Gregor S Reiter, Klaudia Birner, Johannes Schrittwieser, Laetitia Hinterhuber, Irene Steiner, Markus Gumpinger, Simon Schürer-Waldheim, Hrvoje Bogunovic, Ursula Schmidt-Erfurth
{"title":"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","authors":"Gregor S Reiter, Klaudia Birner, Johannes Schrittwieser, Laetitia Hinterhuber, Irene Steiner, Markus Gumpinger, Simon Schürer-Waldheim, Hrvoje Bogunovic, Ursula Schmidt-Erfurth","doi":"10.1167/iovs.66.12.68","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"68"},"PeriodicalIF":4.7000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489871/pdf/","citationCount":"0","resultStr":"{\"title\":\"Deep-Learning-Based Analysis of Disease-Specific Structural Biomarkers on Retinal Sensitivity in Neovascular Age-Related Macular Degeneration.\",\"authors\":\"Gregor S Reiter, Klaudia Birner, Johannes Schrittwieser, Laetitia Hinterhuber, Irene Steiner, Markus Gumpinger, Simon Schürer-Waldheim, Hrvoje Bogunovic, Ursula Schmidt-Erfurth\",\"doi\":\"10.1167/iovs.66.12.68\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":14620,\"journal\":{\"name\":\"Investigative ophthalmology & visual science\",\"volume\":\"66 12\",\"pages\":\"68\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489871/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Investigative ophthalmology & visual science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1167/iovs.66.12.68\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Investigative ophthalmology & visual science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1167/iovs.66.12.68","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Deep-Learning-Based Analysis of Disease-Specific Structural Biomarkers on Retinal Sensitivity in Neovascular Age-Related Macular Degeneration.
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.
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.
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