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Sandberg Melin, Camilla
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Publications (10 of 11) Show all publications
Sandberg Melin, C., Malmberg, F. & Söderberg, P. G. (2019). A strategy for OCT estimation of the optic nerve head pigment epithelium central limit-inner limit of the retina minimal distance, PIMD-2π. Acta Ophthalmologica, 97(2), 208-213
Open this publication in new window or tab >>A strategy for OCT estimation of the optic nerve head pigment epithelium central limit-inner limit of the retina minimal distance, PIMD-2π
2019 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 97, no 2, p. 208-213Article in journal (Refereed) Published
Abstract [en]

Purpose To develop a semi-automatic algorithm for estimation of pigment epithelium central limit-inner limit of the retina minimal distance averaged over 2 pi radians (PIMD-2 pi) and to estimate the precision of the algorithm. Further, the variances in estimates of PIMD-2 pi were to be estimated in a pilot sample of glaucomatous eyes. Methods Three-dimensional cubes of the optic nerve head (ONH) were captured with a commercial SD-OCT device. Raw cube data were exported for semi-automatic segmentation. The inner limit of the retina was automatically detected. Custom software aided the delineation of the ONH pigment epithelium central limit resolved in 500 evenly distributed radii. Sources of variation in PIMD estimates were analysed with an analysis of variance. Results The estimated variance for segmentations and angles was 130 mu m(2) and 1280 mu m(2), respectively. Considering averaging eight segmentations, a 95 % confidence interval for mean PIMD-2 pi was estimated to 212 +/- 10 mu m (df = 7). The coefficient of variation for segmentation was estimated at 0.05. In the glaucomatous eyes, the within-subject variance for captured volumes and for segmentations within volumes was 10 mu m(2) and 50 mu m(2), respectively. Conclusion The developed semi-automatic algorithm enables estimation of PIMD-2 pi in glaucomatous eyes with relevant precision using few segmentations of each captured volume.

National Category
Ophthalmology Medical Image Processing
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-362723 (URN)10.1111/aos.13908 (DOI)000459637900020 ()30198106 (PubMedID)
Funder
Gun och Bertil Stohnes Stiftelse
Available from: 2018-09-10 Created: 2018-10-09 Last updated: 2019-10-01
Sandberg Melin, C. (2019). Morphometry of the Optic Nerve Head as a Diagnostic Tool for Glaucoma. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>Morphometry of the Optic Nerve Head as a Diagnostic Tool for Glaucoma
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Glaucoma is a chronic optic nerve head (ONH) disease. Gradual retinal ganglion cell and nerve fiber loss lead to morphological ONH change and visual field defects. Initial loss is often focal. Rate of progression and life expectancy guide treatment. Currently, confocal scanning laser tomoghraphy (HRT) and optic coherence tomography (OCT) are available for ONH imaging. However, there is no consensus for which morphometric measurement of ONH nerve fiber content to use for glaucoma follow-up.

Purpose: To measure ONH nerve fiber content as neuroretinal rim area (NRA) with HRT, estimate NRA measurement variation and its impact on designing a follow-up strategy. To develop a custom algorithm, Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), for measuring ONH nerve fiber content in OCT data cubes. To measure PIMD in glaucomatous eyes, estimate the variance sources for PIMD and their impact on designing strategies for glaucoma follow-up.

Methods: NRA was measured with HRT in non-glaucomatous and glaucomatous eyes. Sources of variance for NRA were estimated. An OCT data cube of a non-glaucomatous eye was used in developing the PIMD algorithm. PIMD was measured in 500 radii along the ONH circumference. PIMD averaged over the circumference is PIMD-2π. Sources of variance for PIMD-2π were estimated for glaucomatous eyes. Strategies for following PIMD-2π and segments of PIMD-2π within subject over time were proposed.

Results: Variation among subjects was substantial for NRA and PIMD-2π. Contrarily, within subject variation was small for NRA and PIMD-2π. When within subject variation, a previously reported loss rate for progressing glaucoma, and measuring NRA 3 times every 4 months were applied, a significant loss was detected after 54 months. When within subject variation and a PIMD-2π loss rate resulting in blindness after 20 years were applied, a significant PIMD-2π loss was detected in 16 months with visits every 4 months. Within subject segmental PIMD-2π loss can be detected from the 3rd visit. Loss rate of each PIMD can be estimated with linear regression from the 4th visit. Change in segmental PIMD-2π loss rate can be detected at a later visit.

