About

Barbara Blodi, MD, MALD, is the Matthew D. Davis Professor at the University of Wisconsin–Madison, where she also serves as the Medical Director of the Wisconsin Reading Center. Her medical and surgical interests focus on retina, macula, and vitreous diseases, including age-related macular degeneration, diabetic retinopathy, posterior uveitis, retinal diseases, and vein occlusion. She is involved in research related to adaptive optics, analysis of new retinal imaging modalities such as ultra-widefield retinal imaging and OCT-angiography, artificial intelligence, and telemedicine. Dr. Blodi completed her fellowships in Medical Retina at the Bascom Palmer Eye Institute in Miami, FL, and Surgical Retina at the University of Michigan Kellogg Eye Center. She completed her residency at Bascom Palmer Eye Institute and her internship at Good Samaritan Medical Center in Phoenix, AZ. She earned her medical degree from the University of Iowa Carver College of Medicine. Her approach emphasizes listening to patients, providing comprehensive information and guidance about treatment options, and understanding that retinal treatment is often an incremental process requiring multiple visits.

Research topics

• Medicine
• Internal medicine
• Ophthalmology
• Surgery
• Computer Science
• Political Science
• Artificial Intelligence
• Law
• Endocrinology
• Engineering
• Pediatrics
• Engineering ethics

Selected publications

• Standardizing Measurement of Complete Retinal Pigment Epithelial and Outer Retinal Atrophy—Classification of Atrophy Meeting Report 8

  Ophthalmology Retina · 2026-01-01 · 1 citations

  article
  PublisherDOI

• Longitudinal Comparison of Geographic Atrophy Enlargement Using Manual, Semiautomated, and Deep Learning Approaches

  Ophthalmology Science · 2025-04-08 · 3 citations

  articleOpen access

  Objective: To compare a fully automated artificial intelligence (AI) model, a semiautomated method, and manual planimetry in the longitudinal assessment of geographic atrophy (GA) using fundus autofluorescence images.Design: A retrospective analysis of 3 GA assessment methods: AI, Heidelberg Eye Explorer semiautomated software (RegionFinder), and manual planimetry.Subjects and Controls: One hundred eight patients (185 eyes) with GA from a phase IIb clinical trial by GlaxoSmithKline, which evaluated an experimental drug that did not reduce GA enlargement compared with the placebo.Methods: Fundus autofluorescence images of 185 eyes were annotated using manual planimetry, semiautomated RegionFinder, and a fully automated AI model trained and validated on manual planimetry annotations at screening, year 1, and year 2. Artificial intelligence masks were compared with human-guided methods, and regression errors were assessed by stacking masks from consecutive visits.Agreement between methods was assessed using BlandAltman plots, Dice similarity coefficient (DSC), and comparisons of GA growth rates.Artificial intelligence performance was evaluated based on its need for human edits and frequency of regression errors.Main Outcome Measures: Agreement between methods was evaluated using BlandAltman plots, DSC, and intraclass correlation coefficients (ICCs).The mean GA growth rate (mm 2 /year) and square root transformation of GA size were compared across methods.Artificial intelligence performance was assessed by the percentage of acceptable masks and the frequency of longitudinal regression errors.Results: At screening, the mean GA area was 7.22 mm 2 with RegionFinder, 8.37 mm 2 with AI, and 8.66 mm 2 with manual planimetry.RegionFinder measured smaller GA areas than both AI and manual, with a mean difference of 1.45 mm 2 (95% confidence interval [CI]: 1.56, 1.35) versus AI (ICC 0.945) and 1.87 mm 2 (95% CI: 1.99, 1.75) versus manual (ICC 0.920).Growth rates were comparable between RegionFinder (1.54 mm 2 /year), AI (1.68 mm 2 / year), and manual (1.80 mm 2 /year) (P 0.25).Artificial intelligence masks were deemed acceptable in 84.8% of visits, and 81.4% of cases showed no regression over time.Conclusions: Artificial intelligence accurately measures GA in approximately 85% of cases, requiring human intervention in only 15%, indicating potential to streamline GA measurement in clinical trials while maintaining human oversight.

