The European Eye Epidemiology spectral-domain optical coherence tomography classification of macular diseases for epidemiological studies

Purpose: The aim of the European Eye Epidemiology (E3) consortium was to develop a spectral-domain optical coherence tomography (SD-OCT)-based classification for macular diseases to standardize epidemiological studies. Methods: A European panel of vitreoretinal disease experts and epidemiologists belonging to the E3 consortium was assembled to define a classification for SD-OCT imaging of the macula. A series of meeting was organized, to develop, test and finalize the classification. First, grading methods used by the different research groups were presented and discussed, and a first version of classification was proposed. This first version was then tested on a set of 50 SD-OCT images in the Bordeaux and Rotterdam centres. Agreements were analysed and discussed with the panel of experts and a final version of the classification was produced. Results: Definitions and classifications are proposed for the structure assessment of the vitreomacular interface (visibility of vitreous interface, vitreomacular adhesion, vitreomacular traction, epiretinal membrane, full-thickness macular hole, lamellar macular hole, macular pseudo-hole) and of the retina (retinoschisis, drusen, pigment epithelium detachment, hyper-reflective clumps, retinal pigment epithelium atrophy, intraretinal cystoid spaces, intraretinal tubular changes, subretinal fluid, subretinal material). Classifications according to size and location are defined. Illustrations of each item are provided, as well as the grading form. Conclusion: The E3 SD-OCT classification has been developed to harmonize epidemiological studies. This homogenization will allow comparing and sharing data collection between European and international studies.</p

High-fidelity quantitative differential phase contrast deconvolution using dark-field sparse prior

Differential phase contrast (DPC) imaging plays an important role in the family of quantitative phase measurement. However, the reconstruction algorithm for quantitative DPC (qDPC) imaging is not yet optimized, as it does not incorporate the inborn properties of qDPC imaging. In this research, we propose a simple but effective image prior, the dark-field sparse prior (DSP), to facilitate the phase reconstruction quality for all DPC-based phase reconstruction algorithms. The DSP is based on the key observation that most pixel values for an idea differential phase contrast image are zeros since the subtraction of two images under anti-symmetric illumination cancels all background components. With this DSP prior, we formed a new cost function in which L0-norm was used to represent the DSP. Further, we developed the algorithm based on the Half Quadratic Splitting to solve this NP-hard L0-norm problem. We tested our new model on both simulated and experimental data and compare it against state-of-The-Art (SOTA) methods including L2-norm and total variation regularizations. Results show that our proposed model is superior in terms of phase reconstruction quality and implementation efficiency, which significantly increases the experimental robustness, while maintaining the data fidelity. In general, the DSP supports high-fidelity qDPC reconstruction without any modification of the optical system, which simplifies the system complexity and benefit all qDPC applications

Geodesic Tracking of Retinal Vascular Trees with Optical and TV-Flow Enhancement in SE(2)

Retinal images are often used to examine the vascular system in a non-invasive way. Studying the behavior of the vasculature on the retina allows for noninvasive diagnosis of several diseases as these vessels and their behavior are representative of the behavior of vessels throughout the human body. For early diagnosis and analysis of diseases, it is important to compare and analyze the complex vasculature in retinal images automatically. In previous work, PDE-based geometric tracking and PDE-based enhancements in the homogeneous space of positions and orientations have been studied and turned out to be useful when dealing with complex structures (crossing of blood vessels in particular). In this article, we propose a single new, more effective, Finsler function that integrates the strength of these two PDE-based approaches and additionally accounts for a number of optical effects (dehazing and illumination in particular). The results greatly improve both the previous left-invariant models and a recent data-driven model, when applied to real clinical and highly challenging images. Moreover, we show clear advantages of each module in our new single Finsler geometrical method

Retinex-qDPC: automatic background rectified quantitative differential phase contrast imaging

The quality of quantitative differential phase contrast reconstruction (qDPC) can be severely degenerated by the mismatch of the background of two oblique illuminated images, yielding problematic phase recovery results. These background mismatches may result from illumination patterns, inhomogeneous media distribution, or other defocusing layers. In previous reports, the background is manually calibrated which is time-consuming, and unstable, since new calibrations are needed if any modification to the optical system was made. It is also impossible to calibrate the background from the defocusing layers, or for high dynamic observation as the background changes over time. To tackle the mismatch of background and increases the experimental robustness, we propose the Retinex-qDPC in which we use the images edge features as data fidelity term yielding L2-Retinex-qDPC and L1-Retinex-qDPC for high background-robustness qDPC reconstruction. The split Bregman method is used to solve the L1-Retinex DPC. We compare both Retinex-qDPC models against state-of-the-art DPC reconstruction algorithms including total-variation regularized qDPC, and isotropic-qDPC using both simulated and experimental data. Results show that the Retinex qDPC can significantly improve the phase recovery quality by suppressing the impact of mismatch background. Within, the L1-Retinex-qDPC is better than L2-Retinex and other state-of-the-art DPC algorithms. In general, the Retinex-qDPC increases the experimental robustness against background illumination without any modification of the optical system, which will benefit all qDPC applications

