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. 2022 Sep 1;42(9):1673-1682.
doi: 10.1097/IAE.0000000000003557.

VALIDATION OF AN AUTOMATED FLUID ALGORITHM ON REAL-WORLD DATA OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION OVER FIVE YEARS

Bianca S Gerendas  1 , Amir Sadeghipour  1   2 , Martin Michl  1 , Felix Goldbach  1 , Georgios Mylonas  1 , Anastasiia Gruber  3 , Thomas Alten  1 , Oliver Leingang  1 , Stefan Sacu  1 , Hrvoje Bogunovic  1 , Ursula Schmidt-Erfurth  1
Affiliations

VALIDATION OF AN AUTOMATED FLUID ALGORITHM ON REAL-WORLD DATA OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION OVER FIVE YEARS

Bianca S Gerendas et al. Retina. .

Abstract

Background/purpose: To apply an automated deep learning automated fluid algorithm on data from real-world management of patients with neovascular age-related macular degeneration for quantification of intraretinal/subretinal fluid volumes in optical coherence tomography images.

Methods: Data from the Vienna Imaging Biomarker Eye Study (VIBES, 2007-2018) were analyzed. Databases were filtered for treatment-naive neovascular age-related macular degeneration with a baseline optical coherence tomography and at least one follow-up and 1,127 eyes included. Visual acuity and optical coherence tomography at baseline, Months 1 to 3/Years 1 to 5, age, sex, and treatment number were included. Artificial intelligence and certified manual grading were compared in a subanalysis of 20%. Main outcome measures were fluid volumes.

Results: Intraretinal/subretinal fluid volumes were maximum at baseline (intraretinal fluid: 21.5/76.6/107.1 nL; subretinal fluid 13.7/86/262.5 nL in the 1/3/6-mm area). Intraretinal fluid decreased to 5 nL at M1-M3 (1-mm) and increased to 11 nL (Y1) and 16 nL (Y5). Subretinal fluid decreased to a mean of 4 nL at M1-M3 (1-mm) and remained stable below 7 nL until Y5. Intraretinal fluid was the only variable that reflected VA change over time. Comparison with human expert readings confirmed an area under the curve of >0.9.

Conclusion: The Vienna Fluid Monitor can precisely quantify fluid volumes in optical coherence tomography images from clinical routine over 5 years. Automated tools will introduce precision medicine based on fluid guidance into real-world management of exudative disease, improving clinical outcomes while saving resources.

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References

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    1. Keenan TD, Clemons TE, Domalpally A, et al. Retinal specialist versus artificial intelligence detection of retinal fluid from OCT: age-related eye disease study 2: 10-year follow-on study. Ophthalmology 2020;128:100–109.
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