1. Articles from Steffen Schmitz-Valckenberg

    1-21 of 21
    1. Optical Coherence Tomography Signs of Early Atrophy in Age-related Macular Degeneration: Inter-Reader Agreement. CAM Report 6

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

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

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    2. Validation of an Automated Quantification of Relative Ellipsoid Zone Reflectivity on Spectral Domain-Optical Coherence Tomography Images

      Validation of an Automated Quantification of Relative Ellipsoid Zone Reflectivity on Spectral Domain-Optical Coherence Tomography Images

      Purpose : Relative ellipsoid zone reflectivity (rEZR) represents a potential biomarker of photoreceptor health on spectral-domain optical coherence tomography (SD-OCT). Because manual quantification of rEZR is laborious and lacks of spatial resolution, automated quantification of the rEZR would be beneficial. The purpose of this study was to evaluate the reliability and reproducibility of an automated rEZR quantification method. Methods : The rEZR was acquired using a manual and an automated approach in eyes with age-related macular degeneration (AMD) and healthy controls. The rEZR obtained from both methods was compared and the agreement between the methods and their reproducibility assessed. Results : Forty eyes ...

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    3. Progression of Photoreceptor Degeneration in Geographic Atrophy Secondary to Age-related Macular Degeneration

      Progression of Photoreceptor Degeneration in Geographic Atrophy Secondary to Age-related Macular Degeneration

      Importance Sensitive outcome measures for disease progression are needed for treatment trials in geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Objective To quantify photoreceptor degeneration outside regions of GA in eyes with nonexudative AMD, to evaluate its association with future GA progression, and to characterize its spatio-temporal progression. Design, Setting, and Participants Monocenter cohort study (Directional Spread in Geographic Atrophy [ NCT02051998 ]) and analysis of data from a normative data study at a tertiary referral center. One hundred fifty-eight eyes of 89 patients with a mean (SD) age of 77.7 (7.1) years, median area of GA of ...

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    4. Imaging of Therapeutic Effects of Anti-Vascular Endothelial Growth Factor Inhibitors by Optical Coherence Tomography Angiography in a Rat Model

      Imaging of Therapeutic Effects of Anti-Vascular Endothelial Growth Factor Inhibitors by Optical Coherence Tomography Angiography in a Rat Model

      Purpose : The aim of the study was to investigate optical coherence tomography angiography (OCTA) as a high-resolution in vivo imaging modality for monitoring therapeutic response to different vascular endothelial growth factor inhibitors in the rat model of laser-induced choroidal neovascularization (CNV). Further, OCTA findings were compared with fluorescein angiography (FA) and fluorescence microscopy. Methods : Laser treatment at day (D)0 was followed by intravitreal injection of aflibercept, AF564, and NaCl in dark agouti rats. Imaging with OCTA and FA was performed at D2, D7, D14, and D21. OCTA was compared to FA as well as confocal imaged flat mounts and ...

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    5. Replication and Refinement of an Algorithm for Automated Drusen Segmentation on Optical Coherence Tomography

      Replication and Refinement of an Algorithm for Automated Drusen Segmentation on Optical Coherence Tomography

      Here, we investigate the extent to which re-implementing a previously published algorithm for OCT-based drusen quantification permits replicating the reported accuracy on an independent dataset. We refined that algorithm so that its accuracy is increased. Following a systematic literature search, an algorithm was selected based on its reported excellent results. Several steps were added to improve its accuracy. The replicated and refined algorithms were evaluated on an independent dataset with the same metrics as in the original publication. Accuracy of the refined algorithm (overlap ratio 36–52%) was significantly greater than the replicated one (overlap ratio 25–39%). In particular ...

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    6. ORCA study: real-world versus reading centre assessment of disease activity of neovascular age-related macular degeneration (nAMD)

      ORCA study: real-world versus reading centre assessment of disease activity of neovascular age-related macular degeneration (nAMD)

      Background/aims The prospective, non-interventional ORCA module of the OCEAN study (Observation of Treatment Patterns with Lucentis in Approved Indications) evaluated the qualiy of spectral domain-optical coherence tomography (SD-OCT) image interpretation and treatment decisions by clinicians in Germany and the impact on visual outcomes over 24 months in patients with neovascular age-related macular degeneration (nAMD). Methods 2286 SD-OCT scans of 205 eyes were independently evaluated by clinicians and reading centres (RCs) regarding signs of choroidal neovascularisation (CNV) activity, including presence of intraretinal fluid, subretinal fluid, and/or increase in pigment epithelial detachments. Agreement between clinicians and RCs was calculated. Treatment ...

