Implementation of optical coherence tomography in retinopathy of prematurity screening.

Purpose Of Review: In this review, we explore the investigational applications of optical coherence tomography (OCT) in retinopathy of prematurity (ROP), the insights they have delivered thus far, and key milestones for its integration into the standard of care.

Recent Findings: While OCT has been widely integrated into clinical management of common retinal diseases, its use in pediatric contexts has been undermined by limitations in ergonomics, image acquisition time, and field of view. Recently, investigational handheld OCT devices have been reported with advancements including ultra-widefield view, noncontact use, and high-speed image capture permitting real-time en face visualization.

Assessing the Impact of Image Quality on Deep Learning Classification of Infectious Keratitis.

Objective: To investigate the impact of corneal photograph quality on convolutional neural network (CNN) predictions.

Design: A CNN trained to classify bacterial and fungal keratitis was evaluated using photographs of ulcers labeled according to 5 corneal image quality parameters: eccentric gaze direction, abnormal eyelid position, over/under-exposure, inadequate focus, and malpositioned light reflection.

Participants: All eligible subjects with culture and stain-proven bacterial and/or fungal ulcers presenting to Aravind Eye Hospital in Madurai, India, between January 1, 2021 and December 31, 2021.

Improved Training Efficiency for Retinopathy of Prematurity Deep Learning Models Using Comparison versus Class Labels.

Purpose: To compare the efficacy and efficiency of training neural networks for medical image classification using comparison labels indicating relative disease severity versus diagnostic class labels from a retinopathy of prematurity (ROP) image dataset.

Design: Evaluation of diagnostic test or technology.

Participants: Deep learning neural networks trained on expert-labeled wide-angle retinal images obtained from patients undergoing diagnostic ROP examinations obtained as part of the Imaging and Informatics in ROP (i-ROP) cohort study.

Federated Learning for Multicenter Collaboration in Ophthalmology: Implications for Clinical Diagnosis and Disease Epidemiology.

Objective: To utilize a deep learning (DL) model trained via federated learning (FL), a method of collaborative training without sharing patient data, to delineate institutional differences in clinician diagnostic paradigms and disease epidemiology in retinopathy of prematurity (ROP).

Design: Evaluation of a diagnostic test or technology.

Subjects And Controls: We included 5245 patients with wide-angle retinal imaging from the neonatal intensive care units of 7 institutions as part of the Imaging and Informatics in ROP study.

Federated Learning for Multicenter Collaboration in Ophthalmology: Improving Classification Performance in Retinopathy of Prematurity.

Objective: To compare the performance of deep learning classifiers for the diagnosis of plus disease in retinopathy of prematurity (ROP) trained using 2 methods for developing models on multi-institutional data sets: centralizing data versus federated learning (FL) in which no data leave each institution.

Design: Evaluation of a diagnostic test or technology.

Subjects: Deep learning models were trained, validated, and tested on 5255 wide-angle retinal images in the neonatal intensive care units of 7 institutions as part of the Imaging and Informatics in ROP study.

Prevalence of persistent avascular retina in untreated children with a history of retinopathy of prematurity screening.

Persistent avascular retina (PAR) in prematurely born individuals may be a risk factor for late sequelae of retinopathy of prematurity (ROP), including retinal detachment in older childhood and adulthood. Although PAR has been associated with use of vascular endothelial growth factor antagonist therapy for treatment-requiring ROP, the prevalence of this finding in patients without prior ROP treatment is unknown. We performed a cross-sectional study to determine the prevalence of PAR in a cohort of patients 4-8 years of age who were screened for ROP in the neonatal intensive care unit and did not receive treatment.

Tauroursodeoxycholic Acid Protects Retinal and Visual Function in a Mouse Model of Type 1 Diabetes.

Purpose: Previous studies demonstrated that systemic treatment with tauroursodeoxycholic acid (TUDCA) is protective in in vivo mouse models of retinal degeneration and in culture models of hyperglycemia. This study tested the hypothesis that TUDCA will preserve visual and retinal function in a mouse model of early diabetic retinopathy (DR).

Methods: Adult C57BL/6J mice were treated with streptozotocin (STZ) and made diabetic at 8-10 weeks of age.

Applications of interpretability in deep learning models for ophthalmology.

Purpose Of Review: In this article, we introduce the concept of model interpretability, review its applications in deep learning models for clinical ophthalmology, and discuss its role in the integration of artificial intelligence in healthcare.

Recent Findings: The advent of deep learning in medicine has introduced models with remarkable accuracy. However, the inherent complexity of these models undermines its users' ability to understand, debug and ultimately trust them in clinical practice.

Pentosan polysulfate maculopathy.

Pentosan polysulfate sodium (PPS), a semisynthetic sulfated polysaccharide, is the only FDA-approved oral therapy for interstitial cystitis. Recent studies have described a progressive, vision-threatening macular condition associated with long-term PPS use. We reviewed all publications concerning PPS maculopathy to consolidate known clinical features and to evaluate the strength of this association.

