Odstrcilik Jan, Kolar Radim, Horn Folkert, Tornow Ralf-Peter
Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic.
Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.
PLoS One. 2023 May 5;18(5):e0284743. doi: 10.1371/journal.pone.0284743. eCollection 2023.
The paper presents a comparative study of the pulsatile attenuation amplitude (PAA) within the optic nerve head (ONH) at four different areas calculated from retinal video sequences and its relevance to the retinal nerve fiber layer thickness (RNFL) changes in normal subjects and patients with different stages of glaucoma. The proposed methodology utilizes processing of retinal video sequences acquired by a novel video ophthalmoscope. The PAA parameter measures the amplitude of heartbeat-modulated light attenuation in retinal tissue. Correlation analysis between PAA and RNFL is performed in vessel-free locations of the peripapillary region with the proposed evaluating patterns: 360° circular area, temporal semi-circle, nasal semi-circle. For comparison, the full ONH area is also included. Various positions and sizes of evaluating patterns in peripapillary region were tested which resulted in different outputs of correlation analysis. The results show significant correlation between PAA and RNFL thickness calculated in proposed areas. The highest correlation coefficient Rtemp = 0.557 (p<0.001) reflects the highest PAA-RNFL correspondence in the temporal semi-circular area, compared to the lowest value in the nasal semi-circular area (Rnasal = 0.332, p<0.001). Furthermore, the results indicate the most relevant approach to calculate PAA from the acquired video sequences is using a thin annulus near the ONH center. Finally, the paper shows the proposed photoplethysmographic principle based on innovative video ophthalmoscope can be used to analyze changes in retinal perfusion in peripapillary area and can be potentially used to assess progression of the RNFL deterioration.
本文呈现了一项对比研究，该研究针对从视网膜视频序列计算得出的视神经乳头（ONH）内四个不同区域的搏动性衰减幅度（PAA），及其与正常受试者和不同阶段青光眼患者视网膜神经纤维层厚度（RNFL）变化的相关性。所提出的方法利用了一种新型视频检眼镜获取的视网膜视频序列进行处理。PAA参数测量视网膜组织中心跳调制的光衰减幅度。利用所提出的评估模式，在视乳头周围区域无血管的位置进行PAA与RNFL之间的相关性分析：360°圆形区域、颞侧半圆、鼻侧半圆。为作比较，还纳入了整个ONH区域。对视乳头周围区域评估模式的不同位置和大小进行了测试，这导致相关性分析有不同的输出结果。结果表明在提出的区域计算得出的PAA与RNFL厚度之间存在显著相关性。最高相关系数Rtemp = 0.557（p<0.001）反映出颞侧半圆形区域中PAA与RNFL的对应性最高，相比之下鼻侧半圆形区域中的值最低（Rnasal = 0.332，p<0.001）。此外，结果表明从获取的视频序列计算PAA的最相关方法是使用靠近ONH中心的薄环形区域。最后，本文表明基于创新视频检眼镜提出的光电容积描记原理可用于分析视乳头周围区域视网膜灌注的变化，并有可能用于评估RNFL恶化的进展情况。
