1. Articles from Cecilia S. Lee

    1-16 of 16
    1. Model-to-Data Approach for Deep Learning in Optical Coherence Tomography Intraretinal Fluid Segmentation

      Model-to-Data Approach for Deep Learning in Optical Coherence Tomography Intraretinal Fluid Segmentation

      Importance Amid an explosion of interest in deep learning in medicine, including within ophthalmology, concerns regarding data privacy, security, and sharing are of increasing importance. A model-to-data approach, in which the model itself is transferred rather than data, can circumvent many of these challenges but has not been previously demonstrated in ophthalmology. Objective To determine whether a model-to-data deep learning approach (ie, validation of the algorithm without any data transfer) can be applied in ophthalmology. Design, Setting, and Participants This single-center cross-sectional study included patients with active exudative age-related macular degeneration undergoing optical coherence tomography (OCT) at the New England ...

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    2. Vitreous Findings by Handheld Spectral Domain Optical Coherence Tomography Correlate with Retinopathy of Prematurity Severity

      Vitreous Findings by Handheld Spectral Domain Optical Coherence Tomography Correlate with Retinopathy of Prematurity Severity

      Objective To evaluate the association between retinopathy of prematurity and vitreous findings in premature infants detected by handheld spectral-domain optical coherence tomography. Design Prospective, observational cohort study. Participants Consecutive sample of 92 premature infants requiring retinopathy of prematurity screening at two academic neonatal intensive care units, between July 2015 and March 2018. Methods Infants underwent handheld spectral domain optical coherence tomography at the time of routine retinopathy of prematurity examinations. Two masked, trained graders analyzed right eye vitreoretinal findings including semi-automated quantification of punctate hyperreflective vitreous opacities within 5 foveal/parafoveal B-scans (Vitreous Opacity Ratio). Main Outcome Measures: Excluding post-treatment ...

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    3. Methodological Challenges of Deep Learning in Optical Coherence Tomography for Retinal Diseases: A Review

      Methodological Challenges of Deep Learning in Optical Coherence Tomography for Retinal Diseases: A Review

      Artificial intelligence (AI)-based automated classification and segmentation of optical coherence tomography (OCT) features have become increasingly popular. However, its 3-dimensional volumetric nature has made developing an algorithm that generalizes across all patient populations and OCT devices challenging. Several recent studies have reported high diagnostic performances of AI models; however, significant methodological challenges still exist in applying these models in real-world clinical practice. Lack of large-image datasets from multiple OCT devices, nonstandardized imaging or post-processing protocols between devices, limited graphics processing unit capabilities for exploiting 3-dimensional features, and inconsistency in the reporting metrics are major hurdles in enabling AI for ...

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    4. 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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    5. Generating​ ​retinal​ ​flow​ ​maps​ ​from​ ​structural​ ​optical​ ​coherence​ ​tomography​ ​with​ ​artificial intelligence

      Generating​ ​retinal​ ​flow​ ​maps​ ​from​ ​structural​ ​optical​ ​coherence​ ​tomography​ ​with​ ​artificial intelligence

      Despite advances in artificial intelligence (AI), its application in medical imaging has been burdened and limited by expert-generated labels. We used images from optical coherence tomography angiography (OCTA), a relatively new imaging modality that measures retinal blood flow, to train an AI algorithm to generate flow maps from standard optical coherence tomography (OCT) images, exceeding the ability and bypassing the need for expert labeling. Deep learning was able to infer flow from single structural OCT images with similar fidelity to OCTA and significantly better than expert clinicians (P < 0.00001). Our model allows generating flow maps from large volumes of ...

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    6. Generating perfusion maps from structural optical coherence tomography with artificial intelligence

      Generating perfusion maps from structural optical coherence tomography with artificial intelligence

      Despite significant advances in artificial intelligence (AI) for computer vision, its application in medical imaging has been limited by the burden and limits of expert-generated labels. We used images from optical coherence tomography angiography (OCTA), a relatively new imaging modality that measures perfusion of the retinal vasculature, to train an AI algorithm to generate vasculature maps from standard structural optical coherence tomography (OCT) images of the same retinae, both exceeding the ability and bypassing the need for expert labeling. Deep learning was able to infer perfusion of microvasculature from structural OCT images with similar fidelity to OCTA and significantly better ...

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    7. Comparisons Between Histology and Optical Coherence Tomography Angiography of the Periarterial Capillary-Free Zone

      Comparisons Between Histology and Optical Coherence Tomography Angiography of the Periarterial Capillary-Free Zone

      Purpose To use the capillary-free zone along retinal arteries, a physiologic area of superficial avascularization, as an anatomic paradigm to investigate the reliability of optical coherence tomographic angiography (OCTA) for visualizing the deep retinal circulation. Design Validity analysis and laboratory investigation. Methods Five normal human donor eyes (mean age 69.8 years) were perfusion-labelled with endothelial antibodies and the capillary networks of the perifovea were visualized using confocal scanning laser microscopy. Regions of the capillary-free zone along the retinal artery were imaged using OCTA in 16 normal subjects (age range 24-51 years). 3x3mm scans were acquired using the RTVue XR ...

