Visual analytics methods for retinal layers in optical coherence tomography data

Optical coherence tomography is an important imaging technology for the early detection of ocular diseases. Yet, identifying substructural defects in the 3D retinal images is challenging. We therefore present novel visual analytics methods for the exploration of small and localized retinal alterations. Our methods reduce the data complexity and ensure the visibility of relevant information. The results of two cross-sectional studies show that our methods improve the detection of retinal defects, contributing to a deeper understanding of the retinal condition at an early stage of disease.Die optische Kohärenztomographie ist ein wichtiges Bildgebungsverfahren zur Früherkennung von Augenerkrankungen. Die Identifizierung von substrukturellen Defekten in den 3D-Netzhautbildern ist jedoch eine Herausforderung. Wir stellen daher neue Visual-Analytics-Methoden zur Exploration von kleinen und lokalen Netzhautveränderungen vor. Unsere Methoden reduzieren die Datenkomplexität und gewährleisten die Sichtbarkeit relevanter Informationen. Die Ergebnisse zweier Querschnittsstudien zeigen, dass unsere Methoden die Erkennung von Netzhautdefekten in frühen Krankheitsstadien verbessern

Foveal Pit Morphology Characterization: A Quantitative Analysis of the Key Methodological Steps

Disentangling the cellular anatomy that gives rise to human visual perception is one of the main challenges of ophthalmology. Of particular interest is the foveal pit, a concave depression located at the center of the retina that captures light from the gaze center. In recent years, there has been a growing interest in studying the morphology of the foveal pit by extracting geometrical features from optical coherence tomography (OCT) images. Despite this, research has devoted little attention to comparing existing approaches for two key methodological steps: the location of the foveal center and the mathematical modelling of the foveal pit. Building upon a dataset of 185 healthy subjects imaged twice, in the present paper the image alignment accuracy of four different foveal center location methods is studied in the first place. Secondly, state-of-the-art foveal pit mathematical models are compared in terms of fitting error, repeatability, and bias. The results indicate the importance of using a robust foveal center location method to align images. Moreover, we show that foveal pit models can improve the agreement between different acquisition protocols. Nevertheless, they can also introduce important biases in the parameter estimates that should be considered

Foveal Pit Morphology Characterization: A Quantitative Analysis of the Key Methodological Steps

Disentangling the cellular anatomy that gives rise to human visual perception is one of the main challenges of ophthalmology. Of particular interest is the foveal pit, a concave depression located at the center of the retina that captures light from the gaze center. In recent years, there has been a growing interest in studying the morphology of the foveal pit by extracting geometrical features from optical coherence tomography (OCT) images. Despite this, research has devoted little attention to comparing existing approaches for two key methodological steps: the location of the foveal center and the mathematical modelling of the foveal pit. Building upon a dataset of 185 healthy subjects imaged twice, in the present paper the image alignment accuracy of four different foveal center location methods is studied in the first place. Secondly, state-of-the-art foveal pit mathematical models are compared in terms of fitting error, repeatability, and bias. The results indicate the importance of using a robust foveal center location method to align images. Moreover, we show that foveal pit models can improve the agreement between different acquisition protocols. Nevertheless, they can also introduce important biases in the parameter estimates that should be considered.This research was funded by the Department of Health of the Basque Government through the projects 2019111100 and 2020333033, Instituto de Salud Carlos III through the project PI16/00005 (Co-funded by European Regional Development Fund/European Social Fund “A way to make Europe”/”Investing in your future”) and the Basque Foundation for Health Innovation and Research (BIOEF) through the 2017 EITB Telemaratoia call (BIO17/ND/010)

Visual correlates of functional difficulties in Parkinson's disease and Alzheimer's disease

Thesis (Ph.D.)--Boston UniversityAlthough motor dysfunction in Parkinson's disease (PD) and memory deficits in Alzheimer's disease (AD) are the respective hallmark symptoms, both neurodegenerative disorders are also associated with significant disruptions in visual functioning. In PD, visuospatial function is impaired, particularly in patients with left-side onset of motor symptoms (LPD), reflecting pathology in right hemisphere brain regions, including the parietal lobe. LPD visuospatial performance is characterized by perceptual distortions, suggesting that lower-level visual processing may contribute to abnormal performance. In AD and PD, reduced contrast sensitivity and other visual difficulties have the potential to impact everyday functioning. The relation of PD visuospatial problems, and AD and PD contrast sensitivity deficits to higher-order impairments is understudied. The present experiments examined visual and visuospatial difficulties in these groups and evaluated an intervention to improve everyday visual function. Experiment I assessed performance on a line bisection task in PD. Participants included non-demented patients (10 LPD, 10 with right-side motor onset [RPD]) and 11 normal control adults (NC). Performance was related to data from measures of retinal structure (Optical Coherence Tomography) and function (Frequency Doubling Technology; FDT) across the eye. Correlations of structure and function were found for all groups. LPD showed predicted downward bisection bias in some sections of the left visual field. Expected rightward bisection bias in LPD was not consistently seen using this presentation method. For RPD, in some sectors, worse FDT sensitivity correlated with upward line bisection bias, as predicted. Experiment II investigated if performance of a complex, familiar visual search task (bingo) could be enhanced in AD and PD by manipulating the visual components of contrast, size, and visual complexity of task stimuli. Participants were 19 younger adults, 14 AD, 17 PD, and 33 NC. Increased stimulus size and decreased complexity improved performance for all groups. Increasing contrast also benefited the AD patients, presumably by compensating for their contrast sensitivity deficit, which was more severe than in the PD and NC groups. The general finding of improved performance across healthy and afflicted groups suggests the value of visual support as an easy-to-apply intervention to enhance cognitive performance

