61 results on '"Cole ED"'
Search Results
2. Anti-American terrorism and the Middle East: A documentary reader
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Rubin, Judith Cole, ed.
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BOOK REVIEWS - Published
- 2007
3. The Canadian ACE-inhibitor trial to improve renal outcomes and patient survival in kidney transplantation—study design
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Knoll, Greg A., Cantarovitch, Marcelo, Cole, Ed, Gill, John, Gourishankar, Sita, Holland, Dave, Kiberd, Bryce, Muirhead, Norman, Prasad, Ramesh, Tibbles, Lee Anne, Treleaven, Darin, and Fergusson, Dean
- Published
- 2008
4. Partnering: a quality model for contract relations
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Cole, Ed
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Strategic alliances (Business) -- Analysis ,Partnership -- Analysis ,Labor relations -- Analysis ,Government - Abstract
Collaborative working arrangements between public agencies and vendors yield greater quality than adversarial relationships. What should the relationship be between government and its contractors? 'Business on a handshake' appears obsolete, [...]
- Published
- 1993
5. Label-free impedimetric immunosensor for point-of-care detection of COVID-19 antibodies
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Lian C. T. Shoute, Gaser N. Abdelrasoul, Yuhao Ma, Pedro A. Duarte, Cole Edwards, Ran Zhuo, Jie Zeng, Yiwei Feng, Carmen L. Charlton, Jamil N. Kanji, Shawn Babiuk, and Jie Chen
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Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 - Abstract
Abstract The COVID-19 pandemic has posed enormous challenges for existing diagnostic tools to detect and monitor pathogens. Therefore, there is a need to develop point-of-care (POC) devices to perform fast, accurate, and accessible diagnostic methods to detect infections and monitor immune responses. Devices most amenable to miniaturization and suitable for POC applications are biosensors based on electrochemical detection. We have developed an impedimetric immunosensor based on an interdigitated microelectrode array (IMA) to detect and monitor SARS-CoV-2 antibodies in human serum. Conjugation chemistry was applied to functionalize and covalently immobilize the spike protein (S-protein) of SARS-CoV-2 on the surface of the IMA to serve as the recognition layer and specifically bind anti-spike antibodies. Antibodies bound to the S-proteins in the recognition layer result in an increase in capacitance and a consequent change in the impedance of the system. The impedimetric immunosensor is label-free and uses non-Faradaic impedance with low nonperturbing AC voltage for detection. The sensitivity of a capacitive immunosensor can be enhanced by simply tuning the ionic strength of the sample solution. The device exhibits an LOD of 0.4 BAU/ml, as determined from the standard curve using WHO IS for anti-SARS-CoV-2 immunoglobulins; this LOD is similar to the corresponding LODs reported for all validated and established commercial assays, which range from 0.41 to 4.81 BAU/ml. The proof-of-concept biosensor has been demonstrated to detect anti-spike antibodies in sera from patients infected with COVID-19 within 1 h. Photolithographically microfabricated interdigitated microelectrode array sensor chips & label-free impedimetric detection of COVID-19 antibody.
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- 2023
- Full Text
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6. The Cambridge Companion to Masaccio
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Ahl, Diane Cole, ed., Ahl, Diane Cole, ed., Ahl, Diane Cole, ed., and Ahl, Diane Cole, ed.
- Abstract
The Medieval Review, (dlps) baj9928.0407.005, (tmr) 04.07.05, http://quod.lib.umich.edu/t/text/accesspolicy.html
- Published
- 2002
7. Cerebrovascular events in renal transplant recipients
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Abedini, Sadollah, Holme, Ingar, Fellström, Bengt, Jardine, Alan, Cole, Ed, Maes, Bart, Holdaas, Hallvard, Abedini, Sadollah, Holme, Ingar, Fellström, Bengt, Jardine, Alan, Cole, Ed, Maes, Bart, and Holdaas, Hallvard
- Abstract
BACKGROUND: The incidence of stroke and risk factors for different subtypes of cerebrovascular (CBV) events in renal transplant recipients have not been examined in any large prospective controlled trial. METHODS: The Assessment of Lescol in Renal Transplantation was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin (40-80 mg) daily on cardiovascular, and renal outcomes in renal transplant recipients. Patients initially randomized to fluvastatin or placebo in the 5 to 6 year trial was offered open-label fluvastatin in a 2-year extension to the original study. We investigated the incidence of stroke and risk factors for ischemic and hemorrhagic CBV events in 2102 renal graft recipients participating in the Assessment of Lescol in Renal Transplantation core and extension trial with a mean follow-up of 6.7 years. RESULTS: The incidence and type of CBV events did not differ between the lipid lowering arm and the placebo arm. A total of 184 (8.8%, 95% confidence interval 4.6-12.9) of 2102 patients experienced a CBV event during follow-up, corresponding to an incidence of 1.3% CBV event per year. The mortality for patients experiencing a hemorrhagic stroke was 48% (13 of 27), whereas the mortality for ischemic strokes was 6.0% (8 of 133). Diabetes mellitus, previous CBV event, age, and serum creatinine were independent risk factors for cerebral ischemic events. The risk of a hemorrhagic cerebral event was increased by diabetes mellitus, polycystic kidney disease, left ventricular hypertrophy, and systolic blood pressure. INTERPRETATION: Risk factors for CBV events in renal transplant recipients differ according to subtype.
- Published
- 2009
- Full Text
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8. Rail workers branch out
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Cole, Ed
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Banking, finance and accounting industries ,Business ,Business, international - Abstract
From Mr Ed Cole. Sir, I refer to Dr Frances Sandiford-Rossmiller's letter (October 31) and the picture that accompanied one of your articles the same day on the havoc wrought [...]
- Published
- 2000
9. Portal Venous and Enteric Exocrine Drainage Versus Systemic Venous and Bladder Exocrine Drainage of Pancreas Grafts
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Cattral, Mark S., primary, Bigam, David L., additional, Hemming, Alan W., additional, Carpentier, Andre, additional, Greig, Paul D., additional, Wright, Elizabeth, additional, Cole, Ed, additional, Donat, Diane, additional, and Lewis, Gary F., additional
- Published
- 2000
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10. Big at any age
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Cole, Ed
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Bodybuilding -- Health aspects ,Aged -- Beliefs, opinions and attitudes ,Aged -- Health aspects ,Bodybuilding for the aged -- Health aspects - Abstract
At age 65, I started weight training after my doctor said I needed to take better care of myself if I wanted to enjoy the prosperity that I created over [...]
