1. Articles from Dilraj S. Grewal

    1-22 of 22
    1. Comparison of wide-field swept source optical coherence tomography angiography and fundus autofluorescence in tubercular serpiginous-like choroiditis

      Comparison of wide-field swept source optical coherence tomography angiography and fundus autofluorescence in tubercular serpiginous-like choroiditis

      Purpose: To evaluate the potential clinical utility of wide-field swept source optical coherence tomography angiography (SS-OCTA) using a prototype device compared to a wide-field fundus autofluorescence (FAF) for analysis of the disease activity in eyes with tubercular serpiginous-like choroiditis (TBSLC). Methods: Using a prototype SS-OCTA device (PLEX Elite, Carl Zeiss Meditec, Dublin, CA), 17 eyes of 12 consecutive patients with TBSLC were imaged and multiple 12 mm × 12 mm OCTA scans were captured, which were montaged to create wide-field montage OCTA images scans. A wide- FAF (Eidon, CenterVue, Padova, Italy) was performed in the same sitting. Two masked graders independently ...

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    2. Quantification of retinal microvasculature and neurodegeneration changes in branch retinal vein occlusion after resolution of cystoid macular edema on optical coherence tomography angiography

      Quantification of retinal microvasculature and neurodegeneration changes in branch retinal vein occlusion after resolution of cystoid macular edema on optical coherence tomography angiography

      Purpose: To compare foveal avascular zone (FAZ) area and circularity, ganglion cell layer (GCL) thickness, retinal perfusion density (PD), and vessel density (VD) in eyes with branch retinal vein occlusion (BRVO) after resolution of cystoid macular edema (CME) to fellow control eyes and to correlate these parameters with visual acuity (VA). Methods: SD-OCTA scans (Zeiss Angioplex; Carl Zeiss Meditec Version 10) obtained on 32 eyes with BRVO after resolution of the CME with their fellow eyes used as controls were retrospectively evaluated. Parameters analyzed were FAZ size and circularity, PD, and VD in the superficial capillary plexus measured in the ...

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    3. Retinal Microvascular and Neurodegenerative Changes in Alzheimer’s Disease and Mild Cognitive Impairment Compared with Control Participants

      Retinal Microvascular and Neurodegenerative Changes in Alzheimer’s Disease and Mild Cognitive Impairment Compared with Control Participants

      Purpose Evaluate and compare the retinal microvasculature in the superficial capillary plexus (SCP) in Alzheimer’s disease (AD), mild cognitive impairment (MCI), and cognitively intact controls using OCT angiography. OCT parameters were also compared. Design Cross-sectional study. Participants Seventy eyes from 39 AD participants, 72 eyes from 37 MCI participants, and 254 eyes from 133 control participants were enrolled. Methods Participants were imaged using Zeiss Cirrus HD-5000 with AngioPlex (Carl Zeiss Meditec, Dublin, CA) and underwent cognitive evaluation with Mini-Mental State Examination. Main Outcome Measures Vessel density (VD) and perfusion density (PD) in the SCP within the Early Treatment Diabetic ...

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    4. Current role of optical coherence tomography angiography: Expert panel discussion

      Current role of optical coherence tomography angiography: Expert panel discussion

      Optical coherence tomography (OCT) angiography is a promising technique that provides depth resolved images of blood flow in the retina and choroid with levels of detail far exceeding that obtained with older forms of imaging and offers several advantages over conventional angiography to visualize the chorioretinal vasculature in a rapid and noninvasive manner. However, as with any evolving imaging technique, there are ongoing challenges in terms of need for new equipment, limitations of imaging capability and software processing techniques, as well as in understanding the implications of the imaging and its correlation with pathophysiology of the retina and choroid. This ...

