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1دورية أكاديمية
المؤلفون: C. Ellis Wisely, MD, MBA, Alexander Richardson, Ricardo Henao, PhD, Cason B. Robbins, MD, Justin P. Ma, MD, Dong Wang, PhD, Kim G. Johnson, MD, Andy J. Liu, MD, Dilraj S. Grewal, MD, Sharon Fekrat, MD, FASRS
المصدر: Ophthalmology Science, Vol 4, Iss 1, Pp 100355- (2024)
مصطلحات موضوعية: Convolutional neural network, Machine learning, Mild cognitive impairment, OCT, OCT angiography, Ophthalmology, RE1-994
الوصف: Purpose: To develop a machine learning tool capable of differentiating eyes of subjects with normal cognition from those with mild cognitive impairment (MCI) using OCT and OCT angiography (OCTA). Design: Evaluation of a diagnostic technology. Participants: Subjects with normal cognition were compared to subjects with MCI. Methods: A multimodal convolutional neural network (CNN) was built to predict likelihood of MCI from ganglion cell-inner plexiform layer (GC-IPL) thickness maps, OCTA images, and quantitative data including patient characteristics. Main Outcome Measures: Area under the receiver operating characteristic curve (AUC) and summaries of the confusion matrix (sensitivity and specificity) were used as performance metrics for the prediction outputs of the CNN. Results: Images from 236 eyes of 129 cognitively normal subjects and 154 eyes of 80 MCI subjects were used for training, validating, and testing the CNN. When applied to the independent test set using inputs including GC-IPL thickness maps, OCTA images, and quantitative OCT and OCTA data, the AUC value for the CNN was 0.809 (95% confidence interval [CI]: 0.681–0.937). This model achieved a sensitivity of 79% and specificity of 83%. The AUC value for GC-IPL thickness maps alone was 0.681 (95% CI: 0.529–0.832), for OCTA images alone was 0.625 (95% CI: 0.466–0.784) and for both GC-IPL maps and OCTA images was 0.693 (95% CI: 0.543–0.843). Models using quantitative data alone were also tested, with a model using quantitative data derived from images, 0.960 (95% CI: 0.902–1.00), outperforming a model using demographic data alone, 0.580 (95% CI: 0.417–0.742). Conclusions: This novel CNN was able to identify an MCI diagnosis using an independent test set comprised of OCT and OCTA images and quantitative data. The GC-IPL thickness maps provided more useful decision support than the OCTA images. The addition of quantitative data inputs also provided significant decision support to the CNN to identify individuals with MCI. Quantitative imaging metrics provided superior decision support than demographic data. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
وصف الملف: electronic resource
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2دورية أكاديمية
المؤلفون: Anita Kundu, BS, Justin P. Ma, MD, Cason B. Robbins, MD, Praruj Pant, BS, Vithiya Gunasan, Rupesh Agrawal, MMed, Sandra Stinnett, DrPH, Burton L. Scott, MD, PhD, Kathryn P.L. Moore, MD, Sharon Fekrat, MD, FASRS, Dilraj S. Grewal, MD, FASRS
المصدر: Ophthalmology Science, Vol 3, Iss 4, Pp 100393- (2023)
مصطلحات موضوعية: Biomarker, Neurodegeneration, OCTA, Parkinson’s disease, Retina, Ophthalmology, RE1-994
الوصف: Purpose: To quantify rate of change of retinal microvascular and choroidal structural parameters in subjects with Parkinson's disease (PD) compared with controls using OCT and OCT angiography (OCTA). Design: Prospective longitudinal study. Participants: Seventy-four eyes of 40 participants with PD and 149 eyes of 78 control individuals from the Eye Multimodal Imaging in Neurodegenerative Disease database. Methods: Subjects underwent OCT and OCTA imaging at 2 time points approximately 12 months apart. Main Outcome Measures: Imaging parameters included central subfield thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, peripapillary retinal nerve fiber layer thickness, choroidal vascularity index, superficial capillary plexus perfusion density (PFD), vessel density (VD), and foveal avascular zone area. Results: Participants with PD had greater rate of yearly decrease in GC-IPL (PD = −0.403μm, control = + 0.128 μm; P = 0.01), greater yearly decline in PFD in the 3 × 3 mm ETDRS circle (PD = −0.016, control = + 0.002; P
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Dennis Y. Akrobetu, MD, Cason B. Robbins, MD, Justin P. Ma, MD, Srinath Soundararajan, BS, Michael S. Quist, MD, Sandra S. Stinnett, DrPH, Kathryn P.L. Moore, MD, MSc, Kim G. Johnson, MD, Andy J. Liu, MD, Dilraj S. Grewal, MD, FASRS, Sharon Fekrat, MD, FASRS
المصدر: Ophthalmology Science, Vol 3, Iss 2, Pp 100275- (2023)