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    7. MINIMAL OPTICAL COHERENCE TOMOGRAPHY B-SCAN DENSITY FOR RELIABLE DETECTION OF INTRARETINAL AND SUBRETINAL FLUID IN MACULAR DISEASES

      MINIMAL OPTICAL COHERENCE TOMOGRAPHY B-SCAN DENSITY FOR RELIABLE DETECTION OF INTRARETINAL AND SUBRETINAL FLUID IN MACULAR DISEASES

      Purpose: To determine the minimal optical coherence tomography B-scan density for reliable detection of intraretinal and subretinal fluid. Methods: Spectral domain optical coherence tomography raster scanning (Spectralis; Heidelberg Engineering, Heidelberg, Germany) using a scan field of 20° × 20° of 97 B-scans with an interscan distance (ISD) of 60 μm was performed in 150 eyes of 150 consecutive patients at monitoring visits for intravitreal anti–vascular endothelial growth factor therapy. Using custom software, every other B-scan was repeatedly deleted to generate additional data sets with an ISD of 120 μm (49 B-scans), 240 μm (25 B-scans), and 480 μm (13 B-scans ...

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    8. Algorithms for the Automated Analysis of Age-Related Macular Degeneration Biomarkers on Optical Coherence Tomography: A Systematic Review

      Algorithms for the Automated Analysis of Age-Related Macular Degeneration Biomarkers on Optical Coherence Tomography: A Systematic Review

      Purpose : To assess the quality of optical coherence tomography (OCT) grading algorithms for retinal biomarkers of age-related macular degeneration (AMD). Methods : Following a systematic review of the literature data on detection and quantification of AMD retinal biomarkers by available algorithms were extracted and descriptively synthesized. Algorithm quality was assessed using a modified version of the Quality Assessment of Diagnostic Accuracy Studies 2 checklist with a focus on accuracy against established reference standards and risk of bias. Results : Thirty five studies reporting computer-aided diagnosis (CAD) tools for qualitative analysis or algorithms for quantitative analysis were identified. Compared with manual assessment in ...

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    9. Structural Changes in Optical Coherence Tomography Underlying Spots of Increased Autofluorescence in the Perilesional Zone of Geographic Atrophy

      Structural Changes in Optical Coherence Tomography Underlying Spots of Increased Autofluorescence in the Perilesional Zone of Geographic Atrophy

      Purpose : To investigate structural correlates corresponding to the appearance of increased fundus autofluorescence (FAF) in the perilesional area of geographic atrophy (GA) secondary to age-related macular degeneration. Methods : Serial FAF images of 181 eyes with GA of 134 patients participating in the Directional Spread in Geographic Atrophy study (NCT02051998) were screened for increased FAF spots that had developed during the review period. Thickness and reflectivity of the retinal pigment epithelium (RPE)–basal lamina complex, as well as the integrity of the external limiting membrane (ELM) and the ellipsoid zone (EZ), respectively, in corresponding optical coherence tomography (OCT) scans were compared ...

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    10. GPU-Based Image Geodesics for Optical Coherence Tomography

      GPU-Based Image Geodesics for Optical Coherence Tomography

      Within a manifold framework, the interpolation of tomographic image time series is investigated. To this end, the metamorphosis model of a manifold of images is taken into account. Based on a variational time discretization, discrete geodesic paths in this space of images are computed. The space discretization is based on finite elements spanned by tensor product cubic B-splines. An efficient implementation is obtained by utilizing graphics hardware and a proper combination of GPU and CPU computation. First results for time series of optical coherence tomography images of a macular degeneration demonstrate the applicability of this geometric concept.

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    11. In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging

      In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging

      Purpose To determine fundus autofluorescence (FAF) signal variations and corresponding microstructural alterations on spectral-domain optical coherence tomography (SD-OCT) in areas of funduscopically visible drusen associated with age-related macular degeneration (AMD). Methods Thirty eyes from 22 patients with geographic atrophy (GA) secondary to AMD (median age 74, range 64–87 years), who had undergone retinal imaging including color fundus photography (CFP), FAF and SD-OCT (Spectralis HRA+OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) were retrospectively analyzed. In each eye, at least one druse (≥63 μm) in the perilesional zone of GA recorded on CFP was analyzed. Relative FAF intensities and alterations in ...

