1. Articles from Thomas S. Hwang

    1-25 of 25
    1. Automated segmentation of retinal fluid volumes from structural and angiographic optical coherence tomography using deep learning

      Automated segmentation of retinal fluid volumes from structural and angiographic optical coherence tomography using deep learning

      Purpose: We proposed a deep convolutional neural network (CNN), named Retinal Fluid Segmentation Network (ReF-Net) to segment volumetric retinal fluid on optical coherence tomography (OCT) volume. Methods: 3 × 3-mm OCT scans were acquired on one eye by a 70-kHz OCT commercial AngioVue system (RTVue-XR; Optovue, Inc.) from 51 participants in a clinical diabetic retinopathy (DR) study (45 with retinal edema and 6 healthy controls). A CNN with U-Net-like architecture was constructed to detect and segment the retinal fluid. Cross-sectional OCT and angiography (OCTA) scans were used for training and testing ReF-Net. The effect of including OCTA data for retinal fluid ...

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    2. Optical coherence tomography angiography avascular area association with one-year treatment requirement and disease progression in diabetic retinopathy

      Optical coherence tomography angiography avascular area association with one-year treatment requirement and disease progression in diabetic retinopathy

      Purpose To assess the association between optical coherence tomography angiography (OCTA) quantified avascular areas (AA) and diabetic retinopathy (DR) severity, progression and treatment requirement in the following year. Design Prospective cohort study. Methods We recruited diabetic patients from tertiary academic retina practice and obtained 3x3-mm macular OCTA scans with AngioVue system and standard 7-field color photographs at baseline and 1-year visit. A masked grader determined the DR severity from the color photographs using the Early Treatment of Diabetic Retinopathy (ETDRS) scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1mm circle in projection-resolved superficial vascular complex (SVC), intermediate ...

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    3. Detection of reduced retinal vessel density in eyes with geographic atrophy secondary to age-related macular degeneration using projection-resolved optical coherence tomography angiography

      Detection of reduced retinal vessel density in eyes with geographic atrophy secondary to age-related macular degeneration using projection-resolved optical coherence tomography angiography

      Purpose To compare retinal vessel density in eyes with geographic atrophy (GA) secondary to age-related macular degeneration (AMD) to age-matched healthy eyes using projection-resolved optical coherence tomography angiography (PR-OCTA). Design Prospective cross-sectional study. Methods Study participants underwent macular 3×3-mm OCTA scans with spectral domain OCTA. Reflectance-compensated retinal vessel densities were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Quantitative analysis using normalized deviation compared the retinal vessel density in GA regions, 500 μm GA rim regions, and non-GA regions to similar macular locations in control eyes. Results Ten eyes with GA ...

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    4. Maximum value projection produces better en face OCT angiograms than mean value projection

      Maximum value projection produces better en face OCT angiograms than mean value projection

      Optical coherence tomography angiography (OCTA) images rely on en face data projections for both qualitative and quantitative interpretation. Both maximum value and mean value projections are commonly used, and many researchers consider them essentially interchangeable approaches. On the contrary, we find that maximum value projection achieves a consistently higher signal-to-noise ratio and higher image contrast across multiple vascular layers, in both healthy eyes and for each disease examined.

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    5. DETECTION OF CLINICALLY UNSUSPECTED RETINAL NEOVASCULARIZATION WITH WIDE-FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      DETECTION OF CLINICALLY UNSUSPECTED RETINAL NEOVASCULARIZATION WITH WIDE-FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      Purpose: To evaluate wide-field optical coherence tomography angiography (OCTA) for detection of clinically unsuspected neovascularization (NV) in diabetic retinopathy (DR). Methods: This prospective observational single-center study included adult patients with a clinical diagnosis of nonproliferative DR. Participants underwent a clinical examination, standard 7-field color photography, and OCTA with commercial and prototype swept-source devices. The wide-field OCTA was achieved by montaging five 6 × 10-mm scans from a prototype device into a 25 × 10-mm image and three 6 × 6-mm scans from a commercial device into a 15 × 6-mm image. A masked grader determined the retinopathy severity from color photographs. Two trained readers ...