- Published
- 2008
11. Change the Slot.
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Krotje, Andy, Klopp, Ed, Figley, Nathan, Brown, Boyd, Cole, Ed, and Sosin, Mark
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LETTERS to the editor ,CULTURE ,BOATS & boating - Abstract
Several letters to the editor are presented in response to articles in previous issues including "Drumroll," in the July, 2011 issue, "Get Out of Dodge," in the June, 2011 issue, and an article related to change in the American culture in the July, 2011 issue.
- Published
- 2011
12. 1124-191 Predictive risk factors for coronary events in renal transplant patients
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Holdaas, Hallvard, Fellstroem, Bengt, Jardine, Alan, Cole, Ed, Nyberg, Gudrun, Gronhagen-Riska, Carola, Madsen, Soren, Neumayer, Hans-Hellmut, Maes, Bart, Ambuhl, Patrice, Olsson, Anders, Holme, Ingar, Fauchald, Per, Pedersen, Terje, and Logan, John
- Published
- 2004
- Full Text
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13. Case CLOSED.
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Cole, Ed
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PHYSIOLOGICAL effects of heat , *WORK environment , *INDUSTRIAL safety - Abstract
Focuses on heat stress in industrial work environments in the United States. Tips for heat stress avoidance; Protection clothing solutions; Condition triggering the onset of heat stress; Types of heat disorders. INSET: QUICK TIPS: STAYING HYDRATED WHILE WORKING..
- Published
- 2001
14. League of Women Voters of Mississippi Health Care Reform Program (Part 2 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
15. League of Women Voters of Mississippi Health Care Reform Program (Part 1 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
16. League of Women Voters of Mississippi Health Care Reform Program (Part 2 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
17. League of Women Voters of Mississippi Health Care Reform Program (Part 1 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
18. League of Women Voters of Mississippi Health Care Reform Program (Part 2 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
19. League of Women Voters of Mississippi Health Care Reform Program (Part 1 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
20. League of Women Voters of Mississippi Health Care Reform Program (Part 1 of 2)
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
21. League of Women Voters of Mississippi Health Care Reform Program (Part 2 of 2)
- Author
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
22. League of Women Voters of Mississippi Health Care Reform Program (Part 2 of 2)
- Author
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
23. League of Women Voters of Mississippi Health Care Reform Program (Part 1 of 2)
- Author
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Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, Bell, Robert, Mississippi League of Women Voters, Shirley, Aaron, Barber, Rims, Martin, Brian, Cole, Ed, and Bell, Robert
24. ISTFA 2012 User's Group--Contactless Fault Isolation.
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Cole, Ed and Altmann, Frank
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CONFERENCES & conventions , *FAILURE analysis - Abstract
The article discusses the International Symposium for Testing and Failure Analysis (ISTFA 2012) that was held from November 11 to 15, 2012 in the U.S.
- Published
- 2013
- Full Text
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25. 2008 IPRS in Phoenix.
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Cole, Ed
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CONFERENCES & conventions , *RELIABILITY in engineering , *MICROELECTRONICS conferences - Abstract
Information about several topics discussed at the 46th annual meeting by the International Reliability Physics Symposium (IRPS) on April 27 to May 1, 2008 in Phoenix, Arizona is presented. The symposium concentrates on the physics of failure and reliability, encompassing a host of microelectronics topics including electrostatic discharge/electrical overstress and latchup. It features the speech of Michael Pecht on the problem of products that fail in the field but pass qualification tests.
- Published
- 2008
26. FEEDBACK.
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Lopez, Beni, Feldman, Scott, Brinson, Rico, Strickland, Jesse, John, Kevin, Cole, Ed, Gamelin, Tracy DeBrita, Delgado, Juan, and Reinbold, Nathan
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LETTERS to the editor ,PHYSICAL fitness ,DEAD lift (Weight lifting) ,BODYBUILDING competitions ,PHYSICAL education - Abstract
Several letters to the editor are presented, including one that discusses the author's commitment to improve her physique, one that discusses deadlifting, and another that discusses the author's experience in a bodybuilding competition.
- Published
- 2008
27. 2009 AMFA Examines Enabling Technologies.
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Cole, Ed
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CONFERENCES & conventions , *ADULT education workshops , *FAILURE analysis , *FORUMS , *MATERIALS science - Abstract
Information about the fourth Advance Materials and Failure Analysis (AMFA) workshop, which was held in Santa Clara, California on April 3, 2009 is presented. The workshop was aimed to provide a forum for the presentation and active discussion of technical issues and trends. The discussion was focused on materials characterization and failure analysis topics.
- Published
- 2009
28. IRPS 2009 Ventures to Montreal.
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Cole, Ed
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CONFERENCES & conventions , *PHYSICS conferences , *SOLAR energy , *DIELECTRICS - Abstract
Information about the 47th annual International Reliability Physics Symposium (IRPS), which was held in Montreal, Quebec from April 26 to 30, 2009 is presented. The event includes two pre-symposium days of tutorials, an evening poster session, evening workshop sessions and vendor exhibits. The discussion was focused on topics that included high-k dielectrics, product reliability, interconnect reliability and reliability challenges for solar energy.
- Published
- 2009
29. All EDFA Articles Available Electronically as an EDFAS Member Benefit.
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Cole, Ed
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ELECTRONIC information resources , *MEMBERSHIP in associations, institutions, etc. , *ONLINE information services , *WEBSITES , *ELECTRONIC records - Abstract
The article reports that Electronic Device Failure Analysis Society (EDFAS) members can retrieve EDFA magazine articles electronically. The members are encouraged to visit EDFAS' Web site, www.edfas.org, and log in to their MyEDFAS membership account. The members are advised to click on the EDFA Issues sub-button to get a listing of newsletters and EDFA magazines.
- Published
- 2009
30. Occlusive Vasculitis Following Intravitreal Rituximab Injection for Primary Vitreoretinal Lymphoma.
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Cole ED, Dedania V, and Demirci H
- Abstract
Purpose: We report three cases of occlusive vasculitis following intravitreal rituximab therapy for biopsy-proven primary vitreoretinal lymphoma (PVRL), one of which was following an injection of the biosimilar Riabni (rituximab-arrx, AmGen) and two of which were following an injection of Rituxan (rituximab, Genentech)., Methods: Case series., Results: Three cases of occlusive vasculitis confirmed with fluorescein angiography are reported 5 days, 8 days, and 3.5 weeks following intravitreal injection of rituximab. The initial vision was poor (20/500, 20/150, and light perception), but vision recovered to baseline in two cases, and remained poor in the case of combined artery and vein occlusion., Conclusion: Occlusive vasculitis is a rarely reported but potential complication of intravitreal rituximab therapy in patients who have been previously treated with the agent and may have delayed onset. A low threshold for fluorescein angiography as a diagnostic test for post-injection vision loss and prompt treatment with topical and/or oral steroids should be considered.
