1. Articles from Eric M. Moult

    1-24 of 28 1 2 »
    1. High speed, long range, deep penetration swept source OCT for structural and angiographic imaging of the anterior eye

      High speed, long range, deep penetration swept source OCT for structural and angiographic imaging of the anterior eye

      This study reports the development of prototype swept-source optical coherence tomography (SS-OCT) technology for imaging the anterior eye. Advances in vertical-cavity surface-emitting laser (VCSEL) light sources, signal processing, optics and mechanical designs, enable a unique combination of high speed, long range, and deep penetration that addresses the challenges of anterior eye imaging. We demonstrate SS-OCT with a 325 kHz A-scan rate, 12.2 µm axial resolution (in air), and 15.5 mm depth range (in air) at 1310 nm wavelength. The ultrahigh 325 kHz A-scan rate not only facilitates biometry measurements by minimizing acquisition time and thus reducing motion, but ...

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    2. OCT Angiography-based Evaluation of the Choriocapillaris in Neovascular Age-related Macular Degeneration

      OCT Angiography-based Evaluation of the Choriocapillaris in Neovascular Age-related Macular Degeneration

      Neovascular age-related macular degeneration (AMD) can lead to rapid, irreversible vision loss in untreated eyes. While the pathogenesis of neovascular AMD remains incompletely understood, the choriocapillaris has been hypothesized as the initial site of injury. Due to limitations of dye-based angiography, in vivo imaging of the choriocapillaris has been a longstanding challenge. However, the clinical introduction of optical coherence tomography angiography (OCTA) has enabled researchers and clinicians to noninvasively image the choriocapillaris vasculature, allowing the evaluation of the choriocapillaris in eyes with a variety of pathologies. In this perspective, we review important OCTA-based findings regarding choriocapillaris impairment in neovascular AMD ...

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    3. Multiscale correlation of microvascular changes on optical coherence tomography angiography with retinal sensitivity in diabetic retinopathy

      Multiscale correlation of microvascular changes on optical coherence tomography angiography with retinal sensitivity in diabetic retinopathy

      Purpose: To assess global, zonal, and local correlations between vessel density changes measured by optical coherence tomography angiography (OCTA) and retinal sensitivity measured by microperimetry across diabetic retinopathy severity. Methods: Diabetic patients and non-diabetic controls underwent OCTA imaging and microperimetry testing. Pearson's correlation was used to assess associations between average sensitivity and skeletonized vessel density (SVD) or FAZ area centrally. Linear mixed effects modeling was used to assess relationships between local SVD measurements and their spatially corresponding retinal sensitivity measurements. Results: Thirty-nine eyes from 39 participants were imaged. In all slabs, there was a statistically significant positive correlation between ...

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    4. Analysis of correlations between local geographic atrophy growth rates and local OCT angiography-measured choriocapillaris flow deficits

      Analysis of correlations between local geographic atrophy growth rates and local OCT angiography-measured choriocapillaris flow deficits

      The purpose of this study is to quantitatively assess correlations between local geographic atrophy (GA) growth rates and local optical coherence tomography angiography (OCTA)-measured choriocapillaris (CC) flow deficits. Thirty-eight eyes from 27 patients with GA secondary to age-related macular degeneration (AMD) were imaged with a commercial 1050 nm swept-source OCTA instrument at 3 visits, each separated by ∼6 months. Pearson correlations were computed between local GA growth rates, estimated using a biophysical GA growth model, and local OCTA CC flow deficit percentages measured along the GA margins of the baseline visits. The p-values associated with the null hypothesis of ...

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    5. Full Thickness Macular Hole Size by Hypertransmission Signal on Spectral-Domain Optical Coherence Tomography

      Full Thickness Macular Hole Size by Hypertransmission Signal on Spectral-Domain Optical Coherence Tomography

      Purpose: To assess the full thickness macular hole (FTMH) size using the choroidal hypertransmission signal on spectral domain optical coherence tomography (SD-OCT), and to compare this method to the standard aperture measurement of the minimum aperture size at the level of the neurosensory retina. Design: Cross-sectional study of retrospective data. Methods: Eyes with FTMH imaged on SD-OCT were included. Two independent masked graders used the device's built-in caliper tool to measure the FTMH minimum aperture size at the level of the neurosensory retina, and the size of the corresponding hypertransmission signal below the level of the retinal pigment epithelium ...

