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This work presents a novel fully automated method for retinal analysis in images acquired with a flood illuminated adaptive optics retinal camera (AO-FIO). The proposed processing pipeline consists of several steps: First, we register single AO-FIO images in a montage image capturing a larger retinal area. The registration is performed by combination of phase correlation and the scale-invariant feature transform method. A set of 200 AO-FIO images from 10 healthy subjects (10 images from left eye and 10 images from right eye) is processed into 20 montage images and mutually aligned according to the automatically detected fovea center. As a second step, the photoreceptors in the montage images are detected using a method based on regional maxima localization, where the detector parameters were determined with Bayesian optimization according to manually labeled photoreceptors by three evaluators. The detection assessment, based on Dice coefficient, ranges from 0.72 to 0.8. In the next step, the corresponding density maps are generated for each of the montage images. As a final step, representative averaged photoreceptor density maps are created for the left and right eye and thus enabling comprehensive analysis across the montage images and a straightforward comparison with available histological data and other published studies. Our proposed method and software thus enable us to generate AO-based photoreceptor density maps for all measured locations fully automatically, and thus it is suitable for large studies, as those are in pressing need for automated approaches. In addition, the application MATADOR (MATlab ADaptive Optics Retinal Image Analysis) that implements the described pipeline and the dataset with photoreceptor labels are made publicly available.

Purpose : Changes in lipid metabolism, chronic inflammation and increased oxidative stress have been discussed as patho-etiogenetic drivers in age-related macular degeneration (AMD). Systemic medication, such as lipid-lowering drugs (LLD) and anti-diabetic drugs, affect these pathways and may therefore also play a role in AMD pathogenesis. We aimed to investigate associations of commonly used systemic drugs with AMD prevalence in the European population.Methods : We included 38,694 adults from 14 population-based studies from the European Eye Epidemiology (E3) consortium. We performed multivariable logistic regression modelling to examine medication use association with prevalence of AMD as well as late AMD. Analyses were carried out separately by study and results pooled using random effects meta-analysis. We conducted these analyses separately for LLD, anti-diabetic drugs, non-steroidal anti-inflammatory drugs (NSAID), and L-Dopa.Results : Between studies, mean age ranged from 61.5 ± 7.1 to 82.6 ± 3.8 years and prevalence ranged from 12.1% to 64.5% and from 0.5% to 35.5% for any and any late AMD, respectively. In the meta-analysis of our multivariable models, LLD and anti-diabetic drugs were associated with lower AMD prevalence (OR 0.85, 95% confidence interval (CI)=0.79 - 0.91 and OR 0.78, 95% CI=0.66 - 0.91). We found no association with late AMD or with any other medication.Conclusions : Our study shows an association of LLD and anti-diabetic drug use with lower AMD prevalence across multiple European cohorts. Our findings support the importance of metabolic processes in the complex etiology of AMD.

Additional file 3: Table S2. Sectoral analyses derived from cpRNFLT in all subjects with further adjustment for high sensitivity c-reactive protein (N = 8,952).

Additional file 6: Table S5. Sectoral multivariable linear regression analyses for lipid markers and cpRNFLT in all subjects stratified by statin treatment.

Additional file 2: Table S1. Sectoral multivariable linear regression analyses for cardiometabolic biomarkers and cpRNFLT in all subjects with further adjustment for SD-OCT-derived clinical and subclinical ONH abnormalities (including glaucoma and other ONH diseases), as well as patient-reported glaucoma diagnosis and medication (N = 8952).

Additional file 8: Table S7. Sectoral analyses derived from cpRNFLT in patients with optic nerve head abnormalities, self-reported glaucoma diagnosis, and/or glaucoma medication (N = 1,180).

Additional file 5: Table S4. Baseline characteristics of the entire study population stratified by statin treatment.

Additional file 4: Table S3. Baseline characteristics of the entire study population stratified by CKD risk status.

Additional file 7: Table S6. Bayesian information criterion difference (��BIC) for the investigation of potential mediating effects of smoking status on the association between cpRNFLT and the lipid profile.

Additional file 1: Figure S1. Scatterplots illustrating the relationship between global circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and major clinical markers of renal function.

Additional file 3: Supplementary Figures.

Additional file 2: Supplementary Note.

