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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 -
Iranian Journal of Kidney Diseases Mar 2016Amyloidosis is an extracellular deposition of abnormal serum proteins. Systemic amyloidosis could involve different organs such as the spleen, liver, and kidneys. Renal...
Amyloidosis is an extracellular deposition of abnormal serum proteins. Systemic amyloidosis could involve different organs such as the spleen, liver, and kidneys. Renal artery microaneurysm is very rare in renal amyloidosis. We report a 44-year-old woman who was referred to our general hospital for evaluation of rising serum creatinine level, anemia, and pathological fracture. Two hours following renal biopsy, she developed severe pain in the left flank during voiding and ultrasonography revealed a large perinephric hematoma. She underwent angiography that incidentally showed pseudoaneurysm with diffused renal artery microaneurysm. The feeding artery to the pseudoaneurysm was completely ligated by an interventional radiologist. The subsequent histopathological report of the kidney revealed amyloidosis.
Topics: Adult; Amyloidosis; Aneurysm, False; Female; Hematoma; Humans; Kidney; Kidney Diseases; Microaneurysm; Nephrectomy; Renal Artery
PubMed: 26921752
DOI: No ID Found -
Cureus Nov 2022The presentation of abducens nerve palsy after each occurrence of subarachnoid hemorrhage (SAH) is rare. Herein, we report the case of a patient with a ruptured...
A Case of a Ruptured Microaneurysm at the Tip of the Basilar Artery With Right Abducens Nerve Palsy at the Time of the Initial Rupture and Rerupture During an Outpatient Follow-Up.
The presentation of abducens nerve palsy after each occurrence of subarachnoid hemorrhage (SAH) is rare. Herein, we report the case of a patient with a ruptured microaneurysm at the tip of the basilar artery who presented with right abducens nerve palsy at the time of the initial rupture and rerupture during an outpatient follow-up. A 52-year-old woman developed SAH with right abducens nerve palsy, which was treated with coil embolization. One year after the initial SAH, there was a relapse of the SAH and paresis of the right abducent nerve palsy. This may have been caused by the location of the abducens nerve in relation to the surrounding structures, which were susceptible to the effects of hematoma or intracranial pressure fluctuations. Stent-assisted coil embolization is an effective treatment for regrowth that appears after endovascular therapy of microaneurysms.
PubMed: 36569697
DOI: 10.7759/cureus.31797 -
Diabetic Medicine : a Journal of the... Mar 2011To study the association between baseline retinal microaneurysm score and progression and regression of diabetic retinopathy, and response to treatment with candesartan... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To study the association between baseline retinal microaneurysm score and progression and regression of diabetic retinopathy, and response to treatment with candesartan in people with diabetes.
METHODS
This was a multicenter randomized clinical trial. The progression analysis included 893 patients with Type 1 diabetes and 526 patients with Type 2 diabetes with retinal microaneurysms only at baseline. For regression, 438 with Type 1 and 216 with Type 2 diabetes qualified. Microaneurysms were scored from yearly retinal photographs according to the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Retinopathy progression and regression was defined as two or more step change on the ETDRS scale from baseline. Patients were normoalbuminuric, and normotensive with Type 1 and Type 2 diabetes or treated hypertensive with Type 2 diabetes. They were randomized to treatment with candesartan 32 mg daily or placebo and followed for 4.6 years.
RESULTS
A higher microaneurysm score at baseline predicted an increased risk of retinopathy progression (HR per microaneurysm score 1.08, P < 0.0001 in Type 1 diabetes; HR 1.07, P = 0.0174 in Type 2 diabetes) and reduced the likelihood of regression (HR 0.79, P < 0.0001 in Type 1 diabetes; HR 0.85, P = 0.0009 in Type 2 diabetes), all adjusted for baseline variables and treatment. Candesartan reduced the risk of microaneurysm score progression.
CONCLUSIONS
Microaneurysm counts are important prognostic indicators for worsening of retinopathy, thus microaneurysms are not benign. Treatment with renin-angiotensin system inhibitors is effective in the early stages and may improve mild diabetic retinopathy. Microaneurysm scores may be useful surrogate endpoints in clinical trials.
Topics: Adult; Aneurysm; Angiotensin II Type 1 Receptor Blockers; Benzimidazoles; Biphenyl Compounds; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Disease Progression; Female; Humans; Hypoglycemic Agents; Male; Middle Aged; Predictive Value of Tests; Regression, Psychology; Remission Induction; Retinal Diseases; Tetrazoles
PubMed: 21309844
DOI: 10.1111/j.1464-5491.2010.03210.x -
IEEE Transactions on Medical Imaging Feb 2013A method for the automatic detection of microaneurysms (MAs) in color retinal images is proposed in this paper. The recognition of MAs is an essential step in the...
