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Article ; Online: Imaging geographic atrophy: integrating structure and function to better understand the effects of new treatments.

Vujosevic, Stela / Loewenstein, Anat / O'Toole, Louise / Schmidt-Erfurth, Ursula Margarethe / Zur, Dinah / Chakravarthy, Usha

The British journal of ophthalmology

2024

Abstract: Geographic atrophy (GA) is an advanced and irreversible form of age-related macular degeneration (AMD). Chronic low grade inflammation is thought to act as an initiator of this degenerative process, resulting in loss of photoreceptors (PRs), retinal ... ...

Abstract	Geographic atrophy (GA) is an advanced and irreversible form of age-related macular degeneration (AMD). Chronic low grade inflammation is thought to act as an initiator of this degenerative process, resulting in loss of photoreceptors (PRs), retinal pigment epithelium (RPE) and the underlying choriocapillaris. This review examined the challenges of clinical trials to date which have sought to treat GA, with particular reference to the successful outcome of C3 complement inhibition. Currently, optical coherence tomography (OCT) seems to be the most suitable method to detect GA and monitor the effect of treatment. In addition, the merits of using novel anatomical endpoints in detecting GA expansion are discussed. Although best-corrected visual acuity is commonly used to monitor disease in GA, other tests to determine visual function are explored. Although not widely available, microperimetry enables quantification of retinal sensitivity (RS) and macular fixation behaviour related to fundus characteristics. There is a spatial correlation between OCT/fundus autofluorescence evaluation of PR damage outside the area of RPE loss and RS on microperimetry, showing important associations with visual function. Standardisation of testing by microperimetry is necessary to enable this modality to detect AMD progression. Artificial intelligence (AI) analysis has shown PR layers integrity precedes and exceeds GA loss. Loss of the ellipsoid zone has been recognised as a primary outcome parameter in therapeutic trials for GA. The integrity of the PR layers imaged by OCT at baseline has been shown to be an important prognostic indicator. AI has the potential to be invaluable in personalising care and justifying treatment intervention.
Language	English
Publishing date	2024-01-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjo-2023-324246
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Article ; Online: Approved AI-based fluid monitoring to identify morphological and functional treatment outcomes in neovascular age-related macular degeneration in real-world routine (FRB!).

Mares, Virginia / Schmidt-Erfurth, Ursula Margarethe / Leingang, Oliver / Fuchs, Philipp / Nehemy, Marcio B / Bogunovic, Hrvoje / Barthelmes, Daniel / Reiter, Gregor S

The British journal of ophthalmology

2023

Abstract: Aim: To predict antivascular endothelial growth factor (VEGF) treatment requirements, visual acuity and morphological outcomes in neovascular age-related macular degeneration (nAMD) using fluid quantification by artificial intelligence (AI) in a real- ... ...

Abstract	Aim: To predict antivascular endothelial growth factor (VEGF) treatment requirements, visual acuity and morphological outcomes in neovascular age-related macular degeneration (nAMD) using fluid quantification by artificial intelligence (AI) in a real-world cohort. Methods: Spectral-domain optical coherence tomography data of 158 treatment-naïve patients with nAMD from the Fight Retinal Blindness! registry in Zurich were processed at baseline, and after initial treatment using intravitreal anti-VEGF to predict subsequent 1-year and 4-year outcomes. Intraretinal and subretinal fluid and pigment epithelial detachment volumes were segmented using a deep learning algorithm (Vienna Fluid Monitor, RetInSight, Vienna, Austria). A predictive machine learning model for future treatment requirements and morphological outcomes was built using the computed set of quantitative features. Results: Two hundred and two eyes from 158 patients were evaluated. 107 eyes had a lower median (≤7) and 95 eyes had an upper median (≥8) number of injections in the first year, with a mean accuracy of prediction of 0.77 (95% CI 0.71 to 0.83) area under the curve (AUC). Best-corrected visual acuity at baseline was the most relevant predictive factor determining final visual outcomes after 1 year. Over 4 years, half of the eyes had progressed to macular atrophy (MA) with the model being able to distinguish MA from non-MA eyes with a mean AUC of 0.70 (95% CI 0.61 to 0.79). Prediction for subretinal fibrosis reached an AUC of 0.74 (95% CI 0.63 to 0.81). Conclusions: The regulatory approved AI-based fluid monitoring allows clinicians to use automated algorithms in prospectively guided patient treatment in AMD. Furthermore, retinal fluid localisation and quantification can predict long-term morphological outcomes.
Language	English
Publishing date	2023-09-29
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjo-2022-323014
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Quality assessment of colour fundus and fluorescein angiography images using deep learning.

