1. Articles from Frank G. Holz

    1-24 of 36 1 2 »
    1. Does real-time artificial intelligence-based visual pathology enhancement of three-dimensional optical coherence tomography scans optimise treatment decision in patients with nAMD? Rationale and design of the RAZORBILL study

      Does real-time artificial intelligence-based visual pathology enhancement of three-dimensional optical coherence tomography scans optimise treatment decision in patients with nAMD? Rationale and design of the RAZORBILL study

      Background/rationale Artificial intelligence (AI)-based clinical decision support tools, being developed across multiple fields in medicine, need to be evaluated for their impact on the treatment and outcomes of patients as well as optimisation of the clinical workflow. The RAZORBILL study will investigate the impact of advanced AI segmentation algorithms on the disease activity assessment in patients with neovascular age-related macular degeneration (nAMD) by enriching three-dimensional (3D) retinal optical coherence tomography (OCT) scans with automated fluid and layer quantification measurements. Methods RAZORBILL is an observational, multicentre, multinational, open-label study, comprising two phases: (a) clinical data collection (phase I): an ...

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    2. Does real-time artificial intelligence-based visual pathology enhancement of three-dimensional optical coherence tomography scans optimise treatment decision in patients with nAMD? Rationale and design of the RAZORBILL study

      Does real-time artificial intelligence-based visual pathology enhancement of three-dimensional optical coherence tomography scans optimise treatment decision in patients with nAMD? Rationale and design of the RAZORBILL study

      Background/rationale Artificial intelligence (AI)-based clinical decision support tools, being developed across multiple fields in medicine, need to be evaluated for their impact on the treatment and outcomes of patients as well as optimisation of the clinical workflow. The RAZORBILL study will investigate the impact of advanced AI segmentation algorithms on the disease activity assessment in patients with neovascular age-related macular degeneration (nAMD) by enriching three-dimensional (3D) retinal optical coherence tomography (OCT) scans with automated fluid and layer quantification measurements. Methods RAZORBILL is an observational, multicentre, multinational, open-label study, comprising two phases: (a) clinical data collection (phase I): an ...

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    3. The APOSTEL 2.0 Recommendations for Reporting Quantitative Optical Coherence Tomography Studies

      The APOSTEL 2.0 Recommendations for Reporting Quantitative Optical Coherence Tomography Studies

      Objective: To update the consensus recommendations for reporting of quantitative optical coherence tomography (OCT) study results, thus revising the previously published Advised Protocol for OCT Study Terminology and Elements (APOSTEL) recommendations. Methods: To identify studies reporting quantitative OCT results, we performed a PubMed search for the terms "quantitative" and "optical coherence tomography" from 2015 to 2017. Corresponding authors of the identified publications were invited to provide feedback on the initial APOSTEL recommendations via online surveys following the principle of a modified Delphi method. The results were evaluated and discussed by a panel of experts, and changes to the initial recommendations ...

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    4. Optical Coherence Tomography Signs of Early Atrophy in Age-related Macular Degeneration: Inter-Reader Agreement. CAM Report 6

      Optical Coherence Tomography Signs of Early Atrophy in Age-related Macular Degeneration: Inter-Reader Agreement. CAM Report 6

      Objective: To determine the inter-reader agreement for incomplete and complete retinal pigment epithelium and outer retinal atrophy (iRORA and cRORA respectively) and their related features in age-related macular degeneration (AMD). Design: Inter-reader agreement study. Participants: Twelve readers from six reading centers. Methods: Following formal training, readers qualitatively assessed 60 optical coherence tomography (OCT) B-scans from 60 eyes with AMD for nine individual features associated with early atrophy and performed seven different annotations to quantify the spatial extent of OCT features within regions-of-interests. The qualitative and quantitative features were used to derive the presence of iRORA and cRORA, and also in ...