  PublisherOA PDFDOI

• Long-Term Effects of Anti-VEGF Therapy versus Panretinal Photocoagulation on Retinal Vessel Caliber in Eyes with Proliferative Diabetic Retinopathy

  Ophthalmology Retina · 2025-04-10

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Intensive Glycemic Management is Associated with Reduced Retinal Structure Abnormalities on Ocular Coherence Tomography in the DCCT/EDIC Study

  2024-03-29

  preprintOpen access1st authorCorresponding

  <p dir="ltr">OBJECTIVE</p><p dir="ltr">To investigate quantitative and qualitative changes in retinal structure using optical coherence tomography (OCT) and their associations with systemic or other risk factors in individuals with type 1 diabetes.</p><p dir="ltr">RESEARCH DESIGN AND METHODS</p><p dir="ltr">In the Epidemiology of Diabetes Interventions and Complications study, OCT images were obtained during study years 25–28 (2019-2022) in 937 participants; 54% and 46% were from the original intensive (INT) and conventional (CONV) treatment groups, respectively.</p><p dir="ltr">RESULTS</p><p dir="ltr">Participants were on average 61 years old with diabetes duration of 39 years and HbA1c 7.6%. Participants originally in the CONV group were more likely to have disorganization of retinal inner layers (DRIL) (CONV: 27.3% vs INT: 18.7%; P=0.0003), intraretinal fluid (CONV 24.4% vs INT 19.2%; P=0.0222), and intraretinal cysts (CONV 20.8% vs INT 16.6%; P=0.0471). In multivariable models, sex, age, smoking, mean updated SBP, and history of CSME and of anti-VEGF treatment were independently associated with changes in central subfield thickness, while HbA1c, BMI, history of CSME and of ocular surgery were associated with DRIL. Visual acuity decline was associated with significant thinning of all retinal subfields except for the central and inner nasal subfields. </p><p dir="ltr">CONCLUSIONS</p><p dir="ltr">Early intensive glycemic management in type 1 diabetes is associated with a decreased risk of DRIL. This important morphological abnormality was associated with a history of macular edema, a history of ocular surgery and worse visual acuity. This study reveals benefits of intensive glycemic management on the retina beyond features detected by fundus photographs and ophthalmoscopy. </p>

  PublisherDOI

• Intensive Glycemic Management Is Associated With Reduced Retinal Structure Abnormalities on Ocular Coherence Tomography in the DCCT/EDIC Study

  Diabetes Care · 2024-03-29 · 7 citations

  articleOpen access1st author

  OBJECTIVE: To investigate quantitative and qualitative changes in retinal structure using optical coherence tomography (OCT) and their associations with systemic or other risk factors in individuals with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: In the Epidemiology of Diabetes Interventions and Complications (EDIC) study, OCT images were obtained during study years 25-28 (2019-2022) in 937 participants; 54% and 46% were from the original intensive (INT) and conventional (CONV) glycemic management treatment groups, respectively. RESULTS: Average age for participants was 61 years old, diabetes duration 39 years, and HbA1c 7.6%. Participants originally in the CONV group were more likely to have disorganization of retinal inner layers (DRIL) (CONV 27.3% vs. INT 18.7%; P = 0.0003), intraretinal fluid (CONV 24.4% vs. INT 19.2%; P = 0.0222), and intraretinal cysts (CONV 20.8% vs. INT 16.6%; P = 0.0471). In multivariable models, sex, age, smoking, mean updated systolic blood pressure, and history of "clinically significant" macular edema (CSME) and of anti-VEGF treatment were independently associated with changes in central subfield thickness, while HbA1c, BMI, and history of CSME and of ocular surgery were associated with DRIL. Visual acuity (VA) decline was associated with significant thinning of all retinal subfields except for the central and inner nasal subfields. CONCLUSIONS: Early intensive glycemic management in T1D is associated with a decreased risk of DRIL. This important morphological abnormality was associated with a history of macular edema, a history of ocular surgery, and worse VA. This study reveals benefits of intensive glycemic management on the retina beyond features detected by fundus photographs and ophthalmoscopy.