Visual Impairment and Blindness

Blindness and vision impairment affect at least 2.2 billion people worldwide with most individuals having a preventable vision impairment. The majority of people with vision impairment are older than 50 years, however, vision loss can affect people of all ages. Reduced eyesight can have major and long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities, and the ability to access public services. This book provides an overview of the effects of blindness and visual impairment in the context of the most common causes of blindness in older adults as well as children, including retinal disorders, cataracts, glaucoma, and macular or corneal degeneration

Measuring axial length of the eye from magnetic resonance brain imaging

BACKGROUND: Metrics derived from the human eye are increasingly used as biomarkers and endpoints in studies of cardiovascular, cerebrovascular and neurological disease. In this context, it is important to account for potential confounding that can arise from differences in ocular dimensions between individuals, for example, differences in globe size. METHODS: We measured axial length, a geometric parameter describing eye size from T(2)-weighted brain MRI scans using three different image analysis software packages (Mango, ITK and Carestream) and compared results to biometry measurements from a specialized ophthalmic instrument (IOLMaster 500) as the reference standard. RESULTS: Ninety-three healthy research participants of mean age 51.0 ± SD 5.4 years were analyzed. The level of agreement between the MRI-derived measurements and the reference standard was described by mean differences as follows, Mango − 0.8 mm; ITK − 0.5 mm; and Carestream − 0.1 mm (upper/lower 95% limits of agreement across the three tools ranged from 0.9 mm to − 2.6 mm). Inter-rater reproducibility was between − 0.03 mm and 0.45 mm (ICC 0.65 to 0.93). Intra-rater repeatability was between 0.0 mm and − 0.2 mm (ICC 0.90 to 0.95). CONCLUSIONS: We demonstrate that axial measurements of the eye derived from brain MRI are within 3.5% of the reference standard globe length of 24.1 mm. However, the limits of agreement could be considered clinically significant. Axial length of the eye obtained from MRI is not a replacement for the precision of biometry, but in the absence of biometry it could provide sufficient accuracy to act as a proxy. We recommend measuring eye axial length from MRI in studies that do not have biometry but use retinal imaging to study neurodegenerative changes so as to control for differing eye size across individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-022-02289-y

Optic nerve head three-dimensional shape analysis

We present a method for optic nerve head (ONH) 3-D shape analysis from retinal optical coherence tomography (OCT). The possibility to noninvasively acquire in vivo high-resolution 3-D volumes of the ONH using spectral domain OCT drives the need to develop tools that quantify the shape of this structure and extract information for clinical applications. The presented method automatically generates a 3-D ONH model and then allows the computation of several 3-D parameters describing the ONH. The method starts with a high-resolution OCT volume scan as input. From this scan, the model-defining inner limiting membrane (ILM) as inner surface and the retinal pigment epithelium as outer surface are segmented, and the Bruch's membrane opening (BMO) as the model origin is detected. Based on the generated ONH model by triangulated 3-D surface reconstruction, different parameters (areas, volumes, annular surface ring, minimum distances) of different ONH regions can then be computed. Additionally, the bending energy (roughness) in the BMO region on the ILM surface and 3-D BMO-MRW surface area are computed. We show that our method is reliable and robust across a large variety of ONH topologies (specific to this structure) and present a first clinical application

Deep learning in ophthalmology: The technical and clinical considerations

The advent of computer graphic processing units, improvement in mathematical models and availability of big data has allowed artificial intelligence (AI) using machine learning (ML) and deep learning (DL) techniques to achieve robust performance for broad applications in social-media, the internet of things, the automotive industry and healthcare. DL systems in particular provide improved capability in image, speech and motion recognition as well as in natural language processing. In medicine, significant progress of AI and DL systems has been demonstrated in image-centric specialties such as radiology, dermatology, pathology and ophthalmology. New studies, including pre-registered prospective clinical trials, have shown DL systems are accurate and effective in detecting diabetic retinopathy (DR), glaucoma, age-related macular degeneration (AMD), retinopathy of prematurity, refractive error and in identifying cardiovascular risk factors and diseases, from digital fundus photographs. There is also increasing attention on the use of AI and DL systems in identifying disease features, progression and treatment response for retinal diseases such as neovascular AMD and diabetic macular edema using optical coherence tomography (OCT). Additionally, the application of ML to visual fields may be useful in detecting glaucoma progression. There are limited studies that incorporate clinical data including electronic health records, in AL and DL algorithms, and no prospective studies to demonstrate that AI and DL algorithms can predict the development of clinical eye disease. This article describes global eye disease burden, unmet needs and common conditions of public health importance for which AI and DL systems may be applicable. Technical and clinical aspects to build a DL system to address those needs, and the potential challenges for clinical adoption are discussed. AI, ML and DL will likely play a crucial role in clinical ophthalmology practice, with implications for screening, diagnosis and follow up of the major causes of vision impairment in the setting of ageing populations globally