PMID- 25127697 OWN - NLM STAT- MEDLINE DCOM- 20150127 LR - 20211021 IS - 1879-1891 (Electronic) IS - 0002-9394 (Print) IS - 0002-9394 (Linking) VI - 158 IP - 5 DP - 2014 Nov TI - Three-dimensional automated choroidal volume assessment on standard spectral-domain optical coherence tomography and correlation with the level of diabetic macular edema. PG - 1039-48 LID - S0002-9394(14)00481-4 [pii] LID - 10.1016/j.ajo.2014.08.001 [doi] AB - PURPOSE: To measure choroidal thickness on spectral-domain optical coherence tomography (SD OCT) images using automated algorithms and to correlate choroidal pathology with retinal changes attributable to diabetic macular edema (DME). DESIGN: Post hoc analysis of multicenter clinical trial baseline data. METHODS: SD OCT raster scans/fluorescein angiograms were obtained from 284 treatment-naive eyes of 142 patients with clinically significant DME and from 20 controls. Three-dimensional (3D) SD OCT images were evaluated by a certified independent reading center analyzing retinal changes associated with diabetic retinopathy. Choroidal thicknesses were analyzed using a fully automated algorithm. Angiograms were assessed manually. Multiple endpoint correction according to Bonferroni-Holm was applied. Main outcome measures were average retinal/choroidal thickness on fovea-centered or peak of edema (thickest point of edema)-centered Early Treatment Diabetic Retinopathy Study grid, maximum area of leakage, and the correlation between retinal and choroidal thicknesses. RESULTS: Total choroidal thickness is significantly reduced in DME (175 +/- 23 mum; P = .0016) and nonedematous fellow eyes (177 +/- 20 mum; P = .009) of patients compared with healthy control eyes (190 +/- 23 mum). Retinal/choroidal thickness values showed no significant correlation (1-mm: P = .27, r(2) = 0.01; 3-mm: P = .96, r(2) < 0.0001; 6-mm: P = .42, r(2) = 0.006). No significant difference was found in the 1- or 3-mm circle of a retinal peak of edema-centered grid. All other measurements of choroidal/retinal thickness (DME vs healthy, DME vs peak of edema-centered, DME vs fellow, healthy vs fellow, peak of edema-centered vs healthy, peak of edema-centered vs fellow eyes) were compared but no statistically significant correlation was found. By tendency a thinner choroid correlates with larger retinal leakage areas. CONCLUSIONS: Automated algorithms can be used to reliably assess choroidal thickness in eyes with DME. Choroidal thickness was generally reduced in patients with diabetes if DME is present in 1 eye; however, no correlation was found between choroidal/retinal pathologies, suggesting different pathogenetic pathways. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Gerendas, Bianca S AU - Gerendas BS AD - Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Ophthalmic Image Analysis, Medical University of Vienna, Vienna, Austria. FAU - Waldstein, Sebastian M AU - Waldstein SM AD - Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Ophthalmic Image Analysis, Medical University of Vienna, Vienna, Austria. FAU - Simader, Christian AU - Simader C AD - Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Ophthalmic Image Analysis, Medical University of Vienna, Vienna, Austria. Electronic address: optima@meduniwien.ac.at. FAU - Deak, Gabor AU - Deak G AD - Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. FAU - Hajnajeeb, Bilal AU - Hajnajeeb B AD - Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. FAU - Zhang, Li AU - Zhang L AD - Department of Electrical & Computer Engineering, University of Iowa, Iowa City, Iowa. FAU - Bogunovic, Hrvoje AU - Bogunovic H AD - Department of Electrical & Computer Engineering, University of Iowa, Iowa City, Iowa. FAU - Abramoff, Michael D AU - Abramoff MD AD - Department of Electrical & Computer Engineering, University of Iowa, Iowa City, Iowa; Department of Ophthalmology & Visual Sciences, University of Iowa, Iowa City, Iowa; Veterans Affairs, Medical Center, West Iowa City, Iowa. FAU - Kundi, Michael AU - Kundi M AD - Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria. FAU - Sonka, Milan AU - Sonka M AD - Department of Electrical & Computer Engineering, University of Iowa, Iowa City, Iowa; Department of Ophthalmology & Visual Sciences, University of Iowa, Iowa City, Iowa. FAU - Schmidt-Erfurth, Ursula AU - Schmidt-Erfurth U AD - Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Ophthalmic Image Analysis, Medical University of Vienna, Vienna, Austria. LA - eng 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 - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140812 PL - United States TA - Am J Ophthalmol JT - American journal of ophthalmology JID - 0370500 SB - IM MH - Adult MH - Aged MH - *Algorithms MH - Choroid/*pathology MH - Diabetic Retinopathy/*complications/diagnosis MH - Female MH - Fluorescein Angiography MH - Fundus Oculi MH - Humans MH - *Imaging, Three-Dimensional MH - Macular Edema/*diagnosis/etiology MH - Male MH - Middle Aged MH - Reproducibility of Results MH - Retina/pathology MH - Severity of Illness Index MH - Tomography, Optical Coherence/*methods PMC - PMC5750044 MID - NIHMS930303 COIS- ALL AUTHORS HAVE COMPLETED AND SUBMITTED THE ICMJE FORM FOR DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST and reported the following disclosures: The Christian Doppler Laboratory for Ophthalmic Image Analysis (OPTIMA) receives funding by the Austrian Federal Ministry of Economy, Family and Youth (Gerendas, Waldstein, Simader, Zhang, Bogunovic, Abramoff, Sonka, Schmidt-Erfurth). Sonka and Abramoff receive National Institutes of Health funding for their institution and are inventors of United States patents with regard to n-dimensional graph search, from which they receive royalties. Abramoff receives funding from the Veterans Administration for his institution and is the owner of IDx LLC, where he serves as board member and consultant. Kundi serves as consultant for Baxter, Novartis, Sanofi, and GlaxoSmithKline; provides expert testimony for Ashkraft&Gerel LLT, and receives payments from the Austrian Chamber of Physicians and the European Union. Schmidt-Erfurth is a board member for Alcon, Bayer, and Novartis; serves as consultant for Alcon, Bayer, Novartis, and Boehringer-Ingelheim; and receives payments for lectures from Novartis and Bayer. Funding/support: Austrian Federal Ministry of Economy, Family and Youth and the National Foundation for Research, Technology and Development, Vienna, Austria (Gerendas, Waldstein, Simader, Zhang, Bogunovic, Abramoff, Sonka, Schmidt-Erfurth). Contributions of authors: design and conduct of the study (B.S.G., S.M.W., C.C.S., M.K., U.M.S.-E.); collection, management, analysis, and interpretation of the data (B.S.G., S.M.W., C.C.S., G.G.D., B.H., L.Z., H.B., M.D.A., M.K., M.S., U.M.S.-E.); preparation, review, and approval of the manuscript (B.S.G., S.M.W., C.C.S., G.G.D., B.H., L.Z., H.B., M.D.A., M.K., M.S., U.M.S.-E.). EDAT- 2014/08/17 06:00 MHDA- 2015/01/28 06:00 PMCR- 2018/01/02 CRDT- 2014/08/17 06:00 PHST- 2013/11/28 00:00 [received] PHST- 2014/07/30 00:00 [revised] PHST- 2014/08/01 00:00 [accepted] PHST- 2014/08/17 06:00 [entrez] PHST- 2014/08/17 06:00 [pubmed] PHST- 2015/01/28 06:00 [medline] PHST- 2018/01/02 00:00 [pmc-release] AID - S0002-9394(14)00481-4 [pii] AID - 10.1016/j.ajo.2014.08.001 [doi] PST - ppublish SO - Am J Ophthalmol. 2014 Nov;158(5):1039-48. doi: 10.1016/j.ajo.2014.08.001. Epub 2014 Aug 12.