1. Articles from Robert N. Weinreb

    1-24 of 94 1 2 3 4 »
    1. Optical Coherence Tomography Angiography and Glaucoma: A Brief Review

      Optical Coherence Tomography Angiography and Glaucoma: A Brief Review

      Optical coherence tomography angiography (OCTA) is a new modality in ocular imaging which provides non-invasive assessment and measurement of the vascular structures in the retina and optic nerve head. This technique provides useful information in glaucoma, such as quantitative assessment of vessel density. Vessel density measurement can be affected by various subject-related, eye-related, and diseaserelated factors. Overall, OCTA has good repeatability and reproducibility, and can differentiate glaucoma eyes from normal eyes. It can also help detect early glaucoma, reach a floor effect at a more advanced disease stage than optical coherence tomography (OCT), and adds information about glaucoma patients at ...

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    2. Association of Macular and Circumpapillary Microvasculature with Visual Field Sensitivity in Advanced Glaucoma

      Association of Macular and Circumpapillary Microvasculature with Visual Field Sensitivity in Advanced Glaucoma

      Purpose To evaluate the association between optical coherence tomography angiography (OCTA) macular and circumpapillary vessel density and visual field mean deviation (MD) in advanced primary open angle glaucoma (POAG). Design Cross-sectional study. Methods Macula (superficial layer) and optic nerve head [ONH, with (capillary density :CD) and without (vessel density: VD) automated removal of large vessels] OCTA of 34 eyes (34 patients, MD < -10 dB) were investigated as macula whole image VD (wiVD), parafoveal VD (pfVD), ONH wiVD, wiCD, circumpapillary VD (cpVD), and cpCD. Spectral domain OCT circumpapillary retinal nerve fiber layer (cpRNFL), macular ganglion cell complex (GCC) and ganglion cell ...

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    3. Measurement floors and dynamic ranges of optical coherence tomography and angiography in glaucoma

      Measurement floors and dynamic ranges of optical coherence tomography and angiography in glaucoma

      Purpose To determine if optical coherence tomography angiography (OCTA)–derived vessel density measurements can extend the available dynamic range for detecting glaucoma compared to spectral-domain optical coherence tomography (SDOCT)–derived thickness measurements. Design Observational, cross-sectional study. Participants A total of 509 eyes from 38 healthy participants, 63 glaucoma suspects and 193 glaucoma patients enrolled in the Diagnostic Innovations in Glaucoma Study. Methods Relative vessel density and tissue thickness measurement floors of perifoveal superficial vessel density (pfVD), circumpapillary capillary density (cpCD), circumpapillary retinal nerve fiber (cpRNFL) thickness, ganglion cell complex (GCC) thickness and visual field mean deviation were investigated and compared ...

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    4. En face optical coherence tomography imaging of beta and gamma parapapillary atrophy in high myopia

      En face optical coherence tomography imaging of beta and gamma parapapillary atrophy in high myopia

      Objective Recent studies have suggested that optical coherence tomography (OCT)-based classification of parapapillary atrophy (PPA) may be helpful in distinguishing glaucomatous from myopic optic disc changes. However, the pathological implications of PPA may be different in highly myopic eyes that exhibit optic disc deformations distinct from low to moderate myopia. Therefore, we conducted the current study to investigate factors associated with OCT-defined PPA zones measured in en face reconstructed swept source OCT (SS OCT) images in highly myopic eyes. Design Retrospective, cross-sectional study. Participants Seventy-seven eyes of 55 subjects with high myopia (spherical equivalent refractive error ≤ -8 diopters or ...

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    5. Repeatability and Reproducibility of Corneal Epithelial Thickness Mapping with Spectral Domain Optical Coherence Tomography in Normal and Diseased Cornea Eyes

      Repeatability and Reproducibility of Corneal Epithelial Thickness Mapping with Spectral Domain Optical Coherence Tomography in Normal and Diseased Cornea Eyes

      Purpose To evaluate the performance of the epithelial thickness mapping (ETM) of the iVue spectral domain optical coherence tomography (SD-OCT) (Optovue Inc., Fremont, CA) in normal and diseased cornea eyes. Design Reliability and validity analysis. Methods Sixty eyes of 60 subjects were recruited for the study that included normal subjects (n=12) and patients with corneal diseases (12 each with dry eye syndrome (DES), contact lens (CL) wear, post laser refractive surgery (LRS), and keratoconus (KCN)). Three repeated scans were acquired on 3 iVue SD-OCTs with device-designated operators from consented subjects. Each subject was scanned on each device. Repeatability (based ...

