[Algorithm for predicting treatment outcomes in vascular pigment epithelial detachment in neovascular age-related macular degeneration].

Q3 Medicine

Vestnik oftalmologii Pub Date : 2025-01-01 DOI:10.17116/oftalma202514104112

E V Kozina, A N Samoylov, K D Aksenov, L E Aksenova

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引用次数: 0

Abstract

Automated analysis of optical coherence tomography (OCT) biomarkers improves the prediction of results of loading anti-VEGF therapy of vascular pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nAMD).

Objective: This study evaluated the effectiveness of OCT biomarker analysis algorithm in predicting the anatomical outcomes of loading anti-VEGF therapy for vascular PED in nAMD.

Material and methods: OCT scans performed prior to loading anti-VEGF therapy were analyzed using the algorithm in 69 treatment-naïve nAMD patients (70 eyes) with vascular PED exceeding 200 µm in height. Qualitative biomarkers included subretinal fluid (SRF), intraretinal fluid (IRF), hyperreflective material beneath the PED, PED defects, and hyperreflective foci in the outer retinal layers. Quantitative parameters - height, width, and area of PED - were manually measured and segmented using a U-NET-based neural network.

Results: The algorithm predicted flattening of higher (499.2±198.1 μm) and wider (3205.6±734.2 μm) PEDs containing large hyperreflective foci in the mid-retinal layers and defects in PED (n=35 eyes). Resistance to loading therapy was predicted in lower (430.1±126.4 μm) and narrower (2824.1±732.8 μm) PEDs with sub-PED hyperreflective material without IRF (n=31 eyes). Risk of retinal pigment epithelium (RPE) tear was predicted for PEDs higher than 600 μm (mean 587.4±193.6 μm) in the presence of SRF but without PED defects (n=4 eyes). The automated OCT biomarker analysis algorithm effectively predicted resistance of PEDs with the lowest height, width, and area. Greater PED area and width were predictive of flattening, while PED height over 600 μm, calculated using the algorithm, was a predictor of RPE tear.

Conclusion: The developed OCT biomarker analysis algorithm enables effective prediction of anatomical outcomes following loading anti-VEGF therapy in vascular PED in nAMD.

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[预测血管性年龄相关性黄斑变性患者血管色素上皮脱离治疗结果的算法]。

光学相干断层扫描（OCT）生物标志物的自动分析提高了对与新生血管性年龄相关性黄斑变性（nAMD）相关的血管色素上皮脱离（PED）的负载抗vegf治疗结果的预测。目的：本研究评估OCT生物标志物分析算法在预测nAMD血管性PED加载抗vegf治疗的解剖结果中的有效性。材料和方法：使用该算法分析69例（70只眼）血管性PED高度超过200µm的treatment-naïve nAMD患者在加载抗vegf治疗之前进行的OCT扫描。定性生物标志物包括视网膜下液（SRF）、视网膜内液（IRF）、PED下的高反射物质、PED缺陷和视网膜外层的高反射灶。定量参数- PED的高度、宽度和面积-被人工测量并使用基于u - net的神经网络分割。结果：该算法预测了较高（499.2±198.1 μm）和较宽（3205.6±734.2 μm）的PED的平坦化，其中视网膜中层含有较大的高反射焦点和PED的缺陷（n=35只眼）。低ped（430.1±126.4 μm）和窄ped（2824.1±732.8 μm）高反射材料无IRF （n=31眼）预测对加载治疗的抵抗。在存在SRF但没有PED缺陷（n=4眼）的PEDs大于600 μm（平均587.4±193.6 μm）时，预测视网膜色素上皮（RPE）撕裂的风险。自动化OCT生物标志物分析算法可有效预测具有最低高度、宽度和面积的ped的耐药性。较大的PED面积和宽度预示着RPE变平，而使用算法计算的PED高度超过600 μm，预示着RPE撕裂。结论：开发的OCT生物标志物分析算法能够有效预测nAMD血管PED加载抗vegf治疗后的解剖结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vestnik oftalmologii Medicine-Ophthalmology

CiteScore

0.80

自引率

0.00%

发文量

129

期刊介绍： The journal publishes materials on the diagnosis and treatment of eye diseases, hygiene of vision, prevention of ophthalmic affections, history of Russian ophthalmology, organization of ophthalmological aid to the population, as well as the problems of special equipment. Original scientific articles and surveys on urgent problems of theory and practice of Russian and foreign ophthalmology are published. The journal contains book reviews on ophthalmology, information on the activities of ophthalmologists" scientific societies, chronicle of congresses and conferences.The journal is intended for ophthalmologists and scientific workers dealing with clinical problems of diseases of the eye and physiology of vision.