A method for the automatic detection of microaneurysms (MAs) in color retinal images is proposed in this paper. The recognition of MAs is an essential step in the diagnosis and grading of diabetic retinopathy. The proposed method realizes MA detection through the analysis of directional cross-section profiles centered on the local maximum pixels of the preprocessed image. Peak detection is applied on each profile, and a set of attributes regarding the size, height, and shape of the peak are calculated subsequently. The statistical measures of these attribute values as the orientation of the cross-section changes constitute the feature set that is used in a naïve Bayes classification to exclude spurious candidates. We give a formula for the final score of the remaining candidates, which can be thresholded further for a binary output. The proposed method has been tested in the Retinopathy Online Challenge, where it proved to be competitive with the state-of-the-art approaches. We also present the experimental results for a private image set using the same classifier setup.
Topics: Algorithms; Anatomy, Cross-Sectional; Aneurysm; Diabetic Retinopathy; Fluorescein Angiography; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Pattern Recognition, Automated; Reproducibility of Results; Retinal Artery; Retinoscopy; Rotation; Sensitivity and Specificity
PubMed: 23192523
DOI: 10.1109/TMI.2012.2228665 -
Ophthalmology May 1986In a group of 55 insulin-dependent diabetic patients with early diabetic retinopathy, microaneurysm counts from fluorescein angiograms were related to the level and...
In a group of 55 insulin-dependent diabetic patients with early diabetic retinopathy, microaneurysm counts from fluorescein angiograms were related to the level and severity of retinopathy derived by grading eight standard stereo color photographs as used in the Early Treatment of Retinopathy Study (ETDRS). All patients were studied at 0, 8, and 24 months. Significant correlations were present between both "definite" and "possible" microaneurysm count and retinopathy level of the eye studied and the mean retinopathy level of the two eyes, at all three time intervals, (P less than 0.05-less than 0.001). Similarly, there were significant correlations between microaneurysm counts and severity of the following lesions: microaneurysms and haemorrhages, cotton-wool spots (P less than 0.05-less than 0.001); to a lesser degree, severity of hard exudates (P less than 0.1-less than 0.001) and intraretinal microvascular abnormalities (P not significant-less than 0.001). There was no correlation between microaneurysm count and venous abnormalities (as at no time were there more than 11 eyes with any venous abnormality). We conclude that microaneurysm counts from fluorescein angiograms accurately reflect the severity of important signs in early diabetic retinopathy.
Topics: Adolescent; Adult; Aneurysm; Child; Diabetic Retinopathy; Fluorescein Angiography; Humans; Microcirculation; Retina; Time Factors
PubMed: 3725317
DOI: 10.1016/s0161-6420(86)33692-3 -
Surgical Neurology International 2021Nontraumatic acute subdural hematoma (ASDH) may be caused by rupture of a microaneurysm of a cortical artery. In some cases, microaneurysms may have been caused by...
BACKGROUND
Nontraumatic acute subdural hematoma (ASDH) may be caused by rupture of a microaneurysm of a cortical artery. In some cases, microaneurysms may have been caused by earlier trauma. Although it is difficult to detect microaneurysms on contrast-enhanced computed tomography (CT) angiography or digital subtraction angiography, it may be suspected based on the plain CT scan results and the clinical course.
CASE DESCRIPTION
We experienced three cases presumed to be ASDH due to rupture of a microaneurysm. Plain CT scan showed that the midline shift was smaller than the hematoma thickness, and we judged from the clinical course that there was no trauma immediately before the onset. All three patients had decreased consciousness after arrival and underwent craniotomy for hematoma removal. The source of hemorrhage was in the distal part of the cortical artery, and a microaneurysm was found. In one case, histopathological examination was performed, and traumatic pseudoaneurysm was diagnosed. The postoperative course was good in all three cases.
CONCLUSION
If nontraumatic ASDH is suspected, the source of hemorrhage may be located more distally to the middle cerebral artery than in traumatic ASDH; hence, extensive craniotomy is required to search for the location of hemorrhage.
PubMed: 34513167
DOI: 10.25259/SNI_210_2021 -
Ophthalmologica. Journal International... 2009To examine the relationship between microaneurysm turnover (formation rate), using a new semi-automatic method (MA-Tracker) based on color fundus photographs, and...
Microaneurysm turnover is a biomarker for diabetic retinopathy progression to clinically significant macular edema: findings for type 2 diabetics with nonproliferative retinopathy.
PURPOSE
To examine the relationship between microaneurysm turnover (formation rate), using a new semi-automatic method (MA-Tracker) based on color fundus photographs, and diabetic retinopathy (DR) progression to clinically significant macular edema (CSME).
METHODS
In total, 113 patients/eyes with nonproliferative DR (NPDR) were followed up every 6 months for 2 years as controls of the DR clinical trials, and by conventional general and ophthalmological care for the next 8 years (over a total of 10 years' follow-up). Microaneurysm turnover for the 2 first years was computed using the MA-Tracker.
