Browsing by Author "Thompson, Atalie C"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Item Open Access Choroidal Structural Analysis in Alzheimer's Disease, Mild Cognitive Impairment, and Cognitively Healthy Controls.(Am J Ophthalmol, 2020-10-08) Robbins, Cason B; Grewal, Dilraj S; Thompson, Atalie C; Powers, James H; Soundararajan, Srinath; Koo, Hui Yan; Yoon, Stephen P; Polascik, Bryce W; Liu, Andy; Agrawal, Rupesh; Fekrat, SharonPURPOSE: To assess choroidal structural parameters in symptomatic Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively healthy controls. DESIGN: Prospective cross-sectional study. METHODS: Setting: Outpatient neurological disorders clinic. STUDY POPULATION: One hundred and twelve eyes of 67 individuals with AD, 143 eyes of 74 individuals with MCI, and 248 eyes of 137 controls. Individuals with diabetes, glaucoma, or retinal pathology were excluded. OBSERVATION PROCEDURE: High-definition EDI foveal scans were obtained using Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss Meditec, Dublin, CA). Subfoveal choroidal thickness (SFCT) was measured by two masked graders with a third adjudicator. Total choroidal area (TCA), luminal area (LA), and choroidal vascularity index (CVI) were calculated after image binarization. MAIN OUTCOME MEASURES: Association of choroidal parameters with AD, MCI, or controls using generalized estimating equations, adjusted for age and sex. RESULTS: After adjustment for age, sex, and visual acuity, TCA was significantly greater in AD (ß 2.73, p = 0.001) and MCI (ß 4.38, p < 0.001) compared to controls, LA was significantly greater in AD (ß 1.68, p = 0.001) and MCI (ß 2.69, p < 0.001) compared to controls, and CVI was significantly lower in MCI (ß -0.58, p = 0.002) compared to controls. SFCT was similar among AD, MCI, and controls on multivariable analysis (p > 0.05). CONCLUSIONS: TCA, LA, and CVI may differ between individuals with AD, MCI, and healthy cognition, whereas SFCT may not differ between these groups. TCA, LA, and CVI deserve further study in individuals along the Alzheimer's continuum.Item Open Access Convolutional neural network to identify symptomatic Alzheimer's disease using multimodal retinal imaging.(The British journal of ophthalmology, 2020-11-26) Wisely, C Ellis; Wang, Dong; Henao, Ricardo; Grewal, Dilraj S; Thompson, Atalie C; Robbins, Cason B; Yoon, Stephen P; Soundararajan, Srinath; Polascik, Bryce W; Burke, James R; Liu, Andy; Carin, Lawrence; Fekrat, SharonBACKGROUND/AIMS:To develop a convolutional neural network (CNN) to detect symptomatic Alzheimer's disease (AD) using a combination of multimodal retinal images and patient data. METHODS:Colour maps of ganglion cell-inner plexiform layer (GC-IPL) thickness, superficial capillary plexus (SCP) optical coherence tomography angiography (OCTA) images, and ultra-widefield (UWF) colour and fundus autofluorescence (FAF) scanning laser ophthalmoscopy images were captured in individuals with AD or healthy cognition. A CNN to predict AD diagnosis was developed using multimodal retinal images, OCT and OCTA quantitative data, and patient data. RESULTS:284 eyes of 159 subjects (222 eyes from 123 cognitively healthy subjects and 62 eyes from 36 subjects with AD) were used to develop the model. Area under the receiving operating characteristic curve (AUC) values for predicted probability of AD for the independent test set varied by input used: UWF colour AUC 0.450 (95% CI 0.282, 0.592), OCTA SCP 0.582 (95% CI 0.440, 0.724), UWF FAF 0.618 (95% CI 0.462, 0.773), GC-IPL maps 0.809 (95% CI 0.700, 0.919). A model incorporating all images, quantitative data and patient data (AUC 0.836 (CI 0.729, 0.943)) performed similarly to models only incorporating all images (AUC 0.829 (95% CI 0.719, 0.939)). GC-IPL maps, quantitative data and patient data AUC 0.841 (95% CI 0.739, 0.943). CONCLUSION:Our CNN used multimodal retinal images to successfully predict diagnosis of symptomatic AD in an independent test set. GC-IPL maps were the most useful single inputs for prediction. Models including only images performed similarly to models also including quantitative data and patient data.Item Open Access Relationship between electronically measured medication adherence and vision-related quality of life in a cohort of patients with open-angle glaucoma.(BMJ open ophthalmology, 2018-01) Thompson, Atalie C; Woolson, Sandra; Olsen, Maren K; Danus, Susanne; Bosworth, Hayden B; Muir, Kelly WObjective
To investigate whether electronically measured medication adherence is associated with vision-related quality of life (VRQoL) in patients with open-angle glaucoma.Methods and analysis
This is a 3-year prospective cohort study of 79 subjects with open-angle glaucoma at a Veterans Affairs medical centre. Participants returned a medication event monitoring system (MEMS) for their glaucoma eye-drops and had at least two visits with glaucoma during the study period. Those taking less than 80% of prescribed glaucoma medication doses were considered to be non-adherent. Subjects were interviewed using the National Eye Institute's Visual Function Questionnaire-25 (VFQ-25) at baseline and after 3 years.Results
