Semiautomated Image Processing Method for Identification and Quantification of Geographic Atrophy in Age-Related Macular Degeneration
Semiautomated Image Processing Method for Identification and Quantification of Geographic Atrophy in Age-Related Macular Degeneration
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DOI：
10.1167/iovs.11-7457
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发表时间：
2011-09-01
影响因子：
4.4
通讯作者：
Holz, Frank G.
中科院分区：
文献类型：
--
作者：
Schmitz-Valckenberg, Steffen;Brinkmann, Christian K.;Holz, Frank G.
目的.目的：探讨新型半自动化软件对年龄相关性黄斑变性相关地图状萎缩（GA）的定量测量的观察者内和观察者间纵向测量变异性，该软件基于共焦扫描激光眼底镜眼底自发荧光（FAF）成像。在6个月和12个月后，根据标准化方案在基线记录30名GA受试者的三场FAF（激发488 nm，发射500-700 nm）、近红外反射率（820 nm）和蓝色反射率（488 nm）图像。在所有访视中，由7名独立阅片员使用半自动软件在中央FAF图像上分析GA区域。该软件允许从数据库中直接导出FAF图像，并通过阴影校正、血管检测和种子点选择半自动检测萎缩区域。基线时萎缩的平均大小和平均进展率分别为5.96 mm（2）（范围：1.80-15.87）和1.25 mm（2）/年（0.42-2.93）。基线访视时观察者间一致性的平均差异（Bland-Altman统计）范围为-0.25至0.30 mm（2），萎缩进展率范围为-0.14至0.11 mm（2）/年。相应的反射率图像有助于病灶边界的辨别，尤其是在图像质量较差时，有助于评价黄斑中心凹GA受累。新的图像处理软件提供了一个准确的，可重复的，时间效率高的识别和定量的外部视网膜萎缩及其随时间的进展。它有助于在自然史研究和干预性试验中进行测量，以评估旨在限制GA扩大的新药物。（Invest Ophthalmol维斯科学。2011;52：7640-7646）DOI：10.1167/iovs.11-7457
PURPOSE. To determine intraobserver and interobserver longitudinal measurement variability of novel semiautomated software for quantification of age-related macular degeneration-associated geographic atrophy (GA) based on confocal scanning laser ophthalmoscopy fundus autofluorescence (FAF) imaging.METHODS. Three-field FAF (excitation 488 nm, emission 500-700 nm), near-infrared reflectance (820 nm), and blue reflectance (488 nm) images of 30 GA subjects were recorded according to a standardized protocol at baseline after 6 and 12 months. At all visits, the GA area was analyzed on central FAF images by seven independent readers using semiautomated software. The software allows direct export of FAF images from the database and semiautomated detection of atrophic areas by shadow correction, vessel detection, and selection of seed points.RESULTS. The mean size of atrophy at baseline and the mean progression rate were 5.96 mm(2) (range, 1.80-15.87) and 1.25 mm(2)/year (0.42-2.93), respectively. Mean difference of interobserver agreement (Bland-Altman statistics) ranged from -0.25 to 0.30 mm(2) for the baseline visit and from -0.14 to 0.11 mm(2)/year for the atrophy progression rate. Corresponding reflectance images were helpful for lesion boundary discrimination, particularly for evaluation of foveal GA involvement and when image quality was poor.CONCLUSIONS. The new image processing software offers an accurate, reproducible, and time-efficient identification and quantification of outer retinal atrophy and its progression over time. It facilitates measurements both in natural history studies and in interventional trials to evaluate new pharmacologic agents designed to limit GA enlargement. (Invest Ophthalmol Vis Sci. 2011;52:7640-7646) DOI:10.1167/iovs.11-7457