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Zhonghua Nei Ke Za Zhi Jul 2022Polyarteritis nodosa (PAN) is a rare vasculitis that mainly involves small and medium arteries. It often occurs at the points where the vessels bifurcate, leading to...
Polyarteritis nodosa (PAN) is a rare vasculitis that mainly involves small and medium arteries. It often occurs at the points where the vessels bifurcate, leading to microaneurysm formation, thrombosis, aneurysm rupture and bleeding, and infarction of organs.About a third of cases are associated with hepatitis B virus (HBV) infection.All tissues and organs of the body can be affected, with skin, joints and peripheral nerves being the most common.The pathological changes were fibrinoid necrosis, inflammatory cell infiltration and luminal thrombosis in the acute stage, and fibrous hyperplasia in the chronic stage.Overall outcomes for the disease have improved in recent decades, mainly reflecting early diagnosis and more effective treatments.The main treatments for PAN are glucocorticoid and cyclophosphamide.Patients with HBV-associated PAN should receive antiviral therapy and plasma exchange.
Topics: Hepatitis B; Hepatitis B virus; Humans; Plasma Exchange; Polyarteritis Nodosa; Vasculitis
PubMed: 35764557
DOI: 10.3760/cma.j.cn112138-20211201-00852 -
Journal Francais D'ophtalmologie Jun 2018
Topics: Fluorescein Angiography; Humans; Male; Microaneurysm; Morocco; Optic Atrophy, Hereditary, Leber; Retinal Telangiectasis; Retinal Vessels; Tomography, Optical Coherence; Young Adult
PubMed: 29887406
DOI: 10.1016/j.jfo.2017.10.012 -
Computer Methods and Programs in... May 2018Diabetic retinopathy is a microvascular complication of diabetes that can lead to sight loss if treated not early enough. Microaneurysms are the earliest clinical signs...
BACKROUND AND OBJECTIVES
Diabetic retinopathy is a microvascular complication of diabetes that can lead to sight loss if treated not early enough. Microaneurysms are the earliest clinical signs of diabetic retinopathy. This paper presents an automatic method for detecting microaneurysms in fundus photographies.
METHODS
A novel patch-based fully convolutional neural network with batch normalization layers and Dice loss function is proposed. Compared to other methods that require up to five processing stages, it requires only three. Furthermore, to the best of the authors' knowledge, this is the first paper that shows how to successfully transfer knowledge between datasets in the microaneurysm detection domain.
RESULTS
The proposed method was evaluated using three publicly available and widely used datasets: E-Ophtha, DIARETDB1, and ROC. It achieved better results than state-of-the-art methods using the FROC metric. The proposed algorithm accomplished highest sensitivities for low false positive rates, which is particularly important for screening purposes.
CONCLUSIONS
Performance, simplicity, and robustness of the proposed method demonstrates its suitability for diabetic retinopathy screening applications.
Topics: Algorithms; Automation; Datasets as Topic; Diabetic Retinopathy; Diagnostic Imaging; Fundus Oculi; Humans; Microaneurysm; Neural Networks, Computer; Photography
PubMed: 29544784
DOI: 10.1016/j.cmpb.2018.02.016 -
European Journal of Ophthalmology May 2020Diabetic retinopathy is a common diabetes complication representing a heavy burden in terms of visual impairment and heath expenditure. Optical coherence tomography... (Review)
Review
Diabetic retinopathy is a common diabetes complication representing a heavy burden in terms of visual impairment and heath expenditure. Optical coherence tomography angiography is a relatively new imaging method and has proven to be a powerful tool in the analysis of diabetic retinopathy common features, including microaneurysms, intraretinal microvascular abnormalities, or neovascularization, as well as in research field, challenging the gold standard of fluorescein angiography. Many studies underlined the vascular impairment observed through optical coherence tomography angiography and its typical parameters such as vessel length density, foveal avascular zone, and fractal dimension. Choriocapillaris involvement in the pathogenesis of diabetic retinopathy is an interesting point, derived from the analysis of this plexus using optical coherence tomography angiography. In conclusion, optical coherence tomography angiography, which is not free of limitations, such as motion artifacts or segmentation errors, has become an indispensable technique in adding more information to our understanding of diabetic retinopathy.
Topics: Choroid; Diabetic Retinopathy; Fluorescein Angiography; Humans; Macula Lutea; Optic Disk; Retinal Vessels; Tomography, Optical Coherence
PubMed: 31928211
DOI: 10.1177/1120672119899901 -
Clinical Neuroradiology Sep 2023Digital subtraction angiography provides excellent spatial and temporal resolution; however, it lacks the capability to depict the nonvascular anatomy of the brain and...