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    8. Deep-learning based, automated segmentation of macular edema in optical coherence tomography

      Deep-learning based, automated segmentation of macular edema in optical coherence tomography

      Evaluation of clinical images is essential for diagnosis in many specialties. Therefore the development of computer vision algorithms to help analyze biomedical images will be important. In ophthalmology, optical coherence tomography (OCT) is critical for managing retinal conditions. We developed a convolutional neural network (CNN) that detects intraretinal fluid (IRF) on OCT in a manner indistinguishable from clinicians. Using 1,289 OCT images, the CNN segmented images with a 0.911 cross-validated Dice coefficient, compared with segmentations by experts. Additionally, the agreement between experts and between experts and CNN were similar. Our results reveal that CNN can be trained to ...

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    9. Comparison of retina specialist preferences regarding spectral-domain and swept-source optical coherence tomography angiography

      Comparison of retina specialist preferences regarding spectral-domain and swept-source optical coherence tomography angiography

      Purpose: The aim of this study was to compare physician preferences regarding the commercially available spectral-domain (SD) optical coherence tomography angiography (OCTA) and swept-source (SS) OCTA prototype device. Design: Comparative analysis of diagnostic instruments was performed. Patients and methods: Subjects at the University of Washington Eye Institute and Harborview Medical Center were prospectively recruited and imaged with the Zeiss SD OCTA (HD-5000, Angioplex) and Zeiss SS OCTA (Plex Elite, Everest) devices on the same day. The study included 10 eyes from 10 subjects diagnosed with a retinal/choroidal disease. Deidentified images were compiled into a survey and sent to retina ...

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    10. Deep Learning Is Effective for Classifying Normal versus Age-Related Macular Degeneration Optical Coherence Tomography Images

      Deep Learning Is Effective for Classifying Normal versus Age-Related Macular Degeneration Optical Coherence Tomography Images

      Purpose The advent of electronic medical records (EMRs) with large electronic imaging databases along with advances in deep neural networks with machine learning has provided a unique opportunity to achieve milestones in automated image analysis. Optical coherence tomography (OCT) is the most common imaging modality in ophthalmology and represents a dense and rich data set when combined with labels derived from the EMR. We sought to determine whether deep learning could be utilized to distinguish normal OCT images from images from patients with age-related macular degeneration (AMD). Design EMR and OCT database study. Subjects Normal and AMD patients who underwent ...

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    11. Association between OCT-based microangiography perfusion indices and diabetic retinopathy severity

      Association between OCT-based microangiography perfusion indices and diabetic retinopathy severity

      Aim To evaluate the association between retinal capillary non-perfusion and diabetic retinopathy (DR) severity using optical coherence tomography-based microangiography (OMAG). Methods 33 patients (51 eyes) with a history of diabetes underwent imaging with a 68 kHz Cirrus-5000 spectral domain OMAG prototype. Demographic and clinical characteristics were collected. The perfusion index (PI) was defined as per cent coverage of area by retinal vessels with flow, measured within a minimum of 6.8×6.8 mm 2 OMAG scan. The PI in each ETDRS zone was analysed using an automated algorithm. Univariate and multivariate analyses were used to determine the degree of ...

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    12. Projection Artifact Removal Improves Visualization and Quantitation of Macular Neovascularization Imaged by Optical Coherence Tomography Angiography

      Projection Artifact Removal Improves Visualization and Quantitation of Macular Neovascularization Imaged by Optical Coherence Tomography Angiography

      Purpose To visualize and quantify the size and vessel density of macular neovascularization (MNV) using optical coherence tomography angiography (OCTA) with a projection artifact removal algorithm. Design Multicenter, observational study. Participants Subjects with MNV in ≥1 eye. Methods Patients were imaged using either a swept-source OCTA prototype system or a spectral-domain OCTA prototype system. The optical microangiography (OMAG) algorithm was used to generate the OCTA images. Projection artifacts from the overlying retinal circulation were removed from the OMAG OCTA images using a novel algorithm. After removal of the projection artifacts from the OCTA images, we assessed the size and vascularity ...

