1. Articles from srinivas r. sadda

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    1. Automatic Segmentation in Multiple OCT Layers For Stargardt Disease Characterization Via Deep Learning

      Automatic Segmentation in Multiple OCT Layers For Stargardt Disease Characterization Via Deep Learning

      Purpose : This study sought to perform automated segmentation of 11 retinal layers and Stargardt-associated features on spectral-domain optical coherence tomography (SD-OCT) images and to analyze differences between normal eyes and eyes diagnosed with Stargardt disease. Methods : Automated segmentation was accomplished through application of the deep learning–shortest path (DL-SP) framework, a shortest path segmentation approach that is enhanced by a deep learning fully convolutional neural network. To compare normal eyes and eyes diagnosed with Stargardt disease, various retinal layer thickness and intensity feature maps associated with the outer retinal layers were generated. Results : The automated DL-SP approach achieved a mean ...

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    2. Comparison between Widefield Optical Coherence Tomography Devices in Eyes with High Myopia

      Comparison between Widefield Optical Coherence Tomography Devices in Eyes with High Myopia

      Background: To compare four different optical coherence tomography (OCT) devices for visualization of retinal and subretinal layers in highly myopic eyes. Methods: In this prospective, observational, cross-sectional study, consecutive patients with high myopia and control subjects were imaged by four OCT devices: Spectralis OCT2, PlexElite 2.0 100 kHz, PlexElite 2.0 200 kHz and the Canon Xephilio OCT-S1. The acquisition protocol for comparison consisted of single vertical and horizontal line scans centered on the fovea. Comparison between the devices in the extent of visible retina, presence of conjugate image or mirror artifacts, visibility of the sclerochoroidal interface and retrobulbar ...

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      Mentions: UCLA
    3. Optical Coherence Tomography Signs of Early Atrophy in Age-related Macular Degeneration: Inter-Reader Agreement. CAM Report 6

      Optical Coherence Tomography Signs of Early Atrophy in Age-related Macular Degeneration: Inter-Reader Agreement. CAM Report 6

      Objective: To determine the inter-reader agreement for incomplete and complete retinal pigment epithelium and outer retinal atrophy (iRORA and cRORA respectively) and their related features in age-related macular degeneration (AMD). Design: Inter-reader agreement study. Participants: Twelve readers from six reading centers. Methods: Following formal training, readers qualitatively assessed 60 optical coherence tomography (OCT) B-scans from 60 eyes with AMD for nine individual features associated with early atrophy and performed seven different annotations to quantify the spatial extent of OCT features within regions-of-interests. The qualitative and quantitative features were used to derive the presence of iRORA and cRORA, and also in ...

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    4. Comparison of Spectralis and Cirrus optical coherence tomography for the detection of incomplete and complete retinal pigment epithelium and outer retinal atrophy

      Comparison of Spectralis and Cirrus optical coherence tomography for the detection of incomplete and complete retinal pigment epithelium and outer retinal atrophy

      Purpose: To evaluate and compare the detection of incomplete and complete retinal pigment epithelial and outer retinal atrophy (iRORA and cRORA) using Spectralis and Cirrus optical coherence tomography (OCT) devices. Methods: Subjects with late age-related macular degeneration (AMD) were imaged on the same day with Spectralis and Cirrus OCT. Two masked, independent and experienced retina specialist graders evaluated each case for the presence of cRORA and iRORA lesions. Results: A significantly higher number of lesions were observed using Spectralis compared with Cirrus (239 vs 226 and 223 vs 209). Higher number of iRORA lesions were identified with Spectralis (105 vs ...

