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Article ; Online: Asymmetric bilateral retinitis in patient with subacute sclerosing panencephalitis

De‐Kuang Hwang / Shih‐Jen Chen / Szu‐Hong Wang / Der‐Jen Yen

Kaohsiung Journal of Medical Sciences, Vol 35, Iss 9, Pp 578-

2019 Volume 579

Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2019-09-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prediction of treatment outcome in neovascular age-related macular degeneration using a novel convolutional neural network

Tsai-Chu Yeh / An-Chun Luo / Yu-Shan Deng / Yu-Hsien Lee / Shih-Jen Chen / Po-Han Chang / Chun-Ju Lin / Ming-Chi Tai / Yu-Bai Chou

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 8

Abstract: Abstract While prognosis and risk of progression are crucial in developing precise therapeutic strategy in neovascular age-related macular degeneration (nAMD), limited predictive tools are available. We proposed a novel deep convolutional neural network ... ...

Abstract	Abstract While prognosis and risk of progression are crucial in developing precise therapeutic strategy in neovascular age-related macular degeneration (nAMD), limited predictive tools are available. We proposed a novel deep convolutional neural network that enables feature extraction through image and non-image data integration to seize imperative information and achieve highly accurate outcome prediction. The Heterogeneous Data Fusion Net (HDF-Net) was designed to predict visual acuity (VA) outcome (improvement ≥ 2 line or not) at 12th months after anti-VEGF treatment. A set of pre-treatment optical coherence tomography (OCT) image and non-image demographic features were employed as input data and the corresponding 12th-month post-treatment VA as the target data to train, validate, and test the HDF-Net. This newly designed HDF-Net demonstrated an AUC of 0.989 (95% CI 0.970–0.999), accuracy of 0.936 [95% confidence interval (CI) 0.889–0.964], sensitivity of 0.933 (95% CI 0.841–0.974), and specificity of 0.938 (95% CI 0.877–0.969). By simulating the clinical decision process with mixed pre-treatment information from raw OCT images and numeric data, HDF-Net demonstrated promising performance in predicting individualized treatment outcome. The results highlight the potential of deep learning to simultaneously process a broad range of clinical data to weigh and leverage the complete information of the patient. This novel approach is an important step toward real-world personalized therapeutic strategy for typical nAMD.
Keywords	Medicine ; R ; Science ; Q
Subject code	006
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Automatic Segmentation of Retinal Fluid and Photoreceptor Layer from Optical Coherence Tomography Images of Diabetic Macular Edema Patients Using Deep Learning and Associations with Visual Acuity

Huan-Yu Hsu / Yu-Bai Chou / Ying-Chun Jheng / Zih-Kai Kao / Hsin-Yi Huang / Hung-Ruei Chen / De-Kuang Hwang / Shih-Jen Chen / Shih-Hwa Chiou / Yu-Te Wu

Biomedicines, Vol 10, Iss 1269, p

2022 Volume 1269

Abstract: Diabetic macular edema (DME) is a highly common cause of vision loss in patients with diabetes. Optical coherence tomography (OCT) is crucial in classifying DME and tracking the results of DME treatment. The presence of intraretinal cystoid fluid (IRC) ... ...

Abstract	Diabetic macular edema (DME) is a highly common cause of vision loss in patients with diabetes. Optical coherence tomography (OCT) is crucial in classifying DME and tracking the results of DME treatment. The presence of intraretinal cystoid fluid (IRC) and subretinal fluid (SRF) and the disruption of the ellipsoid zone (EZ), which is part of the photoreceptor layer, are three crucial factors affecting the best corrected visual acuity (BCVA). However, the manual segmentation of retinal fluid and the EZ from retinal OCT images is laborious and time-consuming. Current methods focus only on the segmentation of retinal features, lacking a correlation with visual acuity. Therefore, we proposed a modified U-net, a deep learning algorithm, to segment these features from OCT images of patients with DME. We also correlated these features with visual acuity. The IRC, SRF, and EZ of the OCT retinal images were manually labeled and checked by doctors. We trained the modified U-net model on these labeled images. Our model achieved Sørensen–Dice coefficients of 0.80 and 0.89 for IRC and SRF, respectively. The area under the receiver operating characteristic curve (ROC) for EZ disruption was 0.88. Linear regression indicated that EZ disruption was the factor most strongly correlated with BCVA. This finding agrees with that of previous studies on OCT images. Thus, we demonstrate that our segmentation network can be feasibly applied to OCT image segmentation and assist physicians in assessing the severity of the disease.
Keywords	optical coherence tomography segmentation ; deep learning ; diabetic macular edema ; visual acuity ; Biology (General) ; QH301-705.5
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Flow signal change in polyps after anti-vascular endothelial growth factor therapy.

