VARPA Group, Biomedical Research Institute of A Coruña (INIBIC), University of A Coruña, A Coruña, Spain; CITIC-Research Center of Information and Communication Technologies, University of A Coruña, A Coruña, Spain.
Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon), Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Zaragoza, Spain.
Artif Intell Med. 2024 Dec;158:103006. doi: 10.1016/j.artmed.2024.103006. Epub 2024 Nov 1.
The prevalence of neurodegenerative diseases (NDDs) such as Alzheimer's (AD), Parkinson's (PD), Essential tremor (ET), and Multiple Sclerosis (MS) is increasing alongside the aging population. Recent studies suggest that these disorders can be identified through retinal imaging, allowing for early detection and monitoring via Optical Coherence Tomography (OCT) scans. This study is at the forefront of research, pioneering the application of multi-view OCT and 3D information to the neurological diseases domain. Our methodology consists of two main steps. In the first one, we focus on the segmentation of the retinal nerve fiber layer (RNFL) and a class layer grouping between the ganglion cell layer and Bruch's membrane (GCL-BM) in both macular and optic disc OCT scans. These are the areas where changes in thickness serve as a potential indicator of NDDs. The second phase is to select patients based on information about the retinal layers. We explore how the integration of both views (macula and optic disc) improves each screening scenario: Healthy Controls (HC) vs. NDD, AD vs. NDD, ET vs. NDD, MS vs. NDD, PD vs. NDD, and a final multi-class approach considering all four NDDs. For the segmentation task, we obtained satisfactory results for both 2D and 3D approaches in macular segmentation, in which 3D performed better due to the inclusion of depth and cross-sectional information. As for the optic disc view, transfer learning did not improve the metrics over training from scratch, but it did provide a faster training. As for screening, 3D computational biomarkers provided better results than 2D ones, and multi-view methods were usually better than the single-view ones. Regarding separability among diseases, MS and PD were the ones that provided better results in their screening approaches, being also the most represented classes. In conclusion, our methodology has been successfully validated with an extensive experimentation of configurations, techniques and OCT views, becoming the first multi-view analysis that merges data from both macula-centered and optic disc-centered perspectives. Besides, it is also the first effort to examine key retinal layers across four major NDDs within the framework of pathological screening.
神经退行性疾病(NDDs)如阿尔茨海默病(AD)、帕金森病(PD)、特发性震颤(ET)和多发性硬化症(MS)的患病率随着人口老龄化而增加。最近的研究表明,这些疾病可以通过视网膜成像来识别,从而通过光学相干断层扫描(OCT)扫描进行早期检测和监测。本研究处于前沿领域,率先将多视图 OCT 和 3D 信息应用于神经疾病领域。我们的方法包括两个主要步骤。在第一步中,我们专注于对黄斑和视盘 OCT 扫描中的视网膜神经纤维层(RNFL)和节细胞层与 Bruch 膜之间的类层分组(GCL-BM)进行分割。这些区域中厚度的变化可能是 NDD 的潜在指标。第二步是根据视网膜层的信息选择患者。我们探索了整合两个视图(黄斑和视盘)如何改善每个筛选方案:健康对照(HC)与 NDD、AD 与 NDD、ET 与 NDD、MS 与 NDD、PD 与 NDD 以及考虑所有四个 NDD 的最终多类方法。对于分割任务,我们在黄斑分割方面获得了 2D 和 3D 方法的满意结果,3D 方法由于包含深度和横截面信息而表现更好。对于视盘视图,迁移学习并没有在从头开始训练的基础上提高指标,而是提供了更快的训练。在筛选方面,3D 计算生物标志物的结果优于 2D 生物标志物,多视图方法通常优于单视图方法。关于疾病之间的可分离性,MS 和 PD 是在其筛选方法中提供更好结果的疾病,也是最具代表性的两类疾病。总之,我们的方法已经通过广泛的配置、技术和 OCT 视图实验得到了成功验证,成为了第一个融合来自以黄斑为中心和以视盘为中心的视角的数据的多视图分析。此外,它也是首次在病理性筛选框架内检查四个主要 NDDs 之间的关键视网膜层的努力。