Conclusions: Small within subject variation allows for within subject NRA and PIMD follow-up over time. Segmental PIMD-2π has potential to detect focal glaucomatous defects and worsening of existing defects. There is potential to detect a change in segmental PIMD-2π loss rate. Segmental PIMD-2π has potential as a tool for within subject follow-up of glaucoma.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 67
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1610
Keywords
optic nerve head, ONH, nerve fibers, glaucoma, optical coherence tomography, OCT, Pigment epithelium central limit-inner limit of the retina minimal distance, PIMD, PIMD-2π, Segmental PIMD-2π, confocal scanning laser tomography, HRT, NRA, variation, variability, variance, loss rate, follow-up.
National Category
Ophthalmology
Identifiers
urn:nbn:se:uu:diva-393989 (URN)978-91-513-0798-5 (ISBN)
Public defence
2019-12-20, Rudbeckssalen, Rudbecklaboratoriet, entréplan, C11, Dag Hammarskjöldsväg 20, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2019-11-27 Created: 2019-10-01 Last updated: 2020-01-13
Söderberg, P., Yu, Z. & Sandberg Melin, C. (2019). Optic nerve head morphometry for glaucoma diagnosis, optimization of clinical measurement strategy. Paper presented at Conference on Ophthalmic Technologies XXIX, SPIE BiOS 2019, San Francisco, California, United States, Feb 2-3, 2019. Proceedings of SPIE, 10858, 45:1-45:8, Article ID 108581C.
Open this publication in new window or tab >>Optic nerve head morphometry for glaucoma diagnosis, optimization of clinical measurement strategy
2019 (English)In: Proceedings of SPIE, ISSN 0277-786X, Vol. 10858, p. 45:1-45:8, article id 108581CArticle in journal (Refereed) Published
Abstract [en]

The present study aimed to develop a strategy for evaluation of instant PIMD-2 pi measurements as a basis for clinical monitoring of glaucoma. PIMD-2 pi is a morphometric measure of the waist of the nerve fiber layer at the optic nerve head (ONH). Clinical measurements of PIMD-2 pi in patients with early to moderate stage glaucoma demonstrated a high variability among subjects. The high variability among subjects renders comparison of instant PIMD-2 pi measurements to tolerance limits for normality derived from a normative database inefficient. It is suggested to instead compare sequential measurements of PIMD-2 pi within a patient. Initially, the difference between an instant measurement and the average of previous measurements can be compared to tolerance limits for difference between measurements within subject. Once, a potential loss of PIMD-2 pi is detected, a sufficient number of measurements within a sufficiently wide time interval can be used to estimate the PIMD-2 pi loss rate with regression and the deviation of the estimated loss rate can be evaluated as a 95 % confidence interval for the loss rate. If the upper confidence limit excludes 0, a significant loss rate has been detected. The currently proposed strategy has the potential to detect glaucoma earlier than the current gold standard, computer perimetry, with less inconvenience for the patient.

National Category
Ophthalmology
Identifiers
urn:nbn:se:uu:diva-384735 (URN)10.1117/12.2516319 (DOI)000481649100010 ()
Conference
Conference on Ophthalmic Technologies XXIX, SPIE BiOS 2019, San Francisco, California, United States, Feb 2-3, 2019
Available from: 2019-06-07 Created: 2019-06-07 Last updated: 2019-09-27Bibliographically approved
Söderberg, P. G. & Sandberg Melin, C. (2018). Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological optic nerve head imaged by OCT. In: Manns, F Soderberg, PG Ho, A (Ed.), OPHTHALMIC TECHNOLOGIES XXVIII: . Paper presented at 28th Conference on Ophthalmic Technologies as a part of the SPIE Photonics West BiOS Meeting, JAN 27-28, 2018, San Francisco, CA. SPIE-INT SOC OPTICAL ENGINEERING, Article ID 1047413.
Open this publication in new window or tab >>Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological optic nerve head imaged by OCT
2018 (English)In: OPHTHALMIC TECHNOLOGIES XXVIII / [ed] Manns, F Soderberg, PG Ho, A, SPIE-INT SOC OPTICAL ENGINEERING , 2018, article id 1047413Conference paper, Published paper (Refereed)
Abstract [en]

