Researchers developed a new algorithm that can use a single OCT scan to predict whether a patient with diabetic macular edema is likely to respond to anti-VEGF treatments. They tested it on pretreatment OCT images (top row) and used post-treatment OCT images (bottom row) to track response to treatment. Case 24 and 36 responded to treatment.
Credit: Sina Farsiu, Duke University
New algorithm poised to help doctors individualize treatment for diabetic macular edema
A new approach that uses artificial intelligence to analyze retinal images could one day help doctors select the best treatment for patients with vision loss from diabetic macular edema. This diabetes complication is a major cause of vision loss among working-age adults.
Anti-vascular endothelial growth factor (VEGF) agents are widely used as the first line of therapy for diabetic macular edema, but they don’t work for everyone. There’s a need to identify who would benefit from the therapy because it requires multiple injections that are costly and burdensome for both patients and physicians.
“We developed an algorithm that can be used to automatically analyze optical coherence tomography (OCT) images of the retina to predict whether a patient is likely to respond to anti-VEGF treatments,” said research team leader Sina Farsiu from Duke University. “This research represents a step toward precision medicine, in which such predictions help clinicians better select first-line therapies for patients based on specific disease conditions.”
In The Optical Society (OSA) journal Biomedical Optics Express, Farsiu and colleagues show that the new algorithm can analyze just one pre-treatment volumetric scan to accurately predict whether a patient is likely to respond to anti-VEGF therapy.
“Our approach could potentially be used in eye clinics to prevent unnecessary and costly trial-and-error treatments and thus alleviate a substantial treatment burden for patients,” Farsiu said. “The algorithm could also be adapted to predict therapy response for many other eye diseases, including neovascular age-related macular degeneration.”
Predicting treatment response
The algorithm developed by the researchers is based on a novel convolutional neural network (CNN) architecture, a type of artificial intelligence that can analyze images by assigning importance to various aspects or objects. They used the algorithm to examine images acquired with OCT, a noninvasive technology that produces high-resolution cross-sectional retinal images and is the standard of care for assessing and treating many eye conditions.
“Unlike previously developed approaches, our algorithm requires OCT images from only a single pretreatment timepoint,” said Reza Rasti, first author of the paper and a postdoctoral scholar in Farsiu’s laboratory. “There’s no need for time-series OCT images, patient records or other metadata to predict therapy response.”
The new algorithm preserves and highlights global structures in the OCT image while enhancing local features from diseased regions to efficiently use retinal thickness information. To help with treatment decision making, the researchers incorporated an additional step that looks for CNN-encoded features that are highly correlated with anti-VEGF response.
Testing the algorithm
The researchers tested their new algorithm with OCT images from 127 patients who had been treated for diabetic macular edema with three consecutive injections of anti-VEGF agents. They applied the algorithm to analyze OCT images taken before the anti-VEGF injections, then compared the algorithm’s predictions to OCT images taken after anti-VEGF therapy to confirm whether the therapy improved the condition.
Based on the results, the researchers calculated that the algorithm would have an 87 percent chance of correctly predicting who would respond to treatment. It exhibited an average precision and specificity of 85 percent and a sensitivity of 80 percent.
Next, the researchers plan to confirm and extend the findings from this pilot study by performing a larger observational trial of patients who have not yet undergone treatment.
The Latest Updates from Bing News & Google News
Go deeper with Bing News on:
Diabetic macular edema
- Emerging Therapies for Diabetic Macular Edemaon June 18, 2020 at 5:00 pm
Diabetic macular edema remains an important cause of visual loss among patients with diabetes mellitus. Some patients continue to lose vision despite standard treatments. Many investigational ...
- Retinal Hemodynamics in Early Diabetic Macular Edemaon June 16, 2020 at 5:00 pm
The defined groups represent a relatively early form of diabetic retinopathy and are ... Groups 3 and 4, those with visible retinopathy and macular edema, respectively, had significantly higher ...
- Opthea’s OPT-302 meets primary endpoints in phase IIa diabetic macular edema trialon June 16, 2020 at 2:40 pm
Regeneron Pharmaceuticals Inc.) in treatment-refractory patients with persistent diabetic macula edema (DME).
- Rezolute Announces Publication of RZ402 Data in Diabetic Macular Edema (DME) in Investigative Ophthalmology & Visual Scienceon June 15, 2020 at 5:40 am
Small molecule RZ402 inhibits the action of that kallikrein pathway, potentially offering the means to clinical treatment objectives including edema reduction and improved visual acuity in people with ...
- What’s Opthea eyeing now that it has two successful trials under its belt?on June 9, 2020 at 8:44 pm
Having now proven its drug works on two eye diseases, Opthea (ASX:OPT) is looking to future treatment options. The immediate consideration ... Read More The post What’s Opthea eyeing now that it has ...
Go deeper with Google Headlines on:
Diabetic macular edema
Go deeper with Bing News on:
Diabetes related vision loss
- Vitamin A may help treat early vision loss in diabeteson June 23, 2020 at 10:12 am
However, the two are closely related. For the study ... therapeutic strategy for the early stages of diabetic retinopathy to prevent vision loss in [people] with diabetes.” ...
- Comment on: How is the risk of being diagnosed with referable diabetic retinopathy affected by failure to attend diabetes eye screening appointments?on June 22, 2020 at 1:03 pm
I enjoyed reading the article “How is the risk of being diagnosed with referable diabetic retinopathy affected by failure to attend diabetes eye screening appointments?” published in your esteemed ...
- Why are diabetics more likely to develop cataractson June 18, 2020 at 8:06 am
You may have heard that diabetes causes eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. But, it ...
- 10 Possible Reasons Your Eyes Are Acting Weird, According to Doctorson June 10, 2020 at 7:57 am
Macular degeneration (or age-related macular degeneration ... “Someone with high cholesterol can have transient vision loss that comes and goes, like a curtain or shade coming and going over their eye ...
- Correctable Visual Impairment Among Persons with Diabetes --- United States, 1999-2004on June 4, 2020 at 5:00 pm
Persons with diabetes ... impairment among persons with diabetes in the United States. The high prevalence of CVI among persons with diabetes indicates a need for enhanced vision-related public ...