Diagnostics

Research

11 pages, 1689 KiB

Open AccessArticle

A Novel Noninvasive Screening Tool for Dry Eye Disease

by Sabrina Vaccaro, Massimiliano Borselli, Giovanni Scalia, Costanza Rossi, Mario Damiano Toro, Robert Rejdak, Marco Pellegrini, Vincenzo Scorcia and Giuseppe Giannaccare

Diagnostics 2024, 14(12), 1209; https://doi.org/10.3390/diagnostics14121209 - 7 Jun 2024

Viewed by 788

Abstract

Purpose: To assess the feasibility and the diagnostic accuracy of the new tool, DEvice© (AI, Rome, Italy), for screening patients with dry eye disease (DED). Methods: This study was performed at the University Magna Græcia of Catanzaro. Enrolled patients were classified as affected [...] Read more.

Purpose: To assess the feasibility and the diagnostic accuracy of the new tool, DEvice© (AI, Rome, Italy), for screening patients with dry eye disease (DED). Methods: This study was performed at the University Magna Græcia of Catanzaro. Enrolled patients were classified as affected by DED (group 1) or not (group 2) using an already validated tool (Keratograph 5M, Oculus, Germany), evaluating the noninvasive keratograph breakup time (NIKBUT), tear meniscus height (TMH), meibomian gland loss (MGL), and bulbar redness. All the patients were then examined by means of DEvice©, which allowed the measurement of the relative humidity (RH) and temperature of the ocular surface. Symptoms were scored using the Ocular Surface Disease Index (OSDI) questionnaire. Results: Overall, 40 patients (17 males and 23 females, mean age 38.0 ± 17.1 years) were included: of these, 20 belonged to group 1 and the remaining 20 to group 2. Using Keratograph 5M, significant differences between groups 1 and 2 were detected for NIKBUT-first (respectively, 4.97 ± 1.85 vs. 13.95 ± 4.8 s; p < 0.0001) and for NIKBUT-average (10.55 ± 4.39 vs. 15.96 ± 4.08 s; p = 0.0003). No statistically significant changes were detected for TMH (p = 0.565), MGL (p = 0.051), and bulbar redness (p = 0.687). Using Device©, a statistically significant higher value of RH was found in group 1 compared to group 2 (respectively, 85.93 ± 10.63 vs. 73.05 ± 12.84%; p = 0.0049). A statistically significant correlation was found between RH and OSDI (r = 0.406; p = 0.009). The value RH showed a discriminating power to detect DED with an AUC = 0.782 (standard error 0.07264; 95% CI 0.6401–0.9249; p = 0.0022). Conclusions: The DEvice© can effectively discriminate DED patients from healthy subjects. The parameter RH showed good sensitivity, making this tool ideal for a fast and noninvasive DED screening. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

11 pages, 1941 KiB

Open AccessArticle

Feasibility of Tear Meniscus Height Measurements Obtained with a Smartphone-Attachable Portable Device and Agreement of the Results with Standard Slit Lamp Examination

by Massimiliano Borselli, Mario Damiano Toro, Costanza Rossi, Andrea Taloni, Rohan Khemlani, Shintato Nakayama, Hiroki Nishimura, Eisuke Shimizu, Vincenzo Scorcia and Giuseppe Giannaccare

Diagnostics 2024, 14(3), 316; https://doi.org/10.3390/diagnostics14030316 - 1 Feb 2024

Cited by 1 | Viewed by 1115

Abstract

Purpose: We aimed to evaluate the feasibility of using a novel device, the Smart Eye Camera (SEC), for assessing tear meniscus height (TMH) after fluorescein staining and the agreement of the results with measurements obtained using standard slit lamp examination. Methods: TMH was [...] Read more.

Purpose: We aimed to evaluate the feasibility of using a novel device, the Smart Eye Camera (SEC), for assessing tear meniscus height (TMH) after fluorescein staining and the agreement of the results with measurements obtained using standard slit lamp examination. Methods: TMH was assessed using both SEC and conventional slit lamp examination. The images were analyzed using the software ImageJ 1.53t (National Institutes of Health, Bethesda, MD, USA). A common measurement unit scale was established based on a paper strip, which was used as a calibration marker to convert pixels into metric scale. A color threshold was applied using uniform parameters for brightness, saturation, and hue. The images were then binarized to black and white to enhance the representation of the tear menisci. A 2 mm area around the upper and lower meniscus in the central eye lid zone was selected and magnified 3200 times to facilitate manual measurement. The values obtained using SEC were compared with those obtained with a slit lamp. Results: The upper and lower TMH values measured using the SEC were not statistically different from those obtained with a slit lamp (0.209 ± 0.073 mm vs. 0.235 ± 0.085, p = 0.073, and 0.297 ± 0.168 vs. 0.260 ± 0.173, p = 0.275, respectively). The results of Bland–Altman analysis demonstrated strong agreement between the two instruments, with a mean bias of −0.016 mm (agreement limits: −0.117 to 0.145 mm) for upper TMH and 0.031 mm (agreement limits: −0.306 to 0.368 mm) for lower TMH. Conclusions: The SEC demonstrated sufficient validity and reliability for assessing TMH in healthy eyes in a clinical setting, demonstrating concordance with the conventional slit lamp examination. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

