1. Articles from Robert N. Weinreb

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    1. Combining OCT and OCT-Angiography Longitudinal Data for the Detection of Visual Field Progression in Glaucoma

      Combining OCT and OCT-Angiography Longitudinal Data for the Detection of Visual Field Progression in Glaucoma

      PURPOSE To use longitudinal optical coherence tomography (OCT) and OCT-Angiography (OCTA) data to detect glaucomatous visual field (VF) progression with a supervised machine learning approach. DESIGN Prospective cohort study. METHODS 110 eyes of glaucoma suspect (33.6%) and glaucoma (66.4%) patients with a minimum of five 24-2 VF tests and three optic nerve head and macula images over an average follow-up duration of 4.1 years were included. VF progression was defined using a composite measure including either a “likely progression event” on Guided Progression Analysis, a statistically significant negative slope of VF mean deviation or VF index, or ...

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      Mentions: UCSD
    2. Deep Learning Estimation of 10-2 Visual Field Map Based on Circumpapillary Retinal Nerve Fiber Layer Thickness Measurements

      Deep Learning Estimation of 10-2 Visual Field Map Based on Circumpapillary Retinal Nerve Fiber Layer Thickness Measurements

      PURPOSE : To estimate central 10° visual field (VF) map from spectral-domain optical coherence tomography (SD-OCT) retinal nerve fiber layer thickness (RNFL) measurements in glaucoma with artificial intelligence. DESIGN : Artificial intelligence (convolutional neural networks) study. METHODS : This study included 5352 SD-OCT and 10-2 VF pairs from 1365 eyes of 724 healthy, glaucoma suspect and glaucoma patients. Convolutional neural networks (CNN) were developed to estimate the 68 individual sensitivity thresholds of 10-2 VF map using all-sectors (CNN A ) and temporal-sectors (CNN T ) RNFL thickness information of the SD-OCT circle scan (768 thickness points). 10-2 indices including pointwise total deviation (TD) values, mean ...

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      Mentions: UCSD
    3. Association of macular OCT and OCTA parameters with visual acuity in glaucoma

      Association of macular OCT and OCTA parameters with visual acuity in glaucoma

      Background/aims: To investigate the association of macular optical coherence tomography (OCT)/OCT angiography (OCTA) parameters with visual acuity (VA) in glaucoma. Methods: 144 pseudophakic primary open-angle glaucoma eyes were included. Foveal (fVD), parafoveal (pf), perifoveal (perifVD) and whole-image vessel densities (wiVD) of superficial and deep layers, and their corresponding ganglion cell complex (GCC) thicknesses were obtained from OCTA 6×6 mm 2 macula scans. Foveal avascular zone (FAZ) area, FAZ circumference and foveal density-300 (FD300) were measured. Correlation between OCT/OCTA parameters and Logarithm of the Minimum Angle of Resolution VA (logMAR VA) in early and moderate-advanced glaucoma was ...

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      Mentions: UCSD
    4. Frequency of Optical Coherence Tomography Testing to Detect Progression in Glaucoma

      Frequency of Optical Coherence Tomography Testing to Detect Progression in Glaucoma

      Purpose: To investigate the time to detect progression in glaucomatous eyes using different optical coherence tomography (OCT) test intervals. Methods: Participants with manifest glaucoma from the African Descent and Glaucoma Evaluation Study (ADAGES), a multicenter, prospective, observational cohort study, were included. A total of 2,699 OCT tests from 171 glaucomatous and 149 normal eyes of 182 participants, with at least 5 tests and 2 years of follow-up, were analyzed. Computer simulations (n=10,000 eyes) were performed to estimate time to detect progression of global circumpapillary retinal nerve fiber layer thickness (cpRNFL) measured with OCT tests. Simulations were based ...

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    5. Factors associated with choroidal microvascular dropout change

      Factors associated with choroidal microvascular dropout change

      Background/aims To investigate the factors associated with choroidal microvasculature drop-out (MvD) enlargement detected by optical coherence tomography angiography (OCT-A) in glaucomatous eyes. Methods Ninety-one eyes of 68 primary open-angle glaucoma patients were enrolled. Only eyes with a minimum of four good quality OCT-A and OCT scans of the optic nerve head acquired at least and with a minimum of 2 years follow-up were included. Area and angular circumference of MvD were analysed on en face images. Univariable and multivariable mixed effects models were constructed to identify the factors contributing to MvD area and angular circumference change over time. Results ...

