BACKGROUND: Large vessel carotid stenosis is a significant cause of ischaemic stroke. Indications for surgical revascularisation depend on the severity of the stenosis and clinical symptoms. However, mild symptoms such as TIA (Transient ischaemic attack), amaurosis fugax or minor stroke precede large strokes in only 15% of cases. AIM: The aim of this prospective study is to evaluate whether retinal perfusion is impacted in significant carotid stenosis. Automated retinal oximetry will be used to better assess perfusion in the post-stenotic basin. We presume the more stenotic the blood vessel, the more reduced the retinal perfusion is, resulting in adaptive changes such as greater arteriovenous saturation difference due to greater oxygen extraction. This could broaden the indication spectrum for revascularisation for carotid stenosis. METHODS: We plan to enroll yearly 50 patients with significant carotid stenosis and cross-examine them with retinal oximetry. The study group will provide stenotic vessels and, non-stenotic vessels will form the control group. Patients with significant carotid stenosis will undergo an MRI (Magnetic Resonnance imaging) examination to determine the presence of asymptomatic recent ischaemic lesions in the stenotic basin, and the correlation to oximetry parameters. STATISTICS: The stenosis severity and retinal oximetry parameters will be compared for study and control groups with a threshold of 70%, respectively 80% and 90% stenosis. Results will be then reevaluated with emphasis on MRI findings in the carotid basin. CONCLUSION: This prospective case control study protocol will be used to launch a multicentre trial assessing the relationship between significant carotid stenosis and retinal perfusion measured with automated retinal oximetry. Despite these differences, the findings indicate the potential of retinal oximetry for noninvasive real-time measurements of oxyhaemoglobin saturation in central nervous system vessels. Following calibration upgrade and technological improvement, verification retinal oximetry may potentially be applied to critically ill and anaesthesia care patients. The study on combined scanning laser ophthalmoscope and retinal oximetry supports the feasibility of the technique for oximetry analysis in newly born babies. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT06085612.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- oxymetrie * metody MeSH
- prospektivní studie MeSH
- retina diagnostické zobrazování patofyziologie MeSH
- retinální cévy diagnostické zobrazování patofyziologie MeSH
- senioři MeSH
- stenóza arteria carotis * patofyziologie chirurgie komplikace MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
Retinopathy of prematurity (ROP) represents a vasoproliferative disease, especially in newborns and infants, which can potentially affect and damage the vision. Despite recent advances in neonatal care and medical guidelines, ROP still remains one of the leading causes of worldwide childhood blindness. The paper presents a unique dataset of 6,004 retinal images of 188 newborns, most of whom are premature infants. The dataset is accompanied by the anonymized patients' information from the ROP screening acquired at the University Hospital Ostrava, Czech Republic. Three digital retinal imaging camera systems are used in the study: Clarity RetCam 3, Natus RetCam Envision, and Phoenix ICON. The study is enriched by the software tool ReLeSeT which is aimed at automatic retinal lesion segmentation and extraction from retinal images. Consequently, this tool enables computing geometric and intensity features of retinal lesions. Also, we publish a set of pre-processing tools for feature boosting of retinal lesions and retinal blood vessels for building classification and segmentation models in ROP analysis.