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    5. Assessment of Differences in Retinal Microvasculature Using OCT Angiography in Alzheimer's Disease: A Twin Discordance Report

      Assessment of Differences in Retinal Microvasculature Using OCT Angiography in Alzheimer's Disease: A Twin Discordance Report

      The authors report the optical coherence tomography angiography (OCTA)-based comparative assessment of the retinal microvasculature in a rare pair of 96-year-old female monozygotic twins discordant for Alzheimer's disease (AD). Using automated mapping of the superficial capillary plexus, the authors observed that the twin with advanced AD had a significantly reduced vessel density and a larger foveal avascular zone in the superficial capillary plexus as well as a thinner choroid compared to the twin who was cognitively normal. This unique twin discordance report adds to the evidence supporting the use of retinal microvasculature changes in the superficial capillary plexus ...

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    6. Rapid regression of retinal neovascularization following intravitreal bevacizumab in branch retinal vein occlusion imaged by optical coherence tomography angiography

      Rapid regression of retinal neovascularization following intravitreal bevacizumab in branch retinal vein occlusion imaged by optical coherence tomography angiography

      Retinal neovascularization developing secondary to ischemic branch retinal vein occlusion (BRVO) is conventionally treated with sector panretinal photocoagulation (PRP). Elevated levels of the vascular endothelial growth factor (VEGF) play an important role in the development of these new vessels [1] and thus administration of anti-VEGF agents has been reported to be of therapeutic use as well. [2] , [3] We present a case of BRVO in a 55-year-old female, previously treated with PRP that had persistent neovascularization that was treated with a single anti-VEGF injection. The authors report the use of optical coherence tomography-angiography (OCT-A) as a noninvasive imaging platform to ...

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      Mentions: Duke University
    7. Role of Disorganization of Retinal Inner Layers as an Optical Coherence Tomography Biomarker in Diabetic and Uveitic Macular Edema

      Role of Disorganization of Retinal Inner Layers as an Optical Coherence Tomography Biomarker in Diabetic and Uveitic Macular Edema

      The role of optical coherence tomography (OCT) in characterizing normal and pathologic retinal architecture is still evolving. Numerous groups have tried to use OCT findings of retinal features as a surrogate for visual acuity in macular edema, but no traditional measure consistently accounts for visual outcomes. Retina specialists are still trying to process the data in the literature regarding this topic, as no good review currently exists. Dilraj S. Grewal, MD, and Glenn J. Jaffe, MD, provide us with an overview of the literature and focus on the role of disorganization of the retinal inner layers (DRIL) as an OCT ...

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      Mentions: Duke University
    8. Widefield en face optical coherence tomography to quantify the extent of paracentral acute middle maculopathy

      Widefield en face optical coherence tomography to quantify the extent of paracentral acute middle maculopathy

      Paracentral acute middle maculopathy (PAMM) has been described as a hyperreflective band or plaque-like region on spectral-domain optical coherence tomography (SD-OCT) at the level of the inner nuclear layer (INL), which is straddled by the intermediate and deep retinal capillary plexuses. 1,2 PAMM has been reported to cause eccentric wedge-shaped lesions that extend to the edge of the foveal avascular zone. 3 Although these lesions resolve over time, patients are left with irreversible INL atrophy, resulting in a permanent paracentral visual field defect.

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    9. Portable Optical Coherence Tomography Detection or Confirmation of Ophthalmoscopically Invisible or Indeterminate Active Retinoblastoma

      Portable Optical Coherence Tomography Detection or Confirmation of Ophthalmoscopically Invisible or Indeterminate Active Retinoblastoma

      Portable, hand-held optical coherence tomography (OCT) revealed three clinically relevant yet not ophthalmoscopically detected or confirmed manifestations of retinoblastoma in a single patient with familial bilateral disease. Specifically, OCT showed new retinal tumors, new vitreous seeds, and tumor recurrence before they could be detected or confirmed by ophthalmoscopy.

