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Disorganization of Retinal Inner Layers (DRIL) and Neuroretinal Dysfunction in Early Diabetic Retinopathy
摘要： To elucidate the relationship between disorganization of retinal inner layers (DRILs) and retinal function in diabetic patients without diabetic retinopathy (DR) and with nonproliferative DR, but without diabetic macular edema (DME). Fifty-seven participants with diabetes mellitus (DM) and 18 healthy controls underwent comprehensive ophthalmic examination, fundus photography, and spectral-domain optical coherence tomography. Scans of the fovea were evaluated for the presence of DRIL. Retinal function was evaluated using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, the quick contrast sensitivity function (qCSF) on the AST Sentio Platform, short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), and frequency doubling perimetry (FDP). ANOVA and Kruskal-Wallis were used to compare retinal function in subjects with and without DRIL. Tukey-Kramer test and Wilcoxon were used for post hoc analysis. DRIL was identi?ed in 9 of 57 diabetic subjects. DRIL subjects had higher body mass index and longer diabetes duration compared to diabetic subjects without DRIL (P ? 0.03 and P ? 0.009, respectively). Subjects with DRIL had reduced ETDRS visual acuity (P ? 0.003), contrast sensitivity function (P ? 0.0003), and SAP performance (PSD, P < 0.0001) compared to controls and diabetic subjects without DRIL. Structural analysis revealed inner retinal thinning, and some outer retinal thinning, associated with DRIL. Diabetic subjects with DRIL have reduced retinal function compared to those without DRIL, and defective retinal lamination may be an early cellular consequence of diabetes responsible for this in some patients. Following further longitudinal studies, DRIL may be a readily available and reliable structural biomarker for reduced retinal function in early diabetic neuroretinal disease.
关键词： perimetry,diabetic retinopathy,contrast sensitivity,DRIL,OCT
更新于2025-09-23 15:21:01
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Automatic detection of diabetic retinopathy and its progression in sequential fundus images of patients with diabetes
摘要： Regular screening by fundus images is known to be effective in detecting the early signs of diabetic retinopathy (DR). Early detection and timely treatment of DR are crucial to prevent the development of sight-threatening DR and visual loss. Due to global increase in the prevalence of diabetes from the current 425 million to 629 million in 2045, also the number of people with DR are estimated to triple from 2005 to 2050. Thus, the workload required for screening for DR will increase tremendously. Novel technological solutions and interventions might fortunately ease this challenging task in the future. We have developed an algorithm to detect early DR and its progression in the chronological follow-up fundus images to minimize the time-consuming evaluation of the images by a trained nurse or an ophthalmologist.
关键词： progression,diabetic retinopathy,fundus images,automatic detection,diabetes
更新于2025-09-23 15:21:01
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Subthreshold yellow micropulse laser for treatment of diabetic macular edema: Comparison between fixed and variable treatment regimen
摘要： Purpose: To compare the efficacy between fixed and variable treatment regimens of subthreshold yellow micropulse laser for the treatment of diabetic macular edema. Methods: This is a retrospective, comparative, 12-month study of 39 eyes: 24 eyes received fixed treatment regimen of subthreshold micropulse laser treatment and 15 eyes underwent variable treatment regimen of subthreshold micropulse laser, all eyes were followed up for 12 months. Subthreshold micropulse laser was performed with the following parameters: 100 μm spot size on slit lamp, 5% duty cycle of 0.2 s, and 250 mW power. To choose the power of the variable treatment regimen of subthreshold micropulse laser group, continuous laser power was titrated to a barely visible burn and then switched to MicroPulse mode, multiplying the test burn power by 4 and using a 5% duty cycle of 0.2 s. Main outcomes included changes in central macular thickness and best-corrected visual acuity. Results: At baseline, the mean LogMAR best-corrected visual acuity was 0.297 ± 0.431 in the variable treatment regimen of subthreshold micropulse laser group and 0.228 ± 0.341 in the fixed treatment regimen of subthreshold micropulse laser group. At the end of follow-up, the mean LogMAR best-corrected visual acuity was 0.289 ± 0.473 (p = 0.785) and 0.245 ± 0.376 (p = 0.480) in the variable and fixed treatment regimens of subthreshold micropulse laser groups, respectively. Similarly, central macular thickness decreased in both groups after treatment; at baseline, the mean central macular thickness was 371.06 ± 37.8 in the variable treatment regimen of subthreshold micropulse laser group and improved to 325.60 ± 110.0 μm (p = 0.025) at the end of the follow-ups, while it was 342.30 ± 35.4 in the fixed treatment regimen of subthreshold micropulse laser group and improved to 308.51 ± 67.5 (p = 0.037). Conclusion: Both treatment regimens are effective for the treatment of mild center-involving diabetic macular edema: fixed treatment appears more suitable minimizing treatment time and reducing the possible errors due to wrong titration in the switch from continuous to micropulse mode.
