Type 1 Choroidal Neovascularization Is Associated with Reduced Localized Progression of Atrophy in Age-Related Macular Degeneration

Pfau, Maximilian; Möller, Philipp T.; Künzel, Sandrine H.; Emde, Leon von der; Lindner, Moritz; Thiele, Sarah; Dysli, Chantal; Nadal, Jennifer; Schmid, Matthias; Schmitz-Valckenberg, Steffen; Holz, Frank G.; Fleckenstein, Monika

doi:10.1016/j.oret.2019.09.016

Cited by 56 publications

(67 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Their model performed at a DSC of 0.87 (95% CI = 0.85–0.89) when all topographic locations were considered. 46 …”

Section: Resultsmentioning

confidence: 99%

“… 41 Finally, Pfau et al used the DSC metrics to assess predicted and observed atrophy and achieved a model DSC of 0.87 (95% CI = 0.85–0.89) for regions not previously affected by atrophy. 46 …”

Section: Discussionmentioning

confidence: 99%

“…GA spatial progression was also investigated by Niu et al and Pfau et al 45 , 46 Niu et al 45 coupled their previously formulated Chan-Vese model along with a random forest with 100 trees to build 3 potential prediction models using 19 extracted features from a dataset of 118 SD-OCT scans from 38 eyes of 29 patients. Performance metrics used were DSC, sensitivity, specificity, positive predictive values, and negative predictive values (PPVs and NPVs, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Pfau and colleagues categorized eyes into three diagnostic groups and assessed both localized and global progressions with AI-extracted features, such as pixel-wise locations. 46 They fitted a mixed-effects logistic regression for localized progression, followed by a global progression using point-wise (mixed-effects) model, and found that both localized presence of treatment-naïve quiescent type 1 CNV and localized presence of exudative type 1 CNV were both associated with markedly reduced odds for the localized future progression of RPE atrophy (OR = 0.21 and 0.46, respectively; P < 0.001). The DSC was 0.87 (95% CI = 0.85–0.89) when all topographic locations were considered.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Artificial Intelligence Algorithms for Analysis of Geographic Atrophy: A Review and Evaluation

Arslan

Samarasinghe

Benke

et al. 2020

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

Purpose The purpose of this study was to summarize and evaluate artificial intelligence (AI) algorithms used in geographic atrophy (GA) diagnostic processes (e.g. isolating lesions or disease progression). Methods The search strategy and selection of publications were both conducted in accordance with the Preferred of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed and Web of Science were used to extract literary data. The algorithms were summarized by objective, performance, and scope of coverage of GA diagnosis (e.g. lesion automation and GA progression). Results Twenty-seven studies were identified for this review. A total of 18 publications focused on lesion segmentation only, 2 were designed to detect and classify GA, 2 were designed to predict future overall GA progression, 3 focused on prediction of future spatial GA progression, and 2 focused on prediction of visual function in GA. GA-related algorithms reported sensitivities from 0.47 to 0.98, specificities from 0.73 to 0.99, accuracies from 0.42 to 0.995, and Dice coefficients from 0.66 to 0.89. Conclusions Current GA-AI publications have a predominant focus on lesion segmentation and a minor focus on classification and progression analysis. AI could be applied to other facets of GA diagnoses, such as understanding the role of hyperfluorescent areas in GA. Using AI for GA has several advantages, including improved diagnostic accuracy and faster processing speeds. Translational Relevance AI can be used to quantify GA lesions and therefore allows one to impute visual function and quality-of-life. However, there is a need for the development of reliable and objective models and software to predict the rate of GA progression and to quantify improvements due to interventions.

show abstract

“…Their model performed at a DSC of 0.87 (95% CI = 0.85–0.89) when all topographic locations were considered. 46 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Artificial Intelligence Algorithms for Analysis of Geographic Atrophy: A Review and Evaluation

Arslan

Samarasinghe

Benke

et al. 2020

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

show abstract

“…Another explanation could be that the progression of atrophic changes may be furthered by decreased perfusion and resulting ischaemia, as the regression of CNV with anti-VEGF may eliminate the only remaining blood supply for the outer retina [92]. Published reports demonstrate a potential protective effect of sub-RPE choroidal neovascularization (type 1 CNV) in slowing macular atrophy in eyes with nAMD [21,23,36,40,52,[93][94][95].…”

