{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:12:24Z","timestamp":1791547944434,"version":"4.3.4"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Artificial intelligence (AI) and deep learning (DL)-based systems have gained wide interest in macular disorders, including diabetic macular edema (DME). This paper aims to validate an AI algorithm for identifying and quantifying different major optical coherence tomography (OCT) biomarkers in DME eyes by comparing the algorithm to human expert manual examination. Intraretinal (IRF) and subretinal fluid (SRF) detection and volumes, external limiting-membrane (ELM) and ellipsoid zone (EZ) integrity, and hyperreflective retina foci (HRF) quantification were analyzed. Three-hundred three DME eyes were included. The mean central subfield thickness was 386.5 \u00b1 130.2 \u00b5m. IRF was present in all eyes and confirmed by AI software. The agreement (kappa value) (95% confidence interval) for SRF presence and ELM and EZ interruption were 0.831 (0.738\u20130.924), 0.934 (0.886\u20130.982), and 0.936 (0.894\u20130.977), respectively. The accuracy of the automatic quantification of IRF, SRF, ELM, and EZ ranged between 94.7% and 95.7%, while accuracy of quality parameters ranged between 99.0% (OCT layer segmentation) and 100.0% (fovea centering). The Intraclass Correlation Coefficient between clinical and automated HRF count was excellent (0.97). This AI algorithm provides a reliable and reproducible assessment of the most relevant OCT biomarkers in DME. It may allow clinicians to routinely identify and quantify these parameters, offering an objective way of diagnosing and following DME eyes.<\/jats:p>","DOI":"10.3390\/jcm12062134","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T01:35:37Z","timestamp":1678325737000},"page":"2134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Validation of an Automated Artificial Intelligence Algorithm for the Quantification of Major OCT Parameters in Diabetic Macular Edema"],"prefix":"10.3390","volume":"12","author":[{"given":"Edoardo","family":"Midena","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of Padova, 35128 Padova, Italy"},{"name":"IRCCS\u2014Fondazione Bietti, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5311-5184","authenticated-orcid":false,"given":"Lisa","family":"Toto","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D\u2019Annunzio Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1749-2737","authenticated-orcid":false,"given":"Luisa","family":"Frizziero","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8523-2032","authenticated-orcid":false,"given":"Giuseppe","family":"Covello","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5535-9350","authenticated-orcid":false,"given":"Tommaso","family":"Torresin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-6631","authenticated-orcid":false,"given":"Giulia","family":"Midena","sequence":"additional","affiliation":[{"name":"IRCCS\u2014Fondazione Bietti, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4947-0444","authenticated-orcid":false,"given":"Luca","family":"Danieli","sequence":"additional","affiliation":[{"name":"IRCCS\u2014Fondazione Bietti, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6677-7697","authenticated-orcid":false,"given":"Elisabetta","family":"Pilotto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2243-9033","authenticated-orcid":false,"given":"Michele","family":"Figus","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Mariotti","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6817-2488","authenticated-orcid":false,"given":"Marco","family":"Lupidi","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1016\/j.ophtha.2021.04.027","article-title":"Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Review and Meta-analysis","volume":"128","author":"Teo","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"010427","DOI":"10.7189\/jogh.09.010427","article-title":"Global epidemiology of retinal vein occlusion: A systematic review and meta-analysis of prevalence, incidence, and risk factors","volume":"9","author":"Song","year":"2019","journal-title":"J. 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