Deep-Learning-Based Analysis of Disease-Specific Structural Biomarkers on Retinal Sensitivity in Neovascular Age-Related Macular Degeneration.

IF 4.7 2区医学 Q1 OPHTHALMOLOGY

Investigative ophthalmology & visual science Pub Date : 2025-09-02 DOI:10.1167/iovs.66.12.68

Gregor S Reiter, Klaudia Birner, Johannes Schrittwieser, Laetitia Hinterhuber, Irene Steiner, Markus Gumpinger, Simon Schürer-Waldheim, Hrvoje Bogunovic, Ursula Schmidt-Erfurth

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引用次数: 0

Abstract

Purpose: To evaluate the impact of disease-specific biomarkers on pointwise sensitivity (PWS) in patients with active neovascular age-related macular degeneration (nAMD) using two microperimetry (MP) instruments.

Methods: Participants in this prospective cross-sectional study underwent imaging with a SPECTRALIS HRA+OCT and MP with the photopic MP-3 (NIDEK) and mesopic MAIA (CenterVue). Pigment epithelium detachment (PED), intraretinal and subretinal fluid (IRF, SRF), ellipsoid zone loss (EZL), and subretinal hyperreflective material (SHRM) were quantified using deep learning (DL). DL enabled co-registration between the MP and optical coherence tomography (OCT). Univariate and multivariable mixed-effects models using variable selection including interaction terms were used to assess the effects of the biomarkers on PWS.

Results: Twenty eyes of 20 subjects (mean age, 76.0 years) were included. Sensitivity in the MAIA was lower (-2.87 dB; 95% confidence interval [CI], -3.15 to -2.59) than in the MP-3. Significant interactions between EZL and SRF, EZL and IRF, and between EZL and eccentricity were observed. EZL significantly reduced PWS (-1.30 dB; 95% CI, -2.08 to -0.51) at 0° eccentricity with SRF of 0.15 nL and absent IRF. IRF presence further decreased PWS by -2.57 dB (95% CI, -3.66 to -1.47). SRF negatively impacted PWS (-2.08 dB/nL; 95% CI, -2.53 to -1.64), but showed no association when EZL was present (+0.05 dB/nL; 95% CI, -0.81 to 0.92). SHRM presence and PED volume reduced PWS by -5.13 dB (95% CI, -5.83 to -4.43) and -0.71 dB/nL (95% CI, -0.92 to -0.50), respectively. Eccentricity only impaired function in the presence of EZL (-0.49 dB/°; 95% CI, -0.61 to -0.37).

Conclusions: DL-quantified biomarkers mostly had a negative impact on PWS in nAMD, particularly IRF and SHRM presence. The above-mentioned biomarkers should be considered when managing patients with nAMD and using MP in trials and clinical settings.

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基于深度学习的疾病特异性结构生物标志物对新生血管性年龄相关性黄斑变性视网膜敏感性的分析

目的：利用两种显微视野（MP）仪器评估疾病特异性生物标志物对活动性新生血管性年龄相关性黄斑变性（nAMD）患者点敏感（PWS）的影响。方法：在这项前瞻性横断面研究中，参与者使用SPECTRALIS HRA+OCT进行成像，并使用MP-3 （NIDEK）和介观MAIA （CenterVue）进行MP成像。采用深度学习（DL）对色素上皮脱离（PED）、视网膜内和视网膜下液（IRF， SRF）、椭球区损失（EZL）和视网膜下高反射物质（SHRM）进行量化。DL实现了MP和光学相干断层扫描（OCT）之间的共配准。采用包括相互作用项在内的变量选择的单变量和多变量混合效应模型来评估生物标志物对PWS的影响。结果：纳入20例受试者20只眼，平均年龄76.0岁。MAIA的敏感性低于MP-3 （-2.87 dB； 95%可信区间[CI]， -3.15至-2.59）。EZL与SRF、EZL与IRF、EZL与偏心率之间存在显著的交互作用。在0°偏心时，EZL显著降低PWS (-1.30 dB; 95% CI, -2.08至-0.51)，SRF为0.15 nL，无IRF。IRF的存在进一步降低了PWS -2.57 dB （95% CI, -3.66至-1.47）。SRF对PWS有负面影响（-2.08 dB/nL, 95% CI, -2.53至-1.64），但当EZL存在时，无相关性（+0.05 dB/nL, 95% CI, -0.81至0.92）。SHRM的存在和PED体积分别使PWS降低了-5.13 dB （95% CI, -5.83至-4.43）和-0.71 dB/nL （95% CI, -0.92至-0.50）。偏心仅在EZL存在时损害功能（-0.49 dB/°；95% CI, -0.61至-0.37）。结论：dl量化的生物标志物大多对nAMD患者的PWS有负面影响，尤其是IRF和SHRM的存在。在管理nAMD患者和在试验和临床环境中使用MP时，应考虑上述生物标志物。

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

Investigative ophthalmology & visual science 医学-眼科学

CiteScore

6.90

自引率

4.50%

发文量

339

审稿时长

1 months

期刊介绍： Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.