Pigment epithelial detachment composition indices (PEDCI) in neovascular age-related macular degeneration

Abstract

We provide an automated analysis of the pigment epithelial detachments (PEDs) in neovascular age-related macular degeneration (nAMD) and estimate areas of serous, neovascular, and fibrous tissues within PEDs. A retrospective analysis of high-definition spectral-domain OCT B-scans from 43 eyes of 37 patients with nAMD with presence of fibrovascular PED was done. PEDs were manually segmented and then filtered using 2D kernels to classify pixels within the PED as serous, neovascular, or fibrous. A set of PED composition indices were calculated on a per-image basis using relative PED area of serous (PEDCI-S), neovascular (PEDCI-N), and fibrous (PEDCI-F) tissue. Accuracy of segmentation and classification within the PED were graded in masked fashion. Mean overall intra-observer repeatability and inter-observer reproducibility were 0.86 ± 0.07 and 0.86 ± 0.03 respectively using intraclass correlations. The mean graded scores were 96.99 ± 8.18, 92.12 ± 7.97, 91.48 ± 8.93, and 92.29 ± 8.97 for segmentation, serous, neovascular, and fibrous respectively. Mean (range) PEDCI-S, PEDCI-N, and PEDCI-F were 0.253 (0–0.952), 0.554 (0–1), and 0.193 (0–0.693). A kernel-based image processing approach demonstrates potential for approximating PED composition. Evaluating follow up changes during nAMD treatment with respect to PEDCI would be useful for further clinical applications.

Comparison of pigment epithelium detachment composition indices between neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

“…n-AMD and PCV may show regression of PED with resultant atrophy on treatment. The average capillary size ranges from 2.5 to 10 μm and is broadly similar to the axial and transverse resolution of OCT scans, suggesting that vessels in FVPED may be few pixels in size; therefore, correct characterization with current OCT technology has inherent limitations [ 12 ].…”

“…This was done by computing the scarring likelihood metric based on multiple filtering steps. Here, we used PEDCI-F, the ratio of fibrous tissue area to the total PED lesion [ 12 ].…”

“…We recently published the methodology and analysis of pigment epithelium detachment composition indices (PEDCI) using our automated algorithm based on the heterogeneity of the PED composition [ 12 ]. In the current work, we aimed to study PEDCI (fibrous component, PEDCI-F) changes in eyes with n-AMD and PCV treated with anti-vascular endothelial growth factors (anti-VEGF) for 12 months.…”

Radiomics-Based Prediction of Anti-VEGF Treatment Response in Neovascular Age-Related Macular Degeneration With Pigment Epithelial Detachment

“…For example, previous work has successfully segmented PED into serous, drusenoid, and fibrovascular fluid types. 32 Understanding how such separation of fluid type relates to radiomic features would improve the interpretability of radiomics features on the one hand and possibly reveal additional subcategories of fluid that can be distinguished by radiomics features on the other hand. Further work in these areas could lead to improved clinical decision making and new understanding of the pathophysiology of PED.…”

The Complement System as a Therapeutic Target in Retinal Disease

“…This form of atrophy leads to the sharply demarcated lesions of GA. Management of early and intermediate AMD includes counseling, smoking cessation, consuming leafy vegetables, use of AREDS vitamins, and clinical monitoring for signs of CNV, such as metamorphopsia and central scotoma. Exudative AMD is typically treated with anti-vascular endothelial growth factor injections [ 40 ], while GA treatments will be discussed below.…”