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    6. Potential clinical applications of optical coherence tomography angiography in glaucoma

      Potential clinical applications of optical coherence tomography angiography in glaucoma

      Editorial: Elevated intraocular pressure has been identified as a major risk factor for primary open-angle glaucoma (POAG), and current treatments focus on reducing the intraocular pressure to prevent disease progression. However, some glaucomatous patients continue to progress despite intraocular pressure lowering, and in these patients, other risk factors like decreased ocular perfusion pressure and vascular dysfunction may be causative factors. 1 , 2 The recent advent of optical coherence tomography angiography (OCTA) has allowed for fast and noninvasive assessment of microvasculature in the peripapillary retina and macula. 3 Different strategies have been used for assessing microvasculature in different OCTA machines. The ...

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    7. Repeatability and comparability of peripapillary vessel density measurements of high-density and non-high-density optical coherence tomography angiography scans in normal and glaucoma eyes

      Repeatability and comparability of peripapillary vessel density measurements of high-density and non-high-density optical coherence tomography angiography scans in normal and glaucoma eyes

      Aims To compare the peripapillary vessel density (VD) measurements of high-density (HD) and non-HD optical coherence tomography angiography (OCTA) scans in normal and glaucoma eyes, and to evaluate the intrasession repeatability of VD measurements of HD scans. Methods In a cross-sectional study, 46 normal (33 subjects) and 89 glaucoma (64 patients) eyes underwent 3 HD and 1 non-HD optic nerve head OCTA scans in the same session. Agreement in VD measurements between HD and non-HD scans was assessed using Bland and Altman analysis. Repeatability of the VD measurements of HD scans was assessed using within-subject coefficient of repeatability (CRw) and ...

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    8. Conjunctival and Intrascleral Vasculatures Assessed Using Anterior-Segment Optical Coherence Tomography Angiography in Normal Eyes

      Conjunctival and Intrascleral Vasculatures Assessed Using Anterior-Segment Optical Coherence Tomography Angiography in Normal Eyes

      Purpose To investigate conjunctival and intrascleral vasculatures using anterior-segment (AS) optical coherence tomography angiography (OCTA) in normal eyes. Design Cross-sectional study. Methods AS-OCTA images of the corneal limbus were acquired circumferentially using a swept-source OCT system in 10 eyes of 10 healthy subjects. AS-OCTA flow patterns with en face maximum projection were compared between the superficial (from the conjunctival epithelium to a depth of 200 μm) and deep (from a depth of 200 μm to 1000 μm) layers. The OCTA images were also compared with fluorescein scleral angiography and indocyanine green aqueous angiography images. Quantitative parameters (vessel density, vessel length ...

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    9. Optic disc microvasculature dropout in primary open-angle glaucoma measured with optical coherence tomography angiography

      Optic disc microvasculature dropout in primary open-angle glaucoma measured with optical coherence tomography angiography

      Purpose To evaluate microvasculature dropout in the optic disc (Mvd-D) using optical coherence tomography angiography (OCTA) and investigate factors associated with Mvd-D in primary open-angle glaucoma (POAG) eyes. Methods One hundred twenty-three eyes of 123 POAG patients were included from the Diagnostic Innovations in Glaucoma Study. The 3.0×3.0-mm optic nerve head OCTA scans were acquired using a spectral-domain OCT instrument. Images with whole-signal-mode were evaluated. Eyes were classified into 3 categories (Mvd-D, pseudo-Mvd-D, and no Mvd-D). Mvd-D and pseudo-Mvd-D had complete loss of OCTA signals on the temporal side of the optic disc on the en face ...

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    10. Retinal Nerve Fiber Layer Features Identified by Unsupervised Machine Learning on Optical Coherence Tomography Scans Predict Glaucoma Progression

      Retinal Nerve Fiber Layer Features Identified by Unsupervised Machine Learning on Optical Coherence Tomography Scans Predict Glaucoma Progression

      Purpose : To apply computational techniques to wide-angle swept-source optical coherence tomography (SS-OCT) images to identify novel, glaucoma-related structural features and improve detection of glaucoma and prediction of future glaucomatous progression. Methods : Wide-angle SS-OCT, OCT circumpapillary retinal nerve fiber layer (cpRNFL) circle scans spectral-domain (SD)-OCT, standard automated perimetry (SAP), and frequency doubling technology (FDT) visual field tests were completed every 3 months for 2 years from a cohort of 28 healthy participants (56 eyes) and 93 glaucoma participants (179 eyes). RNFL thickness maps were extracted from segmented SS-OCT images and an unsupervised machine learning approach based on principal component analysis ...

