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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Branch retinal artery occlusion (BRAO) is an ocular emergency, which could lead to blindness. Quantitative analysis of the BRAO region in the retina is necessary for the assessment of the severity of retinal ischemia. In this paper, a fully automatic framework was proposed to segment BRAO regions based on 3D spectral-domain optical coherence tomography (SD-OCT) images. To the best of our knowledge, this is the first automatic 3D BRAO segmentation framework. First, the input 3D image is automatically classified into BRAO of acute phase and BRAO of chronic phase or normal retina using an AdaBoost classifier based on combining local structural, intensity, textural features with our new feature distribution analyzing strategy. Then, BRAO regions of acute phase and chronic phase are segmented separately. A thickness model is built to segment BRAO in the chronic phase. While for segmenting BRAO in the acute phase, a two-step segmentation strategy is performed: rough initialization and refine segmentation. The proposed method was tested on SD-OCT images of 35 patients (12 BRAO acute phase, 11 BRAO chronic phase, and 12 normal eyes) using the leave-one-out strategy. The classification accuracy for BRAO acute phase, BRAO chronic phase, and normal retina were 100%, 90.9%, and 91.7%, respectively. The overall true positive volume fraction (TPVF) and false positive volume fraction (FPVF) for the acute phase were 91.1% and 5.5% and for the chronic phase were 92.7% and 8.4%, respectively.
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PMID:A Framework for Classification and Segmentation of Branch Retinal Artery Occlusion in SD-OCT. 2845 88

Acute retinal arterial ischemia, including vascular transient monocular vision loss (TMVL) and branch (BRAO) and central retinal arterial occlusions (CRAO), are ocular and systemic emergencies requiring immediate diagnosis and treatment. Guidelines recommend the combination of urgent brain magnetic resonance imaging with diffusion-weighted imaging, vascular imaging, and clinical assessment to identify TMVL, BRAO, and CRAO patients at highest risk for recurrent stroke, facilitating early preventive treatments to reduce the risk of subsequent stroke and cardiovascular events. Because the risk of stroke is maximum within the first few days after the onset of visual loss, prompt diagnosis and triage are mandatory. Eye care professionals must make a rapid and accurate diagnosis and recognize the need for timely expert intervention by immediately referring patients with acute retinal arterial ischemia to specialized stroke centers without attempting to perform any further testing themselves. The development of local networks prompting collaboration among optometrists, ophthalmologists, and stroke neurologists should facilitate such evaluations, whether in a rapid-access transient ischemic attack clinic, in an emergency department-observation unit, or with hospitalization, depending on local resources.
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PMID:Management of Acute Retinal Ischemia: Follow the Guidelines! 3100 96