1. Articles from srinivas r. sadda

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    1. Hyperreflective Membrane at the Vitreoretinal Interface in Diabetic Macular Edema: A Finding in Ultra-High-Resolution Optical Coherence Tomography

      Hyperreflective Membrane at the Vitreoretinal Interface in Diabetic Macular Edema: A Finding in Ultra-High-Resolution Optical Coherence Tomography

      Purpose: Detecting subtle vitreoretinal interface (VRI) findings, such as a posterior hyaloid membrane, is difficult with conventional retinal imaging. We compared ultra-high-resolution spectral domain optical coherence tomography (UHR-SD-OCT) with standard-resolution OCT (SD-OCT) for the imaging of VRI abnormalities in diabetic retinopathy (DR). Methods: This prospective cross-sectional study included 113 consecutive patients (91 patients with diabetes and 22 healthy controls). The VRI was evaluated, and the results were compared between the conventional SD-OCT and UHR-SD-OCT images. VRI findings were also investigated before and after internal limiting membrane peeling during vitrectomy for proliferative DR. Results: A total of 159 eyes (87.4 ...

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    2. Persistent subfoveal fluid in pneumatic retinopexy versus pars plana vitrectomy for rhegmatogenous retinal detachment: posthoc analysis of the PIVOT randomised trial

      Persistent subfoveal fluid in pneumatic retinopexy versus pars plana vitrectomy for rhegmatogenous retinal detachment: posthoc analysis of the PIVOT randomised trial

      Purpose To assess the incidence of persistent subfoveal fluid (PSFF) in pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) following rhegmatogenous retinal detachment (RRD) repair and to determine its association with functional outcomes. Methods Posthoc analysis of the PIVOT randomised trial. Eyes with gradable en face and cross-sectional spectral-domain optical coherence tomography (SD-OCT) scans at 1–2 months postoperatively were included. Primary outcome was the proportion of patients with PSFF following PnR versus PPV at 1–2 months postoperatively. Secondary outcomes included association of PSFF with Early Treatment Diabetic Retinopathy Study (ETDRS) letter score at 3, 6 and 12 months ...

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    3. Age-related assessment of foveal avascular zone and surrounding capillary networks with swept source optical coherence tomography angiography in healthy eyes

      Age-related assessment of foveal avascular zone and surrounding capillary networks with swept source optical coherence tomography angiography in healthy eyes

      Aim To assess the macular capillary networks and foveal avascular zone (FAZ) with swept-source optical coherence tomography angiography in healthy eyes. Methods This cross-sectional, prospective, observational study enrolled 222 eyes of 116 healthy participants with no ocular or systemic disease. SS-OCTA images were captured using the PLEX Elite 9000 (Carl Zeiss Meditec Inc., Dublin, CA, USA) with a 6 × 6 mm pattern centered on the foveal center. Vessel length density (VLD), perfusion density (PD), and FAZ parameters were analyzed using the manufacturer’s automated software. Results A significant negative correlation was observed between age and average VLD in the superficial ...

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      Mentions: UCLA
    4. Correlation of Diabetic Disease Severity to Degree of Quadrant Asymmetry in En Face OCTA Metrics

      Correlation of Diabetic Disease Severity to Degree of Quadrant Asymmetry in En Face OCTA Metrics

      Purpose: To determine if diabetic retinopathy (DR) severity affects quadrant asymmetry (QA) of optical coherence tomography angiography (OCTA) metrics differentially. Methods: Ninety eyes (60 patients) with no diabetes mellitus (DM) (n = 39) or varying levels of DR (n = 51) had OCTA images (3 × 3 mm, Cirrus5000) acquired five times and averaged. The vessel length density (VLD) and perfusion density (PD) of the superficial retinal layer (SRL) and deep retinal layer (DRL) were measured. QA was defined as the maximum minus minimum value among four parafoveal Early Treatment Diabetic Retinopathy quadrants, and compared with DR severity by linear regression including fixed ...

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    5. Effect of OCT B-scan density on sensitivity for detection of intraretinal hyperreflective foci in eyes with age-related macular degeneration

      Effect of OCT B-scan density on sensitivity for detection of intraretinal hyperreflective foci in eyes with age-related macular degeneration

      Purpose To evaluate the impact of reducing the density of B-scans in an optical coherence tomography (OCT) volume on the sensitivity for detecting intraretinal hyperreflective foci (IHRF) in eyes with intermediate age-related macular degeneration (AMD) Methods A total of 165 eyes with intermediate AMD and IHRF were evaluated in this retrospective analysis. For each case, Cirrus HD-OCT volumes were imported into the reading center 3D-OCTOR software. The number of IHRF cases was assessed based on all 128 B-scans (spaced 47 μm apart), using a categorical scale (graded as 1–4, 5–9, 10–14, 15–19, and >20). Additionally, the ...

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    6. Quantification of Anterior Chamber Cells in Children with Uveitis Using Anterior Segment Optical Coherence Tomography

      Quantification of Anterior Chamber Cells in Children with Uveitis Using Anterior Segment Optical Coherence Tomography

      Purpose : To evaluate the feasibility of anterior segment optical coherence tomography (AS-OCT) for measuring anterior chamber (AC) cells in children with uveitis and to compare different AS-OCT acquisition modes. Design : Validity and reliability analysis. Methods : We enrolled children younger than 18 years of age who had uveitis involving the anterior segment and children without eye disease as controls. All underwent clinical grading of AC cells. AC images of each eye were obtained using the Optovue Avanti RTVue XR AS-OCT. Two acquisition modes were used: a single cross-sectional line scan and an 8-line radial scan in an asterisk pattern. Two independent ...

