1. Articles from Jerry A. Shields

    1-25 of 25
    1. Iris microhemangiomatosis: Clinical, fluorescein angiography, and optical coherence tomography angiography in 14 consecutive patients

      Iris microhemangiomatosis: Clinical, fluorescein angiography, and optical coherence tomography angiography in 14 consecutive patients

      Purpose To describe the clinical and imaging findings and treatment options in a series of patients with iris microhemangiomatosis. Design: Retrospective observational case series. Methods Setting : Single institution. Study Population : Twenty-two eyes of 14 consecutive patients with iris microhemangiomatosis were reviewed. Observation Procedures : Clinical examination and slit lamp photography were performed on every patient. Anterior segment optical coherence tomography (AS-OCT), anterior segment optical coherence tomography angiography (AS-OCTA), anterior segment intravenous fluorescein angiography (AS-IVFA) and ultrasound biomicroscopy were performed when possible. Main Outcome Measures : Clinical and imaging features and treatment strategies. Results Twenty-two eyes of 14 patients with iris microhemangiomatosis were ...

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    2. Optical coherence tomography angiography of iris microhemangiomatosis

      Optical coherence tomography angiography of iris microhemangiomatosis

      Purpose To report optical coherence tomography angiography (OCTA) of iris microhemangiomatosis. Observations A 75-year-old asymptomatic Caucasian man was found to have bilateral pupillary vascular lesions during cataract evaluation. Visual acuity was counting fingers in the right eye (OD) and 20/40 in the left eye (OS) with normal intraocular pressures in both eyes (OU). In each eye there were multifocal, round, dark red, pinpoint vascular tufts at the pupillary margin, randomly distributed and numbering 1 in OD and 7 in OS, each measuring 0.2–0.3 mm in diameter and without active bleeding or hyphema. Fundus examination OU was ...

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    3. CLINICALLY INVISIBLE RETINAL HEMANGIOBLASTOMAS DETECTED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND FLUORESCEIN ANGIOGRAPHY IN TWINS

      CLINICALLY INVISIBLE RETINAL HEMANGIOBLASTOMAS DETECTED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND FLUORESCEIN ANGIOGRAPHY IN TWINS

      Purpose: To report subclinical retinal hemangioblastoma detected by enhanced depth imaging optical coherence tomography and fluorescein angiography in at-risk twins. Methods: Case report. Results: A set of twins, age 7 years, (Twin A and Twin B) with known family history of von Hippel-Lindau disease (gene test positive) and no systemic manifestations were evaluated. Visual acuity was 20/20 in both eyes of both twins. Anterior segment examination and intraocular pressures were unremarkable in both eyes. Twin A showed no clinically visible tumor in the right eye, and a clinically evident 4-mm hemangioblastoma in the superior retina of the left eye ...

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    4. Retinal Astrocytic Hamartoma Arises in Nerve Fiber Layer and Shows “Moth-Eaten” Optically Empty Spaces on Optical Coherence Tomography

      Retinal Astrocytic Hamartoma Arises in Nerve Fiber Layer and Shows “Moth-Eaten” Optically Empty Spaces on Optical Coherence Tomography

      Purpose To evaluate the specific spectral-domain (SD) optical coherence tomography (OCT) features of retinal astrocytic hamartoma (RAH) and the relationship of these features with tumor size and location. Design Retrospective case series. Participants Forty-seven eyes of 42 patients with RAH. Methods All patients with clinically confirmed RAH were imaged with fundus photography and SD OCT. Main Outcome Measures Precise OCT location of RAH features and the relationship of patient age, visual acuity, tumor size, and tumor location to the presence and size of intralesional optically empty spaces (OESs), appearing as so-called moth-eaten spaces. Results Of 42 patients with RAH, 36 ...

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    5. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF THE MACULA AFTER PLAQUE RADIOTHERAPY OF CHOROIDAL MELANOMA: Comparison of Irradiated Versus Nonirradiated Eyes in 65 Patients

      OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF THE MACULA AFTER PLAQUE RADIOTHERAPY OF CHOROIDAL MELANOMA: Comparison of Irradiated Versus Nonirradiated Eyes in 65 Patients

      Purpose: To study radiation retinopathy after plaque radiotherapy of choroidal melanoma using optical coherence tomography angiography. Methods: Retrospective comparative analysis of 65 consecutive patients with choroidal melanoma, treated with standard dose I-125 plaque radiotherapy and imaged with optical coherence tomography angiography. A comparison of irradiated versus contralateral, nonirradiated (control) eyes was performed. Results: The mean patient age was 55 years. Underlying medical diseases included diabetes mellitus (4/65, 4%) or hypertension (25/65, 38%), but no patient demonstrated disease-related retinopathy. The mean pretreatment melanoma diameter was 11 mm and mean thickness was 5 mm. The mean radiation dose to the ...

