1. Articles from Chui Ming Gemmy Cheung

    1-26 of 26
    1. Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia

      Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia

      The thresholds of macular microvasculature parameters associated with mild visual impairment in diabetic macular ischemia (DMI) patients are unclear. Therefore, this prospective observational study is aimed at demonstrating the optical coherence tomography angiography parameters that best correlate with mild visual impairment (<70 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, Snellen equivalent 20/40) in DMI. The study was completed at the Moorfields Eye Hospital from December 2019 to August 2021. A total of 123 eyes of 87 patients with stable-treated proliferative diabetic retinopathy following panretinal photocoagulation were recruited. DMI was defined as an irregular foveal avascular zone (FAZ) area ≥ 0 ...

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    2. Normative data and associations of Optical Coherence Tomography Angiography measurements of the macula: The Singapore Malay Eye Study

      Normative data and associations of Optical Coherence Tomography Angiography measurements of the macula: The Singapore Malay Eye Study

      Objective: To describe the normative quantitative parameters of macular retinal vasculature and their systemic and ocular associations, using optical coherence tomography angiography (OCTA). Design: Population based cross sectional study SUBJECTS: Adults above 50 years old were recruited from the third examination of the population-based Singapore Malay Eye Study. Methods: All participants underwent standardized comprehensive examination and Spectral domain-OCTA (Optovue, USA) of the macula. OCTA scans with pre-existing retinal disease, macular pathology, and poor quality were excluded. Main outcome measures: Normative quantitative vessel densities of the superficial, deep layer and foveal avascular zone were evaluated. Ocular and systemic associations with macular ...

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    3. Combining retinal and choroidal microvascular metrics improves discriminative power for diabetic retinopathy

      Combining retinal and choroidal microvascular metrics improves discriminative power for diabetic retinopathy

      Purpose To use optical coherence tomography angiography (OCTA) parameters from both the retinal and choroidal microvasculature to detect the presence and severity of diabetic retinopathy (DR). Method This is a cross-sectional case–control study. OCTA parameters from retinal vasculature, fovea avascular zone (FAZ) and choriocapillaris were evaluated from 3×3 mm 2 fovea-centred scans. Areas under the receiver operating characteristic (ROC) curve were used to compare the discriminative power on the presence of diabetes mellitus (DM), the presence of DR and need for referral: group 1 (no DM vs DM no DR), group 2 (no DR vs any DR) and ...

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    4. Editorial: Application of Optical Coherence Tomography Angiography in Retinal and Optic Nerve Disorders

      Editorial: Application of Optical Coherence Tomography Angiography in Retinal and Optic Nerve Disorders

      Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality capable of directly assessing retinal microvascular changes without intravenous dye injection ( 1 ). It maps the movement of red blood cells through the degree of motion contrast, which corresponds to angiographic flow ( 2 ). While fluorescein angiography (FA) has been widely used in clinical practice over the last 50 years to image flow, it has several limitations. One major limitation is that the visualization of retinal vessels is largely limited to the superficial vasculature ( 3 ). This occurs due to the scattering of light from inner retinal layers hence decreasing contrast of the ...

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    5. Six-year incidence of age-related macular degeneration and correlation to OCT-derived drusen volume measurements in a Chinese population

      Six-year incidence of age-related macular degeneration and correlation to OCT-derived drusen volume measurements in a Chinese population

      Aims To report the 6-year incidence of optical coherence tomography (OCT)-derived age-related changes in drusen volume and related systemic and ocular associations. Methods Chinese adults aged 40 years and older were assessed at baseline and 6 years with colour fundus photography (CFP) and spectral domain (SD) OCT. CFPs were graded for age-related macular degeneration (AMD) features and drusen volume was generated using commercially available automated software. Results A total of 4172 eyes of 2580 participants (mean age 58.12±9.03 years; 51.12% women) had baseline and 6-year follow-up CFP for grading, of these, 2130 eyes of 1305 ...

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    6. Correlation of choriocapillaris hemodynamic data from dynamic indocyanine green and optical coherence tomography angiography

      Correlation of choriocapillaris hemodynamic data from dynamic indocyanine green and optical coherence tomography angiography

      To investigate the correlation between posterior pole choroidal blood flow evaluated with digital subtraction indocyanine green angiography and enface optical coherence tomography angiography (OCTA). Imaging in animal study. The anatomy of 2 cynomogulus monkeys was studied. Each monkey was given a 0.75 mg/kg injection of indocyanine green in the saphenous vein. The dynamic angiographic filling sequence was recorded at 15 frames per second using the Heidelberg Spectralis. After image registration, sequential frame subtraction was used to image the dye front moving through the choroid. The OCTA was obtained by frame averaging nine separate choriocapillaris slab flow images obtained ...