23 pages, 5727 KiB

Open AccessArticle

Characteristics of Rare Inherited Retinal Dystrophies in Adaptive Optics—A Study on 53 Eyes

by Katarzyna Samelska, Jacek Paweł Szaflik, Maria Guszkowska, Anna Katarzyna Kurowska and Anna Zaleska-Żmijewska

Diagnostics 2023, 13(15), 2472; https://doi.org/10.3390/diagnostics13152472 - 25 Jul 2023

Cited by 2 | Viewed by 1033

Abstract

Inherited retinal dystrophies (IRDs) are genetic disorders that lead to the bilateral degeneration of the retina, causing irreversible vision loss. These conditions often manifest during the first and second decades of life, and their primary symptoms can be non-specific. Diagnostic processes encompass assessments [...] Read more.

Inherited retinal dystrophies (IRDs) are genetic disorders that lead to the bilateral degeneration of the retina, causing irreversible vision loss. These conditions often manifest during the first and second decades of life, and their primary symptoms can be non-specific. Diagnostic processes encompass assessments of best-corrected visual acuity, fundoscopy, optical coherence tomography, fundus autofluorescence, fluorescein angiography, electrophysiological tests, and genetic testing. This study focuses on the application of adaptive optics (AO), a non-invasive retinal examination, for the assessment of patients with IRDs. AO facilitates the high-quality, detailed observation of retinal photoreceptor structures (cones and rods) and enables the quantitative analysis of parameters such as cone density (DM), cone spacing (SM), cone regularity (REG), and Voronoi analysis (

N % 6

). AO examinations were conducted on eyes diagnosed with Stargardt disease (STGD,

N = 36

), cone dystrophy (CD,

N = 9

), and cone-rod dystrophy (CRD,

N = 8

), and on healthy eyes (

N = 14

). There were significant differences in the DM, SM, REG, and

N % 6

parameters between the healthy and IRD-affected eyes (

p < 0.001

for DM, SM, and REG;

p = 0.008

for

N % 6

). The mean DM in the CD, CRD, and STGD groups was 8900.39/mm

^{2}

, 9296.32/mm

^{2}

, and 16,209.66/mm

^{2}

, respectively, with a significant inter-group difference (

p = 0.006

). The mean SM in the CD, CRD, and STGD groups was 12.37

μ

m, 14.82

μ

m, and 9.65

μ

m, respectively, with a significant difference observed between groups (

p = 0.002

). However, no significant difference was found in REG and

N % 6

among the CD, CRD, and STGD groups. Significant differences were found in SM and DM between CD and STGD (

p = 0.014

for SM;

p = 0.003

for DM) and between CRD and STGD (

p = 0.027

for SM;

p = 0.003

for DM). Our findings suggest that AO holds significant potential as an impactful diagnostic tool for IRDs. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

15 pages, 5075 KiB

Open AccessArticle

Detection of Hydroxychloroquine Retinopathy via Hyperspectral and Deep Learning through Ophthalmoscope Images

by Wen-Shuang Fan, Hong-Thai Nguyen, Ching-Yu Wang, Shih-Wun Liang, Yu-Ming Tsao, Fen-Chi Lin and Hsiang-Chen Wang

Diagnostics 2023, 13(14), 2373; https://doi.org/10.3390/diagnostics13142373 - 14 Jul 2023

Cited by 3 | Viewed by 1345

Abstract

Hydroxychloroquine, also known as quinine, is primarily utilized to manage various autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and Sjogren’s syndrome. However, this drug has side effects, including diarrhea, blurred vision, headache, skin itching, poor appetite, and gastrointestinal discomfort. Blurred vision [...] Read more.