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    6. OCT-OCTA segmentation: combining structural and blood flow information to segment Bruch's membrane

      OCT-OCTA segmentation: combining structural and blood flow information to segment Bruch's membrane

      In this paper we present a fully automated graph-based segmentation algorithm that jointly uses optical coherence tomography (OCT) and OCT angiography (OCTA) data to segment Bruch's membrane (BM). This is especially valuable in cases where the spatial correlation between BM, which is usually not visible on OCT scans, and the retinal pigment epithelium (RPE), which is often used as a surrogate for segmenting BM, is distorted by pathology. We validated the performance of our proposed algorithm against manual segmentation in a total of 18 eyes from healthy controls and patients with diabetic retinopathy (DR), non-exudative age-related macular degeneration (AMD ...

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    7. Efficient and high accuracy 3-D OCT angiography motion correction in pathology

      Efficient and high accuracy 3-D OCT angiography motion correction in pathology

      We describe a novel method for non-rigid 3-D motion correction of orthogonally raster-scanned optical coherence tomography angiography volumes. This is the first approach that aligns predominantly axial structural features such as retinal layers as well as transverse angiographic vascular features in a joint optimization. Combined with orthogonal scanning and favorization of kinematically more plausible displacements, subpixel alignment and micrometer-scale distortion correction is achieved in all 3 dimensions. As no specific structures are segmented, the method is by design robust to pathologic changes. Furthermore, the method is designed for highly parallel implementation and short runtime, allowing its integration into clinical workflow ...

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    8. Geometric Perfusion Deficits: A Novel OCT Angiography Biomarker for Diabetic Retinopathy Based on Oxygen Diffusion

      Geometric Perfusion Deficits: A Novel OCT Angiography Biomarker for Diabetic Retinopathy Based on Oxygen Diffusion

      Purpose To develop geometric perfusion deficits (GPD), an optical coherence tomography angiography (OCTA) biomarker based on oxygen diffusion, and to evaluate its utility in a pilot study of healthy subjects and patients with diabetic retinopathy (DR). Design Retrospective cross-sectional study. Methods Commercial spectral-domain OCTA instruments were used to acquire repeated 3×3 mm 2 and 6×6 mm 2 motion-corrected macular OCTA volumes. En face OCTA images corresponding to the superficial capillary plexus (SCP), deep capillary plexus (DCP), and full retinal projections were obtained using automatic segmentation. For each projection, the GPD percentage and the vessel density percentage, the control ...

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    9. High-Speed, Ultrahigh-Resolution Spectral-Domain OCT with Extended Imaging Range Using Reference Arm Length Matching

      High-Speed, Ultrahigh-Resolution Spectral-Domain OCT with Extended Imaging Range Using Reference Arm Length Matching

      Purpose : To develop high-speed, extended-range, ultrahigh-resolution spectral-domain optical coherence tomography (UHR SD-OCT) and demonstrate scan protocols for clinical retinal imaging. Methods : A UHR SD-OCT operating at 840-nm with 150-nm bandwidths was developed. The axial imaging range was extended by dynamically matching reference arm length to the retinal contour during acquisition. Two scan protocols were demonstrated for imaging healthy participants and patients with dry age-related macular degeneration. A high-definition raster protocol with intra–B-scan reference arm length matching (ReALM) was used for high-quality cross-sectional imaging. A cube volume scan using horizontal and vertical rasters with inter–B-scan ReALM and software motion ...

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    10. Analyzing Relative Flow Speeds in Diabetic Retinopathy Using Variable Interscan Time Analysis Optical Coherence Tomography Angiography

      Analyzing Relative Flow Speeds in Diabetic Retinopathy Using Variable Interscan Time Analysis Optical Coherence Tomography Angiography

      Objective Further insight into the flow characteristics of the vascular features associated with diabetic retinopathy (DR) may improve assessment and treatment of disease progression. The variable interscan time analysis (VISTA) algorithm is an extension of optical coherence tomography angiography (OCTA) that detects relative blood flow speeds which can then be depicted on a color-coded map. This study utilized VISTA to analyze relative blood flow speeds in the microvascular changes associated with DR. Design and Participants: In this cross-sectional study at New England Eye Center, Boston, Massachusetts, thirteen patients of varying severities of DR were enrolled. Methods OCTA images centered at ...

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    11. Macular and Peripapillary OCTA Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data

      Macular and Peripapillary OCTA Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data

      Purpose To identify optical coherence tomography angiography (OCTA) derived vessel metrics of the macula and optic nerve head (ONH) that predict diabetic retinopathy (DR) disease progression. Design Secondary analysis of clinical trial data Methods This was a sub-analysis of prospectively collected data from 73 subjects that participated in the TIME-2b Study (Aerpio Pharmaceuticals), a multi-center clinical trial for patients with moderate to severe DR treated with AKB-9778 and followed over a 12-month period. Eligible subjects were tested every 3 months with color fundus photography, spectral domain OCT and slit-lamp biomicroscopy. OCTA of the macula and ONH was obtained for a ...