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    5. Hyper-reflectivity on optical coherence tomography in macular telangiectasia type 2

      Hyper-reflectivity on optical coherence tomography in macular telangiectasia type 2

      Purpose: To define, characterize and classify hyper-reflectivity on optical coherence tomography (OCT) and report its prevalence in macular telangiectasia type 2 (MacTel). Methods: In a primary cross-sectional analysis, multimodal imaging data were retrospectively analyzed. The definition of hyper-reflectivity and neovascularization on OCT followed OCT-angiography-based criteria. Eyes were graded for the presence of hyper-reflectivity and neovascularization and further categorized into three classes based on position and extent of hyper-reflectivity. In a secondary analysis, eyes were reviewed for ≥24 months using OCT-imaging. Results: 322 eyes from 161 patients were analyzed as part of the cross-sectional analysis. Hyper-reflectivity was found in 177 (55 ...

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    6. Validation of an Automated Quantification of Relative Ellipsoid Zone Reflectivity on Spectral Domain-Optical Coherence Tomography Images

      Validation of an Automated Quantification of Relative Ellipsoid Zone Reflectivity on Spectral Domain-Optical Coherence Tomography Images

      Purpose : Relative ellipsoid zone reflectivity (rEZR) represents a potential biomarker of photoreceptor health on spectral-domain optical coherence tomography (SD-OCT). Because manual quantification of rEZR is laborious and lacks of spatial resolution, automated quantification of the rEZR would be beneficial. The purpose of this study was to evaluate the reliability and reproducibility of an automated rEZR quantification method. Methods : The rEZR was acquired using a manual and an automated approach in eyes with age-related macular degeneration (AMD) and healthy controls. The rEZR obtained from both methods was compared and the agreement between the methods and their reproducibility assessed. Results : Forty eyes ...

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    7. Progression of Photoreceptor Degeneration in Geographic Atrophy Secondary to Age-related Macular Degeneration

      Progression of Photoreceptor Degeneration in Geographic Atrophy Secondary to Age-related Macular Degeneration

      Importance Sensitive outcome measures for disease progression are needed for treatment trials in geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Objective To quantify photoreceptor degeneration outside regions of GA in eyes with nonexudative AMD, to evaluate its association with future GA progression, and to characterize its spatio-temporal progression. Design, Setting, and Participants Monocenter cohort study (Directional Spread in Geographic Atrophy [ NCT02051998 ]) and analysis of data from a normative data study at a tertiary referral center. One hundred fifty-eight eyes of 89 patients with a mean (SD) age of 77.7 (7.1) years, median area of GA of ...

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    8. Imaging of Therapeutic Effects of Anti-Vascular Endothelial Growth Factor Inhibitors by Optical Coherence Tomography Angiography in a Rat Model

      Imaging of Therapeutic Effects of Anti-Vascular Endothelial Growth Factor Inhibitors by Optical Coherence Tomography Angiography in a Rat Model

      Purpose : The aim of the study was to investigate optical coherence tomography angiography (OCTA) as a high-resolution in vivo imaging modality for monitoring therapeutic response to different vascular endothelial growth factor inhibitors in the rat model of laser-induced choroidal neovascularization (CNV). Further, OCTA findings were compared with fluorescein angiography (FA) and fluorescence microscopy. Methods : Laser treatment at day (D)0 was followed by intravitreal injection of aflibercept, AF564, and NaCl in dark agouti rats. Imaging with OCTA and FA was performed at D2, D7, D14, and D21. OCTA was compared to FA as well as confocal imaged flat mounts and ...