Digital subtraction angiography provides excellent spatial and temporal resolution; however, it lacks the capability to depict the nonvascular anatomy of the brain and spinal cord.A review of the institutional database identified five patients in whom a new integrated fusion workflow of cross-sectional imaging and 3D rotational angiography (3DRA) provided important diagnostic information and assisted in treatment planning. These included two acutely ruptured brain arteriovenous malformations (AVM), a small superficial brainstem AVM after radiosurgery, a thalamic microaneurysm, and a spine AVM, and fusion was crucial for diagnosis and influenced further treatment.Fusion of 3DRA and cross-sectional imaging may help to gain a deeper understanding of neurovascular diseases. This is advantageous for planning and providing treatment and, most importantly, may harbor the potential to minimize complication rates. Integrating image fusion in the work-up of cerebrovascular diseases is likely to have a major impact on the neurovascular field in the future.
Topics: Humans; Angiography, Digital Subtraction; Imaging, Three-Dimensional; Intracranial Arteriovenous Malformations; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 36745215
DOI: 10.1007/s00062-022-01260-0 -
The British Journal of Ophthalmology Feb 2019To analyse retinopathy phenotypes and microaneurysm (MA) turnover in mild non-proliferative diabetic retinopathy (NPDR) as predictors of progression to diabetic...
AIM
To analyse retinopathy phenotypes and microaneurysm (MA) turnover in mild non-proliferative diabetic retinopathy (NPDR) as predictors of progression to diabetic central-involved macular oedema (CIMO) in patients with type 2 diabetes mellitus (DM) in two different ethnic populations.
METHODS
205 patients with type 2 DM and mild NPDR were followed in a prospective observational study for 2 years or until development of CIMO, in two centres from different regions of the world. Ophthalmological examinations, including best-corrected visual acuity (BCVA), fundus photography with RetmarkerDR analysis, and optical coherence tomography (OCT), were performed at baseline and 6 12 and 24 months.
RESULTS
158 eyes/patients reached either the study endpoint, CIMO (24) or performed the last study visit (24-month visit) without developing CIMO (134). From the eyes/patients in analysis, 27 eyes (17.1%) progressed to more advanced ETDRS (Early Treatment Diabetic Retinopathy Study) levels: 6 progressed to mild NPDR (level 35), 15 progressed to moderate NPDR (level 43), 5 progressed to moderately severe NPDR (level 47) and 1 progressed to high risk PDR (level 71). Worsening in ETDRS level is associated with phenotype C (p=0.005). From the 130 eyes/patients with a low MA turnover, 18 (13.8%) eyes/patients had an increase in ETDRS level, and from the 19 eyes/patients with a high MA turnover, 9 (47.4%) had an increase in ETDRS level (p<0.001).
CONCLUSION
Eyes in the initial stages of diabetic retinopathy show different phenotypes with different risks for progression to CIMO. In phenotype C, MA turnover correlates with ETDRS grading worsening and development of CIMO.
Topics: Adult; Aged; Blood Glucose; Blood Pressure; Body Mass Index; Cholesterol; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Disease Progression; Female; Glycated Hemoglobin; Humans; Image Processing, Computer-Assisted; Macular Edema; Male; Microaneurysm; Middle Aged; Prospective Studies; Risk Factors
PubMed: 29699981
DOI: 10.1136/bjophthalmol-2018-311887 -
OTO Open 2023We investigated the association between retinal microvascular changes and hearing loss based on the hypothesis that both may result from shared microvascular pathology....
We investigated the association between retinal microvascular changes and hearing loss based on the hypothesis that both may result from shared microvascular pathology. Data from 536 older adults from the National Health and Nutritional Examination Survey 2005 to 2006 including sociodemographic and health characteristics, pure-tone hearing thresholds, and retinal pathologies were collected and analyzed. Associations between retinal and hearing pathologies were modeled with multivariable-adjusted linear regressions. 75% of participants had hearing loss and 15% of participants had retinopathy. The association between retinopathy, microaneurysms, and blot hemorrhages with better speech-frequency pure tone average was -2.81 (95% confidence interval [CI]: -5.72 to 0.10), -4.75 (95% CI: -8.73 to -0.78), and -5.34 (95% CI: -8.68 to -2.00), respectively. The presence of retinopathy, microaneurysms, and blot hemorrhages was inversely associated with hearing loss. Further studies are needed to better understand the potential relationship between microvascular pathologies of the eye and ear.