Thirty per cent (n=24/79) of participants took less than 80% of prescribed doses of their glaucoma medications at baseline. Patients who did not adhere to their medications at baseline had lower mean composite VFQ-25 scores at baseline (70.66±20.50 vs 75.91±19.12, standardised mean difference=0.27) and after 3 years (71.68±21.93 vs 76.25±21.67, standardised mean difference=0.21). Visual acuity (P=0.03), but not visual field severity (P=0.13) or medication adherence (P=0.30), was significantly associated with composite VFQ-25 score in an adjusted model.Conclusions
Subjects who were non-adherent to their glaucoma medications at baseline as assessed by a MEMS device reported lower VRQoL than adherent subjects at baseline and after 3 years. However, visual acuity was significantly associated with VRQoL. Future studies should assess whether improved adherence to eye-drops impacts VRQoL in patients with glaucoma.Item Open Access Retinal and Choroidal Changes in Men Compared with Women with Alzheimer's Disease: A Case-Control Study.(Ophthalmology science, 2022-03) Mirzania, Delaram; Thompson, Atalie C; Robbins, Cason B; Soundararajan, Srinath; Lee, Jia Min; Agrawal, Rupesh; Liu, Andy J; Johnson, Kim G; Grewal, Dilraj S; Fekrat, SharonPurpose
To evaluate differences in the retinal microvasculature and structure and choroidal structure among men and women with Alzheimer's disease (AD) compared with age-matched cognitively normal male and female controls.Design
Case-control study of participants ≥ 50 years of age.Participants
A total of 202 eyes of 139 subjects (101 cases and 101 controls).Methods
All participants and controls underwent OCT and OCT angiography (OCTA), and parameters of subjects with AD were compared with those of cognitively normal controls.Main outcome measures
The foveal avascular zone (FAZ) area, vessel density (VD), and perfusion density (PD) in the superficial capillary plexus within the 3- and 6-mm circle and ring using Early Treatment Diabetic Retinopathy Study (ETDRS) grid overlay on OCTA; central subfield thickness (CST), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, and choroidal vascularity index (CVI) on OCT.Results
No significant sex differences in VD or PD were found in the AD or control cohorts; however, there were greater differences in VD and PD among AD female participants than AD male participants compared with their respective controls. The CST and FAZ area were not different between male and female AD participants. Among controls, men had a thicker CST (P < 0.001) and smaller FAZ area (P = 0.003) compared with women. The RNFL thickness, GCIPL thickness, and CVI were similar among male and female AD participants and controls.Conclusions
There may be a loss of the physiologic sex-related differences in retinal structure and microvasculature in those with AD compared with controls. Further studies are needed to elucidate the pathophysiological basis for these findings.Item Open Access The Effect of Age on Increasing Susceptibility to Retinal Nerve Fiber Layer Loss in Glaucoma.(Investigative ophthalmology & visual science, 2020-11) Jammal, Alessandro A; Berchuck, Samuel I; Thompson, Atalie C; Costa, Vital P; Medeiros, Felipe APurpose:To determine whether aging modifies the effect of intraocular pressure (IOP) on progressive glaucomatous retinal nerve fiber layer (RNFL) thinning over time. Methods:This was a retrospective cohort study involving patients with glaucoma or suspected of having glaucoma who were followed over time from the Duke Glaucoma Registry. Rates of RNFL loss from spectral-domain optical coherence tomography (SD-OCT) were used to assess disease progression. Generalized estimating equations with robust sandwich variance estimators were used to investigate the effects of the interaction of age at baseline and mean IOP on rates of RNFL loss over time. Models were adjusted for gender, race, diagnosis, central corneal thickness, follow-up time, and baseline disease severity. Results:The study included 85,475 IOP measurements and 60,026 SD-OCT tests of 14,739 eyes of 7814 patients. Eyes had a mean follow-up time of 3.5 ± 1.9 years. The average rate of change in RNFL thickness was -0.70 µm/year (95% confidence interval, -0.72 to -0.67). There was a significant interaction between age and mean IOP and the rate of RNFL loss (P = 0.001), with older eyes having significantly faster rates of RNFL loss than younger ones for the same level of IOP. The effect of IOP on rates of change was greater in the inferior and superior regions of the optic disc. Conclusions:Age is a significant modifier of the relationship between IOP and glaucomatous loss in RNFL thickness over time. Older patients may be more susceptible to glaucomatous progression than younger patients at the same level of IOP.