Hydroxychloroquine, also known as quinine, is primarily utilized to manage various autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and Sjogren’s syndrome. However, this drug has side effects, including diarrhea, blurred vision, headache, skin itching, poor appetite, and gastrointestinal discomfort. Blurred vision is caused by irreversible retinal damages and can only be mitigated by reducing hydroxychloroquine dosage or discontinuing the drug under a physician’s supervision. In this study, color fundus images were utilized to identify differences in lesions caused by hydroxychloroquine. A total of 176 color fundus images were captured from a cohort of 91 participants, comprising 25 patients diagnosed with hydroxychloroquine retinopathy and 66 individuals without any retinopathy. The mean age of the participants was 75.67 ± 7.76. Following the selection of a specific region of interest within each image, hyperspectral conversion technology was employed to obtain the spectrum of the sampled image. Spectral analysis was then conducted to discern differences between normal and hydroxychloroquine-induced lesions that are imperceptible to the human eye on the color fundus images. We implemented a deep learning model to detect lesions, leveraging four artificial neural networks (ResNet50, Inception_v3, GoogLeNet, and EfficientNet). The overall accuracy of ResNet50 reached 93% for the original images (ORIs) and 96% for the hyperspectral images (HSIs). The overall accuracy of Inception_v3 was 87% for ORIs and 91% for HSI, and that of GoogLeNet was 88% for ORIs and 91% for HSIs. Finally, EfficientNet achieved an overall accuracy of 94% for ORIs and 97% for HSIs. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

12 pages, 7029 KiB

Open AccessArticle

Two-Port “Dry Vitrectomy” as a New Surgical Technique for Rhegmatogenous Retinal Detachment: Focus on Macula-on Results

by Tomaso Caporossi, Alessandra Scampoli, Filippo Tatti, Lorenzo Mangoni, Matteo Mario Carlà, Emanuele Siotto Pintor, Francesca Frongia, Claudio Iovino, Patrizio Bernardinelli and Enrico Peiretti

Diagnostics 2023, 13(7), 1301; https://doi.org/10.3390/diagnostics13071301 - 30 Mar 2023

Viewed by 2117

Abstract

We evaluated a new surgical technique for treating primary rhegmatogenous retinal detachment (RRD), consisting of localized vitrectomy near the retinal break associated with drainage of subretinal fluid without infusion. Twelve eyes of twelve patients with primary RRDs with macula-on superior, temporal, and/or nasal [...] Read more.

We evaluated a new surgical technique for treating primary rhegmatogenous retinal detachment (RRD), consisting of localized vitrectomy near the retinal break associated with drainage of subretinal fluid without infusion. Twelve eyes of twelve patients with primary RRDs with macula-on superior, temporal, and/or nasal quadrants’ RRD with retinal breaks between 8 and 4 o’clock, pseudophakic or phakic eyes, were enrolled. All eyes underwent a two-port 25-gauge vitrectomy with localized removal of the vitreous surrounding the retinal break(s), followed by a 20% SF6 injection and cryopexy. The difference between pre-operative (T0) and post-operative mean BCVA at 6 months follow-up (T6) was not statistically significant (0.16 logMAR vs. 0.21 logMAR; p = 0.055). Primary anatomic success at 6 months was achieved by 86% of patients. No other complications, except for two retinal re-detachments linked to an incorrect head position of the patients, were recorded. Although further studies are necessary to evaluate the treatment’s efficacy, we believe our technique could be considered a valid alternative for managing primary RRD. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

11 pages, 2095 KiB

Open AccessArticle

Smartphone Slit Lamp Imaging—Usability and Quality Assessment

by Daniel Rudolf Muth, Frank Blaser, Nastasia Foa, Pauline Scherm, Wolfgang Johann Mayer, Daniel Barthelmes and Sandrine Anne Zweifel

Diagnostics 2023, 13(3), 423; https://doi.org/10.3390/diagnostics13030423 - 24 Jan 2023

Cited by 3 | Viewed by 1895

Abstract

Purpose: To assess the usability and image quality of a smartphone adapter for direct slit lamp imaging. Methods: A single-center, prospective, clinical study conducted in the Department of Ophthalmology at the University Hospital Zurich, Switzerland. The smartphone group consisted of 26 medical staff [...] Read more.

