title: Assessment of Ischemic Index in Retinal Vascular Diseases Using Ultra-Wide-Field Fluorescein Angiography: Single Versus Summarized Image.
abstract: OBJECTIVE
  To compare a single image with a computer-generated summarized image from the ultra-wide-field fluorescein angiogram (UWFFA) sequence for evaluation of ischemic index (ISI).
  
  
  METHODS
  UWFFA sequences from patients with diabetic retinopathy (DR) (n=5), branch retinal vein occlusion (BRVO) (n=5), and central retinal vein occlusion (CRVO) (n=5) were evaluated by six graders. A single image best illustrating retinal non-perfusion was compared to a summarized image generated by computerized superimposition of angiograms. Non-perfused and ungradable retinal areas were outlined and the ISI between the single and summarized images was compared.
  
  
  RESULTS
  The mean ISI in the single versus (vs) summarized images was 17% vs 15% in BRVO (p=0.12), 48% vs 48% in CRVO (p=0.67), and 25% vs 23% in DR (p=0.005). Inter-grader agreement of ISI in single versus summarized images was 0.43 vs 0.40 in BRVO, 0.69 vs 0.71 in CRVO, and 0.53 vs 0.34 in DR.
  
  
  CONCLUSIONS
  Computer-generated summarized images were similar to single images for grading ISI in BRVO and CRVO, but underestimated it in DR.
authors.affiliation: a Jules Stein Eye Institute, Retina Division , University of California Los Angeles , Los Angeles , CA , USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Franco-Cardenas
authors.affiliation: a Jules Stein Eye Institute, Retina Division , University of California Los Angeles , Los Angeles , CA , USA.
authors.forename: Sanket U
authors.initials: SU
authors.lastname: Shah
authors.affiliation: a Jules Stein Eye Institute, Retina Division , University of California Los Angeles , Los Angeles , CA , USA.
authors.forename: David
authors.initials: D
authors.lastname: Apap
authors.affiliation: a Jules Stein Eye Institute, Retina Division , University of California Los Angeles , Los Angeles , CA , USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Joseph
authors.affiliation: a Jules Stein Eye Institute, Retina Division , University of California Los Angeles , Los Angeles , CA , USA.
authors.forename: Gad
authors.initials: G
authors.lastname: Heilweil
authors.affiliation: b VAMPIRE/CVIP, School of Computing , University of Dundee , Dundee , UK.
authors.forename: Kris
authors.initials: K
authors.lastname: Zutis
authors.affiliation: b VAMPIRE/CVIP, School of Computing , University of Dundee , Dundee , UK.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Trucco
authors.affiliation: a Jules Stein Eye Institute, Retina Division , University of California Los Angeles , Los Angeles , CA , USA.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Hubschman
mesh_terms: D000368:Aged; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D012170:Retinal Vein Occlusion / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
keywords: Automated retinal image analysis; branch retinal vein occlusion; capillary dropout; central retinal vein occlusion; diabetic retinopathy; fluorescein angiography; inter-grader agreement; ischemic index; non-perfusion; retinal ischemia