PROLIFERATIVE RETINOPATHY IN A 13-YEAR-OLD WITH ADAMS-OLIVER SYNDROME.

Purpose: Adams-Oliver syndrome is a rare, inherited disorder of embryologic development that affects multiple systems. Ocular manifestations have been poorly characterized because of the low prevalence and high mortality of the disease when it is associated with internal organ and/or ophthalmic manifestations. We present a case of Adams-Oliver syndrome in a 13-year-old patient whose multimodal retinal imaging findings helped direct management.

Pentosan Polysulfate Maculopathy versus Inherited Macular Dystrophies: Comparative Assessment with Multimodal Imaging.

Purpose: To evaluate whether pentosan polysulfate (PPS) maculopathy manifests distinctive characteristics that permit differentiation from hereditary maculopathies with multimodal fundus imaging.

Design: Retrospective review.

Participants: Emory Eye Center databases were queried for the following International Classification of Diseases codes from May 20, 2014, through October 22, 2019: 362.

Phenotypic Spectrum of Pentosan Polysulfate Sodium-Associated Maculopathy: A Multicenter Study.

Importance: A unique pigmentary maculopathy was recently described in 6 patients with long-term exposure to pentosan polysulfate sodium (PPS), a long-standing oral therapy for interstitial cystitis.

Objective: To characterize the exposure characteristics and clinical manifestations of PPS-associated maculopathy.

Design, Setting, And Participants: In this multi-institutional case series, medical records of patients who exhibited the characteristic maculopathy in the setting of prior PPS exposure were retrospectively reviewed.

Late-Stage Sorsby Fundus Dystrophy Manifesting Severe Vision Loss in the Absence of Choroidal Neovascularization.

A patient with a family history of molecularly confirmed Sorsby fundus dystrophy (SFD) presented with 9 years of progressive, bilateral central vision loss. Specific mutation analysis of the TIMP3 gene confirmed SFD, identifying a pathogenic mutation of p.Ser204Cys:c.

Early Onset Neovascular Inflammatory Vitreoretinopathy Due to a Mutation: Report of a Case.

Autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV) is a rare autoimmune condition that typically presents as progressive uveitis and vitreoretinal degeneration between the second and third decades of life. Though traditionally attributed to inherited mutations of the CAPN5 gene, few reports of de novo variants exist. This report of vision and hearing loss in a 3 year-old girl describes the youngest documented case of ADNIV due to a de novo pathogenic c.

Use of percutaneous bleomycin sclerotherapy for orbital lymphatic malformations.

Purpose: Bleomycin sclerotherapy has been shown to be a viable treatment for lymphatic malformations. However, its use for these lesions confined to the orbit is becoming increasingly documented in the literature. In this study, we summarize the clinical manifestations and outcomes observed following percutaneous bleomycin sclerotherapy for orbital lymphatic malformation.

TrkB signalling pathway mediates the protective effects of exercise in the diabetic rat retina.

Diabetic retinopathy is a leading cause of vision loss. Treatment options for early retinopathy are sparse. Exercise protects dying photoreceptors in models of retinal degeneration, thereby preserving vision.

The RNA-binding protein, ZC3H14, is required for proper poly(A) tail length control, expression of synaptic proteins, and brain function in mice.

A number of mutations in genes that encode ubiquitously expressed RNA-binding proteins cause tissue specific disease. Many of these diseases are neurological in nature revealing critical roles for this class of proteins in the brain. We recently identified mutations in a gene that encodes a ubiquitously expressed polyadenosine RNA-binding protein, ZC3H14 (Zinc finger CysCysCysHis domain-containing protein 14), that cause a nonsyndromic, autosomal recessive form of intellectual disability.

Whole-eye electrical stimulation therapy preserves visual function and structure in P23H-1 rats.

Low-level electrical stimulation to the eye has been shown to be neuroprotective against retinal degeneration in both human and animal subjects, using approaches such as subretinal implants and transcorneal electrical stimulation. In this study, we investigated the benefits of whole-eye electrical stimulation (WES) in a rodent model of retinitis pigmentosa. Transgenic rats with a P23H-1 rhodopsin mutation were treated with 30 min of low-level electrical stimulation (4 μA at 5 Hz; n = 10) or sham stimulation (Sham group; n = 15), twice per week, from 4 to 24 weeks of age.

Neuroprotective Effects of Voluntary Exercise in an Inherited Retinal Degeneration Mouse Model.

Purpose: Our previous investigations showed that involuntary treadmill exercise is neuroprotective in a light-induced retinal degeneration mouse model, and it may act through activation of tropomyosin-related kinase B (TrkB) receptors. This study investigated whether voluntary running wheel exercise can be neuroprotective in an inheritable model of the retinal degenerative disease retinitis pigmentosa (RP), rd10 mice.

Methods: Breeding pairs of rd10 and C57BL/6J mice were given free-spinning (active) or locked (inactive) running wheels.