关键词： Diabetic retinopathy,retina,diabetic macular edema,cystoid macular edema (CME),retina—medical therapies,retinal pathology/research
更新于2025-09-23 15:19:57
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[IEEE 2018 International Conference on Soft-computing and Network Security (ICSNS) - Coimbatore, India (2018.2.14-2018.2.16)] 2018 International Conference on Soft-computing and Network Security (ICSNS) - A Survey for Diabetic Retinopathy
摘要： Diabetic retinopathy has ended up a exceptionally common eye illness which causes visual deficiency among individuals. This Study on diabetic retinopathy makes a great examination of how diverse strategy is they to identify. It may offer assistance to identify the malady as early as conceivable and allow them a conceivable treatment. Identifying the exudates in early organize can avoid a vision misfortune. Retinal blood vessel are recognized and utilized for them to detect. Due to the growing prevalence of metabolic disorders, ask for diabetic retinopathy (DR) screening stages is steeply growing. Early location and treatment of DR are key open wellbeing mediations that can significantly decrease the probability of vision misfortune. Current DR screening programs regularly utilize retinal fundus photography, which depends on gifted perusers for manual DR appraisal. Be that as it may, this is labor- intensive and endures from irregularity over destinations. Subsequently, there has been a later multiplication of robotized retinal picture investigation computer program that may potential
关键词： retina,Diabetic retinopathy,exudates,Image Segmentation
更新于2025-09-23 15:19:57
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The Effects of Diabetic Retinopathy Stage and Light Flicker on Inner Retinal Oxygen Extraction Fraction
摘要： PURPOSE. We determined the effects of light ?icker and diabetic retinopathy (DR) stage on retinal vascular diameter (D), oxygen saturation (SO2), and inner retinal oxygen extraction fraction (OEF). METHODS. Subjects were categorized as nondiabetic control (NC, n ? 42), diabetic with no clinical DR (NDR; n ? 32), nonproliferative DR (NPDR; n ? 42), or proliferative DR (PDR; n ? 14). Our customized optical imaging system simultaneously measured arterial and venous D (DA, DV) and SO2 (SO2A, SO2V) before and during light ?icker. Inner retinal OEF was derived from SO2 values. Light ?icker–induced ratios of metrics (DAR, DVR, SO2AR, SO2VR, OEFR) were calculated. RESULTS. Arterial D was larger in NPDR compared to NC (P ? 0.01) and PDR (P ? 0.002), whereas DV was similar among groups (P ? 0.16). Light ?icker increased DA and DV (P (cid:2) 0.004), but DAR and DVR were similar among groups (P ? 0.09). Arterial SO2 was higher in all groups compared to NC (P (cid:2) 0.02) and higher in PDR compared to NDR and NPDR (P<0.001). Arterial SO2 did not change with light ?icker (P ? 0.1). Venous SO2 was higher in NPDR and PDR compared to NC and NDR (P (cid:2) 0.02). Light ?icker increased SO2V in NC, NDR, and PDR (P (cid:2) 0.003), and SO2VR was lower in NPDR compared to NC and NDR (P (cid:2) 0.05). Inner retinal OEF was lower in NPDR compared to NDR and PDR (P (cid:2) 0.02). Light ?icker decreased OEF (P (cid:2) 0.03), but OEFR was greater in NPDR compared to NC and NDR (P (cid:2) 0.03). CONCLUSIONS. The ?ndings of alterations in retinal D, SO2, OEF, and their light ?icker–induced responses at stages of DR may be useful to elucidate the pathophysiology of DR.