  PublisherOA PDFDOI

• Ultra-Widefield and Early Treatment Diabetic Retinopathy Study 7-Field Grading of Diabetic Retinopathy

  JAMA Ophthalmology · 2024-08-15 · 4 citations

  letterOpen access

  Importance: High concordance in diabetic retinopathy (DR) outcomes between 7-field (7F) and ultra-widefield (UWF) images would allow for combining longitudinal assessments based on the 2 modalities both in clinical studies and clinical care. Objective: To compare 7F and UWF imaging with regard to DR severity and the associations of DR severity with risk factors, such as hemoglobin A1c, age, diabetes duration, and sex. Design, Setting, and Participants: This cross-sectional study describes the outcomes of the randomized clinical Diabetes Control and Complications Trial (DCCT) and its subsequent observational study, the Epidemiology of Diabetes Interventions and Complications (EDIC) study. Of the 1441 participants with type 1 diabetes in the DCCT, 1375 were enrolled in the EDIC study. Of the 1171 participants who were active between March 2019 and December 2021, 200° UWF color imaging and 7F fundus photographs were obtained for 785 participants once at the same visit. Central graders assessed 7F-UWF with a 7F template masking the retinal periphery and the full UWF image (UWF-global). Data were analyzed from January 2022 to March 2023. Exposures: Hemoglobin A1c was assessed quarterly during the DCCT and annually during the EDIC study using high-performance liquid chromatography. Main Outcomes and Measures: Retinopathy was determined independently for all imaging as mild, moderate, or severe nonproliferative DR (SNPDR) using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading scale for the 7F images and the global ETDRS grading scale for the UWF images. Panretinal and focal photocoagulation were self-reported or based on scarring location and pattern observed during grading. Proliferative DR (PDR) was defined by observed neovascularization or evidence of panretinal photocoagulation. Results: Among the 785 participants included in this study, 420 (53%) were male and 365 (47%) were female. The mean (SD) age was 61 (7) years. DR grading between UWF-7F and 7F imaging was correlated for all outcomes, including for severe outcomes, such as SNPDR (κ, 0.73; concordance, 96%), PDR (κ, 0.74; concordance, 97%), scatter photocoagulation (κ, 0.97; concordance, 99%), and focal photocoagulation (κ, 0.71; concordance, 98%). Most DR severity scores were within 1 step (1410 of 1529 [92%]), and 3% (51 of 1529) were more than 2 steps apart (κ, 0.45; 95% CI, 0.42-0.49; weighted κ, 0.63; 95% CI, 0.60-0.67) on the ETDRS severity scale. DR severity assessed within the UWF-global area was higher compared to 7F (median [IQR] UWF-global score, 3 [2-3] vs median 7F level score, 2.0 [1-3]; P < .001), although the 2 modalities were correlated (1225 of 1508 [81%] 1-step agreement; weighted κ, 0.41). Conclusions and Relevance: Standard ETDRS 7F and UWF evaluations of DR were comparable for ETDRS severity levels as previously reported by Diabetic Retinopathy Clinical Research Retina Network reports. In addition, these evaluations of DR were comparable for DCCT/EDIT study outcomes and major study conclusions, suggesting that use of UWF imaging is not likely to introduce relevant measurement biases in future longitudinal studies. Trial Registration: ClinicalTrials.gov Identifiers: NCT00360815.

  PublisherOA PDFDOI

• Intensive Glycemic Management is Associated with Reduced Retinal Structure Abnormalities on Ocular Coherence Tomography in the DCCT/EDIC Study