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    5. The effect of intravitreal recombinant tissue plasminogen activator injection on diabetic tractional fibrovascular membranes: Proposed criteria using optical coherence tomography

      The effect of intravitreal recombinant tissue plasminogen activator injection on diabetic tractional fibrovascular membranes: Proposed criteria using optical coherence tomography

      Purpose: To evaluate the effect of intravitreal recombinant tissue plasminogen activator (tPA) on diabetic tractional fibrovascular membranes (FVM) using proposed optical coherence tomography (OCT) criteria. Methods: This prospective, interventional case series enrolled eyes with tractional retinal detachment who were candidates for pars plana vitrectomy. OCT images were obtained to evaluate the border of the attached-detached retina and overlying FVP at baseline and 1 week post-intravitreal tPA injection using the follow-up scan acquisition protocol. Two independent graders assessed retinal detachment (RD) height, FVM height, and retinal thickness at the site of membrane attachment. Results: Thirteen eyes from 13 individuals were included ...

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    6. Relative Postpartum Retinal Vasoconstriction Detected With Optical Coherence Tomography Angiography

      Relative Postpartum Retinal Vasoconstriction Detected With Optical Coherence Tomography Angiography

      Purpose : To characterize changes in retinal perfusion during pregnancy and the postpartum period using optical coherence tomography angiography (OCTA). Methods : A nonmydriatic OCTA camera was used to image healthy women who were pregnant or in the postpartum period along with nonpregnant controls. Perfusion density (PD) and vessel length density (VLD) in the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) were evaluated. Results : A total of 16, 15, and 13 eyes from nonpregnant, pregnant, and healthy postpartum subjects, respectively, were evaluated. When compared to controls, there were significant increases in ICP PD during the second ...

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    7. Assessing accommodative presbyopic biometric changes of the entire anterior segment using single swept-source OCT image acquisitions

      Assessing accommodative presbyopic biometric changes of the entire anterior segment using single swept-source OCT image acquisitions

      Background/Objectives To evaluate biometric changes throughout the anterior chamber during accommodation and presbyopia using single image acquisition swept-source anterior-segment optical coherence tomography (AS-OCT). Subject/Methods Anterior-segment images were obtained using a new swept-source AS-OCT device (ANTERION, Heidelberg Engineering) from healthy volunteers ( n  = 71) across two centers in this prospective observational case series. In one image acquisition, cornea through posterior lens, including the ciliary muscle on both sides of the right eye, was imaged. Subjects undertook no accommodative effort and −1, −3, and −5 D of target vergence. Two-way repeated measures ANOVA modeling was performed for ciliary muscle measurements, lens ...

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    8. Deliberations of an International Panel of Experts on OCTA Nomenclature of nAMD

      Deliberations of an International Panel of Experts on OCTA Nomenclature of nAMD

      A panel of imaging experts was assembled to review neovascular age-related macular degeneration optical coherence tomography angiography descriptors published to date, and test agreement on use of these terms, which was found to be low. Optical coherence tomography angiography (OCTA) has been used to identify and characterize macular neovascularization (MNV) secondary to age-related macular degeneration (AMD). 1-4 Many studies have explored OCTA morphological features of MNV that might serve as biomarkers to assess disease activity and response to treatment. 1-6 The proliferation of studies however has resulted in an OCTA terminology that has been variable and inconsistent. To address inconsistency ...

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    9. Maternal Optical Coherence Tomography Angiography Changes Related to Small for Gestational Age Pregnancies

      Maternal Optical Coherence Tomography Angiography Changes Related to Small for Gestational Age Pregnancies

      Purpose : To study maternal retinal changes in pregnancies that resulted in a small for gestational age (SGA) infant. Methods : Pregnant women with SGA infants at birth and age-matched pregnant women with appropriate for gestational age (AGA) infants at birth (controls) were enrolled. All subjects underwent spectral domain optical coherent tomography angiography (OCTA) imaging using a 10° × 10° scan pattern centered on the fovea. Vessel density (VD) and vessel length density (VLD) of the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) were analyzed and compared between the two groups. Results : Twelve eyes of eight subjects ...