مصطلحات موضوعية: Alzheimer, Mild cognitive impairment, OCTA, Parkinson, Repeatability, Ophthalmology, RE1-994
الوصف: Purpose: To assess the intrasession repeatability of macular OCT angiography (OCTA) parameters in Alzheimer's disease (AD), mild cognitive impairment (MCI), Parkinson's disease (PD), and normal cognition (NC). Design: Cross sectional study. Subjects: Patients with a clinical diagnosis of AD, PD, MCI, or NC were imaged. Images with poor quality and of those with diabetes mellitus, glaucoma, or vitreoretinal disease were excluded from analysis. Methods, Intervention or Testing: All participants were imaged using the Zeiss Cirrus HD-5000 with AngioPlex (Carl Zeiss Meditec, Software Version 11.0.0.29946) and repeat OCTA images were obtained for both eyes. Perfusion density (PFD), vessel density (VD), and Foveal avascular zone (FAZ) area were measured from 3 × 3 mm and 6 × 6 mm OCTA images centered on the fovea using an ETDRS grid overlay. Main Outcome Measures: Intraclass correlation coefficients were used to quantify repeatability of PFD, VD, and FAZ area measurements obtained from imaging. Results: 3 × 3 mm scans of 22 AD, 40 MCI, 21 PD, and 26 NC participants and 6 × 6 mm scans of 29 AD, 44 MCI, 29 PD, and 30 NC participants were analyzed. Repeatability values ranged from 0.64 (0.49–0.82) for 6 × 6 mm PFD in AD participants to 0.87 (0.67–0.92) for 3 × 3 mm PFD in AD participants. No significant differences were observed in repeatability between NC participants and those with neurodegenerative disease. Conclusions: Overall, similar OCTA repeatability was observed between NC participants and those with neurodegeneration. Regardless of diagnostic group, macular OCTA metrics demonstrated moderate to good repeatability. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Justin P. Ma, BS, Cason B. Robbins, MD, Sandra S. Stinnett, DrPH, Kim G. Johnson, MD, Burton L. Scott, MD, PhD, Dilraj S. Grewal, MD, Sharon Fekrat, MD, FASRS
المصدر: Ophthalmology Science, Vol 1, Iss 4, Pp 100075- (2021)
مصطلحات موضوعية: Alzheimer disease, Mild cognitive impairment, Neurodegeneration, OCT angiography, Parkinson disease, Peripapillary, Ophthalmology, RE1-994
الوصف: Purpose: To assess the repeatability of peripapillary OCT angiography (OCTA) in those with Alzheimer disease (AD), mild cognitive impairment (MCI), Parkinson disease (PD), or normal cognition. Design: Cross-sectional. Participants: Patients with a clinical diagnosis of AD, MCI, PD, or normal cognition were imaged. Those with glaucoma, diabetes mellitus, vitreoretinal pathology, and poor-quality images were excluded. Methods: Each eligible eye of each participant underwent 2 OCTA 4.5 × 4.5-mm peripapillary scans in a single session using a Zeiss Cirrus HD-OCT 5000 with AngioPlex (Carl Zeiss Meditec). The Zeiss software (v11.0.0.29946) quantified measures of perfusion in the radial peripapillary capillary (RPC) plexus in 4 sectors (superior, nasal, inferior, temporal). The average of these sectors was calculated and reported. Main Outcome Measures: Radial peripapillary capillary plexus perfusion was quantified using 2 parameters: capillary perfusion density (CPD) and capillary flux index (CFI). Intraclass correlation coefficients (ICCs) were used to quantify repeatability. For subjects who had both eyes included, the average values of each scan pair were used to assess interocular symmetry of CPD and CFI. Results: Of 374 eyes, 46 were from participants who had AD, 85 were from participants who had MCI, 87 were from participants who had PD, and 156 were from participants who had normal cognition. Capillary perfusion density ICC in AD = 0.88 (95% confidence interval [CI], 0.79–0.93), MCI = 0.95 (0.92–0.96), PD = 0.91 (0.87–0.94), and controls = 0.90 (0.87–0.93). Capillary flux index ICC in AD = 0.82 (0.70–0.90), MCI = 0.87 (0.80–0.91), PD = 0.91 (0.87–0.94) and controls = 0.85 (0.79–0.89). There were no significant differences in interocular variation in average CPD and CFI in AD, MCI, or PD (all P > 0.05). Isolated interocular sectoral CPD differences were noted in AD (nasal, P = 0.049; temporal, P = 0.024), PD (nasal, P = 0.036), and controls (nasal, P = 0.016). Interocular differences in CFI in the superior sector in MCI (P = 0.028) and in average CFI for controls (P = 0.035) were observed. Conclusions: Peripapillary OCTA repeatability in AD, MCI, and PD is good-excellent and similar to those with normal cognition. Insignificant interocular asymmetry in peripapillary OCTA suggests neurodegeneration may proceed uniformly; future studies may reveal the appropriateness of single-eye imaging.