Purpose: To assess the usability and image quality of a smartphone adapter for direct slit lamp imaging. Methods: A single-center, prospective, clinical study conducted in the Department of Ophthalmology at the University Hospital Zurich, Switzerland. The smartphone group consisted of 26 medical staff (consultants, residents, and students). The control group consisted of one ophthalmic photographer. Both groups took images of the anterior and the posterior eye segment of the same proband. The control group used professional photography equipment. The participant group used an Apple iPhone 11 mounted on a slit lamp via a removable SlitREC smartphone adapter (Custom Surgical GmbH, Munich, Germany). The image quality was graded independently by two blinded ophthalmologists on a scale from 0 (low) to 10 (high quality). Images with a score ≥ 7.0/10 were considered as good as the reference images. The acquisition time was measured. A questionnaire on usability and experience in smartphone and slit lamp use was taken by all of the participants. Results: Each participant had three attempts at the same task. The overall smartphone quality was 7.2/10 for the anterior and 6.4/10 for the posterior segment. The subjectively perceived difficulty decreased significantly over the course of three attempts (Kendall’s W). Image quality increased as well but did not improve significantly from take 1 to take 3. However, the image quality of the posterior segment was significantly, positively correlated (Spearman’s Rho) with work experience. The mean acquisition time for anterior segment imaging was faster in the smartphone group compared to the control group (156 vs. 206 s). It was vice versa for the posterior segment (180 vs. 151 s). Conclusion: Slit lamp imaging with the presented smartphone adapter provides high-quality imaging of the anterior segment. Posterior segment imaging remains challenging in terms of image quality. The adapter constitutes a cost-effective, portable, easy-to-use solution for recording ophthalmic photos and videos. It can facilitate clinical documentation and communication among colleagues and with the patient especially outside normal consultation hours. Direct slit lamp imaging allows for time to be saved and increases the independence of ophthalmologists in terms of patient mobility and the availability of photographic staff. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

11 pages, 1776 KiB

Open AccessArticle

Comparative Analysis of Corneal Parameters Performed with GalileiG6 and OCT Casia 2

by Robert Mazur, Adam Wylęgała, Edward Wylęgała and Dariusz Dobrowolski

Diagnostics 2023, 13(2), 267; https://doi.org/10.3390/diagnostics13020267 - 11 Jan 2023

Cited by 3 | Viewed by 1607

Abstract

Backgrounds: To compare keratometry (Ks and Kf), astigmatism (Ast.), and the astigmatism axes (Ax.) of the posterior surface of the cornea; the total, central cornea thickness (CCT); and the thinnest corneal thickness (TCT) measured using two different measurement methods. Methods: Patients qualified for [...] Read more.

Backgrounds: To compare keratometry (Ks and Kf), astigmatism (Ast.), and the astigmatism axes (Ax.) of the posterior surface of the cornea; the total, central cornea thickness (CCT); and the thinnest corneal thickness (TCT) measured using two different measurement methods. Methods: Patients qualified for cataract surgery at the Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, Katowice, Poland, were included in the study and monitored with the following two devices: OCT-CASIA2 and Dual Scheimpflug Analyzer GalileiG6. Our work was a randomized, prospective study in which compliance with the agreement of measurements between the devices was evaluated using the Bland–Altman method. Results: A total of 110 patients (62 females and 48 males) were examined. Overall, 100 eyes of patients that qualified for cataract surgery were enrolled in the study. No statistically significant difference was observed for Total-Ks and Total-Kf. A significant difference was observable for the following parameters: total Ks-ax, total Kf-ax, the total power of astigmatism, and in all parameters of the part of the cornea and corneal thickness (CCT and TCT). Conclusions: The measurements obtained using Casia2 and the Dual Scheimpflug Analyzer GalileiG6 were significantly different and not interchangeable except for total Ks and Kf. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

22 pages, 4884 KiB

Open AccessArticle

Diagnostic Algorithm for Surgical Management of Limbal Stem Cell Deficiency

by Boris Malyugin, Svetlana Kalinnikova, Ruslan Isabekov, Dmitriy Ostrovskiy, Boris Knyazer and Maxim Gerasimov

Diagnostics 2023, 13(2), 199; https://doi.org/10.3390/diagnostics13020199 - 5 Jan 2023

Cited by 2 | Viewed by 4155

Abstract

Background: Limbal stem cell deficiency (LCSD) presents several challenges. Currently, there is no clearly defined systematic approach to LSCD diagnosis that may guide surgical tactics. Methods: The medical records of 34 patients with LSCD were analyzed. Diagnostic modalities included standard (visometry, tonometry, visual [...] Read more.

Background: Limbal stem cell deficiency (LCSD) presents several challenges. Currently, there is no clearly defined systematic approach to LSCD diagnosis that may guide surgical tactics. Methods: The medical records of 34 patients with LSCD were analyzed. Diagnostic modalities included standard (visometry, tonometry, visual field testing, slit-lamp biomicroscopy with corneal fluorescein staining, Schirmer test 1, ultrasonography) and advanced ophthalmic examination methods such as anterior segment optical coherence tomography, in vivo confocal microscopy, impression cytology, and enzyme-linked immunoassay. Results: Standard ophthalmological examination was sufficient to establish the diagnosis of LSCD in 20 (58.8%) cases, whereas advanced evaluation was needed in 14 (41.2%) cases. Depending on the results, patients with unilateral LSCD were scheduled to undergo glueless simple limbal epithelial transplantation (G-SLET) or simultaneous G-SLET and lamellar keratoplasty. Patients with bilateral LSCD with normal or increased corneal thickness were enrolled in the paralimbal oral mucosa epithelium transplantation (pLOMET) clinical trial. Conclusions: Based on the diagnostic and surgical data analyzed, the key points in LSCD diagnosis were identified, hel** to guide the surgeon in selecting the appropriate surgical procedure. Finally, we proposed a novel step-by-step diagnostic algorithm and original surgical guidelines for the treatment of patients with LSCD. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