Understanding the clinical and molecular basis of thyroid orbitopathy:a review of recent evidence

Thyroid eye disease (TED) is an autoimmune orbital inflammatory disease which ranges from mild to severe. Tissue remodeling, fibrosis and fat proliferation cause changes in the orbital tissues which can affect esthetics and visual function. In its severe form, it is sight threatening, debilitating, and disfiguring and may lead to social stigma, the embarrassment about which has an impact on the quality of life of those affected and the family members. The pathogenesis of TED, which is influenced by genetic, immunological, and environmental factors, is complex and not fully elucidated. However, it remains unknown what factors determine the severity of the disease. Recent research has revealed a number of diagnostic and prognostic biomarkers of this disease. In this overview of TED, we focus on new insights and perspectives regarding biological agents that may provide a basis for new treatment modalities.</p

Confocal Blue Reflectance Imaging in Type 2 Idiopathic Macular Telangiectasia

PURPOSE. To report the characteristics of confocal blue reflectance imaging in type 2 idiopathic macular telangiectasia (type 2 IMT). METHODS. In a prospective observational cross-sectional study, both eyes of 33 patients with type 2 IMT were examined by means of fundus biomicroscopy, fundus photography, fluorescein angiography, and optical coherence tomography (OCT). Confocal blue reflectance (CBR) imaging was performed using a confocal scanning laser ophthalmoscope (HRA2; Heidelberg Engineering, Heidelberg, Germany). To compare the results derived from different imaging modalities, an analysis was performed using image analysis software (Heidelberg Eye Explorer; Heidelberg Engineering). RESULTS. CBR imaging revealed a parafoveal area of increased reflectance that was slightly larger than the area of hyperfluorescence in late-phase fluorescein angiography. The area usually encompassed an oval parafoveal area, but sectors could be spared. A parafoveal area of increased CBR was detected in 98% of eyes that showed angiographic evidence for type 2 IMT. CONCLUSIONS. CBR imaging is a new, noninvasive, and sensitive method that may contribute to differentiate type 2 IMT from other diseases. Abnormalities of macular pigment distribution and Miiller cell pathology may contribute to the phenomenon of increased CBR and thus the pathophysiology of type 2 IMT

Pupil-driven quantitative differential phase contrast imaging

In this research, we reveal the inborn but hitherto ignored properties of quantitative differential phase contrast (qDPC) imaging: the phase transfer function being an edge detection filter. Inspired by this, we highlighted the duality of qDPC between optics and pattern recognition, and propose a simple and effective qDPC reconstruction algorithm, termed Pupil-Driven qDPC (pd-qDPC), to facilitate the phase reconstruction quality for the family of qDPC-based phase reconstruction algorithms. We formed a new cost function in which modified L0-norm was used to represent the pupil-driven edge sparsity, and the qDPC convolution operator is duplicated in the data fidelity term to achieve automatic background removal. Further, we developed the iterative reweighted soft-threshold algorithms based on split Bregman method to solve this modified L0-norm problem. We tested pd-qDPC on both simulated and experimental data and compare against state-of-the-art (SOTA) methods including L2-norm, total variation regularization (TV-qDPC), isotropic-qDPC, and Retinex qDPC algorithms. Results show that our proposed model is superior in terms of phase reconstruction quality and implementation efficiency, in which it significantly increases the experimental robustness while maintaining the data fidelity. In general, the pd-qDPC enables the high-quality qDPC reconstruction without any modification of the optical system. It simplifies the system complexity and benefits the qDPC community and beyond including but not limited to cell segmentation and PTF learning based on the edge filtering property

Effect of combined water drinking test and dark room provocative testing in Caucasian eyes with narrow angles

Purpose: To assess the usefulness of water drinking test and dark room provocative testing (WDT + DRPT) in current clinical practice by evaluating input parameters from Swept-source Optical Coherence Tomography (SS-OCT) images, and to determine if clinical factors like axial length, central endothelial cell count (CECC) and retinal nerve fibre layer thickness (RNFL) thickness are associated with a positive WDT + DRPT. Methods: SS-OCT examination was performed in consecutive subjects presenting as new patients in the outpatient clinic aged > 40 years. If at least one eye met the inclusion criteria (anterior chamber angles <20° and anterior chamber depth < 2.5 mm on SS-OCT), subjects were included in this study and WDT + DRPT was carried out. The eye with the smallest angle was analysed. The difference in parameters between eyes with a positive (≥8 mmHg) and negative (<8 mmHg) increase in intraocular pressure (IOP) after WDT + DRPT were statistically analysed. Second, the correlation between IOP increase after WDT + DRPT and anterior chamber angle parameters (RNFL thickness, CECC and axial length) was studied. Results: A total of 95 subjects with a mean age of 64 years were included. There was an association between IOP increase after WDT + DRPT and anterior chamber angle characteristics, however this was not of clinical significance. No positive results after WDT + DRPT were found in patients with anterior chamber angles ≥ 20°. Conclusions: The present findings indicate that this combined provocative test has no definite correlative or predictive value in angle closure disease. Further, the test is not useful in predicting early diagnosis or possible CECC or RNFL loss