1. Articles from philip j. rosenfeld

    1-24 of 75 1 2 3 4 »
    1. Replacement of polyps with type 1 macular neovascularization in polypoidal choroidal vasculopathy imaged with swept source OCT angiography

      Replacement of polyps with type 1 macular neovascularization in polypoidal choroidal vasculopathy imaged with swept source OCT angiography

      Purpose: To investigate the morphological changes of polyps in eyes with polypoidal choroidal vasculopathy (PCV) after treatment with vascular endothelial growth factor (VEGF) inhibitors using swept source optical coherence tomography angiography (SS-OCTA). Observations: Following anti-VEGF therapy, polyps were found to evolve into typical type 1 macular neovascularization (MNV) in five eyes. In all of these five eyes, a polypoidal lesion was detected adjacent to a serous or hemorrhagic retinal pigment epithelial detachment (PED). Conclusions and importance: Polypoidal lesions in PCV can evolve into typical type 1 MNV. This morphological evolution suggests that these polyps are clusters of tangled vessels that ...

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    2. 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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    3. Correlations Between Choriocapillaris and Choroidal Measurements and the Growth of Geographic Atrophy using Swept Source OCT Imaging

      Correlations Between Choriocapillaris and Choroidal Measurements and the Growth of Geographic Atrophy using Swept Source OCT Imaging

      Purpose The correlations between enlargement rates (ERs) of geographic atrophy (GA) and choriocapillaris (CC) flow deficits (FDs), mean choroidal thickness (MCT), and choroidal vascularity index (CVI) were investigated using swept source optical coherence tomography (SS-OCT) in age-related macular degeneration (AMD). Design Retrospective review of prospective, observational case series. Methods Eyes with GA from AMD were imaged with SS-OCT (PLEX® Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA) using 6x6 mm scan pattern. GA lesions were identified and measured using custom en face structural images and annual square root ERs of GA were calculated. At baseline, CC FDs from different regions ...

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    4. Comparison Between Graders in Detection of Diabetic Neovascularization with Swept Source OCT Angiography and Fluorescein Angiography

      Comparison Between Graders in Detection of Diabetic Neovascularization with Swept Source OCT Angiography and Fluorescein Angiography

      Purpose To compare the ability of ophthalmologists to identify neovascularization (NV) in patients with proliferative diabetic retinopathy (PDR) using swept source optical coherence tomography angiography (SS-OCTA) and fluorescein angiography (FA). Design Retrospective study comparing diagnostic instruments. Methods Eyes with PDR or severe non-proliferative diabetic retinopathy and a high suspicion of NV based on clinical examination were imaged using SS-OCTA and FA at the same visit. Two separate grading sets consisting of scrambled, anonymized SS-OCTA and FA images were created. The ground truth for presence of NV was established by consensus of two graders with OCTA experience who did not participate ...

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    5. A Comparison Study of Polypoidal Choroidal Vasculopathy Imaged with Indocyanine Green Angiography and Swept Source OCT Angiography

      A Comparison Study of Polypoidal Choroidal Vasculopathy Imaged with Indocyanine Green Angiography and Swept Source OCT Angiography

      Purpose Indocyanine green angiography (ICGA) was compared with swept source optical coherence tomography angiography (SS-OCTA) for the detection of polypoidal choroidal vasculopathy (PCV). Design Retrospective, cross-sectional. Methods Patients with treatment-naïve PCV based on ICGA imaging underwent same day SS-OCTA imaging at Kyung Hee University Medical Center between April 2017 to November 2018. ICGA and SS-OCTA images were graded independently. SS-OCTA images were graded using both flow and structural information. Images were graded for the number of polypoidal lesions and the total lesion area, which included both the polypoidal lesions and the branching vascular networks (BVNs). Results A total of ...

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    6. Longitudinal Swept Source OCT Angiography of Juxtapapillary Retinal Capillary Hemangioblastoma

      Longitudinal Swept Source OCT Angiography of Juxtapapillary Retinal Capillary Hemangioblastoma

      In this case report, SS-OCTA identified the key diagnostic features of JRCH seen with multimodal imaging. Serial SS-OCTA imaging showed transient decreases in vascular congestion and exudation after intravitreal anti-VEGF injections. SS-OCTA may be the sole imaging modality needed for the diagnosis of JRCH, an important entity that is commonly misdiagnosed as disc edema or choroidal neovascularization. Transient responses to anti-VEGF therapy suggests that higher dose or sustained-release anti-VEGF therapy may be effective for retinal capillary hemangioblastomas.

