Applications of deep learning for detecting ophthalmic diseases with ultrawide-field fundus

AIM:To summarize the application of deep learning in detecting ophthalmic disease with ultrawide-field fundus images and analyze the advantages,limitations,and possible solutions common to all tasks.METHODS:We searched three academic databases,including PubMed,Web of Science,and Ovid,with the date of August 2022.We matched and screened according to the target keywords and publication year and retrieved a total of 4358 research papers according to the keywords,of which 23 studies were retrieved on applying deep learning in diagnosing ophthalmic disease with ultrawide-field images.RESULTS:Deep learning in ultrawide-field images can detect various ophthalmic diseases and achieve great performance,including diabetic retinopathy,glaucoma,age-related macular degeneration,retinal vein occlusions,retinal detachment,and other peripheral retinal diseases.Compared to fundus images,the ultrawide-field fundus scanning laser ophthalmoscopy enables the capture of the ocular fundus up to 200°in a single exposure,which can observe more areas of the retina.CONCLUSION:The combination of ultrawide-field fundus images and artificial intelligence will achieve great performance in diagnosing multiple ophthalmic diseases in the future.

Non-linear relationship between age and subfoveal choroidal thickness in Chinese patients with proliferative diabetic retinopathy

BACKGROUND No study has investigated the change regularity between age and subfoveal choroidal thickness(SFCT)in proliferative diabetic retinopathy(PDR).AIM To investigate the relationship between the SFCT and age in Chinese patients with PDR.METHODS This was a cross-sectional retrospective study.The participants were hospitalized individuals with type 2 diabetes who underwent vitrectomy for PDR.Contralateral eyes that met the criteria were included in the study.All necessary laboratory tests were performed at the time of admission.Central macular thickness(CMT)and SFCT were two quantitative assessments made using enhanced depth imaging optical coherence tomography.CMT was measured automatically and SFCT was measured manually with digital calipers provided by the Heidelberg Eye Explorer software.RESULTS The final analysis included a total of 234 individuals with PDR.The average age was 55.60 years old±10.03 years old,and 57.69%of the population was male.Univariate analysis revealed a significant negative connection between age and SFCT in patients with PDR[β=-2.44,95%confidence interval(95%CI):-3.46 to-1.42;P<0.0001].In the fully adjusted model,the correlation between SFCT and age remained steady(β=-1.68,95%CI:-2.97 to-0.39;P=0.0117).Spline smoothing showed that the relationship between SFCT and age in patients with PDR was non-linear,with an inflection point at 54 years of age.CONCLUSION Our findings suggest that age is a key determinant of choroidal thickness.The non-linear link between SFCT and age in PDR patients should be taken into account.

LXHY Formula Inhibits Choroidal Neovascularization Development via Inhibiting the Recruitment and Adhesion of BMCs to the Retina

Objective:The objective of this study is to investigate the inhibitory effect of LXHY,a Chinese medicine compound formula,on choroidal neovascularization(CNV) and to find the possible working mechanism.Methods:CNV was induced in C57 BL/6 mice by krypton laser and bone marrow-derived cells(BMCs) isolated from enhanced green fluorescent protein(EGFP) transgenic mice were injected through tail vein 0.5–1 h after the laser surgery.The BMC-treated mice were randomly divided into two groups gavaged with either distilled water(DW group) or LXHY formula solution from day 1 after laser surgery.On days 7,14,and 28 after treatment,histopathologic examination,fundus fluorescein angiography,and choroidal flatmount assay were performed to measure the CNV severity and BMC recruitment.CXCR4 levels in peripheral blood were measured by enzyme-linked immunosorbent assay.Stromal cell-derived factor-1α(SDF?1α),vascular cell adhesion molecule-1(VCAM-1),and intercellular adhesion molecule-1(ICAM-1) were detected by immunofluorescent staining.Results:On days 7 and 14 after treatment,CNV lesions in the LXHY-treated mice showed less recruitment of BMCs and were smaller in size compared to DW-treated mice.Histological examination also confirmed less severe CNV lesions in the LXHY group.CXCR4 levels in peripheral blood in the LXHY group were less than that of DW group on days 7 and 14.Moreover,the expression levels of SDF-1α,ICAM?1,and VCAM?1 at the lesion sites in the LXHY group were lower compared with the DW group.Conclusion:This experiment indicated that LXHY formula could inhibit CNV formation and development,probably by inhibiting the recruitment and attachment of BMCs into CNV area.