Ophthalmologica最新文献

{"title":"Prediction of chronic central serous chorioretinopathy through combined manual annotation and AI-assisted volume measurement of flat irregular pigment epithelium.","authors":"Lorenzo Ferro Desideri, Davide Scandella, Lieselotte Berger, Raphael Sznitman, Martin Zinkernagel, Rodrigo Anguita","doi":"10.1159/000538543","DOIUrl":"https://doi.org/10.1159/000538543","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to investigate the role of an artificial intelligence (AI)-developed OCT program to predict the clinical course of central serous chorioretinopathy (CSC ) based on baseline pigment epithelium detachment (PED) features.</p><p><strong>Methods: </strong>Single-center, observational study with a retrospective design. Treatment-naïve patients with acute CSC and chronic CSC were recruited and OCTs were analyzed by an AI-developed platform (Discovery OCT Fluid and Biomarker Detector, RetinAI AG, Switzerland), providing automatic detection and volumetric quantification of PEDs. Flat irregular PED presence was annotated manually and afterwards measured by the AI program automatically.</p><p><strong>Results: </strong>115 eyes of 101 patients with CSC were included, of which 70 were diagnosed with chronic CSC and 45 with acute CSC. It was found that patients with baseline presence of foveal flat PEDs and multiple flat foveal and extrafoveal PEDs had a higher chance of developing chronic form. AI-based volumetric analysis revealed no significant differences between the groups.</p><p><strong>Conclusions: </strong>While more evidence is needed to confirm the effectiveness of AI-based PED quantitative analysis, this study highlights the significance of identifying flat irregular PEDs at the earliest stage possible in patients with CSC, to optimize patient management and long-term visual outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Submacular hemorrhage during neovascular age-related macular degeneration: a meta-analysis and meta-regression on the use of tPA and anti-VEGFs.","authors":"Daniele Veritti, Valentina Sarao, Deborah Martinuzzi, Sara Menzio, Paolo Lanzetta","doi":"10.1159/000537939","DOIUrl":"10.1159/000537939","url":null,"abstract":"<p><strong>Background: </strong>Submacular hemorrhage (SMH) associated with neovascular age-related macular degeneration (nAMD) precipitates rapid visual decline and impacts quality of life. Treatments vary, but combined recombinant tissue plasminogen activator (tPA) and anti-vascular endothelial growth factor (anti-VEGF) therapy has gained prominence as a viable treatment option.</p><p><strong>Objectives: </strong>This study aims to evaluate the efficacy of the combination of tPA and anti-VEGF.</p><p><strong>Methods: </strong>We conducted a systematic review meta-analysis following PRISMA guidelines, focusing on studies examining tPA and anti-VEGF therapy in SMH secondary to nAMD. Outcomes measured were change in best-corrected visual acuity (BCVA) and success rate of SMH displacement. Meta-regression assessed the relative efficacy of intravitreal and subretinal delivery.</p><p><strong>Results: </strong>Out of 257 initial reports, 22 studies involving 29 patient populations met inclusion criteria. Our analysis showed significant improvement in BCVA and a high rate of successful SMH displacement with combined tPA and anti-VEGF therapy. No significant differences were found between subretinal and intravitreal tPA administration. Furthermore, when evaluating the effects of subretinal versus intravitreal anti-VEGF administration in patients treated with subretinal tPA, the results indicated similar efficacy.</p><p><strong>Conclusions: </strong>Combined tPA and anti-VEGF therapy is effective in managing SMH in nAMD patients, significantly improving visual acuity and SMH displacement. The location of tPA and anti-VEGF delivery did not significantly impact outcomes.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal Thickness in healthy eyes measured by Widefield Optical Coherence Tomography.","authors":"Blanca Eslava, Sofia Bryan, Mariluz Puertas, Jorge Ruiz Medrano, José M Ruiz-Moreno","doi":"10.1159/000538129","DOIUrl":"10.1159/000538129","url":null,"abstract":"<p><strong>Introduction: </strong>The choroid and its role in posterior segment pathology has become an increasing subject of study. The objective of the present study was to analyze choroidal thickness (CT) in healthy eyes by widefield (WF) optical coherence tomography (OCT) up to the periphery and to compare the reliability of manual versus automatic measurement.