Evaluation of Diabetic Macular Ischaemia. DIME study V1
Research type
Research Study
Full title
Image Analysis Approach of Quantitative Evaluation of Diabetic Macular Ischaemia in the presence of Macular Oedema on Optical Coherence Tomography Angiography Images. DIME Study
IRAS ID
296263
Contact name
Maged Habib
Contact email
Sponsor organisation
Research and Innovation Department. South Tyneside and Sunderland NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
The worldwide prevalence of Diabetes has progressively increased in recent decades and is predicted to grow to 430 million by 2030. Diabetic sight-threatening complications occur as a result of the development of proliferative disease, or with macular involvement such as in diabetic macular oedema (DMO) and diabetic macular ischaemia (DMI).
The recent development of Optical Coherence Tomography Angiography (OCTA) has allowed for non-invasive three-dimensional 3D detailed imaging of the retinal vasculature.DMO develops due to a combination of both Vascular Endothelial Growth Factor (VEGF)- mediated and inflammatory factors resulting in the alteration of blood-retinal barrier and subsequent leak of fluid into the retinal tissues.
The presence of intra-retinal fluid cysts results in decreased OCT signal intensity. It can interfere with the imaging and segmentation capabilities of the OCTA due to difficulties in automated identification of anatomical landmarks needed for accurate segmentation.
There are several features to estimate DMI in OCTA based on the vessels distribution and density around the macular centre.
Two separate challenges need to be overcome to accurately segment out the retinal vessels in DMO to allow for accurate estimation of DMI:
1) The displacement and deformation of vessels by the oedema,
2) Masking of vessels by haemorrhages or exudates
In this proposal we will aim to develop novel algorithms to address these challenges for accurate DMI estimation
We will recruit 40 subjects with active DMO and perform the analysis on images on OCTA scans captured before and after treatment. We based our analysis plan on the now-accepted theory that current treatments for DMO do not cause short term alterations in the retinal microvasculature following resolution of the oedema.
To enable global adoption of our algorithms, we will aim to compare the algorithm performance using scans captured by the 3 major OCTA manufacturers.REC name
London - Bromley Research Ethics Committee
REC reference
21/PR/0413
Date of REC Opinion
14 Apr 2021
REC opinion
Favourable Opinion