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    6. Posterior Scleral Bowing With Choroidal Nevus on Enhanced-Depth Imaging Optical Coherence Tomography

      Posterior Scleral Bowing With Choroidal Nevus on Enhanced-Depth Imaging Optical Coherence Tomography

      Importance Recognition of posterior scleral bowing with choroidal nevus is essential to avoid an underestimation of tumor thickness. Objective To describe a particular observation of posterior scleral bowing associated with choroidal nevus on enhanced-depth imaging (EDI) optical coherence tomography (OCT). Design, Setting, and Participants Retrospective observational case series at a referral center involving 17 eyes of 17 patients. Patients were seen from June 2013 to July 2014, with all data collected and analyzed from June 2014 to July 2014. Interventions Retrospective medical record review and multimodal imaging including fundus photography, autofluorescence, infrared reflectance, ultrasonography, and EDI-OCT. Main Outcomes and Measures ...

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    7. SUBMILLIMETER CHOROIDAL MELANOMA DETECTION BY ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY IN A PATIENT WITH OCULODERMAL MELANOCYTOSIS

      SUBMILLIMETER CHOROIDAL MELANOMA DETECTION BY ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY IN A PATIENT WITH OCULODERMAL MELANOCYTOSIS

      Purpose: To describe a tiny subclinical choroidal melanoma visualized only with enhanced depth imaging optical coherence tomography in a newly symptomatic patient with known oculodermal melanocytosis. Methods: Case report. Results: A 52-year-old white man with heterochromia and known oculodermal melanocytosis of the right eye, followed for 2 years without change, developed blurred vision and was referred for possible central serous chorioretinopathy. On examination, visual acuity was 20/20 in each eye. There was oculodermal melanocytosis in the right eye involving the periocular skin, episclera, iris, and choroid. On ophthalmoscopy and ocular ultrasonography, there was no appreciable mass, but subtle subfoveal ...

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    8. Review of spectral domain enhanced depth imaging optical coherence tomography of tumors of the choroid

      Review of spectral domain enhanced depth imaging optical coherence tomography of tumors of the choroid

      Background: Spectral domain enhanced depth imaging optical coherence tomography (EDI-OCT) can provide anatomic localization of intraocular tumors. Aims: The aim was to identify topographical and intrinsic patterns of choroidal tumors on EDI-OCT. Settings and Design: Retrospective review. Materials and Methods: Analysis of published reports and personal observations using office based EDI-OCT. Results: Using EDI-OCT, choroidal nevus displayed a smooth, dome-shaped topography with overlying retinal pigment epithelium alterations, drusen, and occasional subretinal cleft demonstrating photoreceptor loss. Small choroidal melanoma showed smooth, moderately dome-shaped topography, commonly with overlying shallow subretinal fluid that often depicted "shaggy" photoreceptors. Choroidal metastasis showed a minimally "lumpy ...

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    9. Review of spectral domain-enhanced depth imaging optical coherence tomography of tumors of the retina and retinal pigment epithelium in children and adults

      Review of spectral domain-enhanced depth imaging optical coherence tomography of tumors of the retina and retinal pigment epithelium in children and adults

      Background: Spectral domain (SD) enhanced depth imaging optical coherence tomography (EDI-OCT) is a useful tool for anatomic, cross-sectional imaging of retinal conditions. Aims: The aim was to identify characteristic patterns of retinal and retinal pigment epithelial tumors on EDI-OCT in children and adults. Settings and Design: Retrospective review. Materials and Methods: Analysis of published reports and personal observations using office-based EDI-OCT for adults and portable hand-held SD OCT for infants and children. Results: Using EDI-OCT, retinal tumors such as small retinoblastoma, astrocytic hamartoma, and hemangioblastoma arose abruptly from the retina, immediately adjacent to normal retina. Small exophytic retinoblastoma and retinal ...

