PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Retinal-scan analysis can predict advance of macular degeneration, Stanford study finds

2014-11-05
(Press-News.org) Stanford University School of Medicine scientists have found a new way to forecast which patients with age-related macular degeneration are likely to suffer from the most debilitating form of the disease.

The new method predicts, on a personalized basis, which patients' AMD would, if untreated, probably make them blind, and roughly when this would occur. Simply by crunching imaging data that is already commonly collected in eye doctors' offices, ophthalmologists could make smarter decisions about when to schedule an individual patient's next office visit in order to optimize the chances of detecting AMD progression before it causes blindness.

AMD is the leading cause of blindness and central vision loss among adults older than 65. An estimated 10-15 million people in the United States suffer from the disease, in which the macula — the key area of the retina responsible for vision — shows signs of degeneration. During normal aging, yellowish deposits called drusen form in the retina, which is the light-sensitive layer of tissue at the back of the eye. As drusen increase in size and number, they eventually begin to damage the light-sensitive cells of the macula. This stage of the disease, called "dry" AMD, can mean blurry central vision and impaired day-to-day activity.

While about four of every five people with AMD have the dry form of the disease, it's the so-called "wet" form that most concerns ophthalmologists, because it accounts for 80-90 percent of all legal blindness associated with the disease. In wet AMD, abnormal blood vessels accumulate underneath the macula and leak blood and fluid. When that happens, irreversible damage to the macula can quickly ensue if not treated quickly.

But until now, there has been no effective way to tell which individuals with AMD are likely to progress to the wet stage. Current treatments are costly and invasive — they typically involve injections of medicines directly into the eyeball — making the notion of treating people with early or intermediate stages of AMD a non-starter. Doctors and patients have to hope the next office visit will be early enough to catch wet AMD at its onset, before it takes too great a toll.

Predicting Progression to 'Wet' AMD

In a study published in the November issue of Investigative Ophthalmology & Visual Science, the researchers derived a formula that they say predicts, with high accuracy, whether a patient with mild or intermediate AMD will progress to the wet stage. The formula distinguishes likely from unlikely progressors by analyzing patient data that's routinely collected by ophthalmologists and optometrists when they perform retinal scans with an imaging technique called spectral domain optical coherence tomography.

This imaging technique is analogous to ultrasound: The macula is scanned with a beam of focused laser light, and the amount of reflected light coming back at each point is measured and recorded. The resulting stream of data is computationally converted into an extremely high-resolution, three-dimensional image.

"Right now, a patient who goes into the ophthalmologist's office typically gets an SD-OCT scan anyway," said the study's senior author, Daniel Rubin, MD, assistant professor of radiology and of biomedical informatics. "Our technique involves no new procedures in the doctor's office — patients get the same care they've been getting anyway. We've simply added on a computerized image-processing step that analyzes not only that scan but any previous ones available from that same patient's earlier visits."

Generating a Risk Score

From this computerized analysis, the investigators are able to generate a risk score: a number that predicts a patient's likelihood of progressing to the wet stage within one year, three years or five years. The likelihood of progression within one year is most relevant, because it translates into a concrete recommendation: how soon to schedule the patient's next office visit.

Until now, attempts to predict AMD progression have relied on eye doctors examining color photographs of the retina taken in their offices. There is no way to translate that information into risk scores. The high-resolution imaging technique, Rubin said, provides much richer detail. "You can almost see individual cells," he said. Plus, it is far more amenable to digital analysis. Previously proposed predictive models have shown some accuracy over long periods of time, but none has been adequately accurate over the shorter, one-year time frame that's relevant to making decisions about office-visit frequency, Rubin said.

In the study, the Stanford team analyzed data from 2,146 scans of 330 eyes in 244 patients seen at Stanford Health Care over a five-year period. They found that certain key features in the images, such as the area and height of drusen, the amount of reflectivity at the macular surface and the degree of change in these features over time, could be weighted to generate a patient's risk score. Patients were followed for as long as four years, and predictions of the model were compared with actual instances of progression to wet AMD. The model accurately predicted every occurrence of progression to the wet stage within a year. About 40 percent of the time when the model did predict progression to wet AMD within a year, the prediction was not borne out.

"No test gets it right 100 percent of the time," Rubin said. "You can tweak the model to trade off the risk of telling someone they will progress when they actually won't against the risk of telling them they won't progress when they actually will. With AMD you really don't want any false negatives, so you tune the model accordingly. The downside is that some patients will wind up being told to come in sooner than, in fact, they probably need to. But that's nothing compared with the downside of a patient at high risk for progression's not coming in soon enough."

