TY  - JOUR
AB  - BACKGROUND: Retinal imaging, including fundus autofluorescence (FAF), strongly depends on the clearness of the optical media. Lens status is crucial since the ageing lens has both light-blocking and autofluorescence (AF) properties that distort image analysis. Here, we report both lens opacification and AF metrics and the effect on automated image quality assessment. METHODS: 227 subjects (range: 19-89 years old) received quantitative AF of the lens (LQAF), Scheimpflug, anterior chamber optical coherence tomography as well as blue/green FAF (BAF/GAF), and infrared (IR) imaging. LQAF values, the Pentacam Nucleus Staging score and the relative lens reflectivity were extracted to estimate lens opacification. Mean opinion scores of FAF and IR image quality were compiled by medical readers. A regression model for predicting image quality was developed using a convolutional neural network (CNN). Correlation analysis was conducted to assess the association of lens scores, with retinal image quality derived from human or CNN annotations. RESULTS: Retinal image quality was generally high across all imaging modalities (IR (8.25±1.99) >GAF >BAF (6.6±3.13)). CNN image quality prediction was excellent (average mean absolute error (MAE) 0.9). Predictions were comparable to human grading. Overall, LQAF showed the highest correlation with image quality grading criteria for all imaging modalities (eg, Pearson correlation±CI -0.35 (-0.50 to 0.18) for BAF/LQAF). BAF image quality was most vulnerable to an increase in lenticular metrics, while IR (-0.19 (-0.38 to 0.01)) demonstrated the highest resilience. CONCLUSION: The use of CNN-based retinal image quality assessment achieved excellent results. The study highlights the vulnerability of BAF to lenticular remodelling. These results can aid in the development of cut-off values for clinical studies, ensuring reliable data collection for the monitoring of retinal diseases.
AU  - von der Emde, L.*
AU  - Rennen, G.C.*
AU  - Vaisband, M.*
AU  - Hasenauer, J.
AU  - Liegl, R.*
AU  - Fleckenstein, M.*
AU  - Pfau, M.*
AU  - Holz, F.G.*
AU  - Ach, T.*
C1  - 70592
C2  - 55586
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
TI  - Impact of lens autofluorescence and opacification on retinal imaging.
JO  - BMJ Open Ophthalmol.
VL  - 9
IS  - 1
PB  - Bmj Publishing Group
PY  - 2024
SN  - 2397-3269
ER  - 

TY  - JOUR
AB  - Objective To estimate age-related macular degeneration (AMD) incidence/progression across a wide age range. Methods and analysis AMD at baseline and follow-up (colour fundus imaging, Three Continent AMD Consortium Severity Scale, 3CACSS, clinical classification, CC) was assessed for 1513 individuals aged 35-95 years at baseline from three jointly designed population-based cohorts in Germany: Kooperative Gesundheitsforschung in der Region Augsburg (KORA-Fit, KORA-FF4) and Altersbezogene Untersuchungen zur Gesundheit der Universität Regensburg (AugUR) with 18-year, 14-year or 3-year follow-up, respectively. Baseline assessment included lifestyle, metabolic and genetic markers. We derived cumulative estimates, rates and risk factor association for: (1) incident early AMD, (2) incident late AMD among no AMD at baseline (definition 1), (3) incident late AMD among no/early AMD at baseline (definition 2), (4) progression from early to late AMD. Results Incidence/progression increased by age, except progression in 70+-year old. We observed 35-55-year-old with 3CACSS-based early AMD who progressed to late AMD. Predominant risk factor for incident late AMD definition 2 was early AMD followed by genetics and smoking. When separating incident late AMD definition 1 from progression (instead of combined as incident late AMD definition 2), estimates help judge an individual's risk based on age and (3CACSS) early AMD status: for example, for a 65-year old, 3-year late AMD risk with no or early AMD is 0.5% or 7%, 3-year early AMD risk is 3%; for an 85-year old, these numbers are 0.5%, 21%, 12%, respectively. For CC-based 'early/intermediate' AMD, incidence was higher, but progression was lower. Conclusion We provide a practical guide for AMD risk for ophthalmology practice and healthcare management and document a late AMD risk for individuals aged <55 years.
AU  - Brandl, C.*
AU  - Günther, F.*
AU  - Zimmermann, M.E.*
AU  - Hartmann, K.I.*
AU  - Eberlein, G.*
AU  - Barth, T.*
AU  - Winkler, T.W.*
AU  - Linkohr, B.
AU  - Heier, M.
AU  - Peters, A.
AU  - Li, J.Q.*
AU  - Finger, R.P.*
AU  - Helbig, H.*
AU  - Weber, B.H.F.*
AU  - Küchenhoff, H.*
AU  - Mueller, A.*
AU  - Stark, K.J.*
AU  - Heid, I.M.*
C1  - 64095
C2  - 51987
TI  - Incidence, progression and risk factors of age-related macular degeneration in 35-95-year-old individuals from three jointly designed German cohort studies.
JO  - BMJ Open Ophthalmol.
VL  - 7
IS  - 1
PY  - 2022
SN  - 2397-3269
ER  - 

TY  - JOUR
AB  - Introduction The actual prevalence of a SARS-CoV-2 infection and the individual assessment of being or having been infected may differ. Facing the great uncertainty - especially at the beginning of the pandemic - and the possibility of asymptomatic or mildly symptomatic, subclinical infections, we evaluate the experience of SARS-CoV-2 antibody screening at a tertiary clinical setting. Methods and analysis All employees of a tertiary eye centre and a research institute of ophthalmology were offered antibody testing in May 2020, using a sequential combination of different validated assays/antigens and point-of-care (POC) testing for a subset (NCT04446338). Before taking blood, a systematic inquiry into past symptoms, known contacts and a subjective self-assessment was documented. The correlations between serostatus, patient contacts and demographic characteristics were analysed. Different tests were compared by Kappa statistics. Results Among 318 participants, SARS-CoV-2 antibodies were detected in 9 employees. Chemiluminescence assays (chemiluminescence immunoassay and electrochemiluminescence) showed superior specificity and high reproducibility, compared with ELISA and POC results. In contrast to the low seropositivity (2.8%) of healthcare workers, higher than that of the other departments of the hospital, a large proportion mistakenly assumed that they might have already been infected. Antiviral antibody titres increased and remained on a plateau for at least 3 months. Conclusions The great demand and acceptance confirmed the benefit of highly sensitive testing methods in the early phase of the pandemic. The coincidence of low seroprevalence and anxious employees may have contributed to internalising the need of hygiene measures.
AU  - Ziemssen, F.*
AU  - Feng, Y.S.*
AU  - Schnichels, S.*
AU  - Bayyoud, T.*
AU  - Ueffing, M.*
AU  - Bartz-Schmidt, K.U.*
AU  - Martus, P.*
AU  - Peter, A.
C1  - 61855
C2  - 50187
TI  - Testing for SARS-CoV-2 seroprevalence: Experiences of a tertiary eye centre.
JO  - BMJ Open Ophthalmol.
VL  - 6
IS  - 1
PY  - 2021
SN  - 2397-3269
ER  -