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    13. Evaluation of bilateral central retinal artery occlusions with optical coherence tomography-based microangiography

      Evaluation of bilateral central retinal artery occlusions with optical coherence tomography-based microangiography

      Background We report a case of bilateral central retinal artery occlusion and the evaluation of retinal vasculature and capillaries by using optical coherence tomography angiography. Case presentation A 75-year-old white man presented with central retinal artery occlusion in one eye and underwent a carotid angioplasty. Upon discontinuing anticoagulant, he had a subsequent central retinal artery occlusion in the other eye. Optical coherence tomography angiography images were obtained to compare the retinal microvasculature in both eyes. Conclusions Atrophy of the involved retina continues for several weeks after central retinal artery occlusion but the loss of retinal capillaries is immediate and stable ...

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    14. Use of Mechanical Turk as a MapReduce Framework for Macular OCT Segmentation

      Use of Mechanical Turk as a MapReduce Framework for Macular OCT Segmentation

      Purpose . To evaluate the feasibility of using Mechanical Turk as a massively parallel platform to perform manual segmentations of macular spectral domain optical coherence tomography (SD-OCT) images using a MapReduce framework. Methods. A macular SD-OCT volume of 61 slice images was map-distributed to Amazon Mechanical Turk. Each Human Intelligence Task was set to 0.01 and required the user to draw five lines to outline the sublayers of the retinal OCT image after being shown example images. Each image was submitted twice for segmentation, and interrater reliability was calculated. The interface was created using custom HTML5 and JavaScript code, and ...

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    15. Wide-field optical coherence tomography based microangiography for retinal imaging

      Wide-field optical coherence tomography based microangiography for retinal imaging

      Optical coherence tomography angiography (OCTA) allows for the evaluation of functional retinal vascular networks without a need for contrast dyes. For sophisticated monitoring and diagnosis of retinal diseases, OCTA capable of providing wide-field and high definition images of retinal vasculature in a single image is desirable. We report OCTA with motion tracking through an auxiliary real-time line scan ophthalmoscope that is clinically feasible to image functional retinal vasculature in patients, with a coverage of more than 60 degrees of retina while still maintaining high definition and resolution. We demonstrate six illustrative cases with unprecedented details of vascular involvement in retinal ...

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    16. Reevaluating the Definition of Intraretinal Microvascular Abnormalities and Neovascularization Elsewhere in Diabetic Retinopathy using Optical Coherence Tomography and Fluorescein Angiography

      Reevaluating the Definition of Intraretinal Microvascular Abnormalities and Neovascularization Elsewhere in Diabetic Retinopathy using Optical Coherence Tomography and Fluorescein Angiography

      Purpose To evaluate the agreement between clinical examination, spectral domain ocular coherence tomography (SD-OCT), and fluorescein angiography (FA) in diagnosing intraretinal microvascular abnormality (IRMA) and neovascularization elsewhere (NVE) and define the SD-OCT features that differentiate NVEs from IRMAs. Design Retrospective study Methods Data were collected from 23 lesions from 8 diabetic patients, seen from 07/2012 through 10/2013 at Moorfields Eye Hospital, United Kingdom. Main outcomes were SD-OCT features and FA leakage of IRMA and neovascular complex. The agreement between 3 evaluations was analyzed by Fleiss’ kappa. Results The following 5 SD-OCT features significantly differentiated IRMAs from NVEs: 1 ...

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    1-16 of 16
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    1. (12 articles) University of Washington
    2. (6 articles) Ruikang K. Wang
    3. (4 articles) Adnan Tufail
    4. (4 articles) Carl Zeiss Meditec
    5. (3 articles) University of Washington
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    Reevaluating the Definition of Intraretinal Microvascular Abnormalities and Neovascularization Elsewhere in Diabetic Retinopathy using Optical Coherence Tomography and Fluorescein Angiography Wide-field optical coherence tomography based microangiography for retinal imaging Use of Mechanical Turk as a MapReduce Framework for Macular OCT Segmentation Evaluation of bilateral central retinal artery occlusions with optical coherence tomography-based microangiography Projection Artifact Removal Improves Visualization and Quantitation of Macular Neovascularization Imaged by Optical Coherence Tomography Angiography Association between OCT-based microangiography perfusion indices and diabetic retinopathy severity Comparison of retina specialist preferences regarding spectral-domain and swept-source optical coherence tomography angiography Deep-learning based, automated segmentation of macular edema in optical coherence tomography Comparisons Between Histology and Optical Coherence Tomography Angiography of the Periarterial Capillary-Free Zone Generating​ ​retinal​ ​flow​ ​maps​ ​from​ ​structural​ ​optical​ ​coherence​ ​tomography​ ​with​ ​artificial intelligence Impact of cardiometabolic factors on retinal vasculature: A 3x3, 6x6 and 8x8-mm optical coherence tomography angiography study Quantitative research on the interaction between cerebral edema and peripheral cerebral blood perfusion using swept-source optical coherence tomography