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    12. Correction propagation for user-assisted optical coherence tomography segmentation: general framework and application to Bruch’s membrane segmentation

      Correction propagation for user-assisted optical coherence tomography segmentation: general framework and application to Bruch’s membrane segmentation

      Optical coherence tomography (OCT) is a commonly used ophthalmic imaging modality. While OCT has traditionally been viewed cross-sectionally (i.e., as a sequence of B-scans), higher A-scan rates have increased interest in en face OCT visualization and analysis. The recent clinical introduction of OCT angiography (OCTA) has further spurred this interest, with chorioretinal OCTA being predominantly displayed via en face projections. Although en face visualization and quantitation are natural for many retinal features (e.g., drusen and vasculature), it requires segmentation. Because manual segmentation of volumetric OCT data is prohibitively laborious in many settings, there has been significant research and ...

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    13. Topographic analysis of macular choriocapillaris flow deficits in diabetic retinopathy using swept–source optical coherence tomography angiography

      Topographic analysis of macular choriocapillaris flow deficits in diabetic retinopathy using swept–source optical coherence tomography angiography

      Background The purpose of this study was to investigate the association between diabetic retinopathy (DR) severity and macular choriocapillaris (CC) flow deficit percentage (FD %) in different macular regions using swept-source optical coherence tomography angiography (SS-OCTA). Methods Diabetic patients with SS-OCTA images were graded by severity and retrospectively assessed. CC FD % was calculated in four different regions of the OCTA image: inner, middle, outer, and full-field region. The generalized estimating equations (GEE) approach for clustered eye data was used to determine effect size and significance of age and disease severity on FD % for each region. Results 160 eyes from 90 total ...

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    14. A Framework for Multiscale Quantitation of Relationships Between Choriocapillaris Flow Impairment and Geographic Atrophy Growth

      A Framework for Multiscale Quantitation of Relationships Between Choriocapillaris Flow Impairment and Geographic Atrophy Growth

      Purpose To develop a multiscale analysis framework for investigating the relationships between geographic atrophy (GA) growth rate and choriocapillaris (CC) blood flow impairment using optical coherence tomography (OCT) and OCT angiography (OCTA). Design Retrospective case series. Methods We developed an OCT/OCTA analysis framework that quantitatively measures GA growth rates at global and local scales, and CC impairment at global, zonal, and local scales. A geometric GA growth model was used to measure local GA growth rates. The utility of the framework was demonstrated on 7 eyes with GA imaged at two time points using a prototype 400 kHz, 1050 ...

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    15. Global Analysis of Macular Choriocapillaris Perfusion in Dry Age-Related Macular Degeneration using Swept-Source Optical Coherence Tomography Angiography

      Global Analysis of Macular Choriocapillaris Perfusion in Dry Age-Related Macular Degeneration using Swept-Source Optical Coherence Tomography Angiography

      Purpose : Swept-source optical coherence tomography angiography (SS-OCTA) was used to investigate if the clinical stage of dry age-related macular degeneration (AMD) was correlated with global and regional macular choriocapillaris (CC) perfusion. Methods : In this retrospective, cross-sectional study, 6 × 6-mm SS-OCTA images from eyes with early, intermediate, and advanced dry AMD (56 eyes, 41 patients) were analyzed using algorithms described in the literature to assess regional flow deficit percentage (FD%) and average flow deficit size. Regions were defined by concentric areas centered on the fovea: a 1-mm-diameter area, 3-mm-diameter ring, 5-mm-diameter area, 5-mm-diameter ring, and 6 × 6-mm whole image. Data were ...

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    16. Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Purpose : To evaluate whether retinal capillary nonperfusion is found predominantly adjacent to arteries or veins in eyes with diabetic retinopathy (DR). Methods : Sixty-three eyes from 44 patients with proliferative DR (PDR) or non-PDR (NPDR) were included. Images (12 × 12-mm) foveal-centered optical coherence tomography (OCT) angiography (OCTA) images were taken using the Zeiss Plex Elite 9000. In 37 eyes, widefield montages with five fixation points were also obtained. A semiautomatic algorithm that detects nonperfusion in full-retina OCT slabs was developed, and the percentages of capillary nonperfusion within the total image area were calculated. Retinal arteries and veins were manually traced. Based ...