Larger Studies Needed

Rubin emphasized that this proof-of-principle study needs to be followed up by a larger study, ideally using data gathered from patients seen at other institutions. He and his associates have now embarked on such a study.

INFORMATION:

The study's lead author is Luis de Sisternes, PhD, a postdoctoral scholar in radiology. Other Stanford co-authors are Robert Tibshirani, PhD, professor of health research and policy and of statistics; Theodore Leng, MD, clinical assistant professor of ophthalmology; and former postdoctoral scholar Noah Simon, PhD, now at the University of Washington.

The work was supported by grants from Stanford Bio-X and Spectrum-Stanford Predictives and Diagnostics Accelerator.

Information about Stanford's Department of Radiology, which also supported this work, is available at http://www.radiology.stanford.edu.

The Stanford University School of Medicine consistently ranks among the nation's top medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://med.stanford.edu/school.html. The medical school is part of Stanford Medicine, which includes Stanford Health Care and Lucile Packard Children's Hospital Stanford. For information about all three, please visit http://med.stanford.edu.



ELSE PRESS RELEASES FROM THIS DATE:

NASA's TRMM and GPM satellites analyze Hurricane Vance before landfall

NASAs TRMM and GPM satellites analyze Hurricane Vance before landfall
2014-11-05
Hurricane Vance was a hurricane on Nov. 4 when the Tropical Rainfall Measuring Mission or TRMM satellite and the Global Precipitation Measurement (GPM) mission satellite passed overhead and measured its rainfall from space. TRMM and GPM revealed areas of heavy rain within the storm before it weakened to a depression and made landfall on Nov. 5. The TRMM satellite flew over hurricane Vance on Nov. 4 at 0953 UTC (4:53 a.m. EST). Rainfall derived from TRMM's Microwave Imager (TMI) data collected were overlaid on a 1000 UTC (5 a.m. EST) image from NOAA's GOES-West satellite ...

NASA sees Typhoon Nuri pass Iwo To, Japan

NASA sees Typhoon Nuri pass Iwo To, Japan
2014-11-05
Typhoon Nuri continued moving in a northeasterly direction passing the island of Iwo To, Japan when NASA's Aqua satellite passed overhead. The Moderate Resolution Imaging Spectroradiometer or MODIS instrument that flies aboard NASA's Aqua satellite captured a visible picture of Typhoon Nuri on Nov. 5 at 4:10 UTC (11:10 p.m. EST, Nov. 4). At 1002 UTC (5:02 a.m. EST) a microwave image captured from NASA/JAXA's Tropical Rainfall Measuring Mission or TRMM satellite showed that the low-level center of circulation was beginning to weaken. The strongest thunderstorms had become ...

Interstitial lung disease is a significant risk factor for lung inflammation following stereotactic body radiation therapy for lung cancer

2014-11-05
DENVER – Pretreatment interstitial lung disease (ILD) is a significant risk factor for developing symptomatic and severe radiation pneumonitis in stage I non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT) alone. ILD is a group of diseases that cause scarring and stiffing of the tissue and space around the air sacs in the lungs, which results in diminished gas exchange. The incidence of ILD among lung cancer patients is higher than in the general population as tobacco smoking is a common risk factor for both. Some ...

Shape of things to come in platelet mimicry

Shape of things to come in platelet mimicry
2014-11-05
CLEVELAND—Artificial platelet mimics developed by a research team from Case Western Reserve University and University of California, Santa Barbara, are able to halt bleeding in mouse models 65 percent faster than nature can on its own. For the first time, the researchers have been able to integratively mimic the shape, size, flexibility and surface chemistry of real blood platelets on albumin-based particle platforms. The researchers believe these four design factors together are important in inducing clots to form faster selectively at vascular injury sites while ...

EARTH Magazine: Tiny ants are heroic weathering agents

2014-11-05
Alexandria, Va. — Earth's abundant silicate minerals are degraded over time by exposure to water, chemical dissolution, and physical and chemical weathering by tree roots and even insects such as ants and termites. Such weathering plays a significant role in decreasing carbon dioxide in the atmosphere, as carbon dioxide is consumed in chemical weathering reactions and the resultant carbonate becomes sequestered in the form of limestone and dolomite. To study the effects of weathering over time, researchers buried basalt sand at multiple test sites and dug up the ...