König, Michael / Seeböck, Philipp / Gerendas, Bianca S / Mylonas, Georgios / Winklhofer, Rudolf / Dimakopoulou, Ioanna / Schmidt-Erfurth, Ursula Margarethe

The British journal of ophthalmology

2023 Volume 108, Issue 1, Page(s) 98–104

Abstract: Background/aims: Image quality assessment (IQA) is crucial for both reading centres in clinical studies and routine practice, as only adequate quality allows clinicians to correctly identify diseases and treat patients accordingly. Here we aim to ... ...

Abstract	Background/aims: Image quality assessment (IQA) is crucial for both reading centres in clinical studies and routine practice, as only adequate quality allows clinicians to correctly identify diseases and treat patients accordingly. Here we aim to develop a neural network for automated real-time IQA in colour fundus (CF) and fluorescein angiography (FA) images. Methods: Training and evaluation of two neural networks were conducted using 2272 CF and 2492 FA images, with binary labels in four (contrast, focus, illumination, shadow and reflection) and three (contrast, focus, noise) modality specific categories plus an overall quality ranking. Performance was compared with a second human grader, evaluated on an external public dataset and in a clinical trial use-case. Results: The networks achieved a F1-score/area under the receiving operator characteristic/precision recall curve of 0.907/0.963/0.966 for CF and 0.822/0.918/0.889 for FA in overall quality prediction with similar results in most categories. A clear relation between model uncertainty and prediction error was observed. In the clinical trial use-case evaluation, the networks achieved an accuracy of 0.930 for CF and 0.895 for FA. Conclusion: The presented method allows automated IQA in real time, demonstrating human-level performance for CF as well as FA. Such models can help to overcome the problem of human intergrader and intragrader variability by providing objective and reproducible IQA results. It has particular relevance for real-time feedback in multicentre clinical studies, when images are uploaded to central reading centre portals. Moreover, automated IQA as preprocessing step can support integrating automated approaches into clinical practice.
MeSH term(s)	Humans ; Fluorescein Angiography/methods ; Deep Learning ; Color ; Fundus Oculi ; Neural Networks, Computer
Language	English
Publishing date	2023-12-18
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjo-2022-321963
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Article ; Online: Detection of diabetic neovascularisation using single-capture 65°-widefield optical coherence tomography angiography.

Stino, Heiko / Niederleithner, Michael / Iby, Johannes / Sedova, Aleksandra / Schlegl, Thomas / Steiner, Irene / Sacu, Stefan / Drexler, Wolfgang / Schmoll, Tilman / Leitgeb, Rainer / Schmidt-Erfurth, Ursula Margarethe / Pollreisz, Andreas

The British journal of ophthalmology

2023 Volume 108, Issue 1, Page(s) 91–97

Abstract: Aim: To assess the detection rate of retinal neovascularisation (NV) in eyes with proliferative diabetic retinopathy (PDR) using widefield optical coherence tomography angiography (WF-OCTA) in comparison to ultrawidefield fluorescein angiography (UWF-FA) ...

Abstract	Aim: To assess the detection rate of retinal neovascularisation (NV) in eyes with proliferative diabetic retinopathy (PDR) using widefield optical coherence tomography angiography (WF-OCTA) in comparison to ultrawidefield fluorescein angiography (UWF-FA). Methods: Single-capture 65°-WF-OCTA-imaging was performed in patients with NV at the disc or elsewhere (NVE) detected on UWF-FA using a modified PlexElite system and B-scans were examined for blood flow signals breaching the internal limiting membrane. Sensitivity of WF-OCTA and UWF colour fundus (UWF-CF) photography for correct diagnosis of PDR was determined and interdevice agreement (Fleiss' κ) between WF-OCTA and UWF-FA for detection of NV in the total gradable area and each retinal quadrant was evaluated. Results: Fifty-nine eyes of 41 patients with PDR detected on UWF-FA were included. Sensitivity of detecting PDR on WF-OCTA scans was 0.95 in contrast to 0.78 on UWF-CF images. Agreement in detecting NVE between WF-OCTA and UWF-FA was high in the superotemporal (κ=0.98) and inferotemporal (κ=0.94) and weak in the superonasal (κ=0.24) and inferonasal quadrants (κ=0.42). On UWF-FA, 63% of NVEs (n=153) were located in the temporal quadrants with 93% (n=142) of them being detected on WF-OCTA scans. Conclusion: The high reliability of non-invasive WF-OCTA imaging in detecting PDR can improve clinical examination with the potential to replace FA as a single diagnostic tool.
MeSH term(s)	Humans ; Retinal Vessels/diagnostic imaging ; Tomography, Optical Coherence/methods ; Reproducibility of Results ; Fluorescein Angiography/methods ; Diabetic Retinopathy/diagnostic imaging ; Diabetes Mellitus
Language	English
Publishing date	2023-12-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjo-2022-322134
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: RAP study, report 1: novel subtype of macular neovascularisation type III, cilioretinal MNV3.