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    7. Computer-aided detection and abnormality score for the outer retinal layer in optical coherence tomography

      Computer-aided detection and abnormality score for the outer retinal layer in optical coherence tomography

      Background: To develop computer-aided detection (CADe) of ORL abnormalities in the retinal pigmented epithelium, interdigitation zone and ellipsoid zone via optical coherence tomography (OCT). Methods: In this retrospective study, healthy participants with normal ORL, and patients with abnormality of ORL including choroidal neovascularisation (CNV) or retinitis pigmentosa (RP) were included. First, an automatic segmentation deep learning (DL) algorithm, CADe, was developed for the three outer retinal layers using 120 handcraft masks of ORL. This automatic segmentation algorithm generated 4000 segmentations, which included 2000 images with normal ORL and 2000 (1000 CNV and 1000 RP) images with focal or wide defects ...

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    8. Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year

      Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year

      Purpose : To prospectively evaluate whether diabetic macular ischemia detected with coherence tomography angiography (OCTA) is associated with change in functional outcomes over a period of one year. Methods : This is a one-year prospective, observational study that included 56 eyes with varying levels of diabetic retinopathy. All participants underwent best corrected visual acuity evaluation, swept-source OCTA and microperimetry at baseline and repeated at one year. Parafoveal vessel densities (VD) and foveal avascular zone (FAZ) areas were generated from OCTA in the superficial and deep vascular plexuses. The influence of baseline and change in OCTA parameters on change in visual acuity and ...

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    9. Quantitative OCT angiography of the retinal microvasculature and choriocapillaris in highly myopic eyes with myopic macular degeneration

      Quantitative OCT angiography of the retinal microvasculature and choriocapillaris in highly myopic eyes with myopic macular degeneration

      Purpose: To quantify retinal and choriocapillaris (CC) microvasculature in highly myopic (HM) eyes with myopic macular degeneration (MMD) using swept-source optical coherence tomography angiography (SS-OCTA). Methods: 162 HM eyes (spherical equivalent ≤ -6.0 dioptres or axial length (AL) ≥26.5 mm) from 98 participants were enrolled, including 60 eyes (37.0%) with tessellated fundus, 54 eyes (33.3%) with peripapillary diffuse chorioretinal atrophy (PDCA), 27 eyes (16.7%) with macular diffuse chorioretinal atrophy (MDCA) and 21 eyes (13.0%) with patchy or macular atrophy. PLEX Elite 9000 SS-OCTA was performed to obtain perfusion densities (PD) of the superficial and deep ...

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    10. 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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    11. Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study

      Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study

      To describe patterns of reperfusion in the superficial vascular plexus (SVP), deep capillary plexus (DCP) and choriocapillaris (CC) as detected on optical coherence tomography (OCTA) in cynomogulus macaque monkey model following increase in intraocular pressure by an intravitreal injection. Animal imaging study. Two cynomogulus macaque monkeys. A 100 µL intravitreal injection (IVI) of saline was given in one eye of each monkey. Serial OCTA using a Zeiss Plex Elite 9000 was used to evaluate reperfusion patterns within the SCP, DCP, and CC. OCTA evidence of perfusion. Pulsation of the central retinal artery was detected after the intraocular pressure was elevated ...

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    12. Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm

      Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm

      Background The ability of deep learning (DL) algorithms to identify eyes with neovascular age-related macular degeneration (nAMD) from optical coherence tomography (OCT) scans has been previously established. We herewith evaluate the ability of a DL model, showing excellent performance on a Korean data set, to generalse onto an American data set despite ethnic differences. In addition, expert graders were surveyed to verify if the DL model was appropriately identifying lesions indicative of nAMD on the OCT scans. Methods Model development data set—12 247 OCT scans from South Korea; external validation data set—91 509 OCT scans from Washington, USA ...