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    10. Age- and refraction-related changes in anterior segment anatomical structures measured by swept-source anterior segment OCT

      Age- and refraction-related changes in anterior segment anatomical structures measured by swept-source anterior segment OCT

      Abstract Purpose: To assess the effects of age and refractive status on anterior segment anatomical structures, including the ciliary body, using a new swept-source anterior segment optical coherence tomography (AS-OCT) device. Methods: This prospective observational study included 63 healthy volunteers (mean age: 44.2 years). Images of the anterior segment were obtained using a new swept-source AS-OCT (ANTERION, Heidelberg Engineering GmbH, Heidelberg, Germany) with tracking and image averaging from the right eye of all participants. Repeatability as well as inter- and intra-observer reliability of biometric measurements were evaluated. The impact of image tracking and averaging on ciliary muscle measurements was ...

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    11. Evaluation of the inner choroid using OCT angiography

      Evaluation of the inner choroid using OCT angiography

      The advent of optical coherence tomography angiography (OCTA) has allowed a qualitative and quantitative analysis of the retinal vasculature and the choriocapillaris. With the use of OCTA, several studies evaluated the changes in the choriocapillaris showing how this vascular structure plays a significant role in the pathogenesis of different conditions. This article reviews the current methods of analysis of the choriocapillaris and the relevant findings in different chorioretinal diseases.

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    12. Comparison and Repeatability of High Resolution and High Speed Scans from Spectralis Optical Coherence Tomography Angiography

      Comparison and Repeatability of High Resolution and High Speed Scans from Spectralis Optical Coherence Tomography Angiography

      Purpose : The purpose of this study was to evaluate and compare the repeatability of optical coherence tomography angiography (OCTA) derived retinal vascular quantitative metrics using high resolution (HR) versus high speed (HS) acquisition modes. Methods : Macular 4.4 × 2.9-mm OCTA images from normal, healthy volunteers were captured using both HR (768 A-scans × 256 B-scans) and HS (384 A-scans × 256 B-scans) acquisition protocols. Vessel density and vessel length density of the superficial capillary plexus and deep capillary plexus, as well as choriocapillaris flow deficit were computed. In a subset of eyes, the OCTA scans were repeated twice 2 days later ...

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    13. Impact of Scan Tilt on Quantitative Assessments Using Optical Coherence Tomography Angiography

      Impact of Scan Tilt on Quantitative Assessments Using Optical Coherence Tomography Angiography

      Purpose : To investigate the impact of scan tilt on quantitative assessments using swept-source optical coherence tomography angiography (SS-OCTA) in healthy participants. Methods : Healthy participants were imaged with a SS-OCTA system (PLEX Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA). After a standard scan was obtained, tilted scans were obtained by moving the optical coherence tomography beam entrance position horizontally. The tilting angle was measured from the B-scan image, and the flattest (horizontal) and the most tilted images were selected for comparative analysis. Foveal avascular zone (FAZ) area, vessel density (VD), and vessel length density (VLD) from the superficial and deep ...

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    14. 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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    15. Optical coherence tomography angiography for detection of macular neovascularization associated with atrophy in age-related macular degeneration

      Optical coherence tomography angiography for detection of macular neovascularization associated with atrophy in age-related macular degeneration

      Purpose To evaluate the ability of optical coherence tomography angiography (OCTA) to detect macular neovascularization (MNV) in eyes with atrophy compared with fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). Methods In this prospective study, eyes with MNV and atrophy (termed macular atrophy or MA) secondary to age-related macular degeneration (AMD), and AMD eyes with geographic atrophy (GA) without MNV underwent multimodal imaging with FA, ICGA, structural OCT, and OCTA. The presence of MNV was determined using all imaging modalities by senior retina specialists and was considered the gold standard reference. Each individual imaging modality was ...