Haj Najeeb, Bilal / Deak, Gabor G / Schmidt-Erfurth, Ursula Margarethe / Gerendas, Bianca S

The British journal of ophthalmology

2020 Volume 105, Issue 1, Page(s) 113–117

Abstract: Purpose: To report on patients with macular neovascularisation type III (MNV3) arising from cilioretinal arteries (CRAs) (cilioretinal macular neovascularisation type III (cMNV3)).: Methods: We reviewed baseline examinations of patients with ... ...

Abstract	Purpose: To report on patients with macular neovascularisation type III (MNV3) arising from cilioretinal arteries (CRAs) (cilioretinal macular neovascularisation type III (cMNV3)). Methods: We reviewed baseline examinations of patients with neovascular age-related macular degeneration using multimodal imaging. We determined the type and distribution of MNV lesions in each cMNV3 case, the range of distances from the fovea, existence of exudative maculopathy, intraretinal haemorrhage and other morphological characteristics. 50 consecutive eyes with usual MNV3 without CRA were included as a control group. Results: 102 eyes of 102 patients were identified with MNV3 lesions. Among these, we found 12 eyes (12%) with cMNV3, 84 eyes (82%) with usual MNV3 without CRA and 6 eyes (6%) with usual MNV3 with CRA. Ten cases of cMNV3 had one lesion, and two cases had two lesions. The lesions were distributed equally between the superior and inferior halves of the macula, whereas in the nasal and temporal halves, there were 8 (57%) and 6 (43%) lesions, respectively. All cMNV3 lesions were located between 500 and 1500 µm from the central fovea except one, which was located between 1500 and 3000 µm. None of the lesions had macular neovascularisation type I (MNV1) or macular neovascularisation type II (MNV2) elsewhere in both groups. Exudative maculopathy and intraretinal haemorrhage were found in seven (88%) and five (63%) of the eight pure cMNV3 cases, respectively. Conclusion: cMNV3 can be solitary or multiple, isolated or accompanied with usual MNV3 lesions, but not with concurrent MNV1 or MNV2. It is frequently associated with extensive exudative maculopathy, intraretinal haemorrhage and subretinal fluid.
MeSH term(s)	Aged ; Aged, 80 and over ; Ciliary Arteries/diagnostic imaging ; Ciliary Arteries/pathology ; Double-Blind Method ; Female ; Fluorescein Angiography ; Humans ; Macula Lutea ; Male ; Middle Aged ; Multimodal Imaging ; Prospective Studies ; Retinal Artery/diagnostic imaging ; Retinal Artery/pathology ; Retinal Neovascularization/classification ; Retinal Neovascularization/diagnosis ; Retrospective Studies ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity
Language	English
Publishing date	2020-03-11
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2019-315311
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Article ; Online: Systematic ultrastructural comparison of swept-source and full-depth spectral domain optical coherence tomography imaging of diabetic macular oedema.

Mitsch, Christoph / Lammer, Jan / Karst, Sonja / Scholda, Christoph / Pablik, Eleonore / Schmidt-Erfurth, Ursula Margarethe

The British journal of ophthalmology

2019 Volume 104, Issue 6, Page(s) 868–873

Abstract: Background/aims: Optical coherence tomography (OCT) is commonly used to diagnose and assess diabetic macular oedema (DME). Swept-source OCT (SS-OCT) promises improved imaging depth and more independence from media opacities. Heidelberg Spectralis full- ... ...

