糖尿病性黄斑水肿红色与绿色图像中囊肿的比较
Comparison of Cysts in Red and Green Images for Diabetic Macular Edema.
作者信息
Alhamami Mastour A, Elsner Ann E, Malinovsky Victor E, Clark Christopher A, Haggerty Bryan P, Ozawa Glen Y, Cuadros Jorge A, Baskaran Karthikeyan, Gast Thomas J, Litvin Taras V, Muller Matthew S, Brahm Shane G, Young Stuart B, Miura Masahiro
机构信息
*MS, PhD †PhD, FAAO ‡OD, FAAO §OD, PhD ∥AA **OD ††OD, PhD, FAAO ‡‡PhD §§MD, PhD ∥∥MS, MBA Indiana University School of Optometry, Bloomington, Indiana (MAA, VEM, AEE, BPH, KB, TJG, SGB, SBY); University of California, Berkeley School of Optometry, Berkeley, California (TVL, GYO, JAC); Aeon Imaging, LLC, Bloomington, Indiana (MSM, AEE, TJG); EyePACS, LLC, San Jose, California (JAC); and Department of Ophthalmology, Tokyo Medical University Ibaraki Medical Center, Inashiki, Ibaraki, Japan (MM).
出版信息
Optom Vis Sci. 2017 Feb;94(2):137-149. doi: 10.1097/OPX.0000000000001010.
PURPOSE
To investigate whether cysts in diabetic macular edema are better visualized in the red channel of color fundus camera images, as compared with the green channel, because color fundus camera screening methods that emphasize short-wavelength light may miss cysts in patients with dark fundi or changes to outer blood retinal barrier.
METHODS
Fundus images for diabetic retinopathy photoscreening were acquired for a study with Aeon Imaging, EyePACS, University of California Berkeley, and Indiana University. There were 2047 underserved, adult diabetic patients, of whom over 90% self-identified as a racial/ethnic identify other than non-Hispanic white. Color fundus images at nominally 45 degrees were acquired with a Canon Cr-DGi non-mydriatic camera (Tokyo, Japan) then graded by an EyePACS certified grader. From the 148 patients graded to have clinically significant macular edema by the presence of hard exudates in the central 1500 μm of the fovea, we evaluated macular cysts in 13 patients with cystoid macular edema. Age ranged from 33 to 68 years. Color fundus images were split into red, green, and blue channels with custom Matlab software (Mathworks, Natick, MA). The diameter of a cyst or confluent cysts was quantified in the red-channel and green-channel images separately.
RESULTS
Cyst identification gave complete agreement between red-channel images and the standard full-color images. This was not the case for green-channel images, which did not expose cysts visible with standard full-color images in five cases, who had dark fundi. Cysts appeared more numerous and covered a larger area in the red channel (733 ± 604 μm) than in the green channel (349 ± 433 μm, P < .006).
CONCLUSIONS
Cysts may be underdetected with the present fundus camera methods, particularly when short-wavelength light is emphasized or in patients with dark fundi. Longer wavelength techniques may improve the detection of cysts and provide more information concerning the early stages of diabetic macular edema or the outer blood retinal barrier.
目的
研究糖尿病性黄斑水肿中的囊肿在彩色眼底相机图像的红色通道中是否比绿色通道中显示得更好，因为强调短波长光的彩色眼底相机筛查方法可能会遗漏眼底较暗或外层血视网膜屏障发生变化的患者中的囊肿。
方法
与Aeon Imaging、EyePACS、加利福尼亚大学伯克利分校和印第安纳大学合作开展一项研究，获取用于糖尿病视网膜病变照片筛查的眼底图像。共有2047名未得到充分服务的成年糖尿病患者，其中超过90%自我认定为非西班牙裔白人以外的种族/族裔。使用佳能Cr-DGi免散瞳相机（日本东京）采集标称45度的彩色眼底图像，然后由EyePACS认证的分级人员进行分级。在148例因黄斑中心凹1500μm范围内存在硬性渗出而被分级为具有临床显著性黄斑水肿的患者中，我们评估了其中13例患有黄斑囊样水肿患者的黄斑囊肿。年龄范围为33至68岁。使用定制的Matlab软件（Mathworks，马萨诸塞州纳蒂克）将彩色眼底图像分离为红色、绿色和蓝色通道。分别在红色通道和绿色通道图像中对囊肿或融合囊肿的直径进行量化。
结果
囊肿识别在红色通道图像和标准全彩色图像之间完全一致。绿色通道图像则不然，在5例眼底较暗患者中，绿色通道图像未显示出标准全彩色图像中可见的囊肿。囊肿在红色通道（733±604μm）中比在绿色通道（349±433μm，P<.006）中显得更多且覆盖面积更大。
结论
使用目前的眼底相机方法可能会漏检囊肿，尤其是在强调短波长光时或在眼底较暗的患者中。较长波长技术可能会改善囊肿的检测，并提供更多关于糖尿病性黄斑水肿早期阶段或外层血视网膜屏障的信息。
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