  2024-03-29

  preprintOpen access1st authorCorresponding

  &lt;p dir="ltr"&gt;OBJECTIVE&lt;/p&gt;&lt;p dir="ltr"&gt;To investigate quantitative and qualitative changes in retinal structure using optical coherence tomography (OCT) and their associations with systemic or other risk factors in individuals with type 1 diabetes.&lt;/p&gt;&lt;p dir="ltr"&gt;RESEARCH DESIGN AND METHODS&lt;/p&gt;&lt;p dir="ltr"&gt;In the Epidemiology of Diabetes Interventions and Complications study, OCT images were obtained during study years 25–28 (2019-2022) in 937 participants; 54% and 46% were from the original intensive (INT) and conventional (CONV) treatment groups, respectively.&lt;/p&gt;&lt;p dir="ltr"&gt;RESULTS&lt;/p&gt;&lt;p dir="ltr"&gt;Participants were on average 61 years old with diabetes duration of 39 years and HbA1c 7.6%. Participants originally in the CONV group were more likely to have disorganization of retinal inner layers (DRIL) (CONV: 27.3% vs INT: 18.7%; P=0.0003), intraretinal fluid (CONV 24.4% vs INT 19.2%; P=0.0222), and intraretinal cysts (CONV 20.8% vs INT 16.6%; P=0.0471). In multivariable models, sex, age, smoking, mean updated SBP, and history of CSME and of anti-VEGF treatment were independently associated with changes in central subfield thickness, while HbA1c, BMI, history of CSME and of ocular surgery were associated with DRIL. Visual acuity decline was associated with significant thinning of all retinal subfields except for the central and inner nasal subfields. &lt;/p&gt;&lt;p dir="ltr"&gt;CONCLUSIONS&lt;/p&gt;&lt;p dir="ltr"&gt;Early intensive glycemic management in type 1 diabetes is associated with a decreased risk of DRIL. This important morphological abnormality was associated with a history of macular edema, a history of ocular surgery and worse visual acuity. This study reveals benefits of intensive glycemic management on the retina beyond features detected by fundus photographs and ophthalmoscopy. &lt;/p&gt;

  PublisherOA PDFDOI

• Visit Adherence and Visual Acuity in Study of COmparative Treatments for REtinal Vein Occlusion 2 (SCORE2)

  Ophthalmic Epidemiology · 2023-03-08 · 1 citations

  articleOpen access

  Purpose We quantify the association between visit adherence and visual acuity (VA) in retinal vein occlusions (CRVO).Methods The SCORE2 protocol included a visit every 4 weeks (every 28–35 days) during the first year. Visit adherence was measured as follows: number of missed visits, average and longest (avg and max days) visit interval, and average and longest (avg and max missed days) and unintended visit interval. Avg and max missed days were categorized as on time (0 days), late (>0–60 days), and very late (>60 days). The primary outcome was a change in the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity letter score (VALS) between baseline study visit and last attended visit during Year 1, using multivariate linear regression models controlling for numerous demographic and clinical factors.Results After adjustment, for each visit missed, patients lost 3.0 letters (95% CI: −6.2, 0.2) of vision (p = .07). On average, the 48 patients who missed at least 1 visit lost 9.4 letters (95% CI: −14.4, −4.3, p < .001) of vision after adjustment. Average days and maximal intervals between visits were not associated with changes in VALS (p > .22) for both comparisons. However, when a visit was missed, the average missed days between missed visits and the max missed interval were both associated with loss of VALS (both variables: 0 days missed as reference, late [1–60 days] −10.8 letters [95% CI: −16.9, −4.7], very late [>60 days] −7.3 letters [95% CI: −14.5, −0.2]; p = .003 for both).Conclusions Visit adherence is associated with VALS outcomes in CRVO patients.

  PublisherOA PDFDOI

• Comparison of Standard 7-Field, Clarus, and Optos Ultrawidefield Imaging Systems for Diabetic Retinopathy (COCO Study)

  Ophthalmology Science · 2023-11-11 · 10 citations

  articleOpen accessSenior author

  Purpose: The purpose of this study was to compare diabetic retinopathy (DR) severity levels assessed from 7 standard-field stereoscopic color photographs on a 35° fundus camera to both Clarus and Optos ultrawidefield color images. Design: Cross-sectional, comparative imaging study. Participants: Participants with DR imaged at a single-center retina practice. Methods: Participants were imaged on 3 cameras at a single visit with the Topcon 35° fundus camera, Clarus, and Optos. The DR Severity Scale (DRSS) level was determined within the 7-field (7F) area of each image set using the ETDRS scale. An additional global DRSS was assigned for both Clarus and Optos images using the entire visible retina. Weighted kappa (wκ) measured the agreement between cameras. Main Outcome Measures: The primary outcome was a 3-way comparison of DRSS level within the 7F area imaged on the 3 cameras. Secondary outcomes included a comparison of the DRSS obtained with standard 7F imaging to the global DRSS of Clarus and Optos and a comparison of the global DRSS between Clarus and Optos only. Results: Ninety-seven eyes (50 participants) were evaluated. Agreement within 1-step of ETDRS levels between standard 7F imaging and Clarus 7F was 90.1% (wκ = 0.65), and with Optos 7F in 85.9%, (wκ = 0.58). Agreement within 1-step between standard 7F imaging and Clarus global was 88.9% of eyes (wκ = 0.63), and Optos global was 85.7%, (wκ = 0.54). Agreement between Clarus and Optos global DR level within 1-step was 89.1% (wκ = 0.68). Intergrader agreement for the 7F ETDRS level was 96% for standard 7F imaging, 98% for Clarus, and 95.5% for Optos. Conclusions: These findings suggest that when evaluating the 7F area on Clarus and Optos, DR severity grades are comparable to standard 7F imaging. However, it is important to understand the unique attributes and differences of each fundus camera when changing the type of system used in a clinical setting due to upgrading equipment. Additionally, if the facility has access to > 1 device, there should not be an exchange between cameras for the same patient. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