- MeSH
- lidé MeSH
- novorozenec nedonošený * MeSH
- novorozenec MeSH
- počítačové zpracování obrazu MeSH
- retina * diagnostické zobrazování MeSH
- retinopatie nedonošených * diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- dataset MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND AND OBJECTIVES: Retinal optical coherence tomography (OCT) provides promising prognostic imaging biomarkers for future disease activity in multiple sclerosis (MS). However, raw OCT-derived measures have multiple dependencies, supporting the need for establishing reference values adjusted for possible confounders. The purpose of this study was to investigate the capacity for age-adjusted z scores of OCT-derived measures to prognosticate future disease activity and disability worsening in people with MS (PwMS). METHODS: We established age-adjusted OCT reference data using generalized additive models for location, scale, and shape for peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer (GCIP) thicknesses, involving 910 and 423 healthy eyes, respectively. Next, we transformed the retinal layer thickness of PwMS from 3 published studies into age-adjusted z scores (pRNFL-z and GCIP-z) based on the reference data. Finally, we investigated the association of pRNFL-z or GCIP-z as predictors with future confirmed disability worsening (Expanded Disability Status Scale score increase) or disease activity (failing of the no evidence of disease activity [NEDA-3] criteria) as outcomes. Cox proportional hazards models or logistic regression analyses were applied according to the original studies. Optimal cutoffs were identified using the Akaike information criterion as well as location with the log-rank and likelihood-ratio tests. RESULTS: In the first cohort (n = 863), 172 PwMS (24%) had disability worsening over a median observational period of 2.0 (interquartile range [IQR]:1.0-3.0) years. Low pRNFL-z (≤-2.04) were associated with an increased risk of disability worsening (adjusted hazard ratio (aHR) [95% CI] = 2.08 [1.47-2.95], p = 3.82e-5). In the second cohort (n = 170), logistic regression analyses revealed that lower pRNFL-z showed a higher likelihood for disability accumulation at the two-year follow-up (reciprocal odds ratio [95% CI] = 1.51[1.06-2.15], p = 0.03). In the third cohort (n = 78), 46 PwMS (59%) did not maintain the NEDA-3 status over a median follow-up of 2.0 (IQR: 1.9-2.1) years. PwMS with low GCIP-z (≤-1.03) had a higher risk of showing disease activity (aHR [95% CI] = 2.14 [1.03-4.43], p = 0.04). Compared with raw values with arbitrary cutoffs, applying the z score approach with optimal cutoffs showed better performance in discrimination and calibration (higher Harrell's concordance index and lower integrated Brier score). DISCUSSION: In conclusion, our work demonstrated reference cohort-based z scores that account for age, a major driver for disease progression in MS, to be a promising approach for creating OCT-derived measures useable across devices and toward individualized prognostication.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- optická koherentní tomografie * MeSH
- prognóza MeSH
- progrese nemoci * MeSH
- retina diagnostické zobrazování patologie patofyziologie MeSH
- roztroušená skleróza * patofyziologie diagnostické zobrazování MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Retinal optical coherence tomography has been identified as biomarker for disease progression in relapsing-remitting multiple sclerosis (RRMS), while the dynamics of retinal atrophy in progressive MS are less clear. We investigated retinal layer thickness changes in RRMS, primary and secondary progressive MS (PPMS, SPMS), and their prognostic value for disease activity. Here, we analyzed 2651 OCT measurements of 195 RRMS, 87 SPMS, 125 PPMS patients, and 98 controls from five German MS centers after quality control. Peripapillary and macular retinal nerve fiber layer (pRNFL, mRNFL) thickness predicted future relapses in all MS and RRMS patients while mRNFL and ganglion cell-inner plexiform layer (GCIPL) thickness predicted future MRI activity in RRMS (mRNFL, GCIPL) and PPMS (GCIPL). mRNFL thickness predicted future disability progression in PPMS. However, thickness change rates were subject to considerable amounts of measurement variability. In conclusion, retinal degeneration, most pronounced of pRNFL and GCIPL, occurs in all subtypes. Using the current state of technology, longitudinal assessments of retinal thickness may not be suitable on a single patient level.
