1. Articles from Shiv Saidha

    1-24 of 24
    1. Emerging Applications of Optical Coherence Tomography Angiography (OCTA) in neurological research

      Emerging Applications of Optical Coherence Tomography Angiography (OCTA) in neurological research

      Purpose To review the clinical and research value of optical coherence tomography angiography (OCTA) in the field of neurology. Methods Current literature involving OCTA were reviewed through PubMed using the search terms “optical coherence tomography angiography”, with “multiple sclerosis”, “Alzheimer’s disease”, “optic neuropathy”, or other closely-related terms. Results OCTA has been applied in research to advance our understanding of the pathobiology of neurological disorders. OCTA-derived blood flow and vessel density measures are altered in multiple sclerosis (MS), Alzheimer’s disease (AD), and various optic neuropathies (ON) in varying regions of the posterior segment vasculature of the eye. These emerging ...

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    2. Can Optical Coherence Tomography Be Used to Guide Treatment Decisions in Adult or Pediatric Multiple Sclerosis?

      Can Optical Coherence Tomography Be Used to Guide Treatment Decisions in Adult or Pediatric Multiple Sclerosis?

      Purpose of review With the recognition that neurodegeneration represents the principal substrate of disability in multiple sclerosis (MS), there has been increased strives towards identifying biomarkers for accurately quantifying and tracking neurodegeneration during the disease course. The retina provides an opportune “window” into the central nervous system (CNS) in MS, with retinal changes in MS reflecting not only local, but also global aspects of neurodegeneration and inflammation operative in the disease. Optical coherence tomography (OCT) is a rapid, inexpensive, reproducible, high-resolution imaging technique allowing accurate quantification of discrete retinal layers. OCT determined thinning of inner retinal layers such as the ...

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    3. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Background Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. Methods In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis, and progressive multiple sclerosis. Patients were recruited from centres in Spain, Italy, France, Germany ...

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    4. Monitoring the Course of MS With Optical Coherence Tomography

      Monitoring the Course of MS With Optical Coherence Tomography

      Retinae of patients with multiple sclerosis (MS), as part of the central nervous system (CNS), display inflammatory and neurodegenerative changes. There is increasing evidence suggesting that retinal changes, and in particular neurodegeneration, mirror global CNS alterations in MS. Spectral domain optical coherence tomography (SD-OCT) is an inexpensive, rapid, non-invasive, and reproducible imaging technique that generates high-resolution images of tissues such as the retina. An advantage of SD-OCT over magnetic resonance imaging techniques in the assessment of neurodegeneration may be its sensitivity to capture changes at the individual patient level. Several studies demonstrate that changes within the inner retina (primarily as ...

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    5. The APOSTEL recommendations for reporting quantitative optical coherence tomography studies

      The APOSTEL recommendations for reporting quantitative optical coherence tomography studies

      Objective: To develop consensus recommendations for reporting of quantitative optical coherence tomography (OCT) study results. Methods: A panel of experienced OCT researchers (including 11 neurologists, 2 ophthalmologists, and 2 neuroscientists) discussed requirements for performing and reporting quantitative analyses of retinal morphology and developed a list of initial recommendations based on experience and previous studies. The list of recommendations was subsequently revised during several meetings of the coordinating group. Results: We provide a 9-point checklist encompassing aspects deemed relevant when reporting quantitative OCT studies. The areas covered are study protocol, acquisition device, acquisition settings, scanning protocol, funduscopic imaging, postacquisition data selection ...

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    6. Voxel based morphometry in optical coherence tomography: validation and core findings

      Voxel based morphometry in optical coherence tomography: validation and core findings

      Optical coherence tomography (OCT) of the human retina is now becoming established as an important modality for the detection and tracking of various ocular diseases. Voxel based morphometry (VBM) is a long standing neuroimaging analysis technique that allows for the exploration of the regional differences in the brain. There has been limited work done in developing registration based methods for OCT, which has hampered the advancement of VBM analyses in OCT based population studies. Following on from our recent development of an OCT registration method, we explore the potential benefits of VBM analysis in cohorts of healthy controls (HCs) and ...

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    7. Simultaneous segmentation of retinal surfaces and microcystic macular edema in SDOCT volumes

      Simultaneous segmentation of retinal surfaces and microcystic macular edema in SDOCT volumes

      Optical coherence tomography (OCT) is a noninvasive imaging modality that has begun to find widespread use in retinal imaging for the detection of a variety of ocular diseases. In addition to structural changes in the form of altered retinal layer thicknesses, pathological conditions may also cause the formation of edema within the retina. In multiple sclerosis, for instance, the nerve fiber and ganglion cell layers are known to thin. Additionally, the formation of pseudocysts called microcystic macular edema (MME) have also been observed in the eyes of about 5% of MS patients, and its presence has been shown to be ...

