1. Articles from John B. Miller

    1-24 of 45 1 2 »
    1. Retinal microvasculature and vasoreactivity changes in hypertension using optical coherence tomography-angiography

      Retinal microvasculature and vasoreactivity changes in hypertension using optical coherence tomography-angiography

      Purpose: To evaluate the retinal vasculature and vasoreactivity of patients with hypertension (HTN) using spectral domain optical coherence tomography angiography (SD-OCTA). Methods: Patients with and without a diagnosis of HTN were included in this cross-sectional observational study. All eyes were imaged with SD-OCTA using 3 mm × 3 mm and 6 mm × 6 mm centered on both the fovea and optic disk. A second 6 mm × 6 mm scan was taken after a 30 s breath-hold. Vessel density (VD), vessel skeletonized density (VSD), and fractal dimension (FD) were calculated using customized MATLAB scripts. Vessel diameter index (VDI) was obtained by taking ...

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    2. Nonperfusion Area and Other Vascular Metrics by Wider Field Swept-Source OCT Angiography as Biomarkers of Diabetic Retinopathy Severity

      Nonperfusion Area and Other Vascular Metrics by Wider Field Swept-Source OCT Angiography as Biomarkers of Diabetic Retinopathy Severity

      Purpose: To study the wider field swept-source optical coherence tomography angiography (WF SS-OCTA) metrics, especially non-perfusion area (NPA), in the diagnosing and staging of DR. Design: Cross-sectional observational study (November 2018-September 2020). Participants: 473 eyes of 286 patients (69 eyes of 49 control patients and 404 eyes of 237 diabetic patients). Methods: We imaged using 6mm×6mm and 12mm×12mm angiograms on WF SS-OCTA. Images were analyzed using the ARI Network and FIJI ImageJ. Mixed effects multiple regression models and receiver operator characteristic analysis was used for statistical analyses. Main outcome measures: Quantitative metrics such as vessel density (VD); vessel ...

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    3. Juxtapapillary Choroidal Neovascular Membrane as a Complication of Optic Disc Drusen: Multimodal Imaging With Swept Source-Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Juxtapapillary Choroidal Neovascular Membrane as a Complication of Optic Disc Drusen: Multimodal Imaging With Swept Source-Optical Coherence Tomography and Optical Coherence Tomography Angiography

      A 55-year-old Caucasian man presented to the neuro-ophthalmology department for follow-up evaluation due to long-standing bilateral optic nerve head drusen (ONHD). On examination, the BCVA was 20/20-2 in both eyes. Dilated fundus examination revealed extensive ONHD in both eyes, retinal hemorrhages, exudates inferonasal to the macula, and macular edema inferotemporal to the disc margin. Automated visual field testing revealed generalized depression in both eyes. Late phase leakage was observed on fluorescein angiography (FA). Optical coherence tomography angiography identified a small juxtapapillary choroidal neovascular membrane inferonasal to the macula in the right eye correlating with the area of retinal hemorrhage ...

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    4. Remote Imaging Capture with Widefield Swept-Source OCT Angiography During the COVID-19 Pandemic

      Remote Imaging Capture with Widefield Swept-Source OCT Angiography During the COVID-19 Pandemic

      Purpose: The COVID-19 pandemic has had a widespread impact on the health sector worldwide, both in the clinical and research subsector. This has necessitated for the invention of protocols compliant with social distancing policies to efficiently tackle the current needs. Our aim is to describe a novel remote imaging technique, which helped us continue our research with widefield swept-source optical coherence tomography angiography (WF SS-OCTA). Patients and Methods: As a part of this cross-sectional observational study from August 2020 to September 2020 at Massachusetts Eye and Ear (MEE), we used our institute approved remote desktop, outside of MEE, to gain ...

