1. Articles from Robert N. Weinreb

    1-24 of 105 1 2 3 4 5 »
    1. Optical Coherence Tomography Angiography and Visual Field Progression in Primary Angle Closure Glaucoma

      Optical Coherence Tomography Angiography and Visual Field Progression in Primary Angle Closure Glaucoma

      Precis: Lower whole enface disc (coefficient: 0.02, P =0.03) and macular vessel densities (coefficient: 0.04, P =0.02) on OCT angiography were significantly associated with faster rate of mean deviation decline. Purpose: To evaluate the association between optical coherence tomography angiography (OCTA) features and prior visual field (VF) progression in primary angle closure glaucoma (PACG). Methods: In a cross-sectional study, 46 eyes of 31 PACG patients with 5 reliable VF examinations performed over ≥3 years of follow-up underwent OCTA imaging. Effect of clinical (age, gender, number of anti-glaucoma medications, mean and SD of intraocular pressure during follow-up ...

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    2. OCT angiography measured changes in the foveal avascular zone area after glaucoma surgery

      OCT angiography measured changes in the foveal avascular zone area after glaucoma surgery

      Background/aims: To evaluate quantitative changes in the foveal avascular zone (FAZ) area after glaucoma surgery using swept-source optical coherence tomography angiography (SS-OCTA). Methods: Fifty-four consecutive patients with primary open-angle glaucoma (POAG) who met the inclusion criteria and underwent unilateral glaucoma surgery to reduce intraocular pressure (IOP) between April 2018 and July 2019.Eyes underwent IOP-lowering glaucoma surgery and their fellow (non-surgical) eyes were included. OCTA of the macula was performed in both eyes before glaucoma surgery and 3 months postoperatively. Two blinded examiners reviewed the image quality. Within- and between-group comparisons of the FAZ area and correlation of the ...

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    3. Referenced scans improve the repeatability of optical coherence tomography angiography measurements in normal and glaucoma eyes

      Referenced scans improve the repeatability of optical coherence tomography angiography measurements in normal and glaucoma eyes

      Aim To compare the repeatability of peripapillary perfusion density and flux index measurements on referenced and non-referenced optical microangiography (OMAG) scans in normal, glaucoma suspect and glaucoma eyes. Methods In a cross-sectional study, 48 eyes (33 subjects) underwent three repeat, non-referenced peripapillary OMAG scans in the same session and 43 eyes (25 subjects) underwent three referenced peripapillary OMAG scans. In the referenced scan group, repeat scans (second and the third scan) were acquired exactly on the baseline (first) scan using the ‘track to prior scan’ option on the device. Repeatability estimates of the mean and four-sector (temporal, superior, nasal and ...

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    4. Geometric Perfusion Deficits: A Novel OCT Angiography Biomarker for Diabetic Retinopathy Based on Oxygen Diffusion

      Geometric Perfusion Deficits: A Novel OCT Angiography Biomarker for Diabetic Retinopathy Based on Oxygen Diffusion

      Purpose To develop geometric perfusion deficits (GPD), an optical coherence tomography angiography (OCTA) biomarker based on oxygen diffusion, and to evaluate its utility in a pilot study of healthy subjects and patients with diabetic retinopathy (DR). Design Retrospective cross-sectional study. Methods Commercial spectral-domain OCTA instruments were used to acquire repeated 3×3 mm 2 and 6×6 mm 2 motion-corrected macular OCTA volumes. En face OCTA images corresponding to the superficial capillary plexus (SCP), deep capillary plexus (DCP), and full retinal projections were obtained using automatic segmentation. For each projection, the GPD percentage and the vessel density percentage, the control ...

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    5. Impact of Pupil Dilation on Optical Coherence Tomography Angiography Retinal Microvasculature in Healthy Eyes

      Impact of Pupil Dilation on Optical Coherence Tomography Angiography Retinal Microvasculature in Healthy Eyes

      Précis: Small but significant decreases in OCTA-measured circumpapillary capillary density were observed in healthy eyes dilated with 2.5% phenylephrine/0.5% tropicamide. Though likely clinically insignificant, ophthalmologists should consider these changes when interpreting OCTA results from dilated eyes. Purpose: To investigate the effect of pupil dilation using 2.5% phenylephrine and 0.5% tropicamide on quantitative assessment of retinal microvasculature using OCTA. Methods: OptoVue AngioVue high density (HD) and non-HD OCTA macula and optic nerve head (ONH) images were obtained at 15-minute intervals pre- and post- dilation in 26 healthy participants (mean age: 40.0; 95% CI=33 ...