13 pages, 3774 KiB

Open AccessArticle

Functional and Anatomical Outcomes of Pars Plana Vitrectomy for Epiretinal Membrane in Patients with Uveitis

by Irina-Elena Cristescu, Tsveta Ivanova, George Moussa, Mariantonia Ferrara, Niall Patton, Felipe Dhawahir-Scala, Soon Wai Ch’ng, Arijit Mitra, Ajai K. Tyagi, Kim Son Lett and Assad Jalil

Diagnostics 2022, 12(12), 3044; https://doi.org/10.3390/diagnostics12123044 - 5 Dec 2022

Cited by 2 | Viewed by 1543

Abstract

Purpose-To evaluate the anatomical and functional outcomes of vitrectomy and epiretinal membrane (ERM) peeling in patients with uveitis. Secondarily, we evaluated the effect of internal limiting membrane (ILM) peeling on surgical outcomes, and of surgery on uveitis activity and, thus, therapeutic regime. [...] Read more.

Purpose-To evaluate the anatomical and functional outcomes of vitrectomy and epiretinal membrane (ERM) peeling in patients with uveitis. Secondarily, we evaluated the effect of internal limiting membrane (ILM) peeling on surgical outcomes, and of surgery on uveitis activity and, thus, therapeutic regime. Methods-Bicentre, retrospective, interventional case series of 29 eyes of 29 consecutive patients affected by uveitis and ERM, that had undergone pars plana vitrectomy with ERM peel between 2012 and 2020, with a minimum postoperative follow-up (FU) of six-months. Demographic data, best-corrected visual-acuity (BCVA), clinical findings, intraoperative and postoperative complications, and macular optical-coherence-tomography scans were reviewed. Results-The mean (standard deviation) duration of follow-up was 32 (22) months. At six-month FU, mean central-retinal-thickness (CRT) significantly improved (from 456 (99) to 353 (86) microns; p < 0.001), and mean BCVA improved from 0.73 (0.3) to 0.49 (0.36) logMAR (p < 0.001), with only one (3%) patient experiencing worsening of vision. The rate of concomitant cystoid macular edema decreased from 19 (66%) eyes at presentation to eight (28%) eyes at final-FU (p = 0.003). Comparing eyes in which ILM peeling was performed in addition to ERM peeling only, BCVA or CRT reduction were comparable. Only a minority of six (21%) eyes had a worsening in uveitis activity requiring additional medications, whereas most patients resumed the same treatment (52%) or received less treatment (28%) (p = 0.673). Conclusions-Vitrectomy with ERM peeling led to favourable anatomical and functional outcomes in patients with uveitis regardless of whether the ILM is peeled or not. As in most patients, no activation of the uveitis requiring additional medications was noted, we do not recommend changes in anti-inflammatory/immunosuppressive therapy postoperatively. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

9 pages, 1333 KiB

Open AccessArticle

Duration of Diabetes as a Risk Factor for Retinal Microvasculature Alterations Detected with Optical Coherence Tomography Angiography in Patients without Clinical Retinopathy

by **g Qian, Zeeshan Haq, Daphne Yang, Joy Q. ** and Jay M. Stewart

Diagnostics 2022, 12(12), 3020; https://doi.org/10.3390/diagnostics12123020 - 2 Dec 2022

Cited by 2 | Viewed by 1262

Abstract

In this study, we examined the impact of diabetes mellitus (DM) disease duration on optical coherence tomography angiography (OCTA) parameters in diabetic patients without diabetic retinopathy (DR). A total of 1118 eyes from 1118 DM patients without DR were divided into three groups [...] Read more.

