A Zeiss Cirrus Spectral domain (SD)-OCT 5000 with AngioPlex™ (Carl Zeiss Meditec, Dublin, CA, USA, software version 6.0), at a scan rate of 68,000 A-scans per second and a central wavelength of 840 nm, was used to measure the mGC/IPLT and cpRNFLT. After pupil dilatation, the macular cube 200 × 200 scan protocol (6 × 6 mm2) and the optic disc cube 200 × 200 scan protocol (6 × 6 mm2) were performed for each eye. The software algorithm automatically identified the outer boundaries of the RNFL and IPL. The mGC/IPLT, within a 14.13 mm2 elliptical annulus area centered on the fovea, was calculated as the distance between these two boundaries. The average, minimum, and six sectoral (superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal) mGC/IPLT values were measured (Figure 1 A). The optic disc cube protocol was used to measure the cpRNFLT and to generate a cpRNFLT map. A 3.46 mm-diameter circle scan consisting of 256 A-scans was located around the optic disc. The average, four sectoral (temporal, superior, nasal, and inferior), and twelve clock-hour cpRNFLT were measured (Figure 1 B).
Angioplex
Manufactured by Zeiss
Sourced in United States, Germany, Ireland
AngioPlex is a high-resolution optical coherence tomography (OCT) imaging system designed for medical applications. It provides detailed visualization of blood vessels and other anatomical structures.
Automatically generated - may contain errors
Lab products found in correlation
Cirrus hd oct 5000, by Zeiss (3 mentions)
Spectralis hra oct, by Heidelberg Engineering (2 mentions)
Humphrey field analyzer 2, by Zeiss (1 mentions)
Bq 900, by Haag-Streit (1 mentions)
Dri triton oct device, by Topcon (1 mentions)
Spectralis oct2, by Heidelberg Engineering (1 mentions)
Cirrus oct 5000, by Zeiss (1 mentions)
Spectralis hra2, by Heidelberg Engineering (1 mentions)
Cirrus oct, by Zeiss (1 mentions)
Cirrus hd oct model 5000, by Zeiss (1 mentions)
Ark 530, by Nidek (1 mentions)
Cirrus 5000, by Zeiss (1 mentions)
Iolmaster 500, by Zeiss (1 mentions)
21 protocols using angioplex
1
Comprehensive mGC/IPLT and cpRNFLT Assessment with SD-OCT
2
Comprehensive Ophthalmic Evaluation in Optic Neuritis
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Participants underwent complete ophthalmologic evaluation during their initial visit. The examination included measurements of VA, refraction error, IOP with Goldmann applanation tonometer (GAT; Haag-Streit model BQ-900; Haag-Streit, Inc., Bern, Switzerland), and axial lengths, slit lamp examinations and dilated fundus examinations with a 90D lens. Patients also underwent color disc stereophotography, red-free fundus photography, standard automated perimetry (SAP; 24–2 SITA standard, Humphrey Field Analyzer II; Carl Zeiss Meditec, Inc., Dublin, California, USA), cirrus OCT (Carl Zeiss Meditec, Inc., Dublin, California, USA) and cirrus OCT angiography (AngioPlex; Carl Zeiss Meditec). Medical history was reviewed. Patients who were clinically diagnosed with optic neuritis subsequently underwent MRI using gadnolium contrast and serologic testing. Patients, who in the opinion of their treating physicians warranted treatment, were admitted to receive 1000mg of intravenous methylprednisolone sodium succinate daily for 3 days, followed by tapering with oral prednisolone starting from 1mg/kg body weight (maximum of 60 mg oral prednisolone). Blood pressure was measured at admission. Patients were followed at 1, 3, and 6 months since diagnosis at an out-patient clinic.