وصف الملف: electronic resource
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5دورية أكاديمية
المؤلفون: Anojan Navaratnam, MBBS, FRACS, Jameson Cumsky, BS, Haidar Abdul-Muhsin, MB, ChB, Justin Gagneur, MA, Jiajian Shen, PhD, Heidi Kosiorek, MS, Michael Golafshar, MS, Akira Kawashima, MD, William Wong, MD, Robert Ferrigni, MD, Mitchell R. Humphreys, MD
المصدر: Advances in Radiation Oncology, Vol 5, Iss 1, Pp 92-100 (2020)
مصطلحات موضوعية: Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: Purpose: To assess the efficacy of placing a polyethylene glycol (PEG) spacing hydrogel in patients undergoing proton beam radiation therapy for prostate cancer. This study also aims to assess the effect on rectal radiation dose of prostate–rectum separation in various anatomic planes. Methods and Materials: Seventy-two consecutive prostate cancer patients undergoing conventionally fractionated pencil beam scanning proton radiation therapy with and without hydrogel placement were compared. Magnetic resonance images taken after hydrogel placement measured prostate–rectum separation and were correlated to rectal dosing and rectal toxicity. Univariate analysis of clinical variables and radiation dosing was conducted using nonparametric Wilcoxon rank-sum test with continuity correction between groups (hydrogel spacer vs controls). Spearman's rank correlation coefficient assessed relationships between the various anatomic dimensions of perirectal space and rectal radiation dosing. Results: Fifty-one patients had hydrogel placement before therapy and 21 did not. There was a 42.2% reduction in rectal dosing (mL3 rectum) in hydrogel patients (P
وصف الملف: electronic resource
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المؤلفون: Justin P. Ma, Cason B. Robbins, Jia Min Lee, Srinath Soundararajan, Sandra S. Stinnett, Rupesh Agrawal, Brenda L. Plassman, Eleonora M. Lad, Heather Whitson, Dilraj S. Grewal, Sharon Fekrat
المصدر: Ophthalmol Retina
مصطلحات موضوعية: Ophthalmology, Alzheimer Disease, Choroid, Apolipoprotein E4, Humans, Neurodegenerative Diseases, Prospective Studies, Article, Retina
الوصف: PURPOSE: To assess baseline differences and longitudinal rate of change in retinal and choroidal imaging parameters between APOE ε4 carriers and non-carriers with normal cognition. DESIGN: Prospective study. SUBJECTS: 413 eyes of 218 individuals with normal cognition aged ≥55 years with known APOE status (98 ε4 carriers, 120 non-carriers). Exclusion criteria included diabetes mellitus, uncontrolled hypertension, glaucoma, and vitreoretinal or neurodegenerative disease. METHODS: Optical coherence tomography (OCT) and OCT angiography (OCTA) was performed at baseline and at 2 years [Zeiss Cirrus HD-OCT 5000 with AngioPlex (Zeiss Meditec, Dublin, CA)]. Groups were compared using sex- and age-adjusted generalized estimating equations. MAIN OUTCOME MEASURES: OCT: retinal nerve fiber layer thickness, macular ganglion cell-inner plexiform layer thickness, central subfield thickness (CST), choroidal vascularity index. OCTA: foveal avascular zone area, perfusion density (PD), vessel density, peripapillary capillary perfusion density and capillary flux index (CFI). Rate of change per year was calculated. RESULTS: At baseline, ε4 carriers had lower CST (p=0.018), PD in the 6mm Early Treatment Diabetic Retinopathy Study (ETDRS) circle (p=0.049), and temporal CFI (p=0.047). Seventy-one ε4 carriers and 78 non-carriers returned at 2 years; at follow-up, the 6mm ETDRS circle (p=0.05) and outer ring (p=0.049) showed lower PD in ε4 carriers, with no differences in rates of change between groups (all p0.05). CONCLUSIONS: There was exploratory evidence of differences in CST, PD, and peripapillary CFI between APOE ε4 carriers and non-carriers, both with normal cognition. Larger and longer-term studies may further elucidate the potential value of these findings.
