Multitask Learning for Activity Detection in Neovascular Age-Related Macular Degeneration.

Purpose: The purpose of this study was to provide a comparison of performance and explainability of a multitask convolutional deep neuronal network to single-task networks for activity detection in neovascular age-related macular degeneration (nAMD).

Methods: From 70 patients (46 women and 24 men) who attended the University Eye Hospital Tübingen, 3762 optical coherence tomography B-scans (right eye = 2011 and left eye = 1751) were acquired with Heidelberg Spectralis, Heidelberg, Germany. B-scans were graded by a retina specialist and an ophthalmology resident, and then used to develop a multitask deep learning model to predict disease activity in neovascular age-related macular degeneration along with the presence of sub- and intraretinal fluid.

Clinical validation of saliency maps for understanding deep neural networks in ophthalmology.

Deep neural networks (DNNs) have achieved physician-level accuracy on many imaging-based medical diagnostic tasks, for example classification of retinal images in ophthalmology. However, their decision mechanisms are often considered impenetrable leading to a lack of trust by clinicians and patients. To alleviate this issue, a range of explanation methods have been proposed to expose the inner workings of DNNs leading to their decisions.

Expert-validated estimation of diagnostic uncertainty for deep neural networks in diabetic retinopathy detection.

Deep learning-based systems can achieve a diagnostic performance comparable to physicians in a variety of medical use cases including the diagnosis of diabetic retinopathy. To be useful in clinical practice, it is necessary to have well calibrated measures of the uncertainty with which these systems report their decisions. However, deep neural networks (DNNs) are being often overconfident in their predictions, and are not amenable to a straightforward probabilistic treatment.

Photodynamic therapy with double duration for circumscribed choroidal haemangioma: functional and anatomical results based on initial parameters.

Importance: Pre-treatment symptoms longer than 12 months and foveal cystoid changes are indicators for poor anatomical and functional outcome after photodynamic therapy (PDT).

Background: To evaluate the prognostic factors on the effectiveness of PDT with double duration for treatment of exudative circumscribed choroidal haemangioma.

Design: Retrospective study.

[Chronic central serous chorioretinopathy (cCSC): differential diagnosis to choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD)].

Central neurosensory detachments (NSD) with time-dependent height constitute a disease called central serous chorioretinopathy (CSC), if not arising from uveitis, choroidal neovascularisations (CNV) or leaking retinal vessels. In 10 % of these patients, CSC develops into a chronic disease with recurrent NSD, atrophy of photoreceptors and severe drop in visual acuity. This review article summarises recent progress in understanding this disease and its appearance in funduscopy, FLA, ICG, OCT, autofluorescence as well as its progress, therapy and possible development into secondary CNV.

[Spectral domain optical coherence tomography in the treatment of myopic choroidal neovascularization].

Spectral domain optical coherence tomography (SD-OCT) investigations provide additional information about the morphological characteristics of myopic choroidal neovascularization (mCNV). Reproducible measurements of intraretinal and subretinal fluid are of growing importance for an evaluation of progression. The non-invasive technique reduces the need for frequent fluorescence angiography after individual assessment.

[Morphological features of myopic choroidal neovascularization: differences to neovascular age-related macular degeneration].

Choroidal neovascularization due to pathological myopia (mCNV) differs in important characteristics from lesions seen in age-related macular degeneration (ARMD). Myopic CNV is associated with typical phenomena, such as lacquer cracks or patchy atrophy drusen or pigment epithelium detachment are rare occurrences. The dimensions of mCNV and the extent of leakage are substantially smaller.

Visualization and follow-up of acute macular neuroretinopathy with the Spectralis HRA+OCT device.

Background: Acute macular neuroretinopathy (AMNR) is a rare disease entity, the diagnosis of which is frequently complicated by the subtlety of biomicroscopic findings.

Methods: Two cases of AMNR are presented, in which the diagnosis and follow-up was enabled using the Spectralis HRA+OCT in the absence of clear biomicroscopic findings.

