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Current applications of machine learning in the screening and diagnosis of glaucoma: a systematic review and Meta-analysis

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International Journal of Ophthalmology(English edition) 2020年第1期13卷 149-162页

作者： patrick murtagh Garrett Greene Colm O'Brien Department of Ophthalmology Mater Misericordiae University HospitalEccles StreetDublin D07 R2WYIreland RCSI Education and Research Centre Beaumont HospitalDublin D05 AT88Ireland

AIM: To compare the effectiveness of two well described machine learning modalities, ocular coherence tomography(OCT) and fundal photography, in terms of diagnostic accuracy in the screening and diagnosis of glaucoma. METHODS: A systematic search of Embase and Pub Med databases was undertaken up to 1 st of February 2019. Articles were identified alongside their reference lists and relevant studies were aggregated. A Meta-analysis of diagnostic accuracy in terms of area under the receiver operating curve(AUROC) was performed. For the studies which did not report an AUROC, reported sensitivity and specificity values were combined to create a summary ROC curve which was included in the ***: A total of 23 studies were deemed suitable for inclusion in the Meta-analysis. This included 10 papers from the OCT cohort and 13 from the fundal photos cohort. Random effects Meta-analysis gave a pooled AUROC of 0.957(95%CI=0.917 to 0.997) for fundal photos and 0.923(95%CI=0.889 to 0.957) for the OCT cohort. The slightly higher accuracy of fundal photos methods is likely attributable to the much larger database of images used to train the models(59 788 vs 1743). CONCLUSION: No demonstrable difference is shown between the diagnostic accuracy of the two modalities. The ease of access and lower cost associated with fundal photo acquisition make that the more appealing option in terms of screening on a global scale, however further studies need to be undertaken, owing largely to the poor study quality associated with the fundal photography cohort.

关键词： machine learning glaucoma ocular coherence tomography fundal photography diagnosis Meta-analysis

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Final anatomic and visual outcomes appear independent of duration of silicone oil intraocular tamponade in complex retinal detachment surgery

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International Journal of Ophthalmology(English edition) 2018年第1期11卷 83-88页

作者： Maedbh Rhatigan Elizabeth Mc Elnea patrick murtagh Kirk Stephenson Elaine Harris Paul Connell David Keegan Department of Ophthalmology Mater Misericordiae University Hospital

AIM： To report anatomic and visual outcomes following silicone oil removal in a cohort of patients with complex retinal detachment, to determine association between duration of tamponade and outcomes and to compare patients with oil removed and those with oil in situ in terms of demographic, surgical and visual factors. METHODS： We reported a four years retrospective case series of 143 patients with complex retinal detachments who underwent intraocular silicone oil tamponade. Analysis between anatomic and visual outcomes, baseline demographics, duration of tamponade and number of surgical procedures were carried out using Fisher＇s exact test and unpaired two-tailed t-test. RESULTS： One hundred and six patients（76.2%） had undergone silicone oil removal at the time of review with 96 patients（90.6%） showing retinal reattachment following oil removal. Duration of tamponade was not associated with final reattachment rate or with a deterioration in best corrected visual acuity（BCVA）. Patients with oil removed had a significantly better baseline and final BCVA compared to those under oil tamponade（P=0.0001, 〈0.0001 respectively）. CONCLUSION： Anatomic and visual outcomes in this cohort are in keeping with those reported in the literature. Favorable outcomes were seen with oil removal but duration of oil tamponade does not affect final attachment rate with modern surgical techniques and should be managed on a case by case basis.

关键词： silicone oil tamponade proliferative vitreoretinopathy retinal detachment

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Neuromyelitis optica spectrum disorders and anti-myelin oligodendrocyte glycoprotein positive optic neuropathies

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International Journal of Ophthalmology(English edition) 2022年第7期15卷 1095-1107页

作者： patrick murtagh Amy Coman Kirk Stephenson Maria Gaughan David Ryan Graeme McNeill Christopher McGuigan Lorraine Cassidy Royal Victoria Eye and Ear Hospital Adelaide RoadDublin 2D02 XK51Republic of Ireland St Vincent’s University Hospital Elm ParkDublin 4D04 N2E0Republic of Ireland

AIM: To describe the clinical characteristics and treatments associated with antibody positive optic neuropathies including anti-myelin oligodendrocyte glycoprotein(MOG) and anti-aquaporin 4(AQP4), alongside diagnostic modalities, investigations, and outcomes. METHODS: A cross-sectional single-centre retrospective case series consisting of 16 patients including 12 antiMOG positive patients and 4 anti-AQP4 positive patients. Each of these patients had clinical signs and symptoms of optic neuritis and consisted of all patients who had a positive blood antibody result in our centre. Clinical findings including presence of a relative afferent pupillary defect, colour vision and disc assessment were recorded. Structured clinical exam and multimodal imaging was undertaken sequentially on each. Optical coherence tomography(OCT) scanning was preformed to examine the correlation between ganglion cell layer(GCL) thickness and visual acuity(VA) at presentation and as a determinant of final visual outcome in both groups. Initial and long-term treatment is also summarised. RESULTS: A total of 16 patients were included in the study consisting of 12 anti-MOG and 4 anti-AQP4 positive patients. Nine of the 16 patients were female and the average age of onset was 29.2 y in the MOG group and 42 y in the AQP4 group. There was no statistically significant correlation(Pearson correlation) between GCL thickness and presenting and final VA [r(10)=0.081, P=0.08 and r(10)=0.089, P=0.34 respectively]. The same statistical analysis was performed for the correlation between retinal nerve fibre layer(RNFL) and VA and similar outcomes wereobserved [r(10)=0.04, P=0.22 and r(10)=0.09, P=0.04]. No correlation was seen for initial RNFL thickness and final visual outcome in this group either [r(2)=0.19, P=0.38]. Visual field testing and radiological findings for each group are described. CONCLUSION: No correlation between initial VA or RNFL and final visual outcome is identified. A broad range of visu

关键词： neuromyelitis anti-myelin oligodendrocyte glycoprotein antibody anti-aquaporin 4

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