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    10. CHOROIDAL OSTEOMA SHOWS BONE LAMELLA AND VASCULAR CHANNELS ON ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY IN 15 EYES

      CHOROIDAL OSTEOMA SHOWS BONE LAMELLA AND VASCULAR CHANNELS ON ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY IN 15 EYES

      Purpose: To describe enhanced depth imaging optical coherence tomography findings of choroidal osteoma. Methods: Retrospective, observational case series of 15 eyes with choroidal osteoma imaged with EDI-OCT. Results: The mean age at presentation was 27 years. There were 10 women and 3 men. The visual acuity ranged from 20/20 to hand motion, with reduced visual acuity secondary to photoreceptor loss in the foveola (n = 5) or subfoveal fluid (n = 1), and additional choroidal neovascular membrane (n = 3). The mean basal tumor diameter was 8.0 mm, and ultrasonographic thickness was 1.5 mm. Using enhanced depth imaging optical coherence ...

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    11. ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY OF INTRAOCULAR TUMORS: From Placid to Seasick to Rock and Rolling Topography-The 2013 Francesco Orzalesi Lecture.

      ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY OF INTRAOCULAR TUMORS: From Placid to Seasick to Rock and Rolling Topography-The 2013 Francesco Orzalesi Lecture.

      Purpose: To review enhanced depth imaging optical coherence tomography of intraocular tumors.

      Methods: Review of tumor surface topography and internal characteristics based on published reports and personal experience.

      Results: Using enhanced depth imaging optical coherence tomography, choroidal nevus showed smooth moderate dome-shape and with overlying retinal pigment epithelial alterations, subretinal cleft, and photoreceptor loss. Choroidal melanoma was smooth, moderately dome-shaped, and with overlying "shaggy" photoreceptors. Choroidal metastasis showed "lumpy, bumpy" irregular surface topography, subretinal fluid, and shaggy photoreceptors. Choroidal hemangioma was smooth, acutely dome-shaped and with subretinal fluid and/or cystoid retinal edema. Choroidal lymphoma showed "placid, rippled, or seasick ...

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    12. Choroidal Melanocytosis Evaluation with Enhanced Depth Imaging Optical Coherence Tomography

      Choroidal Melanocytosis Evaluation with Enhanced Depth Imaging Optical Coherence Tomography

      Objective To assess eyes with unilateral choroidal melanocytosis using enhanced depth imaging (EDI) optical coherence tomography (OCT). Design Retrospective, observational case series. Participants Fifteen patients with unilateral choroidal melanocytosis. Methods Each patient was evaluated with EDI-OCT, and comparison was made of involved versus uninvolved foveal retinal and choroidal layers. Main Outcome Measures Enhanced depth imaging OCT features of choroidal melanocytosis. Results The mean patient age was 28 years (median, 23 years; range, 5–76 years). There were 9 male and 6 female patients. Best-corrected visual acuity ranged from 20/20 to 20/30. All patients had subfoveal involvement with choroidal ...

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    13. Sclerochoroidal Calcification Is Primarily a Scleral Condition Based on Enhanced Depth Imaging Optical Coherence Tomography

      Sclerochoroidal Calcification Is Primarily a Scleral Condition Based on Enhanced Depth Imaging Optical Coherence Tomography

      Sclerochoroidal calcification (SC) is found in elderly white individuals with calcium pyrophosphate deposition in the sclera and/or choroid, appearing as a typical yellow subretinal mass usually along the retinal vascular arcades. 1 - 4 Most cases are idiopathic, but some have a systemic relationship. 1 - 2 We review multimodal imaging findings of SC.

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    14. Solitary Idiopathic Choroiditis: Findings on Enhanced Depth Imaging Optical Coherence Tomography in 10 Cases

      Solitary Idiopathic Choroiditis: Findings on Enhanced Depth Imaging Optical Coherence Tomography in 10 Cases

      Objective To describe the imaging characteristics of solitary idiopathic choroiditis (SIC). Design Retrospective, observational case series. Participants Ten eyes in 10 patients with SIC. Methods Review of chart, fundus photography, ultrasonography, fundus autofluorescence (FAF), infrared reflectance (IR) imaging, and enhanced depth imaging optical coherence tomography (EDI OCT). Main Outcome Measures Scleral, choroidal, and retinal features of SIC as analyzed by EDI OCT. Results The mean age at diagnosis was 47 years (range, 7–76 years). There were 4 male patients and 6 female patients. The mean best-corrected visual acuity was 20/25 (range, 20/20–20/150). The SIC lesions ...