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    9. Optical coherence tomography-angiography for monitoring neovascularisations in macular telangiectasia type 2

      Optical coherence tomography-angiography for monitoring neovascularisations in macular telangiectasia type 2

      Purpose To evaluate the utility of optical coherence tomography-angiography (OCT-A) for monitoring activity, progression and response to therapy of neovascularisations (NVs) secondary to macular telangiectasia type 2 (MacTel). Methods In a retrospective analysis, eyes with NVs secondary to MacTel were reviewed over a period of ≥8 months. Examinations at monthly intervals included visual acuity testing, dilated funduscopy, spectral domain-OCT and OCT-A. Eyes were treated with intravitreal VEGF (vascular endothelial growth factor)-inhibitors following a pro-re-nata (PRN) regime, and treatment decisions were based on morphological signs of activity as determined by B-scan OCT and funduscopy. Signs of neovascular activity were defined ...

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    10. Replication and Refinement of an Algorithm for Automated Drusen Segmentation on Optical Coherence Tomography

      Replication and Refinement of an Algorithm for Automated Drusen Segmentation on Optical Coherence Tomography

      Here, we investigate the extent to which re-implementing a previously published algorithm for OCT-based drusen quantification permits replicating the reported accuracy on an independent dataset. We refined that algorithm so that its accuracy is increased. Following a systematic literature search, an algorithm was selected based on its reported excellent results. Several steps were added to improve its accuracy. The replicated and refined algorithms were evaluated on an independent dataset with the same metrics as in the original publication. Accuracy of the refined algorithm (overlap ratio 36–52%) was significantly greater than the replicated one (overlap ratio 25–39%). In particular ...

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    11. Automated thresholding algorithms outperform manual thresholding in macular optical coherence tomography angiography image analysis

      Automated thresholding algorithms outperform manual thresholding in macular optical coherence tomography angiography image analysis

      Introduction For quantification of Optical Coherence Tomography Angiography (OCTA) images, Vessel Density (VD) and Vessel Skeleton Density (VSD) are well established parameters and different algorithms are in use for their calculation. However, comparability, reliability and ability to discriminate healthy and impaired macular perfusion of different algorithms are unclear, yet, of potential high clinical relevance. Hence, we assessed comparability and test-retest reliability of the most common approaches. Materials and methods Two consecutive 3×3mm OCTA en face images of the superficial and deep retinal layer were acquired with swept-source OCTA. VD and VSD were calculated with manual thresholding and six automated ...

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    12. ORCA study: real-world versus reading centre assessment of disease activity of neovascular age-related macular degeneration (nAMD)

      ORCA study: real-world versus reading centre assessment of disease activity of neovascular age-related macular degeneration (nAMD)

      Background/aims The prospective, non-interventional ORCA module of the OCEAN study (Observation of Treatment Patterns with Lucentis in Approved Indications) evaluated the qualiy of spectral domain-optical coherence tomography (SD-OCT) image interpretation and treatment decisions by clinicians in Germany and the impact on visual outcomes over 24 months in patients with neovascular age-related macular degeneration (nAMD). Methods 2286 SD-OCT scans of 205 eyes were independently evaluated by clinicians and reading centres (RCs) regarding signs of choroidal neovascularisation (CNV) activity, including presence of intraretinal fluid, subretinal fluid, and/or increase in pigment epithelial detachments. Agreement between clinicians and RCs was calculated. Treatment ...

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    13. Estimating Retinal Sensitivity Using Optical Coherence Tomography With Deep-Learning Algorithms in Macular Telangiectasia Type 2

      Estimating Retinal Sensitivity Using Optical Coherence Tomography With Deep-Learning Algorithms in Macular Telangiectasia Type 2

      Importance As currently used, microperimetry is a burdensome clinical testing modality for testing retinal sensitivity requiring long testing times and trained technicians. Objective To create a deep-learning network that could directly estimate function from structure de novo to provide an en face high-resolution map of estimated retinal sensitivity. Design, Setting, and Participants A cross-sectional imaging study using data collected between January 1, 2016, and November 30, 2017, from the Natural History Observation and Registry of macular telangiectasia type 2 (MacTel) evaluated 38 participants with confirmed MacTel from 2 centers. Main Outcomes and Measures Mean absolute error of estimated compared with ...