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    17. Controlling for Artifacts in Widefield Optical Coherence Tomography Angiography Measurements of Non-Perfusion Area

      Controlling for Artifacts in Widefield Optical Coherence Tomography Angiography Measurements of Non-Perfusion Area

      The recent clinical adoption of optical coherence tomography (OCT) angiography (OCTA) has enabled non-invasive, volumetric visualization of ocular vasculature at micron-scale resolutions. Initially limited to 3 mm × 3 mm and 6 mm × 6 mm fields-of-view (FOV), commercial OCTA systems now offer 12 mm × 12 mm, or larger, imaging fields. While larger FOVs promise a more complete visualization of retinal disease, they also introduce new challenges to the accurate and reliable interpretation of OCTA data. In particular, because of vignetting, wide-field imaging increases occurrence of low-OCT-signal artifacts, which leads to thresholding and/or segmentation artifacts, complicating OCTA analysis. This study presents ...

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    18. QUANTIFICATION OF RETINAL CAPILLARY NONPERFUSION IN DIABETICS USING WIDE-FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      QUANTIFICATION OF RETINAL CAPILLARY NONPERFUSION IN DIABETICS USING WIDE-FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      Purpose: To combine advances in high-speed, wide-field optical coherence tomography angiography ( OCTA ) with image processing methods for semiautomatic quantitative analysis of capillary nonperfusion in patients with diabetic retinopathy (DR). Methods: Sixty-eight diabetic patients (73 eyes), either without retinopathy or with different degrees of retinopathy, were prospectively recruited for volumetric swept-source OCTA imaging using 12 mm × 12 mm fields centered at the fovea. A custom, semiautomatic software algorithm was used to quantify areas of capillary nonperfusion . Results: The mean percentage of nonperfused area was 0.1% (95% confidence interval: 0.0–0.4) in the eyes without DR; 2.1% (95 ...

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    19. A Joint Probabilistic Model for Speckle Variance, Amplitude Decorrelation and Interframe Variance (IFV) Optical Coherence Tomography Angiography

      A Joint Probabilistic Model for Speckle Variance, Amplitude Decorrelation and Interframe Variance (IFV) Optical Coherence Tomography Angiography

      Optical Coherence Tomography Angiography (OCTA) is a general method to visualize blood flow in biological tissue. Despite its good results in practice, the commonly used Amplitude Decorrelation OCTA (AD-OCTA) measure suffers from a well-understood objective function, which makes it challenging to mathematically model post processing tasks like, e.g., denoising. In this paper, a probabilistic model is developed for the three OCTA measures Speckle Variance OCTA, ADOCTA and the newly proposed Interframe Variance OCTA (IFV-OCTA) to enable further tasks like regularization-based denoising. From a theoretical point of view, IFV-OCTA is shown to be in-between the other two methods and can ...

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    20. Polypoidal Choroidal Vasculopathy on Swept-Source Optical Coherence Tomography Angiography with Variable Interscan Time Analysis

      Polypoidal Choroidal Vasculopathy on Swept-Source Optical Coherence Tomography Angiography with Variable Interscan Time Analysis

      Purpose : To use a novel optical coherence tomography angiography (OCTA) algorithm termed variable interscan time analysis (VISTA) to evaluate relative blood flow speeds in polypoidal choroidal vasculopathy (PCV). Methods : Prospective cross-sectional study enrolling patients with confirmed diagnosis of PCV. OCTA of the retina and choroid was obtained with a prototype swept-source OCT system. The acquired OCT volumes were centered on the branching vascular network (BVN) and polyps as determined by indocyanine-green angiography (ICGA). The relative blood flow speeds were characterized on VISTA-OCTA. Results : Seven eyes from seven patients were evaluated. Swept-source OCTA enabled detailed enface visualization of the BVN and ...

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    21. SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS CHORIOCAPILLARIS ALTERATIONS IN EYES WITH NASCENT GEOGRAPHIC ATROPHY AND DRUSEN-ASSOCIATED GEOGRAPHIC ATROPHY

      SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS CHORIOCAPILLARIS ALTERATIONS IN EYES WITH NASCENT GEOGRAPHIC ATROPHY AND DRUSEN-ASSOCIATED GEOGRAPHIC ATROPHY

      Purpose: To investigate choriocapillaris (CC) alteration in patients with nascent geographic atrophy (nGA) and/or drusen-associated geographic atrophy (DAGA) using swept-source optical coherence tomography angiography (OCTA). Methods: A 1,050-nm wavelength, 400 kHz A-scan rate swept-source optical coherence tomography prototype was used to perform volumetric swept-source optical coherence tomography angiography over 6 mm x 6 mm fields of view in patients with nGA and/or DAGA. The resulting optical coherence tomography (OCT) and OCTA data were analyzed using a combination of en face and cross-sectional techniques. Variable interscan time analysis (VISTA) was used to differentiate CC flow impairment from complete ...

