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Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 June 2023) | Viewed by 16840

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Prof. Dr. Rodolfo Mastropasqua

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Ophthalmology Clinic, Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestiti, 31, Chieti, Italy
Interests: ophthalmology; retinal imaging; vitreoretinal diseases; ocular surgery
Special Issues, Collections and Topics in MDPI journals

Dr. Rossella D'Aloisio

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Guest Editor

Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, via dei Vestiti, 31, Chieti, Italy
Interests: ophthalmology; retinal imaging; medical retina, vitreoretinal diseases; ocular surgery

Special Issue Information

Dear Colleagues,

On behalf of the Journal of Clinical Medicine Editorial Team, I am delighted to present the second edition of the Special Issue “Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0”.

In recent decades, the role of imaging in ophthalmology has aroused increasing interest due to the advent of novel diagnostic tools that are aiming at an early diagnosis and a change in the approach of patient management. Such advances allow physicians of different medical subspecialities to start collaborations with ophthalmologists, to recognize and treat systemic diseases through concerted efforts.

This Special Issue aims at creating a multidisciplinary forum of discussion about the role of retinal and optic nerve imaging and its application in ophthalmic diseases and clinical medicine. Given the success obtained from the first edition of this Special Issue, we decided to repropose this topic.

Accepted papers will describe new developments in these areas. This Special Issue invites high-quality articles containing original research results as well as review articles of exceptional merit.

Potential topics include but are not limited to the following keywords.

Prof. Dr. Rodolfo Mastropasqua
Dr. Rossella D'Aloisio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

retinal diseases
eye inherited diseases
uveitis
glaucoma
neuro-ophthalmology
optic nerve imaging
retinal imaging
microbiology
diabetes
infectious disease

Published Papers (10 papers)

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Research

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11 pages, 2845 KiB

Open AccessArticle

Macular Anatomy Differs in Dyslexic Subjects

by Jose Javier Garcia-Medina, Nieves Bascuñana-Mas, Paloma Sobrado-Calvo, Celia Gomez-Molina, Elena Rubio-Velazquez, Maravillas De-Paco-Matallana, Vicente Zanon-Moreno, Maria Dolores Pinazo-Duran and Monica Del-Rio-Vellosillo

J. Clin. Med. 2023, 12(6), 2356; https://doi.org/10.3390/jcm12062356 - 17 Mar 2023

Cited by 1 | Viewed by 1542

Abstract

The macula, as the central part of the retina, plays an important role in the reading process. However, its morphology has not been previously studied in the context of dyslexia. In this research, we compared the thickness of the fovea, parafovea and perifovea between dyslexic subjects and normal controls, in 11 retinal segmentations obtained by optical coherence tomography (OCT). With this aim, we considered the nine sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid and also summarized data from sectors into inner ring subfield (parafovea) and outer ring subfield (perifovea). The thickness in all the four parafoveal sectors was significantly thicker in the complete retina, inner retina and middle retina of both eyes in the dyslexic group, as well as other macular sectors (fovea and perifovea) in the inner nuclear layer (INL), inner plexiform layer (IPL), IPL + INL and outer plexiform layer + outer nuclear layer (OPL + ONL). Additionally, the inner ring subfield (parafovea), but not the outer ring subfield (perifovea), was thicker in the complete retina, inner retina, middle retina (INL + OPL + ONL), OPL + ONL, IPL + INL and INL in the dyslexic group for both eyes. In contrast, no differences were found between the groups in any of the sectors or subfields of the outer retina, retinal nerve fiber layer, ganglion cell layer or ganglion cell complex in any eye. Thus, we conclude from this exploratory research that the macular morphology differs between dyslexic and normal control subjects, as measured by OCT, especially in the parafovea at middle retinal segmentations. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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9 pages, 1537 KiB

Open AccessArticle

Discriminating Healthy Optic Discs and Visible Optic Disc Drusen on Fundus Autofluorescence and Color Fundus Photography Using Deep Learning—A Pilot Study

