{
  "abstract": "Aim To explore associations between artificial intelligence (AI)-based baseline optical coherence tomography (OCT) fluid compartment quantifications and 12-month visual outcomes in diabetic macular oedema (DME) eyes treated with the intravitreal dexamethasone implant.Methods This was a multicentre, real-world, national DME database and associated OCT dataset study. Demographics, visual acuity (VA), treatments and visit data were collected using a validated web-based tool (Fight Retinal Blindness). Fluid compartment quantifications, including intraretinal fluid (IRF) and subretinal fluid (SRF), were measured in nanolitres (nL) using a validated AI tool (Discovery). Univariate and multivariate regression mixed models evaluated associations between anatomical variables and VA outcomes.Results A total of 101 treatment-naïve DME eyes were grouped into quartiles according to their fluid volume for each fluid compartment (Q1: lowest volume, Q4: highest volume). Baseline IRF was associated with greater VA gains at month 12 (+6.34 letters, p=0.07) but poorer final VA (−8.95, p=0.07), while SRF was associated with worse final VA at 12 months (−12.5, p=0.01). At month 3, IRF was associated with a VA decrease at 12 months (−13.7, p=0.02) and lower final VA (−29.8, p<0.001). At month 12, IRF was associated with lower final VA (−11.6, p=0.03). Quantitatively, a reduction of 100 nL of IRF at 3 months was associated with a +1.54 letters gain (p=0.03) in the multivariate analysis.Conclusion This real-world, multicentre study describes objective baseline fluid volumes that predict visual outcomes at 12 months in routine clinical care. Accurate quantification of baseline fluid volumes may play a predictive role for final visual outcomes.",
  "authors": [
    {
      "affiliations": [
        "Hospital Clinic de Barcelona, Barcelona, Spain",
        "Universitat de Barcelona Facultat de Medicina i Ciencies de la Salut, Barcelona, Spain"
      ],
      "name": "Francesc Franquesa-Garcia"
    },
    {
      "affiliations": [
        "Hospital Clinic de Barcelona, Barcelona, Spain",
        "Universitat de Barcelona Facultat de Medicina i Ciencies de la Salut, Barcelona, Spain"
      ],
      "name": "Barbara Romero-Nuñez"
    },
    {
      "affiliations": [
        "IDIBAPS, Barcelona, Spain"
      ],
      "name": "Ruben Martin-Pinardel"
    },
    {
      "affiliations": [
        "RetinAI Medical, Bern, Switzerland",
        "Research, Ikerian, Bern, Switzerland"
      ],
      "name": "Sandro De Zanet"
    },
    {
      "affiliations": [
        "Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain"
      ],
      "name": "Julio José González-López"
    },
    {
      "affiliations": [
        "Hospital Dos de Maig, Barcelona, Spain"
      ],
      "name": "Jose Juan Escobar-Barranco"
    },
    {
      "affiliations": [
        "Miguel Servet University Hospital, Zaragoza, Spain"
      ],
      "name": "María P Ruiz-Del-Tiempo"
    },
    {
      "affiliations": [
        "Hospital Universitario Vall de Hebrón, Barcelona, Spain"
      ],
      "name": "Anna Boixadera"
    },
    {
      "affiliations": [
        "Ophthalmology, Hospital de Cruces, Bilbao, Spain"
      ],
      "name": "Alex Fonollosa"
    },
    {
      "affiliations": [
        "Fundació Privada Hospital Asil Granollers, Granollers, Spain"
      ],
      "name": "Alba Gómez-Benlloch"
    },
    {
      "affiliations": [
        "Clínica Villoria, Vigo, Spain"
      ],
      "name": "Daniel Velazquez-Villoria"
    },
    {
      "affiliations": [
        "Ophthalmology, Hospital Universitario Clínico San Carlos, Madrid, Spain",
        "Ophthalmology, Centro Internacional de Oftalmología Avanzada, Madrid, Spain"
      ],
      "name": "José Ignacio Fernández-Vigo"
    },
    {
      "affiliations": [
        "Ophthalmology, OSI Bilbao-Basurto, Bilbao, Spain"
      ],
      "name": "Gonzaga Garay-Aramburu"
    },
    {
      "affiliations": [
        "Ophthalmology, Hospital del Mar, Barcelona, Spain"
      ],
      "name": "Alba Parrado-Carrillo"
    },
    {
      "affiliations": [
        "Hospital San Juan de Dios del Aljarafe, Bormujos, Spain"
      ],
      "name": "Luis Castillon"
    },
    {
      "affiliations": [
        "Hospital Universitari Germans Trias i Pujol, Badalona, Spain"
      ],
      "name": "Sandra Gómez Sánchez"
    },
    {
      "affiliations": [
        "Ophthalmology, Hospital Punta de Europa, Algeciras, Spain"
      ],
      "name": "Francisco Javier Lavid"
    },
    {
      "affiliations": [
        "Retina Section, Hospital Príncipe de Asturias, Alcalá de Henares, Spain",
        "Novovision, Madrid, Spain"
      ],
      "name": "Carolina Arruabarrena"
    },
    {
      "affiliations": [
        "Hospital Clinic de Barcelona, Barcelona, Spain",
        "IDIBAPS, Barcelona, Spain"
      ],
      "name": "Marc Figueras-Roca"
    },
    {
      "affiliations": [
        "Hospital Clinic de Barcelona, Barcelona, Spain",
        "IDIBAPS, Barcelona, Spain"
      ],
      "name": "Carolina Bernal-Morales"
    },
    {
      "affiliations": [
        "RetinAI Medical, Bern, Switzerland",
        "Research, Ikerian, Bern, Switzerland"
      ],
      "name": "Carlos Ciller"
    },
    {
      "affiliations": [
        "Hospital Clinic de Barcelona, Barcelona, Spain",
        "Universitat de Barcelona Facultat de Medicina i Ciencies de la Salut, Barcelona, Spain",
        "IDIBAPS, Barcelona, Spain"
      ],
      "name": "Javier Zarranz-Ventura"
    },
    {
      "affiliations": [],
      "name": "on behalf of DIADEMA investigators"
    }
  ],
  "title": "Artificial intelligence-based fluid quantification predicts clinical outcomes in diabetic macular oedema eyes treated with intravitreal dexamethasone implants: DIADEMA project",
  "uid": "be3c827b-63b8-5a0a-886b-3461c26a0834"
}