- MeSH
- chronicko-progresivní roztroušená skleróza * diagnostické zobrazování patologie patofyziologie MeSH
- degenerace retiny * diagnostické zobrazování patologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- nervová vlákna patologie MeSH
- optická koherentní tomografie * metody MeSH
- prognóza MeSH
- progrese nemoci * MeSH
- relabující-remitující roztroušená skleróza * diagnostické zobrazování patologie patofyziologie MeSH
- retina * diagnostické zobrazování patologie MeSH
- retinální gangliové buňky patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Úvod: Alzheimerova nemoc (AN), nejčastější příčina demence, postihuje podle odhadů 3–40 % populace hlavně vyššího věku a její incidence narůstá. Představuje velkou zátěž pro zdravotnický systém. Standardní diagnostická neurokognitivní vyšetření jsou náročná jak časově, tak finančně, proto je snaha o nalezení vhodné screeningové metody rizikových pacientů. Sítnice oka je embryologicky prodloužením mozku a lze předpokládat úzkou souvislost mezi stavem sítnice, detekovaným pomocí optické koherentní tomografie (OCT), a kognitivními funkcemi. Cílem práce bylo provést systematický přehled studií, které se zabývaly vztahem mezi tloušťkou nervových vláken sítnice (RNFL – retinal nerve fibre layer), a kognitivními funkcemi u pacientů Alzheimerovou nemocí. Metody: Z databází PubMed a Google Scholar byly na základě zvolených klíčových slov: Optical coherence tomography, dementia, retinal nerve fibre layer, cognitive function vybrány relevantní studie, které sledovaly změny tloušťky nervových vláken sítnice pomocí OCT a jejich vztah s výskytem Alzheimerovy nemoci. Výsledky: Do analýzy bylo zařazeno 16 studií. Většina prací konzistentně prokázala vztah mezi tloušťkou nervových vláken při OCT a výskytem Alzheimerovy nemoci. V naprosté většině studií bylo pozorováno snížení tloušťky pRNFL (papilární tloušťka nervových vláken) v horních a dolních kvadrantech, zatímco v nasálních a temporálních kvadrantech tento pokles nebyl zaznamenán. Snížení tloušťky pRNFL bylo detekováno i u pacientů s mírným kognitivním deficitem. Závěr: Snížení tloušťky nervových vláken pomocí neinvazivního vyšetření OCT koreluje s výskytem Alzheimerovy nemoci. OCT by ta
: Alzheimer disease (AD) as the most common cause of dementia, is affecting approximately 3-40 % of the elderly population and its incidence grows. It is a great burden for healthcare system. Standard diagnostic neurocognitive examination is time consuming and quite expensive. Therefore there is need for fast and accurate screening test. The retina of the eye is embryologically extension of the brain so it is assumed that there is correlation between status of the retina detected by optical coherence tomography and cognitive function. The aim of this study is to create a systematic review of studies which analysed correlation betwen retinal nerve fiber layer thickness (RNFL) and cognitive functions in patients with Alzheimer disease. Methods: Relevant studies from PubMed and Google scholar were searched using key words: Optical coherence tomography, dementia, retinal nerve fibre layer, cognitive function. Only results of studies where RNFL was measured with OCT scan and their association with Alzheimer disease were then analysed. Results: There were 16 studies eligible for the analysis. Most studies consistently proved association between RNFL thickness at the OCT and the presence of Alzheimer disease. In nearly every available study there is thinning of RNFL in superior and inferior quadrants, while in nasal and temporal quadrants there was no significant thinning present. Conclusion: So far as the results are being reviewed, there is an evidence that patients with Alzheimer disease have their retinal nerve fibre layer thickness decreased. This finding could lead to faster diagnosis of this disease and better therapeutical approach in this group of patients. There is sought for other studies with larger cohort and with modern imaging devices and software.
BACKGROUND AND OBJECTIVES: Optical coherence tomography angiography (OCTA) is a noninvasive high-resolution imaging technique for assessing the retinal vasculature and is increasingly used in various ophthalmologic, neuro-ophthalmologic, and neurologic diseases. To date, there are no validated consensus criteria for quality control (QC) of OCTA. Our study aimed to develop criteria for OCTA quality assessment. METHODS: To establish criteria through (1) extensive literature review on OCTA artifacts and image quality to generate standardized and easy-to-apply OCTA QC criteria, (2) application of OCTA QC criteria to evaluate interrater agreement, (3) identification of reasons for interrater disagreement, revision of OCTA QC criteria, development of OCTA QC scoring guide and training set, and (4) validation of QC criteria in an international, interdisciplinary multicenter study. RESULTS: We identified 7 major aspects that affect OCTA quality: (O) obvious problems, (S) signal strength, (C) centration, (A) algorithm failure, (R) retinal pathology, (M) motion artifacts, and (P) projection artifacts. Seven independent raters applied the OSCAR-MP criteria to a set of 40 OCTA scans from people with MS, Sjogren syndrome, and uveitis and healthy individuals. The interrater kappa was substantial (κ 0.67). Projection artifacts were the main reason for interrater disagreement. Because artifacts can affect only parts of OCTA images, we agreed that prior definition of a specific region of interest (ROI) is crucial for subsequent OCTA quality assessment. To enhance artifact recognition and interrater agreement on reduced image quality, we designed a scoring guide and OCTA training set. Using these educational tools, 23 raters from 14 different centers reached an almost perfect agreement (κ 0.92) for the rejection of poor-quality OCTA images using the OSCAR-MP criteria. DISCUSSION: We propose a 3-step approach for standardized quality control: (1) To define a specific ROI, (2) to assess the occurrence of OCTA artifacts according to the OSCAR-MP criteria, and (3) to evaluate OCTA quality based on the occurrence of different artifacts within the ROI. OSCAR-MP OCTA QC criteria achieved high interrater agreement in an international multicenter study and is a promising QC protocol for application in the context of future clinical trials and studies.