Abstract	Background/aims: Optical coherence tomography (OCT) is commonly used to diagnose and assess diabetic macular oedema (DME). Swept-source OCT (SS-OCT) promises improved imaging depth and more independence from media opacities. Heidelberg Spectralis full-depth imaging (FDI) combines details at different depths to one representation. The aim of this study was to determine the comparability of the imaging methods concerning DME ultrastructure. Methods: Two graders assessed the presence of typical DME phenomena in eyes with centre-involving DME on Topcon Atlantis SS-OCT and Heidelberg Spectralis FDI spectral-domain OCT (SD-OCT) B-scans. Retinal layer segmentation was corrected and choroidal layers were manually segmented. Graders measured cyst and subretinal fluid (SRF) diameters and counted hyper-reflective foci (HRF). Findings were recorded and statistically analysed. Results: Statistically significant systematic biases (Spectralis-Atlantis) were found for the HRF count (outside the central mm, -6.39, p=0.0338), chorioretinal thickness (central mm: -35.45 µm, p=0.00034), choroidal thickness (central mm: -60.97 µm, p=0.00004) and Sattler's layer thickness (-42.69 µm, p=0.0001). Intergrader agreement was excellent or very good for posterior vitreous detachment, vitreomacular attachment (central mm) and SRF presence in both devices. Manually delineated Sattler's layer thickness showed an intraclass correlation of 0.85 with FDI SD-OCT but 0.26 with SS-OCT (p=0.003). Conclusion: Prominent aspects such as cysts in the outer nuclear layer and SRF can be identified with comparable confidence, while a significant systematic bias underlies chorioretinal, choroidal and Sattler's layer thickness and HRF count. Specialists should use the same device at every examination during longitudinal clinical consideration or cross-sectional evaluation of these ultrastructural biomarkers.
MeSH term(s)	Aged ; Choroid/ultrastructure ; Cross-Sectional Studies ; Diabetic Retinopathy/complications ; Diabetic Retinopathy/diagnosis ; Female ; Humans ; Macula Lutea/ultrastructure ; Macular Edema/diagnosis ; Male ; Prospective Studies ; Tomography, Optical Coherence/methods
Language	English
Publishing date	2019-08-31
Publishing country	England
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2019-314591
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Microvascular abnormalities and long-term efficacy after stereotactic radiotherapy under continued intravitreal anti-VEGF treatment for neovascular AMD.

Hatz, Katja / Zimmermann, Frank / Lazaridis, Emmanouil / Kardamakis, Dimitrios / Guichard, Magdalena / Türksever, Cengiz / Pruente, Christian / Schmidt-Erfurth, Ursula Margarethe / Gerendas, Bianca S

The British journal of ophthalmology

2020 Volume 106, Issue 3, Page(s) 415–421

Abstract: Background: For treatment of neovascular age-related macular degeneration (nAMD), multiple intravitreal injections of drugs targeting vascular endothelial growth factors (VEGF) result in a high burden for patients and healthcare systems. Low-energy ... ...

Abstract	Background: For treatment of neovascular age-related macular degeneration (nAMD), multiple intravitreal injections of drugs targeting vascular endothelial growth factors (VEGF) result in a high burden for patients and healthcare systems. Low-energy stereotactic radiotherapy (SRT) might reduce the anti-VEGF need. This study evaluated the long-term efficacy and safety of adjunct SRT to anti-VEGF injections in a treat-and-extend regimen in nAMD. Methods: 50 consecutive patients were followed 3 years after single-session SRT, a safety analysis including standardised study imaging, and a reading centre based image analysis was performed after 2 years. Results: After increase from baseline (4.24±0.66 weeks) to 12 months (7.52±3.05 weeks, p<0.001), mean recurrence-free anti-VEGF treatment interval remained stable at 24 (7.40±3.17, p=0.746) and 36 months (6.89±3.00, p=0.175). Mean visual acuity change was -5.8±15.9 and -11.0±20.1 letters at 24 and 36 months, respectively. 36% of eyes showed microvascular abnormalities (MVAs) on colour fundus photography and/or fluoresceine angiography most frequently located in parafoveal inferior and nasal regions. Conclusion: In real life, low-energy SRT was associated with a reduced anti-VEGF injection frequency through year 3. However, due to an observed visual acuity reduction and remarkable number of MVAs, a close follow-up of these patients is recommended. The real-life use, optimal treatment schedule and dose should be rediscussed critically.
MeSH term(s)	Angiogenesis Inhibitors/therapeutic use ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Ranibizumab/therapeutic use ; Recombinant Fusion Proteins ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; Visual Acuity ; Wet Macular Degeneration/diagnosis ; Wet Macular Degeneration/drug therapy ; Wet Macular Degeneration/radiotherapy
Chemical Substances	Angiogenesis Inhibitors ; Recombinant Fusion Proteins ; Vascular Endothelial Growth Factor A ; Ranibizumab (ZL1R02VT79)
Language	English
Publishing date	2020-12-21
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2020-317563
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Automated quantification of macular fluid in retinal diseases and their response to anti-VEGF therapy.