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    12. Imaging Geographic Atrophy in Age-Related Macular Degeneration

      Imaging Geographic Atrophy in Age-Related Macular Degeneration
      Advances in retinal imaging technology have largely contributed to the understanding of the natural history, prognostic markers and disease mechanisms of geographic atrophy (GA) due to age-related macular degeneration. There is still no therapy available to halt or slow the disease process. In order to evaluate potential therapeutic effects in interventional trials, there is a need for precise quantification of the GA progression rate. Fundus autofluorescence imaging allows for accurate identification and segmentation of atrophic areas and currently represents the gold standard for evaluating progressive GA enlargement. By means of high-resolution spectral-domain optical coherence tomography, distinct microstructural alterations related to ...
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    13. Optical coherence tomography and autofluorescence findings in areas with geographic atrophy due to age-related macular degeneration

      Optical coherence tomography and autofluorescence findings in areas with geographic atrophy due to age-related macular degeneration
      Purpose: To analyze outer retinal changes within the atrophic lesion in patients with geographic atrophy (GA) secondary to age-related macular degeneration. Methods: Twenty-one simultaneously obtained fundus autofluorescence (FAF, excitation:488 nm; emission:500-700 nm) and spectral-domain optical coherence tomography (SD-OCT) scans (Spectralis HRA+OCT, Heidelberg Engineering, Germany) of 21 GA patients (mean age 75.1±7.4 years) were included and separately exported. Two readers independently graded the following parameters: Width of the atrophic lesion on the FAF image at the site where the SD-OCT scan had been placed. On the SD-OCT image, widths of the linear disruption of the ...
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    14. Spectral Domain Optical Coherence Tomography in Adult-Onset Vitelliform Macular Dystrophy With Cuticular Drusen

      Spectral Domain Optical Coherence Tomography in Adult-Onset Vitelliform Macular Dystrophy With Cuticular Drusen
      Purpose: The purpose of this study was to investigate morphologic differences in a consecutive case series of patients suffering from adult-onset vitelliform macular dystrophy with cuticular drusen (CD) compared with another patient group with a vitelliform lesion only using high-resolution in vivo retinal imaging. Methods: Simultaneous spectral domain optical coherence tomography (870 nm, 40.000 A-scans per second) and confocal scanning laser ophthalmoscopy were performed in 6 patients (12 eyes) with adult-onset vitelliform macular dystrophy using a combined instrument (Spectralis HRA+OCT; Heidelberg Engineering). Results: Mean age was 69 years (59-82 years), and mean visual acuity was 20/80. The ...
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    15. Tracking Progression with Spectral-Domain Optical Coherence Tomography in Geographic Atrophy Caused by Age-Related Macular Degeneration

      Tracking Progression with Spectral-Domain Optical Coherence Tomography in Geographic Atrophy Caused by Age-Related Macular Degeneration
      Purpose. To investigate, with the use of spectral-domain optical coherence tomography (SD-OCT), microstructural alterations over time in eyes with progressive geographic atrophy (GA) due to age-related macular degeneration. Methods. Forty-six eyes of 26 patients (median age, 77.9 years [interquartile range (IQR), 71.8–81.0]) with GA without evidence of active or previous neovascular disease at baseline were examined by simultaneous confocal scanning laser ophthalmoscopy (cSLO) and SD-OCT. Serial examinations with alignment of follow-up to baseline scans were performed over a median period of 12.2 months (IQR, 10.2–15.3). Longitudinal SD-OCT variations were evaluated, including quantification ...
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    16. Outer Retinal Hyperreflective Spots on Spectral-Domain Optical Coherence Tomography in Macular Telangiectasia Type 2

      Outer Retinal Hyperreflective Spots on Spectral-Domain Optical Coherence Tomography in Macular Telangiectasia Type 2
      Purpose: To analyze focal hyperreflective morphologic alterations in outer retinal layers in patients with type 2 idiopathic macular telangiectasia (MacTel type 2) using spectral-domain optical coherence tomography (SD OCT).Design: Cross-sectional case-control study.Participants: Forty-one patients with MacTel type 2.Methods: Anatomic layers were evaluated and compared with those of controls of similar age. Simultaneous SD OCT scans were obtained with a combined confocal scanning laser ophthalmoscope for simultaneous tomographic and topographic in vivo imaging (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany).Main Outcome Measures: Morphologic alterations in the retinal layers secondary to MacTel type 2.Results: Hyperreflective spots in ...
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    17. Outer Retinal Hyperreflective Spots on Spectral-Domain Optical Coherence Tomography in Macular Telangiectasia Type 2