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      Mentions: UCSD
    6. Comparison of Optic Disc Ovality Index and Rotation Angle Measurements in Myopic Eyes Using Photography and OCT Based Techniques

      Comparison of Optic Disc Ovality Index and Rotation Angle Measurements in Myopic Eyes Using Photography and OCT Based Techniques

      Purpose: To compare optic nerve head (ONH) ovality index and rotation angle measurements based on semi-automated delineation of the clinical ONH margin derived from photographs and automated BMO configuration derived from optical coherence tomography (OCT) images in healthy and glaucomatous eyes with high-, mild- and no axial myopia. Methods: One hundred seventy-five healthy and glaucomatous eyes of 146 study participants enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) with optic disc photographs and Spectralis OCT ONH scans acquired on the same day were stratified by level of axial myopia (non-myopic [ n = 56, axial length (AL) <24 mm], mild-myopic [ n ...

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    7. Diagnostic accuracy of macular thickness map and texture en-face images for detecting glaucoma in eyes with axial high myopia

      Diagnostic accuracy of macular thickness map and texture en-face images for detecting glaucoma in eyes with axial high myopia

      To evaluate the diagnostic accuracy of a novel optical coherence tomography (OCT) texture-based en-face image analysis, called SALSA-Texture, that requires segmentation of only one retinal layer for glaucoma detection in eyes with axial high myopia, and to compare to standard macular ganglion cell-inner plexiform layer (GCIPL) thickness, macular retinal nerve fiber layer (mRNFL) thickness, and ganglion cell complex (GCC) thickness maps.

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      Mentions: UCSD
    8. OCT Angiography Face Mask-associated Artifacts During the COVID-19 Pandemic

      OCT Angiography Face Mask-associated Artifacts During the COVID-19 Pandemic

      Prcis: Face mask wearing has no significant effects on artifacts or vessel density measurements in optic nerve head and macular OCT-Angiography scans. Purpose: To assess the difference in area of artifacts observed in optical coherence tomography angiography (OCT-A) scans with and without face mask wear and to verify if mask wear interferes with OCT-A vessel density measurements. Subjects and controls: 64 eyes of 10 healthy subjects, 4 ocular hypertensive, 8 glaucoma suspects, and 17 glaucoma patients were included. Methods: High density optic nerve head (ONH) and macula OCT-A scans were obtained in patients with and without surgical masks. Seven different ...

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      Mentions: UCSD
    9. Association of Initial Optical Coherence Tomography Angiography Vessel Density Loss With Faster Visual Field Loss in Glaucoma

      Association of Initial Optical Coherence Tomography Angiography Vessel Density Loss With Faster Visual Field Loss in Glaucoma

      Importance: Rapid vessel density loss during an initial follow-up period may be associated with the rates of visual field loss over time. Objectives: To evaluate the association between the rate of vessel density loss during initial follow-up and the rate of visual field loss during an extended follow-up period in patients suspected of having glaucoma and patients with primary open-angle glaucoma. Design, setting, and participants: This retrospective cohort study assessed 124 eyes (86 with primary open-angle glaucoma and 38 suspected of having glaucoma) of 82 patients who were followed up at a tertiary glaucoma center for a mean of 4 ...

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      Mentions: UCSD
    10. Relationship of macular ganglion cell complex thickness to choroidal microvasculature drop-out in primary open-angle glaucoma

      Relationship of macular ganglion cell complex thickness to choroidal microvasculature drop-out in primary open-angle glaucoma

      Background/aims To investigate the rate of ganglion cell complex (GCC) thinning in primary open-angle glaucoma (POAG) patients with and without deep-layer microvasculature drop-out (MvD). Methods POAG patients who had at least 1.5 years of follow-up and a minimum of three visits were included from the Diagnostic Innovations in Glaucoma Study. MvD was detected at baseline by optical coherence tomography angiography (OCT-A). Area and angular circumference of MvD were evaluated on en face choroidal vessel density images and horizontal B-scans. Rates of global and hemisphere GCC thinning were compared in MvD and non-MvD eyes using linear mixed-effects models. Results ...

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      Mentions: UCSD
    11. Performances of machine learning in detecting glaucoma using fundus and retinal optical coherence tomography images: A meta-analysis

      Performances of machine learning in detecting glaucoma using fundus and retinal optical coherence tomography images: A meta-analysis

      Purpose To evaluate the performance of machine learning (ML) in detecting glaucoma using fundus and retinal optical coherence tomography (OCT) images. Design Meta-analysis. Methods PubMed and EMBASE were searched on August 11, 2021. Bivariate random-effects model was used to pool ML's diagnostic sensitivity, specificity, and area under the curve (AUC). Subgroup analyses were performed based on ML classifier categories and dataset types. Results 105 (3.3%) studies were retrieved. 73 (69.5%), 30 (28.6%), and 2 (1.9%) studies tested ML using fundus, OCT, and both image types, respectively. Total testing data size was 197174 for fundus and ...