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    10. Length-adaptive graph search for automatic segmentation of pathological features in optical coherence tomography images

      Length-adaptive graph search for automatic segmentation of pathological features in optical coherence tomography images

      We introduce a metric in graph search and demonstrate its application for segmenting retinal optical coherence tomography (OCT) images of macular pathology. Our proposed “adjusted mean arc length” (AMAL) metric is an adaptation of the lowest mean arc length search technique for automated OCT segmentation. We compare this method to Dijkstra’s shortest path algorithm, which we utilized previously in our popular graph theory and dynamic programming segmentation technique. As an illustrative example, we show that AMAL-based length-adaptive segmentation outperforms the shortest path in delineating the retina/vitreous boundary of patients with full-thickness macular holes when compared with expert manual ...

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    11. Choroidal Thickness and En Face Optical Coherence Tomography Imaging in Autoimmune Retinopathy

      Choroidal Thickness and En Face Optical Coherence Tomography Imaging in Autoimmune Retinopathy

      A 57-year-old white woman developed autoimmune retinopathy (AIR) in both eyes associated with bilateral autoimmune sensorineural hearing loss. Laboratory testing was positive for 68kDa (heat-shock protein) and 136kDa (human interstitial retinoid-binding protein). Extensive cancer screening was negative. Spectral-domain optical coherence tomography enhanced depth imaging demonstrated a markedly thickened choroid in both eyes. En face imaging showed a distinctive pattern of granular hyperreflective foveal dots. The concurrent sensorineural hearing loss was thought to be of autoimmune origin and also responded to immunosuppressive treatment. Eyes with non-paraneoplastic, seropositive AIR may have associated increased choroidal thickness. Audiology testing should be considered.

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      Mentions: Duke University
    12. Wide field of view swept-source optical coherence tomography for peripheral retinal disease

      Wide field of view swept-source optical coherence tomography for peripheral retinal disease

      Background/aims To assess peripheral retinal lesions and the posterior pole in single widefield optical coherence tomography (OCT) volumes. Methods A wide field of view (FOV) swept-source OCT (WFOV SSOCT) system was developed using a commercial swept-source laser and a custom sample arm consisting of two indirect ophthalmic lenses. Twenty-seven subjects with peripheral lesions (choroidal melanomas, choroidal naevi, sclerochoroidal calcification, retinitis pigmentosa, diabetic retinopathy, retinoschisis and uveitis) were imaged with the WFOV SSOCT. Volumes were taken in primary gaze. Using the optic nerve to fovea distance as a reference measurement, comparisons were made between the lateral FOV of the WFOV ...

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    13. Optical coherence tomography platforms and parameters for glaucoma diagnosis and progression

      Optical coherence tomography platforms and parameters for glaucoma diagnosis and progression

      Purpose of review: With the rapid adoption of spectral domain optical coherence tomography (SDOCT) in clinical practice and the recent advances in software technology, there is a need for a review of the literature on glaucoma detection and progression analysis algorithms designed for the commercially available instruments. Recent findings: Peripapillary retinal nerve fiber layer (RNFL) thickness and macular thickness, including segmental macular thickness calculation algorithms, have been demonstrated to be repeatable and reproducible, and have a high degree of diagnostic sensitivity and specificity in discriminating between healthy and glaucomatous eyes across the glaucoma continuum. Newer software capabilities such as glaucoma ...

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    14. Assessment of Foveal Microstructure and Foveal Lucencies Using Optical Coherence Tomography Radial Scans Following Macular Hole Surgery

      Assessment of Foveal Microstructure and Foveal Lucencies Using Optical Coherence Tomography Radial Scans Following Macular Hole Surgery

      Purpose To evaluate the foveal microstructure using high density (24-line) radial scans and their correlation with visual recovery following macular hole surgery Design Retrospective, consecutive, interventional case series. Methods Forty-five 45 eyes of 43 patients with ≥6 months follow-up following surgery were analyzed. Preoperative predictive measures evaluated included basal hole and minimum linear diameters. Outcome measures included best-corrected visual-acuity (BCVA), postoperative foveal lucency horizontal and vertical size, external limiting membrane and ellipsoid zone defect. Results Mean basal hole diameter was 642±330μm and minimum linear diameter was 277±161μm. BCVA (logMAR) improved from 0.67±0.23 to ...