- Published
- 2024
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31. Myopic Traction Maculopathy in Low Myopia.
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Cole ED and Johnson MW
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- Humans, Traction, Retina, Tomography, Optical Coherence, Retrospective Studies, Myopia, Retinal Diseases diagnosis, Retinal Diseases etiology, Vitreous Detachment, Macular Degeneration, Myopia, Degenerative complications, Myopia, Degenerative diagnosis, Myopia, Degenerative surgery
- Abstract
We describe a case of myopic traction maculopathy (MTM) in a patient with low myopia that resolved with surgical intervention. Our patient demonstrated no other features of myopic degeneration and none of the typical tractional elements that cause MTM, such as vitreomacular traction due to partial posterior vitreous detachment (PVD) with vitreomacular adhesion, epiretinal membrane, or a remnant cortical vitreous layer following PVD. Possible pathogenic mechanisms in our patient include reduced compliance of the aging internal limiting membrane and/or traction from elasticity within the thin cortical vitreous layer that forms the posterior wall of the premacular liquefied pocket. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:481-484.] .
- Published
- 2023
- Full Text
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32. Efficacy of Smartphone-Based Telescreening for Retinopathy of Prematurity With and Without Artificial Intelligence in India.
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Young BK, Cole ED, Shah PK, Ostmo S, Subramaniam P, Venkatapathy N, Tsai ASH, Coyner AS, Gupta A, Singh P, Chiang MF, Kalpathy-Cramer J, Chan RVP, and Campbell JP
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- Infant, Newborn, Infant, Humans, Female, Adult, Male, Cross-Sectional Studies, Prospective Studies, Smartphone, Artificial Intelligence, Infant, Premature, Gestational Age, Sensitivity and Specificity, Ophthalmoscopy methods, Retinopathy of Prematurity diagnosis, Ophthalmology, Telemedicine methods
- Abstract
Importance: Retinopathy of prematurity (ROP) telemedicine screening programs have been found to be effective, but they rely on widefield digital fundus imaging (WDFI) cameras, which are expensive, making them less accessible in low- to middle-income countries. Cheaper, smartphone-based fundus imaging (SBFI) systems have been described, but these have a narrower field of view (FOV) and have not been tested in a real-world, operational telemedicine setting., Objective: To assess the efficacy of SBFI systems compared with WDFI when used by technicians for ROP screening with both artificial intelligence (AI) and human graders., Design, Setting, and Participants: This prospective cross-sectional comparison study took place as a single-center ROP teleophthalmology program in India from January 2021 to April 2022. Premature infants who met normal ROP screening criteria and enrolled in the teleophthalmology screening program were included. Those who had already been treated for ROP were excluded., Exposures: All participants had WDFI images and from 1 of 2 SBFI devices, the Make-In-India (MII) Retcam or Keeler Monocular Indirect Ophthalmoscope (MIO) devices. Two masked readers evaluated zone, stage, plus, and vascular severity scores (VSS, from 1-9) in all images. Smartphone images were then stratified by patient into training (70%), validation (10%), and test (20%) data sets and used to train a ResNet18 deep learning architecture for binary classification of normal vs preplus or plus disease, which was then used for patient-level predictions of referral warranted (RW)- and treatment requiring (TR)-ROP., Main Outcome and Measures: Sensitivity and specificity of detection of RW-ROP, and TR-ROP by both human graders and an AI system and area under the receiver operating characteristic curve (AUC) of grader-assigned VSS. Sensitivity and specificity were compared between the 2 SBFI systems using Pearson χ2testing., Results: A total of 156 infants (312 eyes; mean [SD] gestational age, 33.0 [3.0] weeks; 75 [48%] female) were included with paired examinations. Sensitivity and specificity were not found to be statistically different between the 2 SBFI systems. Human graders were effective with SBFI at detecting TR-ROP with a sensitivity of 100% and specificity of 83.49%. The AUCs with grader-assigned VSS only were 0.95 (95% CI, 0.91-0.99) and 0.96 (95% CI, 0.93-0.99) for RW-ROP and TR-ROP, respectively. For the AI system, the sensitivity of detecting TR-ROP sensitivity was 100% with specificity of 58.6%, and RW-ROP sensitivity was 80.0% with specificity of 59.3%., Conclusions and Relevance: In this cross-sectional study, 2 different SBFI systems used by technicians in an ROP screening program were highly sensitive for TR-ROP. SBFI systems with AI may be a cost-effective method to improve the global capacity for ROP screening.
- Published
- 2023
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33. Variability in Plus Disease Diagnosis using Single and Serial Images.
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Cole ED, Park SH, Kim SJ, Kang KB, Valikodath NG, Al-Khaled T, Patel SN, Jonas KE, Ostmo S, Coyner A, Berrocal A, Drenser KA, Nagiel A, Horowitz JD, Lee TC, Kalpathy-Cramer J, Chiang MF, Campbell JP, and Chan RVP
- Subjects
- Infant, Newborn, Humans, Cohort Studies, Reproducibility of Results, Diagnostic Imaging methods, Retinopathy of Prematurity diagnosis, Telemedicine methods
- Abstract
Purpose: To assess changes in retinopathy of prematurity (ROP) diagnosis in single and serial retinal images., Design: Cohort study., Participants: Cases of ROP recruited from the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) consortium evaluated by 7 graders., Methods: Seven ophthalmologists reviewed both single and 3 consecutive serial retinal images from 15 cases with ROP, and severity was assigned as plus, preplus, or none. Imaging data were acquired during routine ROP screening from 2011 to 2015, and a reference standard diagnosis was established for each image. A secondary analysis was performed using the i-ROP deep learning system to assign a vascular severity score (VSS) to each image, ranging from 1 to 9, with 9 being the most severe disease. This score has been previously demonstrated to correlate with the International Classification of ROP. Mean plus disease severity was calculated by averaging 14 labels per image in serial and single images to decrease noise., Main Outcome Measures: Grading severity of ROP as defined by plus, preplus, or no ROP., Results: Assessment of serial retinal images changed the grading severity for > 50% of the graders, although there was wide variability. Cohen's kappa ranged from 0.29 to 1.0, which showed a wide range of agreement from slight to perfect by each grader. Changes in the grading of serial retinal images were noted more commonly in cases of preplus disease. The mean severity in cases with a diagnosis of plus disease and no disease did not change between single and serial images. The ROP VSS demonstrated good correlation with the range of expert classifications of plus disease and overall agreement with the mode class (P = 0.001). The VSS correlated with mean plus disease severity by expert diagnosis (correlation coefficient, 0.89). The more aggressive graders tended to be influenced by serial images to increase the severity of their grading. The VSS also demonstrated agreement with disease progression across serial images, which progressed to preplus and plus disease., Conclusions: Clinicians demonstrated variability in ROP diagnosis when presented with both single and serial images. The use of deep learning as a quantitative assessment of plus disease has the potential to standardize ROP diagnosis and treatment., (Copyright © 2022. Published by Elsevier Inc.)