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    5. Quantifying Retinal Microvascular Morphology in Schizophrenia Using Swept-Source Optical Coherence Tomography Angiography

      Quantifying Retinal Microvascular Morphology in Schizophrenia Using Swept-Source Optical Coherence Tomography Angiography

      Background: Retinovascular changes are reported on fundus imaging in schizophrenia (SZ). This is the first study to use swept-source optical coherence tomography angiography (OCT-A) to comprehensively examine retinal microvascular changes in SZ. Methods: This study included 30 patients with SZ/schizoaffective disorder (8 early and 15 chronic) and 22 healthy controls (HCs). All assessments were performed at Beth Israel Deaconess Medical Center and Massachusetts Eye and Ear. All participants underwent swept-source OCT-A of right (oculus dextrus [OD]) and left (oculus sinister [OS]) eye, clinical, and cognitive assessments. Macular OCT-A images (6 × 6 mm) were collected with the DRI Topcon Triton ...

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    6. Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia

      Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia

      Background/aims: Pathological myopia (PM) is a leading cause of blindness worldwide. We aimed to evaluate microvascular and chorioretinal changes in different stages of myopia with wide-field (WF) swept-source (SS) optical coherence tomography angiography (OCTA). Methods: This prospective cross-sectional observational study included 186 eyes of 122 patients who had undergone imaging between November 2018 and October 2020. Vessel density (VD) and vessel skeletonised density (VSD) of superficial capillary plexus, deep capillary plexus and whole retina, as well as foveal avascular zone parameters, retinal thickness (RT) and choroidal thickness (CT), were calculated. Results: This study evaluated 75 eyes of 48 patients ...

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    7. Inter-device reliability of swept source and spectral domain optical coherence tomography and retinal layer differences in schizophrenia

      Inter-device reliability of swept source and spectral domain optical coherence tomography and retinal layer differences in schizophrenia

      Introduction Optical coherence tomography (OCT) is used to study retinal structure in schizophrenia. Changes in retinal structure, especially the retinal nerve fiber layer (RNFL) has been correlated with psychotic disorders. Measurement variability is a concern since there are various generations of OCT devices. We investigated the inter- and intra-device agreement of macular thickness between spectral domain (SD−OCT) and swept source−OCT (SS−OCT), and compared macula and peripapillary group differences in schizophrenia using SS−OCT. Methods Macular OCT thickness was obtained for schizophrenia (SZ, n = 30) and healthy controls (HC, n = 22) subjects using SD−OCT (Heidelberg Spectralis) and ...

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    8. Artificial Intelligence (AI) and Retinal Optical Coherence Tomography (OCT)

      Artificial Intelligence (AI) and Retinal Optical Coherence Tomography (OCT)

      Ophthalmology has been at the forefront of medical specialties adopting artificial intelligence. This is primarily due to the "image-centric" nature of the field. Thanks to the abundance of patients' OCT scans, analysis of OCT imaging has greatly benefited from artificial intelligence to expand patient screening and facilitate clinical decision-making.In this review, we define the concepts of artificial intelligence, machine learning, and deep learning and how different artificial intelligence algorithms have been applied in OCT image analysis for disease screening, diagnosis, management, and prognosis.Finally, we address some of the challenges and limitations that might affect the incorporation of artificial ...

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    9. Wide Field Swept Source Optical Coherence Tomography Angiography for the Evaluation of Proliferative Diabetic Retinopathy and Associated Lesions: A Review

      Wide Field Swept Source Optical Coherence Tomography Angiography for the Evaluation of Proliferative Diabetic Retinopathy and Associated Lesions: A Review

      Retinal imaging remains the mainstay for monitoring and grading diabetic retinopathy. The gold standard for detecting proliferative diabetic retinopathy (PDR) requiring treatment has long been the seven-field stereoscopic fundus photography and fluorescein angiography. In the past decade, ultra-wide field fluorescein angiography (UWF-FA) has become more commonly used in clinical practice for the evaluation of more advanced diabetic retinopathy. Since its invention, optical coherence tomography (OCT) has been an important tool for the assessment of diabetic macular edema; however, OCT offered little in the assessment of neovascular changes associated with PDR until OCT-A became available. More recently, swept source OCT allowed ...

