/diagnóstico por imagem , Esclera/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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