</p><p><strong>Methods: </strong>Cross-sectional and non-interventional study conducted on 191 healthy eyes of 101 patients. All patients were scanned by using WF-OCT (Xephilio WF-OCT S1; Canon Corp, Tokyo, Japan). CT was measured in 2000 µm intervals automatically using the built-in software and manually by two masked observers. All analyses were performed using the IBM-PSSS statistical software program (IBM-SPSS, v. 28.0.0.0, Chicago, IL, USA).</p><p><strong>Results: </strong>CT was measured in 100% of the sample. The mean age of the study cohort was 39.05±19.06 years old. Mean subfoveal (SF)CT measured automatically was 343.67±84.18 μm and manually was 336.55±75.57 μm. The thickest point was located 2000 μm from the fovea in the superior sector in 62.83% of the subjects. According to age distribution, mean CT became significantly thinner from 40 years of age. When comparing automatic and manually measuring, the intraclass correlation coefficient was excellent (p<0.01) in all quadrants. Moreover, manual measurement interobserver agreement was excellent in all quadrants (p<0.01).</p><p><strong>Conclusion: </strong>The automatic system is valid and serves as the basis of choroid measurement. In more than 50% of the healthy subjects, superior CT is thicker than subfoveolar CT and mean CT became significantly thinner from 40 years of age.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Experience of Two Sutureless Intrascleral Fixation Techniques for Secondary Intraocular Lens Implantation.","authors":"Kai Januschowski, Annekatrin Rickmann, Karl T Boden, Gregor V Ehrlich-Treuenstätt, Philip Wakili, Lukas Bisorca-Gassendorf","doi":"10.1159/000532065","DOIUrl":"10.1159/000532065","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the outcome of the modified Carlevale intraocular lens (IOL) fixation technique, using two different vitrectomy ports (23- vs. 27-gauge) as anchor fixation.</p><p><strong>Methods: </strong>Retrospective, consecutive study of 282 eyes (282 patients) who underwent a secondary IOL implantation using the Carlevale IOL (Soleko IOL Division, Italy) with two anchor haptics for intrascleral implantation with either 23- or 27-gauge (G) port.</p><p><strong>Results: </strong>Transient post-operative ocular hypotonia (intraocular pressure ≤5 mm Hg) was observed less in the 27-G group (13 vs. 4 patients, p = 0.057) three requiring additional tunnel sutures (2 cases for 23-G; 1 case 27-G). Post-operative vitreous haemorrhage was recorded more often in the 23-G group (8 vs. 1 patient, p = 0.034), but all cases in both groups resolved without intervention. Visual acuity did improve post-operatively in the two groups. No post-operative complications such as retinal detachment, endophthalmitis, and IOL-dislocation tilt were observed in the follow-up.</p><p><strong>Conclusion: </strong>The 27-G modified technique for sutureless intrascleral implantation is simple and effective and causes less post-operative hypotony.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pars Plana Vitrectomy with or without Internal Limiting Membrane Peel for Epiretinal Membrane: A Systematic Review and Meta-Analysis.","authors":"Andrew Mihalache, Ryan S Huang, Haleema Ahmed, Nikhil S Patil, Marko M Popovic, Peter J Kertes, Rajeev H Muni","doi":"10.1159/000534851","DOIUrl":"10.1159/000534851","url":null,"abstract":"<p><strong>Background: </strong>The safety and effectiveness of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling remains poorly understood for the treatment of epiretinal membrane (ERM).</p><p><strong>Objectives: </strong>Our study aims to compare the safety and effectiveness of PPV with and without ILM peeling for ERM.</p><p><strong>Methods: </strong>A systematic literature search was conducted on Ovid MEDLINE, Embase, Cochrane Library, and Google Scholar from January 2000 to January 2023 for comparative studies reporting visual and anatomical outcomes for patients with ERM that received PPV with or without ILM peeling. Primary outcomes included best-corrected visual acuity (BCVA) at last study observation and change in BCVA from baseline. Secondary outcomes included retinal thickness (RT) at last study observation, change in RT from baseline, risk of ERM recurrence, and adverse events. A random-effects meta-analysis was performed. Risk of bias of randomized controlled trials was assessed using the Risk of Bias 2 tool of observational studies using the Risk of Bias in Non-randomized Studies of Interventions-I tool. The certainty of evidence of outcomes was evaluated using Grading of Recommendations, Assessment, Development and Evaluation criteria.