Baseline predictors for subretinal fibrosis in neovascular age-related macular degeneration

Roberts, Philipp; Schranz, Markus; Motschi, Alice; Desissaire, Sylvia; Häcker, Valentin; Pircher, Michael; Sacu, Stefan; Buehl, Wolf; Hitzenberger, Christoph K.; Schmidt–Erfurth, U.

doi:10.1038/s41598-021-03716-8

Cited by 17 publications

(5 citation statements)

References 37 publications

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“…The introduction of intravitreal anti–vascular endothelial growth factor therapy for neovascular age-related macular degeneration (AMD) has dramatically changed the prognosis for the most prevalent cause of irreversible vision loss in the developed world . A key factor for treatment success is early intervention before onset of irreversible subretinal fibrosis . Treatment delay translates to significantly worse visual acuity, which has become especially apparent during the COVID-19 pandemic .…”

Section: Introductionmentioning

confidence: 99%

“…1,2 A key factor for treatment success is early intervention before onset of irreversible subretinal fibrosis. [3][4][5] Treatment delay translates to significantly worse visual acuity, which has become especially apparent during the COVID-19 pandemic. [6][7][8] Thus, diagnostic tools for early detection of neovascular AMD are essential to preserve vision in patients with AMD.…”

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confidence: 99%

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Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration

et al. 2023

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ImportancePatients with nonneovascular age-related macular degeneration (AMD) are encouraged to use the Amsler grid test for self-assessment to facilitate early diagnosis. The test is widely recommended, suggesting a belief that it signals worsening AMD, warranting its use in home monitoring.ObjectiveTo systematically review studies of the diagnostic test accuracy of the Amsler grid in the diagnosis of neovascular AMD and to perform diagnostic test accuracy meta-analyses.Data SourcesA systematic literature search was conducted in 12 databases for relevant titles from database inception until May 7, 2022.Study SelectionStudies included those with groups defined as having (1) neovascular AMD and (2) either healthy eyes or eyes with nonneovascular AMD. The index test was the Amsler grid. The reference standard was ophthalmic examination. After removal of obviously irrelevant reports, 2 authors (J.B. and M.S.) independently screened the remaining references in full text for potential eligibility. Disagreements were resolved by a third author (Y.S.).Data Extraction and SynthesisTwo authors (J.B. and I.P.) independently extracted all data and evaluated quality and applicability of eligible studies using the Quality Assessment of Diagnostic Accuracy Studies 2. Disagreements were resolved by a third author (Y.S.).Main Outcomes and MeasuresSensitivity and specificity of the Amsler grid for detecting neovascular AMD with comparators being either healthy control participants or patients with nonneovascular AMD.ResultsOf 523 records screened, 10 studies were included with a total of 1890 eyes (mean participant age ranging from 62 to 83 years). Sensitivity and specificity to diagnose neovascular AMD were 67% (95% CI, 51%-79%) and 99% (95% CI, 85%-100%), respectively, when comparators were healthy control participants and 71% (95% CI, 60%-80%) and 63% (95% CI, 49%-51%), respectively, when control participants were patients with nonneovascular AMD. Overall, potential sources of bias were low across studies.Conclusions and RelevanceAlthough the Amsler grid is easy and inexpensive to use for detection of metamorphopsia, its sensitivity may be at levels typically not recommended for monitoring. Coupling this lower sensitivity with only moderate specificity to identify neovascular AMD in a population at risk, these findings suggest that such patients typically should be encouraged to undergo ophthalmic examination regularly, regardless of any results of Amsler grid self-assessment.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration

et al. 2023

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“… 29 Of note, our study's analysis did not account for the factor of subretinal hemorrhage, which presented in a small proportion of study eyes (11.7%). 30 …”

Section: Discussionmentioning

confidence: 99%

Clinical Correlation of Retinal Fluid Fluctuation Represented by Fluctuation Index in Wet Age-Related Macular Degeneration: TOWER Study Report 2

Chantarasorn,

Ruamviboonsuk,

Thoongsuwan

et al. 2023

Trans. Vis. Sci. Tech.

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Purpose To explore outcomes and biomarkers associated with retinal fluid instability represented by a new parameter in neovascular age-related macular degeneration (nAMD). Methods Patients with treatment-naïve nAMD receiving anti-vascular endothelial growth factor (VEGF) injections for a duration of 1 to 3 years were consecutively reviewed. Fluctuation Index (FI) of each eye, calculated by averaging the sum of differences in 1-mm central subfield thickness between each follow-up from months 3 to 24, was arranged into ascending order from the lowest to the highest and split equally into low, moderate, and high fluctuation groups. Outcomes were analyzed at 24 months. Results Of 558 eyes, FI values showed a negative correlation with a degree–response gradient with 24-month visual improvement. After controlling for baseline best-corrected visual acuity and potential confounders, eyes with low fluctuation gained more Early Treatment Diabetic Retinopathy Study letters than those in the moderate and high fluctuation group (Δ, 10.1 and 14.0 letters, respectively). Significant best-corrected visual acuity improvement from baseline to month 24 (11.8 letters) was observed exclusively in the low fluctuation group despite the indifference in the number of injections and types of anti-VEGF drug used among groups. Patients presenting with central subfield thickness of ≥405 µm or intraretinal fluid coinciding with subretinal fluid showed a significant association with foveal thickness instability during the maintenance phase. Conclusions Apart from the central subfield thickness values, unstable macular thickening represented by the FI was associated with some baseline features and may contribute to substandard visual outcomes. Translational Relevance FI may be a valuable tool for assessing therapeutic adequacy in the treatment of nAMD.

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“…We used the dataset from a longitudinal prospective clinical study (clinicaltrials.gov: NCT03838679) of 56 treatment-naïve patients with neovascular AMD, conducted at the Department of Ophthalmology and Optometry and the Center for Medical Physics and Biomedical Engineering (CMPBE) at the Medical University of Vienna [ 58 , 59 ]. This study was approved by the local ethics committee and adhered to the tenets of the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

Automated inter-device 3D OCT image registration using deep learning and retinal layer segmentation

Rivas-Villar¹,

Motschi²,

Pircher³

et al. 2023

Biomed. Opt. Express

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Optical coherence tomography (OCT) is the most widely used imaging modality in ophthalmology. There are multiple variations of OCT imaging capable of producing complementary information. Thus, registering these complementary volumes is desirable in order to combine their information. In this work, we propose a novel automated pipeline to register OCT images produced by different devices. This pipeline is based on two steps: a multi-modal 2D en-face registration based on deep learning, and a Z-axis (axial axis) registration based on the retinal layer segmentation. We evaluate our method using data from a Heidelberg Spectralis and an experimental PS-OCT device. The empirical results demonstrated high-quality registrations, with mean errors of approximately 46 µm for the 2D registration and 9.59 µm for the Z-axis registration. These registrations may help in multiple clinical applications such as the validation of layer segmentations among others.

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Baseline predictors for subretinal fibrosis in neovascular age-related macular degeneration

Cited by 17 publications

References 37 publications

Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration

Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration

Clinical Correlation of Retinal Fluid Fluctuation Represented by Fluctuation Index in Wet Age-Related Macular Degeneration: TOWER Study Report 2

Automated inter-device 3D OCT image registration using deep learning and retinal layer segmentation

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