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7دورية أكاديمية
المصدر: Foot & Ankle Orthopaedics, Vol 3 (2018)
مصطلحات موضوعية: Orthopedic surgery, RD701-811
الوصف: Category: Ankle Introduction/Purpose: There has been increased attention regarding normative values for patient reported outcomes. Differences in population demographics and factors such as previous surgery, could influence functional improvement, obfuscating generalizability among previous studies. To determine realistic patient outcomes, it is important to establish normative values for commonly reported foot and ankle outcome measures, while accounting for population effects. The primary purpose of this study was to determine normative values for the Foot and Ankle Ability Measure(FAAM) Activities of Daily Living(ADL) subscale, FAAM Sport subscale, Tegner activity scale, and SF-12 Physical Component Summary(PCS) and Mental Component Summary(MCS), in individuals who are representative of the “normal” adult population in the United States(US). Methods: This study was approved by an institutional review board. The target population was adults, >18 years old, in the “normal” population. Normal was defined as previously done by AAOS, which is the random sample of individuals from the general US population. Individuals were only excluded if younger than 18 years old. There were 271 people in this study (101 females, 170 males) with an average age of 31.4 (SD=15.1; range 18–77) years. Average BMI was 25.9 (SD=5.9; range 16.5–44.9). The questionnaire included demographics: age, sex and BMI and outcome measures: FAAM ADL, FAAM Sport, Tegner and SF-12 PCS and MCS. Mean outcome scores were determined for each cohort and tested for differences in each variable of interest using analysis of variance (ANOVA) and independent t-tests. Results: The average FAAM ADL was 92.3 (SD=12.3; range 32.1–100.0). The average FAAM Sport was 85.1 (SD=20.2; range 0.0– 100.0). The average SF-12 PCS was 48.6 (SD=8.2; range 20.2–64.1). The average SF-12 MCS was 47.6 (SD=11.0; range 17.2–65.1). Median Tegner was 4 (SD=2.1; range 0–10). There was no significant difference in FAAM ADL between females and males(P=.256) or FAAM Sport(P=.050). Females had significantly higher SF-12 PCS(P=.001). Males had significantly higher SF-12 MCS(P
وصف الملف: electronic resource
Relation: https://doaj.org/toc/2473-0114
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المؤلفون: Cason B. Robbins, Dennis Akrobetu, Justin P. Ma, Sandra S. Stinnett, Srinath Soundararajan, Andy J. Liu, Kim G. Johnson, Dilraj S. Grewal, Sharon Fekrat
المصدر: Retina (Philadelphia, Pa.). 42(7)
مصطلحات موضوعية: Retinal Ganglion Cells, Ophthalmology, Nerve Fibers, Angiography, Humans, Cognitive Dysfunction, General Medicine, Tomography, Optical Coherence
الوصف: To assess retinal microvascular alterations in individuals with amnestic mild cognitive impairment (MCI) and nonamnestic MCI.One hundred twelve eyes of 59 amnestic MCI participants, 32 eyes of 17 nonamnestic MCI participants, and 111 eyes of 56 controls with normal cognition were included. Optical coherence tomography angiography vessel density and perfusion density in the Early Treatment Diabetic Retinopathy Study 3-mm circle and ring were assessed. Retinal thickness parameters including retinal nerve fiber layer thickness, ganglion cell-inner plexiform layer thickness, central subfield thickness, and subfoveal choroidal thickness were also analyzed. Multivariable generalized estimating equations were used for statistical analysis.Perfusion density in the 3-mm inner ring was significantly lower in amnestic MCI patients when compared with nonamnestic MCI participants (0.29 ± 0.03 vs. 0.34 ± 0.09, P = 0.025) and controls with normal cognition (0.29 ± 0.03 vs. 0.39 ± 0.02, P0.001), after adjustment for age and sex as covariates. Vessel density, retinal nerve fiber layer thickness, ganglion cell-inner plexiform layer thickness, central subfield thickness, and subfoveal choroidal thickness did not differ among or between diagnostic groups.Perfusion density was significantly reduced in individuals with amnestic MCI, compared with those with nonamnestic MCI and controls with normal cognition.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::31ec2db2f123a9f53a5338cfa5979a86