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    22. TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis

      TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis

      Purpose: Currently available optical coherence tomography angiography systems provide information about blood flux but only limited information about blood flow speed. The authors develop a method for mapping the previously proposed variable interscan time analysis (VISTA) algorithm into a color display that encodes relative blood flow speed. Methods: Optical coherence tomography angiography was performed with a 1,050 nm, 400 kHz A-scan rate, swept source optical coherence tomography system using a 5 repeated B-scan protocol. Variable interscan time analysis was used to compute the optical coherence tomography angiography signal from B-scan pairs having 1.5 millisecond and 3.0 milliseconds ...

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    23. Visualizing the Choriocapillaris Under Drusen: Comparing 1050-nm Swept-Source Versus 840-nm Spectral-Domain Optical Coherence Tomography Angiography

      Visualizing the Choriocapillaris Under Drusen: Comparing 1050-nm Swept-Source Versus 840-nm Spectral-Domain Optical Coherence Tomography Angiography

      Purpose : To investigate the appearance of choriocapillaris (CC) flow under drusen by comparing long-wavelength (1050 nm) swept-source optical coherence tomography (SS-OCT) angiography with shorter-wavelength (840 nm) spectral-domain (SD) OCT angiography. Methods : Patients with drusen imaged on both devices on the same day were selected and graded. Ambiguous OCT angiography (OCTA) signal loss was defined as low OCTA signal on the en face OCTA CC image that also had low OCT signal in the corresponding area on the en face OCT CC image and OCT B-scans. Unambiguous OCTA signal loss was defined as low OCTA signal on the en face OCTA ...

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    24. ULTRAHIGH SPEED SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL AND CHORIOCAPILLARIS ALTERATIONS IN DIABETIC PATIENTS WITH AND WITHOUT RETINOPATHY

      ULTRAHIGH SPEED SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL AND CHORIOCAPILLARIS ALTERATIONS IN DIABETIC PATIENTS WITH AND WITHOUT RETINOPATHY

      Purpose: To investigate the utility of ultrahigh speed, swept source optical coherence tomography angiography in visualizing retinal microvascular and choriocapillaris (CC) changes in diabetic patients. Methods: The study was prospective and cross-sectional. A 1,050 nm wavelength, 400 kHz A-scan rate swept source optical coherence tomography prototype was used to perform volumetric optical coherence tomography angiography of the retinal and CC vasculatures in diabetic patients and normal subjects. Sixty-three eyes from 32 normal subjects, 9 eyes from 7 patients with proliferative diabetic retinopathy, 29 eyes from 16 patients with nonproliferative diabetic retinopathy, and 51 eyes from 28 diabetic patients without ...

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    1-24 of 28 1 2 »
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    Ultrahigh-Speed, Swept-Source Optical Coherence Tomography Angiography in Nonexudative Age-Related Macular Degeneration with Geographic Atrophy Choroidal neovascularization analyzed on ultra-high speed swept source optical coherence tomography angiography compared to spectral domain optical coherence tomography angiography Visualization of Changes in the Choriocapillaris, Choroidal Vessels, and Retinal Morphology After Focal Laser Photocoagulation Using OCT Angiography Choroidal Neovascularization Analyzed on Ultrahigh-Speed Swept-Source Optical Coherence Tomography Angiography Compared to Spectral-Domain Optical Coherence Tomography Angiography ULTRAHIGH SPEED SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL AND CHORIOCAPILLARIS ALTERATIONS IN DIABETIC PATIENTS WITH AND WITHOUT RETINOPATHY Visualizing the Choriocapillaris Under Drusen: Comparing 1050-nm Swept-Source Versus 840-nm Spectral-Domain Optical Coherence Tomography Angiography TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS CHORIOCAPILLARIS ALTERATIONS IN EYES WITH NASCENT GEOGRAPHIC ATROPHY AND DRUSEN-ASSOCIATED GEOGRAPHIC ATROPHY QUANTIFICATION OF RETINAL CAPILLARY NONPERFUSION IN DIABETICS USING WIDE-FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY Efficient and high accuracy 3-D OCT angiography motion correction in pathology Comparison of Two Novel Integrated Swept-source EFFECT OF ORAL CARBONIC ANHYDRASE INHIBITOR ON CYSTOID MACULAR EDEMA ASSOCIATED WITH RETINITIS PIGMENTOSA: an OCT and OCT angiography study