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      Mentions: UCSD
    12. Optical microangiography and progressive ganglion cell-inner plexiform layer loss in primary open angle glaucoma

      Optical microangiography and progressive ganglion cell-inner plexiform layer loss in primary open angle glaucoma

      Purpose To evaluate the association between optical microangiography (OMAG) measurements and progressive ganglion cell-inner plexiform layer (GCIPL) loss in primary open angle glaucoma (POAG). Design Prospective case-series Methods Sixty-three eyes of 38 POAG patients were studied for at least 2 years and with at least 3 optical coherence tomography (OCT) examinations. Only those hemifields with mild to moderate functional damage at baseline (106 hemifields) were included in the analysis. OMAG imaging was performed at the baseline visit. Effect of clinical parameters (age, gender, central corneal thickness, presence of disc hemorrhage, mean and fluctuation of intraocular pressure), baseline mean deviation (MD ...

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    13. Deep learning image analysis of optical coherence tomography angiography measured vessel density improves classification of healthy and glaucoma eyes

      Deep learning image analysis of optical coherence tomography angiography measured vessel density improves classification of healthy and glaucoma eyes

      Purpose : To compare convolutional neural network (CNN) analysis of en face vessel density images to gradient boosting classifier (GBC) analysis of instrument provided, feature-based optical coherence tomography angiography (OCTA) vessel density measurements and OCT RNFL thickness measurements for classifying healthy and glaucomatous eyes. Design : Comparison of diagnostic approaches Methods : 130 eyes of 80 healthy individuals and 275 eyes of 185 glaucoma patients with optic nerve head (ONH) OCTA and OCT imaging were included. Classification performance of a VGG16 CNN trained and tested on entire en face 4.5 mm x 4.5 mm radial peripapillary capillary OCTA ONH images was ...

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      Mentions: UCSD
    14. Optic Disc Microvasculature Dropout in Glaucoma Detected by Swept-Source Optical Coherence Tomography Angiography

      Optic Disc Microvasculature Dropout in Glaucoma Detected by Swept-Source Optical Coherence Tomography Angiography

      Purpose To assess the clinical utility of swept-source optical coherence tomography angiography (SS-OCTA) in detecting optic disc microvasculature dropout (MvD-D) in primary open-angle glaucoma (POAG) eyes. Design Cross sectional study. Methods One hundred and ninety-seven eyes of 197 POAG patients with acceptable-quality SS-OCTA (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, CA, USA) images were enrolled. A whole-signal-mode 6.0 × 6.0-mm optic disc cube was obtained with projection artifact removal. Three groups were categorized: no MvD-D (Group 1), MvD-D (Group 2, complete loss of microvasculature within the optic disc), and indiscernible MvD-D (Group 3, poor visualization of the anterior lamina ...

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    15. Measurements of OCTA Complement OCT for Diagnosing Early Primary Open Angle Glaucoma

      Measurements of OCTA Complement OCT for Diagnosing Early Primary Open Angle Glaucoma

      Purpose: To compare measurements of global and regional circumpapillary capillary density (cpCD) with retinal nerve fiber layer (RNFL) thickness, and characterize their relationship with visual function in early primary open-angle glaucoma (POAG). Design: Cross-sectional study PARTICIPANTS: Eighty healthy eyes, 64 pre-perimetric, and 184 mild POAG eyes from the Diagnostic Innovations in Glaucoma Study. Methods: Global and regional RNFL thickness and cpCD measurements were obtained using optical coherence tomography (OCT) and OCT angiography (OCTA). For direct comparison at the individual and diagnostic group level, RNFL thickness and capillary density values were converted to a normalized relative loss scale. Main outcome measures ...

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      Mentions: UCSD
    16. Central macular OCTA parameters in glaucoma

      Central macular OCTA parameters in glaucoma

      Background/aims: To investigate the relationship between the foveal avascular zone (FAZ) parameters assessed by optical coherence tomography angiography (OCTA) and central visual field parameters in glaucoma and healthy subjects. Methods: One hundred and eighty-eight subjects (248 eyes), including 24 healthy (38 eyes), 37 glaucoma suspect (42 eyes, and 127 primary open angle glaucoma (POAG) patients (168 eyes), underwent imaging using OCTA and standard automated perimetry using the 24-2 and 10-2 Swedish Interactive Thresholding Algorithm. OCTA-based and OCT-based FAZ parameters (superficial FAZ area, FAZ circumference), foveal vessel density (FD300) and foveal thickness were measured. The correlation between FAZ parameters and ...