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    6. Automated Quantification of Nonperfusion Areas in 3 Vascular Plexuses With Optical Coherence Tomography Angiography in Eyes of Patients With Diabetes

      Automated Quantification of Nonperfusion Areas in 3 Vascular Plexuses With Optical Coherence Tomography Angiography in Eyes of Patients With Diabetes

      Importance Diabetic retinopathy (DR) is a leading cause of vision loss that is managed primarily through qualitative clinical examination of the retina. Optical coherence tomography angiography (OCTA) may offer an objective and quantitative method of evaluating DR. Objective To quantify capillary nonperfusion in 3 vascular plexuses in the macula of eyes patients with diabetes of various retinopathy severity using projection-resolved OCTA (PR-OCTA). Design, Setting, and Participants Cross-sectional study at a tertiary academic center comprising 1 eye each from healthy control individuals and patients with diabetes at different severity stages of retinopathy. Data were acquired and analyzed between January 2015 and ...

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    7. Automated detection of photoreceptor disruption in mild diabetic retinopathy on volumetric optical coherence tomography

      Automated detection of photoreceptor disruption in mild diabetic retinopathy on volumetric optical coherence tomography

      Diabetic retinopathy is a pathology where microvascular circulation abnormalities ultimately result in photoreceptor disruption and, consequently, permanent loss of vision. Here, we developed a method that automatically detects photoreceptor disruption in mild diabetic retinopathy by mapping ellipsoid zone reflectance abnormalities from en face optical coherence tomography images. The algorithm uses a fuzzy c-means scheme with a redefined membership function to assign a defect severity level on each pixel and generate a probability map of defect category affiliation. A novel scheme of unsupervised clustering optimization allows accurate detection of the affected area. The achieved accuracy, sensitivity and specificity were about 90 ...

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    8. Automated drusen detection in dry age-related macular degeneration by multiple-depth, en face optical coherence tomography

      Automated drusen detection in dry age-related macular degeneration by multiple-depth, en face optical coherence tomography

      We introduce a method to automatically detect drusen in dry age-related macular degeneration (AMD) from optical coherence tomography with minimum need for layer segmentation. The method is based on the en face detection of drusen areas in C-scans at certain distances above the Bruch’s membrane, circumventing the difficult task of pathologic retinal pigment epithelium segmentation. All types of drusen can be detected, including the challenging subretinal drusenoid deposits (pseudodrusen). The high sensitivity and accuracy demonstrated here shows its potential for detection of drusen onset in early AMD.

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    9. Reflectance-based projection-resolved optical coherence tomography angiography [Invited]

      Reflectance-based projection-resolved optical coherence tomography angiography [Invited]

      O ptical coherence tomography angiography (OCTA) is limited by projection artifacts from the superficial blood vessels onto deeper layers. We have recently described projection-resolved (PR) OCTA that solves the ambiguity between in situ flow and flow projection along each axial scan and suppresses the artifact on both en face and cross-sectional angiograms. While this method significantly improved the depth resolution of OCTA, the vascular integrity of the deeper layers was not fully preserved. In this study, we propose a novel reflectance-based projection-resolved (rbPR) OCTA algorithm which uses OCT reflectance to enhance the flow signal and suppress the projection artifacts in ...

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    10. Automated boundary detection of the optic disc and layer segmentation of the peripapillary retina in volumetric structural and angiographic optical coherence tomography

      Automated boundary detection of the optic disc and layer segmentation of the peripapillary retina in volumetric structural and angiographic optical coherence tomography

      To improve optic disc boundary detection and peripapillary retinal layer segmentation, we propose an automated approach for structural and angiographic optical coherence tomography. The algorithm was performed on radial cross-sectional B-scans. The disc boundary was detected by searching for the position of Bruch’s membrane opening, and retinal layer boundaries were detected using a dynamic programming-based graph search algorithm on each B-scan without the disc region. A comparison of the disc boundary using our method with that determined by manual delineation showed good accuracy, with an average Dice similarity coefficient ≥0.90 in healthy eyes and eyes with diabetic retinopathy ...