</p><p><strong>Results: </strong>Nineteen studies reporting on 1,291 eyes at baseline were included. PPV with and without ILM peel achieved a similar BCVA at last study observation (p = 0.68) and change in BCVA from baseline (p = 0.79). These findings remained consistent irrespective of whether simultaneous phacoemulsification was performed. PPV with ILM peel achieved a significantly lower incidence of ERM recurrence (risk ratio [RR] = 0.26, 95% CI = [0.13, 0.51], p &lt; 0.0001) and additional surgery (RR = 0.17, 95% CI = [0.04, 0.74], p = 0.02) compared to PPV without ILM peel.</p><p><strong>Conclusion: </strong>PPV with and without ILM peel achieved a similar BCVA at last study observation in ERM patients. Patients treated with PPV and ILM peel also had a reduced risk of ERM recurrence and lower reoperation risk. These conclusions are associated with a moderate certainty of evidence and potential for bias from multiple non-randomized studies.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"30-43"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Landscape of Central Serous Chorioretinopathy in Germany: Retina.net CSC Registry Report Number 1.","authors":"Clemens A Lange, Charlotte Ohlmeier, Anna Kiskämper, Christoph von Schwarzkopf, Hinrich Hufnagel, Markus Gruber, Benedikt Schworm, Ulrike Brocks, Franziska Reinking, Lisa Schreiner, Yoko Miura, Milena Grundel, Tibor Lohmann, Christoph R Clemens, Maria-Andreea Gamulescu, Nicole Eter, Salvatore Grisanti, Siegfried Priglinger, Martin S Spitzer, Peter Walter, Hansjürgen A Agostini, Andreas Stahl, Laurenz J B Pauleikhoff","doi":"10.1159/000535930","DOIUrl":"10.1159/000535930","url":null,"abstract":"<p><strong>Introduction: </strong>The German Registry of central serous chorioretinopathy (CSC) collects data on CSC patients in a nationwide multicenter approach to analyze epidemiology, risk factors, clinical presentations, as well as diagnosis and treatment patterns.</p><p><strong>Methods: </strong>In this multicenter cohort study, patients with CSC were enrolled in nine tertiary referral centers in Germany between January 2022 and June 2023. After consenting to the study, demographic data, risk factors, reported symptoms, best-corrected visual acuity (BCVA), funduscopic findings, disease severity, and diagnostic and treatment decisions were recorded and analyzed.</p><p><strong>Results: </strong>A total of 539 eyes of 411 CSC patients were enrolled in this study including 308 males (75%) and 103 females (25%). Patients were predominantly of Caucasian origin and had a mean age of 55.5 years (IQR 41.0-70.0). 28% of eyes were classified as acute (&lt;4 months duration) CSC, 28% as chronic (&gt;4 months duration) CSC, 21% as inactive CSC, 11% as chronic atrophic CSC, and 12% as CSC with secondary CNV. 128 patients (31%) demonstrated bilateral CSC. The most common risk factors reported were psychological stress (52%), smoking (38%), arterial hypertension (38%), and a history of or current use of steroids (30%). Most frequently encountered symptoms included decreased visual acuity (76%), metamorphopsia (49%), relative scotoma (47%), blurred vision (19%), and dyschromatopsia (9%). The mean logMAR BCVA on initial examination was 0.2 (≈20/30, IQR 0.2-0.4) but showed significant variation with a tendency of lower BCVA in chronic cases. At the baseline visit, 74% of the overall cohort received no treatment, while 19% underwent local treatment and only 2% underwent systemic treatment. Of the local therapies, anti-VEGF injections were the most frequently performed procedure (33%, mainly for secondary CNV), followed by micropulse laser (28%), focal nonpulsed laser (23%), verteporfin photodynamic therapy (14%), and nonsteroidal anti-inflammatory eye drops (2%). Among intravitreal anti-VEGF agents, aflibercept was used most frequently, followed by bevacizumab and ranibizumab.</p><p><strong>Conclusion: </strong>This registry represents one of the largest cohorts of European patients with CSC to date. Patient age and the proportion of women were higher than expected and bilateral active disease was lower than anticipated, highlighting that neither age nor gender should be overemphasized when diagnosing CSC. Therapeutic interventions are heterogeneous and include verteporfin photodynamic therapy, micropulse laser, and anti-VEGF injections in case of secondary CNV.