Can love make us mean?

Can love make us mean?
2014-11-05
BUFFALO, N.Y. – Empathy is among humanity's defining characteristics. Understanding another person's plight can inspire gentle emotions and encourage nurturing behaviors. Yet under certain circumstances, feelings of warmth, tenderness and sympathy can in fact predict aggressive behaviors, according to a recent study by two University at Buffalo researchers. But why? That an expression of kindness might be manifest as a punch in the nose can leave observers scratching their heads. The answer is that it's not about anger or feeling personally threatened, says ...

New e-Incubator enables real-time imaging of bioengineered tissues in controlled unit

New e-Incubator enables real-time imaging of bioengineered tissues in controlled unit
2014-11-05
"New Rochelle, NY, November 5, 2014—The e-incubator, an innovative miniature incubator that is compatible with magnetic resonance imaging (MRI), enables scientists to grow tissue-engineered constructs under controlled conditions and to study their growth and development in real-time without risk of contamination or damage. Offering the potential to test engineered tissues before human transplantation, increase the success rate of implantation, and accelerate the translation of tissue engineering methods from the lab to the clinic, the novel e-incubator is described ...

IU researchers: Protein linked to aging identified as new target for controlling diabetes

IU researchers: Protein linked to aging identified as new target for controlling diabetes
2014-11-05
INDIANAPOLIS -- Indiana University School of Medicine researchers have identified a small protein with a big role in lowering plasma glucose and increasing insulin sensitivity. Their research appeared online today in Diabetes, the journal of the American Diabetes Association. The report indicates that Sestrin 3 plays a critical role in regulating molecular pathways that control the production of glucose and insulin sensitivity in the liver, making it a logical target for drug development for type 2 diabetes and metabolic syndrome, which can produce increased blood pressure, ...

How corals can actually benefit from climate change effects

How corals can actually benefit from climate change effects
2014-11-05
Researchers from Northeastern University's Marine Science Center and the University of North Carolina at Chapel Hill have found that moderate ocean acidification and warming can actually enhance the growth rate of one reef-​​building coral species. Only under extreme acidification and thermal conditions did calcification decline. Their work, which was published Wednesday in the journal Proceedings of the Royal Society B: Biological Sciences, is the first to show that some corals may benefit from moderate ocean acidification. Justin Ries, an associate professor ...

Engineered for tolerance, bacteria pump out higher quantity of renewable gasoline

Engineered for tolerance, bacteria pump out higher quantity of renewable gasoline
2014-11-05
WASHINGTON, DC—November 4, 2014—An international team of bioengineers has boosted the ability of bacteria to produce isopentenol, a compound with desirable gasoline properties. The finding, published in mBio®, the online open-access journal of the American Society for Microbiology, is a significant step toward developing a bacterial strain that can yield industrial quantities of renewable bio-gasoline. The metabolic engineering steps to produce short-chain alcohol solvents like isopentenol in the laboratory bacteria Escherichia coli have been worked on ...

LAST 30 PRESS RELEASES:

Pink skies

Monkeys are world’s best yodellers - new research

Key differences between visual- and memory-led Alzheimer’s discovered

% weight loss targets in obesity management – is this the wrong objective?

An app can change how you see yourself at work

NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals

New research shows that propaganda is on the rise in China

Even the richest Americans face shorter lifespans than their European counterparts, study finds

Novel genes linked to rare childhood diarrhea

New computer model reveals how Bronze Age Scandinavians could have crossed the sea

Novel point-of-care technology delivers accurate HIV results in minutes

Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others

Study finds nearly five-fold increase in hospitalizations for common cause of stroke

Study reveals how alcohol abuse damages cognition

Medicinal cannabis is linked to long-term benefits in health-related quality of life

Microplastics detected in cat placentas and fetuses during early pregnancy

Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming

Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly

Alcohol makes male flies sexy

TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income

Study links teen girls’ screen time to sleep disruptions and depression

Scientists unveil starfish-inspired wearable tech for heart monitoring

Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs

AI effectively predicts dementia risk in American Indian/Alaska Native elders

First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes

Existing international law can help secure peace and security in outer space, study shows

Pinning down the process of West Nile virus transmission

UTA-backed research tackles health challenges across ages

In pancreatic cancer, a race against time

Targeting FGFR2 may prevent or delay some KRAS-mutated pancreatic cancers

[Press-News.org] Retinal-scan analysis can predict advance of macular degeneration, Stanford study finds