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      Mentions: UCSD
    17. Individualized Glaucoma Change Detection Using Deep Learning Auto Encoder-Based Regions of Interest

      Individualized Glaucoma Change Detection Using Deep Learning Auto Encoder-Based Regions of Interest

      Purpose : To compare change over time in eye-specific optical coherence tomography (OCT) retinal nerve fiber layer (RNFL)-based region-of-interest (ROI) maps developed using unsupervised deep-learning auto-encoders (DL-AE) to circumpapillary RNFL (cpRNFL) thickness for the detection of glaucomatous progression. Methods : Forty-four progressing glaucoma eyes (by stereophotograph assessment), 189 nonprogressing glaucoma eyes (by stereophotograph assessment), and 109 healthy eyes were followed for ≥3 years with ≥4 visits using OCT. The San Diego Automated Layer Segmentation Algorithm was used to automatically segment the RNFL layer from raw three-dimensional OCT images. For each longitudinal series, DL-AEs were used to generate individualized eye-based ROI maps ...

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      Mentions: UCSD
    18. Optical microangiography and progressive retinal nerve fiber layer loss in primary open angle glaucoma

      Optical microangiography and progressive retinal nerve fiber layer loss in primary open angle glaucoma

      Purpose : To evaluate the association between optical microangiography (OMAG) measurements and progressive retinal nerve fiber layer (RNFL) loss in primary open angle glaucoma (POAG). Design : Prospective case series Methods : Sixty-four eyes of 40 POAG patients (108 quadrants) with mild to moderate functional damage were longitudinally studied for at least 2 years and with a minimum of 3 optical coherence tomography (OCT) examinations. OMAG imaging was performed at the baseline visit. Effect of clinical parameters (age, gender, presence of systemic diseases, central corneal thickness, presence of disc hemorrhage, mean and fluctuation of intraocular pressure during follow-up), baseline hemifield mean deviation (MD ...

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    19. Long-Term Reproducibility of Optical Coherence Tomography Angiography in Stable Glaucomatous Eyes

      Long-Term Reproducibility of Optical Coherence Tomography Angiography in Stable Glaucomatous Eyes

      Purpose : To assess and compare long-term reproducibility of optical coherence tomography angiography (OCTA) vascular parameters and spectral-domain optical coherence tomography (OCT) thickness parameters in stable glaucoma, glaucoma suspect, and healthy eyes. Methods : A total of 88 eyes (15 healthy, 38 glaucoma suspect, and 35 non-progressive POAG) of 68 subjects were enrolled who had at least 3 visits within 1 to 1.5 years and both OCT and OCTA (Optovue Inc, Fremont, California, USA) imaging on the same day. A series of vascular and thickness parameters were measured including macula whole image vessel density (wiVD), optic nerve head (ONH) circumpapillary capillary ...

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    20. Predicting central 10 degrees visual field from peripapillary optical coherence tomography using deep learning approach

      Predicting central 10 degrees visual field from peripapillary optical coherence tomography using deep learning approach

      Purpose: To develop a deep learning (DL) simulation of standard automated perimetry (SAP) in the central 10 ° based on spectral domain optical coherence tomography (SD-OCT) retinal nerve fiber layer thickness (RNFLT). Methods : This study included 5352 pairs of SD-OCT and 10-2 SAP from 1365 eyes of 724 healthy, glaucoma suspect and glaucoma patients from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). Each pair of SD-OCT and 10-2 SAP was obtained within a 6-month duration. The dataset was randomly divided into training (65%), validation (15%), and test (20%) sets at the patient ...

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      Mentions: UCSD
    21. Optical Coherence Tomography Angiography Artifacts in Glaucoma

      Optical Coherence Tomography Angiography Artifacts in Glaucoma

      Purpose: To determine the prevalence of different types of artifacts seen in optical coherence tomography angiography (OCTA) images of healthy and glaucoma eyes and to evaluate the characteristics associated with the increased likelihood of obtaining poor quality images. Design: Retrospective study. Participants: A total of 649 eyes of 368 healthy, glaucoma suspect, and glaucoma patients. Methods: Angiovue high density (HD) and non-HD optic nerve head and macula OCTA images of participants were evaluated by 4 expert reviewers for the presence of different artifacts including eye movement, defocus, shadow, decentration, segmentation error, blink and Z offset in the superficial vascular layer ...

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      Mentions: UCSD
    22. 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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    23. 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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      Mentions: UCSD
    24. 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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      Mentions: UCSD
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