by Raphael Diener, Jost Lennart Lauermann, Nicole Eter and Maximilian Treder

J. Clin. Med. 2023, 12(5), 1951; https://doi.org/10.3390/jcm12051951 - 01 Mar 2023

Cited by 1 | Viewed by 2311

Abstract

The aim of this study was to use deep learning based on a deep convolutional neural network (DCNN) for automated image classification of healthy optic discs (OD) and visible optic disc drusen (ODD) on fundus autofluorescence (FAF) and color fundus photography (CFP). In this study, a total of 400 FAF and CFP images of patients with ODD and healthy controls were used. A pre-trained multi-layer Deep Convolutional Neural Network (DCNN) was trained and validated independently on FAF and CFP images. Training and validation accuracy and cross-entropy were recorded. Both generated DCNN classifiers were tested with 40 FAF and CFP images (20 ODD and 20 controls). After the repetition of 1000 training cycles, the training accuracy was 100%, the validation accuracy was 92% (CFP) and 96% (FAF), respectively. The cross-entropy was 0.04 (CFP) and 0.15 (FAF). The sensitivity, specificity, and accuracy of the DCNN for classification of FAF images was 100%. For the DCNN used to identify ODD on color fundus photographs, sensitivity was 85%, specificity 100%, and accuracy 92.5%. Differentiation between healthy controls and ODD on CFP and FAF images was possible with high specificity and sensitivity using a deep learning approach. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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9 pages, 2563 KiB

Open AccessArticle

En Face Choroidal Vascularity in Both Eyes of Patients with Unilateral Central Serous Chorioretinopathy

by Filippo Tatti, Claudio Iovino, Giuseppe Demarinis, Emanuele Siotto Pintor, Marco Pellegrini, Oliver Beale, Kiran Kumar Vupparaboina, Mohammed Abdul Rasheed, Giuseppe Giannaccare, Jay Chhablani and Enrico Peiretti

J. Clin. Med. 2023, 12(1), 150; https://doi.org/10.3390/jcm12010150 - 24 Dec 2022

Cited by 1 | Viewed by 1099

Abstract

The aim of this study was to evaluate the choroidal vascularity analyzing en face optical coherence tomography (OCT) images in patients with unilateral central serous chorioretinopathy (CSC). We retrospectively evaluated 40 eyes of 20 CSC patients and 20 eyes of 10 gender- and age-matched healthy individuals. The sample consisted of: (1) CSC affected eyes; (2) unaffected fellow eyes; (3) healthy eyes. Multiple cross-sectional enhanced depth imaging OCT scans were obtained to create a volume scan. En face scans of the whole choroid were obtained at 5μm intervals and were binarized to calculate the choroidal vascularity index (CVI). The latter, defined as the proportion of the luminal area to the total choroidal area, was calculated at the level of choriocapillaris, superficial, medium and deep layers. No significant differences between choriocapillaris, superficial, medium and deep CVI were found in both eyes of CSC patients, whereas a significant different trend of changes was found in healthy eyes. Nevertheless, the en face CVI shows no difference between affected fellow and healthy eyes. In conclusion, CSC-affected eyes and fellow eyes showed a similar vascular architecture, with no statistical difference between all choroidal layers. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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11 pages, 1792 KiB

Open AccessArticle

How Could Medical and Surgical Treatment Affect the Quality of Life in Glaucoma Patients? A Cross-Sectional Study

by Marco Rocco Pastore, Serena Milan, Rossella Agolini, Leonardo Egidi, Tiziano Agostini, Lorenzo Belfanti, Gabriella Cirigliano and Daniele Tognetto

J. Clin. Med. 2022, 11(24), 7301; https://doi.org/10.3390/jcm11247301 - 08 Dec 2022

Cited by 1 | Viewed by 948

Abstract

Background: To evaluate and compare the visual function and the quality of life (QoL) in glaucomatous patients treated with topical medical therapy (TMT) alone, canaloplasty (CP), or trabeculectomy (TB). Methods: A total of 291 eyes of 167 patients with primary open-angle glaucoma or secondary pseudoexfoliative glaucoma in TMT or surgically treated with CP or TB were included. Eligibility criteria for surgical patients included not needing TMT after surgery. Each patient underwent a visual field assessment and peripapillary retinal nerve fiber layer (pRNFL) optical coherence tomography and filled out the Glaucoma Symptoms Scale (GSS) questionnaire and the 25-Item National Eye Institute Visual Functioning Questionnaire (25-NEI-VFQ). Comparison between the QoL level of the three groups and its correlation with optic nerve’s anatomical and functional status was the primary outcome. Results: CP patients reported the best general vision (p = 0.01), a lower incidence of eye burning (p = 0.03), and the lowest annoyance level of non-visual symptoms (p = 0.006). QoL positively correlated with pRNFL thickness, whereas no correlation was found with visual field damage. Conclusion: CP provides a better QoL when compared both to TB and TMT, regardless of glaucoma stage. pRNFL seems to provide additional information for predicting change in QoL. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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10 pages, 1287 KiB

Open AccessArticle

Optical Coherence Tomography Analysis of Retinal Layers in Celiac Disease

by Livio Vitiello, Maddalena De Bernardo, Luca Erra, Federico Della Rocca, Nicola Rosa and Carolina Ciacci