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    10. Widefield Swept-source OCT Angiography Metrics Associated with the Development of Diabetic Vitreous Hemorrhage A Prospective Study

      Widefield Swept-source OCT Angiography Metrics Associated with the Development of Diabetic Vitreous Hemorrhage A Prospective Study

      Objective: To investigate the association among widefield swept-source optical coherence tomography angiography (WF SS-OCTA) metrics and systemic parameters and the occurrence of vitreous hemorrhage (VH) in eyes with proliferative diabetic retinopathy (PDR). Design: Prospective, observational study. Participants: Fifty-five eyes from 45 adults with PDR, with no history of VH, followed for at least 3 months. Methods: All patients were imaged with WF SS-OCTA (Montage 15×15mm and HD-51 Line scan). Images were independently evaluated by two graders for quantitative and qualitative WF SS-OCTA metrics defined a priori. Systemic and ocular parameters and WF SS-OCTA metrics were screened using Least Absolute ...

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    11. Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA)

      Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA)

      The advent of optical coherence tomography (OCT) revolutionized both clinical assessment and research of vitreoretinal conditions. Since then, extraordinary advances have been made in this imaging technology, including the relatively recent development of swept-source OCT (SS-OCT). SS-OCT enables a fast scan rate and utilizes a tunable swept laser at longer wavelengths than conventional spectral-domain devices. These features enable imaging of larger areas with reduced motion artifact, and a better visualization of the choroidal vasculature, respectively. Building on the principles of OCT, swept-source OCT has also been applied to OCT angiography (SS-OCTA), thus enabling a non-invasive in depth-resolved imaging of the ...

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    12. Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

      Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

      Aims To compare the efficacy of diabetic retinal neovascularisation (NV) detection using the widefield swept-source optical coherence tomography angiography (WF SS-OCTA) vitreoretinal interface (VRI) Angio slab and SS-OCT VRI Structure slab. Methods A prospective, observational study was performed at Massachusetts Eye and Ear from January 2019 to June 2020. Patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy and patients with diabetes but without diabetic retinopathy were included. All patients were imaged with WF SS-OCTA using the 12×12 mm Angio scan protocol centred on the fovea and optic disc. The en-face SS-OCTA VRI Angio slab and SS-OCT ...

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    13. Disorganisation of retinal inner layers is associated with reduced contrast sensitivity in retinal vein occlusion

      Disorganisation of retinal inner layers is associated with reduced contrast sensitivity in retinal vein occlusion

      Background/Aims To determine if disorganisation of retinal inner layers (DRIL) is associated with reduced contrast sensitivity (CS) in patients with retinal vein occlusion (RVO) with a history of macular oedema (ME). Methods Prospective, observational cohort study. Patients with a history of ME secondary to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) from October 2017 to July 2019 at a single institution were included. Patients underwent complete ophthalmic examination, spectral domain optical coherence tomography (SD-OCT) and CS testing using the quick contrast sensitivity function (qCSF) method. Eyes with coexisting macular disease were excluded. SD-OCT images were ...

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    14. A quantitative comparison of four optical coherence tomography angiography devices in healthy eyes

      A quantitative comparison of four optical coherence tomography angiography devices in healthy eyes

      Purpose Optical coherence tomography angiography (OCT-A) is a novel imaging modality for the diagnosis of chorioretinal diseases. A number of FDA-approved OCT-A devices are currently commercially available, each with unique algorithms and scanning protocols. Although several published studies have compared different combinations of OCT-A machines, there is a lack of agreement on the consistency of measurements across OCT-A devices. Therefore, we conducted a prospective quantitative comparison of four available OCT-A platforms. Methods Subjects were scanned on four devices: Optovue RTVue-XR, Heidelberg Spectralis OCT2 module, Zeiss Plex Elite 9000 Swept-Source OCT, and Topcon DRI-OCT Triton Swept-Source OCT. 3 mm × 3 mm ...