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    11. Diagnostic Abilities of the Optical Microangiography Parameters of the 3×3 mm and 6×6 mm Macular Scans in Glaucoma

      Diagnostic Abilities of the Optical Microangiography Parameters of the 3×3 mm and 6×6 mm Macular Scans in Glaucoma

      Purpose: To evaluate the diagnostic abilities of macular vessel length and perfusion densities measured with optical microangiography (OMAG) over a 3×3 mm and a 6×6 mm region, and to compare these with macular ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with primary open-angle glaucoma (POAG). Methods: In a cross-sectional study, 96 eyes of 57 control subjects and 88 eyes of 57 POAG patients underwent macular imaging with optical coherence tomography. Area under receiver operating characteristic curves (AUC) and sensitivities at 90% specificity of OMAG and GCIPL parameters were evaluated. Results: Most OMAG parameters of the 3×3 ...

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    12. Deep-Layer Microvasculature Dropout by Optical Coherence Tomography Angiography and Microstructure of Parapapillary Atrophy

      Deep-Layer Microvasculature Dropout by Optical Coherence Tomography Angiography and Microstructure of Parapapillary Atrophy

      Purpose : To investigate the association between the microstructure of β-zone parapapillary atrophy (βPPA) and parapapillary deep-layer microvasculature dropout assessed by optical coherence tomography angiography (OCT-A). Methods : Thirty-seven eyes with βPPA devoid of the Bruch's membrane (BM) (γPPA) ranging between completely absent and discontinuous BM were matched by severity of the visual field (VF) damage with 37 eyes with fully intact BM (βPPA +BM ) based on the spectral-domain (SD) OCT imaging. Parapapillary deep-layer microvasculature dropout was defined as a dropout of the microvasculature within choroid or scleral flange in the βPPA on the OCT-A. The widths of βPPA, γPPA, and ...

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    13. Optical Coherence Tomography Angiography Macular Vascular Density Measurements and the Central 10-2 Visual Field in Glaucoma

      Optical Coherence Tomography Angiography Macular Vascular Density Measurements and the Central 10-2 Visual Field in Glaucoma

      Purpose: To evaluate the association between macula vascular density assessed by optical coherence tomography angiography (OCT-A) and central visual field (VF) threshold sensitivities in healthy, glaucoma suspect and glaucoma patients. Methods: A total of 185 eyes from 38 healthy participants, 31 glaucoma suspects, 72 mild glaucoma patients, and 44 moderate/severe glaucoma patients from the Diagnostic Innovations in Glaucoma Study who underwent OCT-A images of the macula and 10-2 VF testing were enrolled in this observational cross-sectional study. The relationship between central VF mean sensitivity and superficial macula whole-image vessel density (wiVD), and the relationship between the MS of the ...

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    14. Inter-eye Asymmetry of Optical Coherence Tomography Angiography Vessel Density in Bilateral Glaucoma, Glaucoma Suspect, and Healthy Eyes

      Inter-eye Asymmetry of Optical Coherence Tomography Angiography Vessel Density in Bilateral Glaucoma, Glaucoma Suspect, and Healthy Eyes

      Purpose To investigate inter-eye retinal vessel density asymmetry in healthy, glaucoma suspect, and mild to moderate glaucoma subjects, and its potential utility for early detection of glaucomatous damage. Design Cross-sectional study. Methods 153 subjects including 55 healthy, 32 glaucoma suspect, and 66 glaucoma subjects enrolled in the Diagnostic Innovations in Glaucoma Study(DIGS). Vessel density was obtained from optical coherence tomography angiography (OCT-A) macular and optic nerve head scans. Thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (mGCC) was measured with spectral-domain optical coherence tomography (SD-OCT) scans. Inter-eye asymmetry was calculated by taking the absolute ...

