Algorithm of automatic identification of diabetic retinopathy foci based on ultra-widefield scanning laser ophthalmoscopy

AIM:To propose an algorithm for automatic detection of diabetic retinopathy(DR)lesions based on ultra-widefield scanning laser ophthalmoscopy(SLO).METHODS:The algorithm utilized the FasterRCNN(Faster Regions with CNN features)+ResNet50(Residua Network 50)+FPN(Feature Pyramid Networks)method for detecting hemorrhagic spots,cotton wool spots,exudates,and microaneurysms in DR ultra-widefield SLO.Subimage segmentation combined with a deeper residual network FasterRCNN+ResNet50 was employed for feature extraction to enhance intelligent learning rate.Feature fusion was carried out by the feature pyramid network FPN,which significantly improved lesion detection rates in SLO fundus images.RESULTS:By analyzing 1076 ultra-widefield SLO images provided by our hospital,with a resolution of 2600×2048 dpi,the accuracy rates for hemorrhagic spots,cotton wool spots,exudates,and microaneurysms were found to be 87.23%,83.57%,86.75%,and 54.94%,respectively.CONCLUSION:The proposed algorithm demonstrates intelligent detection of DR lesions in ultra-widefield SLO,providing significant advantages over traditional fundus color imaging intelligent diagnosis algorithms.

Visual quality after implantation of trifocal intraocular lenses in highly myopic eyes with different axial lengths

AIM:To analyze postoperative clinical results after implantation of trifocal intraocular lenses(IOLs)in highly myopic eyes with different axial lengths(ALs).METHODS:This retrospective study describes 61 eyes of 44 patients that were implanted with trifocal diffractive IOLs(AT LISA tri 839 MP).Twenty-one eyes(15 patients)were included in the AL<26 mm group,19 eyes(13 patients)in the AL≥26 mm and<28 mm group,and 21 eyes(16 patients)in the AL≥28 mm group.Postoperative outcomes,including corrected and uncorrected distance visual acuity(UDVA),intermediate and near visual acuity at 167 cd/m2 luminance,depth of focus at 85 cd/m2 luminance,and objective optical quality parameters assessed using the Optical Quality Analysis System(OQAS),were compared among the groups at 3 mo.RESULTS:There were no significant differences in the mean UDVA,uncorrected intermediate visual acuity,uncorrected near visual acuity,corrected distance visual acuity,distance-corrected intermediate visual acuity,and distance-corrected near visual acuity(DCNVA)among the three groups(P>0.05).Better near and intermediate visual acuity(from-1.5 D to-3.0 D)were noted on the defocus curve of the AL<26 mm group(P<0.01 vs AL≥28 mm group).Significantly higher objective scatter index(OSI)values and lower modulation transfer function(MTF)cut-off values,Strehl ratio(SR),and OQAS values(OVs)were observed in the AL≥28 mm group(P<0.01 vs AL<26 mm group).All OQAS parameters had statistically significant correlations with DCNVA and visual acuity at the vergence of-2.5 D(P<0.05 to P<0.01).CONCLUSION:Implantation of trifocal IOLs provides good short-term visual and refractive outcomes in highly myopic eyes with different ALs.However,the near vision decreases in the extremely myopic eyes at lower luminance,which is associated with the lower objective optical quality in these eyes.

All-trans retinoic acid increases ARPE-19 cell apoptosis via activation of reactive oxygen species and endoplasmic reticulum stress pathways

AIM:To explore the apoptosis of ARPE-19 cells after the treatment with different doses of all-trans-retinoic acid(ATRA).METHODS:ARPE-19 cells were used in the in-vitro experiment.Flow cytometry assay was employed to evaluate the level of reactive oxygen species(ROS)and apoptosis.The effects of ATRA(concentrations from 2.5 to 20μmol/L)on the expression of endoplasmic reticulum stress(ERS)markers in vitro were evaluated by Western blot and realtime quantitative polymerase chain reaction(qRT-PCR)assays.The contribution of ROS and ERS-induced apoptosis in vitro was determined by using N-acetyl-L-cysteine(NAC)and Salubrinal,an antagonist of NAC and ERS,respectively.RESULTS:Flow cytometry showed that ATRA significantly increased ARPE-19 cell apoptosis and ROS levels in each group(F=86.39,P<0.001;F=116.839.P<0.001).Western blot and qRT-PCR revealed that levels of CHOP and BIP were elevated in a concentration-dependent pattern after the cells were incubated with ATRA(2.5-20μmol/L).The upregulation of VEGF-A and CHOP induced by ATRA could be inhibited by NAC(antioxidant)and Salubrinal(ERS inhibitor)in vitro.CONCLUSION:ATRA induces the apoptosis of ARPE-19 cells via activated ROS and ERS signaling pathways.