Results: The typical lesions were visualized by hyporeflexion during infrared imaging and faded over time.

Bevacizumab for choroidal neovascularization secondary to pathologic myopia: Is there a decline of the treatment efficacy after 2 years?

Background: The Verteporfin in Photodynamic Therapy (VIP) Study failed to prove a statistically significant benefit for myopic choroidal neovascularization (CNV) at the end of the second year. Therefore, we wanted to evaluate whether the early effects seen under anti-VEGF treatment can be maintained over longer follow-up intervals.

Methods: This consecutive case series included all patients at the Centre for Ophthalmology, Tuebingen, with a 2-year follow-up after treatment with 1.

[Clinical relevance of a new digital integration method (DIM) for the precise integration of OCT and fluorescein angiography (FLA)].

Background: We describe the establishment of a new digital integration method (DIM) for the anatomically precise and objective correlation of OCT and FLA. The aim of the study was to evaluate the clinical impact of DIM and deduce possible new knowledge in unclear angiographic findings.

Patients And Method: DIM uses a newly developed software for the integration of OCT and FLA images of the same date.

Can the risk of retinal pigment epithelium tears after bevacizumab treatment be predicted? An optical coherence tomography study.

Background: Retinal pigment epithelium (RPE) tears after bevacizumab treatment for neovascular age-related macular degeneration accompanied by a pigment epithelial detachment (PED) might be caused by stretching forces on the already weakened RPE. The purpose of this study was to evaluate whether simple measurements of optical coherence tomography (OCT) can predict the individual risk of an RPE tear in preoperative candidates.

Methods: A retrospective chart review study of 393 consecutive patients with neovascular age-related macular degeneration evaluated OCT images (Stratus-OCT Zeiss, Jena, Germany).

Retinal pigment epithelial tears after single administration of intravitreal bevacizumab for neovascular age-related macular degeneration.

Purpose: To analyse retinal pigment epithelial (RPE) tears following single administration of intravitreal bevacizumab for neovascular age-related macular degeneration (AMD) during early follow-up.

Methods: Interventional, retrospective, non-comparative case series included 397 patients (409 eyes) of the 746 consecutive patients that met the eligibility criteria. Standardized visual acuity testing, fluorescein angiography, and optical coherence tomography were performed.

[Early antiexudative response--OCT monitoring after intravitreal bevacizumab injection].

VEGF is more potent than histamine by a factor of 50,000 for inducing increased vessel permeability. Already in the first few minutes, hydraulic conductivity and diffusive permeability are significantly increased, followed by a longer-lasting, marked leakage over 20 h. Specific inhibition of the angiogenic, vasoactive, and permeability-inducing protein VEGF is now possible by new drugs, one of which is the first available (off-label) treatment in Germany for routine clinical use (Avastin).

Verteporfin photodynamic therapy induced apoptosis in choroidal neovascular membranes.

Aim: To evaluate the impact of verteporfin photodynamic therapy (PDT) on the induction of apoptosis in choroidal neovascular membranes (CNV) secondary to age related macular degeneration.

Methods: Retrospective review of 22 surgically excised CNV. 12 of these patients had been treated with PDT 3-146 days previously.

Chorioretinal neovascularization after radial optic neurotomy for central retinal vein occlusion.

Radial optic neurotomy was recently introduced for the treatment of central retinal vein occlusion. Two patients developed chorioretinal neovascularization through the radial cut of the optic disc after pars plana vitrectomy, radial optic neurotomy, and endophotocoagulation. Patients undergoing radial optic neurotomy should be closely observed to minimize the risk of this complication.

Comparison of early retreatment with the standard regimen in verteporfin therapy of neovascular age-related macular degeneration.

Purpose: To compare the efficacy and safety of early retreatment with verteporfin therapy with that of approved standard verteporfin therapy in neovascular age-related macular degeneration.

Design: Prospective, randomized, multicenter clinical trial.

Participants: Two hundred three patients with predominantly classic choroidal neovascularization secondary to age-related macular degeneration.

