Patterns of Fundus Autofluorescence Defects in Neovascular Age-Related Macular Degeneration Subtypes

Özkök, Ahmet; Sigford, Douglas Kenneth; Tezel, Tongalp H.

doi:10.1097/iae.0000000000001034

Cited by 5 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 Third, atrophy is proposed to arise non-specifically in response to the exudative process itself, with episodic leakage over time, mechanical damage secondary to vascular outgrowth and contraction (dramatically demonstrated via OCT-angiography 62 ), and concomitant inflammation and ischemia. 3 Newly recognized forms of severe photoreceptor degeneration, 40 the non-progressive nature of RPE change at the ELM descent herein described, and FAF signatures consistent with a floodplain 3, 9, 19, 23, 57, 59 (Figure 7) support this third model, as do recent analysis of fellow eyes to those treated with anti-VEGF agents. 24 …”

Section: Discussionsupporting

confidence: 56%

“…Third, areas of absent FAF are preceded by and surrounded by areas of an abnormally granular FAF 21, 57 , seen as pigmentary disturbances in color imaging that are also associated with poor vision. 4 Fourth, several published FAF images 3, 9, 19, 22, 23, 57, 59 include a band of relatively uniform hyperautofluorescence with smoothly contoured edges surrounding atrophic areas (Figure 7B). This pattern recalls the inferior-angling gravitational tracks that typify central serous retinopathy 60 and gives the impression of fluid having washed over the RPE, like a floodplain of exudation.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Visualizing Retinal Pigment Epithelium Phenotypes in the Transition to Atrophy in Neovascular Age-Related Macular Degeneration

Zanzottera

Ach

Huisingh

et al. 2016

Retina

View full text Add to dashboard Cite

Purpose To enable future studies of retinal pigment epithelium (RPE) fate in the macular atrophy occurring in eyes with neovascular AMD (nvAMD), we determined how RPE morphology changes across the transition from health to atrophy in donor eyes with nvAMD. Method In RPE-Bruch’s membrane flat mounts of 5 nvAMD eyes the terminations of organized RPE cytoskeleton and autofluorescent material were compared. In high-resolution histological sections of 27 nvAMD eyes, RPE phenotypes were assessed at ±500 and ±100 µm from the descent of the external limiting membrane (ELM) towards Bruch’s membrane. Thicknesses of RPE, basal laminar deposit (BLamD), and RPE+BLamD were determined. Shapes of the ELM descent were recorded. Results Approaching the ELM descent, the percentage of different RPE phenotypes (Zanzottera, IOVS 2015) and the thickness of RPE, BLamD, and RPE + BLamD each stayed roughly constant. When compared to a separately described cohort of eyes with geographic atrophy, eyes with nvAMD were more likely to have RPE dysmorphia that did not worsen towards the atrophy border, thinner BLamD overall (3.25 ± 3.46 µm vs 7.99 ± 7.49 µm for geographic atrophy), and a higher proportion of oblique ELM descents (47.9% vs 31.9%). Conclusion The distribution of RPE phenotypes at the transition to macular atrophy in eyes with nvAMD differs from that in primary geographic atrophy, likely reflecting greater photoreceptor loss and the effects of exudation in nvAMD. This distribution, the shape of ELM descents, and thickness profiles may be useful metrics in clinical studies of macular atrophy utilizing optical coherence tomography and fundus autofluorescence.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 98%

Visualizing Retinal Pigment Epithelium Phenotypes in the Transition to Atrophy in Neovascular Age-Related Macular Degeneration

Zanzottera

Ach

Huisingh

et al. 2016

Retina

View full text Add to dashboard Cite

show abstract

“…12 By learning patterns and features of GA from extensive image databases, AI models can apply this knowledge to new images for automated GA diagnosis. 13 However, while deep learning models employing FAF and OCT have shown remarkable performance in identifying GA when compared with CFP, their practicality and availability in various healthcare settings remain limited. [14][15][16] In contrast, CFP stands out as a more widespread, accessible and cost-effective technique for GA screening and monitoring.…”

Section: How This Study Might Affect Research Practice or Policymentioning

confidence: 99%

Explainable artificial intelligence model for the detection of geographic atrophy using colour retinal photographs