Chia-Jui Chang / Yi-Ming Huang / Ming-Hung Hsieh / An-Fei Li / Shih-Jen Chen

PLoS ONE, Vol 15, Iss 10, p e

2020 Volume 0241230

Abstract: Optical coherence tomography angiography (OCTA) is a novel, non-invasive imaging tool used to detect vascular flow. The absence of a flow signal in OCTA in polyps revealed by indocyanine green angiography (ICGA) in patients with polypoidal choroidal ... ...

Abstract	Optical coherence tomography angiography (OCTA) is a novel, non-invasive imaging tool used to detect vascular flow. The absence of a flow signal in OCTA in polyps revealed by indocyanine green angiography (ICGA) in patients with polypoidal choroidal vasculopathy (PCV) may indicate slow or compromised filling of blood flow from choroidal vessels. Naïve patients with PCV treated with intravitreal injections of aflibercept (IVI-A) were enrolled in this study to validate the hypothesis that baseline flow may affect the outcome of polyp regression in ICGA. The flow signal of polyps in OCTA was detected by manual segmentation in the corresponding location by ICGA. Polyps were defined as high-flow if both OCTA and ICGA showed positive findings, and low-flow if OCTA showed a negative flow signal in 3 consecutive horizontal scans at the polyp area shown in ICGA. A total of 24 polyps were identified in 13 PCV patients at baseline. Of these 24 polyps, 22 (91.7%) were high-flow and 2 (8.3%) were low-flow. After 3 monthly IVI-A, all low-flow polyps had complete regression in ICGA. Among 17 (77%) high-flow polyps at baseline that had regression after treatment, 10 (58.8%) became low-flow, while 5 (22.7%) persistent polyps remained high-flow. Flow signal of polyps as detected by OCTA could be a predictive factor for treatment response in patients with PCV. Monitoring changes in flow signal after treatment is clinically relevant.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Accurate Joint-Alignment of Indocyanine Green and Fluorescein Angiograph Sequences for Treatment of Subretinal Lesions.

Chia-Ling Tsai / Hung-Chuan Hsu / Xin-Chang Wu / Shih-Jen Chen / Wei-Yang Lin

IEEE journal of biomedical and health informatics

2017 Volume 21, Issue 3, Page(s) 785–793

Abstract: In ophthalmology, aligning images in indocyanine green and fluorescein angiograph sequences is important for the treatment of subretinal lesions. This paper introduces an algorithm that is tailored to align jointly in a common reference space all the ... ...

Abstract	In ophthalmology, aligning images in indocyanine green and fluorescein angiograph sequences is important for the treatment of subretinal lesions. This paper introduces an algorithm that is tailored to align jointly in a common reference space all the images in an angiogram sequence containing both modalities. To overcome the issues of low image contrast and low signal-to-noise ratio for late-phase images, the structural similarity between two images is enhanced using Gabor wavelet transform. Image pairs are pairwise registered and the transformations are simultaneously and globally adjusted for a mutually consistent joint alignment. The joint registration process is incremental and the success depends on the correctness of matches from the pairwise registration. To safeguard the joint process, our system performs the consistency test to exclude incorrect pairwise results automatically to ensure correct matches as more images are jointly aligned. Our dataset consists of 60 sequences of polypoidal choroidal vasculopathy collected by the EVEREST Study Group. On average, each sequence contains 20 images. Our algorithm successfully pairwise registered 95.04% of all image pairs, and joint registered 98.7% of all images, with an average alignment error of 1.58 pixels.
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2695320-1
ISSN	2168-2208 ; 2168-2194
ISSN (online)	2168-2208
ISSN	2168-2194
DOI	10.1109/JBHI.2016.2538265
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Management of neovascular age-related macular degeneration