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      Mentions: Visionix UCLA
    7. How Home Diagnostic Tools Will Alter the Future of Wet Age-Related Macular Degeneration

      How Home Diagnostic Tools Will Alter the Future of Wet Age-Related Macular Degeneration

      SriniVas R. Sadda, MD, looks to the future at the dawn of home diagnostics and home monitoring for patients with exudative age-related macular degeneration ( wet AMD ) through the promise and anticipated approval of at-home optical coherence tomography (OCT). Dr Sadda sees home OCT as a practice-changing advance in mitigating the burden of frequent office visits for patients and their families and as a part of the treat-and-extend approach, where intervals between office visits can be extended. Dr Sadda envisions a future in which patients can scan themselves at home using OCT technology and pick up the earliest signs of increased ...

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      Mentions: UCLA
    8. Correlation between Fundus Autofluorescence and En Face Optical Coherence Tomography Measurements of Geographic Atrophy

      Correlation between Fundus Autofluorescence and En Face Optical Coherence Tomography Measurements of Geographic Atrophy

      Purpose: To evaluate the correlation between fundus autofluorescence (FAF) and en face spectral-domain optical coherence tomography (SDOCT) measurements of geographic atrophy (GA) associated with age-related macular degeneration (AMD). Design: Retrospective, cross-sectional study. Participants: 270 eyes from 172 subjects with GA associated with AMD. Methods: Subjects with atrophic AMD with both fundus autofluorescence (FAF; Heidelberg HRA + Spectralis) and dense volume (128 B-scans over 6x6mm) spectral domain optical coherence tomography (SDOCT; Cirrus OCT) imaging were included in this retrospective analysis. The borders of all areas of definite decreased autofluorescence (DDAF) corresponding to GA were manually outlined on FAF images by certified graders ...

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      Mentions: UCLA
    9. Advanced retinal imaging and applications for clinical practice: A consensus review

      Advanced retinal imaging and applications for clinical practice: A consensus review

      Imaging is an integral part of the evaluation and management of retinal disorders. Each imaging modality has its own unique capabilities and can show a different aspect or perspective of disease. Multimodal retinal imaging provides a wealth of substantive and insightful information; however, the integration of all this complex data can be overwhelming. We discuss the applications and the strengths and limitations of the many different retinal imaging tools that are approved for clinical use. These modalities include color fundus photography, widefield imaging, fundus autofluorescence, near infrared reflectance, optical coherence tomography angiography, and en face optical coherence tomography. We also ...

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    10. Diagnosing Persistent Hyper-Transmission Defects on En Face OCT Imaging of Age-Related Macular Degeneration

      Diagnosing Persistent Hyper-Transmission Defects on En Face OCT Imaging of Age-Related Macular Degeneration

      Purpose: A training exercise was performed to study the ability of graders to reliably identify precursor lesions to geographic atrophy (GA), known as persistent choroidal hyper-transmission defects (hyperTDs), using en face optical coherence tomography (OCT) images from eyes with non-exudative age-related macular degeneration (AMD). Design: Intergrader agreement study PARTICIPANTS: Eleven graders participated in this exercise. Methods: Formal training on how to identify persistent hyperTDs on en face OCT images was provided to the graders. Persistent hyperTDs were defined as bright lesions having a greatest linear dimension (GLD) of at least 250 μm. Training consisted of a tutorial session followed by ...

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    11. Comparison Between Different Segmentation Strategies for the Choriocapillaris Using Optical Coherence Tomography Angiography

      Comparison Between Different Segmentation Strategies for the Choriocapillaris Using Optical Coherence Tomography Angiography

      Background and objective: To assess the relationship between retinal pigment epithelium (RPE) and RPE fit-based segmentations of the choriocapillaris (CC) and its expected anatomic location. Patients and methods: Consecutive healthy participants' eyes were imaged with optical coherence tomography angiography (PLEX Elite) with 3 × 3-mm and 6 × 6-mm scan. Ground-truth images were generated using 16-μm-thick slabs starting from 4 μm below the automatically segmented Bruch's membrane (BM) band. A series of slabs positioned below the RPE band and RPE fit were also generated, and CC flow deficit percentage was compared with the ground-truth segmentation. Results: Twenty-six eyes of 26 ...

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      Mentions: UCLA
    12. Longitudinal Assessment of Ellipsoid Zone Recovery using En Face Optical Coherence Tomography after Retinal Detachment Repair

      Longitudinal Assessment of Ellipsoid Zone Recovery using En Face Optical Coherence Tomography after Retinal Detachment Repair

      Purpose Suboptimal functional outcomes following rhegmatogenous retinal detachment (RRD) repair may be related to photoreceptor abnormalities including alterations of the ellipsoid zone (EZ) which may not be apparent on cross-sectional optical coherence tomography (OCT). This study assessed EZ recovery using en face OCT following RRD repair and its association with visual acuity. Design Post hoc analysis of a randomized controlled trial. Methods Patients with macula-off RRD were followed at 3, 6, 12 and 24 months post-operatively and annually thereafter. En face OCT of the EZ slab were analyzed. Hyporeflective areas were co-localized with EZ abnormalities on cross-sectional OCT B-Scans and ...

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      Mentions: UCLA
    13. 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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    14. 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
    15. OCT Signs of Early Atrophy in Age-Related Macular Degeneration: Interreader Agreement: Classification of Atrophy Meetings Report 6

      OCT Signs of Early Atrophy in Age-Related Macular Degeneration: Interreader Agreement: Classification of Atrophy Meetings 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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    16. 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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    17. 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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    18. 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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    19. 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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    20. 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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    21. 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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    22. 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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    23. 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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    24. 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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