Multi-Modal Retinal Imaging

Revolutionizing today’s retinal disease treatment

During the 15th Congress of the Asia-Pacific Vitreo-retina Society (APVRS 2022) the Media MICE team covered a number of topics where researchers are making leaps and bounds, all for the benefit of patients and significantly improved patient outcomes.

Case in point: The symposium on Advanced Retinal Imaging emphasized how imaging is revolutionizing the treatment of retinal diseases today.

Imaging uveitis

To kick off the session, Dr. ShwuJiuan Sheu from the department of ophthalmology at Kaohsiung Medical University Hospital (Kaohsiung, Taiwan) gave an interesting presentation on Imaging in Posterior Uveitis.

While she covered a number of topics related to multi-modal imaging in the treatment of uveitis, the one that particularly caught our interest was fundus autofluorescence (FAF), a non-invasive imaging modality that can map naturally and pathologically occurring fluorophores in the posterior segment. Dr. Sheu reported that this technique is particularly useful as it can identify the hyperautofluorescence caused by uveitis, which occurs from a “loss of

by Andrew Sweeney

beneficial, especially for eyes with severe levels of DR, as its broad focus provides the best data for “optimal assessment and prognostication.” Finally, Dr. Sadda said that in one of his own studies, a deep learning model using UWF images was able to perform “at a level that suggests utility in a clinical environment,” and that a trial is currently underway to ascertain its performance in a realworld setting.

If you smoke, please stop

In another presentation —

Classification of AMD on OCT: rhodopsin from photoreceptors.” In addition, she recommended the use of a multi-modal imaging approach when diagnosing and treating uveitis.

Diabetes, a half-a-billion ticking timebomb

Dr. Srinivas Sadda, the director of the Artificial Intelligence & Imaging Research Department at the Doheny Eye Institute, and professor of ophthalmology at the University of California Los Angeles (UCLA) provided another excellent presentation — UWF Imaging in Screening DR: Implications from AI He pointed out the global need for improved diabetic retinopathy (DR) screening and treatment options, as by 2040 there will be “620 million people diagnosed with diabetes.”

The challenge, Dr. Sadda said, was intervening early enough with this new cohort of future patients to save their sight. As currently, only 29% of patients are meeting standard screening recommendations.

Dr. Sadda stated he believes that autonomous, AI-based approaches are now available that have the sufficient capacity and reliability to facilitate DR screening programs. The trick is that they must be able to “consider the entire retina area” while doing so. He points to the use of UWF imaging as being particularly

Update from CAM — Dr. Lim Tock Han, adjunct professor at the Lee Kong Chian School of Medicine in Singapore, introduced CAM, a group originally founded to investigate treatments for geographic atrophy (GA) and to manage chronic systemic disease related to macular atrophy. One of the recommendations that Dr. Han takes from this collective is that the use of color fundus photo is insufficient to “identify early stages of the disease,” especially for GA. He said that instead, clinicians should always opt for a multi-modal imaging technique to achieve the best diagnostic results.

Dr. Han also spoke about the importance of identifying cases of AMD drusen and cases associated with macular atrophy. He said that this requires a “deep dive into multimodal imaging” to differentiate AMD drusen from other cases as the treatment pathway is different from more conventional cases of AMD.

Finally, he said clinicians in general (from the Asia-Pacific region specifically) should adopt a population-based approach to managing patients with AMD by intervening early and promoting smoking cessation, which remains a major problem in the region.

Editor’s Note

The 15th Congress of the AsiaPacific Vitreo-retina Society (APVRS 2022) was held on November 18 to 20, 2022, in Taipei, Taiwan. Reporting for this story took place during the event. A version of this article was first published on piemagazine.org