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    7. Correlations between Different Choriocapillaris Flow Deficit Parameters in Normal Eyes using Swept Source OCT Angiography

      Correlations between Different Choriocapillaris Flow Deficit Parameters in Normal Eyes using Swept Source OCT Angiography

      Purpose Choriocapillaris (CC) imaging of normal eyes with swept-source optical coherence tomography SS-OCTA was performed, and the percentage of CC flow deficits (FD%) and the average area of CC flow deficits (FDa) were compared within given macular regions. Design A prospective, cross-sectional study. Methods Subjects with normal eyes ranging in age from their 20s through their 80s were imaged with SS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec, Dublin, CA) using both 3x3 mm and 6x6 mm macular scan patterns. The CC images were generated using a previously published and validated algorithm. In both 3x3 mm and 6x6 mm scans, the ...

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    8. Are Dilated Fundus Exams Needed for Optical Coherence Tomography–Guided Re-treatment of Exudative Age-Related Macular Degeneration?

      Are Dilated Fundus Exams Needed for Optical Coherence Tomography–Guided Re-treatment of Exudative Age-Related Macular Degeneration?

      Purpose To determine whether presence of macular hemorrhage on dilated fundus exam (DFE) or fundus photography influences vision outcomes with optical coherence tomography (OCT)-guided pro re nata (PRN) ranibizumab (RBZ) re-treatment in patients with neovascular age-related macular degeneration (nAMD), we investigated whether hemorrhage without OCT-detectable fluid impacted vision outcomes. Design Post hoc analysis of prospectively collected data from the 24-month phase III HARBOR trial (NCT00891735). Participants This post hoc analysis examined 1097 patients from the intention-to-treat population of HARBOR. Methods DFE and fundus photography were evaluated for hemorrhage, and spectral domain (SD)-OCT images from HARBOR participants were analyzed ...

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    9. Two-Year Risk of Exudation in Eyes with Nonexudative Age-Related Macular Degeneration and Subclinical Neovascularization Detected with Swept Source Optical Coherence Tomography Angiography

      Two-Year Risk of Exudation in Eyes with Nonexudative Age-Related Macular Degeneration and Subclinical Neovascularization Detected with Swept Source Optical Coherence Tomography Angiography

      Purpose Swept source optical coherence tomography angiography (SS-OCTA) was used to study the prevalence, incidence, and natural history of subclinical macular neovascularization (MNV) in eyes with unilateral nonexudative age-related macular degeneration. Design Prospective cohort study. Methods Patients were imaged using 3- × 3-mm and 6- × 6-mm SS-OCTA scan patterns. MNV was detected using the outer retina to choriocapillaris en face slab. Prevalence and incidence of subclinical MNV, Kaplan–Meier cumulative estimates for the overall risk of exudation, and the association between neovascular lesion size and the risk of exudation were assessed through 2 years. Results From August 2014 through March 2018 ...

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    10. Widefield Swept-Source Optical Coherence Tomography Angiography of Proliferative Diabetic Retinopathy

      Widefield Swept-Source Optical Coherence Tomography Angiography of Proliferative Diabetic Retinopathy

      BACKGROUND AND OBJECTIVE: To demonstrate the utility of widefield swept-source optical coherence tomography angiography (SS-OCTA) for the diagnosis and management of proliferative diabetic retinopathy (PDR). PATIENTS AND METHODS: Consecutive patients with vision-threatening diabetic retinopathy were imaged with widefield SS-OCTA using the 12 mm × 12 mm scan pattern. RESULTS: Twenty-four eyes of 12 patients underwent SS-OCTA imaging. In all 24 eyes, the en face total retinal flow images detected areas of decreased retinal perfusion, and the en face vitreoretinal interface (VRI) slabs detected foci of retinal neovascularization (NV). NV was treated and followed using the VRI images. CONCLUSIONS: Widefield SS-OCTA is ...

