Age related macular degeneration (AMD) is one of the primary causes of blindness in the U.S. A wealth of powerful new treatments, especially anti-VEGF agents, have recently become available to restore visual function in choroidal neovascularization (CNV), the most severe form of AMD. The risk of ocular adverse events increases with repeated intravitreal treatment injections. Ideally a patient-specific dosing strategy with the minimally necessary number of anti-VEGF injections would be employed. This study will address which patient-specific properties of the intra- and sub-retinal fluid, cysts, and retinal layers of the macula (obtained from 3D spectral domain optical coherence tomography or OCT) (i) are associated with individual response to anti-VGEF treatment, and (ii) can predict proper treatment timing and response. The main hypothesis motivating the proposed research is that a model of retinal response to initial anti-VEGF treatment for CNV, based on quantitative 3D OCT-derived measures, can predict the timing of retreatment. We have identified the following specific aims:
Aim 1 : Further refine and validate a comprehensive set of analysis methods and approaches for 3D spectral OCT image analysis in the presence of wet AMD pathology (Symptomatic Exudate Associated Derangements or SEADs) and assess its performance by comparison to expert analyses.
Aim 2 : Determine associations between standard 2D Spectralis OCT clinical readings from retinal specialists and quantitative SEAD- and layer-derived measures from 3D Cirrus OCT.
Aim 3 : Determine how well the quantitative SEAD- and layer-derived measures from 3D OCT predict the patient-specific outcome parameters in response to post-induction anti-VEGF treatment in patients with CNV, in order to predict the timing of retreatment. The work will be performed prospectively in in-vivo spectral-domain OCT images acquired during the course of CNV disease treatment. We will repeatedly image 200 patients with choroidal neovascularization before and during treatment and during the 1-year follow-up phase.

Public Health Relevance

Three dimensional spectral OCT imaging provides a wealth of information about the morphology and tissue characteristics of human retinal. We propose to study structural and functional relationships of the macular intraretinal layers using this new 3-D OCT imaging device and relate the information about patient-specific retinal composition and structure with treatment outcome in age-related macular degeneration. This study has potentially important consequences for image guided treatment of this blindness-causing disease.

National Institute of Health (NIH)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Shen, Grace L
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Iowa
Engineering (All Types)
Biomed Engr/Col Engr/Engr Sta
Iowa City
United States
Zip Code
Zhang, Li; Sonka, Milan; Folk, James C et al. (2014) Quantifying disrupted outer retinal-subretinal layer in SD-OCT images in choroidal neovascularization. Invest Ophthalmol Vis Sci 55:2329-35
Kanagasingam, Yogesan; Bhuiyan, Alauddin; Abramoff, Michael D et al. (2014) Progress on retinal image analysis for age related macular degeneration. Prog Retin Eye Res 38:20-42
Abràmoff, Michael D; Wu, Xiaodong; Lee, Kyungmoo et al. (2014) Subvoxel accurate graph search using non-Euclidean graph space. PLoS One 9:e107763
Garvin, Mona K; Lee, Kyungmoo; Burns, Trudy L et al. (2013) Reproducibility of SD-OCT-based ganglion cell-layer thickness in glaucoma using two different segmentation algorithms. Invest Ophthalmol Vis Sci 54:6998-7004
Christopher, Mark; Scheetz, Todd E; Mullins, Robert F et al. (2013) Selection of Phototransduction Genes in Homo sapiens. Invest Ophthalmol Vis Sci 54:5489-96
Trucco, Emanuele; Ruggeri, Alfredo; Karnowski, Thomas et al. (2013) Validating retinal fundus image analysis algorithms: issues and a proposal. Invest Ophthalmol Vis Sci 54:3546-59
Abramoff, Michael D; Mullins, Robert F; Lee, Kyungmoo et al. (2013) Human photoreceptor outer segments shorten during light adaptation. Invest Ophthalmol Vis Sci 54:3721-8
Kafieh, Raheleh; Rabbani, Hossein; Abramoff, Michael D et al. (2013) Intra-retinal layer segmentation of 3D optical coherence tomography using coarse grained diffusion map. Med Image Anal 17:907-28
Lee, Kyungmoo; Sonka, Milan; Kwon, Young H et al. (2013) Adjustment of the retinal angle in SD-OCT of glaucomatous eyes provides better intervisit reproducibility of peripapillary RNFL thickness. Invest Ophthalmol Vis Sci 54:4808-12
Sohn, Elliott H; Chen, John J; Lee, Kyungmoo et al. (2013) Reproducibility of diabetic macular edema estimates from SD-OCT is affected by the choice of image analysis algorithm. Invest Ophthalmol Vis Sci 54:4184-8

Showing the most recent 10 out of 23 publications