Sarao,

Veritti,

De Nardin

et al. 2023

BMJ Open Ophth

View full text Add to dashboard Cite

ObjectiveTo develop and validate an explainable artificial intelligence (AI) model for detecting geographic atrophy (GA) via colour retinal photographs.Methods and analysisWe conducted a prospective study where colour fundus images were collected from healthy individuals and patients with retinal diseases using an automated imaging system. All images were categorised into three classes: healthy, GA and other retinal diseases, by two experienced retinologists. Simultaneously, an explainable learning model using class activation mapping techniques categorised each image into one of the three classes. The AI system’s performance was then compared with manual evaluations.ResultsA total of 540 colour retinal photographs were collected. Data was divided such that 300 images from each class trained the AI model, 120 for validation and 120 for performance testing. In distinguishing between GA and healthy eyes, the model demonstrated a sensitivity of 100%, specificity of 97.5% and an overall diagnostic accuracy of 98.4%. Performance metrics like area under the receiver operating characteristic (AUC-ROC, 0.988) and the precision-recall (AUC-PR, 0.952) curves reinforced the model’s robust achievement. When differentiating GA from other retinal conditions, the model preserved a diagnostic accuracy of 96.8%, a precision of 90.9% and a recall of 100%, leading to an F1-score of 0.952. The AUC-ROC and AUC-PR scores were 0.975 and 0.909, respectively.ConclusionsOur explainable AI model exhibits excellent performance in detecting GA using colour retinal images. With its high sensitivity, specificity and overall diagnostic accuracy, the AI model stands as a powerful tool for the automated diagnosis of GA.

show abstract

“…FAF abnormalities have been shown to be more common in patients with PCV than in patients with retinal angiomatous proliferation or typical neovascular AMD. [ 44 ] Studies have demonstrated that PCV lesions show distinct FAF patterns. In a study by Yamagishi et al ., polypoidal lesions were observed as having confluent hypoautofluorescence, and BVN as having granular hypoautofluorescence.…”

Section: Diagnosis Of Pcvmentioning

confidence: 99%

Current management strategy of polypoidal choroidal vasculopathy

Lai

2018

Indian J Ophthalmol

View full text Add to dashboard Cite

Polypoidal choroidal vasculopathy (PCV) is a retinal disorder commonly found in Asians presenting as neovascular age-related macular degeneration and is characterized by serous macular detachment, serous or hemorrhagic pigment epithelial detachment, subretinal hemorrhage, and occasionally visible orange-red subretinal nodular lesions. PCV is diagnosed using indocyanine green angiography (ICGA), and the lesions appear as polypoidal aneurysmal vascular lesions with or without abnormal branching vascular network. Although ICGA remains the gold standard for the diagnosis of PCV, various imaging modalities have also facilitated the diagnosis and monitoring of PCV. Recent advances in imaging technology including the use of high resolution spectral domain optical coherence tomography (OCT) and OCT angiography have provided new insights on the pathogenesis of PCV, suggesting a link between PCV and pachychoroid spectrum of macular disorders. With the evolving understanding on the pathogenesis and clinical characteristics of PCV, different therapeutic options have been proposed. These include intravitreal anti-vascular endothelial growth factor (anti-VEGF) monotherapy, combination therapy with anti-VEGF and verteporfin photodynamic therapy, and thermal laser photocoagulation. In recent years, major multi-center randomized clinical trials such as EVEREST, EVEREST II, and PLANET studies have been conducted to compare the efficacy and safety of various treatment options for PCV. This review aims to summarize the results of recent literature, clinical trials and studies to provide an update on the management options of PCV. An overall management strategy for PCV will also be proposed.

show abstract

Patterns of Fundus Autofluorescence Defects in Neovascular Age-Related Macular Degeneration Subtypes

Abstract: Presence of peripapillary fundus autofluorescence defects in neovascular age-related macular degeneration maybe suggestive of polypoidal choroidal vasculopathy as a variant of neovascular age-related macular degeneration.

Cited by 5 publications

References 23 publications

Visualizing Retinal Pigment Epithelium Phenotypes in the Transition to Atrophy in Neovascular Age-Related Macular Degeneration

Visualizing Retinal Pigment Epithelium Phenotypes in the Transition to Atrophy in Neovascular Age-Related Macular Degeneration

Explainable artificial intelligence model for the detection of geographic atrophy using colour retinal photographs

Current management strategy of polypoidal choroidal vasculopathy

Contact Info

Product

Resources

About