In this study, we examined the impact of diabetes mellitus (DM) disease duration on optical coherence tomography angiography (OCTA) parameters in diabetic patients without diabetic retinopathy (DR). A total of 1118 eyes from 1118 DM patients without DR were divided into three groups by DM duration: 0–5 years (short cohort; n = 571), 6–10 years (medium cohort; n = 306), and >10 years (long cohort; n = 241). Ultra-widefield fundus photography and nine OCTA parameters derived from the superficial retinal capillary plexus were analyzed. Perfusion density (PD) and vessel length density (VD) were significantly decreased within the 1 mm patch in patient OCTAs from the medium cohort compared to the short cohort. Conversely, PD and VD were significantly decreased within the 6 mm patch and inner ring among the long cohort compared to the short and medium cohorts. These findings remained consistent after controlled analysis. Patients in the medium cohort had the largest FAZ area, while patients in the long cohort had the smallest FAZ area, with a statistically significant difference between the two groups. Superficial PD and VD significantly decreased among the medium and long cohorts compared to the short cohort, confirming that subclinical, progressive macular vasculature change is associated with longer DM duration. However, while FAZ area significantly increased in the medium cohort, the long cohort exhibited decreased FAZ area, suggesting the latter may possess protective factors that decrease overall risk of DR development. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

10 pages, 2684 KiB

Open AccessArticle

Macrophage-like Cells Are Increased in Patients with Vision-Threatening Diabetic Retinopathy and Correlate with Macular Edema

by Nigel T. Zhang, Peter L. Nesper, Janice X. Ong, Jacob M. Wang, Amani A. Fawzi and Jeremy A. Lavine

Diagnostics 2022, 12(11), 2793; https://doi.org/10.3390/diagnostics12112793 - 15 Nov 2022

Cited by 9 | Viewed by 1740

Abstract

Macrophage-like cells (MLCs) are potential inflammatory biomarkers. We previously showed that MLCs are increased in proliferative diabetic retinopathy (PDR) eyes. Vision-threatening diabetic retinopathy (VTDR) includes PDR, severe non-PDR (NPDR), and diabetic macular edema (DME). No prior data exist on MLCs in eyes with [...] Read more.

Macrophage-like cells (MLCs) are potential inflammatory biomarkers. We previously showed that MLCs are increased in proliferative diabetic retinopathy (PDR) eyes. Vision-threatening diabetic retinopathy (VTDR) includes PDR, severe non-PDR (NPDR), and diabetic macular edema (DME). No prior data exist on MLCs in eyes with severe NPDR or DME. This prospective, cross-sectional optical coherence tomography-angiography (OCT-A) imaging study included 40 eyes of 37 participants who had NPDR classified as non-VTDR (n = 18) or VTDR (n = 22). Repeated OCT-A images were registered, averaged, and used to quantify the main outcome measures: MLC density and percent area. MLC density and percent area were correlated with clinical characteristics, NPDR stage, presence of DME, and OCT central subfield thickness (CST). In VTDR eyes, MLC density (2.6-fold, p < 0.001) and MLC percent area (2.5-fold, p < 0.01) were increased compared with non-VTDR eyes. Multiple linear regression analysis between MLC metrics and clinical characteristics found that MLC density was positively correlated with worse NPDR severity (p = 0.023) and higher CST values (p = 0.010), while MLC percent area was only positively associated with increased CST values (p = 0.006). MLCs are increased in patients with VTDR. Macular edema is the most strongly associated factor with increased MLC numbers in NPDR eyes. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

11 pages, 1710 KiB

Open AccessArticle

Automated Quantitative Analysis of Anterior Segment Inflammation Using Swept-Source Anterior Segment Optical Coherence Tomography: A Pilot Study

by Hiroshi Keino, Takuto Aman, Ryota Furuya, Makiko Nakayama, Annabelle A. Okada, Wataru Sunayama and Yuji Hatanaka

Diagnostics 2022, 12(11), 2703; https://doi.org/10.3390/diagnostics12112703 - 5 Nov 2022

Cited by 3 | Viewed by 1742

Abstract

Background: The aim of this study is to develop an automated evaluation of anterior chamber (AC) cells in uveitis using anterior segment (AS) optical coherence tomography (OCT) images. Methods: We analyzed AS swept-source (SS)-OCT (CASIA 2) images of 31 patients (51 eyes) with [...] Read more.