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- 2022
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34. Deep Learning for the Diagnosis of Stage in Retinopathy of Prematurity: Accuracy and Generalizability across Populations and Cameras.
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Chen JS, Coyner AS, Ostmo S, Sonmez K, Bajimaya S, Pradhan E, Valikodath N, Cole ED, Al-Khaled T, Chan RVP, Singh P, Kalpathy-Cramer J, Chiang MF, and Campbell JP
- Subjects
- Area Under Curve, Birth Weight, Datasets as Topic, Female, Gestational Age, Humans, Infant, Newborn, Male, Nepal, North America, ROC Curve, Reference Standards, Reproducibility of Results, Retinopathy of Prematurity classification, Sensitivity and Specificity, Deep Learning, Diagnosis, Computer-Assisted, Image Processing, Computer-Assisted, Photography instrumentation, Retinopathy of Prematurity diagnosis
- Abstract
Purpose: Stage is an important feature to identify in retinal images of infants at risk of retinopathy of prematurity (ROP). The purpose of this study was to implement a convolutional neural network (CNN) for binary detection of stages 1, 2, and 3 in ROP and to evaluate its generalizability across different populations and camera systems., Design: Diagnostic validation study of CNN for stage detection., Participants: Retinal fundus images obtained from preterm infants during routine ROP screenings., Methods: Two datasets were used: 5943 fundus images obtained by RetCam camera (Natus Medical, Pleasanton, CA) from 9 North American institutions and 5049 images obtained by 3nethra camera (Forus Health Incorporated, Bengaluru, India) from 4 hospitals in Nepal. Images were labeled based on the presence of stage by 1 to 3 expert graders. Three CNN models were trained using 5-fold cross-validation on datasets from North America alone, Nepal alone, and a combined dataset and were evaluated on 2 held-out test sets consisting of 708 and 247 images from the Nepali and North American datasets, respectively., Main Outcome Measures: Convolutional neural network performance was evaluated using area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), sensitivity, and specificity., Results: Both the North American- and Nepali-trained models demonstrated high performance on a test set from the same population: AUROC, 0.99; AUPRC, 0.98; sensitivity, 94%; and AUROC, 0.97; AUPRC, 0.91; and sensitivity, 73%; respectively. However, the performance of each model decreased to AUROC of 0.96 and AUPRC of 0.88 (sensitivity, 52%) and AUROC of 0.62 and AUPRC of 0.36 (sensitivity, 44%) when evaluated on a test set from the other population. Compared with the models trained on individual datasets, the model trained on a combined dataset achieved improved performance on each respective test set: sensitivity improved from 94% to 98% on the North American test set and from 73% to 82% on the Nepali test set., Conclusions: A CNN can identify accurately the presence of ROP stage in retinal images, but performance depends on the similarity between training and testing populations. We demonstrated that internal and external performance can be improved by increasing the heterogeneity of the training dataset features of the training dataset, in this case by combining images from different populations and cameras., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
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35. Telemedicine, Telementoring, and Technology: Improving Patient Outcomes and Access to Care in Low and Middle-Income Countries.
- Author
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Al-Khaled T, Cole ED, and Chan RVP
- Subjects
- Developing Countries, Health Services Accessibility, Humans, Retinal Neoplasms, Retinoblastoma, Telemedicine
- Published
- 2021
- Full Text
- View/download PDF
36. Development of Screening Criteria for Retinopathy of Prematurity in Ulaanbaatar, Mongolia, Using a Web-based Data Management System.
- Author
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Olson SL, Chuluunbat T, Cole ED, Jonas KE, Bayalag M, Chuluunkhuu C, Valikodath NG, Cherwek DH, Congdon N, MacKeen LD, Hallak J, Yap V, Ostmo S, Wu WC, Campbell JP, Chiang MF, and Chan RVP
- Subjects
- Female, Follow-Up Studies, Gestational Age, Humans, Incidence, Infant, Newborn, Male, Mongolia epidemiology, Prospective Studies, Retinopathy of Prematurity epidemiology, Risk Factors, Internet, Neonatal Screening methods, Retinopathy of Prematurity diagnosis
- Abstract
Purpose: To describe a process for identifying birth weight (BW) and gestational age (GA) screening guidelines in Mongolia., Methods: This was a prospective cohort study in a tertiary care hospital in Ulaanbataar, Mongolia, of 193 premature infants with GA of 36 weeks or younger and/or BW of 2,000 g or less) with regression analysis to determine associations between BW and GA and the development of retinopathy of prematurity (ROP)., Results: As BW and GA decreased, the relative risk of developing ROP increased. The relative risk of developing any stage of ROP in infants born at 29 weeks or younger was 2.91 (95% CI: 1.55 to 5.44; P < .001] compared to older infants. The relative risk of developing any type of ROP in infants with BW of less than 1,200 g was 2.41 (95% CI: 1.35 to 4.29; P = .003] and developing type 2 or worse ROP was 2.05 (95% CI: 0.99 to 4.25; P = .05)., Conclusions: Infants in Mongolia with heavier BW and older GA who fall outside of current United States screening guidelines of GA of 30 weeks or younger and/or BW of 1,500 g or less developed clinically relevant ROP. [J Pediatr Ophthalmol Strabismus. 2020;57(5):333-339.]., (Copyright 2020, SLACK Incorporated.)
- Published
- 2020
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37. VISUALIZATION OF CHOROIDAL NEOVASCULARIZATION USING TWO COMMERCIALLY AVAILABLE SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY DEVICES.