RESULTS
The 17 patients that developed CSME over the 10 years of follow-up presented a microaneurysm formation rate of 9.2 +/- 18.2 microaneurysms/year (mean +/- SD) during the first 2 years, which was statistically higher than the eyes that did not develop CSME (0.5 +/- 1.2 microaneurysms/year, p < 0.001). These 17 patients also presented higher HbA(1C) levels at baseline (8.5 +/- 1.2%) compared to the patients who did not develop CSME (7.3 +/- 1.2%, p = 0.001).
CONCLUSIONS
A high microaneurysm formation rate on color fundus photographs appears to be a good biomarker for DR progression to CSME in type 2 diabetic patients with NPDR.
Topics: Adult; Aged; Aneurysm; Biomarkers; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Diagnostic Techniques, Ophthalmological; Disease Progression; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Macular Edema; Male; Middle Aged; Photography; Retinal Vessels; Retrospective Studies
PubMed: 19372723
DOI: 10.1159/000213639 -
Computer Methods in Biomechanics and... Nov 2022Blood flow within the vasculature of the retina has been found to influence the progression of diabetic retinopathy. In this research cell resolved blood flow...
Blood flow within the vasculature of the retina has been found to influence the progression of diabetic retinopathy. In this research cell resolved blood flow simulations are used to study the pulsatile flow of whole blood through a segmented retinal microaneurysm. Images were collected using adaptive optics optical coherence tomography of the retina of a patient with diabetic retinopathy, and a sidewall (sacciform) microaneurysm was segmented from the volumetric data. The original microaneurysm neck width was varied to produce two additional aneurysm geometries in order to probe the influence of neck width on the transport of red blood cells and platelets into the aneurysm. Red blood cell membrane stiffness was also increased to resolve the impact of rigid red blood cells, as a result of diabetes, in blood flow. Wall shear stress and wall shear stress gradients were calculated throughout the aneurysm domains, and the quantification of the influence of the red blood cells is presented. Average wall shear stress and wall shear stress gradients increased due to the increase of red blood cell membrane stiffness. Stiffened red blood cells were also found to induce higher local wall shear stress and wall shear stress gradients as they passed through the leading and draining parental vessels. Stiffened red blood cells were found to penetrate the aneurysm sac more than healthy red blood cells, as well as decreasing the margination of platelets to the vessel walls of the parental vessel, which caused a decrease in platelet penetration into the aneurysm sac.
Topics: Humans; Microaneurysm; Diabetic Retinopathy; Erythrocytes; Stress, Mechanical; Aneurysm; Models, Cardiovascular; Diabetes Mellitus
PubMed: 35199620
DOI: 10.1080/10255842.2022.2034794 -
Acta Diabetologica Mar 2010To explore the number and distribution of microaneurysms (MA) in the macula of type 2 diabetics in Kinmen, Taiwan and associated risks for early diabetic retinopathy...
To explore the number and distribution of microaneurysms (MA) in the macula of type 2 diabetics in Kinmen, Taiwan and associated risks for early diabetic retinopathy (DR). A baseline mass screening extracts 971 type 2 diabetics between 1991 and 1993 and follow-up eye screening at 1999 was then done. Number of MA was counted and associated systemic factors collected from a centered 45 degrees color fundus photograph of dilated eyes of type 2 diabetics (Topcon-NW5). Thirty-three (6.2%, n = 527) had MA retinopathy. Those with one eye involved (n = 26) had two mean MA; those with bilateral involvement (n = 7) had four mean per eye. Most MA were located temporally (mean MA = 0.79), then superiorly (mean = 0.58), inferiorly (mean = 0.46) and nasal (mean = 0.28). MA occurred at the 6,000-microm outermost ring (mean = 1.51), then the 3,000-microm ring (mean = 0.35), the 1,500-microm ring (mean = 0.26) and center 500 microm circle (mean = 0.01). After adjusting for confounding factors, early DR with MA was associated with longer duration of type 2 diabetes [odds ratios (OR) = 1.10, 95% confidence interval (CI) 1.00-1.21], higher glycosylated hemoglobin (OR = 1.36, 95%CI 1.11-1.66) and wider waist circumference (OR = 1.04, 95%CI 1.01-1.07). Our photograph grading system suggests that MA number and distribution at the macula may reflect severity of early DR and is a valid tool for predicting the progression of DR. Identifying those factors associated with MA only DR is important in developing prevention strategies for this early microvascular complication of type 2 diabetes.
Topics: Aged; Analysis of Variance; Aneurysm; Blood Pressure; Blood Urea Nitrogen; Body Mass Index; Cholesterol; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Fluorescein Angiography; Functional Laterality; Glycated Hemoglobin; Humans; Macula Lutea; Middle Aged; Regression Analysis; Retinal Diseases; Taiwan; Triglycerides
PubMed: 19183838
DOI: 10.1007/s00592-009-0095-6