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Telemedicine in Ophthalmology
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Jane Scheetz, Samantha Simkin, Zachary Tan, Shuan Dai, Mingguang He
To perform image-grading responsibilities, the individual must be specially trained in how to interpret retinal images for disease. Most commonly, ophthalmologists or optometrists are used in diabetic teleophthalmology programs; however, non-medical staff can also be trained to undertake this role. The quality and consistency of image grading are essential to the effectiveness of a teleophthalmology program. The UK National Health Service (NHS) DR screening program requires a minimum qualification to be qualified as an image grader (25). This includes undertaking a level 3 qualification in DR screening and providing evidence of ongoing professional development such as monthly quality assurance tests that include grading a set of 20 random retinal images (25). Other retinal grading certification programs are available through the University of Wisconsin Fundus Photograph Reading Center and the Retinal Reading Program at the University of California. Various fundus photograph reading centers exist across the globe and have the capacity to grade not only for DR but other sight-threatening disease such as glaucoma and macular degeneration. For those cases that are not clear-cut, an adjudicating grader should be consulted. In many cases, this will be a highly specialized grader such as an ophthalmologist who specializes in retinal disease.
Medical and Mathematical Background
Published in Arwa Ahmed Gasm Elseid, Alnazier Osman Mohammed Hamza, Computer-Aided Glaucoma Diagnosis System, 2020
Arwa Ahmed Gasm Elseid, Alnazier Osman Mohammed Hamza
The ocular fundus can be noticed in the reflection of the flash attachment on the camera as red eyes. In ocular diseases, if fundus photography is needed for diagnostic purposes, the pupil is dilated with eye drops and a special camera called a fundus camera is used to focus on the fundus.
The thin-film optical detector: a novel approach to artificial vision
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Garcia Charles A, Uwaydat Sami H, Soula Thouria Ben, Zomorrodian A.l.i, Wu Na Juan, Ignatiev Alex
Ceramic detectors with diameters of 80–500μm were inserted into blebs formed in the subretinal space using an ab externo approach. The operated eyes were examined by indirect ophthalmoscopy 1, 2, and 6 weeks after surgery. Fundus photography was performed periodically. Six weeks after implantation, a section of the retina containing the detector was removed for histologic examination. Microscopic examination of the retina outside the site of implantation revealed well-preserved structures. The inner retinal layers overlying the implant (inner nuclear, inner plexiform, and ganglion cell layers) were also well preserved in thickness and architecture. However, the outer nuclear layers and outer plexiform layers were disorganized. These changes were similar to those observed in the sham surgical eyes, and are therefore more likely to be attributable to surgical manipulation and trauma. Occasionally, a few macrophages were seen proximal to the scleral entry site. These results indicate that the TOD mounted on a PLGA polymer is well tolerated when inserted in the subretinal space of rabbits for up to 6 weeks. Biocompatibility was also shown in previous experiments where the TOD was added to cultures of human retinal pigment epithelial cells for periods of up to 6 weeks with no adverse effects.
Cross-camera Performance of Deep Learning Algorithms to Diagnose Common Ophthalmic Diseases: A Comparative Study Highlighting Feasibility to Portable Fundus Camera Use
Published in Current Eye Research, 2023
Shuang He, Gabriella Bulloch, Liangxin Zhang, Yiyu Xie, Weiyu Wu, Yahong He, Wei Meng, Danli Shi, Mingguang He
The use of fundus photography has become a popular non-invasive method for observing the structures of the retina and diagnosing various ocular diseases. This boom is largely owed to deep learning (DL) algorithms which now hold the capability to automatically segment and interpret fundus photographs with diagnostic specificity comparable to that of trained ophthalmologists.1–5 Numerous DL models have been developed for the detection of eye diseases including age-related macular degeneration (AMD) and glaucomatous optic neuropathy (GON)1,3,6–11 and diabetic retinopathy (DR). For DR in particular, a DL model can achieve an area under the curve (AUC) of 0.98–0.99, which is greater than most ophthalmologists.2,12–15
Relationship between Brachial–Ankle Pulse Wave Velocity and Fundus Arteriolar Area Calculated Using a Deep-Learning Algorithm
Published in Current Eye Research, 2022
Kanae Fukutsu, Michiyuki Saito, Kousuke Noda, Miyuki Murata, Satoru Kase, Ryosuke Shiba, Naoki Isogai, Yoshikazu Asano, Nagisa Hanawa, Mitsuru Dohke, Manabu Kase, Susumu Ishida
Pulse wave velocity (PWV) is considered the gold standard for arterial stiffness assessment in clinical practice.1 Among the various non-invasive methods to measure PWV, carotid–femoral PWV and brachial–ankle PWV (baPWV) are frequently used in clinical settings. Both methods show a similar extent of association with risk factors and clinical events in patients with cardiovascular disease.2 The baPWV is automatically measured using a separate cuff for each of the four limbs by an oscillometric method. Since baPWV is easily applied in clinical practice, it is frequently measured during medical checkups in Japan to assess cardiovascular disease risks.3 However, baPWV requires a long measurement time more than 10 min and a wide space to place the patient in the supine position. In contrast, retinal fundus photography requires less than 1 min and a smaller space for a fundus camera.
A Novel Quantitative Assessment Method of Disease Activity in Susac’s Syndrome Based on Ultra-Wide Field Imaging
Published in Current Eye Research, 2022
T. Hamann, M. Wiest, W. Innes, S. Zweifel
ScS was suspected and steroid burst therapy was initiated. Follow-up UW-fundus-photography depicted additional signs of ScS disease activity when compared to the last UW-FA. cMRI demonstrated an increase of supra- and infratentorial lesions, also affecting the corpus callosum. Another burst of steroids, with slow tapering was applied. Accompanying immunomodulatory therapy (Rituximab) was initiated. Cyclophosphamid therapy was considered but not carried out due to increased risk of hemorrhagic cystitis, as patient 05 had reoccurring urinary retention. Increasing neurological impairment in form of immobilizing ataxy and vertigo was noted. While baseline DA-FA score was 11, follow-up UW-FA demonstrated an increase in DA-FA score to 21. The ophthalmological findings, in this case increased disease activity in fundus-photography preceded the systemic findings. IVIG treatment was initiated after free samples were provided by the producer. Treatment response was assessable in DA-FA score by reduction to 11 (21) and by continuous improvement of cognitive and motor-function (Figure 3).