- Author
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Arya M, Rebhun CB, Cole ED, Sabrosa AS, Arcos-Villegas G, Louzada RN, Novais EA, Lane M, Dang S, Ávila M, Witkin AJ, Baumal CR, Duker JS, and Waheed NK
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Fluorescein Angiography instrumentation, Fluorescein Angiography methods, Fluorescein Angiography standards, Fovea Centralis diagnostic imaging, Humans, Male, Middle Aged, Observer Variation, Prospective Studies, Tomography, Optical Coherence methods, Tomography, Optical Coherence standards, Choroidal Neovascularization diagnostic imaging, Tomography, Optical Coherence instrumentation
- Abstract
Purpose: To compare the sensitivity of detection and the measured size of choroidal neovascularization (CNV) on two commercially available spectral domain optical coherence tomography angiography (OCTA) devices, the Optovue RTVue XR Avanti with AngioVue and the Zeiss Cirrus HD-OCT with AngioPlex., Methods: Patients with CNV lesions were imaged consecutively on both OCTA devices on the same day of their visit. 3 × 3 mm and 6 × 6 mm scans centered at the fovea were obtained. Two independent masked readers evaluated the OCTA images for CNV identification and its area measurements., Results: No significant differences were observed between the 2 OCTA devices in CNV area measurements on their 3 × 3 mm and 6 × 6 mm scans. However, there was suboptimal performance of their automated segmentation algorithms as compared to manually adjusted segmentation for visualizing CNV lesions., Conclusion: There was no significant difference in the size of the CNV lesion as measured on either commercially available spectral domain OCTA device. Both devices were comparable in their detection of CNV lesions on manual adjustment of segmentation lines. However, their automated segmentation algorithms need improvement to allow for accurate measurement of CNV lesions for routine clinical application.
- Published
- 2019
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38. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY TO DETECT MACULAR CAPILLARY ISCHEMIA IN PATIENTS WITH INNER RETINAL CHANGES AFTER RESOLVED DIABETIC MACULAR EDEMA.
- Author
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Moein HR, Novais EA, Rebhun CB, Cole ED, Louzada RN, Witkin AJ, Baumal CR, Duker JS, and Waheed NK
- Subjects
- Capillaries diagnostic imaging, Cross-Sectional Studies, Diabetic Retinopathy diagnosis, Female, Follow-Up Studies, Fundus Oculi, Humans, Ischemia etiology, Macular Edema diagnosis, Male, Middle Aged, Retinal Vessels, Retrospective Studies, Diabetic Retinopathy complications, Fluorescein Angiography methods, Ischemia diagnosis, Macula Lutea blood supply, Macular Edema complications, Tomography, Optical Coherence methods, Visual Acuity
- Abstract
Purpose: To compare foveal vascular anatomy between patients with and without disorganization of retinal inner layers (DRILs) after resolved diabetic macular edema using optical coherence tomography angiography (OCTA)., Methods: Twenty-four eyes of 21 age- and sex-matched patients with resolved diabetic macular edema were included in this retrospective, cross-sectional study. All eyes were imaged with enhanced high-definition line or cross-line structural B scans and 3 × 3-mm OCTA scans. Optical coherence tomography B scans were analyzed for the presence of DRIL, and based on this, eyes were classified as either DRIL present or DRIL absent. The foveal avascular zone area on OCTA was compared between patients with and without DRIL. The foveal avascular zone area was correlated with visual acuity., Results: Nine eyes with DRIL and resolved diabetic macular edema were compared with 15 control eyes without DRIL and resolved diabetic macular edema. Area of ischemia on OCTA scans corresponded to the area of DRIL as determined on OCT B scans. The foveal avascular zone area in full retina as well as superficial and deep retinal plexuses OCTA slabs were significantly larger in patients with DRIL as compared to those without DRIL (P = 0.005, P < 0.001, and P = 0.004, respectively). The larger foveal avascular zone in full retinal segmentation (r = 0.72, P = 0.03) and superficial plexus (r = 0.74, P = 0.02) were positively correlated with lower visual acuity., Conclusion: Optical coherence tomography angiography can visualize retinal ischemia in patients with and without DRIL. Correspondence of impaired blood flow with DRIL suggests that retinal ischemia and loss of normal vasculature contributes to DRIL.
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- 2018
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39. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AFTER PHOTOCOAGULATION OF TYPE 2 NEOVASCULARIZATION.
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Arya M, Cole ED, Novais EA, Louzada RN, Waheed NK, and Duker JS
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- Aged, 80 and over, Diabetes Mellitus, Type 2 complications, Diabetic Retinopathy surgery, Humans, Male, Retinal Neovascularization surgery, Diabetic Retinopathy diagnostic imaging, Fluorescein Angiography methods, Laser Coagulation, Retinal Neovascularization diagnostic imaging, Tomography, Optical Coherence methods
- Abstract
Purpose: To illustrate errors in the automated segmentation image analysis of optical coherence tomography angiography after laser photocoagulation therapy for Type 2 neovascularization., Methods: This case report describes a patient with extrafoveal Type 2 neovascularization treated with argon laser photocoagulation evaluated before and after treatment by optical coherence tomography angiography., Results: Disrupted retinal layers after laser photocoagulation therapy lead to segmentation errors., Conclusion: Images of optical coherence tomography angiography are prone to degradation by artifacts in cases in which there is disruption of the retinal layers. Clinicians must be aware of these errors because they can be misinterpreted as active Type 2 neovascularization. Improvement in optical coherence tomography angiography image analysis to minimize automated segmentation errors needs to be further explored.
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- 2018
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40. Optical Coherence Tomography Angiography in Nonarteritic Anterior Ischemic Optic Neuropathy.
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Wright Mayes E, Cole ED, Dang S, Novais EA, Vuong L, Mendoza-Santiesteban C, Duker JS, and Hedges TR 3rd
- Subjects
- Aged, Capillaries pathology, Cross-Sectional Studies, Female, Fundus Oculi, Humans, Male, Middle Aged, Optic Disk blood supply, Optic Neuropathy, Ischemic physiopathology, Regional Blood Flow physiology, Reproducibility of Results, Retinal Vessels physiopathology, Retrospective Studies, Fluorescein Angiography methods, Microcirculation physiology, Optic Disk pathology, Optic Neuropathy, Ischemic diagnosis, Retinal Vessels pathology, Tomography, Optical Coherence methods, Visual Fields physiology
- Abstract
Background: Optical coherence tomography angiography (OCTA) has demonstrated good utility in qualitative analysis of retinal and choroidal vasculature and therefore may be relevant in the diagnostic and treatment efforts surrounding nonarteritic anterior ischemic optic neuropathy (NAION)., Methods: Retrospective, cross-sectional study of 10 eyes of 9 patients with a previous or new diagnosis of NAION that received imaging with OCTA between November 2015 and February 2016. Two independent readers qualitatively analyzed the retinal peripapillary capillaries (RPC) and peripapillary choriocapillaris (PCC) for flow impairment. Findings were compared with automated visual field and structural optical coherence tomography (OCT) studies., Results: Flow impairment seen on OCTA in the RPC corresponded to structural OCT deficits of the retinal nerve fiber layer (RNFL) and ganglion cell layer complex (GCC) in 80% and 100% of eyes, respectively, and to automated visual field deficits in 90% of eyes. Flow impairment seen on OCTA in the PCC corresponded to structural OCT deficits of the RNFL and GCC in 70% and 80% of eyes, respectively, and to visual field deficits in 60%-80% of eyes., Conclusions: OCTA can noninvasively visualize microvascular flow impairment in patients with NAION.