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    11. Automated three-dimensional registration and volume rebuilding for wide-field angiographic and structural optical coherence tomography

      Automated three-dimensional registration and volume rebuilding for wide-field angiographic and structural optical coherence tomography

      We propose a three-dimensional (3-D) registration method to correct motion artifacts and construct the volume structure for angiographic and structural optical coherence tomography (OCT). This algorithm is particularly suitable for the nonorthogonal wide-field OCT scan acquired by a ultrahigh-speed swept-source system ( > 200    kHz >200  kHz A-scan rate). First, the transverse motion artifacts are corrected by the between-frame registration based on en face OCT angiography (OCTA). After A-scan transverse translation between B-frames, the axial motions are corrected based on the rebuilt boundary of inner limiting membrane. Finally, a within-frame registration is performed for local optimization based on cross-sectional OCTA. We evaluated ...

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    12. Automated detection of dilated capillaries on optical coherence tomography angiography

      Automated detection of dilated capillaries on optical coherence tomography angiography

      Automated detection and grading of angiographic high-risk features in diabetic retinopathy can potentially enhance screening and clinical care. We have previously identified capillary dilation in angiograms of the deep plexus in optical coherence tomography angiography as a feature associated with severe diabetic retinopathy. In this study, we present an automated algorithm that uses hybrid contrast to distinguish angiograms with dilated capillaries from healthy controls and then applies saliency measurement to map the extent of the dilated capillary networks. The proposed algorithm agreed well with human grading.

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    13. Visualization of 3 Distinct Retinal Plexuses by Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Visualization of 3 Distinct Retinal Plexuses by Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Importance Projection artifacts in optical coherence tomography angiography (OCTA) blur the retinal vascular plexuses together and limit visualization of the individual plexuses. Objective To describe projection-resolved (PR) OCTA in eyes with diabetic retinopathy (DR) and healthy eyes. Design, Setting, and Participants In this case-control study, patients with DR and healthy controls were enrolled in this observational study from January 26, 2015, to December 4, 2015, at a tertiary academic center. Spectral-domain, 70-kHz OCT obtained 3 × 3-mm macular scans. The PR algorithm suppressed projection artifacts. A semiautomated segmentation algorithm divided PR-OCTA into superficial, intermediate, and deep retinal plexuses. Two masked graders ...

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    14. Optical Coherence Tomography Reflective Drusen Substructures Predict Progression to Geographic Atrophy in Age-related Macular Degeneration

      Optical Coherence Tomography Reflective Drusen Substructures Predict Progression to Geographic Atrophy in Age-related Macular Degeneration

      Purpose Structural and compositional heterogeneity within drusen comprising lipids, carbohydrates, and proteins have been previously described. We sought to detect and define phenotypic patterns of drusen heterogeneity in the form of optical coherence tomography–reflective drusen substructures (ODS) and examine their associations with age-related macular degeneration (AMD)–related features and AMD progression. Design Retrospective analysis in a prospective study. Participants Patients with intermediate AMD (n = 349) enrolled in the multicenter Age-Related Eye Disease Study 2 (AREDS2) ancillary spectral-domain optical coherence tomography (SD OCT) study. Methods Baseline SD OCT scans of 1 eye per patient were analyzed for the presence of ...

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    15. Automated Quantification of Nonperfusion in Three Retinal Plexuses Using Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Automated Quantification of Nonperfusion in Three Retinal Plexuses Using Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Purpose : The purpose of this study was to evaluate an automated algorithm for detecting avascular area (AA) in optical coherence tomography angiograms (OCTAs) separated into three individual plexuses using a projection-resolved technique. Methods : A 3 × 3 mm macular OCTA was obtained in 13 healthy and 13 mild nonproliferative diabetic retinopathy (NPDR) participants. A projection-resolved algorithm segmented OCTA into three vascular plexuses: superficial, intermediate, and deep. An automated algorithm detected AA in each of the three plexuses that were segmented and in the combined inner-retinal angiograms. We assessed the diagnostic accuracy of extrafoveal and total AA using segmented and combined angiograms ...