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    16. Association of Intravitreal Aflibercept With Optical Coherence Tomography Angiography Vessel Density in Patients With Proliferative Diabetic Retinopathy: A Secondary Analysis of a Randomized Clinical Trial

      Association of Intravitreal Aflibercept With Optical Coherence Tomography Angiography Vessel Density in Patients With Proliferative Diabetic Retinopathy: A Secondary Analysis of a Randomized Clinical Trial

      Importance Although previous studies have evaluated the association between anti–vascular endothelial growth factor therapy and macular vessel density, they were confounded by the presence of macular edema, which may be associated with artifacts and segmentation errors in optical coherence tomography angiography (OCTA). Objective To evaluate the association of intravitreal aflibercept with changes in macular vascular density using OCTA in patients with proliferative diabetic retinopathy without diabetic macular edema. Design, Setting, and Participants This post hoc analysis of a randomized clinical trial used data on 40 eyes of 40 patients with proliferative diabetic retinopathy without diabetic macular edema who were ...

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    17. Automated Retinal Layer Segmentation Using Graph-based Algorithm Incorporating Deep-learning-derived Information

      Automated Retinal Layer Segmentation Using Graph-based Algorithm Incorporating Deep-learning-derived Information

      Regular drusen, an accumulation of material below the retinal pigment epithelium (RPE), have long been established as a hallmark early feature of nonneovascular age-related macular degeneration (AMD). Advances in imaging have expanded the phenotype of AMD to include another extracellular deposit, reticular pseudodrusen (RPD) (also termed subretinal drusenoid deposits, SDD), which are located above the RPE. We developed an approach to automatically segment retinal layers associated with regular drusen and RPD in spectral domain (SD) optical coherence tomography (OCT) images. More specifically, a shortest-path algorithm enhanced with probability maps generated through a fully convolutional neural network was used to segment ...

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    18. Subtype-differentiated impacts of subretinal drusenoid deposits on photoreceptors revealed by adaptive optics scanning laser ophthalmoscopy

      Subtype-differentiated impacts of subretinal drusenoid deposits on photoreceptors revealed by adaptive optics scanning laser ophthalmoscopy

      Purpose To examine the structure of photoreceptors surrounding two subtypes of subretinal drusenoid deposits (SDD), namely, dot and ribbon SDD, using multimodal imaging including adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral-domain optical coherence tomography (SD-OCT). Methods Twenty-six eyes of 13 patients with age-related macular degeneration (AMD) and SDD and 16 eyes of 8 subjects in normal chorioretinal health were studied. SDD presence, stage, and subtype were determined using color fundus photographs, infrared reflectance, autofluorescence imaging, and SD-OCT. SDD and surrounding photoreceptors were imaged using AOSLO. The structure of cone photoreceptors and SDD was examined at the baseline and at ...

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    19. Thresholding strategies to measure vessel density by optical coherence tomography angiography

      Thresholding strategies to measure vessel density by optical coherence tomography angiography

      Objective A variety of binarization strategies have been used to measure vessel density by optical coherence tomography angiography (OCT-A), but it is uncertain if they produce similar results. The purpose of the study was to evaluate the impact of different thresholding methods and contrast and brightness adjustment on OCT-A vessel density metrics. Design Observational, cross-sectional case series. Participants Consecutive healthy volunteers. Methods Healthy volunteers underwent fovea-centred 3 mm × 3 mm OCT-A scans using PlexElite 9000. Images of the superficial vascular plexus were generated using the instrument’s automated segmentation. Images were thresholded with 5 different threshold tools in ImageJ (Default ...

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    20. Optimizing the Repeatability of Choriocapillaris Flow Deficit Measurement from Optical Coherence Tomography Angiography

      Optimizing the Repeatability of Choriocapillaris Flow Deficit Measurement from Optical Coherence Tomography Angiography

      Purpose To evaluate impact of processing technique and slab selection on the repeatability of choriocapillaris (CC) flow deficit (FD) measurements as assessed using optical coherence tomography angiography (OCTA) Design: prospective, cross-sectional study Methods Healthy subjects were imaged with four consecutive 3x3mm OCTA using a swept source OCT (PLEX elite 9000, Carl Zeiss Meditec, Dublin, CA). OCTA images were generated using the Max projection, and three 10 μm-thick slabs starting 11, 21 and 31 μm posterior to the automatically segmented retinal pigment epithelium (RPE) band. The resultant images were binarized using Phansalkar’s method with a 43.94 μm radius and ...