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- 2017
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41. Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis Syndrome Presenting With Branch Retinal Artery Occlusion.
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Zacharia JA, Chin AT, Rebhun CB, Louzada RN, Adhi M, Cole ED, Moreira-Neto C, Waheed NK, and Duker JS
- Subjects
- Adult, Aneurysm surgery, Female, Fluorescein Angiography, Humans, Laser Coagulation, Retinal Artery Occlusion surgery, Retinal Vasculitis surgery, Retinitis surgery, Tomography, Optical Coherence, Vitrectomy, Aneurysm diagnosis, Retinal Artery Occlusion diagnosis, Retinal Vasculitis diagnosis, Retinal Vessels pathology, Retinitis diagnosis
- Abstract
Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) is a rare syndrome affecting the retinal and optic disc vasculature. Diffuse retinal ischemia, macular edema, and neovascularization may lead to bilateral vision loss. The authors report a case of a 36-year-old woman presenting with branch retinal artery occlusion (BRAO) in her right eye who was subsequently diagnosed with IRVAN syndrome. She was treated with panretinal photocoagulation for peripheral retinal ischemia and pars plana vitrectomy for vitreous hemorrhage. She later developed a BRAO in her left eye. This case demonstrates that BRAO may be a presenting feature of IRVAN syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:948-951.]., (Copyright 2017, SLACK Incorporated.)
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- 2017
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42. The Definition, Rationale, and Effects of Thresholding in OCT Angiography.
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Cole ED, Moult EM, Dang S, Choi W, Ploner SB, Lee B, Louzada R, Novais E, Schottenhamml J, Husvogt L, Maier A, Fujimoto JG, Waheed NK, and Duker JS
- Abstract
Purpose: To examine the definition, rationale, and effects of thresholding in OCT angiography (OCTA)., Design: A theoretical description of OCTA thresholding in combination with qualitative and quantitative analysis of the effects of OCTA thresholding in eyes from a retrospective case series., Participants: Four eyes were qualitatively examined: 1 from a 27-year-old control, 1 from a 78-year-old exudative age-related macular degeneration (AMD) patient, 1 from a 58-year-old myopic patient, and 1 from a 77-year-old nonexudative AMD patient with geographic atrophy (GA). One eye from a 75-year-old nonexudative AMD patient with GA was quantitatively analyzed., Main Outcome Measures: A theoretical thresholding model and a qualitative and quantitative description of the dependency of OCTA on thresholding level., Results: Due to the presence of system noise, OCTA thresholding is a necessary step in forming OCTA images; however, thresholding can complicate the relationship between blood flow and OCTA signal., Conclusions: Thresholding in OCTA can cause significant artifacts, which should be considered when interpreting and quantifying OCTA images., Competing Interests: Conflicts of Interest: J.S.D.: Consultant and research support — Carl Zeiss Meditec, OptoVue, and Topcon Medical Systems Inc; stock — Hemera Biosciences Inc, EyeNetra, and Ophthotech Corp. N.K.W.: Consultant — Iconic Therapeutics; speaker’s bureau —ThromboGenics; research support — Carl Zeiss Meditec, Inc. J.G.F.: Royalties — intellectual property owned by the Massachusetts Institute of Technology and licensed to Carl Zeiss Meditec Inc, Optovue Inc; stock options — Optovue Inc. There are no conflicting relationships for any other author.
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- 2017
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43. Diagnosing Choroidal Neovascularization in Asymptomatic Individuals Using Optical Coherence Tomography Angiography.
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Park MM, Rebhun CB, Cole ED, Louzada RN, Novais EA, Rifai F, Yasin Alibhai A, Duker JS, and Waheed NK
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- Aged, 80 and over, Fundus Oculi, Humans, Male, Reproducibility of Results, Choroidal Neovascularization diagnosis, Fluorescein Angiography methods, Retinal Vessels pathology, Tomography, Optical Coherence methods
- Abstract
Optical coherence tomography angiography (OCTA) is a noninvasive, rapid imaging technique that generates angiographic images without intravenous dye injections. Cross-sectional studies have described the presence of asymptomatic choroidal neovascularization (CNV) in patients with intermediate age-related macular degeneration (AMD). This case report describes the OCT features on longitudinal follow-up of a patient who started with unilateral asymptomatic CNV and eventually developed symptomatic exudative AMD. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:596-598.]., (Copyright 2017, SLACK Incorporated.)
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- 2017
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44. Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography.
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Gill A, Cole ED, Novais EA, Louzada RN, de Carlo T, Duker JS, Waheed NK, Baumal CR, and Witkin AJ
- Abstract
Background: Central vision loss in diabetic retinopathy is commonly related to diabetic macular edema (DME). The objective of this study was to describe changes between consecutive visits on optical coherence tomography angiography (OCTA) of the foveal avascular zone (FAZ) in eyes with DME., Methods: 20 eyes from 14 patients with DME were imaged on 2 successive clinic visits separated by at least 1 month. The mean interval between visits was 3.2 months. The only intervention used was intravitreal anti-VEGF in 11 eyes; the others were observed over time without treatment. Two different readers measured FAZ area using a pseudo-automated tool in comparison to a manual tracing tool. Qualitative changes in the appearance of the vasculature surrounding the FAZ were also recorded. The retinal capillary plexus was segmented into deep and superficial plexuses, and FAZ measurements were done on the superficial, deep, and summated plexuses., Results: Pseudo-automated and manual measurements of FAZ area decreased significantly ( p < 0.05) between visits in the deep, superficial, and summated plexuses. Qualitative analysis of vasculature surrounding the FAZ showed that most of the vascular changes (65%) over time were visible in the deep plexus, compared to 30 and 20% in the superficial and summated plexuses, respectively., Conclusions: The most significant differences in FAZ size over time were in the summated plexus ( p < 0.001), while changes in FAZ appearance were most prominent in the deep plexus. Absolute decrease in FAZ size over visits was largest in the deep plexus. Our results demonstrate that OCTA can effectively be used to measure FAZ area in patients with DME, visualize qualitative changes in retinal vasculature, and visualize the segmentation levels at which these changes can be best appreciated. However, larger studies are needed to evaluate the reproducibility of manual and pseudo-automated measuring techniques.