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    13. DIABETIC MACULAR ISCHEMIA Correlation of Retinal Vasculature Changes by Optical Coherence Tomography Angiography and Functional Deficit

      DIABETIC MACULAR ISCHEMIA Correlation of Retinal Vasculature Changes by Optical Coherence Tomography Angiography and Functional Deficit

      Purpose: To examine the relationship between macular microvasculature parameters and functional changes in persons with diabetic retinopathy (DR). Methods: Cross-sectional study of 76 eyes with varying levels of DR. Optical coherence tomography angiography (OCTA) quantified superficial and deep perifoveal vessel densities and foveal avascular zone areas. Retinal sensitivity was measured using microperimetry . Optical coherence tomography angiography parameters and retinal sensitivity were correlated. Results: Deep perifoveal vessel density decreased with increasing severity of DR (adjusted mean 51.93 vs. 49.89 vs. 47.96, P -trend = 0.005). Superficial and deep foveal avascular zone area increased with increasing DR severity (adjusted ...

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    14. Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

      Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

      Purpose : We investigate macular perfusion and the systemic and ocular associations in a population-based setting. Methods : In this cross-sectional study, 2018 adults residing in Hong Kong underwent detailed ophthalmic examinations after consenting to participate. Macular perfusion was measured with optical coherence tomography angiography (OCTA) using the split-spectrum amplitude decorrelation angiography algorithm. The parafoveal flow index and vessel area density were quantified using automated custom-built software. Results : Of the 2018 participants, the OCTA measurements were available for 1940, and 1631 (84.1%) had good quality scans. The right eyes of these 1631 participants (43.1% men) were included for final analysis ...

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    15. Correlation of Color Fundus Photograph Grading with Risks of Early Age-related Macular Degeneration by using Automated OCT-derived Drusen Measurements

      Correlation of Color Fundus Photograph Grading with Risks of Early Age-related Macular Degeneration by using Automated OCT-derived Drusen Measurements

      We evaluated automated OCT-derived drusen volume measures in a population-based study (n = 4,512) aged ≥40 years, and its correlation with conventional color fundus photographs (CFP)-derived early AMD features. Participants had protocol-based assessment to capture medical and ocular history, genotyping for SNPs in CFH , ARMS2 , and CETP , CFP-based AMD grading and automated drusen volume based on SD-OCT using built-in software (Cirrus OCT advanced RPE analysis software). Significantly fewer eyes with early AMD features (drusen, hyperpigmentation, soft or reticular drusen) had drusen volume = 0 mm 3 (p < 0.001). In eyes with drusen volume > 0 mm 3 , increasing AMD severity ...

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    16. Comparison Of Optical Coherence Tomography Angiographic Changes After Anti–Vascular Endothelial Growth Factor Therapy Alone Or In Combination With Photodynamic Therapy In Polypoidal Choroidal Vasculopathy

      Comparison Of Optical Coherence Tomography Angiographic Changes After Anti–Vascular Endothelial Growth Factor Therapy Alone Or In Combination With Photodynamic Therapy In Polypoidal Choroidal Vasculopathy

      Purpose: To compare changes in optical coherence tomography angiography in eyes with polypoidal choroidal vasculopathy after treatment with anti–vascular endothelial growth factor monotherapy or combined with photodynamic therapy . Methods: This is a longitudinal case-controlled study. The authors performed optical coherence tomography angiography at baseline and Month 3 in patients with treatment-naive polypoidal choroidal vasculopathy undergoing monotherapy (n = 10) or combination therapy (n = 13). We analyzed flow signal within the outer retina and choriocapillaris using automated segmentation. The authors analyzed the presence of pachyvessels using a 10.4- μ m segment through Haller layer . The changes in each layer were compared ...

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    17. IMPROVED DETECTION AND DIAGNOSIS OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING A COMBINATION OF OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      IMPROVED DETECTION AND DIAGNOSIS OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING A COMBINATION OF OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      Purpose: To assess the ability of optical coherence tomography (OCT) alone and in combination with OCT angiography (OCTA) to differentiate polypoidal choroidal vasculopathy (PCV) from neovascular age-related macular degeneration , as compared to fluorescein angiography and indocyanine green angiography. Methods: This is a cross-sectional study. All participants had a standardized history, clinical examination including measurement of best-corrected visual acuity, slit-lamp biomicroscopy, and indirect fundus examination, and underwent standardized imaging (color photography, fluorescein and indocyanine green angiography, OCT, and OCTA) after predefined protocols. We used a 2-step approach (Step 1: spectral domain OCT; Step 2: addition of OCTA) combining structural OCT and ...

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    18. Clinical Use of Optical Coherence Tomography Angiography in Diabetic Retinopathy Treatment Ready for Showtime?