Michl, Martin / Fabianska, Maria / Seeböck, Philipp / Sadeghipour, Amir / Haj Najeeb, Bilal / Bogunovic, Hrvoje / Schmidt-Erfurth, Ursula Margarethe / Gerendas, Bianca S

The British journal of ophthalmology

2020 Volume 106, Issue 1, Page(s) 113–120

Abstract: Aim: To objectively assess disease activity and treatment response in patients with retinal vein occlusion (RVO), neovascular age-related macular degeneration (nAMD) and centre-involved diabetic macular oedema (DME), using artificial intelligence-based ... ...

Abstract	Aim: To objectively assess disease activity and treatment response in patients with retinal vein occlusion (RVO), neovascular age-related macular degeneration (nAMD) and centre-involved diabetic macular oedema (DME), using artificial intelligence-based fluid quantification. Methods: Posthoc analysis of 2311 patients (11 151 spectral-domain optical coherence tomography volumes) from five clinical, multicentre trials, who received a flexible antivascular endothelial growth factor (anti-VEGF) therapy over a 12-month period. Fluid volumes were measured with a deep learning algorithm at baseline/months 1, 2, 3 and 12, for three concentric circles with diameters of 1, 3 and 6 mm (fovea, paracentral ring and pericentral ring), as well as four sectors surrounding the fovea (superior, nasal, inferior and temporal). Results: In each disease, at every timepoint, most intraretinal fluid (IRF) per square millimetre was present at the fovea, followed by the paracentral ring and pericentral ring (p<0.0001). While this was also the case for subretinal fluid (SRF) in RVO/DME (p<0.0001), patients with nAMD showed more SRF in the paracentral ring than at the fovea up to month 3 (p<0.0001). Between sectors, patients with RVO/DME showed the highest IRF volumes temporally (p<0.001/p<0.0001). In each disease, more SRF was consistently found inferiorly than superiorly (p<0.02). At month 1/12, we measured the following median reductions of initial fluid volumes. For IRF: RVO, 95.9%/97.7%; nAMD, 91.3%/92.8%; DME, 37.3%/69.9%. For SRF: RVO, 94.7%/97.5%; nAMD, 98.4%/99.8%; DME, 86.3%/97.5%. Conclusion: Fully automated localisation and quantification of IRF/SRF over time shed light on the fluid dynamics in each disease. There is a specific anatomical response of IRF/SRF to anti-VEGF therapy in all diseases studied.
MeSH term(s)	Angiogenesis Inhibitors/therapeutic use ; Artificial Intelligence ; Endothelial Growth Factors ; Humans ; Intravitreal Injections ; Macular Edema/diagnosis ; Macular Edema/drug therapy ; Macular Edema/metabolism ; Ranibizumab/therapeutic use ; Retinal Vein Occlusion/diagnosis ; Retinal Vein Occlusion/drug therapy ; Retinal Vein Occlusion/metabolism ; Subretinal Fluid ; Tomography, Optical Coherence/methods ; Vascular Endothelial Growth Factor A/metabolism ; Visual Acuity ; Wet Macular Degeneration/diagnosis ; Wet Macular Degeneration/drug therapy ; Wet Macular Degeneration/metabolism
Chemical Substances	Angiogenesis Inhibitors ; Endothelial Growth Factors ; Vascular Endothelial Growth Factor A ; Ranibizumab (ZL1R02VT79)
Language	English
Publishing date	2020-10-21
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2020-317416
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Article ; Online: Effect of posterior vitreous detachment on treat-and-extend versus monthly ranibizumab for neovascular age-related macular degeneration.

Waldstein, Sebastian M / Coulibaly, Leonard / Riedl, Sophie / Sadeghipour, Amir / Gerendas, Bianca S / Schmidt-Erfurth, Ursula Margarethe

The British journal of ophthalmology

2019 Volume 104, Issue 7, Page(s) 899–903

Abstract: Aims: To investigate the impact of posterior vitreous detachment (PVD) on the efficacy of treat-and-extend (T&E) ranibizumab in neovascular age-related macular degeneration.: Methods: In a post hoc analysis of a randomised controlled clinical trial, ... ...