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- 2017
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45. En Face Doppler Optical Coherence Tomography Measurement of Total Retinal Blood Flow in Diabetic Retinopathy and Diabetic Macular Edema.
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Lee B, Novais EA, Waheed NK, Adhi M, de Carlo TE, Cole ED, Moult EM, Choi W, Lane M, Baumal CR, Duker JS, and Fujimoto JG
- Subjects
- Cross-Sectional Studies, Diabetic Retinopathy complications, Diabetic Retinopathy physiopathology, Doppler Effect, Female, Follow-Up Studies, Humans, Image Processing, Computer-Assisted methods, Macular Edema etiology, Macular Edema physiopathology, Male, Middle Aged, Retina pathology, Retinal Vessels diagnostic imaging, Retrospective Studies, Severity of Illness Index, Diabetic Retinopathy diagnosis, Macular Edema diagnosis, Regional Blood Flow physiology, Retina physiopathology, Retinal Vessels physiopathology, Tomography, Optical Coherence methods
- Abstract
Importance: Alterations in ocular blood flow play an important role in the pathogenesis and progression of diabetic retinopathy (DR). However, the measurement of retinal blood flow in clinical studies has been challenging. En face Doppler optical coherence tomography (OCT) provides an effective method for measuring total retinal blood flow (TRBF) in the clinic., Objective: To investigate TRBF in eyes with DR of varying severity, with or without diabetic macular edema (DME), using en face Doppler OCT., Design, Setting, and Participants: This was a cross-sectional study conducted from May 23, 2014, to January 11, 2016, which analyzed 41 eyes with DR from 31 diabetic patients, 20 eyes without DR from 11 diabetic patients, and 16 eyes from 12 healthy age-matched controls, all at the New England Eye Center in Boston, Massachusetts., Main Outcomes and Measures: Participants were imaged with a high-speed, swept-source OCT prototype at 1050-nm wavelength using repeated en face Doppler OCT raster scans, comprising 600 × 80 axial scans and covering a 1.5 × 2-mm2 area centered at the optic disc. The TRBF was automatically calculated using custom Matlab software., Results: This study included 41 eyes with DR from 31 diabetic patients (mean [SD] age, 62.8 [13.4] years; 12 were female patients), 20 eyes without DR from 11 diabetic patients (mean [SD] age, 58.8 [10.1] years; 5 were female patients), and 16 eyes from 12 healthy age-matched controls (mean [SD] age, 57.9 [8.1] years; 8 were female participants). The mean (SD) TRBF was 28.0 (8.5) µL/min in the eyes with DME, 48.8 (13.4) µL/min in the eyes with DR but without DME, 40.1 (7.7) µL/min in the diabetic eyes without retinopathy, and 44.4 (8.3) µL/min in age-matched healthy eyes. A difference in TRBF between the eyes with DME that were treated and the eyes with DME that were not treated was not identified. The TRBF was consistently low in the eyes with DME regardless of DR severity. The eyes with moderate nonproliferative DR but without DME exhibited a wide range of TRBF from 31.1 to 75.0 µL/min, with the distribution being highly skewed., Conclusions and Relevance: High-speed en face Doppler OCT can measure TRBF in healthy and diabetic eyes. Diabetic eyes with DME exhibited lower TRBF than healthy eyes (P ≤ .001). Further longitudinal studies of TRBF in eyes with DR would be helpful to determine whether reduced TRBF is a risk factor for DME.
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- 2017
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46. CLINICAL TRIAL ENDPOINTS FOR OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.
- Author
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Cole ED, Ferrara D, Novais EA, Louzada RN, and Waheed NK
- Subjects
- Angiogenesis Inhibitors therapeutic use, Choroidal Neovascularization diagnostic imaging, Choroidal Neovascularization drug therapy, Clinical Trials as Topic, Humans, Macular Degeneration diagnostic imaging, Tomography, Optical Coherence methods, Vascular Endothelial Growth Factor A antagonists & inhibitors, Choroidal Neovascularization etiology, Macular Degeneration complications
- Abstract
Purpose: To describe qualitative and quantitative optical coherence tomography (OCT) angiography (OCTA) parameters for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and their applicability as potential clinical trial endpoints., Methods: A review of current literature related to the topic of OCTA and AMD., Results: There are a number of promising OCTA parameters that can be used to diagnose the presence of CNV and to monitor the activity and progression of the lesion, pre- and post-treatment morphological characteristics, CNV dimensions, and automated quantitative parameters such as vessel density., Conclusion: The OCTA parameters described in this review have promise for the future development of clinical trial endpoints, but require further validation before they can be widely used.
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- 2016
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47. TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis.
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Ploner SB, Moult EM, Choi W, Waheed NK, Lee B, Novais EA, Cole ED, Potsaid B, Husvogt L, Schottenhamml J, Maier A, Rosenfeld PJ, Duker JS, Hornegger J, and Fujimoto JG
- Subjects
- Algorithms, Blood Flow Velocity physiology, Case-Control Studies, Choroid blood supply, Computed Tomography Angiography methods, Diabetic Retinopathy diagnostic imaging, Geographic Atrophy diagnostic imaging, Humans, Middle Aged, Multimodal Imaging, Tomography, Optical Coherence methods, Diabetic Retinopathy physiopathology, Geographic Atrophy physiopathology
- Abstract
Purpose: Currently available optical coherence tomography angiography systems provide information about blood flux but only limited information about blood flow speed. The authors develop a method for mapping the previously proposed variable interscan time analysis (VISTA) algorithm into a color display that encodes relative blood flow speed., Methods: Optical coherence tomography angiography was performed with a 1,050 nm, 400 kHz A-scan rate, swept source optical coherence tomography system using a 5 repeated B-scan protocol. Variable interscan time analysis was used to compute the optical coherence tomography angiography signal from B-scan pairs having 1.5 millisecond and 3.0 milliseconds interscan times. The resulting VISTA data were then mapped to a color space for display., Results: The authors evaluated the VISTA visualization algorithm in normal eyes (n = 2), nonproliferative diabetic retinopathy eyes (n = 6), proliferative diabetic retinopathy eyes (n = 3), geographic atrophy eyes (n = 4), and exudative age-related macular degeneration eyes (n = 2). All eyes showed blood flow speed variations, and all eyes with pathology showed abnormal blood flow speeds compared with controls., Conclusion: The authors developed a novel method for mapping VISTA into a color display, allowing visualization of relative blood flow speeds. The method was found useful, in a small case series, for visualizing blood flow speeds in a variety of ocular diseases and serves as a step toward quantitative optical coherence tomography angiography., Competing Interests: There are no conflicting relationships for any other author.