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    16. Evaluation of artifact reduction in optical coherence tomography angiography with real-time tracking and motion correction technology

      Evaluation of artifact reduction in optical coherence tomography angiography with real-time tracking and motion correction technology

      Artifacts introduced by eye motion in optical coherence tomography angiography (OCTA) affect the interpretation of images and the quantification of parameters with clinical value. Eradication of such artifacts in OCTA remains a technical challenge. We developed an algorithm that recognizes five different types of motion artifacts and used it to evaluate the performance of three motion removal technologies. On en face maximum projection of flow images, the summed flow signal in each row and column and the correlation between neighboring rows and columns were calculated. Bright line artifacts were recognized by large summed flow signal. Drifts, distorted lines, and stretch ...

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    17. Optical Coherence Tomography Angiography

      Optical Coherence Tomography Angiography

      Optical coherence tomography angiography (OCTA) is a noninvasive approach that can visualize blood vessels down to the capillary level. With the advent of high-speed OCT and efficient algorithms, practical OCTA of ocular circulation is now available to ophthalmologists. Clinical investigations that used OCTA have increased exponentially in the past few years. This review will cover the history of OCTA and survey its most important clinical applications. The salient problems in the interpretation and analysis of OCTA are described, and recent advances are highlighted.

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    18. Projection-resolved optical coherence tomographic angiography

      Projection-resolved optical coherence tomographic angiography

      Shadowgraphic projection artifacts from superficial vasculature interfere with the visualization of deeper vascular networks in optical coherence tomography angiography (OCT-A). We developed a novel algorithm to remove this artifact by resolving the ambiguity between in situ and projected flow signals. The algorithm identifies voxels with in situ flow as those where intensity-normalized decorrelation values are higher than all shallower voxels in the same axial scan line. This “projection-resolved” (PR) algorithm effectively suppressed the projection artifact on both en face and cross-sectional angiograms and enhanced depth resolution of vascular networks. In the human macula, the enhanced angiograms show three distinct vascular ...

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    19. Automated volumetric segmentation of retinal fluid on optical coherence tomography

      Automated volumetric segmentation of retinal fluid on optical coherence tomography

      We propose a novel automated volumetric segmentation method to detect and quantify retinal fluid on optical coherence tomography (OCT). The fuzzy level set method was introduced for identifying the boundaries of fluid filled regions on B-scans (x and y-axes) and C-scans (z-axis). The boundaries identified from three types of scans were combined to generate a comprehensive volumetric segmentation of retinal fluid. Then, artefactual fluid regions were removed using morphological characteristics and by identifying vascular shadowing with OCT angiography obtained from the same scan. The accuracy of retinal fluid detection and quantification was evaluated on 10 eyes with diabetic macular edema ...

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    20. Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy

      Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. Objective To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. Design, Setting, and Participants An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 × 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7 ...

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    21. Advanced image processing for optical coherence tomographic angiography of macular diseases

      Advanced image processing for optical coherence tomographic angiography of macular diseases

      This article provides an overview of advanced image processing for three dimensional (3D) optical coherence tomographic (OCT) angiography of macular diseases, including age-related macular degeneration (AMD) and diabetic retinopathy (DR). A fast automated retinal layers segmentation algorithm using directional graph search was introduced to separates 3D flow data into different layers in the presence of pathologies. Intelligent manual correction methods are also systematically addressed which can be done rapidly on a single frame and then automatically propagated to full 3D volume with accuracy better than 1 pixel. Methods to visualize and analyze the abnormalities including retinal and choroidal neovascularization, retinal ...

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    22. DETECTION OF NONEXUDATIVE CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      DETECTION OF NONEXUDATIVE CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

      Purpose: To evaluate eyes with age-related macular degeneration and high-risk characteristics for choroidal neovascularization (CNV) with optical coherence tomographic (OCT) angiography to determine whether earlier detection of CNV is possible. Methods: Eyes with drusen, pigmentary changes, and with CNV in the fellow eye were scanned with a 70-kHz spectral domain OCT system (Optovue RTVue-XR Avanti). The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to distinguish blood flow from static tissue. Two masked graders reviewed scans for CNV, defined as flow in the outer retinal/sub-RPE slab. Choroidal neovascularization flow area repeatability and between-grader reproducibility were calculated. Results: Of 32 eyes ...

