Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion

Acute central retinal artery occlusion (CRAO) induces a time-dependent increase in retinal thickness. By manually measuring the relative retinal thickness increase (RRTI) in comparison to the contralateral eye based on optical coherence tomography (OCT), ischemia onset within the past 4.5 hours coul...

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Main Authors: Maria Casagrande, Robert Kromer, Daniel A. Wenzel, Sven Poli, Martin S. Spitzer, Vasyl Druchkiv, Maximilian Schultheiss, Spyridon Dimopoulos
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2021/5527292
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author Maria Casagrande
Robert Kromer
Daniel A. Wenzel
Sven Poli
Martin S. Spitzer
Vasyl Druchkiv
Maximilian Schultheiss
Spyridon Dimopoulos
author_facet Maria Casagrande
Robert Kromer
Daniel A. Wenzel
Sven Poli
Martin S. Spitzer
Vasyl Druchkiv
Maximilian Schultheiss
Spyridon Dimopoulos
author_sort Maria Casagrande
collection DOAJ
description Acute central retinal artery occlusion (CRAO) induces a time-dependent increase in retinal thickness. By manually measuring the relative retinal thickness increase (RRTI) in comparison to the contralateral eye based on optical coherence tomography (OCT), ischemia onset within the past 4.5 hours could be determined with 100% sensitivity and 94.3% specificity. To enable examiner-independent and quicker diagnostics, we analyzed the RRTI using the automatic retinal thickness measurement. In this retrospective study, 28 eyes were evaluated with an acute CRAO (<46 hours). All patients received a Spectralis SD-OCT image of both eyes. The RRTI was calculated for the ETDRS sectors using the Segmentation Module for Single Retinal Layer Analysis. Receiver operating characteristic (ROC) analysis was performed to determine patients ≤4.5 hours by RRTI. In all sectors, time to OCT (TTO) and RRTI correlated positively. The optimal cutoff point to detect CRAOs ≤4.5 hours was between 18.7% nasally and 22.9% RRTI temporally. Sensitivity and specificity varied between the sectors with 90–95% sensitivity and 89–100% specificity. In conclusion, the automatic measurement of RRTI also allows the differentiation of CRAOs within a possible therapeutic time window ≤4.5 hours and CRAOs ≥4.5 hours with a high sensitivity and specificity. Additionally, it offers quicker, easier, and a user-independent assessment of ischemia onset, helping to set a base for establishing automatic indices generated by the OCT machines.
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institution Kabale University
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spelling doaj-art-63647edfbda44254aff414e63b74e3502025-02-03T01:20:32ZengWileyJournal of Ophthalmology2090-004X2090-00582021-01-01202110.1155/2021/55272925527292Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery OcclusionMaria Casagrande0Robert Kromer1Daniel A. Wenzel2Sven Poli3Martin S. Spitzer4Vasyl Druchkiv5Maximilian Schultheiss6Spyridon Dimopoulos7Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUniversity Eye Hospital, Centre of Ophthalmology, University Medical Center Tübingen, Tübingen, GermanyDepartment of Neurology & Stroke, University Medical Center Tübingen, Tübingen, GermanyDepartment of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUniversity Eye Hospital, Centre of Ophthalmology, University Medical Center Tübingen, Tübingen, GermanyAcute central retinal artery occlusion (CRAO) induces a time-dependent increase in retinal thickness. By manually measuring the relative retinal thickness increase (RRTI) in comparison to the contralateral eye based on optical coherence tomography (OCT), ischemia onset within the past 4.5 hours could be determined with 100% sensitivity and 94.3% specificity. To enable examiner-independent and quicker diagnostics, we analyzed the RRTI using the automatic retinal thickness measurement. In this retrospective study, 28 eyes were evaluated with an acute CRAO (<46 hours). All patients received a Spectralis SD-OCT image of both eyes. The RRTI was calculated for the ETDRS sectors using the Segmentation Module for Single Retinal Layer Analysis. Receiver operating characteristic (ROC) analysis was performed to determine patients ≤4.5 hours by RRTI. In all sectors, time to OCT (TTO) and RRTI correlated positively. The optimal cutoff point to detect CRAOs ≤4.5 hours was between 18.7% nasally and 22.9% RRTI temporally. Sensitivity and specificity varied between the sectors with 90–95% sensitivity and 89–100% specificity. In conclusion, the automatic measurement of RRTI also allows the differentiation of CRAOs within a possible therapeutic time window ≤4.5 hours and CRAOs ≥4.5 hours with a high sensitivity and specificity. Additionally, it offers quicker, easier, and a user-independent assessment of ischemia onset, helping to set a base for establishing automatic indices generated by the OCT machines.http://dx.doi.org/10.1155/2021/5527292
spellingShingle Maria Casagrande
Robert Kromer
Daniel A. Wenzel
Sven Poli
Martin S. Spitzer
Vasyl Druchkiv
Maximilian Schultheiss
Spyridon Dimopoulos
Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion
Journal of Ophthalmology
title Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion
title_full Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion
title_fullStr Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion
title_full_unstemmed Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion
title_short Determination of Ischemia Onset Based on Automatically Generated Spectralis SD-OCT Values in Acute Central Retinal Artery Occlusion
title_sort determination of ischemia onset based on automatically generated spectralis sd oct values in acute central retinal artery occlusion
url http://dx.doi.org/10.1155/2021/5527292
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