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"95-106"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11160426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-Month Outcomes of Three Episcleral Surgeries in Treatment of Rhegmatogenous Retinal Detachment.","authors":"Zigan Zhou, Binghua Guo, Hantao Zhou, Chen Yang, Jinghao Mei, Chuying Deng, Ronghan Wu, Zhong Lin","doi":"10.1159/000539854","DOIUrl":"10.1159/000539854","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the long-term outcomes of conventional scleral buckling (CSB), modified scleral buckling (MSB), and scleral encircling (SE) in the treatment of rhegmatogenous retinal detachment and identify factors influencing the outcomes.</p><p><strong>Methods: </strong>This comparative, retrospective cohort study assigned patients to CSB, MSB, and SE groups. The follow-up was 12 months, and the reattachment rate, complication rate, visual acuity, number of newly discovered tears during surgery, and changes in diopters were compared among the three surgeries. Influential factors on anatomical and functional reattachment were identified.</p><p><strong>Results: </strong>There were no significant differences in the primary reattachment rate, overall complication rate, or best corrected visual acuity at 6 or 12 months among the three groups. The MSB group had a higher number of newly discovered tears during surgery compared with the other two groups. At 12 months of post-surgery, the SE group displayed the greatest change of diopter, whereas the MSB group showed the least change. The surgical approach did not influence the primary reattachment rate. Long-term visual outcomes were influenced by factors including sex, preoperative visual acuity, macular status, and duration of symptoms.</p><p><strong>Conclusion: </strong>MSB is an effective method for treating rhegmatogenous retinal detachment. Its advantages include the ability to identify smaller tears and induce minimal changes in diopter.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"214-223"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of a New Monofocal Intraocular Lens in Patients Undergoing Phacovitrectomy for Idiopathic Epiretinal Membrane.","authors":"Tomislav Jukić, Gentian Bajraktari, Nenad Vukojević, Martin Oroz, Andrea Radolović, Krešimir Mandić, Miro Kalauz","doi":"10.1159/000540362","DOIUrl":"10.1159/000540362","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to evaluate the clinical outcomes and quality of life of newly generated monofocal intraocular lens (IOL) in patients diagnosed with idiopathic epiretinal membrane (IEM) following phacovitrectomy.</p><p><strong>Methods: </strong>In this prospective study, 42 patients with IEM and cataract underwent pars plana vitrectomy. They were divided into the ICB00 group (21 patients) and the ZCB00 group (21 patients). Data collected before and after the surgery were compared between the two groups, including uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), vision-related quality of life (VRQOL), intraocular pressure, contrast sensitivity (CS), and central macular thickness (CMT).</p><p><strong>Results: </strong>The preoperative characteristics of the two groups showed no significant differences. However, at the 6-month follow-up after surgery, there were significant improvements in UDVA (p &lt; 0.001), UIVA (p &lt; 0.001), VRQOL (p &lt; 0.001), CS (p &lt; 0.001), and CMT (p &lt; 0.001) compared to baseline. Notably, the Eyhance ICB00 group showed a significantly higher UCIVA value at 6 months post-surgery when compared to the Tecnis ZCB00 group (p = 0.001), while other parameters did not show significant differences between the groups.</p><p><strong>Conclusion: </strong>The Eyhance IOL significantly improved both intermediate and distance visual acuity, with no notable difference in quality of life or CS compared to the Tecnis ZCB00 IOL after IEM removal. It appears to be a favorable choice for combined cataract and vitreoretinal surgery, offering enhanced vision for daily tasks and a promising alternative to traditional monofocal IOLs.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"251-260"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravitreal Triamcinolone Acetonide for Diabetic Macular Edema and Macular Edema Secondary to Retinal Vein Occlusion: A Meta-Analysis.","authors":"Andrew Mihalache, Amin Hatamnejad, Nikhil S Patil, Marko M Popovic, Peter J Kertes, Miguel Cruz-Pimentel, Rajeev H Muni","doi":"10.1159/000533443","DOIUrl":"10.1159/000533443","url":null,"abstract":"<p><strong>Background: </strong>The comparative safety and efficacy of different doses of intravitreal triamcinolone acetonide (IVTA) for diabetic macular edema (DME) and macular edema (ME) secondary to retinal vein occlusion (RVO) is unclear.