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    15. Relationship of Macular Thickness and Function to Optical Microangiography Measurements in Glaucoma

      Relationship of Macular Thickness and Function to Optical Microangiography Measurements in Glaucoma

      Purpose: The purpose of this article was to evaluate the relationship between macular optical microangiography (OMAG), ganglion cell-inner plexiform layer (GCIPL) thickness, and visual sensitivity measurements of different macular sectors in primary open-angle glaucoma. Methods: In a cross-sectional study, 39 eyes of 26 primary open-angle glaucoma patients underwent optical coherence tomography imaging and 10-2 visual field examination of the macula in the same session. Linear regression models were used to evaluate the relationships between OMAG, GCIPL thickness, and visual sensitivity measurements in different macular sectors. Strength of relationship was reported as coefficient of determination ( R 2 ). Results: R 2 values ...

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    16. The Association between Macula and ONH Optical Coherence Tomography Angiography (OCT-A) Vessel Densities in Glaucoma, Glaucoma Suspect and Healthy Eyes

      The Association between Macula and ONH Optical Coherence Tomography Angiography (OCT-A) Vessel Densities in Glaucoma, Glaucoma Suspect and Healthy Eyes

      Purpose: To evaluate strength of associations between Optical Coherence Tomography-Angiography (OCT-A) vessel density (VD) measurements in the macula and peripapillary region of the optic nerve head (ONH) with standard structural OCT thickness measures. Methods: This cross-sectional study included 333 eyes of 219 primary open angle glaucoma patients, 41 glaucoma suspects, and 73 healthy participants from the Diagnostics Innovations in Glaucoma Study (DIGS) with good quality OCT-A images. The strength of associations between microvasculature measures in the ONH retinal nerve fiber layer (RNFL) and superficial macula layer was assessed using linear regression models. Associations between ONH and macula VD, and circumpapillary ...

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    17. Structural and functional imaging of aqueous humor outflow: a review

      Structural and functional imaging of aqueous humor outflow: a review

      Maintaining healthy aqueous humor outflow (AHO) is important for intraocular cellular health and stable vision. Impairment of AHO can lead to increased intraocular pressure, optic nerve damage, and concomitant glaucoma. An improved understanding of AHO will lead to improved glaucoma surgeries that enhance native AHO as well as facilitate the development of AHO-targeted pharmaceuticals. Recent AHO imaging has evolved to live human assessment and has focused on the structural evaluation of AHO pathways and the functional documentation of fluid flow. Structural AHO evaluation is predominantly driven by optical coherence tomography, and functional evaluation of flow is performed using various methods ...

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    18. Optical Coherence Tomography Angiography Vessel Density Measurements in Eyes with Primary Open Angle Glaucoma and Disc Hemorrhage

      Optical Coherence Tomography Angiography Vessel Density Measurements in Eyes with Primary Open Angle Glaucoma and Disc Hemorrhage

      Purpose: To compare the vessel density measurements of optic nerve head (ONH), peripapillary and macular regions in severity-matched primary open angle glaucoma (POAG) eyes with and without disc hemorrhage (DH) using optical coherence tomography (OCT) angiography (OCTA), and to compare their diagnostic abilities with that of the rim area, retinal nerve fiber layer and the ganglion cell complex thickness measurements on OCT. Methods: In a cross-sectional study, 66 eyes of 46 control subjects, 34 eyes of 33 POAG patients with DH (median mean deviation, MD: -3.7 dB) and 63 eyes of 43 POAG patients without DH (median MD: -3 ...

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    19. Comparing optical coherence tomography radial and cube scan patterns for measuring Bruch's membrane opening minimum rim width (BMO-MRW) in glaucoma and healthy eyes: cross-sectional and longitudinal analysis

      Comparing optical coherence tomography radial and cube scan patterns for measuring Bruch's membrane opening minimum rim width (BMO-MRW) in glaucoma and healthy eyes: cross-sectional and longitudinal analysis

      Aim To compare the cube and radial scan patterns of the spectral domain optical coherence tomography (SD-OCT) for quantifying the Bruch's membrane opening minimum rim width (BMO-MRW). Methods Sixty healthy eyes and 189 glaucomatous eyes were included. The optic nerve head cube and radial pattern scans were acquired using Spectralis SD-OCT. BMO-MRWs were automatically delineated using the San Diego Automated Layer Segmentation Algorithm. The BMO-MRW diagnostic accuracy for glaucoma detection and rates of change derived from the two scan patterns were compared. Results There was a significant difference between the baseline global BMO-MRW measurements of cube and radial scans ...