Abstract	Aims: To investigate the impact of posterior vitreous detachment (PVD) on the efficacy of treat-and-extend (T&E) ranibizumab in neovascular age-related macular degeneration. Methods: In a post hoc analysis of a randomised controlled clinical trial, spectral-domain optical coherence tomography images of treatment-naïve patients randomised to receive T&E (n=265) or monthly (n=264) ranibizumab for 12 months were included. Certified, masked graders diagnosed the presence or the absence of complete PVD. The main outcome measures were the mean change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at month 12, the number of administered ranibizumab injections and the proportion of patients extended to more than 8 weeks. Results: At baseline, complete PVD was present in 51% and 56% of patients in the monthly and T&E arms, respectively. Mean change in BCVA at month 12 was +9.0 (PVD) vs +9.5 letters (no PVD, p=0.78) in monthly treated eyes, and +6.0 (PVD) vs +7.5 letters (no PVD, p=0.42) in T&E treated eyes. Conversely, mean change in CRT at month 12 was -174 (PVD) vs -173 µm (no PVD, p=0.98) in the monthly arm, and -175 (PVD) vs -164 µm (no PVD, p=0.58) in the T&E arm. In T&E treated patients, the median number of injections was eight vs nine (p=0.035). 71% of PVD eyes were extended successfully, compared with 55% of eyes without PVD (p=0.005). Conclusion: PVD was not found to impact functional and anatomical outcomes of T&E ranibizumab therapy. However, patients without a complete PVD required more retreatments and were significantly less likely to be successfully extended. Trial registration number: NCT01948830.
MeSH term(s)	Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/administration & dosage ; Angiogenesis Inhibitors/therapeutic use ; Choroidal Neovascularization/diagnosis ; Choroidal Neovascularization/drug therapy ; Choroidal Neovascularization/physiopathology ; Double-Blind Method ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Prospective Studies ; Ranibizumab/administration & dosage ; Ranibizumab/therapeutic use ; Retina/physiopathology ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Vitreous Detachment/diagnostic imaging ; Vitreous Detachment/physiopathology ; Wet Macular Degeneration/diagnosis ; Wet Macular Degeneration/drug therapy ; Wet Macular Degeneration/physiopathology
Chemical Substances	Angiogenesis Inhibitors ; VEGFA protein, human ; Vascular Endothelial Growth Factor A ; Ranibizumab (ZL1R02VT79)
Language	English
Publishing date	2019-09-28
Publishing country	England
Document type	Clinical Trial, Phase III ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2019-314661
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Longitudinal analysis of microvascular perfusion and neurodegenerative changes in early type 2 diabetic retinal disease.

Aschauer, Julia / Pollreisz, Andreas / Karst, Sonja / Hülsmann, Martin / Hajdu, Dorottya / Datlinger, Felix / Egner, Berit / Kriechbaum, Katharina / Pablik, Eleonore / Schmidt-Erfurth, Ursula Margarethe

The British journal of ophthalmology

2020 Volume 106, Issue 4, Page(s) 528–533

Abstract: Aim: To prospectively monitor subclinical changes in capillary perfusion and retinal layer thickness in patients with type 2 diabetes and early diabetic retinal disease over 2 years.: Methods: In this longitudinal study we performed biannual retinal ... ...

Abstract	Aim: To prospectively monitor subclinical changes in capillary perfusion and retinal layer thickness in patients with type 2 diabetes and early diabetic retinal disease over 2 years. Methods: In this longitudinal study we performed biannual retinal vascular imaging using optical coherence tomography angiography (RTVue) to analyse the foveal avascular zone (FAZ) area, perimeter, acircularity index (AI) and parafoveal superficial/deep vessel density (VD). Spectral-domain optical coherence tomography (Spectralis) was used to measure the thickness of nine macular layers and the peripapillary nerve fibre layer. Results: Among 117 eyes (58 left) of 59 patients (21 female), 105 had no diabetic retinopathy (DR), 6 mild and 6 moderate non-proliferative DR at baseline. We found DR progression in 13 eyes at year 2. The FAZ area (+0.008±0.002 mm Conclusion: Subclinical signs of microangiopathy and neurodegeneration appear in parallel and are highly progressive even in the earliest stages of diabetic retinal disease.
MeSH term(s)	Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetic Retinopathy/diagnosis ; Female ; Fluorescein Angiography/methods ; Humans ; Longitudinal Studies ; Male ; Perfusion ; Retinal Vessels/diagnostic imaging ; Tomography, Optical Coherence/methods
Language	English
Publishing date	2020-12-08
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2020-317322
Database	MEDical Literature Analysis and Retrieval System OnLINE

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