Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Laboratory for Ophthalmic Image Analysis (OPTIMA), Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Sci Rep. 2024 Aug 20;14(1):19278. doi: 10.1038/s41598-024-70234-8.
To investigate quantitative associations between AI-assessed disease activity and optical coherence tomography angiography (OCTA)-derived parameters in patients with neovascular age-related macular degeneration (nAMD) undergoing anti-VEGF therapy. OCTA and SD-OCT images obtained from multicenter, randomized study data were evaluated. A deep learning algorithm (RetInSight) was used to detect and quantify macular fluid on SD-OCT. Mixed effects models were applied to evaluate correlations between fluid volumes, macular neovascularization (MNV)-type and OCTA-derived MNV parameters; lesion size (LS) and vessel area (NVA). 230 patients were included. A significant positive correlation was observed between SRF and NVA (estimate = 199.8 nl/mm, p = 0.023), while a non-significant but negative correlation was found between SRF and LS (estimate = - 71.3 nl/mm, p = 0.126). The presence of Type I and Type II MNV was associated with significantly less intraretinal fluid (IRF) compared to Type III MNV (estimate type I:- 52.1 nl, p = 0.019; estimate type II:- 51.7 nl, p = 0.021). A significant correlation was observed between pigment epithelial detachment (PED) and the interaction between NVA and LS (estimate:28.97 nl/mm; p = 0.012). Residual IRF at week 12 significantly correlated to baseline NVA (estimate:38.1 nl/mm; p = 0.015) and LS (estimate:- 22.6 nl/mm; p = 0.012). Fluid in different compartments demonstrated disparate associations with MNV OCTA features. While IRF at baseline was most pronounced in type III MNV, residual IRF was driven by neovascular MNV characteristics. Greater NVA in proportion to LS was associated with higher amounts of SRF and PED. The correlation between these parameters may represent MNV maturation and can be used as a biomarker for resolution of disease activity. AI-based OCT analysis allows for a deeper understanding of neovascular disease in AMD and the potential to adjust therapeutic strategies to optimize outcomes through precision medicine.
为了研究接受抗血管内皮生长因子治疗的新生血管性年龄相关性黄斑变性（nAMD）患者中，人工智能评估的疾病活动与光学相干断层扫描血管造影（OCTA）衍生参数之间的定量关联。评估了来自多中心、随机研究数据的 OCTA 和 SD-OCT 图像。使用深度学习算法（RetInSight）检测和量化 SD-OCT 上的黄斑积液。应用混合效应模型评估积液量、黄斑新生血管（MNV）-类型和 OCTA 衍生的 MNV 参数（病变大小（LS）和血管面积（NVA）之间的相关性。纳入 230 例患者。观察到 SRF 与 NVA 之间存在显著正相关（估计值=199.8 nl/mm，p=0.023），而 SRF 与 LS 之间存在非显著但负相关（估计值=-71.3 nl/mm，p=0.126）。与 III 型 MNV 相比，I 型和 II 型 MNV 的存在与明显较少的视网膜内液（IRF）相关（估计值 I 型：-52.1 nl，p=0.019；估计值 II 型：-51.7 nl，p=0.021）。观察到色素上皮脱离（PED）与 NVA 和 LS 之间的相互作用之间存在显著相关性（估计值：28.97 nl/mm；p=0.012）。第 12 周时残留的 IRF 与基线时的 NVA（估计值：38.1 nl/mm；p=0.015）和 LS（估计值：-22.6 nl/mm；p=0.012）显著相关。不同部位的积液与 MNV OCTA 特征存在不同的关联。虽然基线时的 IRF 在 III 型 MNV 中最为明显，但残留的 IRF 由新生血管性 MNV 特征驱动。NVA 与 LS 的比例越大，SRF 和 PED 越高。这些参数之间的相关性可能代表 MNV 的成熟度，并可作为疾病活动消退的生物标志物。基于人工智能的 OCT 分析可以更深入地了解 AMD 中的新生血管疾病，并有可能通过精准医学调整治疗策略以优化结果。