Optical coherence tomography angiography (OCT-A) is a novel, non-invasive, fast, repeatable, 3D imaging method for retinal, choroidal, and optic nerve vessels. OCT-A has the potential to become a new biomarker of various ophthalmological (e.g. glaucoma, diabetic retinopathy, age-related macular degeneration) and neurological disorders. Retinal microcirculation share similar features with cerebral small blood vessels, thus OCT-A may be considered a "window" for the detection of microvascular changes which are associated with neurodegenerative disorders, such as multiple sclerosis. In this review, we summarize recent findings regarding the utility of OCT-A as a novel, prospective biomarker for early diagnosis and monitoring of multiple sclerosis.
O
C
T
‐
a
n
g
i
o
g
r
a
f
i
a
(
O
p
t
i
c
a
l
c
o
h
e
r
e
n
c
e
t
o
m
o
g
r
a
p
h
y
a
n
g
i
o
g
r
a
p
h
y
,
O
C
T
‐
A
)
j
e
n
o
v
á
,
n
e
i
n
v
a
z
í
v
n
a
,
r
ý
c
h
l
a
,
r
e
p
r
o
d
u
k
o
v
a
t
e
ľ
n
á
3
D
z
o
b
r
a
z
o
v
a
c
i
a
m
e
t
ó
d
a
c
i
e
v
s
i
e
t
n
i
c
e
,
c
i
e
v
o
v
k
y
a
z
r
a
k
o
v
é
h
o
n
e
r
v
u
.
O
C
T
‐
A
m
á
p
o
t
e
n
c
i
á
l
s
t
a
ť
s
a
n
o
v
ý
m
b
i
o
m
a
r
k
e
r
o
m
c
h
o
r
o
b
n
ý
c
h
z
m
i
e
n
s
i
e
t
n
i
c
e
p
r
i
p
o
č
e
t
n
ý
c
h
o
č
n
ý
c
h
(
n
a
p
r
.
g
l
a
u
k
ó
m
,
d
i
a
b
e
t
i
c
k
á
r
e
t
i
n
o
p
a
t
i
a
,
v
e
k
o
m
p
o
d
m
i
e
n
e
n
á
d
e
g
e
n
e
r
á
c
i
a
m
a
k
u
l
y
)
a
n
e
u
r
o
l
o
g
i
c
k
ý
c
h
c
h
o
r
o
b
á
c
h
.
R
e
t
i
n
á
l
n
a
c
i
r
k
u
l
á
c
i
a
z
o
d
p
o
v
e
d
á
c
i
r
k
u
l
á
c
i
i
d
r
o
b
n
ý
c
h
c
i
e
v
m
o
z
g
u
,
p
r
e
t
o
m
e
t
ó
d
a
O
C
T
‐
A
p
r
e
d
s
t
a
v
u
j
e
a
k
é
s
i
"
o
k
n
o
"
,
v
k
t
o
r
o
m
m
o
ž
n
o
s
l
e
d
o
v
a
ť
z
m
e
n
y
m
i
k
r
o
c
i
r
k
u
l
á
c
i
e
p
r
i
p
r
i
m
á
r
n
y
c
h
(
A
l
z
h
e
i
m
e
r
o
v
a
c
h
o
r
o
b
a
,
P
a
r
k
i
n
s
o
n
o
v
a
c
h
o
r
o
b
a
)
i
s
e
k
u
n
d
á
r
n
y
c
h
n
e
u
r
o
d
e
g
e
n
e
r
a
t
í
v
n
y
c
h
o
c
h
o
r
e
n
i
a
c
h
m
o
z
g
u
,
a
k
o
j
e
s
c
l
e
r
o
s
i
s
m
u
l
t
i
p
l
e
x
.