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    15. A Pilot Quantitative Study of Topographic Correlation between Reticular Pseudodrusen and the Choroidal Vasculature Using En Face Optical Coherence Tomography

      A Pilot Quantitative Study of Topographic Correlation between Reticular Pseudodrusen and the Choroidal Vasculature Using En Face Optical Coherence Tomography

      Purpose To analyze the topographic correlation between reticular pseudodrusen (RPD) visualized on infrared reflectance (IR) and choroidal vasculature using en-face volumetric spectral-domain optical coherence tomography (SD-OCT). Methods A masked observer marked individual RPD on IR images using ImageJ (NIH, Bethesda, MD). Using the macular volume scan (Cirrus, Carl Zeiss Meditec Inc, Dublin, CA), the RPE slab function was used to generate a C-scan of the most superficial choroidal vasculature. An independent masked grader created a topographic binary map of the choroidal vasculature by thresholding the en-face image, which was overlaid onto the IR map of RPD. For each IR image ...

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    16. Diagnosis of glaucoma and detection of glaucoma progression using spectral domain optical coherence tomography

      Diagnosis of glaucoma and detection of glaucoma progression using spectral domain optical coherence tomography

      Purpose of review: With the rapid adoption of spectral domain optical coherence tomography (SDOCT) in clinical practice and the recent advances in software technology, there is a need for a review of the literature on glaucoma detection and progression analysis algorithms designed for the commercially available instruments. Recent findings: Peripapillary retinal nerve fiber layer (RNFL) thickness and macular thickness, including segmental macular thickness calculation algorithms, have been demonstrated to be repeatable and reproducible, and have a high degree of diagnostic sensitivity and specificity in discriminating between healthy and glaucomatous eyes across the glaucoma continuum. Newer software capabilities such as glaucoma ...

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    17. Detection of Progressive Retinal Nerve Fiber Layer Thickness Loss With Optical Coherence Tomography Using 4 Criteria for Functional Progression

      Detection of Progressive Retinal Nerve Fiber Layer Thickness Loss With Optical Coherence Tomography Using 4 Criteria for Functional Progression

      Purpose: To compare the rates of retinal nerve fiber layer (RNFL) thickness loss using optical coherence tomography (OCT) in progressing versus nonprogressing eyes using 4 methods to define functional progression. Methods: Normal and glaucomatous eyes with >=3 years of follow up were prospectively enrolled. Standard automated perimetry (Swedish Interactive Threshold Algorithm Standard 24-2) and OCT (Stratus OCT, Carl Zeiss Meditec, Dublin, CA) imaging were performed every 6 months in glaucomatous eyes. OCT imaging was performed annually in normal eyes. Functional progression was determined using early manifest glaucoma trial criterion, visual field index (VFI), Progressor software, and the 3-omitting method. Results ...

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    18. Quantification of Change in Axonal Birefringence Following Surgical Reduction in Intraocular Pressure

      Quantification of Change in Axonal Birefringence Following Surgical Reduction in Intraocular Pressure
      BACKGROUND AND OBJECTIVE The purpose of this study was to examine the hypothesis that retinal nerve fiber layer (RNFL) birefringence increases following surgical reduction of intraocular pressure (IOP). PATIENTS AND METHODS Twenty-six glaucomatous eyes requiring trabeculectomy or drainage implant were enrolled. Optical coherence tomography (OCT), scanning laser polarimetry (SLP), and IOP measurements were performed preoperatively and 3 months postoperatively. The OCT and SLP images were aligned using a new algorithm that aligns the vessels in an OCT image to those in the corresponding SLP reflectance image. The SLP retardance values at the location of the OCT scan circle were then ...
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    19. Assessment of central corneal thickness in normal, keratoconus, and post-laser in situ keratomileusis eyes using Scheimpflug imaging, spectral domain optical coherence tomography, and ultrasound pachymetry