Purpose: To evaluate the relationship between the presence of cortical cataract and accommodation effort, using refractive error as a proxy. Methods: Patients between 50 and 90 years, scheduled for cataract surgery, were selected with the help of a photographic database. Nuclear and cortical cataract were graded and patients grouped having no cataract, pure cortical, mixed or pure nuclear cataract. Refraction data at the time of the photograph was converted to estimated spherical equivalent refractive error each patient would have had at the age of 45 years. Results: From the initial 239 eyes from 239 patients, cases with myopia below –6.5 dpt and hyperopia above 6.5 dpt were excluded, resulting in 199 cases for final analysis. Eyes with no cataract showed the lowest median refractive error (–3.65 dpt), followed by the pure nuclear group (–2.69 dpt). The median refractive error for pure cortical (–0.23 dpt) and mixed cataracts (–0.87 dpt) were close to emmetropia. Cortical cataracts were found in 37% of myopes, 82% of emmetropes, and 85% of hyperopes. Conclusion: Emmetropes and hyperopes tend to develop more cortical cataract than myopes. These cortical cataracts might be caused by shear stress inside the crystalline lens due to accommodation efforts at the time of onset of presbyopia.

Background: Cross-sectional survey of ocular biometry and visual function in healthy eyes across the life span of a German population aged 20 to 69 years (n = 218). Subject number in percent per age category reflected the percentage within the respective age band of the population of Leipzig, Germany. Methods: Measurements obtained: subjective and objective refraction, best-corrected visual acuity, accommodation, contrast sensitivity, topography and pachymetry with Scheimpflug camera, axial length with non-contact partial coherence interferometry, and spectral-domain optical coherence tomography of the retina. Pearson correlation coefficients with corresponding p-values were given to present interrelationships between stature, biometric and refractive parameters or their associations with age. Two-sample T-tests were used to calculate gender differences. The area under the logarithmic contrast sensitivity function (AULCSF) was calculated for the analysis of contrast sensitivity as a single figure across a range of spatial frequencies. Results: The results of axial length (AL), anterior chamber depth (ACD) and anterior chamber volume (ACV) differed as a function of the age of the participants (rho (p value): AL −0.19 (0.006), ACD −0.56 (< 0.001), ACV-0.52 (< 0.001)). Longer eyes had deeper ACD (AL:ACD 0.62 (< 0.001), greater ACV (AL:ACV 0.65 (< 0.001) and steeper corneal radii (AL:R1ant; R2ant; R1post; R2post 0.40; 0.35; 0.36; 0.36 (all with (< 0.001)). Spherical equivalent was associated with age (towards hyperopia: 0.34 (< 0.001)), AL (−0.66 (< 0.001)), ACD (−0.52 (< 0.001)) and ACV (−0.46 (< 0.001)). Accommodation was found lower for older subjects (negative association with age, r = −0.82 (< 0.001)) and contrast sensitivity presented with smaller values for older ages (AULCSF −0.38, (< 0.001)), no change of retinal thickness with age. 58 % of the study cohort presented with a change of refractive correction above ±0.50 D in one or both eyes (64 % of these were habitual spectacle wearers), need for improvement was present in the young age-group and for older subjects with increasing age. Conclusion: Biometrical data of healthy German eyes, stratified by age, gender and refractive status, enabled cross-comparison of all parameters, providing an important reference database for future patient-based research and specific in-depth investigations of biometric data in epidemiological research. Trial registration: ClinicalTrials.gov # NCT01173614 July 28, 2010

BACKGROUND: The LIFE-Adult-Study is a population-based cohort study, which has recently completed the baseline examination of 10,000 randomly selected participants from Leipzig, a major city with 550,000 inhabitants in the east of Germany. It is the first study of this kind and size in an urban population in the eastern part of Germany. The study is conducted by the Leipzig Research Centre for Civilization Diseases (LIFE). Our objective is to investigate prevalences, early onset markers, genetic predispositions, and the role of lifestyle factors of major civilization diseases, with primary focus on metabolic and vascular diseases, heart function, cognitive impairment, brain function, depression, sleep disorders and vigilance dysregulation, retinal and optic nerve degeneration, and allergies. METHODS/DESIGN: The study covers a main age range from 40-79 years with particular deep phenotyping in elderly participants above the age of 60. The baseline examination was conducted from August 2011 to November 2014. All participants underwent an extensive core assessment programme (5-6 h) including structured interviews, questionnaires, physical examinations, and biospecimen collection. Participants over 60 underwent two additional assessment programmes (3-4 h each) on two separate visits including deeper cognitive testing, brain magnetic resonance imaging, diagnostic interviews for depression, and electroencephalography. DISCUSSION: The participation rate was 33 %. The assessment programme was accepted well and completely passed by almost all participants. Biomarker analyses have already been performed in all participants. Genotype, transcriptome and metabolome analyses have been conducted in subgroups. The first follow-up examination will commence in 2016.