      Outer Retinal Hyperreflective Spots on Spectral-Domain Optical Coherence Tomography in Macular Telangiectasia Type 2
      Purpose: To analyze focal hyperreflective morphologic alterations in outer retinal layers in patients with type 2 idiopathic macular telangiectasia (MacTel type 2) using spectral-domain optical coherence tomography (SD OCT).Design: Cross-sectional case-control study.Participants: Forty-one patients with MacTel type 2.Methods: Anatomic layers were evaluated and compared with those of controls of similar age. Simultaneous SD OCT scans were obtained with a combined confocal scanning laser ophthalmoscope for simultaneous tomographic and topographic in vivo imaging (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany).Main Outcome Measures: Morphologic alterations in the retinal layers secondary to MacTel type 2.Results: Hyperreflective spots in ...
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    18. Combined Confocal Scanning Laser Ophthalmoscopy and Spectral-Domain Optical Coherence Tomography Imaging of Reticular Drusen Associated with Age-Related Macular Degeneration

      Purpose: To determine microstructural retinal alterations associated with reticular drusen in patients with age-related macular degeneration (AMD) using high-resolution in vivo imaging techniques.Design: Retrospective case series.Participants: A total of 116 eyes of 78 AMD patients with reticular drusen were examined.Methods: Simultaneous spectral-domain optical coherence tomography (SD OCT; 870 nm, 40 000 A-scans/sec) and near-infrared confocal scanning laser ophthalmoscopy (cSLO; 830 nm) were performed using a combined imaging instrument (Spectralis HRA+OCT, Heidelberg Engineering, Heidelberg, Germany). Individual anatomic layers in SD OCT were evaluated and correlated to en face cSLO fundus imaging.Main Outcome Measures: Description of ...
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    19. Clinical evaluation of simultaneous confocal scanning laser ophthalmoscopy imaging combined with high-resolution, spectral-domain optical coherence tomography

      Purpose: To evaluate the clinical relevance of a new diagnostic modality, simultaneous confocal scanning laser ophthalmoscopy (cSLO) and high-speed, high-resolution, spectral-domain optical coherence tomography (OCT), for the visualization of macular pathologies. Methods: OCT images and simultaneous recording of fluorescein angiography, indocyanine green (ICG) angiography, infrared, and blue reflectance ('red-free') or fundus autofluorecence (FAF) images were obtained with a novel imaging device (Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany). An optically pumped solid-state laser generated the excitation wavelength (488 nm) required for blue reflectance, FAF and fluorescein angiography images. For ICG angiography and infrared imaging, diode laser sources at 790 and ...
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    20. Correlation of Lines of Increased Autofluorescence in Macular Dystrophy and Pigmented Paravenous Retinochoroidal Atrophy by Optical Coherence Tomography

      Discrete lines of increased fundus autofluorescence (FAF) have recently been described in various retinal dystrophies.1-2 It has been shown that these lines demarcate areas with impaired retinal sensitivity from those without and may constrict or expand in different retinal dystrophies over time.1-2 Morphological changes corresponding to lines of increased FAF have not been described yet. Likewise, the mechanism underlying the abnormal accumulation of lipofuscin and increased FAF is unknown. In retinitis pigmentosa, abnormally increased FAF commonly forms a parafoveal ring or annulus. Recent optical coherence tomography (OCT) findings suggest that the band that represents the interface of the ...
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    1-21 of 21
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    Outer Retinal Hyperreflective Spots on Spectral-Domain Optical Coherence Tomography in Macular Telangiectasia Type 2 Tracking Progression with Spectral-Domain Optical Coherence Tomography in Geographic Atrophy Caused by Age-Related Macular Degeneration Spectral Domain Optical Coherence Tomography in Adult-Onset Vitelliform Macular Dystrophy With Cuticular Drusen Optical coherence tomography and autofluorescence findings in areas with geographic atrophy due to age-related macular degeneration Outer Retinal Hyperreflective Spots on Spectral-Domain Optical Coherence Tomography in Macular Telangiectasia Type 2 Imaging Geographic Atrophy in Age-Related Macular Degeneration Morphologic outer retinal abnormalities in white dot syndromes on spectral-domain optical coherence tomography Emerging Minimally Invasive Technologies for the Detection of Skin Cancer Update on Optical Coherence Tomography and Optical Coherence Tomography Angiography Imaging in Proliferative Diabetic Retinopathy A diagnostic information based framework for super-resolution and quality assessment of retinal OCT images Impact of image averaging on vessel detection using optical coherence tomography angiography in eyes with macular oedema and in healthy eyes Alteration in Choroidal Microvasculature Determined by Optical Coherence Tomography Angiography in Patients with Acromegaly