J. Clin. Med. 2022, 11(16), 4727; https://doi.org/10.3390/jcm11164727 - 12 Aug 2022

Cited by 4 | Viewed by 1493

Abstract

Celiac disease is an immune-mediated, chronic, inflammatory, and systemic illness which could affect the eye. The aim of this study is to look for possible signs of retinal involvement in celiac disease that could be utilized as biomarkers for this disease. Sixty-six patients with celiac disease and sixty-six sex-matched healthy subjects were enrolled in this observational case–control study. A comprehensive ophthalmological evaluation, axial length measurements, and SD-OCT evaluation were performed. The thickness of the retinal layers at the circle centered on the fovea (1 mm in diameter) and the average of the foveal and parafoveal zones at 2 and 3 mm in diameter were evaluated, together with retinal volume and the peripapillary retinal nerve fiber layer (RNFL). Concerning the thicknesses of the retinal layers in each analyzed region, no statistically significant differences were found. The same results were obtained for the total volume. Regarding peripapillary RNFL, the celiac patients showed slightly thicker values than the healthy controls, except for temporal and nasal-inferior quadrants, with no statistically significant differences. All the analyzed parameters were similar for the celiac patients and the healthy individuals. This could be related either to the non-involvement of the retinal layers in celiac disease pathophysiology or to the gluten-free diet effect. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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7 pages, 443 KiB

Open AccessArticle

Anatomical and Functional Effects of Oral Administration of Curcuma Longa and Boswellia Serrata Combination in Patients with Treatment-Naïve Diabetic Macular Edema

by Olimpia Guarino, Claudio Iovino, Valentina Di Iorio, Andrea Rosolia, Irene Schiavetti, Michele Lanza and Francesca Simonelli

J. Clin. Med. 2022, 11(15), 4451; https://doi.org/10.3390/jcm11154451 - 30 Jul 2022

Cited by 1 | Viewed by 1931

Abstract

Anti-vascular endothelial growth factor nowdays represents the standard of care for diabetic macular edema (DME). Nevertheless, the burden of injections worldwide has created tremendous stress on the healthcare system during the COVID-19 pandemic. The aim of this study was to investigate the effects of the oral administration of Curcuma longa and Boswellia serrata (Retimix^®) in patients with non-proliferative diabetic retinopathy (DR) and treatment-naïve DME < 400 μm, managed during the COVID-19 pandemic. In this retrospective study, patients were enrolled and divided into two groups, one undergoing observation (Group A, n 12) and one receiving one sachet a day of Retimix^® (Group B, n 49). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured by spectral-domain optical coherence tomography were performed at baseline, then at one and six months. A mixed-design ANOVA was calculated to determine whether the change in CMT and BCVA over time differed according to the consumption of Retimix^®. The interaction between time and treatment was significant, with F (1.032, 102.168) = 14.416; η² = 0.127; p < 0.001, indicating that the change in terms of CMT and BCVA over time among groups was significantly different. In conclusion, our results show the efficacy of Curcuma longa and Boswellia serrata in patients with non-proliferative DR and treatment-naïve DME in maintaining baseline CMT and BCVA values over time. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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13 pages, 3939 KiB

Open AccessArticle

Early Structural and Vascular Changes after Within-24 Hours Vitrectomy for Recent Onset Rhegmatogenous Retinal Detachment Treatment: A Pilot Study Comparing Bisected Macula and Not Bisected Macula

by Rossella D’Aloisio, Matteo Gironi, Tommaso Verdina, Chiara Vivarelli, Riccardo Leonelli, Cesare Mariotti, Shaniko Kaleci, Lisa Toto and Rodolfo Mastropasqua

J. Clin. Med. 2022, 11(12), 3498; https://doi.org/10.3390/jcm11123498 - 17 Jun 2022

Cited by 4 | Viewed by 1449

Abstract

Background: In this study we aimed at investigating macular perfusion/anatomical changes in eyes with early onset rhegmatogenous retinal detachment (RRD) after prompt surgery within 24 hours, comparing a bisected macula and not bisected macula RRD. Methods: In this prospective observational study, 14 eyes of 14 patients who underwent within-24 hours vitreoretinal surgery for early onset RRD were enrolled. Patients were further divided into two subgroups: the not bisected macula group (NBM group) and the bisected macula group (BM group). At baseline and 3-month follow up, macular architecture and vessel analysis were assessed using optical coherence tomography angiography (OCTA) imaging. In detail, quantitative and qualitative analyses of the macular area were performed to quantify topographical retinal perfusion changes after surgery, calculating the foveal avascular zone (FAZ), vessel density (VD) and vessel length density (VLD) at the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results: Most cases (43%) were superotemporal RRD. Primary retinal reattachment was obtained in all cases, without recurrences within 3-month follow up. After surgery, a significant FAZ enlargement was observed at both the SCP and DCP level (p < 0.001; p < 0.05), with a significant effect of time noted between the two time points in the NBM and BM subanalysis (F = 3.68; p < 0.017). An excellent functional outcome was maintained for the whole follow-up. On the other hand, after surgery, perfusion parameters did not change significantly apart from the vessel density of the inferior macular sector at the DCP level (p = 0.03). Conclusions: Our findings suggest that the macular perfusion of eyes with RRD is still preserved if the surgery is performed really promptly, thus highlighting the great importance of a correct timing for surgery. OCTA analysis allows for a better understanding of the pathophysiological mechanisms underneath early vascular microarchitecture modifications of the posterior pole in retinal detachment, differentiating the two types of RRD not completely involving the fovea (BM and NBM). Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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Review

