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4. Choriocapillaris and Retinal Vascular Alterations in Presymptomatic Alzheimers Disease.

Author

Corradetti, Giulia, Oncel, Deniz, Kadomoto, Shin, Arakaki, Xianghong, Kloner, Robert, Sadun, Alfredo, Sadda, SriniVas, and Chan, Jane

Subjects
Humans, Alzheimer Disease, Angiography, Choroid, Macula Lutea, Retina, Tomography, Optical Coherence, Cerebrospinal Fluid, Amyloidogenic Proteins, Neurodegenerative Diseases
Abstract

PURPOSE: To compare optical coherence tomography angiography (OCTA) retina metrics between cognitively healthy subjects with pathological versus normal cerebrospinal fluid (CSF) Aβ42/tau ratios. METHODS: Swept-source OCTA scans were collected using the Zeiss PLEX Elite 9000 and analyzed on 23 cognitively healthy (CH) subjects who had previously undergone CSF analysis. Thirteen subjects had a pathological Aβ42/tau (PAT) ratio of

Published
2024

5. Peripapillary Vitreous Traction Syndrome: Expanding the Spectrum of Anterior Optic Neuropathies.

Author

Chan, Jane, Liu, Henry, Ma, Elise, Sadda, Srinivas, and Sadun, Alfredo

Subjects
Humans, Optic Neuropathy, Ischemic, Retinal Ganglion Cells, Traction, Tomography, Optical Coherence, Visual Acuity, Nerve Fibers, Retinal Diseases
Abstract

BACKGROUND: Peripapillary vitreous traction (PVT) occurring without any underlying eye disease has been contemplated as a distinct entity from nonarteritic ischemic optic neuropathy (NAION) for many years and is sometimes difficult to differentiate from classical NAION. We report 6 new cases to analyze the clinical features of PVT syndrome that would expand the clinical spectrum of anterior optic neuropathies. METHODS: Prospective case series. RESULTS: PVT syndrome seems to affect optic discs with a small area with a small cup-to-disc (C/D) ratio. The C/D ratio does not significantly increase in the chronic stage, as in NAION. Vitreous traction without detachment can either lead to mild retinal nerve fiber layer (RNFL) injury with attendant ganglion cell layer/inner plexiform layer (GCL/IPL) thinning in 29% or no injury at all in 71%. Eighty-six percent had good visual acuity (VA) and had no relative afferent pupillary defect (RAPD), whereas 14% had a transient RAPD; 71% had no color defect. Vitreous detachment after a period of severe and persistent traction can lead to more damage to the optic nerve head and RNFL that may look like NAION. Our hypothesized mechanically induced injury to the superficial optic nerve head may not lead to much visual impairment. In our study, no further therapeutic interventions were required. CONCLUSIONS: Based on our analysis of previously published cases and our own prospective case series of 6 patients, the PVT syndrome falls within the spectrum of anterior optic neuropathies, often affecting small optic discs with a small C/D ratio. Vitreous traction can lead to a partial or complete anterior optic neuropathy. The PVT syndrome may be a more anterior optic neuropathy distinct from classical NAION.

Published
2023

6. The relationship of diabetic retinopathy severity scales with frequency and surface area of diabetic retinopathy lesions.

Author

Esmaeilkhanian, Houri, Liu, Henry, Fasih-Ahmed, Sohaib, Gnanaraj, Ramya, Verma, Aditya, Oncel, Deniz, He, Ye, Nittala, Muneeswar, Attiku, Yamini, Kadomoto, Shin, Corradetti, Giulia, Velaga, Swetha, Tsui, Irena, Prasad, Pradeep, Li, Xiaorong, Li, Xiao, Jiang, Shangjun, Choudhry, Netan, Jayadev, Chaitra, and Sadda, SriniVas

Subjects
Diabetic retinopathy, ETDRS, ICDR, NPDR, PDR, Protocol AA
Abstract

PURPOSE: To assess the relationship between qualitative diabetic retinopathy (DR) scales with the precise numbers and surface area of DR lesions within the Early Treatment Diabetic Retinopathy Study (ETDRS) standard seven field (S7F) region on ultrawide-field (UWF) color fundus images. METHODS: In this study, we collected UWF images from adult patients with diabetes. Poor-quality images and eyes with any pathology precluding assessment of DR severity were excluded. The DR lesions were manually segmented. DR severity was graded according to the International Clinical Diabetic Retinopathy (ICDR) and AA protocol by two masked graders within the ETDRS S7F. These lesions numbers and surface area were computed and correlated against the DR scores using the Kruskal-Wallis H test. Cohens Kappa was performed to determine the agreement between two graders. RESULTS: One thousand five hundred and twenty eyes of 869 patients (294 females, 756 right eyes) with a mean age of 58.7 years were included. 47.4% were graded as no DR, 2.2% as mild non-proliferative DR (NPDR), 24.0% as moderate NPDR, 6.3% as severe NPDR, and 20.1% as proliferative DR (PDR). The area and number of DR lesions generally increased as the ICDR level increased up to severe NPDR, but decreased from severe NPDR to PDR. There was perfect intergrader agreement on the DR severity. CONCLUSION: A quantitative approach reveals that DR lesions number and area generally correlate with ICDR-based categorical DR severity levels with an increasing trend in the number and area of DR lesions from mild to severe NPDR and a decrease from severe NPDR to PDR.