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    14. Retinal imaging including OCT angiography for detecting active choroidal neovascularization in pseudoxanthoma elasticum

      Retinal imaging including OCT angiography for detecting active choroidal neovascularization in pseudoxanthoma elasticum

      Importance The diagnostic accuracy of different retinal imaging modalities to detect active choroidal neovascularization (CNV) in pseudoxanthoma elasticum (PXE) is essential to enable a correct diagnosis but currently poorly understood. Background Optical coherence tomography (OCT), fluorescein angiography (FA) and optical coherence tomography angiography (OCT‐A) are employed in daily practice but a systematic comparison of these imaging techniques is lacking. Design Retrospective, observational study. Participants Twenty patients (31 eyes) with PXE. Methods OCT, FA and OCT‐A imaging was performed in each eye and graded separately by independent readers. Main Outcome Measures Diagnostic accuracy, sensitivity and specificity to detect CNVs ...

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    15. Optical coherence tomography angiography in intermediate uveitis

      Optical coherence tomography angiography in intermediate uveitis

      Purpose To investigate the involvement of the retinal and choriocapillaris microvasculature in intermediate uveitis on optical coherence tomography angiography (OCT-A) Design Case-control study Methods Patients and age-matched controls were imaged with swept-source OCT-A (PLEX Elite 9000, Zeiss). Using ImageJ superficial and deep retinal vasculature were semi-automatically analyzed for vessel (VD) and skeleton density (SD), vessel diameter index (VDI) and fractal dimension (FD). Choriocapillaris layer was automatically graded for mean signal intensity, signal intensity standard deviation, kurtosis of signal intensity distribution and flow-signal-voids. Results Twentynine intermediate uveitis eyes and 30 control eyes were included. Both superficial and deep retinal layers showed ...

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    16. CNNs Enable Accurate and Fast Segmentation of Drusen in Optical Coherence Tomography

      CNNs Enable Accurate and Fast Segmentation of Drusen in Optical Coherence Tomography

      Optical coherence tomography (OCT) is used to diagnose and track progression of age-related macular degeneration (AMD). Drusen, which appear as bumps between Bruch’s membrane (BM) and the retinal pigment epithelium (RPE) layer, are among the most important biomarkers for staging AMD. In this work, we develop and compare three automated methods for Drusen segmentation based on the U-Net convolutional neural network architecture. By cross-validating on more than 50, 000 annotated images, we demonstrate that all three approaches achieve much better accuracy than a current state-of-the-art method. Highest accuracy is achieved when the CNN is trained to segment the BM ...

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    17. Algorithms for the Automated Analysis of Age-Related Macular Degeneration Biomarkers on Optical Coherence Tomography: A Systematic Review

      Algorithms for the Automated Analysis of Age-Related Macular Degeneration Biomarkers on Optical Coherence Tomography: A Systematic Review

      Purpose : To assess the quality of optical coherence tomography (OCT) grading algorithms for retinal biomarkers of age-related macular degeneration (AMD). Methods : Following a systematic review of the literature data on detection and quantification of AMD retinal biomarkers by available algorithms were extracted and descriptively synthesized. Algorithm quality was assessed using a modified version of the Quality Assessment of Diagnostic Accuracy Studies 2 checklist with a focus on accuracy against established reference standards and risk of bias. Results : Thirty five studies reporting computer-aided diagnosis (CAD) tools for qualitative analysis or algorithms for quantitative analysis were identified. Compared with manual assessment in ...

