Dataset Information

Automated Diagnosis and Grading of Diabetic Retinopathy Using Optical Coherence Tomography.

ABSTRACT:

Purpose

We determine the feasibility and accuracy of a computer-assisted diagnostic (CAD) system to diagnose and grade nonproliferative diabetic retinopathy (NPDR) from optical coherence tomography (OCT) images.

Methods

A cross-sectional, single-center study was done of type II diabetics who presented for routine screening and/or monitoring exams. Inclusion criteria were age 18 or older, diagnosis of diabetes mellitus type II, and clear media allowing for OCT imaging. Exclusion criteria were inability to image the macula, posterior staphylomas, proliferative diabetic retinopathy, and concurrent retinovascular disease. All patients underwent a full dilated eye exam and spectral-domain OCT of a 6 × 6 mm area of the macula in both eyes. These images then were analyzed by a novel CAD system that segments the retina into 12 layers; quantifies the reflectivity, curvature, and thickness of each layer; and ultimately uses this information to train a neural network that classifies images as either normal or having NPDR, and then further grades the level of retinopathy. A first dataset was tested by "leave-one-subject-out" (LOSO) methods and by 2- and 4-fold cross-validation. The system then was tested on a second, independent dataset.

Results

Using LOSO experiments on a dataset of images from 80 patients, the proposed CAD system distinguished normal from NPDR subjects with 93.8% accuracy (sensitivity = 92.5%, specificity = 95%) and achieved 97.4% correct classification between subclinical and mild/moderate DR. When tested on an independent dataset of 40 patients, the proposed system distinguished between normal and NPDR subjects with 92.5% accuracy and between subclinical and mild/moderate NPDR with 95% accuracy.

Conclusions

A CAD system for automated diagnosis of NPDR based on macular OCT images from type II diabetics is feasible, reliable, and accurate.

SUBMITTER: Sandhu HS

PROVIDER: S-EPMC6018370 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Publications

Automated Diagnosis and Grading of Diabetic Retinopathy Using Optical Coherence Tomography.

Sandhu Harpal Singh HS Eltanboly Ahmed A Shalaby Ahmed A Keynton Robert S RS Schaal Schlomit S El-Baz Ayman A

Investigative ophthalmology & visual science 20180601 7

<h4>Purpose</h4>We determine the feasibility and accuracy of a computer-assisted diagnostic (CAD) system to diagnose and grade nonproliferative diabetic retinopathy (NPDR) from optical coherence tomography (OCT) images.<h4>Methods</h4>A cross-sectional, single-center study was done of type II diabetics who presented for routine screening and/or monitoring exams. Inclusion criteria were age 18 or older, diagnosis of diabetes mellitus type II, and clear media allowing for OCT imaging. Exclusion cr ...[more]

PMID: 30029278

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Project description:Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR.To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography.An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6?×?6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR.Preplanned primary measures were parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6?×?6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA.Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6% (95% CI, 7.7%-17.5%; P?<?.001) and 10.4% (95% CI, 6.8%-14.1%; P?<?.001), respectively. Total avascular area and foveal avascular zone area were greater in eyes with DR by 0.82 mm2 (95% CI, 0.65-0.99 mm2; P?=?.02) and 0.16 mm2 (95% CI, 0.05-0.28 mm2; P?<?.001). The agreement between the vascular areas in the OCT angiogram and FA had a ? value of 0.45 (95% CI, 0.21-0.70; P?<?.001). Total avascular area in the central 5.5-mm-diameter area distinguished eyes with DR from control eyes with 100% sensitivity and specificity.Avascular area analysis with an automated algorithm using OCT angiography, although not equivalent to FA, detected DR reliably in this small pilot study. Further study is necessary to determine the usefulness of the automated quantification in clinical practice.

Project description:Background:Diabetic retinopathy (DR) is a leading cause of blindness due to diabetic macular edema (DME) or complications of proliferative diabetic retinopathy (PDR). Optical coherence tomography (OCT) is a noninvasive imaging technique well established for DME but less used to assess neovascularization in PDR. Developments in OCT imaging and the introduction of OCT angiography (OCTA) have shown significant potential in PDR. Objectives:To describe the tomographic features of PDR, namely of neovascularization, both of the optic disc (NVD) and elsewhere (NVE), intraretinal microvascular abnormalities (IRMA), retinal nonperfusion areas (NPA), status of the posterior vitreous, vitreoschisis and vitreous and subhyaloid/sub-ILM hemorrhages. Data sources:Electronic database search on PubMed and EMBASE, last run on December 19th 2019. Study eligibility criteria participants and interventions:Publications assessing OCT and/or OCTA findings in PDR patients. All study designs were allowed except for case-reports, conference proceedings and letters. Study appraisal:Newcastle-Ottawa Scale for observational studies was used for purposes of risk of bias assessment. Results:From the 1300 studies identified, 283 proceeded to full-text assessment and 60 were included in this comprehensive review. OCT was useful in detecting NVD and NVE, such as in characterizing disease activity and response to laser and/or anti-VEGF therapies. The absence of posterior vitreous detachment seemed determinant for neovascular growth, with the posterior hyaloid acting as a scaffold. OCTA allowed a more detailed characterization of the neovascular complexes, associated NPA and disease activity, allowing the quantification of neovessel area and flow index. However, changes in OCTA blood flow signal following local therapies did not necessarily correlate with structural regression. Widefield and ultra-widefield OCTA were highly sensitive in the detection of PDR, adding value to disease staging and monitoring. Compared to fluorescein angiography, OCTA was more sensitive in detecting microvascular changes indicating disease progression. Limitations:Publication languages were restricted. Most included studies were observational and non-comparative. Risk of bias regarding case representativeness. Conclusions:OCT-based retinal imaging technologies are advancing rapidly and the trend is to be noninvasive and wide-field. OCT has proven invaluable in diagnosing, staging and management of proliferative diabetic disease with daily application in clinical and surgical practices.

Dataset Information

Automated Diagnosis and Grading of Diabetic Retinopathy Using Optical Coherence Tomography.

Purpose

Methods

Results

Conclusions

Publications

Automated Diagnosis and Grading of Diabetic Retinopathy Using Optical Coherence Tomography.

Similar Datasets

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