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    6. Iridocorneal Angle Assessment After Laser Iridotomy with Swept-source Optical Coherence Tomography

      Iridocorneal Angle Assessment After Laser Iridotomy with Swept-source Optical Coherence Tomography

      Aim: To investigate the reliability of anterior chamber angle (ACA) measurements in narrow angles and assess the effect of laser peripheral iridotomy (LPI) on these measurements using novel swept-source optical coherence tomography (SS-OCT) technology. Methods: In this prospective observational study, patients with gonioscopically narrow angles were enrolled and scheduled for prophylactic LPI. Twelve ACA sections were obtained in each eye using SS-OCT (ANTERION, Heidelberg Engineering, Germany) before and after Nd:YAG LPI. A built-in algorithm calculated ACA measurements after manual identification of the scleral spur and ACA recess. Eight ACA parameters were evaluated: ACA (ACA 500, ACA 750); Scleral Spur ...

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    7. Capillary Density Measured by OCT Angiography in Glaucomatous Optic Disc Phenotypes

      Capillary Density Measured by OCT Angiography in Glaucomatous Optic Disc Phenotypes

      Purpose To compare optical coherence tomography angiography (OCTA) measured capillary density of the optic disc among four glaucomatous optic disc phenotypes. Design Cross-sectional study. Methods Circumpapillary capillary density (cpCD) of four glaucomatous optic disc phenotypes in 193 eyes of 141 glaucoma patients and cpCD in 92 eyes of 55 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were compared. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy among groups after adjusting for confounders. Results Four glaucoma phenotypes were assessed including focal ischemic (n=45), generalized cup enlargement (n=60), myopic glaucoma (n ...

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    8. Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography

      Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography

      Changes in retinal vasculature and ocular circulation may play an important role in the glaucoma development and progression. We evaluated the vertical asymmetry across the temporal raphe of the deep retinal layer vessel density, using swept-source optical coherence tomography angiography (SS-OCTA), and its relationship with the central visual field (VF) loss. Thirty-four eyes of 27 patients with open-angle glaucoma were included. SS-OCTA macular scanning was performed within a 3 × 3 mm (300 × 300 pixels) volume, centred on the fovea. The relationships between the vertical asymmetrical deep retinal vessel density reduction (ADRVD) across the temporal raphe and various ocular parameters were ...

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    9. Gradient Bosting Classifiers Combining Vessel Density and Tissue Thickness Measurements for Classifying Early to Moderate Glaucoma

      Gradient Bosting Classifiers Combining Vessel Density and Tissue Thickness Measurements for Classifying Early to Moderate Glaucoma

      Purpose To compare gradient boosting classifier (GBC) analysis of optical coherence tomography angiography (OCTA)-measured vessel density (VD) and OCT-measured tissue thickness to standard OCTA VD and OCT thickness parameters for classifying healthy eyes and eyes with early to moderate glaucoma. Design Comparison of diagnostic tools. Methods One-hundred-eight healthy eyes and 193 glaucomatous eyes with OCTA and OCT imaging of the macula and optic nerve head (ONH) were studied. Four GBCs were evaluated that combined 1) all macula VD and thickness measurements (Macula GBC), 2) all ONH VD and thickness measurements (ONH GBC), 3) all VD measurements from the macula ...

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    10. Diagnostic Ability of Optical Coherence Tomography Angiography Macula Vessel Density for the Diagnosis of Glaucoma Using Difference Scan Sizes

      Diagnostic Ability of Optical Coherence Tomography Angiography Macula Vessel Density for the Diagnosis of Glaucoma Using Difference Scan Sizes

      Précis: There is diagnostic information in the outer region of OCTA macula scans not available in the inner region, and this information is especially useful in the early stages of glaucoma . Purpose: To evaluate the diagnostic accuracy of 3×3▒mm 2 and 6×6▒mm 2 macula OCT-A scans for classifying healthy, mild glaucoma , and moderate to severe glaucoma eyes. Methods: Participants enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) with good quality 3×3▒mm 2 and 6×6▒mm 2 OCT-A images of the macula (AngioVue; Optovue, Freemont, CA) acquired on the same day were ...

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    11. Deep Learning Approaches Predict Glaucomatous Visual Field Damage from Optical Coherence Tomography Optic Nerve Head Enface Images and Retinal Nerve Fiber Layer Thickness Maps

      Deep Learning Approaches Predict Glaucomatous Visual Field Damage from Optical Coherence Tomography Optic Nerve Head Enface Images and Retinal Nerve Fiber Layer Thickness Maps

      Purpose To develop and evaluate a deep learning system for differentiating between eyes with and without glaucomatous visual field damage (GVFD) and predicting the severity of GFVD from spectral domain optical coherence tomography (SDOCT) optic nerve head images. Design Evaluation of a diagnostic technology Participants 9,765 visual field (VF)–SDOCT pairs collected from 1,194 participants with and without GVFD (1909 eyes). Methods Deep learning models were trained to use SDOCT retinal nerve fiber layer (RNFL) thickness maps, RNFL enface images, and confocal scanning laser ophthalmoscopy (CSLO) images to identify eyes with GVFD and predict quantitative VF mean deviation ...

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    12. 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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    13. 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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    14. 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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    15. 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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    16. 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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    17. 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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    18. 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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    19. 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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    20. 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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    21. 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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    22. 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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    23. 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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    24. 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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