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    15. Widefield Swept-Source OCTA in Vogt-Koyanagi-Harada Disease

      Widefield Swept-Source OCTA in Vogt-Koyanagi-Harada Disease

      Herein, the authors describe an initial case report of widefield swept-source optical coherence tomography angiography (SS-OCTA) in Vogt-Koyanagi-Harada (VKH) disease. When compared to fluorescent angiography, indocyanine green angiography, and enhanced-depth OCT — upon which the revised criteria for VHK are based — widefield SS-OCTA enables detection of vitreous inflammation, noninvasive identification of characteristic areas of flow void at the level of choriocapillaris in the acute phase and may be a novel valuable tool not only for noninvasive diagnosis and monitoring of disease progression, persistence, resolution, and recurrence to guide therapy in VKH disease in the future.

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    16. Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent Lancet publication

      Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent Lancet publication

      We read with great interest the correspondence in Lancet by Marinho et al. [ 1 ] describing purported retinal manifestations of coronavirus disease (COVID-19). While there is great interest to understand potential ocular complications of COVID-19 during this pandemic, we have some concerns regarding the interpretation of the fundus and optical coherence tomography (OCT) findings. Marinho et al. examined 12 COVID-19 patients (all confirmed by PCR or antibody testing) with typical systemic disease but no visual symptoms. The reported cohort was relatively young (25–69 years; no mean or median provided) without severe systemic disease, although 2 were hospitalized. Eleven of the ...

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    17. Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy

      Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy

      Aims To compare widefield swept-source optical coherence tomography angiography (WF SS-OCTA) with ultra-widefield colour fundus photography (UWF CFP) and fluorescein angiography (UWF FA) for detecting diabetic retinopathy (DR) lesions. Methods This prospective, observational study was conducted at Massachusetts Eye and Ear from December 2018 to October 2019. Proliferative DR, non-proliferative DR and diabetic patients with no DR were included. All patients were imaged with a WF SS-OCTA using a Montage 15×15 mm scan. UWF CFP and UWF FA were taken by a 200°, single capture retinal imaging system. Images were independently evaluated for the presence or absence of DR ...

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    18. Retinal Microvasculature Changes After Repair of Macula-off Retinal Detachment Assessed with Optical Coherence Tomography Angiography

      Retinal Microvasculature Changes After Repair of Macula-off Retinal Detachment Assessed with Optical Coherence Tomography Angiography

      Objective: To characterize the microvascular retinal changes after repair of macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCT-A). Patients and Methods: A retrospective review of patients who underwent repair of macula-off RRD. Fellow unaffected eyes were used as controls. Post-operative OCT-A allowed comparison of vessel density (VD) and foveal avascular zone (FAZ) area in the superficial and deep retinal capillary plexus (DCP) as well as VD in the choriocapillaris layer. Results: Seventeen eyes of 17 RRD patients were included in the final analysis. There was a reduction in VD of the deep retinal capillary plexus in affected ...

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    19. Superficial Retinal Vascular Abnormalities in Schizophrenia as Shown by Swept Source OCT-Angiography: A Preliminary Study

      Superficial Retinal Vascular Abnormalities in Schizophrenia as Shown by Swept Source OCT-Angiography: A Preliminary Study

      Altered microvasculature is central to the pathophysiology of many CNS disorders, but it has received less attention in schizophrenia. Since retinal and cerebral microvessels are homologous in structure/function, the retina can be used as a window into the brain. Studies using fundus imaging in schizophrenia have identified decreased arteriole diameter and tortuosity, as well as increased venule diameter and tortuosity. Herein, we explore the ability of optical coherence tomography angiography (OCTA) to identify fine retinal vessel alterations in schizophrenia.