      Assessment of central corneal thickness in normal, keratoconus, and post-laser in situ keratomileusis eyes using Scheimpflug imaging, spectral domain optical coherence tomography, and ultrasound pachymetry
      Purpose To compare the central corneal thickness (CCT) in normal eyes, eyes with keratoconus, and eyes after laser in situ keratomileusis (LASIK) using 3 methods. Setting Cornea Clinic, Grewal Eye Institute, Chandigarh, India. Methods In this study, CCT was measured by sequential Scheimpflug imaging, spectral-domain anterior segment optical coherence tomography (AS-OCT), and ultrasound (US) pachymetry. Results Each of the 3 groups comprised 50 eyes. There were no differences between the 3 groups in age, sex, or intraocular pressure. In normal eyes, CCT was statistically significantly higher by US pachymetry (mean 525.8 μm ± 41.4) [SD] than by Scheimpflug imaging ...
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    20. Three-dimensional High-speed Optical Coherence Tomography for Diagnosis of Hypotony Maculopathy After Glaucoma Filtration Surgery

      Purpose: To describe the clinical findings of hypotony maculopathy using 3-dimensional (3D) topography maps reconstructed from spectral domain optical coherence tomography (SD-OCT) imaging, and compare SD-OCT with time domain OCT (TD-OCT) for hypotony maculopathy diagnosis. Methods: This was an observational noncomparative case series comprising 7 patients with hypotony maculopathy after trabeculectomy with mitomycin-C. All patients underwent consecutive imaging with TD-OCT (Stratus OCT) and SD-OCT using various high-resolution instruments. 3-D surface maps obtained using SD-OCT were compared with linear scans obtained using TD-OCT. Results: Two of 7 eyes had minimally detectable folds with TD-OCT imaging in the vertical axis. Five eyes ...
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    21. Diagnostic Ability of Fourier-Domain vs Time-Domain Optical Coherence Tomography for Glaucoma Detection

      Purpose To compare retinal nerve fiber layer (RNFL) thickness assessments and the discriminating ability of Fourier-domain optical coherence tomography (FD-OCT) with that of time-domain optical coherence tomography (TD-OCT) for glaucoma detection. Design Prospective, nonrandomized, observational cohort study. Methods Normal and glaucomatous eyes underwent complete examination, standard automated perimetry, optic disc photography, TD-OCT (Stratus OCT; Carl Zeiss Meditec, Dublin, California, USA), and FD-OCT (RTVue; Optovue Inc, Fremont, California, USA). One eye per subject was enrolled. Two consecutive scans were acquired using a 3.46-mm diameter scan with TD-OCT and a 3.45-mm diameter scan with FD-OCT. For each of 5 RNFL ...
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    1-22 of 22
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    Assessment of central corneal thickness in normal, keratoconus, and post-laser in situ keratomileusis eyes using Scheimpflug imaging, spectral domain optical coherence tomography, and ultrasound pachymetry Quantification of Change in Axonal Birefringence Following Surgical Reduction in Intraocular Pressure Detection of Progressive Retinal Nerve Fiber Layer Thickness Loss With Optical Coherence Tomography Using 4 Criteria for Functional Progression Diagnosis of glaucoma and detection of glaucoma progression using spectral domain optical coherence tomography A Pilot Quantitative Study of Topographic Correlation between Reticular Pseudodrusen and the Choroidal Vasculature Using En Face Optical Coherence Tomography Wide field of view swept-source optical coherence tomography for peripheral retinal disease Widefield en face optical coherence tomography to quantify the extent of paracentral acute middle maculopathy Retinal Microvascular and Neurodegenerative Changes in Alzheimer’s Disease and Mild Cognitive Impairment Compared with Control Participants Vitreous Seeding in Retinocytoma: Importance of Optical Coherence Tomography Utility of Spectral-Domain Optical Coherence Tomography in Differentiating Papilledema From Pseudopapilledema: A Prospective Longitudinal Study Visualizing and quantifying cutaneous microvascular reactivity in humans using optical coherence tomography: Impaired dilator function in diabetes Optical Coherence Tomography of Outer Retinal Hyper-Reflectivity, Neovascularization and Pigment in Type 2 Macular Telangiectasia