Characteristics of visual field defects by scanning laser ophthalmoscope microperimetry after radial optic neurotomy for central retinal vein occlusion.

Purpose: To evaluate visual field defects after radial optic neurotomy (RON) for the treatment of central retinal vein occlusion (CRVO) by using scanning laser ophthalmoscope microperimetry.

Methods: Thirteen eyes of 13 patients with severe vision loss (< or = 20/200) from CRVO who underwent pars plana vitrectomy and RON had postoperative Goldmann kinetic perimetry, scanning laser ophthalmoscope microperimetry, and fluorescein angiographic evaluation.

Results: After a mean follow-up of 8 months, 6 of the 13 patients had visual improvement by > or = 2 lines.

Pigment epithelial detachments with retinal vascular anomalous complex in age-related macular degeneration.

Purpose: To analyze and compare the angiographic features of retinal vascular anomalous complex (RVAC) in patients with a vascularized pigment epithelial detachment (PED) secondary to age-related macular degeneration.

Methods: Retrospective evaluation of fluorescein and indocyanine green angiographies of 180 patients with occult choroidal neovascularization and PED.

Results: On indocyanine green angiography (ICGA), RVAC demonstrated as a focal hyperfluorescence in connection with retinal choroidal anastomosis was identified in 12 of the 180 eyes (6.

Lack of long-term cortical reorganization after macaque retinal lesions.

Several aspects of cortical organization are thought to remain plastic into adulthood, allowing cortical sensorimotor maps to be modified continuously by experience. This dynamic nature of cortical circuitry is important for learning, as well as for repair after injury to the nervous system. Electrophysiology studies suggest that adult macaque primary visual cortex (V1) undergoes large-scale reorganization within a few months after retinal lesioning, but this issue has not been conclusively settled.

Natural course of occult choroidal neovascularization in age-related macular degeneration: development of classic lesions in fluorescein angiography.

Purpose: To analyse the frequency of conversion from occult with no classic choroidal neovascularization (CNV) and occult with minimally classic CNV into predominantly classic CNV secondary to age-related macular degeneration.

Methods: Retrospective evaluation of baseline and repeat angiograms of 54 eyes with a follow-up of 6-12 months.

Results: In the group with initially occult with no classic CNV, nine of 40 eyes (23%) progressed to a predominantly classic lesion, whereas in the group of occult with a minimally classic CNV, 10 of 14 eyes (71%) eyes developed a predominantly classic CNV.

Subfoveal hemorrhage after verteporfin photodynamic therapy in treatment of choroidal neovascularization.

Background: To identify the frequency of new subfoveal hemorrhage and its impact on visual acuity 2 weeks following verteporfin photodynamic therapy (PDT) in the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

Methods: Retrospective, noncomparative, consecutive, interventional case series. At a tertiary retinal referral center, 104 eyes of 97 consecutive patients with predominantly classic subfoveal CNV were treated by PDT.

Verteporfin photodynamic therapy for extrafoveal choroidal neovascularisation in pathologic myopia.

Background: To report long-term functional and morphological outcome of verteporfin photodynamic therapy (PDT) for classic extrafoveal choroidal neovascularisation (CNV) secondary to pathologic myopia.

Methods: This retrospective case series included three eyes of three consecutive patients with classic extrafoveal CNV secondary to pathologic myopia, who underwent PDT at a tertiary retinal referral centre. Change in visual acuity and fluorescein leakage was the main outcome criteria.

In vivo assessment of subretinally implanted microphotodiode arrays in cats by optical coherence tomography and fluorescein angiography.

Background: Following multiple promising investigations into restoration of vision in degenerative retinal disease by implantation of a sub- or epiretinal prosthesis, the step to clinical use in humans is impending. In this study we intended to establish optical coherence tomography (OCT) and fluorescein angiography (FA) first in research animals for noninvasive assessment of the condition of the posterior pole of eyes after intraocular implant surgery.

Methods: Three adult cats that had undergone subretinal implant surgery were evaluated by OCT and FA between 1 and 470 days postoperatively.