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Abstract
Aim To explore associations between artificial intelligence (AI)-based fluid compartment quantifications and 12 months visual outcomes in OCT images from a real-world, multicentre, national cohort of naïve neovascular age-related macular degeneration (nAMD) treated eyes.
Methods Demographics, visual acuity (VA), drug and number of injections data were collected using a validated web-based tool. Fluid compartment quantifications including intraretinal fluid (IRF), subretinal fluid (SRF) and pigment epithelial detachment (PED) in the fovea (1 mm), parafovea (3 mm) and perifovea (6 mm) were measured in nanoliters (nL) using a validated AI-tool.
Results 452 naïve nAMD eyes presented a mean VA gain of +5.5 letters with a median of 7 injections over 12 months. Baseline foveal IRF associated poorer baseline (44.7 vs 63.4 letters) and final VA (52.1 vs 69.1), SRF better final VA (67.1 vs 59.0) and greater VA gains (+7.1 vs +1.9), and PED poorer baseline (48.8 vs 57.3) and final VA (55.1 vs 64.1). Predicted VA gains were greater for foveal SRF (+6.2 vs +0.6), parafoveal SRF (+6.9 vs +1.3), perifoveal SRF (+6.2 vs −0.1) and parafoveal IRF (+7.4 vs +3.6, all p<0.05). Fluid dynamics analysis revealed the greatest relative volume reduction for foveal SRF (−16.4 nL, −86.8%), followed by IRF (−17.2 nL, −84.7%) and PED (−19.1 nL, −28.6%). Subgroup analysis showed greater reductions in eyes with higher number of injections.
Conclusion This real-world study describes an AI-based analysis of fluid dynamics and defines baseline OCT-based patient profiles that associate 12-month visual outcomes in a large cohort of treated naïve nAMD eyes nationwide.
Data availability statement
De-identified data are publicly available in a public, open access repository (Dryad Digital Repository).
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Data availability statement
De-identified data are publicly available in a public, open access repository (Dryad Digital Repository).
Footnotes
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Collaborators FRB SPAIN-IMAGE Project Investigators: Fundació Privada Hospital Asil Granollers, Granollers: Gabriel Londoño, Maximiliano Olivera, Karim Bañon, Cynthia Rethati; Miguel Servet Ophthalmology Research Group (GIMSO), Miguel Servet University Hospital, Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain: Pilar Calvo, Jorge Sánchez, Oscar Ruiz-Moreno; OSI Araba, Vitoria: Arantza Larrauri-Arana, Angela Gómez-Moreno, David Rodríguez-Feijoo, Enrique Diaz-de-Durana-Santa-Coloma, Maialen Aldazabal-Echeveste, Zuriñe del-Barrio-Lopez-de-Ipiña, Irene Herrero-Díaz; Hospital Universitario Vall de Hebrón, Barcelona: Helena Brosa, Laura Sánchez-Vela, José García-Arumí; Hospital Universitario Príncipe de Asturias, Madrid: Rafael Montejano-Milner, Fernando de Aragón; Hospital de Conxo, Santiago de Compostela: María Lidia Gómez Conde, María José Rodríguez-Cid, María Isabel Fernández Rodríguez, Pablo Almuiña Varela; Hospital Universitario Puerta del Hierro, Madrid: Rocío Vega-González, María García Zamora, Ignacio Flores-Moreno; Hospital Universitari Germans Trias i Pujol, Badalona: Xavier Valldeperas, Ferran Vilaplana Mira, Sandra Gómez Sánchez, Pamela Campos Figueroa; Hospital Dos de Maig, Barcelona: Jose Juan Escobar-Barranco, Manel Fernandez-Bonet, Begoña Pina-Marín; Hospital Universitario Ramón y Cajal, Madrid: Esther Ciancas, María Rios, Inma Dominguez, Paula Hernandez, Julio José Gonzalez-López.
Contributors Conception and design, obtained funding, overall responsibility and guarantor: JZ-V; data collection: JI-S, AP-C, GG-A, MP, CA, LS, MA, LB, JJE-B, MF, MAZ, JMR-M, AM-U, CB-M, SoA, MF-R, RPCM and JZ-V; analysis, interpretation and writing: RM-P, JI-S, SDZ, CC, SApostolopoulos, AM, RPCM and JZ-V; manuscript revision: RM-P, JI-S, SDZ, AP-C, GG-A, MP, CA, LS, MA, LB, JJE-B, MF, MAZ, JMR-M, AM-U, CB-M, SA, MF-R, LG-B, CC, StA, AM, RPCM and JZ-V.
Funding This work was supported in part by a research collaboration from Novartis Pharmaceuticals (FCRB code number: CP042794).
Competing interests JZ-V is a grant holder for Novartis Pharmaceuticals, Bayer and Allergan, and a consultant for Novartis Pharmaceuticals, Bayer, Allergan, Alcon, Alimera Sciences, Bausch and Lomb, Brill Pharma, DORC, Preceyes, Roche, Topcon, and Zeiss. Laia Gomez-Baldo is an employee of Novartis. SDZ, CC, SApostolopoulos and AM are employees of RetinAI.
Provenance and peer review Not commissioned; externally peer reviewed.
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