      Clinical Use of Optical Coherence Tomography Angiography in Diabetic Retinopathy Treatment Ready for Showtime?

      Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) are the 2 advanced stages of diabetic retinopathy (DR) that are the main causes for visual loss in patients with diabetes. Both DME and PDR can be readily diagnosed with clinical examination and, increasingly, by the noninvasive use of optical coherence tomography. However, another, less commonly recognized cause of visual loss in patients with diabetes is diabetic macular ischemia (DMI) in the absence of DME. 1 The understanding of the natural history, risk factors, and functional outcomes of DMI remains limited. This is partly because of the long-standing need for invasive ...

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    19. Optical coherence tomography angiography: a review of current and future clinical applications

      Optical coherence tomography angiography: a review of current and future clinical applications

      Optical coherence tomography angiography is a non-invasive imaging technique that now allows for simultaneous in vivo imaging of the morphology as well as the vasculature in the eye. In this review, we provide an update on the existing clinical applications of optical coherence tomography angiography technology from the anterior to posterior segment of the eye. We also discuss the limitations of optical coherence tomography angiography technology, as well as the caveats to the interpretation of images. As current optical coherence tomography angiography systems are optimized for the retina, most studies have focused on interpreting images from conditions such as age ...

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    20. COMPARISON OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHIC CHANGES AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY ALONE OR IN COMBINATION WITH PHOTODYNAMIC THERAPY IN POLYPOIDAL CHOROIDAL VASCULOPATHY

      COMPARISON OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHIC CHANGES AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY ALONE OR IN COMBINATION WITH PHOTODYNAMIC THERAPY IN POLYPOIDAL CHOROIDAL VASCULOPATHY

      Purpose: To compare changes in optical coherence tomography angiography in eyes with polypoidal choroidal vasculopathy after treatment with anti-vascular endothelial growth factor monotherapy or combined with photodynamic therapy. Methods: This is a longitudinal case-controlled study. The authors performed optical coherence tomography angiography at baseline and Month 3 in patients with treatment-naive polypoidal choroidal vasculopathy undergoing monotherapy (n = 10) or combination therapy (n = 13). We analyzed flow signal within the outer retina and choriocapillaris using automated segmentation. The authors analyzed the presence of pachyvessels using a 10.4-[mu]m segment through Haller layer. The changes in each layer were compared ...

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    21. A Novel Optical Coherence Tomography Based Parameter in Patients With Exudative Age-Related Macular Degeneration

      A Novel Optical Coherence Tomography Based Parameter in Patients With Exudative Age-Related Macular Degeneration

      Purpose: To evaluate choroidal structural changes in exudative age-related macular degeneration (AMD) using choroidal vascularity index computed from image binarization on spectral domain optical coherence tomography with enhanced depth imaging. Methods: This prospective case series included 42 consecutive patients with unilateral exudative AMD. Choroidal images were segmented into luminal area and stromal area. Choroidal vascularity index was defined as the ratio of luminal area to total choroid area. Mean choroidal vascularity index and mean choroidal thickness between study and fellow eyes of the same patient with dry AMD were compared using Student's t -test. Results: There was a significantly ...

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    22. Detailed Phenotyping and Characterization of Choroidal Morphological and Vascular Features in Young Men with High Myopia Using Spectral-Domain Optical Coherence Tomography

      Detailed Phenotyping and Characterization of Choroidal Morphological and Vascular Features in Young Men with High Myopia Using Spectral-Domain Optical Coherence Tomography

      Purpose To describe detailed morphological and vascular features of the choroid in eyes with high myopia. Design Cross-sectional study. Methods 515 eyes of young men (mean age 21.59±1.15) years) with high myopia (defined as -6.0 D or worse, mean spherical equivalent -8.66±2.00 D) and 88 controls with emmetropia in both eyes underwent choroidal imaging using spectral domain optical coherence tomography with enhanced depth imaging (EDI-OCT). Raw OCT images were loaded on a custom-written application on MATLAB that enabled delineation for detailed morphological and vascular analyses, including the distance of thickest point from the ...

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    23. CHARACTERIZATION AND DIFFERENTIATION OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      CHARACTERIZATION AND DIFFERENTIATION OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      Purpose: To determine the correlation and agreement between swept-source optical coherence tomography angiography (SS-OCT-A) with fluorescein angiography (FA), indocyanine green angiography (ICGA) and spectral domain OCT (SD-OCT) in characterizing polypoidal choroidal vasculopathy (PCV) and in differentiating eyes with typical age-related macular degeneration (t-AMD). Methods: This study included 32 and 54 eyes with t-AMD and PCV, respectively, who underwent SS-OCT-A, SD-OCT, fluorescein angiography, and indocyanine green angiography. The images from these four techniques were compared. Results: On SS-OCT-A, flow signals with vascular network configuration were detected in 81.2% and 77.8% of eyes with t-AMD and PCV, respectively. 40.4 ...

