Ability of eye-care professionals in grading retinal fluid volumes and change in age-related macular degeneration assessed by automated fluid monitoring

摘要: Purpose: To use an AI-based fluid algorithm to determine the discriminative ability of eye-care professionals in grading intra-and subretinal fluid (IRF, SRF) presence and volume change in real-world OCT images of patients with nAMD.Methods: Patients with nAMD treated at our retina department between 2007 and 2018 were included in the Vienna Imaging Biomarker Eye Study (VIBES) registry. 5 retinologists (RET), 3 ophthalmology residents (RES), 3 general ophthalmologists (GENO), 3 orthoptists (ORTH) and 3 certified graders from the Vienna Reading Center (VRC) graded the presence of IRF/SRF at two consecutive visits as well as the change (increase/no change/decrease) on Spectralis OCT images. Intervals ranged from 28 to 120 days between visits and anti-VEGF injections were given between the two visits. The Vienna Fluid Monitor Version 2 (RetInSight, Vienna, Austria) was applied to automatically segment and quantify IRF/SRF volumes. ROC curves were then generated to determine volume cut-offs (nl) for fluid presence and change that provided the best tradeoff between sensitivity (Sen) and specificity (Spe)(= Youden Index).Results: 124 visit pairs of 59 eyes were included. For IRF presence, fluid volumes between 3, 3-6nl were most accurately detected across all groups with 0, 79-0, 87 (Sen) and 0, 92-0, 97 (Spe). For SRF presence, volumes between 4-7, 1nl correlated with 0, 82-0, 95 (Sen) and 0, 92-0, 97 (Spe). In terms of fluid change, an IRF increase as small as 1, 7-3nl was detected with 0, 91-1, 0 (Sen) and 0, 88-0, 93 (Spe) and an IRF decrease of 2, 8-16, 9nl with 0, 83-0, 9 (Sen) and 0, 9-0, 96 (Spe). SRF increases of 0 …