- Published
- 2016
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48. SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS CHORIOCAPILLARIS ALTERATIONS IN EYES WITH NASCENT GEOGRAPHIC ATROPHY AND DRUSEN-ASSOCIATED GEOGRAPHIC ATROPHY.
- Author
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Moult EM, Waheed NK, Novais EA, Choi W, Lee B, Ploner SB, Cole ED, Louzada RN, Lu CD, Rosenfeld PJ, Duker JS, and Fujimoto JG
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- Aged, Artifacts, Computed Tomography Angiography methods, Female, Geographic Atrophy etiology, Humans, Male, Optic Disk Drusen complications, Choroid blood supply, Geographic Atrophy diagnostic imaging, Optic Disk Drusen diagnostic imaging, Tomography, Optical Coherence methods
- Abstract
Purpose: To investigate choriocapillaris (CC) alteration in patients with nascent geographic atrophy (nGA) and/or drusen-associated geographic atrophy (DAGA) using swept-source optical coherence tomography angiography (OCTA)., Methods: A 1,050-nm wavelength, 400 kHz A-scan rate swept-source optical coherence tomography prototype was used to perform volumetric swept-source optical coherence tomography angiography over 6 mm × 6 mm fields of view in patients with nGA and/or DAGA. The resulting optical coherence tomography (OCT) and OCTA data were analyzed using a combination of en face and cross-sectional techniques. Variable interscan time analysis (VISTA) was used to differentiate CC flow impairment from complete CC atrophy., Results: A total of 7 eyes from 6 patients (mean age: 73.8 ± 5.7 years) were scanned. Seven areas of nGA and three areas of DAGA were identified. Analysis of cross-sectional OCT and OCTA images identified focal alterations of the CC underlying all seven areas of nGA and all three areas of DAGA. En face OCTA analysis of the CC revealed diffuse CC alterations in all eyes. Variable interscan time analysis processing suggested that the observed CC flow alterations predominantly corresponded to flow impairment rather than complete CC atrophy., Conclusion: The OCTA imaging of the CC revealed focal CC flow impairment associated with areas of nGA and DAGA, as well as diffuse CC flow impairment throughout the imaged field. En face OCT analysis should prove useful for understanding the pathogenesis of nGA and DAGA and for identifying the formation of nGA and DAGA as endpoints in therapeutic trials., Competing Interests: There are no conflicting relationships for any other author.
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- 2016
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49. Comparison of Optical Coherence Tomography Angiography and Fluorescein Angiography for the Identification of Retinal Vascular Changes in Eyes With Diabetic Macular Edema.
- Author
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Peres MB, Kato RT, Kniggendorf VF, Cole ED, Onal S, Torres E, Louzada R, Belfort R Jr, Duker JS, Novais EA, and Regatieri CV
- Subjects
- Aged, Cross-Sectional Studies, Female, Fluorescein Angiography, Humans, Macula Lutea physiopathology, Male, Microaneurysm diagnostic imaging, Middle Aged, Prospective Studies, Visual Acuity, Diabetic Retinopathy diagnostic imaging, Fovea Centralis blood supply, Macular Edema diagnostic imaging, Retinal Vessels diagnostic imaging, Retinal Vessels pathology, Tomography, Optical Coherence methods
- Abstract
Background and Objective: To compare the visualization of microaneurysms (MA) and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) versus fluorescein angiography (FA) in patients with diabetic macular edema (DME)., Patients and Methods: Patients were prospectively recruited for same-day imaging on spectral-domain OCTA and FA. OCTA images were automatically segmented into superficial (sOCTA) and deep (dOCTA) capillary plexuses. The number of visible MAs and the FAZ area were compared between the two imaging modalities., Results: Nineteen eyes of 10 patients were included. There was a statistically significant difference between MA counts for FA, sOCTA, and dOCTA (P = .002), and median MA counts were 14.5 (range: 2-43), 9.75 (range: 0-37.5), and 22.5 (range: 5.5-46.5), respectively. dOCTA showed significantly more MAs than sOCTA (P < .001). Although not significant statistically, dOCTA revealed more MAs than FA (P = .06). There was a statistically significant difference between FAZ area for FA, sOCTA, and dOCTA (P = .046), and median FAZ areas were 0.444 (range: 0.1-0.689), 0.224 (range: 0.335-0.806), and 0.345 (range: 0.106-0.881), respectively. FA showed a significantly larger FAZ area than sOCTA (P = .04)., Conclusions: Deep plexus OCTA can better identify microaneurysms compared to either sOCTA or FA. The FAZ area appears larger on FA in contrast to OCTA of both plexuses. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1013-1019.]., (Copyright 2016, SLACK Incorporated.)
- Published
- 2016
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50. Choroidal thickness in older patients with central serous chorioretinopathy.
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Regatieri CV, Novais EA, Branchini L, Adhi M, Cole ED, Louzada R, Lane M, Reichel E, and Duker JS
- Abstract
Background: To investigate the choroidal thickness in older patients with central serous chorioretinopathy (CSCR) compared to age-matched normal subjects., Methods: Fifteen patients (30 eyes) with CSCR, all aged ≥60 years, and 21 age-matched normal subjects (21 eyes) underwent high-definition raster scanning using SD-OCT. Both eyes from CSCR patients were included in the analysis. The eyes in patients with CSCR were divided into two groups: active CSCR (17 eyes) if there was foveal-involving subretinal fluid and inactive contralateral eye group (13 eyes). Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroidal-scleral junction at 500 µm intervals up to 2500 µm temporal and nasal to the fovea (11 locations)., Results: The mean age of the patients with CSCR was 68.87 ± 6.83 years (mean ± standard deviation). Reliable measurements of choroidal thickness were obtainable in 70.6 % of eyes examined. The choroid was statistically significantly thicker in eyes with both active CSCR ( P < 0.001) and inactive contralateral eyes ( P < 0.01) when compared to normal age-matched eyes. The subfoveal choroid was 95 µm ( P < 0.01) thicker in eyes with active CSCR (338.05 ± 31.42 µm) compared with normal eyes (243.05 ± 13.39 µm). The subfoveal choroid thickness in the inactive contralateral eyes was numerically greater than normal, and it was not statistically significantly thicker compared to the normal eyes (difference-55.68 µm, P > 0.05)., Conclusion: Choroid in older patients with active CSCR was thicker than the choroid in age-matched normal eyes. It is important to consider CSCR as a differential diagnosis of serous retinal detachment in elderly patients with thickened choroid and to consider SD-OCT as an imaging modality by which to evaluate the choroidal thickness.
- Published
- 2016
- Full Text
- View/download PDF
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