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    11. Lessons Learned From Avastin and OCT–The Great, the Good, the Bad, and the Ugly

      Lessons Learned From Avastin and OCT–The Great, the Good, the Bad, and the Ugly

      Purpose: To describe the synergistic benefits and cost savings from the use of optical coherence tomography (OCT) and vascular endothelial growth factor (VEGF) inhibitors, particularly intravitreal bevacizumab, in the treatment of exudative age-related macular degeneration (AMD). Design: Retrospective literature review and personal perspective. Methods: Retrospective literature review and personal perspective. Results: The introduction of the first clinically useful OCT instrument coincided with early-phase clinical trials of a drug that would become known as ranibizumab. OCT provided a noninvasive imaging strategy that unambiguously showed the macular fluid associated with exudative AMD and the ability of anti-VEGF therapy to resolve this fluid ...

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    12. Quantification of choriocapillaris with OCTA: a comparison study

      Quantification of choriocapillaris with OCTA: a comparison study

      Purpose To demonstrate the variation in quantitative choriocapillaris (CC) metrics with various binarization approaches using optical coherence tomography angiography (OCTA). Design Retrospective, observational, cross-sectional case series. Methods 3x3 mm and 6x6 mm macular OCTA scans were obtained from normal eyes and from eyes with drusen secondary to AMD. The CC slab was extracted and the CC flow deficits (FDs) were segmented with two previously published algorithms: fuzzy C-means approach (FCM method) and Phansalkar’s local thresholding (Phansalkar method). Four different values for the radius were used in order to investigate the effect on the FD segmentation when using the Phansalkar ...

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    13. Two-Year Risk of Exudation in Eyes with Non-Exudative AMD and Subclinical Neovascularization Detected with Swept Source OCT Angiography

      Two-Year Risk of Exudation in Eyes with Non-Exudative AMD and Subclinical Neovascularization Detected with Swept Source OCT Angiography

      Purpose Swept source optical coherence tomography angiography (SS-OCTA) was used to study the prevalence, incidence, and natural history of subclinical macular neovascularization (MNV) in eyes with unilateral non-exudative age-related macular degeneration (AMD). Design Prospective cohort study. Methods Patients were imaged using 3x3 mm and 6x6 mm SS-OCTA scan patterns. MNV was detected using the outer retina to choriocapillaris en face slab. Prevalence and incidence of subclinical MNV, Kaplan-Meier cumulative estimates for the overall risk of exudation, and the association between neovascular lesion size and the risk of exudation were assessed through 2 years. Results From August 2014 through March 2018 ...

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    14. Appearance of Polypoidal Lesions in Patients With Polypoidal Choroidal Vasculopathy Using Swept-Source Optical Coherence Tomographic Angiography

      Appearance of Polypoidal Lesions in Patients With Polypoidal Choroidal Vasculopathy Using Swept-Source Optical Coherence Tomographic Angiography

      Importance Polypoidal choroidal vasculopathy (PCV) is a major cause of visual loss worldwide, particularly in Asia, and the appropriate understanding of the structures in PCV previously described as polypoidal lesions is important for understanding their pathogenesis, diagnosis, and prognosis. Objective To report the morphologic characteristics of polypoidal lesions and their association with branching vascular networks (BVNs) in eyes with PCV using swept-source optical coherence tomographic angiography (SS-OCTA). Design, Setting, and Participants This cross-sectional observational study included 20 participants recruited from Shanghai General Hospital with a diagnosis of PCV based on the presence of focal hyperfluorescent spots on indocyanine green angiography ...

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    15. The LXXV Edward Jackson Memorial Lecture: Lessons Learned from Avastin and OCT: The Great, The Good, The Bad, and The Ugly

      The LXXV Edward Jackson Memorial Lecture: Lessons Learned from Avastin and OCT: The Great, The Good, The Bad, and The Ugly

      Purpose To describe the synergistic benefits and cost-savings from the use of optical coherence tomography (OCT) and vascular endothelial growth factor (VEGF) inhibitors, particularly intravitreal bevacizumab, in the treatment of exudative age-related macular degeneration (AMD) Design Retrospective literature review and personal perspective. Methods Retrospective literature review and personal perspective. Results The introduction of the first clinically useful OCT instrument coincided with early phase clinical trials of a drug that would become known as ranibizumab. OCT provided a non-invasive imaging strategy that unambiguously showed the macular fluid associated with exudative AMD and the ability of anti-VEGF therapy to resolve this fluid ...