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    23. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye

      Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye

      Retinal vascular diseases are important causes of vision loss. A detailed evaluation of the vascular abnormalities facilitates diagnosis and treatment in these diseases. Optical coherence tomography (OCT) angiography using the highly efficient split-spectrum amplitude decorrelation angiography algorithm offers an alternative to conventional dye-based retinal angiography. OCT angiography has several advantages, including 3D visualization of retinal and choroidal circulations (including the choriocapillaris) and avoidance of dye injection-related complications. Results from six illustrative cases are reported. In diabetic retinopathy, OCT angiography can detect neovascularization and quantify ischemia. In age-related macular degeneration, choroidal neovascularization can be observed without the obscuration of details caused ...

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    24. Retinal and Choroidal Imaging With 870-nm Spectral-Domain OCT Compared With 1050-nm Spectral-Domain OCT, With and Without Enhanced Depth Imaging

      Retinal and Choroidal Imaging With 870-nm Spectral-Domain OCT Compared With 1050-nm Spectral-Domain OCT, With and Without Enhanced Depth Imaging

      Purpose: The purpose of this study was to compare images of the retina and choroid obtained with Spectralis 1050-nm spectral-domain optical coherence tomography (SD-OCT) with and without enhanced depth imaging (EDI) to the commercially available 870-nm SD-OCT with and without EDI. Methods: Full-length 30° line scans were obtained with both 870- and 1050-nm Spectralis OCT instruments, with and without EDI. Two trained retina physicians masked to wavelength and EDI status assessed the ability to visualize the vitreoretinal interface and full-thickness choroid, and subfoveal choroidal thickness (SFCT) was measured. Results: Included in the study were 21 eyes. The vitreoretinal interface was ...

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    25. Spatial correlation between hyperpigmentary changes on color fundus photography and hyperreflective foci on SDOCT in intermediate AMD

      Spatial correlation between hyperpigmentary changes on color fundus photography and hyperreflective foci on SDOCT in intermediate AMD

      Purpose: Macular hyperpigmentation is associated with progression from intermediate to advanced age-related macular degeneration (AMD). The purpose of this study was to accurately correlate hyperpigmentary changes with spectral domain optical coherence tomography (SDOCT) hyperreflective foci in eyes with non-advanced AMD. Methods: A prospective cross-sectional analysis of 314 eyes (314 subjects) with intermediate AMD was performed in the multicenter AREDS2 Ancillary SDOCT Study to correlate hyperpigmentary changes on color fundus photographs (CFP) with abnormal morphology on SDOCT. Spatial coregistration was performed with an automated algorithm in 2 non-overlapping subsets of 20 study eyes with double-masked CFP and SDOCT grading by certified ...

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    1-25 of 25
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    Spatial correlation between hyperpigmentary changes on color fundus photography and hyperreflective foci on SDOCT in intermediate AMD Retinal and Choroidal Imaging With 870-nm Spectral-Domain OCT Compared With 1050-nm Spectral-Domain OCT, With and Without Enhanced Depth Imaging Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye DETECTION OF NONEXUDATIVE CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY Advanced image processing for optical coherence tomographic angiography of macular diseases Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy Optical Coherence Tomography Angiography Automated Quantification of Nonperfusion in Three Retinal Plexuses Using Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy Optical Coherence Tomography Reflective Drusen Substructures Predict Progression to Geographic Atrophy in Age-related Macular Degeneration Visualization of 3 Distinct Retinal Plexuses by Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy Spectrometer calibration with reduced dispersion for optical coherence tomography High‐Aspect‐Ratio Plasmonic Heterostructures for In Vivo Enhanced Optical Coherence Tomography Imaging in the Second Near‐Infrared Biological Window