Section: Discussionmentioning

confidence: 99%

A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II

2020

View full text Add to dashboard Cite

Introduction: To explore the potential link between macular atrophy (MA) of the retinal pigment epithelium (RPE) in patients with neovascular age-related macular degeneration (nAMD) and anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods: Through a balanced overview of the field from a largely clinical perspective, we looked at available evidence on the topic of MA correlation with anti-VEGF therapy and examined possible risk factors for MA development in the context of nAMD treatment with anti-VEGF. Results: Links have been reported to connect both MA incidence and progression to treatment frequency and to the anti-VEGF drug type. Conclusions: All reports agree on the fact that de novo development of MA in anti-VEGFtreated eyes is frequent and multifactorial. Research data shows an expansion of atrophy during anti-VEGF treatment. There are mixed conclusions about the correlation of MA incidence or progression with treatment-related risk factors. It mostly appears that there is no straightforward link. More clinical research is still needed to further understand this association.

show abstract

Progression of Photoreceptor Degeneration in Geographic Atrophy Secondary to Age-related Macular Degeneration

et al. 2020

Self Cite

View full text Add to dashboard Cite

IMPORTANCESensitive outcome measures for disease progression are needed for treatment trials in geographic atrophy (GA) secondary to age-related macular degeneration (AMD).OBJECTIVE To quantify photoreceptor degeneration outside regions of GA in eyes with nonexudative AMD, to evaluate its association with future GA progression, and to characterize its spatio-temporal progression. Monocenter cohort study (Directional Spread in Geographic Atrophy [NCT02051998]) and analysis of data from a normative data study at a tertiary referral center. One hundred fifty-eight eyes of 89 patients with a mean (SD) age of 77.7 (7.1) years, median area of GA of 8.87 mm 2 (IQR, 4.09-15.60), and median follow-up of 1.1 years (IQR, 0.52-1.7 years), as well as 93 normal eyes from 93 participants. DESIGN, SETTING, AND PARTICIPANTSEXPOSURES Longitudinal spectral-domain optical coherence tomography (SD-OCT) volume scans (121 B-scans across 30°× 25°) were segmented with a deep-learning pipeline and standardized in a pointwise manner with age-adjusted normal data (z scores). Outer nuclear layer (ONL), photoreceptor inner segment (IS), and outer segment (OS) thickness were quantified along evenly spaced contour lines surrounding GA lesions. Linear mixed models were applied to assess the association between photoreceptor-related imaging features and GA progression rates and characterize the pattern of photoreceptor degeneration over time.MAIN OUTCOMES AND MEASURES Association of ONL thinning with follow-up time (after adjusting for age, retinal topography [z score], and distance to the GA boundary). RESULTSThe study included 158 eyes of 89 patients (51 women and 38 men) with a mean (SD) age of 77.7 (7.1) years. The fully automated B-scan segmentation was accurate (dice coefficient, 0.82; 95% CI, 0.80-0.85; compared with manual markings) and revealed a marked interpatient variability in photoreceptor degeneration. The ellipsoid zone (EZ) loss-to-GA boundary distance and OS thickness were prognostic for future progression rates. Outer nuclear layer and IS thinning over time was significant even when adjusting for age and proximity to the GA boundary (estimates of −0.16 μm/y; 95% CI, −0.30 to −0.02; and −0.17 μm/y; 95% CI, −0.26 to −0.09).CONCLUSIONS AND RELEVANCE Distinct and progressive alterations of photoreceptor laminae (exceeding GA spatially) were detectable and quantifiable. The degree of photoreceptor degeneration outside of regions of retinal pigment epithelium atrophy varied markedly between eyes and was associated with future GA progression. Macula-wide photoreceptor laminae thinning represents a potential candidate end point to monitor treatment effects beyond mere GA lesion size progression.

show abstract

Type 1 Choroidal Neovascularization Is Associated with Reduced Localized Progression of Atrophy in Age-Related Macular Degeneration

Abstract: To investigate the association between the presence of type-1 choroidal neovascularization (CNV) and the localized progression of atrophy in age-related macular degeneration (AMD).

Cited by 56 publications

References 50 publications

Artificial Intelligence Algorithms for Analysis of Geographic Atrophy: A Review and Evaluation

Artificial Intelligence Algorithms for Analysis of Geographic Atrophy: A Review and Evaluation

A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II

Progression of Photoreceptor Degeneration in Geographic Atrophy Secondary to Age-related Macular Degeneration

Contact Info

Product

Resources

About