Published
2023

14. Automated large-scale prediction of exudative AMD progression using machine-read OCT biomarkers

Author

Rudas, Akos, Chiang, Jeffrey N, Corradetti, Giulia, Rakocz, Nadav, Avram, Oren, Halperin, Eran, and Sadda, Srinivas R

Subjects
Biomedical and Clinical Sciences, Ophthalmology and Optometry, Eye Disease and Disorders of Vision, Biomedical Imaging, Clinical Research, Bioengineering, Macular Degeneration, Neurodegenerative, Aging, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Eye
Abstract

Age-related Macular Degeneration (AMD) is a major cause of irreversible vision loss in individuals over 55 years old in the United States. One of the late-stage manifestations of AMD, and a major cause of vision loss, is the development of exudative macular neovascularization (MNV). Optical Coherence Tomography (OCT) is the gold standard to identify fluid at different levels within the retina. The presence of fluid is considered the hallmark to define the presence of disease activity. Anti-vascular growth factor (anti-VEGF) injections can be used to treat exudative MNV. However, given the limitations of anti-VEGF treatment, as burdensome need for frequent visits and repeated injections to sustain efficacy, limited durability of the treatment, poor or no response, there is a great interest in detecting early biomarkers associated with a higher risk for AMD progression to exudative forms in order to optimize the design of early intervention clinical trials. The annotation of structural biomarkers on optical coherence tomography (OCT) B-scans is a laborious, complex and time-consuming process, and discrepancies between human graders can introduce variability into this assessment. To address this issue, a deep-learning model (SLIVER-net) was proposed, which could identify AMD biomarkers on structural OCT volumes with high precision and without human supervision. However, the validation was performed on a small dataset, and the true predictive power of these detected biomarkers in the context of a large cohort has not been evaluated. In this retrospective cohort study, we perform the largest-scale validation of these biomarkers to date. We also assess how these features combined with other EHR data (demographics, comorbidities, etc) affect and/or improve the prediction performance relative to known factors. Our hypothesis is that these biomarkers can be identified by a machine learning algorithm without human supervision, in a way that they preserve their predictive nature. The way we test this hypothesis is by building several machine learning models utilizing these machine-read biomarkers and assessing their added predictive power. We found that not only can we show that the machine-read OCT B-scan biomarkers are predictive of AMD progression, we also observe that our proposed combined OCT and EHR data-based algorithm outperforms the state-of-the-art solution in clinically relevant metrics and provides actionable information which has the potential to improve patient care. In addition, it provides a framework for automated large-scale processing of OCT volumes, making it possible to analyze vast archives without human supervision.

Published
2023

15. Contributors

Author

Avogaro, Angelo, primary, BouGhanem, Ghazi, additional, Bril, Fernando, additional, Chakravarthy, Usha, additional, Chocarro-Calvo, Ana, additional, Ciudin, Andreea, additional, Donato, Maristella, additional, Escolà-Gil, Joan Carles, additional, Fawzi, Amani, additional, García-Fontana, Beatriz, additional, García-Jiménez, Custodia, additional, García-Martínez, José Manuel, additional, Granado-Casas, Minerva, additional, Groop, Per-Henrik, additional, Hayón-Ponce, María, additional, Hernández, Cristina, additional, Jude, Edward B., additional, Julve, Josep, additional, Lecube, Albert, additional, Mauricio, Didac, additional, Mohan, Viswanathan, additional, Mung, Sai Man, additional, Muñoz-Torres, Manuel, additional, Pardina, Eva, additional, Pedrol, Nuria Alonso, additional, Perez Montes de Oca, Alejandra, additional, Pongrac Barlovic, Drazenka, additional, Pradeepa, Rajendra, additional, Rattazzi, Marcello, additional, Rossell-Rusiñol, Joana, additional, Rossell, Joana, additional, Sacchetta, Luca, additional, Sadda, Srinivas R., additional, Santiago-Vacas, Evelyn, additional, Simó, Rafael, additional, Solini, Anna, additional, Spallone, Vincenza, additional, Sun, Jennifer K., additional, Tan, Tien-En, additional, Tan, Gavin S.W., additional, Tondo, Mireia, additional, Tricò, Domenico, additional, Vlacho, Bogdan, additional, Vujosevic, Stela, additional, and Wong, Tien Yin, additional

Published
2024
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16. Diabetic retinopathy: New insights