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    24. CHOROIDAL VASCULARITY INDEX: A Novel Optical Coherence Tomography Based Parameter in Patients With Exudative Age-Related Macular Degeneration

      CHOROIDAL VASCULARITY INDEX: A Novel Optical Coherence Tomography Based Parameter in Patients With Exudative Age-Related Macular Degeneration

      Purpose: To evaluate choroidal structural changes in exudative age-related macular degeneration (AMD) using choroidal vascularity index computed from image binarization on spectral domain optical coherence tomography with enhanced depth imaging. Methods: This prospective case series included 42 consecutive patients with unilateral exudative AMD. Choroidal images were segmented into luminal area and stromal area. Choroidal vascularity index was defined as the ratio of luminal area to total choroid area. Mean choroidal vascularity index and mean choroidal thickness between study and fellow eyes of the same patient with dry AMD were compared using Student's t-test. Results: There was a significantly lower ...

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    25. Relationship of ocular and systemic factors to the visibility of choroidal–scleral interface using spectral domain optical coherence tomography

      Relationship of ocular and systemic factors to the visibility of choroidal–scleral interface using spectral domain optical coherence tomography

      Purpose To assess the visibility of the choroidal–scleral interface (CSI) from spectral domain optical coherence tomography (SD-OCT) and evaluate the ocular and systemic factors influencing the visibility of CSI in healthy eyes from population-based Malay sample. Methods Participants were consecutively recruited from the population-based Singapore Malay Eye Study-2 (SiMES-2). SD-OCT images were obtained by Spectralis OCT with enhanced depth imaging (EDI) mode. Visibility of CSI was assessed by a grading system ranging from 0 to 2 scores. The reliability of choroidal thickness measurement in different grades of CSI visibility was assessed using intraclass correlation coefficient. Ordinal regression analyses were ...

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    26. Photoreceptor Changes in Acute and Resolved Acute Posterior Multifocal Placoid Pigment Epitheliopathy Documented by Spectral-Domain Optical Coherence Tomography

      Photoreceptor Changes in Acute and Resolved Acute Posterior Multifocal Placoid Pigment Epitheliopathy Documented by Spectral-Domain Optical Coherence Tomography
      . Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is generally believed to be a self-limiting inflammatory disorder affecting the retinal pigment epithelium (RPE). Vision usually recovers within weeks. The exact cause and site of the pathologic abnormality are not confirmed. We describe spectral-domain (SD) optical coherence tomography (OCT) cha
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    1-26 of 26
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    Photoreceptor Changes in Acute and Resolved Acute Posterior Multifocal Placoid Pigment Epitheliopathy Documented by Spectral-Domain Optical Coherence Tomography Relationship of ocular and systemic factors to the visibility of choroidal–scleral interface using spectral domain optical coherence tomography CHOROIDAL VASCULARITY INDEX: A Novel Optical Coherence Tomography Based Parameter in Patients With Exudative Age-Related Macular Degeneration CHARACTERIZATION AND DIFFERENTIATION OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY Detailed Phenotyping and Characterization of Choroidal Morphological and Vascular Features in Young Men with High Myopia Using Spectral-Domain Optical Coherence Tomography A Novel Optical Coherence Tomography Based Parameter in Patients With Exudative Age-Related Macular Degeneration COMPARISON OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHIC CHANGES AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY ALONE OR IN COMBINATION WITH PHOTODYNAMIC THERAPY IN POLYPOIDAL CHOROIDAL VASCULOPATHY Optical coherence tomography angiography: a review of current and future clinical applications Clinical Use of Optical Coherence Tomography Angiography in Diabetic Retinopathy Treatment Ready for Showtime? Correlation of Color Fundus Photograph Grading with Risks of Early Age-related Macular Degeneration by using Automated OCT-derived Drusen Measurements OCT Macular Volume as a Predictor of Vascular Leakage in Uveitis Vanderbilt University Receives NIH Grant for Smart-phone-integrated, non-invasive, depth-resolved optical spectroscopy for the detection of neonatal jaundice