3
Retinal Microvascular Imaging with OCT Angiography
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OCT angiography (AngioPlex; Carl Zeiss Meditec, Inc.) was performed and 6 × 6 scans of the peripapillary and macular areas were collected. The angiography algorithm has been described in detail elsewhere.13 In short, the angiography generated en face microvascular images by producing 350 A-scans per B-scan along the horizontal dimension and repeating the process for 350 B-scans. The internal limiting membrane was set as the inner surface of the superficial retinal layer and the outer border of the inner plexiform layer as the outer surface. The AngioPlex software calculated the vessel density by adding the total length of perfused vasculature per unit area of a 6-mm diameter circle. The vessel density of peripapillary and macular areas were recorded. All examinations were individually assessed by an experienced grader (J.S.L.) and scans with motion artifacts or low signal strength (<7/10) were excluded from analysis. Of 160 eyes, OCT angiography scans were available in 116 eyes, and subgroup analyses were performed.
4
Evaluating Federated Learning Frameworks
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To investigate the performance of the federated learning framework, we evaluated several simulated collaborative training scenarios. First, the model-to-data approach was investigated by training a model on each dataset individually, but without transfer learning, as was done previously.30 (link) Second, a combined dataset with all available images was used for training in the ideal case, where all data are available. The effects of the dataset sizes (and the resulting diversity in training examples) were explored by constructing 2 additional combined datasets with an equal number of images—1 with 14 images randomly sampled from each source (the maximum possible, because the Angioplex [Carl Zeiss Meditec] 3 × 3-mm training set contained 14 images), and 1 with only 4 images randomly sampled from each image source—to approximate the size of a smaller dataset. Finally, the federated model was compared with a model trained on all 4 datasets sequentially in the order shown in Table 1 to simulate a naïve collaborative deep learning approach.
5
OCTA Evaluation of Retinal Microvasculature
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OCTA examination was completed using the 68 kHz Zeiss Cirrus HD-OCT 5000 with AngioPlex at a wavelength of 840 nm (Carl Zeiss Meditec, Dublin, CA, USA) (22 (link)). Volumetric scans were processed using optical microangiography (OMAG) algorithms to generate flow images. The OMAG algorithm analyzes differences in both phase and intensity information from repeated B-scans to quantify motion contrast. The superficial capillary plexus (SCP) was extended from the internal limiting membrane to the inner plexiform layer.
A macular and optic disc-centered 6 × 6 mm scan was taken to investigate microvasculature. Each 6 × 6 mm scan contained 350 A-scans in each B-scan, and each B-scan was repeated two times at the same location. The vessel density (VD) was defined as the total length of perfused vasculature per unit area in a region of measurement, and perfusion density (PD) was defined as the total area of perfused vasculature per unit area in a region of measurement. Cirrus OCTA software (ver. 10.0) automatically calculated the value of the SCP according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields. We analyzed the macular VD, macular PD, peripapillary VD, and peripapillary PD in SCP of the full field of view (FOV).
A macular and optic disc-centered 6 × 6 mm scan was taken to investigate microvasculature. Each 6 × 6 mm scan contained 350 A-scans in each B-scan, and each B-scan was repeated two times at the same location. The vessel density (VD) was defined as the total length of perfused vasculature per unit area in a region of measurement, and perfusion density (PD) was defined as the total area of perfused vasculature per unit area in a region of measurement. Cirrus OCTA software (ver. 10.0) automatically calculated the value of the SCP according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields. We analyzed the macular VD, macular PD, peripapillary VD, and peripapillary PD in SCP of the full field of view (FOV).
6
Multimodal Imaging in Neurodegeneration
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Nonmydriatic images were acquired by experienced Eye Multimodal Imaging in Neurodegenerative Disease study personnel using the Zeiss Cirrus High-Definition-5000 Spectral-Domain OCT with AngioPlex (version 11.0.0.29946, Carl Zeiss Meditec). Active retinal motion tracking was used to reduce motion artifact during acquisition. Follow-up OCT and OCTA images were registered to study entry visits using the inbuilt retinal tracking function, allowing for precise point-to-point measurements of change in each patient. Only patients with registered images were included in the study. All images were individually reviewed manually by trained study personnel for quality assessment. Those that had < 7 of 10 signal strength index, segmentation artifact, motion artifact, shadow artifact, or focal signal loss that would impact the assessment of the quantitative variables were then separately reviewed by a second expert image grader (D.S.G.) for concurrence of poor image quality and excluded from the study to avoid confounding of imaging results because of poor image quality.
