Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability (FOREVER)—A cohort study in a Danish high street optician setting: Design and methodology

Gazzard, Gus; Kolko, Miriam; Torp‐Pedersen, Christian; Benn, Marianne; Brunak, Søren; Cour, Morten la; Tolstrup, Janne S; Toft‐Petersen, Anne Pernille; Burgdorf, Kristoffer Sølvsten; Banasik, Karina; Chmura, Piotr Jaroslaw; Freiberg, Josefine Clement; Rovelt, Jens; Thornit, Dorte Nellemann; Foster, Paul J.; Gazzard, Gus; Crabb, David P.; Viswanathan, Ananth C.; Barman, Sarah; Owen, Christopher G.; Rudnicka, Alicja R.

doi:10.1111/aos.15693

Cited by 3 publications

(1 citation statement)

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“…The design and methodology of project FOREVER has been described thoroughly by Freiberg. et al [ 35 ]. For participants enrolling in project FOREVER, informed written consent will be collected.…”

Section: Methodsmentioning

confidence: 99%

Automated analysis of vessel morphometry in retinal images from a Danish high street optician setting

Freiberg,

Welikala,

Rovelt

et al. 2023

PLoS ONE

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Purpose To evaluate the test performance of the QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) software in detecting retinal features from retinal images captured by health care professionals in a Danish high street optician chain, compared with test performance from other large population studies (i.e., UK Biobank) where retinal images were captured by non-experts. Method The dataset FOREVERP (Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability, Pilot) contains retinal images obtained from a Danish high street optician chain. The QUARTZ algorithm utilizes both image processing and machine learning methods to determine retinal image quality, vessel segmentation, vessel width, vessel classification (arterioles or venules), and optic disc localization. Outcomes were evaluated by metrics including sensitivity, specificity, and accuracy and compared to human expert ground truths. Results QUARTZ’s performance was evaluated on a subset of 3,682 images from the FOREVERP database. 80.55% of the FOREVERP images were labelled as being of adequate quality compared to 71.53% of UK Biobank images, with a vessel segmentation sensitivity of 74.64% and specificity of 98.41% (FOREVERP) compared with a sensitivity of 69.12% and specificity of 98.88% (UK Biobank). The mean (± standard deviation) vessel width of the ground truth was 16.21 (4.73) pixels compared to that predicted by QUARTZ of 17.01 (4.49) pixels, resulting in a difference of -0.8 (1.96) pixels. The differences were stable across a range of vessels. The detection rate for optic disc localisation was similar for the two datasets. Conclusion QUARTZ showed high performance when evaluated on the FOREVERP dataset, and demonstrated robustness across datasets, providing validity to direct comparisons and pooling of retinal feature measures across data sources.

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Section: Methodsmentioning

confidence: 99%

Automated analysis of vessel morphometry in retinal images from a Danish high street optician setting

Freiberg,

Welikala,

Rovelt

et al. 2023

PLoS ONE

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Glaucoma is associated with poorer self-rated vision, vision concerns and health: Results from 59,168 questionnaire responses

Rovelt,

Freiberg,

Reimann

et al. 2024

AJO International

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Longitudinal associations of retinal vessel morphology with intraocular pressure and blood pressure at follow‐up visit—Findings from a Danish eye and vision cohort, Project FOREVER

Freiberg,

Welikala,

Rovelt

et al. 2024

Acta Ophthalmologica

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PurposeTo characterise the retinal vasculometry of a Danish eye and vision cohort and examine associations with systolic blood pressure (BP), diastolic BP, mean arterial BP, and intraocular pressure (IOP).DesignLongitudinal study.MethodsThe retinal vasculature of fundus images from the FOREVER (Finding Ophthalmic Risks and Evaluating the Value of Eye exams and their predictive Reliability) cohort was analysed using a fully automated image analysis program. Longitudinal associations of retinal vessel morphology at follow‐up visit with IOP (baseline and follow‐up) and BP (follow‐up) were examined using multilevel linear regression models adjusting for age, sex and retinal vasculometry at baseline as fixed effects and person as random effect. Width measurements were additionally adjusted for the spherical equivalent.ResultsA total of 2089 subjects (62% female) with a mean age of 61 (standard deviation 8) years and a mean follow‐up period of 4.1 years (SD 0.6 years) were included. The mean arteriolar diameter was approximately 20% thinner than the mean venular diameter, and venules were about 21%–23% less tortuous than arterioles. BP at follow‐up was associated with decreased arteriolar diameter from baseline to follow‐up. After adjusting for baseline IOP, IOP at follow‐up was associated with increased arteriolar tortuosity above baseline (0.59%, 95% CI 0.08–1.10, p‐value 0.024).ConclusionIn a Danish eye and vision cohort, variations in BP and alterations in IOP over time were associated with changes in the width and tortuosity of retinal vessels. Our findings contribute novel insights into retinal vascular alterations over time.

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Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability (FOREVER)—A cohort study in a Danish high street optician setting: Design and methodology

Cited by 3 publications

References 44 publications

Automated analysis of vessel morphometry in retinal images from a Danish high street optician setting

Automated analysis of vessel morphometry in retinal images from a Danish high street optician setting

Glaucoma is associated with poorer self-rated vision, vision concerns and health: Results from 59,168 questionnaire responses

Longitudinal associations of retinal vessel morphology with intraocular pressure and blood pressure at follow‐up visit—Findings from a Danish eye and vision cohort, Project FOREVER

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