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    8. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Background Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. Methods In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis, and progressive multiple sclerosis. Patients were recruited from centres in Spain, Italy, France, Germany ...

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    9. Optical coherence tomography reflects brain atrophy in multiple sclerosis: A four-year study

      Optical coherence tomography reflects brain atrophy in multiple sclerosis: A four-year study

      Objective The aim of this work was to determine whether atrophy of specific retinal layers and brain substructures are associated over time, in order to further validate the utility of optical coherence tomography (OCT) as an indicator of neuronal tissue damage in patients with multiple sclerosis (MS). Methods Cirrus high-definition OCT (including automated macular segmentation) was performed in 107 MS patients biannually (median follow-up: 46 months). Three-Tesla magnetic resonance imaging brain scans (including brain-substructure volumetrics) were performed annually. Individual-specific rates of change in retinal and brain measures (estimated with linear regression) were correlated, adjusting for age, sex, disease duration, and ...

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    10. Optical coherence tomography reflects brain atrophy in MS: A four year study

      Optical coherence tomography reflects brain atrophy in MS: A four year study

      Objective : To determine whether atrophy of specific retinal layers and brain substructures are associated over time, in order to further validate the utility of optical coherence tomography (OCT) as an indicator of neuronal tissue damage in patients with multiple sclerosis (MS). Methods : Cirrus high definition OCT (including automated macular segmentation) was performed in 107 MS patients biannually (median follow-up: 46-months). Three-tesla magnetic resonance imaging brain scans (including brain-substructure volumetrics) were performed annually. Individual-specific rates of change in retinal and brain measures (estimated with linear regression) were correlated, adjusting for age, sex, disease duration, and optic neuritis (ON) history. Results : Rates ...

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    11. Segmentation of microcystic macular edema in Cirrus OCT scans with an exploratory longitudinal study

      Segmentation of microcystic macular edema in Cirrus OCT scans with an exploratory longitudinal study

      Microcystic macular edema (MME) is a term used to describe pseudocystic spaces in the inner nuclear layer (INL) of the human retina. It has been noted in multiple sclerosis (MS) as well as a variety of other diseases. The processes that lead to MME formation and their change over time have yet to be explained sufficiently. The low rate at which MME occurs within such diverse patient groups makes the identification and consistent quantification of this pathology important for developing patient-specific prognoses. MME is observed in optical coherence tomography (OCT) scans of the retina as changes in light reflectivity in ...

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    12. Applying an Open-Source Segmentation Algorithm to Different OCT Devices in Multiple Sclerosis Patients and Healthy Controls: Implications for Clinical Trials

      Applying an Open-Source Segmentation Algorithm to Different OCT Devices in Multiple Sclerosis Patients and Healthy Controls: Implications for Clinical Trials

      Background . The lack of segmentation algorithms operative across optical coherence tomography (OCT) platforms hinders utility of retinal layer measures in MS trials. Objective . To determine cross-sectional and longitudinal agreement of retinal layer thicknesses derived from an open-source, fully-automated, segmentation algorithm, applied to two spectral-domain OCT devices. Methods . Cirrus HD-OCT and Spectralis OCT macular scans from 68 MS patients and 22 healthy controls were segmented. A longitudinal cohort comprising 51 subjects (mean follow-up: 1.4 ± 0.9 years) was also examined. Bland-Altman analyses and interscanner agreement indices were utilized to assess agreement between scanners. Results . Low mean differences (−2.16 to ...

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    13. Automatic segmentation of microcystic macular edema in OCT

      Automatic segmentation of microcystic macular edema in OCT

      Microcystic macular edema (MME) manifests as small, hyporeflective cystic areas within the retina. For reasons that are still largely unknown, a small proportion of patients with multiple sclerosis (MS) develop MME—predominantly in the inner nuclear layer. These cystoid spaces, denoted pseudocysts, can be imaged using optical coherence tomography (OCT) where they appear as small, discrete, low intensity areas with high contrast to the surrounding tissue. The ability to automatically segment these pseudocysts would enable a more detailed study of MME than has been previously possible. Although larger pseudocysts often appear quite clearly in the OCT images, the multi-frame averaging ...