Ling Yeung / Yi-Ting Hsieh / Chang-Hao Yang / Lee-Jen Chen / Shih-Jen Chen / Cheng-Kuo Cheng / Shwu-Jiuan Sheu / Ching-Yao Tsai / Tsung-Tien Wu / Wei-Chi Wu / San-Ni Chen

Journal of the Formosan Medical Association, Vol 120, Iss 12, Pp 2061-

Taiwan expert consensus

2021 Volume 2071

Abstract: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss. The present consensus provides suggestions on diagnosis, evaluation, treatment, and follow-up strategies for nAMD from a panel of 11 practicing ... ...

Abstract	Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss. The present consensus provides suggestions on diagnosis, evaluation, treatment, and follow-up strategies for nAMD from a panel of 11 practicing ophthalmologists. The experts suggest that the baseline visit for nAMD management should include a comprehensive ophthalmologic examination via a multimodal approach consisting of visual and anatomical evaluation. Patients diagnosed with nAMD should be subjected to treatment with the goal of maintaining visual function while diminishing anatomical disease activity and minimizing treatment burden. Currently, anti-VEGF therapy is the main treatment strategy for nAMD, and evaluation involving comprehensive ophthalmologic examination within 1 month of completion of the loading phase comprising three monthly injections is recommended to guide subsequent management. Either a treat-and-extend or pro re nata regimen can be considered for the maintenance phase of anti-VEGF therapy, and the regimen should be chosen and adjusted according to disease activity, reimbursement criteria, financial burden, and patient preferences. In the event of inactive nAMD or poor treatment outcomes, after thorough evaluation and patient education, anti-VEGF therapy may be stopped. The consensus provides practical nAMD management guidelines for ophthalmologists and fellow healthcare professionals.
Keywords	Neovascular age-related macular degeneration ; Wet age-related macular degeneration ; Vascular endothelial growth factors ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Inner Nuclear Layer Microcyst Configuration, Distribution, and Visual Prognosis in Patients With Epiretinal Membrane After Vitrectomy and Membrane Peeling

Ming-Hung Hsieh / Yu-Bai Chou / Yi-Ming Huang / De-Kuang Hwang / Fang-Yi Tsai / Shih-Jen Chen

Scientific Reports, Vol 9, Iss 1, Pp 1-

2019 Volume 7

Abstract: Abstract Inner nuclear layer(INL) microcysts at central macula are a common finding in patients with epiretinal membrane (ERM) after vitrectomy and membrane peeling. Using en face mode of optical coherence tomography (OCT) angiography, patients with ERM ... ...

Abstract	Abstract Inner nuclear layer(INL) microcysts at central macula are a common finding in patients with epiretinal membrane (ERM) after vitrectomy and membrane peeling. Using en face mode of optical coherence tomography (OCT) angiography, patients with ERM after surgery were retrospectively reviewed to understand the configuration and distribution of microcysts as well as their impact on visual acuity. Forty-six eligible patients were enrolled and their baseline best-corrected visual acuities improved from 20/67 to 20/29 (P < 0.01) after surgery. Twenty-eight (60.9%) patients had microcysts that appeared at a median of 5 months after the surgery and persisted for mean 16 months follow-up. The microcyst appeared as spheroidal shape with length ranged from 20 to 80 μm and widths of 80 μm in average. They tend to group in cluster with a density of 245 microcysts per mm2. The frequency of microcyst distribution was 86%, 54%, 32%, 25% and 18% at the nasal, superior, inferior, temporal quadrants and central 1 mm, respectively. Linear regression analysis showed that INL microcysts at central and temporal quadrants were associated with poorer visual acuity (P = 0.02 and P = 0.01, respectively). The presence of INL microcysts in center subfield and involved wider area is a poor prognostic factor for visual outcomes.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Deep learning and ensemble stacking technique for differentiating polypoidal choroidal vasculopathy from neovascular age-related macular degeneration

Yu-Bai Chou / Chung-Hsuan Hsu / Wei-Shiang Chen / Shih-Jen Chen / De-Kuang Hwang / Yi-Ming Huang / An-Fei Li / Henry Horng-Shing Lu

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (nAMD) share some similarity in clinical imaging manifestations. However, their disease entity and treatment strategy as well as visual outcomes are very ... ...

Abstract	Abstract Polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (nAMD) share some similarity in clinical imaging manifestations. However, their disease entity and treatment strategy as well as visual outcomes are very different. To distinguish these two vision-threatening diseases is somewhat challenging but necessary. In this study, we propose a new artificial intelligence model using an ensemble stacking technique, which combines a color fundus photograph-based deep learning (DL) model and optical coherence tomography-based biomarkers, for differentiation of PCV from nAMD. Furthermore, we introduced multiple correspondence analysis, a method of transforming categorical data into principal components, to handle the dichotomous data for combining with another image DL system. This model achieved a robust performance with an accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve of 83.67%, 80.76%, 84.72%, and 88.57%, respectively, by training nearly 700 active cases with suitable imaging quality and transfer learning architecture. This work could offer an alternative method of developing a multimodal DL model, improve its efficiency for distinguishing different diseases, and facilitate the broad application of medical engineering in a DL model design.
Keywords	Medicine ; R ; Science ; Q
Subject code	004 ; 006
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Acute renal failure after intravitreal antivascular endothelial growth factor therapy

Yu-Fang Huang / Shih-Jen Chen / Min-Yen Hsu / De-Kuang Hwang

Journal of the Formosan Medical Association, Vol 116, Iss 6, Pp 490-

2017 Volume 492

Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2017-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Highly efficient capture approach for the identification of diverse inherited retinal disorders

npj Genomic Medicine, Vol 9, Iss 1, Pp 1-

2024 Volume 7

Abstract: Abstract Our study presents a 319-gene panel targeting inherited retinal dystrophy (IRD) genes. Through a multi-center retrospective cohort study, we validated the assay’s effectiveness and clinical utility and characterized the mutation spectrum of ... ...

Abstract	Abstract Our study presents a 319-gene panel targeting inherited retinal dystrophy (IRD) genes. Through a multi-center retrospective cohort study, we validated the assay’s effectiveness and clinical utility and characterized the mutation spectrum of Taiwanese IRD patients. Between January 2018 and May 2022, 493 patients in 425 unrelated families, all initially suspected of having IRD without prior genetic diagnoses, underwent detailed ophthalmic and physical examinations (with extra-ocular features recorded) and genetic testing with our customized panel. Disease-causing variants were identified by segregation analysis and clinical interpretation, with validation via Sanger sequencing. We achieved a read depth of >200× for 94.2% of the targeted 1.2 Mb region. 68.5% (291/425) of the probands received molecular diagnoses, with 53.9% (229/425) resolved cases. Retinitis pigmentosa (RP) is the most prevalent initial clinical impression (64.2%), and 90.8% of the cohort have the five most prevalent phenotypes (RP, cone-rod syndrome, Usher’s syndrome, Leber’s congenital amaurosis, Bietti crystalline dystrophy). The most commonly mutated genes of probands that received molecular diagnosis are USH2A (13.7% of the cohort), EYS (11.3%), CYP4V2 (4.8%), ABCA4 (4.5%), RPGR (3.4%), and RP1 (3.1%), collectively accounted for 40.8% of diagnoses. We identify 87 unique unreported variants previously not associated with IRD and refine clinical diagnoses for 21 patients (7.22% of positive cases). We developed a customized gene panel and tested it on the largest Taiwanese cohort, showing that it provides excellent coverage for diverse IRD phenotypes.
Keywords	Medicine ; R ; Genetics ; QH426-470
Subject code	610
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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