March 2012
Volume 53, Issue 14
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ARVO Annual Meeting Abstract  |   March 2012
Quantitative Assessment of Diabetic Macular Edema using Digital Subtraction of Early and Late Acquisitions of Fluorescein Angiograms
Owhofasa O. Agbedia; Mohamed Ibrahim; Yasir J. Sepah; Millena Bittencourt; Eman Magdy; Raafay Sophie; Anam Akhlaq; Hong T. Liu; Ahmed S. Fahmy; Quan D. Nguyen
Author Affiliations & Notes
  • Owhofasa O. Agbedia
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Mohamed Ibrahim
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Yasir J. Sepah
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Millena Bittencourt
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Eman Magdy
    Center for Informatics Science, Nile University, Cairo, Egypt
  • Raafay Sophie
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Anam Akhlaq
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Hong T. Liu
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Ahmed S. Fahmy
    Center for Informatics Science, Nile University, Cairo, Egypt
  • Quan D. Nguyen
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Footnotes
    Commercial Relationships  Owhofasa O. Agbedia, None; Mohamed Ibrahim, None; Yasir J. Sepah, None; Millena Bittencourt, None; Eman Magdy, None; Raafay Sophie, None; Anam Akhlaq, None; Hong T. Liu, None; Ahmed S. Fahmy, None; Quan D. Nguyen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3111. doi:
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      Owhofasa O. Agbedia, Mohamed Ibrahim, Yasir J. Sepah, Millena Bittencourt, Eman Magdy, Raafay Sophie, Anam Akhlaq, Hong T. Liu, Ahmed S. Fahmy, Quan D. Nguyen; Quantitative Assessment of Diabetic Macular Edema using Digital Subtraction of Early and Late Acquisitions of Fluorescein Angiograms. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3111.

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Abstract
 
Purpose:
 

Traditional method for visualizing and evaluating diabetic macular edema (DME) has been fluorescein angiography (FA) where assessment is often based on subjective interpretation. The advancement of optical coherence tomography (OCT) has increased the capacity to provide detailed visualization of the retina. A novel method using FA that enables automatic segmentation and quantitative evaluation of leakage in DME is described. We evaluate the correlation between the segmentation of DME on FA images employing a novel method that we have developed and images obtained by spectral-domain OCT (SD OCT) in patients with DME.

 
Methods:
 

FA images (early and late time frames) and images of central retina obtained by SD OCT in 20 patients (20 eyes) with DME were analyzed. Images were obtained at the baseline visit of participants currently enrolled in a clinical trial for DME. We modeled the macular image in the early time frame using 2D Gaussian surfaces to correct irregular hyper-fluorescent areas. The model was subtracted from the late time frame image of the macula to enhance DME areas. Intensity values of the resulting Difference Image (DI) were mapped to predicted retinal thickness using a linear transformation that maps minimum and maximum gray levels to 250 and 600 microns respectively. Correlation between predicted thickness and retinal thickness as measured by SD OCT was calculated. FA images obtained with 30 and 35-degree field of view were utilized.

 
Results:
 

For the 9 subfields combined, a mean correlation coefficient of 0.77 (SD: 0.10) was observed between retinal thickness as measured by SD OCT and thickness generated by the proposed method. The correlation between individual subfields in the standardized grid across all patients is summarized in Figure 1.

 
Conclusions:
 

In our novel work, we have proposed a digital subtraction method to quantify DME leakage in FA sequences. Our results have shown that valuable quantitative clinical information such as active retinal vascular leakage may be extracted from the DI, which correlates strongly with the retinal thickness generated by the SD OCT.  

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Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical • diabetic retinopathy 
© 2012, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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