关键词： light ?icker stimulation,inner retinal oxygen extraction fraction,diabetic retinopathy,retina
更新于2025-09-23 15:19:57
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Severity analysis of diabetic retinopathy in retinal images using hybrid structure descriptor and modified CNNs
摘要： Imaging which plays a central role in the diagnosis and treatment planning of diabetic retinopathy and severity is an important diagnostic indicator in treatment planning and results assessment. Retinal image classification is an increasing attention among researchers in the field of computer vision, as it plays an important role in disease diagnosis. Computer Aided Diagnosis (CAD) is in wide practice in clinical work for the location and anticipation of different kinds of variations; the automated image classification systems used for such applications must be significantly efficient in terms of accuracy since false detection may lead to fatal results. Another requirement is the high convergence rate which accounts for the practical feasibility of the system. The overall classification accuracy of the proposed HTF with MCNNs is 98.41%, but the existing methods HTF with SVM and HTF with CNNs produce 97.84% and 96.65% respectively.
关键词： Segmentation,SVM,Medical image processing,Microaneurysms,Diabetic retinopathy,Classification
更新于2025-09-23 15:19:57
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Do microvascular changes occur preceding neural impairment in early-stage diabetic retinopathy? Evidence based on the optic nerve head using optical coherence tomography angiography
摘要： Aims To evaluate the microvascular and neural differences of the optic nerve head (ONH) between type 2 diabetes mellitus (T2DM) subjects and controls. Methods This was a cross-sectional observational study. One hundred and eight eyes of 108 T2DM subjects with or without diabetic retinopathy (DR) (54 preclinical DR and 54 mild-to-moderate DR) were included. Fifty-two eyes of 52 healthy subjects were included as controls. The 4.5-mm Angio Disc scan mode and the ganglion cell complex scan mode were performed with all participants using AngioVue software 2.0 of the optical coherence tomography angiography (OCTA) device. Results Regarding ONH radial peripapillary capillary (RPC) density, the peripapillary region was mainly significantly reduced in the No-DR (NDR) group. Moreover, the RPC density of the peripapillary region and the inside optic disc area were significantly reduced in the non-proliferative DR (NPDR) group. When compared to the controls, significantly reduced peripapillary capillary density in six sections was observed in the NPDR group. However, reduced density was observed in only two sections in the NDR group. The NPDR group had significantly increased focal loss volume (FLV) and reduced peripapillary RNFL thickness in the inferior nasal section compared to those in the controls, but similar changes were not observed in the NDR group. A regression model identified RPCs inside the optic disc as a significant parameter in early-stage DR detection. In the NPDR group, BCVA showed a significantly negative correlation with RPCs inside the optic disc and a significantly positive correlation with FLV. Conclusions OCTA findings of the ONH area may provide evidence that microvascular changes occur preceding neural impairment in early-stage DR. However, further researches are still needed to support the statement. Reduced ONH perfusion inside the optic disc may be one of the crucial biomarkers in early-stage DR detection and is a possible sensitive visual acuity predictor in early-stage DR subjects. With the ONH mode, OCTA may be a more promising tool in DR screening.
关键词： Neural impairment,Optical coherence tomography angiography,Optic nerve head,Microvascular changes,Diabetic retinopathy
更新于2025-09-19 17:15:36
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Exudates Detection Using Morphology Mean Shift Algorithm in Retinal Images
摘要： Exudates is a serious complication causing blindness in diabetic retinopathy (DR) patients. The main objective of this study is to develop a novel method to detect exudates lesions in color retinal images by using a morphology mean shift algorithm (MMSA). The proposed methods start with a normalization of the retinal image, contrast enhancement, noise removal, and the localization of the OD. Then, a coarse segmentation method by using mean shift provides a set of exudates and non-exudates candidates. Finally, a classification using the mathematical morphology algorithm (MMA) procedure is applied, in order to keep only exudates pixels. The optimal value parameters of the MMA will facilitate an increase of the accuracy results from solely MSA method by 13.10%. Based on a comparison between the results and ground truth images, the proposed method obtained an average sensitivity, specificity, and accuracy for of detecting exudates as 98.40%, 98.13%, and 98.35%, respectively.