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    20. Subthreshold Exudative Choroidal Neovascularization Associated With Age-Related Macular Degeneration Identified by Optical Coherence Tomography Angiography

      Subthreshold Exudative Choroidal Neovascularization Associated With Age-Related Macular Degeneration Identified by Optical Coherence Tomography Angiography

      Purpose: This article describes the clinical and multimodal imaging characteristics of subthreshold exudative choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD). Methods: Among 3773 patients with AMD, 8 eyes (6 patients) were identified with the clinical phenotype of interest. Dilated fundus examinations, color fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and OCT angiography (OCTA) were performed. Results: OCT typically showed a moderately reflective irregular pigment epithelial detachment with overlying subretinal fluid (SRF). Traditional FA did not show leakage and ICGA showed no definitive neovascular network or hot spots. However, OCTA clearly demonstrated a ...

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    21. Optical Coherence Tomography-Angiography of a large retinal microaneurysm

      Optical Coherence Tomography-Angiography of a large retinal microaneurysm

      A 63-year-old healthy woman was referred for a retinal examination. Dilated fundus examination of the left eye revealed small retinal hemorrhage with surrounding exudation, most consistent with a large retinal microaneurysm, which was confirmed by fluorescein angiography and optical coherence tomography angiography (OCT-A). OCT-A has the potential to clearly delineate the anatomy of retinal aneurysms and could be used for diagnosis and surveillance, possibly replacing the current gold-standard fluorescein angiography.

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    22. Different Scan Protocols Affect the Detection Rates of Diabetic Retinopathy Lesions by Wide-field Swept-Source Optical Coherence Tomography Angiography

      Different Scan Protocols Affect the Detection Rates of Diabetic Retinopathy Lesions by Wide-field Swept-Source Optical Coherence Tomography Angiography

      Purpose To compare different scan protocols of wide field swept-source optical coherence tomography angiography (SS-OCTA) for the detection of diabetic retinopathy (DR) lesions. Design Comparison of diagnostic approaches. Methods A prospective, observational study was conducted at Mass Eye and Ear from December 2018 to July 2019. Proliferative diabetic retinopathy (PDR), non-proliferative diabetic retinopathy (NPDR) and diabetic patients without DR were included. All patients were imaged with a SS-OCTA using following scan protocol: Angio 3mm×3mm centered on fovea, Angio 6mm×6mm centered on fovea and optic disc, Montage 15mm×9mm and Angio 12mm×12mm centered on fovea and optic disc ...

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    23. Detection of retinal microvascular changes in von Hippel-Lindau disease using optical coherence tomography angiography

      Detection of retinal microvascular changes in von Hippel-Lindau disease using optical coherence tomography angiography

      Purpose Von Hippel-Lindau (VHL) disease is a hereditary disorder that can lead to ophthalmic manifestations, including retinal capillary hemangioma (RCH). The diagnosis of RCH is often guided by wide-field fluorescein angiography. In some cases, optical coherence tomography angiography (OCT-A) serves as a non-invasive alternative to FA. Herein, we used OCT-A to examine the macular microvasculature in patients with VHL disease. Subjects Subjects were selected from patients with a diagnosis of VHL. The control group included eyes without retinal diagnosis from patients with an episode of unilateral retinal detachment or trauma and age ≤ 50 years old. Methods Subjects were scanned on ...

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    24. Imaging Artifacts and Segmentation Errors With Wide-Field Swept-Source Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Imaging Artifacts and Segmentation Errors With Wide-Field Swept-Source Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Purpose : To analyze imaging artifacts and segmentation errors with wide-field swept-source optical coherence tomography angiography (SS-OCTA) in diabetic retinopathy (DR). Methods : We conducted a prospective, observational study at Massachusetts Eye and Ear from December 2018 to March 2019. Proliferative diabetic retinopathy (PDR), nonproliferative diabetic retinopathy (NPDR), diabetic patients with no diabetic retinopathy (DR), and healthy control eyes were included. All patients were imaged with a SS-OCTA and the Montage Angio (15 × 9 mm) was used for analysis. Images were independently evaluated by two graders using the motion artifact score (MAS). All statistical analyses were performed using SPSS 25.0 and ...

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