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    15. The Seasick Choroid: A Finding on Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography of Choroidal Lymphoma

      The Seasick Choroid: A Finding on Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography of Choroidal Lymphoma

      Purpose: To describe previously unreported imaging features of choroidal lymphoma using enhanced depth imaging optical coherence tomography (OCT). Methods: Enhanced depth imaging OCT was performed before and after the therapy. Results: A 32-year-old white man with a 4-month history of blurred vision in the right eye was found to have a macular fold. There was no visible intraocular tumor. There were no signs of anterior segment inflammation, vascular abnormalities, or infiltrative disease. Visual acuity was 20/150 in the right eye and 20/20 in the left eye. Enhanced depth imaging OCT demonstrated a macular retinal fold and marked thickening ...

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    16. Enhanced depth imaging optical coherence tomography of small choroidal melanoma: comparison with choroidal nevus

      Enhanced depth imaging optical coherence tomography of small choroidal melanoma: comparison with choroidal nevus

      Objective To evaluate characteristics of small choroidal melanoma using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Design Retrospective comparative analysis. Results Of 37 eyes with small choroidal melanoma imaged using EDI-OCT, the mean tumor thickness was 1025 μm by EDI-OCT compared with 2300 μm by ultrasonography. By EDI-OCT, choroidal features included optical shadowing in 36 (100%) and overlying choriocapillaris thinning in 37 (100%). Outer retinal features included shaggy photoreceptors in 18 (49%), as well as absence (structural loss) of photoreceptors in 9 (24%), inner segment–outer segment junction in 24 (65%), external limiting membrane in 16 (43%), outer nuclear ...

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    17. Enhanced Depth Imaging Optical Coherence Tomography of Choroidal Nevus in 104 Cases

      Enhanced Depth Imaging Optical Coherence Tomography of Choroidal Nevus in 104 Cases

      Purpose To describe the characteristics of choroidal nevus using the enhanced depth imaging (EDI) feature of spectral-domain optical coherence tomography (OCT). Design Retrospective, observational case series. Participants One hundred four eyes with choroidal nevus. Methods Spectral-domain EDI OCT was performed with a Heidelberg Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) using a custom scan acquisition protocol of up to 13 raster lines of 9-mm scan length with automatic real-time image averaging set at 100 images. The thickness of choroidal nevus was measured by combining Heidelberg's autosegmentation with manual segmentation. Main Outcome Measures Imaging features and thickness correlation of choroidal ...

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    18. Assessment of Anterior Segment Tumors with Ultrasound Biomicroscopy versus Anterior Segment Optical Coherence Tomography in 200 Cases

      Assessment of Anterior Segment Tumors with Ultrasound Biomicroscopy versus Anterior Segment Optical Coherence Tomography in 200 Cases
      Purpose To compare ultrasound biomicroscopy (UBM) versus anterior segment optical coherence tomography (AS-OCT) for imaging of tumors of the anterior segment of the eye. Design Retrospective, noninterventional case series. Participants We included 200 patients. Methods Review of medical records of patients who underwent both UBM and AS-OCT for evaluation of anterior segment tumors. Main Outcome Measures Comparison of tumor surface and internal visualization. Results There were 200 eyes with anterior segment tumors involving the iris stroma in 96 (48%), ciliary body in 14 (7%), combined iris and ciliary body in 32 (16%), iris pigment epithelium (IPE) in 44 (22%), conjunctiva ...
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    19. Anterior Segment Optical Coherence Tomography of Conjunctival Nevus

      Anterior Segment Optical Coherence Tomography of Conjunctival Nevus
      Purpose:: To evaluate conjunctival nevi using anterior segment optical coherence tomography (AS-OCT).Design:: Retrospective interventional case series.Participants:: There were 22 eyes of 21 patients with conjunctival nevus imaged with AS-OCT for evaluation and detection of cysts within conjunctival nevi.Intervention:: Anterior segment OCT.Main Outcome Measures:: Evaluation and detection of intralesional cysts.Results:: All margins of the nevus, including the deep margin, could be visualized on AS-OCT with high resolution of the anterior margin in 100% of cases, posterior margin in 82% of cases, and lateral margin in 86% of cases. The nevus was optically dense with homogeneous pattern ...
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    20. Spontaneous Deflation of an Iris Pigment Epithelial Cyst Documented With AS-OCT

      Spontaneous Deflation of an Iris Pigment Epithelial Cyst Documented With AS-OCT
      A 3-year-old girl presented with a black pupillary margin iris mass in the right eye diagnosed as an iris pigment epithelial (IPE) cyst, central (pupillary) type. The diagnosis was verified by anterior-segment optical coherence tomography (AS-OCT), which initially showed a circumscribed, round thin-walled cyst with clear lumen attached by a strand to the IPE. On follow-up 3 months later, the IPE cyst had deflated and AS-OCT showed an irregular collapsed surface with no lumen and optical shadowing. The authors report a case in which AS-OCT was used to provide information regarding the diagnosis and behavior of an IPE cyst.
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    21. Optical Coherence Tomography Of Optic Disk Melanocytoma In 15 Cases.