Background: The aim of this study is to develop an automated evaluation of anterior chamber (AC) cells in uveitis using anterior segment (AS) optical coherence tomography (OCT) images. Methods: We analyzed AS swept-source (SS)-OCT (CASIA 2) images of 31 patients (51 eyes) with uveitis using image analysis software (Python). An automated algorithm was developed to detect cellular spots corresponding to hyper-reflective spots in the AC, and the correlation with Standardization of Uveitis Nomenclature (SUN) grading AC cells score was evaluated. The approximated AC grading value was calculated based on the logarithmic approximation curve between the number of cellular spots and the SUN grading score. Results: Among 51 eyes, cellular spots were automatically segmented in 48 eyes, whereas three eyes (all SUN grading AC cells score: 4+) with severe fibrin formation in the AC were removed by the automated algorithm. The AC cellular spots increased with an increasing SUN grading score (p < 0.001). The 48 eyes were split into training data (26 eyes) and test data (22 eyes). There was a significant correlation between the SUN grading score and the number of cellular spots in 26 eyes (rho: 0.843, p < 0.001). There was a significant correlation between the SUN grading score and the approximated grading value of 22 eyes based on the logarithmic approximation curve (rho: 0.774, p < 0.001). Leave-one-out cross-validation analysis demonstrated a significant correlation between the SUN grading score and the approximated grading value of 48 eyes (rho: 0.748, p < 0.001). Conclusions: This automated anterior AC cell analysis using AS SS-OCT showed a significant correlation with clinical SUN grading scores and provided SUN AC grading values as a continuous variable. Our findings suggest that automated grading of AC cells could improve the accuracy of a quantitative assessment of AC inflammation using AS-OCT images and allow the objective and rapid evaluation of anterior segment inflammation in uveitis. Further investigations on a large scale are required to validate this quantitative measurement of anterior segment inflammation in uveitic eyes. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

Review

Jump to: Research, Other

14 pages, 730 KiB

Open AccessReview

The Role of Color Doppler Imaging in the Diagnosis of Glaucoma: A Review of the Literature

by Lamprini Banou, Anna Dastiridou, Athanasios Giannoukas, Georgios Kouvelos, Christos Baros and Sofia Androudi

Diagnostics 2023, 13(4), 588; https://doi.org/10.3390/diagnostics13040588 - 5 Feb 2023

Cited by 5 | Viewed by 1669

Abstract

Glaucoma is a progressive optic neuropathy and one of the leading causes of irreversible blindness worldwide. Elevated intraocular pressure (IOP) is the major risk factor for the onset and progression of glaucoma. In addition to elevated IOP, impaired intraocular blood flow is also [...] Read more.

Glaucoma is a progressive optic neuropathy and one of the leading causes of irreversible blindness worldwide. Elevated intraocular pressure (IOP) is the major risk factor for the onset and progression of glaucoma. In addition to elevated IOP, impaired intraocular blood flow is also considered to be involved in the pathogenesis of glaucoma. Various techniques have been used to assess ocular blood flow (OBF), including Color Doppler Imaging (CDI), a technique used in ophthalmology in recent decades. This article reviews the role of CDI in both the diagnosis and effective monitoring of glaucoma progression, presenting the protocol for imaging and its advantages, as well as the limitations of its use. Moreover, it analyzes the pathophysiology of glaucoma, focusing on vascular theory and its role in the onset and progression of the disease. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

14 pages, 3084 KiB

Open AccessReview

Update on Corneal Confocal Microscopy Imaging

by Pilar Cañadas, Marta Alberquilla García-Velasco, José Luis Hernández Verdejo and Miguel A. Teus

Diagnostics 2023, 13(1), 46; https://doi.org/10.3390/diagnostics13010046 - 23 Dec 2022

Cited by 4 | Viewed by 2925

Abstract

In vivo corneal confocal microscopy (IVCM) is a non-invasive ophthalmic imaging technique that provides images of the cornea at the cellular level. Despite the uses in ocular surface pathologies, in the last decades IVCM has been used to provide more knowledge in refractive [...] Read more.

In vivo corneal confocal microscopy (IVCM) is a non-invasive ophthalmic imaging technique that provides images of the cornea at the cellular level. Despite the uses in ocular surface pathologies, in the last decades IVCM has been used to provide more knowledge in refractive surgery wound healing, in neuropathies diagnosis, etc. The observation of the corneal cells, both normal and inflammatory, and the possibility of quantification of the corneal nerve density with manual or automated tools, makes IVCM have a significant potential to improve the diagnosis and prognosis in several systemic and corneal conditions. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

14 pages, 3955 KiB

Open AccessReview

Enhanced Diagnostics for Corneal Ectatic Diseases: The Whats, the Whys, and the Hows

by Louise Pellegrino Gomes Esporcatte, Marcella Q. Salomão, Alexandre Batista da Costa Neto, Aydano P. Machado, Bernardo T. Lopes and Renato Ambrósio, Jr.

Diagnostics 2022, 12(12), 3027; https://doi.org/10.3390/diagnostics12123027 - 2 Dec 2022

Cited by 4 | Viewed by 2377

Abstract

There are different fundamental diagnostic strategies for patients with ectatic corneal diseases (ECDs): screening, confirmation of the diagnosis, classification of the type of ECD, severity staging, prognostic assessment, and clinical follow-up. The conscious application of such strategies enables individualized treatments. The need for [...] Read more.

