To evaluate the changes of choroidal vascular structures in patients after phacoemulsification surgery. A self-control study was conducted on 36 eyes of 36 patients who had uneventful phacoemulsification. Choroidal images were acquired preoperatively, 7 days (D7), 1 month (M1), and 3 months (M3) after surgery from enhanced depth imaging (EDI) optical coherence tomography (OCT) scans. Choroidal vascularity index (CVI) was used to assess vascular status of the choroid using image binarization by the Niblack method. The postoperative values of mean CVI were compared with baseline by paired t-test. Univariate and multiple linear regression analyses were performed to determine the associations between CVI and other factors. The mean age of the recruited patients was 63.1 ± 6.9 years. The mean CVI at baseline was 60.1 ± 5.5%. After surgery, the CVI significantly increased to 61.7 ± 5.3% at D7, 63.6 ± 4.4% at M1 and 64.8 ± 4.0% at M3 (p = 0.035, 0.0006, < 0.0001, respectively). Univariate and multiple regression analysis revealed a positive association between CVI and subfoveal choroidal thickness (SFCT) at pre-operation and no significant association with age, axial length (AL), intraocular pressure (IOP) and gender at all timepoints. Phacoemulsification induced increased CVI in patients diagnosed with cataract. Evaluation of the long-term change of CVI following surgery may provide valuable information for studying the relationship between phacoemulsification and disorders of the choroid.

Purpose: To generate and evaluate individualized post-therapeutic optical coherence tomography (OCT) images that could predict the short-term response of anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME) based on pre-therapeutic images using generative adversarial network (GAN). Methods: Real-world imaging data were collected at the Department of Ophthalmology, Qilu Hospital. A total of 561 pairs of pre-therapeutic and post-therapeutic OCT images of patients with DME were retrospectively included in the training set, 71 pre-therapeutic OCT images were included in the validation set, and their corresponding post-therapeutic OCT images were used to evaluate the synthetic images. A pix2pixHD method was adopted to predict post-therapeutic OCT images in DME patients that received anti-VEGF therapy. The quality and similarity of synthetic OCT images were evaluated independently by a screening experiment and an evaluation experiment. Results: The post-therapeutic OCT images generated by the GAN model based on big data were comparable to the actual images, and the response of edema resorption was also close to the ground truth. Most synthetic images (65/71) were difficult to differentiate from the actual OCT images by retinal specialists. The mean absolute error (MAE) of the central macular thickness (CMT) between the synthetic OCT images and the actual images was 24.51 ± 18.56 μm. Conclusions: The application of GAN can objectively demonstrate the individual short-term response of anti-VEGF therapy one month in advance based on OCT images with high accuracy, which could potentially help to improve treatment compliance of DME patients, identify patients who are not responding well to treatment and optimize the treatment program.