PMID- 23111607
OWN - NLM
STAT- MEDLINE
DCOM- 20130214
LR  - 20220408
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Print)
IS  - 0146-0404 (Linking)
VI  - 53
IP  - 13
DP  - 2012 Dec 7
TI  - Quantification of external limiting membrane disruption caused by diabetic 
      macular edema from SD-OCT.
PG  - 8042-8
LID - 10.1167/iovs.12-10083 [doi]
AB  - PURPOSE: Disruption of external limiting membrane (ELM) integrity on 
      spectral-domain optical coherence tomography (SD-OCT) is associated with lower 
      visual acuity outcomes in patients suffering from diabetic macular edema (DME). 
      However, no automated methods to detect ELM and/or determine its integrity from 
      SD-OCT exist. METHODS: Sixteen subjects diagnosed with clinically significant DME 
      (CSME) were included and underwent macula-centered SD-OCT (512 x 19 x 496 
      voxels). Sixteen subjects without retinal thickening and normal acuity were also 
      scanned (200 x 200 x 1024 voxels). Automated quantification of ELM disruption was 
      achieved as follows. First, 11 surfaces were automatically segmented using our 
      standard 3-D graph-search approach, and the subvolume between surface 6 and 11 
      containing the ELM region was flattened based on the segmented retinal pigment 
      epithelium (RPE) layer. A second, edge-based graph-search surface-detection 
      method segmented the ELM region in close proximity "above" the RPE, and each ELM 
      A-scan was classified as disrupted or nondisrupted based on six texture features 
      in the vicinity of the ELM surface. The vessel silhouettes were considered in the 
      disruption classification process to avoid false detections of ELM disruption. 
      RESULTS: In subjects with CSME, large areas of disrupted ELM were present. In 
      normal subjects, ELM was largely intact. The mean and 95% confidence interval 
      (CI) of the detected disruption area volume for normal and CSME subjects were 
      mean(normal) = 0.00087 mm(3) and CI(normal) = (0.00074, 0.00100), and mean(CSME) 
      = 0.00461 mm(3) and CI(CSME) = (0.00347, 0.00576) mm(3), respectively. 
      CONCLUSIONS: In this preliminary study, we were able to show that automated 
      quantification of ELM disruption is feasible and can differentiate continuous ELM 
      in normal subjects from disrupted ELM in subjects with CSME. We have started 
      determining the relationships of quantitative ELM disruption markers to visual 
      outcome in patients undergoing treatment for CSME.
FAU - Chen, Xinjian
AU  - Chen X
AD  - Department of Electrical and Computer Engineering, University of Iowa, Iowa City, 
      Iowa, USA.
FAU - Zhang, Li
AU  - Zhang L
FAU - Sohn, Elliott H
AU  - Sohn EH
FAU - Lee, Kyungmoo
AU  - Lee K
FAU - Niemeijer, Meindert
AU  - Niemeijer M
FAU - Chen, John
AU  - Chen J
FAU - Sonka, Milan
AU  - Sonka M
FAU - Abramoff, Michael D
AU  - Abramoff MD
LA  - eng
GR  - I01 CX000119/CX/CSRD VA/United States
GR  - R01 EB004640/EB/NIBIB NIH HHS/United States
GR  - R01 EY018853/EY/NEI NIH HHS/United States
GR  - R01 EY019112/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20121207
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
SB  - IM
MH  - Basement Membrane/*pathology
MH  - Diabetic Retinopathy/*complications
MH  - Epiretinal Membrane/*diagnosis/etiology
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - Macular Edema/*complications
MH  - Pilot Projects
MH  - Retina/pathology
MH  - *Tomography, Optical Coherence
MH  - Visual Acuity/physiology
PMC - PMC3517271
COIS- Disclosure: X. Chen, None; L. Zhang, None; E.H. Sohn, None; K. Lee, None; M. 
      Niemeijer, None; J. Chen, None; M. Sonka, P; M.D. Abramoff, P
EDAT- 2012/11/01 06:00
MHDA- 2013/02/15 06:00
PMCR- 2013/06/01
CRDT- 2012/11/01 06:00
PHST- 2012/11/01 06:00 [entrez]
PHST- 2012/11/01 06:00 [pubmed]
PHST- 2013/02/15 06:00 [medline]
PHST- 2013/06/01 00:00 [pmc-release]
AID - iovs.12-10083 [pii]
AID - 10.1167/iovs.12-10083 [doi]
PST - epublish
SO  - Invest Ophthalmol Vis Sci. 2012 Dec 7;53(13):8042-8. doi: 10.1167/iovs.12-10083.