关键词： retinal image,mathematical morphology,mean shift algorithm,Diabetic retinopathy,exudates
更新于2025-09-19 17:15:36
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A predictive screening tool to detect diabetic retinopathy or macular edema in primary health care: construction, validation and implementation on a mobile application
摘要： The most described techniques used to detect diabetic retinopathy and diabetic macular edema have to be interpreted correctly, such that a person not specialized in ophthalmology, as is usually the case of a primary care physician, may experience difficulties with their interpretation; therefore we constructed, validated and implemented as a mobile app a new tool to detect diabetic retinopathy or diabetic macular edema (DRDME) using simple objective variables. We undertook a cross-sectional, observational study of a sample of 142 eyes from Spanish diabetic patients suspected of having DRDME in 2012–2013. Our outcome was DRDME and the secondary variables were: type of diabetes, gender, age, glycated hemoglobin (HbA1c), foveal thickness and visual acuity (best corrected). The sample was divided into two parts: 80% to construct the tool and 20% to validate it. A binary logistic regression model was used to predict DRDME. The resulting model was transformed into a scoring system. The area under the ROC curve (AUC) was calculated and risk groups established. The tool was validated by calculating the AUC and comparing expected events with observed events. The construction sample (n = 106) had 35 DRDME (95% CI [24.1–42.0]), and the validation sample (n = 36) had 12 DRDME (95% CI [17.9–48.7]). Factors associated with DRDME were: HbA1c (per 1%) (OR = 1.36, 95% CI [0.93–1.98], p = 0.113), foveal thickness (per 1 μm) (OR = 1.03, 95% CI [1.01–1.04], p < 0.001) and visual acuity (per unit) (OR = 0.14, 95% CI [0.00–0.16], p < 0.001). AUC for the validation: 0.90 (95% CI [0.75–1.00], p < 0.001). No significant differences were found between the expected and the observed outcomes (p = 0.422). In conclusion, we constructed and validated a simple rapid tool to determine whether a diabetic patient suspected of having DRDME really has it. This tool has been implemented on a mobile app. Further validation studies are required in the general diabetic population.
关键词： Diabetes mellitus,Macular edema,Diagnostic tests,Statistical models,Diabetic retinopathy,Optical coherence tomography
更新于2025-09-19 17:15:36
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Inhibitor of growth 4 affects hypoxia-induced migration and angiogenesis regulation in retinal pigment epithelial cells
摘要： Inhibitor of growth 4 (ING4), a potential tumor suppressor, is implicated in cell migration and angiogenesis. However, its effects on diabetic retinopathy (DR) have not been elucidated. In this study, we aimed to evaluate ING4 expression in normal and diabetic rats and clarify its effects on hypoxia‐induced dysfunction in human retinal pigment epithelial (ARPE‐19) cells. A Type 1 diabetic model was generated by injecting rats intraperitoneally with streptozotocin and then killed them 4, 8, or 12 weeks later. ING4 expression in retinal tissue was detected using western blot analysis, reverse transcription quantitative real‐time polymerase chain reaction (RT‐qPCR), and immunohistochemistry assays. After transfection with an ING4 overexpression lentiviral vector or small interfering RNA (siRNA), ARPE‐19 migration under hypoxia was tested using wound healing and transwell assays. The angiogenic effect of conditioned medium (CM) from ARPE‐19 cells was examined by assessing human retinal endothelial cell (HREC) capillary tube formation. Additionally, western blot analysis and RT‐qPCR were performed to investigate the signaling pathways in which ING4, specificity protein 1 (Sp1), matrix metalloproteinase 2 (MMP‐2), MMP‐9, and vascular endothelial growth factor A (VEGF‐A) were involved. Here, we found that ING4 expression was significantly reduced in the diabetic rats’ retinal tissue. Silencing ING4 aggravated hypoxia‐induced ARPE‐19 cell migration. CM collected from ING4 siRNA‐transfected ARPE‐19 cells under hypoxia promoted HREC angiogenesis. These effects were reversed by ING4 overexpression. Furthermore, ING4 suppressed MMP‐2, MMP‐9, and VEGF‐A expression in an Sp1‐dependent manner in hypoxia‐conditioned ARPE‐19 cells. Overall, our results provide valuable mechanistic insights into the protective effects of ING4 on hypoxia‐induced migration and angiogenesis regulation in ARPE‐19 cells. Restoring ING4 may be a novel strategy for treating DR.
关键词： migration,angiogenesis,diabetic retinopathy,retinal pigment epithelium cells,hypoxia,inhibitor of growth 4
更新于2025-09-19 17:15:36