There are different fundamental diagnostic strategies for patients with ectatic corneal diseases (ECDs): screening, confirmation of the diagnosis, classification of the type of ECD, severity staging, prognostic assessment, and clinical follow-up. The conscious application of such strategies enables individualized treatments. The need for improved diagnostics of ECD is related to the advent of therapeutic refractive procedures that are considered prior to keratoplasty. Among such less invasive procedures, we include corneal crosslinking, customized ablations, and intracorneal ring segment implantation. Besides the paradigm shift in managing patients with ECD, enhancing the sensitivity to detect very mild forms of disease, and characterizing the inherent susceptibility for ectasia progression, became relevant for identifying patients at higher risk for progressive iatrogenic ectasia after laser vision correction (LVC). Moreover, the hypothesis that mild keratoconus is a risk factor for delivering a baby with Down’s syndrome potentially augments the relevance of the diagnostics of ECD. Multimodal refractive imaging involves different technologies, including Placido-disk corneal topography, Scheimpflug 3-D tomography, segmental or layered tomography with layered epithelial thickness using OCT (optical coherence tomography), and digital very high-frequency ultrasound (VHF-US), and ocular wavefront. Corneal biomechanical assessments and genetic and molecular biology tests have translated to clinical measurements. Artificial intelligence allows for the integration of a plethora of clinical data and has proven its relevance in facilitating clinical decisions, allowing personalized or individualized treatments. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

14 pages, 625 KiB

Open AccessReview

Automated Systems for Calculating Arteriovenous Ratio in Retinographies: A Sco** Review

by Rosa García-Sierra, Victor M. López-Lifante, Erik Isusquiza Garcia, Antonio Heras, Idoia Besada, David Verde Lopez, Maria Teresa Alzamora, Rosa Forés, Pilar Montero-Alia, Jurgi Ugarte Anduaga and Pere Torán-Monserrat

Diagnostics 2022, 12(11), 2865; https://doi.org/10.3390/diagnostics12112865 - 18 Nov 2022

Cited by 3 | Viewed by 1937

Abstract

There is evidence of an association between hypertension and retinal arteriolar narrowing. Manual measurement of retinal vessels comes with additional variability, which can be eliminated using automated software. This sco** review aims to summarize research on automated retinal vessel analysis systems. Searches were [...] Read more.

There is evidence of an association between hypertension and retinal arteriolar narrowing. Manual measurement of retinal vessels comes with additional variability, which can be eliminated using automated software. This sco** review aims to summarize research on automated retinal vessel analysis systems. Searches were performed on Medline, Scopus, and Cochrane to find studies examining automated systems for the diagnosis of retinal vascular alterations caused by hypertension using the following keywords: diagnosis; diagnostic screening programs; image processing, computer-assisted; artificial intelligence; electronic data processing; hypertensive retinopathy; hypertension; retinal vessels; arteriovenous ratio and retinal image analysis. The searches generated 433 articles. Of these, 25 articles published from 2010 to 2022 were included in the review. The retinographies analyzed were extracted from international databases and real scenarios. Automated systems to detect alterations in the retinal vasculature are being introduced into clinical practice for diagnosis in ophthalmology and other medical specialties due to the association of such changes with various diseases. These systems make the classification of hypertensive retinopathy and cardiovascular risk more reliable. They also make it possible for diagnosis to be performed in primary care, thus optimizing ophthalmological visits. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

Other

Jump to: Research, Review

3 pages, 2522 KiB

Open AccessInteresting Images

Non-Invasive High-Resolution Imaging of In Vivo Human Myelinated Axons

by Marco Lombardo, Massimo Cesareo, Benedetto Falsini and Andrea Cusumano

Diagnostics 2024, 14(3), 253; https://doi.org/10.3390/diagnostics14030253 - 24 Jan 2024

Viewed by 676

Abstract

This work aims to reveal the microscopic (2–3 micrometer resolution) appearance of human myelinated nerve fibers in vivo for the first time. We analyzed the myelinated retinal nerve fibers of a male patient without other neurological disorders in a non-invasive way using the [...] Read more.

This work aims to reveal the microscopic (2–3 micrometer resolution) appearance of human myelinated nerve fibers in vivo for the first time. We analyzed the myelinated retinal nerve fibers of a male patient without other neurological disorders in a non-invasive way using the transscleral optical phase imaging method with adaptive optics. We also analyzed the fellow eye with non-myelinated nerve fibers and compared the results with traditional ocular imaging methods such as optical coherence tomography. We documented the microscopic appearance of human myelin and myelinated axons in vivo. This method allowed us to obtain better details than through traditional ocular imaging methods. We hope these findings will be useful to the scientific community to evaluate neuro-retinal structures through new imaging techniques and more accurately document nerve anatomy and the pathophysiology of this disease. Full article

(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Related Special Issues

Published Papers (17 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI