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Article ; Online: Automated Macular Fluid Volume As a Treatment Indicator for Diabetic Macular Edema.

Tsuboi, Kotaro / You, Qi Sheng / Guo, Yukun / Wang, Jie / Flaxel, Christina J / Bailey, Steven T / Huang, David / Jia, Yali / Hwang, Thomas S

Journal of vitreoretinal diseases

2023 Volume 7, Issue 3, Page(s) 226–231

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2023-03-29
Publishing country	United States
Document type	Journal Article
ISSN	2474-1272
ISSN (online)	2474-1272
DOI	10.1177/24741264231164846
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Article: Optical Coherence Tomography Features of Tuberculous Serpiginous-like Choroiditis and Serpiginous Choroiditis.

Wang, Xiao Na / You, Qi Sheng / Zhao, Hui Ying / Peng, Xiao Yan

Biomedical and environmental sciences : BES

2018 Volume 31, Issue 5, Page(s) 327–334

Abstract: Objective: To investigate optical coherence tomography (OCT) characteristics of tuberculous serpiginous-like choroiditis (Tb-SLC) and serpiginous choroiditis (SC) and to perform OCT to differentiate between these conditions.: Methods: This ... ...

Abstract	Objective: To investigate optical coherence tomography (OCT) characteristics of tuberculous serpiginous-like choroiditis (Tb-SLC) and serpiginous choroiditis (SC) and to perform OCT to differentiate between these conditions. Methods: This retrospective, case-control study examined consecutively enrolled patients with active Tb-SLC or SC. Patients underwent comprehensive ocular examinations and imaging (OCT, color fundus photography, autofluorescence imaging, fluorescein angiography, and indocyanine green angiography). Findings were examined and compared between eyes with SC and Tb-SLC. Results: Nine patients with active Tb-SLC (14 eyes) and 8 with active SC (12 eyes) were included. The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group: vitreal hyper-reflective spots [5 Tb-SLC eyes (36%), no SC eyes; P = 0.02], intraretinal edema [11 Tb-SLC eyes (79%), 3 SC eyes (25%); P = 0.01], sub-retinal pigment epithelium (RPE) drusenoid deposits [11 Tb-SLC eyes (79%), 2 SC eyes (17%); P < 0.01], and choroidal granulomas [8 Tb-SLC eyes (57%), 2 SC eyes (17%); P = 0.03]. A hyporeflective, wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes (36%), 9 SC eyes (75%); P = 0.045] than in the Tb-SLC group. The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection, outer retinal tabulation, and choriocapillaris point-like hyper-reflection. Conclusion: Vitreal hyper-reflective spots, intraretinal fluid, sub-RPE drusenoid deposits, and choroidal granulomas on OCT images may indicate Tb-SLC. Additionally, a hyporeflective, wedge-shaped band may indicate SC. Therefore, OCT is likely helpful in differentiating between Tb-SLC and SC.
MeSH term(s)	Adult ; Case-Control Studies ; Choroiditis/diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Optical Coherence ; Tuberculosis, Ocular/diagnostic imaging ; Tuberculosis, Ocular/pathology
Language	English
Publishing date	2018-06-04
Publishing country	China
Document type	Journal Article
ZDB-ID	645083-0
ISSN	0895-3988
ISSN	0895-3988
DOI	10.3967/bes2018.043
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Article ; Online: Comparison of Central Macular Fluid Volume With Central Subfield Thickness in Patients With Diabetic Macular Edema Using Optical Coherence Tomography Angiography.

You, Qi Sheng / Tsuboi, Kotaro / Guo, Yukun / Wang, Jie / Flaxel, Christina J / Bailey, Steven T / Huang, David / Jia, Yali / Hwang, Thomas S

JAMA ophthalmology

2021 Volume 139, Issue 7, Page(s) 734–741

Abstract: Importance: Diabetic macular edema (DME) is the predominant cause of visual impairment in patients with type 1 or 2 diabetes. Automated fluid volume measurements using optical coherence tomography (OCT) may improve the diagnostic accuracy of DME ... ...

Abstract	Importance: Diabetic macular edema (DME) is the predominant cause of visual impairment in patients with type 1 or 2 diabetes. Automated fluid volume measurements using optical coherence tomography (OCT) may improve the diagnostic accuracy of DME screening. Objective: To assess the diagnostic accuracy of an automated central macular fluid volume (CMFV) quantification using OCT for DME. Design, setting, and participants: A cross-sectional observational study was conducted at a tertiary academic center among 215 patients with diabetes (1 eye each) enrolled from January 26, 2015, to December 23, 2019. All participants underwent comprehensive examinations, 6 × 6-mm macular structural OCT horizontal raster scans, and 6 × 6-mm macular OCT angiography volumetric scans. From January 1 to March 30, 2020, 2 retinal specialists reviewed the structural OCT scans independently and diagnosed DME if intraretinal or subretinal fluid was present. Diabetic macular edema was considered center involved if fluid was present within the central fovea (central 1-mm circle). A third retinal specialist arbitrated any discrepancy. The mean central subfield thickness (CST) within the central fovea was measured on structural OCT horizontal raster scans. A deep learning algorithm automatically quantified fluid volumes on 6 × 6-mm OCT angiography volumetric scans and within the central foveas (CMFV). Main outcomes and measures: The area under the receiver operating characteristic curve (AUROC) and the sensitivity and specificity of CST and CMFV for DME diagnosis. Results: We enrolled 1 eye each of 215 patients with diabetes (117 women [54.4%]; mean [SD] age, 59.6 [12.4] years). Diabetic macular edema was present in 136 eyes; 93 cases of DME were center involved. The AUROC of CMFV for diagnosis of center-involved DME (0.907 [95% CI, 0.861-0.954]) was greater than the AUROC of CST (0.832 [95% CI, 0.775-0.889]; P = .02). With the specificity set at 95%, the sensitivity of CMFV for detection of center-involved DME (78.5% [95% CI, 68.8%-86.3%]) was higher than that of CST (53.8% [95% CI, 43.1%-64.2%]; P = .002). Center-involved DME cases not detected by CST but detected by CMFV were associated with a thinner CST (290.8 μm [95% CI, 282.3-299.3 μm] vs 369.4 μm [95% CI, 347.1-391.7 μm]; P < .001), higher proportion of previous macular laser treatment (11 of 28 [39.3%; 95% CI, 21.5%-59.4%] vs 12 of 65 [18.5%; 95% CI, 9.9%-30.0%]; P = .03), and female sex (20 of 28 [71.4%; 95% CI, 51.3%-86.8%] vs 31 of 65 [47.7%; 95% CI, 35.1%-60.5%]; P = .04). Conclusions and relevance: These findings suggest that an automated CMFV is a more accurate diagnostic biomarker than CST for DME and may improve screening for DME.
MeSH term(s)	Angiography/adverse effects ; Cross-Sectional Studies ; Diabetes Mellitus ; Diabetic Retinopathy ; Female ; Humans ; Macular Edema/etiology ; Male ; Middle Aged ; Tomography, Optical Coherence/methods
Language	English
Publishing date	2021-04-16
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2701705-9
ISSN	2168-6173 ; 2168-6165
ISSN (online)	2168-6173
ISSN	2168-6165
DOI	10.1001/jamaophthalmol.2021.1275
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Article ; Online: Geographic Atrophy Progression Is Associated With Choriocapillaris Flow Deficits Measured With Optical Coherence Tomographic Angiography.

You, Qi Sheng / Camino, Acner / Wang, Jie / Guo, Yukun / Flaxel, Christina J / Hwang, Thomas S / Huang, David / Jia, Yali / Bailey, Steven T

Investigative ophthalmology & visual science

2021 Volume 62, Issue 15, Page(s) 28

Abstract: Purpose: The purpose of this study was to assess the associations between baseline choriocapillaris (CC) flow deficits and geographic atrophy (GA) progression.: Methods: In this prospective cohort study, patients with GA underwent 3 × 3-mm macular ... ...

Abstract	Purpose: The purpose of this study was to assess the associations between baseline choriocapillaris (CC) flow deficits and geographic atrophy (GA) progression. Methods: In this prospective cohort study, patients with GA underwent 3 × 3-mm macular spectral-domain optical coherence tomographic angiography (OCTA) at baseline and follow-up visits. Annual GA enlargement rate was defined as change of square root of GA area in 12 months. Shadow areas due to iris, media opacity, retinal vessels, and drusen were excluded. CC vessel density (CC-VD) in non-GA areas was measured using a validated machine-learning-based algorithm. Low perfusion area (LPA) was defined as capillary density below the 0.1 percentile threshold of the same location of 40 normal healthy control eye. Focal perfusion loss (FPL) was defined as percentage of CC loss within LPA compared with normal controls. Results: Ten patients with GA were enrolled and followed for 26 months on average. At baseline, the mean GA area was 0.84 ± 0.70 mm2. The mean CC-VD was 44.5 ± 15.2%, the mean LPA was 4.29 ± 2.6 mm2, and the mean FPL was 50.4 ± 28.2%. The annual GA enlargement rate was significantly associated with baseline CC-VD (r = -0.816, P = 0.004), LPA (r = 0.809, P = 0.005), and FPL (r = 0.800, P = 0.005), but not with age (r = 0.008, P = 0.98) and GA area (r = -0.362, P = 0.30). Conclusions: Baseline CC flow deficits were significantly associated with a faster GA enlargement over the course of 1 year, suggesting the choriocapillaris perfusion outside of a GA area may play a role in GA progression.
MeSH term(s)	Aged ; Aged, 80 and over ; Algorithms ; Axial Length, Eye ; Blood Flow Velocity ; Choroid/blood supply ; Computed Tomography Angiography ; Disease Progression ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Geographic Atrophy/diagnosis ; Geographic Atrophy/physiopathology ; Humans ; Male ; Prospective Studies ; Regional Blood Flow/physiology ; Tomography, Optical Coherence ; Visual Acuity/physiology
Language	English
Publishing date	2021-12-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	391794-0
ISSN	1552-5783 ; 0146-0404
ISSN (online)	1552-5783
ISSN	0146-0404
DOI	10.1167/iovs.62.15.28
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Article ; Online: Effect of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography.

You, Qi Sheng / Tan, Ou / Pi, Shaohua / Liu, Liang / Wei, Ping / Chen, Aiyin / Ing, Eliesa / Jia, Yali / Huang, David

The British journal of ophthalmology

2021 Volume 106, Issue 12, Page(s) 1703–1709

Abstract: Purpose: To assess the effects of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography (OCTA).: Methods: In this prospective cross-sectional study, one eye each of 36 normal controls and 64 patients with ... ...

Abstract	Purpose: To assess the effects of algorithms and covariates in glaucoma diagnosis with optical coherence tomography angiography (OCTA). Methods: In this prospective cross-sectional study, one eye each of 36 normal controls and 64 patients with glaucoma underwent 4.5 mm disc-centred and 6 mm macula-centred OCTA scans. The peripapillary nerve fibre layer plexus capillary density (NFLP-CD) and macular superficial vascular complex vessel density (SVC-VD) were measured using both a commercial algorithm (AngioAnalytics) and a custom algorithm (Center for Ophthalmic Optics & Lasers Angiography Reading Toolkit (COOL-ART)). The nerve fibre layer and ganglion cell complex thicknesses were measured on structural OCT. Results: The overall peripapillary NFLP-CD and macular SVC-VD measured with the two algorithms were highly correlated but poorly agreed. Among the normal controls, the perfusion measurements made by both algorithms were significantly correlated with age. AngioAnalytics measurements were also correlated with signal strength index, while COOL-ART measurements were not. These covariates were adjusted. The diagnostic accuracy, measured as the area under the receiver operating characteristic curve for glaucoma detection, was not significantly different between algorithms, between structural and perfusion parameters and between the peripapillary and macular regions (All p>0.05). The macular SVC-VD in the 6 mm square had a significantly higher diagnostic accuracy than that of the central 3 mm square area (p=0.005). Conclusions: AngioAnalytics and COOL-ART vessel density measurements are not interchangeable but potentially interconvertible. Age and signal strength are significant covariates that need to be considered. Both algorithms and both peripapillary and macular perfusion parameters have similarly good diagnostic accuracy comparable to structural OCT. A larger macular analytic area provides higher diagnostic accuracy.
MeSH term(s)	Humans ; Tomography, Optical Coherence/methods ; Optic Disk/blood supply ; Fluorescein Angiography/methods ; Retinal Vessels/diagnostic imaging ; Retinal Vessels/physiology ; Prospective Studies ; Cross-Sectional Studies ; Intraocular Pressure ; Glaucoma/diagnosis ; Algorithms
Language	English
Publishing date	2021-06-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2020-318677
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Article ; Online: Association Between Fluid Volume in Inner Nuclear Layer and Visual Acuity in Diabetic Macular Edema.

Tsuboi, Kotaro / You, Qi Sheng / Guo, Yukun / Wang, Jie / Flaxel, Christina J / Bailey, Steven T / Huang, David / Jia, Yali / Hwang, Thomas S

American journal of ophthalmology

2021 Volume 237, Page(s) 164–172

Abstract: Purpose: In diabetic macular edema (DME), the correlation between visual acuity (VA) and central subfield thickness (CST) is weak. We hypothesize that fluid volume (FV) in the inner nuclear layer (INL) may correlate more strongly with VA.: Design: ... ...

Abstract	Purpose: In diabetic macular edema (DME), the correlation between visual acuity (VA) and central subfield thickness (CST) is weak. We hypothesize that fluid volume (FV) in the inner nuclear layer (INL) may correlate more strongly with VA. Design: Retrospective, cross-sectional study. Methods: One eye each of diabetic patients with DME was included. We measured intraretinal fluid volume that was detected by automated fluid detection algorithm on 3- × 3-mm optical coherence tomography angiogram volume scans. The detected fluid was subdivided into inner FV, bounded by the INL, and outer FV, the fluid between the outer border of INL to the ellipsoid zone. Results: We enrolled 125 patients with DME (60 women; mean age, 61 years). The mean detected inner FV was 0.013 mm Conclusions: The inner FV has a stronger association with VA than other OCT biomarkers in DME and may be more clinically useful.
MeSH term(s)	Cross-Sectional Studies ; Diabetes Mellitus ; Diabetic Retinopathy ; Female ; Humans ; Macular Edema/diagnosis ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity
Language	English
Publishing date	2021-12-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2021.12.012
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Article ; Online: Reply.

You, Qi Sheng / Meshi, Amit / Muftuoglu, Ilkay K / Freeman, William R

Retina (Philadelphia, Pa.)

2017 Volume 37, Issue 11, Page(s) e141–e143

Language	English
Publishing date	2017-10-24
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	603192-4
ISSN	1539-2864 ; 0275-004X
ISSN (online)	1539-2864
ISSN	0275-004X
DOI	10.1097/IAE.0000000000001887
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Article ; Online: Optical Coherence Tomography Angiography Avascular Area Association With 1-Year Treatment Requirement and Disease Progression in Diabetic Retinopathy.

You, Qi Sheng / Wang, Jie / Guo, Yukun / Pi, Shaohua / Flaxel, Christina J / Bailey, Steven T / Huang, David / Jia, Yali / Hwang, Thomas S

American journal of ophthalmology

2020 Volume 217, Page(s) 268–277

Abstract: Purpose: To assess the association between optical coherence tomography angiography (OCTA)-quantified avascular areas (AAs) and diabetic retinopathy (DR) severity, progression, and treatment requirement in the following year.: Design: Prospective ... ...

Abstract	Purpose: To assess the association between optical coherence tomography angiography (OCTA)-quantified avascular areas (AAs) and diabetic retinopathy (DR) severity, progression, and treatment requirement in the following year. Design: Prospective cohort study. Methods: We recruited patients with diabetes from a tertiary academic retina practice and obtained 3-mm × 3-mm macular OCTA scans with the AngioVue system and standard 7-field color photographs at baseline and at a 1-year follow-up visit. A masked grader determined the severity of DR from the color photographs using the Early Treatment of Diabetic Retinopathy scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1-mm circle in projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Results: Of 138 patients, 92 (41 men, ranging in age from 26-84 years [mean 59.4 years]) completed 1 year of follow-up. At baseline, EAAs for SVC, ICP, and DCP were all significantly correlated with retinopathy severity (P < .0001). DCP EAA was significantly associated with worse visual acuity (r = -0.24, P = .02), but SVC and ICP EAA were not. At 1 year, 11 eyes progressed in severity by at least 1 step. Multivariate logistic regression analysis demonstrated the progression was significantly associated with baseline SVC EAA (odds ratio = 8.73, P = .04). During the follow-up period, 33 eyes underwent treatment. Multivariate analysis showed that treatment requirement was significantly associated with baseline DCP EAA (odds ratio = 3.39, P = .002). No baseline metric was associated with vision loss at 1 year. Conclusions: EAAs detected by OCTA in diabetic eyes are significantly associated with baseline DR severity, disease progression, and treatment requirement over 1 year.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Diabetic Retinopathy/diagnosis ; Diabetic Retinopathy/physiopathology ; Diabetic Retinopathy/therapy ; Disease Management ; Disease Progression ; Female ; Fluorescein Angiography/methods ; Follow-Up Studies ; Fundus Oculi ; Humans ; Macula Lutea/pathology ; Male ; Middle Aged ; Prospective Studies ; Retinal Vessels/diagnostic imaging ; Time Factors ; Tomography, Optical Coherence/methods ; Visual Acuity
Language	English
Publishing date	2020-04-29
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2020.04.024
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Article ; Online: Using spectral-domain optical coherence tomography to evaluate the type and thickness of interdigitation zone band in adult Chinese.

Shao, Lei / Zhang, Qing Lin / Zhou, Ling Xiao / Xu, Liang / You, Qi Sheng / Wei, Wen Bin

Scientific reports

2018 Volume 8, Issue 1, Page(s) 12253

Abstract: To study types and thickness of interdigitation zone band in adult Chinese subjects, we conducted a cross-sectional study. The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 ± 9.8 years. 263 people (263eyes) ... ...

Abstract	To study types and thickness of interdigitation zone band in adult Chinese subjects, we conducted a cross-sectional study. The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 ± 9.8 years. 263 people (263eyes) with a mean age of 64.8 years were randomly selected cases without macular diseases included in the study. A detailed ophthalmic examination was performed including SD-OCT for measurement of the thickness of interdigitation zone band. There are two types of interdigitation zone band; the type1 which can distinguish RPE-BM complex in 170 eyes; and the Type 2 which the two layers merged involved 93 eyes. In type1, the mean thickness of the interdigitation zone band was significantly thicker in the foveal center (16.46 ± 2.92 μm), then nasal macular region (16.19 ± 2.69 μm), temporal macular region (15.73 ± 2.68 . μm), superior region (15.72 ± 2.70 μm), and inferior macular region (14.84 ± 2.63 μm) (P all < 0.05). And the mean thickness of the interdigitation zone band in the foveal center associated with the subfoveal choroidal thickness (P = 0.025) and level of education (P = 0.033). The increase in the thickness of the interdigitation zone band may play a role in the pathophysiologic features of various age-related ocular conditions.
MeSH term(s)	Adult ; Aged ; China ; Cross-Sectional Studies ; Diagnostic Techniques, Ophthalmological ; Fovea Centralis/pathology ; Humans ; Macula Lutea/pathology ; Macular Degeneration/diagnosis ; Macular Degeneration/pathology ; Male ; Middle Aged ; Population Groups ; Retinal Pigment Epithelium/pathology ; Tomography, Optical Coherence/methods ; Visual Acuity
Language	English
Publishing date	2018-08-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-018-30848-1
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Article ; Online: The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4-8 years.

Zhang, Jing Shang / Wang, Jin Da / Yusufu, Mayinuer / Cao, Kai / Jin, Shan Shan / Xiong, Ying / Li, Jing / Sun, Xiu Li / Chen, Shu Ying / Liu, Zhen Yu / Fu, Jing / Li, Li / You, Qi Sheng / Wan, Xiu Hua

BMC ophthalmology

2021 Volume 21, Issue 1, Page(s) 332

Abstract: Background: The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4-8 years.: Methods: This is a retrospective case control study. Seventy-seven children (130 eyes) aged ... ...

Abstract	Background: The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4-8 years. Methods: This is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared. Results: In all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients. Conclusions: For older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.
MeSH term(s)	Adolescent ; Capsule Opacification/surgery ; Case-Control Studies ; Cataract ; Child ; Humans ; Lens Capsule, Crystalline/surgery ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Phacoemulsification ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Retrospective Studies
Language	English
Publishing date	2021-09-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2050436-6
ISSN	1471-2415 ; 1471-2415
ISSN (online)	1471-2415
ISSN	1471-2415
DOI	10.1186/s12886-021-02098-9
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