  PublisherOA PDFDOI

• Association of Dietary Nitrate and a Mediterranean Diet With Age-Related Macular Degeneration Among US Adults

  JAMA Ophthalmology · 2022-12-22 · 16 citations

  articleOpen access

  Importance: Low dietary nitrate intake has previously been suggested to be a risk factor for age-related macular degeneration (AMD) progression; however, this finding has not been replicated in other cohorts or adjusted for dietary patterns. Objective: To determine whether there is an association between dietary nitrate intake and AMD progression. Design, Setting, and Participants: This cohort study analyzed data from the prospective Age-Related Eye Disease Study (AREDS) and AREDS2 randomized clinical trial cohorts and their extended follow-up studies, which were conducted in multicenter outpatient retinal practices. Participants in both trials had non-late AMD in at least 1 eye. Data were analyzed from March 1, 2020, to September 30, 2022. Exposure: Dietary nitrate intake. Main Outcomes and Measures: Association between dietary nitrate intake and development of late AMD (neovascular AMD [nAMD] or geographic atrophy [GA]) or large drusen. The interactions of dietary patterns, with common at-risk single-nucleotide polymorphisms, were also assessed. Results: In the combined AREDS/AREDS2 cohort of 7788 participants (4288 AREDS participants and 3610 AREDS2 participants [110 of whom participated in both studies]), there were 13 511 eligible eyes. The combined cohort comprised 4396 women (56%) and 3392 men (44%), and the combined mean (SD) age was 71.1 (6.6) years. Dietary nitrate intake was associated with a decreased risk of progression to late AMD in the combined AREDS/AREDS2 cohort (hazard ratio [HR], 0.77 [95% CI, 0.69-0.86] for quartile 4 vs quartile 1 of intake) and a decreased risk of GA (HR, 0.71 [95% CI, 0.61-0.83]) and nAMD (HR, 0.85 [95% CI, 0.73-0.99]). In AREDS, increased nitrate intake (quartile 4 vs quartile 1) was associated with a decreased risk of late AMD (HR, 0.77 [95% CI, 0.65-0.91]) and GA (HR, 0.80 [95% CI, 0.65-0.97]) but not nAMD; in AREDS2, there was no association between nitrate intake (quartile 4 vs quartile 1) and late AMD (HR, 0.90 [95% CI, 0.80-1.02]) or nAMD (HR, 0.93 [95% CI, 0.78-1.11]). There was a correlation between Mediterranean dietary patterns and dietary nitrate intake (r = 0.52, P < .001). Conclusions and Relevance: The findings of this cohort study suggest that dietary nitrate intake was associated with lower AMD risk. However, this association disappeared after adjusting for Mediterranean dietary patterns. These results are subject to potential bias and are hypothesis-generating in nature; therefore, they are insufficient to support new clinical recommendations. Previously described associations between dietary nitrate intake and AMD may in fact represent overall dietary patterns. Further research is needed before dietary nitrate intake can be recommended as a therapy for AMD.

  PublisherOA PDFDOI

Frequent coauthors

• Amitha Domalpally

  University of Wisconsin–Madison

  60 shared

• Emily Y. Chew

  National Eye Institute

  46 shared

• Ronald J. Prineas

  42 shared

• Andrea M. Kriska

  38 shared

• Elizabeth M. Venditti

  University of Pittsburgh

  38 shared

• William C. Knowler

  37 shared

• Linda Semler

  36 shared

• Amer Rassam

  36 shared

Awards & honors

• Daniel M. Albert Chair, McPherson Eye Research Institute