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    14. Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: Yes

      Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: Yes

      Magnetic resonance imaging (MRI) of the brain is the most widely established imaging modality for monitoring multiple sclerosis (MS). Although conventional MRI parameters such as the development of new T2 lesions and/or contrast-enhancing lesions are sensitive to inflammatory disease activity, the association between MRI markers of inflammation and disability progression in MS is modest. 1 Conversely, MRI measures of neurodegeneration, such as whole-brain atrophy, correlate well with disability progression, 2 with neurodegeneration considered the principal pathological substrate underlying disability in MS. MRI segmentation techniques also enable the measurement of brain substructure volumes. Gray matter (GM) atrophy is now recognized ...

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    15. Optical Coherence Tomography in X-linked Adrenoleukodystrophy

      Optical Coherence Tomography in X-linked Adrenoleukodystrophy

      Background X-linked adrenoleukodystrophy is a metabolic disease caused by mutations in the ABCD1 gene, which codes for a peroxisomal membrane protein, leading to the accumulation of very long-chain fatty acids. Thinning of the retinal nerve fiber layer and macula has been described in adult-onset adrenomyeloneuropathy; however, assessment of these structures in the presymptomatic stage remains largely unexplored. Optical coherence tomography is a high-resolution medical imaging technology that has been widely used to assess ophthalmological diseases and more recently in neurological disease states to quantify the axonal and neuronal injury in the retina that results from demyelination of the optic nerve ...

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    16. In Vivo Demonstration of Homonymous Hemimacular Loss of Retinal Ganglion Cells Due to a Thalamic Lesion Using Optical Coherence Tomography

      In Vivo Demonstration of Homonymous Hemimacular Loss of Retinal Ganglion Cells Due to a Thalamic Lesion Using Optical Coherence Tomography

      A previously healthy 40-year-old woman presented with subacute onset of a left homonymous hemianopia. Contrast-enhanced magnetic resonance imaging of the brain revealed a T2-hyperintense lesion in the right thalamus, with associated subtle gadolinium enhancement ( Figure 1 ), and a small periventricular lesion. Although her visual symptoms were improving, a new left-sided hemiparesis developed 3 weeks later. Additional magnetic resonance imaging of the brain showed extension of the original thalamic lesion into the right internal capsule, with persistent contrast enhancement. Her visual and motor symptoms gradually improved over 3 months.

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    17. Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning

      Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning

      Objective: To determine the effect of clinical and radiologic disease activity on the rate of thinning of the ganglion cell/inner plexiform (GCIP) layer and the retinal nerve fiber layer in patients with multiple sclerosis (MS) using optical coherence tomography (OCT). Methods: One hundred sixty-four patients with MS and 59 healthy controls underwent spectral-domain OCT scans every 6 months for a mean follow-up period of 21.1 months. Baseline and annual contrast-enhanced brain MRIs were performed. Patients who developed optic neuritis during follow-up were excluded from analysis. Results: Patients with the following features of disease activity during follow-up had faster ...

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    18. Comparison of Point Estimates and Average Thicknesses of Retinal Layers Measured Using Manual Optical Coherence Tomography Segmentation for Quantification of Retinal Neurodegeneration in Multiple Sclerosis

      Comparison of Point Estimates and Average Thicknesses of Retinal Layers Measured Using Manual Optical Coherence Tomography Segmentation for Quantification of Retinal Neurodegeneration in Multiple Sclerosis

      Purpose: The advent of macular optical coherence tomography (OCT) segmentation has enabled the in vivo quantitative assessment of retinal axonal and neuronal subpopulations. Recent studies employing OCT in multiple sclerosis (MS) have utilized various manual macular segmentation approaches to quantify retinal layer thicknesses. We investigated whether measurements of retinal layers solely at the points of maximal macular thickness (point estimates) within the central macular B-scan are representative of the corresponding average layer thicknesses for the ganglion cell + inner plexiform (GCIP) layers, inner nuclear layer (INL), outer plexiform layer (OPL) and outer nuclear layer (ONL) in MS and healthy controls. Additionally ...