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13 pages, 3719 KiB

Open AccessReview

Clinical Applications of Optical Coherence Tomography Angiography in Inherited Retinal Diseases: An Up-to-Date Review of the Literature

by Claudio Iovino, Clemente Maria Iodice, Danila Pisani, Luciana Damiano, Valentina Di Iorio, Francesco Testa and Francesca Simonelli

J. Clin. Med. 2023, 12(9), 3170; https://doi.org/10.3390/jcm12093170 - 28 Apr 2023

Cited by 1 | Viewed by 1275

Abstract

Optical coherence tomography angiography (OCT-A) is a valuable imaging technique, allowing non-invasive, depth-resolved, motion-contrast, high-resolution images of both retinal and choroidal vascular networks. The imaging capabilities of OCT-A have enhanced our understanding of the retinal and choroidal alterations that occur in inherited retinal diseases (IRDs), a group of clinically and genetically heterogeneous disorders that may be complicated by several vascular conditions requiring a prompt diagnosis. In this review, we aimed to comprehensively summarize all clinical applications of OCT-A in the diagnosis and management of IRDs, highlighting significant vascular findings on retinitis pigmentosa, Stargardt disease, choroideremia, Best disease and other less common forms of retinal dystrophies. All advantages and limitations of this novel imaging modality will be also discussed. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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9 pages, 269 KiB

Open AccessReview

Application of Deep Learning to Retinal-Image-Based Oculomics for Evaluation of Systemic Health: A Review

by Jo-Hsuan Wu and Tin Yan Alvin Liu

J. Clin. Med. 2023, 12(1), 152; https://doi.org/10.3390/jcm12010152 - 24 Dec 2022

Cited by 6 | Viewed by 2497

Abstract

The retina is a window to the human body. Oculomics is the study of the correlations between ophthalmic biomarkers and systemic health or disease states. Deep learning (DL) is currently the cutting-edge machine learning technique for medical image analysis, and in recent years, DL techniques have been applied to analyze retinal images in oculomics studies. In this review, we summarized oculomics studies that used DL models to analyze retinal images—most of the published studies to date involved color fundus photographs, while others focused on optical coherence tomography images. These studies showed that some systemic variables, such as age, sex and cardiovascular disease events, could be consistently robustly predicted, while other variables, such as thyroid function and blood cell count, could not be. DL-based oculomics has demonstrated fascinating, “super-human” predictive capabilities in certain contexts, but it remains to be seen how these models will be incorporated into clinical care and whether management decisions influenced by these models will lead to improved clinical outcomes. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

Other

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5 pages, 1242 KiB

Open AccessCase Report

Bilateral Branch Retinal Vein Occlusion after mRNA-SARS-CoV-2 Booster Dose Vaccination

by Matteo Gironi, Rossella D’Aloisio, Tommaso Verdina, Benjamin Shkurko, Lisa Toto and Rodolfo Mastropasqua

J. Clin. Med. 2023, 12(4), 1325; https://doi.org/10.3390/jcm12041325 - 07 Feb 2023

Cited by 4 | Viewed by 1277

Abstract

Purpose: We report a case of a patient with a bilateral branch retinal vein occlusion (BRVO) 24 h after a booster vaccination with the mRNA-1237 vaccine. Observations: Fluorescein angiography, performed at three weeks follow-up, showed vascular leakage and blockage, corresponding to hemorrhage areas associated with ischemic areas in the macula and along the arcades involved in the occlusion. Conclusions: The patient was scheduled for urgent injections of intravitreal ranibizumab and laser photocoagulation of the ischemic areas. To the best of our knowledge, this is the first case described of concomitant bilateral RVO after COVID-19 vaccination. The rapid onset of the side effects in a patient with multiple risk factors for thrombotic events suggests that vulnerable microvascular conditions require detailed investigations before administration of a COVID-19 vaccine. Full article

(This article belongs to the Special Issue Application of Retinal and Optic Nerve Imaging in Clinical Medicine 2.0)

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