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    21. Effect of image averaging on optical coherence tomography angiography data in eyes with branch retinal vein occlusion

      Effect of image averaging on optical coherence tomography angiography data in eyes with branch retinal vein occlusion

      Purpose To investigate the effect of image averaging on qualitative and quantitative assessments of optical coherence tomography angiography (OCTA) images from eyes of patients with branch retinal vein occlusion (BRVO). Methods Macular OCTA images of 33 eyes of 33 patients with BRVO were obtained using the HS100 HR-SD-OCT system (Canon, Inc.). For each eye, five OCTA cube scans were obtained with a 3 × 3 mm scan protocol, and the data were averaged and compounded into a single high image quality cube data using built-in software. Pre- and post-averaging images were compared qualitatively and quantitatively in superficial capillary plexus (SCP) and ...

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    22. Reproducibility and agreement of four anterior segment-optical coherence tomography devices for anterior chamber angle measurements

      Reproducibility and agreement of four anterior segment-optical coherence tomography devices for anterior chamber angle measurements

      Purpose To compare the reproducibility and agreement of anterior chamber angle (ACA) parameters and metrics obtained by four different anterior segment-optical coherence tomography (AS-OCT) devices. Methods In this prospective study, 30 eyes from 15 normal subjects underwent anterior segment angle scanning using the Spectralis, Cirrus, and Optovue spectral domain optical coherence tomography (SD-OCT), as well as the Visante time-domain optical coherence tomography (TD-OCT). For each eye, the scan line was performed perpendicularly on the inferior (270°) angle, and the inferior ACA image was acquired 2 times. Inter-instrument and intra-instrument, as well as inter-observer and intra-observer reproducibility of anterior chamber angle ...

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    23. Quantitative assessment of the retinal microvasculature and choriocapillaris in myopic patients using swept-source optical coherence tomography angiography

      Quantitative assessment of the retinal microvasculature and choriocapillaris in myopic patients using swept-source optical coherence tomography angiography

      Purpose To study the retinal capillary microvasculature and the choriocapillaris (CC) in myopic eyes using swept-source optical coherence tomography angiography (SS-OCTA). Methods Patients with high myopia (≥ − 6D; axial length ≥ 26.5 mm), moderate myopia (≥ − 3D, < − 6D), and age-matched healthy subjects presenting to the Shanghai General Hospital and Doheny-UCLA Eye Centers were enrolled in this prospective, multicenter study. Any subjects with evidence of macular abnormalities suggestive of pathologic myopia were excluded. SS-OCTA at both sites was performed using a Zeiss PLEX Elite instrument with a 6 × 6 mm scan pattern centered on the fovea. Two repeated volume scans were acquired for ...

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    24. Appearance of cysts and capillary non perfusion areas in diabetic macular edema using two different OCTA devices

      Appearance of cysts and capillary non perfusion areas in diabetic macular edema using two different OCTA devices

      The aim of this paper was to distinguish the appearance of cysts and non-perfusion areas (NPAs) in diabetic macular edema (DME) using two different Optical Coherence Tomography Angiography (OCTA) devices. In this study, patients underwent OCTA using the AngioVue XR Avanti Spectral Domain (SD) OCTA and the PLEX Elite 9000 Swept-Source (SS) OCTA. Foveal and extrafoveal regions of interest (ROI), defined as any area with an altered flow signal comparing to the surrounding retina, were selected in superficial and deep capillary plexus (SCP and DCP). ROI reflectivity were classified as hypo-reflective or hyper-reflective. Foveal ROI were analyzed to detect suspended ...

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