Evidence mapPaperPMID 34518161Full record

ArticleThe British journal of ophthalmology2023

Deep learning-based signal-independent assessment of macular avascular area on 6×6 mm optical coherence tomography angiogram in diabetic retinopathy: a comparison to instrument-embedded software.

Honglian Xiong, Qi Sheng You, Yukun Guo, Jie Wang, Bingjie Wang, Liqin Gao, Christina J Flaxel, Steven T Bailey, Thomas S Hwang, Yali Jia

Abstract read
In one paragraph

Article in The British journal of ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Widefield OCT angiography.Progress in retinal and eye research · 2025
    Review
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Honglian XiongSchool of Physics and Optoelectronic Engineering, Foshan University, Foshan, Guangdong 528000, China.
Qi Sheng YouCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.ORCID 0000-0003-0743-7320
Yukun GuoCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.ORCID 0000-0002-6784-2355
Jie WangCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Bingjie WangCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Liqin GaoCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Christina J FlaxelCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Steven T BaileyCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.ORCID 0000-0003-4949-1464
Thomas S HwangCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Yali JiaCasey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA jiaya@ohsu.edu.ORCID 0000-0002-2784-1905

Funding

Proteomics CoreP30EY010572 · OREGON HEALTH & SCIENCE UNIVERSITY · 1995 to 2025
$4.4M
OCT Angiography for Age-related Macular DegenerationR01EY024544 · OREGON HEALTH & SCIENCE UNIVERSITY · 2025 to 2025
$680k
OCTA Precursors of Vision-Threatening Complications of Diabetic RetinopathyR01EY035410 · OREGON HEALTH & SCIENCE UNIVERSITY · 2025 to 2025
$627k
Translational Vision Science Research at Oregon Health & Science UniversityT32EY023211 · OREGON HEALTH & SCIENCE UNIVERSITY · 2025 to 2025
$178k
NEI NIH HHS P30 EY010572NEI NIH HHS R01 EY024544NEI NIH HHS R01 EY027833NEI NIH HHS R01 EY035410NIDDK NIH HHS DP3 DK104397
6 · The paper itself

Abstract

synopsisA deep-learning-based macular extrafoveal avascular area (EAA) on a 6×6 mm optical coherence tomography (OCT) angiogram is less dependent on the signal strength and shadow artefacts, providing better diagnostic accuracy for diabetic retinopathy (DR) severity than the commercial software measured extrafoveal vessel density (EVD).

aimsTo compare a deep-learning-based EAA to commercial output EVD in the diagnostic accuracy of determining DR severity levels from 6×6 mm OCT angiography (OCTA) scans.

methodsThe 6×6 mm macular OCTA scans were acquired on one eye of each participant with a spectral-domain OCTA system. After excluding the central 1 mm diameter circle, the EAA on superficial vascular complex was measured with a deep-learning-based algorithm, and the EVD was obtained with commercial software.

resultsThe study included 34 healthy controls and 118 diabetic patients. EAA and EVD were highly correlated with DR severity (ρ=0.812 and -0.577, respectively, both p<0.001) and visual acuity (r=-0.357 and 0.420, respectively, both p<0.001). EAA had a significantly (p<0.001) higher correlation with DR severity than EVD. With the specificity at 95%, the sensitivities of EAA for differentiating diabetes mellitus (DM), DR and severe DR from control were 80.5%, 92.0% and 100.0%, respectively, significantly higher than those of EVD 11.9% (p=0.001), 13.6% (p<0.001) and 15.8% (p<0.001), respectively. EVD was significantly correlated with signal strength index (SSI) (r=0.607, p<0.001) and shadow area (r=-0.530, p<0.001), but EAA was not (r=-0.044, p=0.805 and r=-0.046, p=0.796, respectively). Adjustment of EVD with SSI and shadow area lowered sensitivities for detection of DM, DR and severe DR.

conclusionMacular EAA on 6×6 mm OCTA measured with a deep learning-based algorithm is less dependent on the signal strength and shadow artefacts, and provides better diagnostic accuracy for DR severity than EVD measured with the instrument-embedded software.

Indexed as

Diabetic RetinopathyDeep LearningFluorescein AngiographyHumansRetinal VesselsSoftwareTomography, Optical Coherenceimagingretina

Identifiers

PMID34518161
PMCPMC8918061

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.