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    18. Structural Changes in Optical Coherence Tomography Underlying Spots of Increased Autofluorescence in the Perilesional Zone of Geographic Atrophy

      Structural Changes in Optical Coherence Tomography Underlying Spots of Increased Autofluorescence in the Perilesional Zone of Geographic Atrophy

      Purpose : To investigate structural correlates corresponding to the appearance of increased fundus autofluorescence (FAF) in the perilesional area of geographic atrophy (GA) secondary to age-related macular degeneration. Methods : Serial FAF images of 181 eyes with GA of 134 patients participating in the Directional Spread in Geographic Atrophy study (NCT02051998) were screened for increased FAF spots that had developed during the review period. Thickness and reflectivity of the retinal pigment epithelium (RPE)–basal lamina complex, as well as the integrity of the external limiting membrane (ELM) and the ellipsoid zone (EZ), respectively, in corresponding optical coherence tomography (OCT) scans were compared ...

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    19. The Impact of Lens Opacity on SD-OCT Retinal Nerve Fiber Layer and Bruch's Membrane Opening Measurements Using the Anatomical Positioning System (APS)

      The Impact of Lens Opacity on SD-OCT Retinal Nerve Fiber Layer and Bruch's Membrane Opening Measurements Using the Anatomical Positioning System (APS)

      Purpose : To evaluate the impact of lens opacity on retinal nerve fiber layer thickness (RNFLT) and Bruch's membrane opening (BMO) measurements. Methods : Fifty-nine randomly selected patients without any other relevant ocular pathology undergoing elective routine cataract surgery in two specialized eye clinics were enrolled. RNFLT, BMO area, and BMO minimum rim width (BMO-MRW) were assessed with the Heidelberg Engineering Spectralis OCT using the anatomical positioning system (APS) prior to and 1 day after cataract surgery using a ring scan at different eccentricities of the disc (3.5, 4.1 and 4.7 mm). Lens opacity was quantified using densitometry ...

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    20. In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging

      In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging

      Purpose To determine fundus autofluorescence (FAF) signal variations and corresponding microstructural alterations on spectral-domain optical coherence tomography (SD-OCT) in areas of funduscopically visible drusen associated with age-related macular degeneration (AMD). Methods Thirty eyes from 22 patients with geographic atrophy (GA) secondary to AMD (median age 74, range 64–87 years), who had undergone retinal imaging including color fundus photography (CFP), FAF and SD-OCT (Spectralis HRA+OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) were retrospectively analyzed. In each eye, at least one druse (≥63 μm) in the perilesional zone of GA recorded on CFP was analyzed. Relative FAF intensities and alterations in ...

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    21. High-resolution optical coherence tomography of subpigment epithelial structures in patients with pigment epithelium detachment secondary to age-related macular degeneration

      High-resolution optical coherence tomography of subpigment epithelial structures in patients with pigment epithelium detachment secondary to age-related macular degeneration

      Background The pathophysiology of pigment epithelial detachment (PED) secondary to age-related macular degeneration (AMD) is as yet incompletely understood and treatment remains challenging. Spectral domain optical coherence tomography (SD-OCT) allows for improved morphological characterisation of the space underneath the retinal pigment epithelium (RPE). Objective To investigate eyes with PED for structures underneath the detached RPE cell layer. Methods In a retrospective observational case study, SD-OCT scans of AMD-related PEDs were assessed for the presence of distinctive morphological features in the space between the detached RPE and inner Bruch's membrane. Results Structures present in the space between the detached RPE ...

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    22. Imaging Geographic Atrophy in Age-Related Macular Degeneration

      Imaging Geographic Atrophy in Age-Related Macular Degeneration
      Advances in retinal imaging technology have largely contributed to the understanding of the natural history, prognostic markers and disease mechanisms of geographic atrophy (GA) due to age-related macular degeneration. There is still no therapy available to halt or slow the disease process. In order to evaluate potential therapeutic effects in interventional trials, there is a need for precise quantification of the GA progression rate. Fundus autofluorescence imaging allows for accurate identification and segmentation of atrophic areas and currently represents the gold standard for evaluating progressive GA enlargement. By means of high-resolution spectral-domain optical coherence tomography, distinct microstructural alterations related to ...
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    1-24 of 36 1 2 »
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