The present study aimed to elucidate the angular distribution of the Pigment epithelium central limit-Inner limit of the retina Minimal Distance measured over 2 pi radians in the frontal plane (PIMD-2 pi) in young healthy eyes. Both healthy eyes of 16 subjects aged [20; 30[years were included. In each eye, a volume of the optical nerve head (ONH) was captured three times with a TOPCON DRI OCT Triton (Japan). Each volume renders a representation of the ONH 2.8 mm along the sagittal axis resolved in 993 steps, 6 mm long the frontal axis resolved in 512 steps and 6 x mm along the longitudinal axis resolved in 256 steps. The captured volumes were transferred to a custom made software for semiautomatic segmentation of PIMD around the circumference of the ONH. The phases of iterated volumes were calibrated with cross correlation. It was found that PIMD-2 pi expresses a double hump with a small maximum superiorly, a larger maximum inferiorly, and minima in between. The measurements indicated that there is no difference of PIMD-2 pi between genders nor between dominant and not dominant eye within subject. The variation between eyes within subject is of the same order as the variation among subjects. The variation among volumes within eye is substantially lower.

Place, publisher, year, edition, pages
SPIE-INT SOC OPTICAL ENGINEERING, 2018
Series
Proceedings of SPIE, ISSN 0277-786X, E-ISSN 1996-756X ; 10474
Keywords
optic nerve head, morphometry, OCT, PIMD, PIMD-2 pi, variability
National Category
Other Health Sciences
Identifiers
urn:nbn:se:uu:diva-372522 (URN)10.1117/12.2299723 (DOI)000451753300009 ()978-1-5106-1434-5 (ISBN)978-1-5106-1433-8 (ISBN)
Conference
28th Conference on Ophthalmic Technologies as a part of the SPIE Photonics West BiOS Meeting, JAN 27-28, 2018, San Francisco, CA
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-08Bibliographically approved
Söderberg, P. & Sandberg Melin, C. (2018). Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological  optic nerve head imaged by OCT. SPIE Proc, 10474, 38:1-38:7
Open this publication in new window or tab >>Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological  optic nerve head imaged by OCT
2018 (English)In: SPIE Proc, Vol. 10474, p. 38:1-38:7Article in journal (Refereed) Published
Abstract [en]

The present study aimed to elucidate the angular distribution of the Pigment epithelium central limit-Inner limit of the retina Minimal Distance measured over 2π radians in the frontal plane (PIMD-2π) in young healthy eyes. Both healthy eyes of 16 subjects aged [20;30[ years were included. In each eye, a volume of the optical nerve head (ONH) was captured three times with a TOPCON DRI OCT Triton (Japan). Each volume renders a representation of the ONH 2.8 mm along the sagittal axis resolved in 993 steps, 6 mm long the frontal axis resolved in 512 steps and 6 x mm along the longitudinal axis resolved in 256 steps. The captured volumes were transferred to a custom made software for semiautomatic segmentation of PIMD around the circumference of the ONH. The phases of iterated volumes were calibrated with cross correlation. It was found that PIMD-2π expresses a double hump with a small maximum superiorly, a larger maximum inferiorly, and minima in between. The measurements indicated that there is no difference of PIMD-2π between genders nor between dominant and not dominant eye within subject. The variation between eyes within subject is of the same order as the variation among subjects. The variation among volumes within eye is substantially lower.