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    16. Imaging of Epiretinal Membranes Using En Face Widefield Swept-Source Optical Coherence Tomography

      Imaging of Epiretinal Membranes Using En Face Widefield Swept-Source Optical Coherence Tomography

      BACKGROUND AND OBJECTIVE: Swept-source optical coherence tomography (SS-OCT) imaging was performed on eyes with epiretinal membranes (ERMs), and the extent of the ERMs were compared between the 12 mm × 12 mm scans and the more routine 6 mm × 6 mm field of view (FOV). PATIENTS AND METHODS: Eyes containing ERMs were imaged using a 12 mm × 12 mm SS-OCT scan. En face images derived from vitreoretinal interface (VRI) slabs were reviewed to assess the full extent of the ERM. RESULTS: En face VRI slab images from 12 mm × 12 mm scans could visualize the full extent in eyes with ERMs ...

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    17. Correlations Between Choriocapillaris Flow Deficits Around Geographic Atrophy and Enlargement Rates Based on Swept Source OCT Imaging

      Correlations Between Choriocapillaris Flow Deficits Around Geographic Atrophy and Enlargement Rates Based on Swept Source OCT Imaging

      Purpose To determine the possible correlation between the annual enlargement rates (ERs) of geographic atrophy (GA) with the percentage and size of the choriocapillaris (CC) flow deficits (FDs) surrounding GA, measured with swept source optical coherence tomography angiography (SS-OCTA) images. Design Prospective, observational case series. Participants Patients with GA secondary to non-exudative AMD. Methods Patients were imaged with a 100-kHz SS-OCTA instrument (PLEX Elite 9000, Carl Zeiss Meditec) using a 6x6 mm field of view scan pattern. GA area measurements were obtained from en face SS-OCT sub-RPE slab images. Visualization of the CC and quantification of FDs were performed using ...

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    18. Age-Dependent Changes in the Macular Choriocapillaris of Normal Eyes Imaged with Swept-Source OCT Angiography

      Age-Dependent Changes in the Macular Choriocapillaris of Normal Eyes Imaged with Swept-Source OCT Angiography

      Purpose Swept source optical coherence tomography angiography (SS-OCTA) was used to measure the age-dependent changes in macular choriocapillaris (CC) flow deficits (FDs) in normal eyes. Design A prospective, cross-sectional study. Methods Subjects with normal eyes ranging in age from their 20s to their 80s were imaged using a 100-kHz SS-OCTA instrument (PLEX ® Elite 9000, Carl Zeiss Meditec). Both 3x3 mm and 6x6 mm scans were used to image the macular CC. Visualization of the CC and quantification of FDs were performed using a previously validated algorithm. The percentage of FDs (FD%) in the central 1 mm circle (C 1 ), 1 ...

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    19. Anatomic Localization of Type 1 and Type 2 Macular Neovascularization Using Swept-Source OCT Angiography

      Anatomic Localization of Type 1 and Type 2 Macular Neovascularization Using Swept-Source OCT Angiography

      BACKGROUND AND OBJECTIVE: Swept-source optical coherence tomography angiography (SS-OCTA) and different boundary-specific segmentation strategies were used to distinguish type 1 macular neovascularization (MNV) from type 2 MNV in eyes with exudative age-related macular degeneration (AMD). PATIENTS AND METHODS: Eyes with exudative AMD were enrolled in a prospective study. Segmentation strategies included a slab from the outer retina (OR) to the choriocapillaris (CC) for the entire MNV, a slab from the retinal pigment epithelium (RPE) to the CC for the type 1 MNV, and a slab from the OR to the RPE for the type 2 MNV. RESULTS: In 13 eyes ...