PubMed: 38093719
DOI: 10.1002/oto2.99 -
Canadian Journal of Ophthalmology.... Oct 2019Optical coherence tomography angiography (OCTA) is a noninvasive method that enables visualization of blood flow within retinal vessels down to the size of capillaries... (Review)
Review
Optical coherence tomography angiography (OCTA) is a noninvasive method that enables visualization of blood flow within retinal vessels down to the size of capillaries by detecting motion contrast from moving blood cells. OCTA provides a fast and safe procedure to assess retinal microvasculature with higher contrast and resolution than conventional fluorescence angiography. The different capillary plexuses are displayed separately and their perfusion density can be quantified. Imaging capabilities such as these have led to an emerging field of clinical application for OCTA in vascular diseases such as diabetic retinopathy (DR). Evaluation of parameters such as parafoveal capillary perfusion density could be a biomarker for disease diagnosis and progression. Typical microvascular changes in DR such as capillary nonperfusion, microaneurysms, intraretinal microvascular abnormalities, and neovascularization can be reliably detected in optical coherence tomography angiograms, characterized in detail and attributed to the different capillary plexuses. Monitoring of these lesions in vivo gives potential novel insight into the pathophysiology in DR. The aim of this article is to summarize the potential applications/utility of OCTA in DR reported in the literature.
Topics: Capillaries; Diabetic Retinopathy; Fluorescein Angiography; Fundus Oculi; Humans; Retinal Vessels; Tomography, Optical Coherence
PubMed: 31564340
DOI: 10.1016/j.jcjo.2019.02.010 -
IEEE Transactions on Medical Imaging May 2018Timely detection and treatment of microaneurysms is a critical step to prevent the development of vision-threatening eye diseases such as diabetic retinopathy. However,...
Timely detection and treatment of microaneurysms is a critical step to prevent the development of vision-threatening eye diseases such as diabetic retinopathy. However, detecting microaneurysms in fundus images is a highly challenging task due to the low image contrast, misleading cues of other red lesions, and the large variation of imaging conditions. Existing methods tend to fail in face of the large intra-class variation and small inter-class variations for microaneurysm detection in fundus images. Recently, hybrid text/image mining computer-aided diagnosis systems have emerged to offer a promise of bridging the semantic gap between images and diagnostic information. In this paper, we focus on developing an interleaved deep mining technique to cope intelligently with the unbalanced microaneurysm detection problem. Specifically, we present a clinical report guided multi-sieving convolutional neural network, which leverages a small amount of supervised information in clinical reports to identify the potential microaneurysm regions via the image-to-text mapping in the feature space. These potential microaneurysm regions are then interleaved with fundus image information for multi-sieving deep mining in a highly unbalanced classification problem. Critically, the clinical reports are employed to bridge the semantic gap between low-level image features and high-level diagnostic information. We build an efficient microaneurysm detection framework based on the hybrid text/image interleaving and validate its performance on challenging clinical data sets acquired from diabetic retinopathy patients. Extensive evaluations are carried out in terms of fundus detection and classification. Experimental results show that our framework achieves 99.7% precision and 87.8% recall, comparing favorably with the state-of-the-art algorithms. Integration of expert domain knowledge and image information demonstrates the feasibility of reducing the difficulty of training classifiers under extremely unbalanced data distributions.
Topics: Deep Learning; Diabetic Retinopathy; Humans; Image Interpretation, Computer-Assisted; Microaneurysm; Retinal Vessels
PubMed: 29727278
DOI: 10.1109/TMI.2018.2794988 -
European Journal of Ophthalmology Sep 2020Fundus image analysis is the basis for the better understanding of retinal diseases which are found due to diabetes. Detection of earlier markers such as microaneurysms...
AIM
Fundus image analysis is the basis for the better understanding of retinal diseases which are found due to diabetes. Detection of earlier markers such as microaneurysms that appear in fundus images combined with treatment proves beneficial to prevent further complications of diabetic retinopathy with an increased risk of sight loss.
METHODS
The proposed algorithm consists of three modules: (1) image enhancement through morphological processing; (2) the extraction and removal of red structures, such as blood vessels preceded by detection and removal of bright artefacts; (3) finally, the true microaneurysm candidate selection among other structures based on feature extraction set.
RESULTS
The proposed strategy is successfully evaluated on two publicly available databases containing both normal and pathological images. The sensitivity of 89.22%, specificity of 91% and accuracy of 92% achieved for the detection of microaneurysms for Diaretdb1 database images. The algorithm evaluation for microaneurysm detection has a sensitivity of 83% and specificity 82% for e-ophtha database.
CONCLUSION
In automated detection system, the successful detection of the number of microaneurysms correlates with the stages of the retinal diseases and its early diagnosis. The results for true microaneurysm detection indicates it as a useful tool for screening colour fundus images, which proves time saving for counting of microaneurysms to follow Diabetic Retinopathy Grading Criteria.
Topics: Algorithms; Capillaries; Databases, Factual; Diabetic Retinopathy; Fundus Oculi; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Mathematical Computing; Microaneurysm; Retinal Vessels
PubMed: 31018679
DOI: 10.1177/1120672119843021