National Category
Ophthalmology
Identifiers
urn:nbn:se:uu:diva-384738 (URN)10.1117/12.2299723 (DOI)
Available from: 2019-06-07 Created: 2019-06-07 Last updated: 2019-08-21Bibliographically approved
Söderberg, P. G., Malmberg, F. & Sandberg Melin, C. (2017). Further analysis of clinical feasibility of OCT-based glaucoma diagnosis with Pigment epithelium central limit–Inner limit of the retina Minimal Distance (PIMD). In: Ophthalmic Technologies XXVII: . Bellingham, WA: SPIE - International Society for Optical Engineering, Article ID 100450R.
Open this publication in new window or tab >>Further analysis of clinical feasibility of OCT-based glaucoma diagnosis with Pigment epithelium central limit–Inner limit of the retina Minimal Distance (PIMD)
2017 (English)In: Ophthalmic Technologies XXVII, Bellingham, WA: SPIE - International Society for Optical Engineering, 2017, article id 100450RConference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Bellingham, WA: SPIE - International Society for Optical Engineering, 2017
Series
Proc. SPIE ; 10045
National Category
Ophthalmology Medical Image Processing
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-341869 (URN)10.1117/12.2260139 (DOI)000405820700021 ()978-1-5106-0531-2 (ISBN)
Available from: 2017-02-10 Created: 2018-02-16 Last updated: 2018-03-03Bibliographically approved
Sandberg Melin, C., Malmberg, F. & Söderberg, P. G. (2016). An OCT variable for glaucoma follow-up: Pigment epithelium central limit - Inner limit of the retina, Minimal Distance, PIMD. Paper presented at Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO), MAY 01-05, 2016, Seattle, WA. Investigative Ophthalmology and Visual Science, 57(12)
Open this publication in new window or tab >>An OCT variable for glaucoma follow-up: Pigment epithelium central limit - Inner limit of the retina, Minimal Distance, PIMD
2016 (English)In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 57, no 12Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2016
National Category
Ophthalmology
Identifiers
urn:nbn:se:uu:diva-321044 (URN)000394174002292 ()
Conference
Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO), MAY 01-05, 2016, Seattle, WA
Available from: 2017-04-28 Created: 2017-04-28 Last updated: 2017-04-28Bibliographically approved
Söderberg, P. G., Malmberg, F. & Sandberg-Melin, C. (2016). Analysis of the variation in OCT measurements of a structural bottle neck for eye–brain transfer of visual information from 3D-volumes of the optic nerve head, PIMD-Average [0;2π]. In: Ophthalmic Technologies XXVI: . Bellingham, WA: SPIE - International Society for Optical Engineering, Article ID 96930O.
Open this publication in new window or tab >>Analysis of the variation in OCT measurements of a structural bottle neck for eye–brain transfer of visual information from 3D-volumes of the optic nerve head, PIMD-Average [0;2π]
2016 (English)In: Ophthalmic Technologies XXVI, Bellingham, WA: SPIE - International Society for Optical Engineering, 2016, article id 96930OConference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Bellingham, WA: SPIE - International Society for Optical Engineering, 2016
Series
Proc. SPIE ; 9693
National Category
Ophthalmology Medical Image Processing
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-295359 (URN)10.1117/12.2218208 (DOI)000377398700009 ()978-1-6284-1927-6 (ISBN)
Available from: 2016-03-04 Created: 2016-06-06 Last updated: 2016-08-19Bibliographically approved
Malmberg, F., Sandberg-Melin, C. & Söderberg, P. G. (2016). Estimating a structural bottle neck for eye–brain transfer of visual information from 3D-volumes of the optic nerve head from a commercial OCT device. In: Ophthalmic Technologies XXVI: . Bellingham, WA: SPIE - International Society for Optical Engineering, Article ID 96930N.
Open this publication in new window or tab >>Estimating a structural bottle neck for eye–brain transfer of visual information from 3D-volumes of the optic nerve head from a commercial OCT device
2016 (English)In: Ophthalmic Technologies XXVI, Bellingham, WA: SPIE - International Society for Optical Engineering, 2016, article id 96930NConference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Bellingham, WA: SPIE - International Society for Optical Engineering, 2016
Series
Proc. SPIE ; 9693
National Category
Ophthalmology Medical Image Processing
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-295474 (URN)10.1117/12.2218337 (DOI)000377398700008 ()978-1-6284-1927-6 (ISBN)
Available from: 2016-03-04 Created: 2016-06-07 Last updated: 2016-08-19Bibliographically approved
Söderberg, P., Yu, Z., Malmqvist, L. D., Sandberg-Melin, C., Galichanin, K. & Talebizadeh, N. (2016). Katarakt -: ett optiskt problem i ögats lins. Läkartidningen, 113, 1532-1536, Article ID D6SC.
Open this publication in new window or tab >>Katarakt -: ett optiskt problem i ögats lins
Show others...
2016 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, p. 1532-1536, article id D6SCArticle in journal (Refereed) Published
Abstract [sv]

Katarakt definieras som nedsatt syn på grund av en optisk störning i ögats lins.

Cirka 50 procent av kataraktsjukdomen antas associerad med genetiska faktorer.

Ultraviolett strålning är epidemiologiskt starkt associerad med barkkatarakt, och rökning med kärnkatarakt.

Störning av proteinkoncentrationsgradienten i linsen orsakar ljusspridning.

Kemiska förändringar i linsens vattenlösliga proteiner kan orsaka aggregation av dessa.

Betydande teknisk utveckling inom kataraktkirurgi reflekteras i en linjär ökning av antalet kataraktoperationer i Sverige under de senaste 35 åren.

I snö och vid vatten bör solglasögon av filterkategori 3 användas för att skydda ögonen.

National Category
Ophthalmology
Identifiers
urn:nbn:se:uu:diva-303666 (URN)
Available from: 2016-09-21 Created: 2016-09-21 Last updated: 2017-06-01Bibliographically approved
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