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    20. Attenuation correction assisted automatic segmentation for assessing choroidal thickness and vasculature with swept-source OCT

      Attenuation correction assisted automatic segmentation for assessing choroidal thickness and vasculature with swept-source OCT

      Swept source optical coherence tomography (SS-OCT) is being used more widely in clinical studies to investigate the choroid due to its deeper penetration under the retinal pigment epithelium and improved image quality compared with spectral domain OCT. However, automatic methods to reliably assess choroidal thickness and vasculature are still limited. This paper reports an approach that applies attenuation correction on SS-OCT structural scans to facilitate accurate automatic segmentation of the choroid and provides visualization of the choroidal vasculature without the necessity of OCT angiography. After attenuation correction, enhanced interlayer contrast at the choroidal-scleral interface was observed (from 0.13 ± 0 ...

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    21. Swept-Source Optical Coherence Tomography Angiography of an Amalric Choroidal Infarction in a Rare Presentation of Giant Cell Arteritis With Bilateral Corneal Edema

      Swept-Source Optical Coherence Tomography Angiography of an Amalric Choroidal Infarction in a Rare Presentation of Giant Cell Arteritis With Bilateral Corneal Edema

      A 73-year-old woman with 2 weeks of progressive painless vision loss was found to have bilateral corneal edema, jaw claudication, and temporal headache. Multimodal imaging revealed an Amalric choroidal infarct in the left eye visualized by widefield indocyanine green angiography and swept-source optical coherence tomography angiography (SS-OCTA). Prompt intravenous corticosteroid treatment resulted in 20/20 vision, and giant cell arteritis (GCA) was confirmed by a temporal artery biopsy. The case underscores the use of widefield SS-OCTA as a non-invasive test to aid in the diagnosis of GCA, as well as bilateral cornea edema as a rare presentation of GCA.

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    22. En Face Imaging of Geographic Atrophy Using Different Swept-Source Optical Coherence Tomography Scan Patterns

      En Face Imaging of Geographic Atrophy Using Different Swept-Source Optical Coherence Tomography Scan Patterns

      Purpose Different swept source optical coherence tomography (SS-OCT) scan patterns were used to image geographic atrophy (GA) to determine if they provided similar area and enlargement measurements in eyes with age-related macular degeneration (AMD). Design Prospective, observational case series. Participants Patients with GA secondary to non-exudative AMD Methods Patients were imaged using SS-OCT (PLEX Elite 9000 instrument, Carl Zeiss Meditec, Dublin, CA) with follow-up imaging performed after six months and one year. Both the 6x6 mm and 12x12 mm scan patterns were obtained at each visit. Area measurements of GA were performed on the en face images generated from a ...

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    23. Swept-Source OCT Angiography Identifies Choroidal Neovascularization Arising From a Choroidal Nevus

      Swept-Source OCT Angiography Identifies Choroidal Neovascularization Arising From a Choroidal Nevus

      Swept-source optical coherence tomography angiography (SS-OCTA) was used to diagnose choroidal neovascularization (CNV) arising from a choroidal nevus. A 61-year-old woman initially presented with submacular hemorrhage. She was diagnosed with neovascular age-related macular degeneration (AMD) and received three injections of bevacizumab (Avastin; Genentech, South San Francisco, CA). At a follow-up visit, SS-OCTA showed that the CNV appeared to arise from an adjacent choroidal nevus. This is the first report of using SS-OCTA to diagnose CNV associated with a choroidal nevus masquerading as neovascular AMD.

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    24. Swept-Source OCT Angiographic Imaging of a Central Retinal Vein Occlusion During Pregnancy

      Swept-Source OCT Angiographic Imaging of a Central Retinal Vein Occlusion During Pregnancy

      To avoid fluorescein angiography in a pregnant woman diagnosed with a central retinal vein occlusion (CRVO), swept-source optical coherence tomography angiography (SS-OCTA) was performed and showed no evidence of decreased central retinal perfusion leading to the diagnosis of a nonischemic CRVO. Five months after an intravitreal injection of steroid, both her vision and the retinal appearance had returned to normal. This case demonstrates how a noninvasive, safe, 12 mm × 12 mm SS-OCTA image of a CRVO is useful in evaluating the retinal perfusion at presentation and follow-up during pregnancy.

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