</p><p><strong>Objectives: </strong>This meta-analysis aimed to compare the safety and efficacy of different doses of IVTA in this setting.</p><p><strong>Methods: </strong>A systematic literature search for randomized clinical trials (RCTs) was conducted on Cochrane Library, Ovid MEDLINE, and EMBASE from January 2005 to May 2022. Studies that reported on patients with DME or ME secondary to RVO that received treatment with different doses of IVTA were included. A random-effects meta-analysis was performed. Cochrane's Risk of Bias Tool 2 was used to assess the risk of bias, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines were used to assess certainty of evidence.</p><p><strong>Results: </strong>Five RCTs reporting on 1,041 eyes at baseline were included in this meta-analysis. In eyes with ME secondary to RVO, high-dose (4 mg) IVTA achieved a significantly better change in best-corrected visual acuity (WMD = -4.75 ETDRS letters, 95% CI = [-7.73, -1.78], p = 0.002) and reduction in retinal thickness (WMD = -93.02 μm, 95% CI = [-153.23, -32.82], p = 0.002) at months 4-6 compared to low-dose (1-2 mg) IVTA. However, high-dose IVTA had a higher risk of intraocular pressure-related adverse events (RR = 2.99, 95% CI = [1.05, 8.50], p = 0.04) and cataract surgery (RR = 5.67, 95% CI = [3.09, 10.41], p &lt; 0.00001) than low-dose IVTA in eyes with ME secondary to RVO. These efficacy and safety differences in high-dose and low-dose IVTA were not observed in DME eyes.</p><p><strong>Conclusions: </strong>The RCT evidence in this setting is limited. High-dose IVTA achieved greater improvements in visual acuity and reductions in retinal thickness than low-dose IVTA at months 4-6. However, high-dose IVTA had a less favorable safety profile than low-dose IVTA. The significance of these outcomes was based on patients with ME secondary to RVO, but not DME.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"19-29"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Deep Learning Model for Detecting Rhegmatogenous Retinal Detachment Using Ophthalmologic Ultrasound Images.","authors":"Huihang Wang, Xuling Chen, Xiaocui Miao, Shumin Tang, Yijun Lin, Xiaojuan Zhang, Yingying Chen, Yihua Zhu","doi":"10.1159/000535798","DOIUrl":"10.1159/000535798","url":null,"abstract":"<p><strong>Introduction: </strong>Rhegmatogenous retinal detachment (RRD) is one of the most common fundus diseases. Many rural areas of China have few ophthalmologists, and ophthalmologic ultrasound examination is of great significance for remote diagnosis of RRD. Therefore, this study aimed to develop and evaluate a deep learning (DL) model, to be used for automated RRD diagnosis based on ophthalmologic ultrasound images, in order to support timely diagnosis of RRD in rural and remote areas.</p><p><strong>Methods: </strong>A total of 6,000 ophthalmologic ultrasound images from 1,645 participants were used to train and verify the DL model. A total of 5,000 images were used for training and validating DL models, and an independent testing set of 1,000 images was used to test the performance of eight DL models trained using four different DL model architectures (fully connected neural network, LeNet5, AlexNet, and VGG16) and two preprocessing techniques (original, original image augmented). Receiver operating characteristic (ROC) curves were used to analyze their performance. Heatmaps were generated to visualize the process of the best DL model in the identification of RRD. Finally, five ophthalmologists were invited to diagnose RRD independently on the same test set of 1,000 images for performance comparison with the best DL model.</p><p><strong>Results: </strong>The best DL model for identifying RRD achieved an area under the ROC curve (AUC) of 0.998 with a sensitivity and specificity of 99.2% and 99.8%, respectively. The best preprocessing method in each model architecture was the application of original image augmentation (average AUC = 0.982). The best model architecture in each preprocessing method was VGG16 (average AUC = 0.998).</p><p><strong>Conclusion: </strong>The best DL model determined in this study has higher accuracy, sensitivity, and specificity than the ophthalmologists' diagnosis in identifying RRD based on ophthalmologic ultrasound images. This model may provide support for timely diagnosis in locations without access to ophthalmologic care.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"8-18"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}