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      Addressing inter-device variations in optical coherence tomography angiography: will image-to-image translation systems help?

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          Abstract

          Background

          Optical coherence tomography angiography (OCTA) is an innovative technology providing visual and quantitative data on retinal microvasculature in a non-invasive manner.

          Main body

          Due to variations in the technical specifications of different OCTA devices, there are significant inter-device differences in OCTA data, which can limit their comparability and generalizability. These variations can also result in a domain shift problem that may interfere with applicability of machine learning models on data obtained from different OCTA machines. One possible approach to address this issue may be unsupervised deep image-to-image translation leveraging systems such as Cycle-Consistent Generative Adversarial Networks (Cycle-GANs) and Denoising Diffusion Probabilistic Models (DDPMs). Through training on unpaired images from different device domains, Cycle-GANs and DDPMs may enable cross-domain translation of images. They have been successfully applied in various medical imaging tasks, including segmentation, denoising, and cross-modality image-to-image translation. In this commentary, we briefly describe how Cycle-GANs and DDPMs operate, and review the recent experiments with these models on medical and ocular imaging data. We then discuss the benefits of applying such techniques for inter-device translation of OCTA data and the potential challenges ahead.

          Conclusion

          Retinal imaging technologies and deep learning-based domain adaptation techniques are rapidly evolving. We suggest exploring the potential of image-to-image translation methods in improving the comparability of OCTA data from different centers or devices. This may facilitate more efficient analysis of heterogeneous data and broader applicability of machine learning models trained on limited datasets in this field.

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          Most cited references26

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          Optical coherence tomography angiography

          Optical coherence tomography (OCT) was one of the biggest advances in ophthalmic imaging. Building on that platform, OCT angiography (OCTA) provides depth resolved images of blood flow in the retina and choroid with levels of detail far exceeding that obtained with older forms of imaging. This new modality is challenging because of the need for new equipment and processing techniques, current limitations of imaging capability, and rapid advancements in both imaging and in our understanding of the imaging and applicable pathophysiology of the retina and choroid. These factors lead to a steep learning curve, even for those with a working understanding dye-based ocular angiography. All for a method of imaging that is a little more than 10 years old. This review begins with a historical account of the development of OCTA, and the methods used in OCTA, including signal processing, image generation, and display techniques. This forms the basis to understand what OCTA images show as well as how image artifacts arise. The anatomy and imaging of specific vascular layers of the eye are reviewed. The integration of OCTA in multimodal imaging in the evaluation of retinal vascular occlusive diseases, diabetic retinopathy, uveitis, inherited diseases, age-related macular degeneration, and disorders of the optic nerve is presented. OCTA is an exciting, disruptive technology. Its use is rapidly expanding in clinical practice as well as for research into the pathophysiology of diseases of the posterior pole.
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            A review of optical coherence tomography angiography (OCTA)

            Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging technique that generates volumetric angiography images in a matter of seconds. This is a nascent technology with a potential wide applicability for retinal vascular disease. At present, level 1 evidence of the technology’s clinical applications doesn’t exist. In this paper, we introduce the technology, review the available English language publications regarding OCTA, and compare it with the current angiographic gold standards, fluorescein angiography (FA) and indocyanine green angiography (ICGA). Finally we summarize its potential application to retinal vascular diseases. OCTA is quick and non-invasive, and provides volumetric data with the clinical capability of specifically localizing and delineating pathology along with the ability to show both structural and blood flow information in tandem. Its current limitations include a relatively small field of view, inability to show leakage, and proclivity for image artifact due to patient movement/blinking. Published studies hint at OCTA’s potential efficacy in the evaluation of common ophthalmologic diseases such age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma. OCTA can detect changes in choroidal blood vessel flow and can elucidate the presence of choroidal neovascularization (CNV) in a variety of conditions but especially in AMD. It provides a highly detailed view of the retinal vasculature, which allows for accurate delineation of the foveal avascular zone (FAZ) in diabetic eyes and detection of subtle microvascular abnormalities in diabetic and vascular occlusive eyes. Optic disc perfusion in glaucomatous eyes is notable as well on OCTA. Further studies are needed to more definitively determine OCTA’s utility in the clinical setting and to establish if this technology may offer a non-invasive option of visualizing the retinal vasculature in detail.
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              Domain Adaptation for Medical Image Analysis: A Survey

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                Author and article information

                Contributors
                Hosein.Nouri.2018@gmail.com
                shf.abtahi@yahoo.com
                Journal
                Int J Retina Vitreous
                Int J Retina Vitreous
                International Journal of Retina and Vitreous
                BioMed Central (London )
                2056-9920
                29 August 2023
                29 August 2023
                2023
                : 9
                : 51
                Affiliations
                [1 ]GRID grid.411600.2, Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, , Shahid Beheshti University of Medical Sciences, ; Tehran, Iran
                [2 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, School of Medicine, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [3 ]GRID grid.411750.6, ISNI 0000 0001 0454 365X, School of Engineering, , University of Isfahan, ; Isfahan, Iran
                [4 ]GRID grid.411600.2, Department of Ophthalmology, Torfe Medical Center, , Shahid Beheshti University of Medical Sciences, ; Tehran, Iran
                Author information
                http://orcid.org/0000-0003-1808-0443
                http://orcid.org/0000-0002-1459-6752
                Article
                491
                10.1186/s40942-023-00491-8
                10466880
                37644613
                fd6e7818-96e3-459e-8887-c19330d6a40c
                © Brazilian Retina and Vitreous Society 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 8 July 2023
                : 17 August 2023
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                © Brazilian Retina and Vitreous Society 2023

                optical coherence tomography angiography,artificial intelligence,generative adversarial network,denoising diffusion probabilistic model,unsupervised machine learning,deep learning

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