7
Comprehensive Retinal Imaging Evaluation for MNV
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A comprehensive retinal imaging evaluation consisting of FA, ICGA (HRA2; Heidelberg Engineering, Heidelberg, Germany), OCT (Spectralis HRA-OCT; Heidelberg Engineering), and OCTA was performed. The OCTA images were captured using a DRI-OCT Triton device (Topcon, Tokyo, Japan), Spectralis OCT 2 (Heidelberg Engineering), or AngioPlex (Carl Zeiss Meditec, Dublin, California, USA) to scan a foveal area of 4.5×4.5 mm or 6×6 mm. An artefact removal option was used for this study. Three-dimensional angiographic images were obtained after the instrument was aligned with the macula, and then the four vascular slabs, including the superficial retina, deep retina, outer retina and choriocapillaris, were segmented automatically. Sequentially, MNV was confirmed as evidence of abnormal signals consistent with the pathological vascular component at the level of the outer retinal slab or choriocapillaris slab.
8
Multimodal Imaging of Age-related Macular Degeneration
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An experienced retinal specialist performed a dilated fundal examination to confirm the diagnosis of AMD, and verified the absence of ophthalmic pathology in normal controls. Best-corrected VA was assessed with the Snellen chart, and converted to logarithm of minimal angle of resolution (LogMAR) equivalent. Participants then underwent multimodal imaging, with cross-sectional and enface spectral-domain OCT (SD-OCT, Spectralis HRA-2, Heidelberg Engineering, Inc, Heidelberg, Germany), OCTA (OCTA, Angioplex, Cirrus OCT 5000, Zeiss, Dublin, CA, USA), and IR fundus. This involved volume scans capturing images at enhanced depth and high speed over a 6 × 6 mm macular region centered on the fovea, with 25 B-scans (~ 240 µm between each scan).
9
OCTA Imaging with Cirrus HD-OCT 5000
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OCTA images were obtained using the AngioPlex platform on the Cirrus HD-OCT 5000 (Carl Zeiss Meditec Inc, Dublin, CA) within the 8 8 mm and 6 6 mm imaging protocols. Informed consent was obtained by each study participant for participation in the study and The Institutional Review Board (IRB) at Yale approved the use of a global photography informed consent for all patient data. The tenets of the Declaration of Helsinki were followed. The study was approved by the IRB at Yale.
10
Retinal Microvasculature Assessment with OCT
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Peripapillary RNFL and macular GCIPL thickness were measured with Cirrus OCT (Carl Zeiss Meditec, Inc., Dublin, CA, USA) using the 200 × 200 optic disc cube and 512 × 128 macular cube protocols of Cirrus OCT version 6.0 software, respectively. OCT angiography (AngioPlex; Carl Zeiss Meditec) was performed and 6 × 6 mm2 of peripapillary and macular areas were collected. Its algorithm is described in detail elsewhere.15 Briefly, en face microvascular images are generated by taking 350 A-scans 5 µm apart along the horizontal dimension of a B-scan for 350 B-scans. The internal limiting membrane was set as the inner surface of the superficial retinal layer and the outer border of the inner plexiform layer as the outer surface. VD of superficial vascular plexus of retina was calculated by adding the total length (mm) of perfused vasculature per mm2 of a 6 mm-diameter circle by the AngioPlex software. All OCT and OCT angiography scans were evaluated for image quality by a single investigator (author J.S.L.) and only those scans with a signal strength greater than 6 and without any artifacts were selected for analysis.
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