Introduction We studied the correlation of central macular fluid volume (CMFV) and central subfield thickness (CST) with best-corrected visual acuity (BCVA) in treatment-naïve eyes with diabetic macular edema (DME) 1 month after anti-vascular endothelial growth factor (VEGF) therapy. Methods This retrospective cohort study investigated eyes that received anti-VEGF therapy. All participants underwent comprehensive examinations and optical coherence tomography (OCT) volume scans at baseline (M0) and 1 month after the first treatment (M1). Two deep learning models were separately developed to automatically measure the CMFV and the CST. Correlations were analyzed between the CMFV and the logMAR BCVA at M0 and logMAR BCVA at M1. The area under the receiver operating characteristic curve (AUROC) of CMFV and CST for predicting eyes with BCVA \(\ge\) 20/40 at M1 was analyzed. Results This study included 156 DME eyes from 89 patients. The median CMFV decreased from 0.272 (0.061–0.568) at M0 to 0.096 (0.018–0.307) mm3 at M1. The CST decreased from 414 (293–575) to 322 (252–430) μm. The logMAR BCVA decreased from 0.523 (0.301–0.817) to 0.398 (0.222–0.699). Multivariate analysis demonstrated that the CMFV was the only significant factor for logMAR BCVA at both M0 (β = 0.199, p = 0.047) and M1 (β = 0.279, p = 0.004). The AUROC of CMFV for predicting eyes with BCVA \(\ge\) 20/40 at M1 was 0.72, and the AUROC of CST was 0.69. Conclusions Anti-VEGF therapy is an effective treatment for DME. Automated measured CMFV is a more accurate prognostic factor than CST for the initial anti-VEGF treatment outcome of DME.
(1) Purpose: This study aimed to evaluate morphological changes of the retina in eyes with dissociated optic nerve fiber layer (DONFL) appearance following internal limiting membrane (ILM) peeling for full-thickness idiopathic macular hole (IMH) on spectral-domain optical coherence tomography (SD-OCT). (2) Methods: We retrospectively analyzed 39 eyes of 39 patients with type 1 macular hole closure after a vitrectomy with ILM peeling procedure at a six-month minimum postoperative follow-up. The retinal thickness maps and cross-sectional OCT images were obtained from a clinical OCT device. The cross-sectional area of the retinal nerve fiber layer (RNFL) on cross-sectional OCT images was manually measured by ImageJ software. (3) Results: The inner retinal layers (IRLs) thickness thinned down much more in the temporal quadrant than in nasal quadrants at 2 and 6 months postoperatively (p < 0.001). However, the cross-sectional area of the RNFL did not change significantly at 2 and 6 months postoperatively (p > 0.05) when compared to preoperative data. In addition, the thinning of the IRL did not correlate with the best-corrected visual acuity (BCVA) at 6 months postoperatively. (4) Conclusions: The thickness of the IRL decreased in eyes with a DONFL appearance after ILM peeling for IMH. The thickness of the IRL decreased more in the temporal retina than in the nasal retina, but the change did not affect BCVA during the 6 months after surgery.
Retinal disease is one of the primary causes of visual impairment, and early diagnosis is essential for preventing further deterioration. Nowadays, many works have explored Transformers for diagnosing diseases due to their strong visual representation capabilities. However, retinal diseases exhibit milder forms and often present with overlapping signs, which pose great difficulties for accurate multi-class classification. Therefore, we propose a new framework named Multi-Scale Patch Message Passing Swin Transformer for multi-class retinal disease classification. Specifically, we design a Patch Message Passing (PMP) module based on the Message Passing mechanism to establish global interaction for pathological semantic features and to exploit the subtle differences further between different diseases. Moreover, considering the various scale of pathological features we integrate multiple PMP modules for different patch sizes. For evaluation, we have constructed a new dataset, named OPTOS dataset, consisting of 1,033 high-resolution fundus images photographed by Optos camera and conducted comprehensive experiments to validate the efficacy of our proposed method. And the results on both the public dataset and our dataset demonstrate that our method achieves remarkable performance compared to state-of-the-art methods.