V
t
o
m
t
o
p
r
e
h
ľ
a
d
e
u
v
á
d
z
a
m
e
v
ý
s
l
e
d
k
y
š
t
ú
d
i
í
z
a
m
e
r
a
n
ý
c
h
n
a
O
C
T
‐
A
a
k
o
n
o
v
ý
p
e
r
s
p
e
k
t
í
v
n
y
b
i
o
m
a
r
k
e
r
v
s
k
o
r
e
j
d
i
a
g
n
o
s
t
i
k
e
i
m
o
n
i
t
o
r
o
v
a
n
í
s
c
l
e
r
o
s
i
s
m
u
l
t
i
p
l
e
x
.
- MeSH
- dospělí MeSH
- klinická studie jako téma MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrovaskulární denzita MeSH
- nervus opticus anatomie a histologie diagnostické zobrazování krevní zásobení patologie anatomie a histologie diagnostické zobrazování krevní zásobení patologie MeSH
- neurodegenerativní nemoci diagnostické zobrazování patofyziologie patologie MeSH
- oči anatomie a histologie diagnostické zobrazování krevní zásobení patologie MeSH
- oční symptomy MeSH
- optická koherentní tomografie * metody MeSH
- retina anatomie a histologie diagnostické zobrazování patologie MeSH
- roztroušená skleróza * diagnostické zobrazování patofyziologie patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
- MeSH
- diferenciální diagnóza MeSH
- discus nervi optici diagnostické zobrazování patologie MeSH
- lidé MeSH
- mladiství MeSH
- poruchy zraku etiologie MeSH
- retina diagnostické zobrazování patologie MeSH
- zánět zrakového nervu * diagnóza etiologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Optická koherentná tomografia (OCT) je neinvazívna zobrazovacia metóda štruktúr sietnice, ktorá sa môže využiť v diagnostike a monitorovaní aktivity sclerosis multiplex, predovšetkým zobrazením redukcie celkového makulárneho objemu a stenčenia peripapilárnej vrstvy nervových vlákien sietnice. Závažnosť týchto deficitov je úmerná progresii disability pacienta. Parametre neurodegenerácie zrakového nervu a retinálnych gangliových buniek korelujú s mierou atrofie mozgu a s aktivitou ochorenia vyjadreným stavom NEDA.
Optical coherence tomography (OCT) is a non-invasive imaging method of retinal structures that can be used in the diagnosis and monitoring of multiple sclerosis activity, especially imaging the reduction of total macular volume and thinning of the peripapillary retinal nerve fiber layer. The severity of these deficits is proportional to the progression of the patient's disability. The parameters of optic nerve and retinal ganglion cell neurodegeneration correlate with the degree of brain atrophy and the disease activity expressed by NEDA-status.
- MeSH
- lidé MeSH
- optická koherentní tomografie * metody MeSH
- retina diagnostické zobrazování MeSH
- retinální gangliové buňky MeSH
- roztroušená skleróza * diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- angiografie klasifikace metody MeSH
- diagnostické techniky oftalmologické * klasifikace MeSH
- fluorescence MeSH
- indokyanová zeleň terapeutické užití MeSH
- lidé MeSH
- makulární degenerace * diagnóza etiologie MeSH
- neovaskularizace choroidey diagnostické zobrazování MeSH
- optická koherentní tomografie dějiny metody MeSH
- optické zobrazování MeSH
- retina diagnostické zobrazování patologie MeSH
- umělá inteligence MeSH
- zraková ostrost fyziologie MeSH
- zraková percepce MeSH
- zrakové testy dějiny klasifikace metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
