Smyth, Roger John (2023). The Impact of Fundus Autofluorescence on the Management of Age-related Macular Degeneration. PHD thesis, Aston University.
Abstract
Background: Fundus autofluorescence (FAF) has been described as a topographical map of fluorophores that accumulate within the retinal pigment epithelium as a result of disease. Study aims: To evaluate whether FAF offers information relevant to age-related macular degeneration over that gathered via colour fundus photography (CFP) and optical coherence tomography (OCT). Methods: Ninety-three patients were imaged via CFP, OCT and FAF and the results analysed using Orange Data Mining artificial intelligence and SPSS software. Results: Pupillary dilation makes a significant improvement to FAF image quality. Nuclear sclerotic cataract of > 1.5 on the World Health Organisation scale indicates that there is ≃85% probability that the FAF image will not be of high quality. At > 1.9 there is ≃50% probability of the image not being clinically useful as defined by a novel grading scale. Age was negatively associated with FAF comfort. There is ≥ 90% probability of an abnormal FAF result for an eye with any of the following: > 50 small, > 40 intermediate, > 20 large drusen. Age > 92 years. > 30 packet years of smoking. Any pigmentary abnormalities. ≃80% for any reticular pseudodrusen (RPD). FAF results can be predicted via CFP and OCT data using machine learning with informedness of up to 70.2% and area under the curve (AUC) of 0.903. For transfer learning to be useful within primary care, image pre-processing is likely to be required. Geographic atrophy and pigment epithelial detachments appear to be linked to a patchy FAF pattern. RPD are linked to a reticular FAF pattern. Principle component analysis indicates that drusen were responsible for the greatest percentage of variability in this study’s data (38.6%). Conclusions: Clinical impact: FAF results can be predicted from CFP/OCT via machine learning with 70.2% informedness and AUC of 0.903. Drusen number/size were the most informative variables.
Divisions: | College of Health & Life Sciences > School of Optometry > Optometry |
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Additional Information: | Copyright © Roger John Smyth, 2023. Roger John Smyth asserts their moral right to be identified as the author of this thesis. This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and that no quotation from the thesis and no information derived from it may be published without appropriate permission or acknowledgement. If you have discovered material in Aston Publications Explorer which is unlawful e.g. breaches copyright, (either yours or that of a third party) or any other law, including but not limited to those relating to patent, trademark, confidentiality, data protection, obscenity, defamation, libel, then please read our Takedown Policy and contact the service immediately. |
Institution: | Aston University |
Uncontrolled Keywords: | Fundus autofluorescence,age-related macular degeneration,colour fundus photography,optical coherence tomography |
Last Modified: | 28 Jun 2024 08:22 |
Date Deposited: | 24 Jan 2024 16:51 |
Completed Date: | 2023-03 |
Authors: |
Smyth, Roger John
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