https://pubmed.ncbi.nlm.nih.gov/35723922 -
9دورية أكاديمية
المصدر: Gerontology and Geriatric Medicine, Vol 2 (2016)
مصطلحات موضوعية: Geriatrics, RC952-954.6
الوصف: Objective: The objective of the study is to examine the Champlain. BASE TM ( B uilding A ccess to S pecialists through e Consultation) eConsult service’s impact on access to care for older persons. Methods: We conducted a cross-sectional analysis of all eConsult cases submitted between April 15, 2011, and July 31, 2015, in which the patient was above the age of 65 years. Study data consisted of utilization data collected automatically by the service and responses to surveys completed by primary care providers at the conclusion of all eConsult cases. Results: A total of 1,796 cases were submitted for older persons between April 15, 2011, and July 31, 2015, accounting for 21.3% of all cases submitted during the study period. Specialists responded to cases in a median of 0.8 days. In 94% of cases, providers rated eConsult as having great or excellent value for themselves and their patients. Sixty-eight percent of eConsults did not require a face-to-face visit; only 28% of all cases resulted in a referral. Discussion: As they suffer from higher than average rates of comorbid disease and mobility issues, older persons stand to benefit from shorter wait times and better access to care, which the eConsult service can provide.
وصف الملف: electronic resource
Relation: https://doaj.org/toc/2333-7214
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المؤلفون: Emma Pead, Atalie C. Thompson, Dilraj S. Grewal, Sarah McGrory, Cason B. Robbins, Justin P. Ma, Kim G. Johnson, Andy J. Liu, Charlene Hamid, Emanuele Trucco, Craig W. Ritchie, Graciela Muniz, Imre Lengyel, Baljean Dhillon, Sharon Fekrat, Tom MacGillivray
المصدر: Pead, E, Thompson, A C, Grewal, D S, McGrory, S, Robbins, C B, Ma, J P, Johnson, K G, Liu, A J, Hamid, C, Trucco, E, Ritchie, C W, Muniz, G, Lengyel, I, Dhillon, B, Fekrat, S & MacGillivray, T 2023, ' Retinal Vascular Changes in Alzheimer's Dementia and Mild Cognitive Impairment : A Pilot Study Using Ultra-Widefield Imaging ', Translational Vision Science & Technology, vol. 12, no. 1, pp. 13 . https://doi.org/10.1167/tvst.12.1.13
Pead, E, Thompson, A C, Grewal, D S, McGrory, S, Robbins, C B, Ma, J P, Johnson, K G, Liu, A J, Hamid, C, Trucco, E, Ritchie, C W, Muniz, G, Lengyel, I, Dhillon, B, Fekrat, S & MacGillivray, T 2023, ' Retinal vascular changes in Alzheimer's dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging ', Translational Vision Science & Technology, vol. 12, no. 1, 13 . https://doi.org/10.1167/tvst.12.1.13مصطلحات موضوعية: Ophthalmology, Alzheimer Disease, Alzheimer Disease/diagnostic imaging, Cognitive Dysfunction/diagnostic imaging, Biomedical Engineering, Retinal Vessels, Humans, Cognitive Dysfunction, Pilot Projects, Retinal Vessels/diagnostic imaging, Retina/diagnostic imaging, Retina
الوصف: PURPOSE: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging.METHODS: UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity.RESULTS: Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching.CONCLUSIONS: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease.TRANSLATIONAL RELEVANCE: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.
وصف الملف: application/pdf
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::45b62fb454ef6a2c48cd66a819cedf09
https://doi.org/10.1167/tvst.12.1.13
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