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    19. Detection of clinical and subclinical retinal abnormalities in neurosarcoidosis with optical coherence tomography

      Detection of clinical and subclinical retinal abnormalities in neurosarcoidosis with optical coherence tomography
      The aim of this work was to determine if neurosarcoidosis (NS) patients exhibit quantitative and/or qualitative in vivo evidence of retinal abnormalities on optical coherence tomography (OCT). Retinal imaging was performed using spectral-domain Cirrus HD-OCT in 20 NS patients (40 eyes) and 24 age-matched healthy controls (48 eyes). Study participants also underwent magnetic resonance imaging of the brain and spine, cerebrospinal fluid (CSF) analysis, and detailed neurological and ophthalmological evaluation. Quantitative OCT abnormalities of average macular thickness (AMT), peri-papillary retinal nerve fiber layer (RNFL) thickness, or both, were detectable in 60% of NS patients. Of NS patients with ocular ...
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    20. Optical coherence tomography segmentation reveals ganglion cell layer pathology after optic neuritis

      Optical coherence tomography segmentation reveals ganglion cell layer pathology after optic neuritis

      Post-mortem ganglion cell dropout has been observed in multiple sclerosis; however, longitudinal in vivo assessment of retinal neuronal layers following acute optic neuritis remains largely unexplored. Peripapillary retinal nerve fibre layer thickness, measured by optical coherence tomography, has been proposed as an outcome measure in studies of neuroprotective agents in multiple sclerosis, yet potential swelling during the acute stages of optic neuritis may confound baseline measurements. The objective of this study was to ascertain whether patients with multiple sclerosis or neuromyelitis optica develop retinal neuronal layer pathology following acute optic neuritis, and to systematically characterize such changes in vivo over ...

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    21. Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

      Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

      Background: Post-mortem analyses of multiple sclerosis (MS) eyes demonstrate prominent retinal neuronal ganglion cell layer (GCL) loss, in addition to related axonal retinal nerve fiber layer (RNFL) loss. Despite this, clinical correlations of retinal neuronal layers remain largely unexplored in MS. Objectives: To determine if MS patients exhibit in vivo retinal neuronal GCL loss, deeper retinal neuronal loss, and investigate correlations between retinal layer thicknesses, MS clinical subtype and validated clinical measures. Methods: Cirrus HD-optical coherence tomography (OCT), utilizing automated intra-retinal layer segmentation, was performed in 132 MS patients and 78 healthy controls. MS classification, Expanded Disability Status Scale (EDSS ...

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    22. The Impact of Utilizing Different Optical Coherence Tomography Devices for Clinical Purposes and in Multiple Sclerosis Trials

      The Impact of Utilizing Different Optical Coherence Tomography Devices for Clinical Purposes and in Multiple Sclerosis Trials
      Optical coherence tomography (OCT) derived retinal measures, particularly peri-papillary retinal nerve fiber layer (RNFL) thickness, have been proposed as outcome measures in remyelinating and neuroprotective trials in multiple sclerosis (MS). With increasing utilization of multiple centers to improve power, elucidation of the impact of different OCT technologies is crucial to the design and interpretation of such studies. In this study, we assessed relation and agreement between RNFL thickness and total macular volume (in MS and healthy controls) derived from three commonly used OCT devices: Stratus time-domain OCT, and Cirrus HD-OCT and Spectralis, two spectral-domain (SD) OCT devices. OCT was performed ...
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    23. Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography

      Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography

      Optical coherence tomography studies in multiple sclerosis have primarily focused on evaluation of the retinal nerve fibre layer. The aetiology of retinal changes in multiple sclerosis is thought to be secondary to optic nerve demyelination. The objective of this study was to use optical coherence tomography to determine if a subset of patients with multiple sclerosis exhibit primary retinal neuronopathy, in the absence of retrograde degeneration of the retinal nerve fibre layer and to ascertain if such patients may have any distinguishing clinical characteristics. We identified 50 patients with multiple sclerosis with predominantly macular thinning (normal retinal nerve fibre-layer thickness ...

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    Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography The Impact of Utilizing Different Optical Coherence Tomography Devices for Clinical Purposes and in Multiple Sclerosis Trials Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness Optical coherence tomography segmentation reveals ganglion cell layer pathology after optic neuritis Detection of clinical and subclinical retinal abnormalities in neurosarcoidosis with optical coherence tomography Comparison of Point Estimates and Average Thicknesses of Retinal Layers Measured Using Manual Optical Coherence Tomography Segmentation for Quantification of Retinal Neurodegeneration in Multiple Sclerosis Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning In Vivo Demonstration of Homonymous Hemimacular Loss of Retinal Ganglion Cells Due to a Thalamic Lesion Using Optical Coherence Tomography Optical Coherence Tomography in X-linked Adrenoleukodystrophy Applying an Open-Source Segmentation Algorithm to Different OCT Devices in Multiple Sclerosis Patients and Healthy Controls: Implications for Clinical Trials Phenotyping of Mouse Models with OCT Retinal imaging with optical coherence tomography and low‐loss adaptive optics using a 2.8‐mm beam size