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    20. Automated circumferential construction of first-order aqueous humor outflow pathways using spectral-domain optical coherence tomography

      Automated circumferential construction of first-order aqueous humor outflow pathways using spectral-domain optical coherence tomography

      The purpose was to create a three-dimensional (3-D) model of circumferential aqueous humor outflow (AHO) in a living human eye with an automated detection algorithm for Schlemm’s canal (SC) and first-order collector channels (CC) applied to spectral-domain optical coherence tomography (SD-OCT). Anterior segment SD-OCT scans from a subject were acquired circumferentially around the limbus. A Bayesian Ridge method was used to approximate the location of the SC on infrared confocal laser scanning ophthalmoscopic images with a cross multiplication tool developed to initiate SC/CC detection automated through a fuzzy hidden Markov Chain approach. Automatic segmentation of SC and initial ...

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    21. Determinants of Peripapillary and Macular Vessel Densities Measured by Optical Coherence Tomography Angiography in Normal Eyes

      Determinants of Peripapillary and Macular Vessel Densities Measured by Optical Coherence Tomography Angiography in Normal Eyes

      PURPOSE The aim of this study was to evaluate the effect of subject-related (age, sex, and systemic hypertension and diabetes), eye-related (refractive error, optic disc size), and technology-related (signal strength index, SSI of the scans) determinants on the peripapillary and macular vessel densities measured with optical coherence tomography angiography (OCTA) in normal eyes. METHODS In a cross-sectional study, 181 normal eyes of 107 subjects (45 men, 62 women, median age: 50 y, range: 18 to 77 y) underwent OCTA imaging. Linear mixed models were used to analyze the effect of the determinants on the peripapillary and macular vessel densities measured ...

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    22. Measurements of the parapapillary atrophy zones in en face optical coherence tomography images

      Measurements of the parapapillary atrophy zones in en face optical coherence tomography images

      Objective To measure the parapapillary atrophy (PPA) area in en face images obtained with swept-source optical coherence tomography (SS-OCT), and to evaluate its relationship to glaucoma, myopia, and age in non-highly myopic subjects. Design Retrospective, cross-sectional study. Participants Fifty eyes of 30 subjects with open-angle glaucoma (G group) and forty-three eyes of 26 healthy control subjects (C group). Eyes with high myopia (spherical equivalent refractive error ≤ -8 diopters or axial length ≥ 26.5 mm) were excluded. Methods Mean age ± standard deviation was 59.9 ± 12.4 years. The beta zone and the gamma zone PPA areas were measured in en ...

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    23. Relationship of Optic Nerve Structure and Function to Peripapillary Vessel Density Measurements of Optical Coherence Tomography Angiography in Glaucoma

      Relationship of Optic Nerve Structure and Function to Peripapillary Vessel Density Measurements of Optical Coherence Tomography Angiography in Glaucoma

      Purpose: To evaluate the sectoral and global structure-structure (vessel density-retinal nerve fiber layer thickness) and structure-function (vessel density-visual sensitivity loss) relationships of peripapillary vessel density measurements on optical coherence tomography angiography in primary open-angle glaucoma and to determine if fractional polynomial (FP) models characterize the relationships better than linear models. Materials and Methods: In a cross-sectional study, structure-structure and structure-function relationships of peripapillary vessel densities were determined in 227 eyes of 143 subjects (63 control and 164 primary open-angle glaucoma eyes) who had undergone standard automated perimetry and optical coherence tomography testing within 6 months of each other, using linear ...

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    24. A comparison of the diagnostic ability of vessel density and structural measurements of optical coherence tomography in primary open angle glaucoma

      A comparison of the diagnostic ability of vessel density and structural measurements of optical coherence tomography in primary open angle glaucoma

      Purpose To compare the diagnostic abilities of vessel density measurements of the optic nerve head (ONH), peripapillary and macular regions on optical coherence tomography (OCT) angiography in eyes with primary open angle glaucoma (POAG) with that of the ONH rim area, peripapillary retinal nerve fiber layer (RNFL) thickness and the macular ganglion cell complex (GCC) thickness measurements. Methods In a cross sectional study, 78 eyes of 50 control subjects and 117 eyes of 67 POAG patients underwent vessel density and structural measurements with spectral domain OCT. POAG was diagnosed based on the masked evaluation of optic disc stereo photographs. Area ...

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