      Optic disk melanocytoma showed a nodular configuration with sloping margins by optical coherence tomography. In all 15 cases, the tumor displayed a thin hyperreflective anterior surface and dense shadowing, giving the appearance of an optically empty mass.Page: 441DOI: 10.1097/IAE.0b013e31815e9853Authors: SHIELDS, CAROL L. MD; PEREZ, BENJAMIN MD; BENAVIDES, RAQUEL MD; MATERIN, MIGUEL A. MD; SHIELDS, JERRY A. MD
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    22. Early Macular Morphological Changes Following Plaque Radiotherapy For Uveal Melanoma.

      Optical coherence tomography (OCT) evidence of radiation-induced macular edema can be found as early as 4 months following plaque radiotherapy of uveal melanoma. OCT changes are apparent before clinical signs of classical radiation maculopathy and before substantial visual deterioration occurs. The development of macular edema is significantly associated with larger initial tumor size.Page: 263DOI: 10.1097/IAE.0b013e31814b1b75Authors: HORGAN, NOEL MD; SHIELDS, CAROL L. MD; MASHAYEKHI, ARMAN MD; TEIXEIRA, LUIZ F. MD; MATERIN, MIGUEL A. MD; SHIELDS, JERRY A. MD
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    23. Autofluorescence of orange pigment overlying small choroidal melanoma.

      Related Articles Autofluorescence of orange pigment overlying small choroidal melanoma. Retina. 2007 Oct;27(8):1107-11 Authors: Shields CL, Bianciotto C, Pirondini C, Materin MA, Harmon SA, Shields JA PURPOSE: To describe the autofluorescence features of orange pigment (intracellular lipofuscin) overlying small presumed choroidal melanomas. METHODS: The diagnostic testing results (fluorescein angiography, optical coherence tomography, and fundus autofluorescence imaging) for two patients with pigmented choroidal melanoma and two patients with nonpigmented choroidal melanoma were reviewed. RESULTS: Clinically, the intracellular lipofuscin pigment appeared brown overlying the nonpigmented melanoma (two cases) and orange overlying the pigmented melanoma (two cases). Fluorescein angiography demonstrated ...
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    24. Autofluorescence Of Orange Pigment Overlying Small Choroidal Melanoma.

      Orange pigment overlying small choroidal melanoma shows bright hyperautofluorescence, contrasting with isoautofluorescence of the underlying tumor.Page: 1107DOI: 10.1097/IAE.0b013e31814934efAuthors: SHIELDS, CAROL L. MD; BIANCIOTTO, CARLOS MD; PIRONDINI, CESARE MD; MATERIN, MIGUEL A. MD; HARMON, SARAH A. BS; SHIELDS, JERRY A. MD
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    1-25 of 25
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    1. (25 articles) Carol L. Shields
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    Spontaneous Deflation of an Iris Pigment Epithelial Cyst Documented With AS-OCT Anterior Segment Optical Coherence Tomography of Conjunctival Nevus Assessment of Anterior Segment Tumors with Ultrasound Biomicroscopy versus Anterior Segment Optical Coherence Tomography in 200 Cases Enhanced Depth Imaging Optical Coherence Tomography of Choroidal Nevus in 104 Cases The Seasick Choroid: A Finding on Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography of Choroidal Lymphoma Solitary Idiopathic Choroiditis: Findings on Enhanced Depth Imaging Optical Coherence Tomography in 10 Cases Optical coherence tomography angiography in glaucoma Handheld optical coherence tomography for clinical assessment of dental plaque and gingiva Characterisation of macular superficial vessel density alteration in preclinical ethambutol-induced optic neuropathy using optical coherence tomography angiography Three-dimensional spatial reconstruction of coronary arteries based on fusion of intravascular optical coherence tomography and coronary angiography Dynamic-range compression and contrast enhancement in swept-source optical coherence tomography systems with a frequency gain compensation amplifier Healing and early stent coverage after ultrathin strut biodegradable polymer-coated sirolimus-eluting stent implantation: SiBi optical coherence tomography study