Author

Tan, Tien-En, primary, Tan, Gavin S.W., additional, Sadda, Srinivas R., additional, Chakravarthy, Usha, additional, Sun, Jennifer K., additional, and Wong, Tien Yin, additional

Published
2024
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17. Quantification of Anterior Chamber Cells in Children With Uveitis Using Anterior Segment Optical Coherence Tomography

Author

Tsui, Edmund, Chen, Judy L, Jackson, Nicholas J, Leyva, Omar, Rasheed, Haroon, Baghdasaryan, Elmira, Fung, Simon SM, McCurdy, Deborah K, Sadda, Srinivas R, and Holland, Gary N

Subjects
Biomedical and Clinical Sciences, Ophthalmology and Optometry, Eye Disease and Disorders of Vision, Pediatric, Biomedical Imaging, Clinical Research, Eye, Adolescent, Anterior Chamber, Child, Child, Preschool, Cross-Sectional Studies, Eye Abnormalities, Humans, Reproducibility of Results, Tomography, Optical Coherence, Uveitis, Uveitis, Anterior, anterior segment optical coherence tomography, anterior uveitis, optical coherence tomography, pediatrics, uveitis, Clinical Sciences, Opthalmology and Optometry, Public Health and Health Services, Ophthalmology & Optometry, Ophthalmology and optometry
Abstract

PurposeTo evaluate the feasibility of anterior segment optical coherence tomography (AS-OCT) for measuring anterior chamber (AC) cells in children with uveitis and to compare different AS-OCT acquisition modes.DesignValidity and reliability analysis.MethodsWe enrolled children younger than 18 years who had uveitis involving the anterior segment and children without eye disease as controls. All underwent clinical grading of AC cells. AC images of each eye were obtained using the Optovue Avanti RTVue XR AS-OCT. Two acquisition modes were used: a single cross-sectional line scan and an 8-line radial scan in an asterisk pattern. Two independent, masked graders counted cells manually on AS-OCT images. Rater agreement was assessed using intraclass correlation (ICC).ResultsIncluded were 30 children (59 eyes) with uveitis (median age 13.0 years, range 3-17 years) and 20 control children (40 eyes, median age 10.5 years, range 4-17 years). The number of eyes assigned each clinical grade of cells were as follows: none, 32 (54%); 0.5+, 12 (20.3%); 1+, 5 (8.5%); 2+, 8 (13.6%); 3+, 2 (3.4%). ICC of graders for line and radial scan protocols were 0.87 and 0.90. There was no significant difference between acquisition modes for pooled grader results (95% CI for difference: -0.04 to 0.14). ICC of cell counts between line and radial scan protocols was 0.85 (95% CI: 0.69-0.90). No control eyes had cells on AS-OCT images.ConclusionsQuantification of AC cell in children with uveitis is feasible with AS-OCT and has excellent reliability between different graders and acquisition modes.

Published
2022

26. International Classification System for Ocular Complications of Anti-VEGF Agents in Clinical Trials

Author

Popovic, Marko M., Balas, Michael, Sadda, SriniVas R., Sarraf, David, Huang, Ryan, Bakri, Sophie J., Berrocal, Audina, Chang, Andrew, Gemmy Cheung, Chui Ming, Garg, Sunir, Hillier, Roxane J., Holz, Frank G., Johnson, Mark W., Kaiser, Peter K., Kertes, Peter J., Lai, Timothy Y.Y., Noble, Jason, Park, Susanna S., Paulus, Yannis M., Querques, Giuseppe, Rachitskaya, Aleksandra, Ruamviboonsuk, Paisan, Saidkasimova, Shohista, Sandinha, Maria Teresa, Steel, David H., Terasaki, Hiroko, Weng, Christina Y., Williams, Basil K., Jr., Wu, Lihteh, and Muni, Rajeev H.

Published
2024
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40. OCT Imaging and Applications in the Retina

Author

Wang, Ziyuan, DeBuc, Delia Cabrera, Beg, Mirza Faisal, Sadda, SriniVas Reddy, Hu, Zhihong Jewel, Yogesan, Kanagasingam, editor, Goldschmidt, Leonard, editor, Cuadros, Jorge, editor, and Ricur, Giselle, editor

Published
2023
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50. Reticular Pseudodrusen: Interreader Agreement of Evaluation on OCT Imaging in Age-Related Macular Degeneration

Author

Wu, Zhichao, Schmitz-Valckenberg, Steffen, Blodi, Barbara A., Holz, Frank G., Jaffe, Glenn J., Liakopoulos, Sandra, Sadda, Srinivas R., Bonse, Mari, Brown, Tyler, Choong, John, Clifton, Bailey, Corradetti, Giulia, Corvi, Federico, Dieu, Andrew C., Dooling, Vivienne, Pak, Jeong W., Saßmannshausen, Marlene, Skalak, Cindy, Thiele, Sarah, and Guymer, Robyn H.

Published
2023
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