1. Articles from Dean M. Cestari

    1-10 of 10
    1. Peripapillary Vessel Density in Relation to Optic Disc Drusen: A Multimodal Optical Coherence Tomography Study

      Peripapillary Vessel Density in Relation to Optic Disc Drusen: A Multimodal Optical Coherence Tomography Study

      Background: Optic disc drusen (ODD) are acellular calcified deposits within the optic nerve head known to cause visual field defects. An emerging gold standard for the diagnosis of ODD is enhanced depth imaging optical coherence tomography (EDI-OCT). The presence of ODD affects the adjacent peripapillary vasculature, which can be visualized using OCT angiography (OCTA). This study investigates the association between peripapillary vessel density and anatomical ODD location and volume using a newly developed method of multimodal OCT. Methods: A case–control study with 16 patients diagnosed with ODD in the period 2008–2017 and 24 healthy controls. All patients and ...

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    2. Juxtapapillary Choroidal Neovascular Membrane as a Complication of Optic Disc Drusen: Multimodal Imaging With Swept Source-Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Juxtapapillary Choroidal Neovascular Membrane as a Complication of Optic Disc Drusen: Multimodal Imaging With Swept Source-Optical Coherence Tomography and Optical Coherence Tomography Angiography

      A 55-year-old Caucasian man presented to the neuro-ophthalmology department for follow-up evaluation due to long-standing bilateral optic nerve head drusen (ONHD). On examination, the BCVA was 20/20-2 in both eyes. Dilated fundus examination revealed extensive ONHD in both eyes, retinal hemorrhages, exudates inferonasal to the macula, and macular edema inferotemporal to the disc margin. Automated visual field testing revealed generalized depression in both eyes. Late phase leakage was observed on fluorescein angiography (FA). Optical coherence tomography angiography identified a small juxtapapillary choroidal neovascular membrane inferonasal to the macula in the right eye correlating with the area of retinal hemorrhage ...

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    3. Ophthalmic manifestations of dementing disorders

      Ophthalmic manifestations of dementing disorders

      Purpose of review Dementia is a term for loss of memory, language, problem-solving, and other thinking abilities, which significantly interferes with daily life. Certain dementing conditions may also affect visual function. The eye is an accessible window to the brain that can provide valuable information for the early diagnosis of people who suffer from Alzheimer's disease, Parkinson's disease , dementia with Lewy bodies as well as from more rare causes of dementias, such as Creutzfeldt–Jacob and Huntington's diseases. Herein, we present the ocular manifestations of neurocognitive disorders focusing on the neuro-ophthalmic ones and further discuss potential ocular ...

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    4. Quantitative analysis of optical coherence tomographic angiography

      Quantitative analysis of optical coherence tomographic angiography

      Purpose Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of non-glaucomatous optic neuropathy in older adults. Optical coherence tomographic angiography (OCT-A) is an emerging, non-invasive method to study the microvasculature of the posterior pole, including the optic nerve head. The goal of this study was to assess the vascular changes in the optic nerve head and peripapillary area associated with NAION using OCT-A. Design Retrospective comparative case series. Methods We performed OCT-A in 25 eyes (7 acute and 18 non-acute) in 19 patients with NAION. Fellow, unaffected eyes were analyzed for comparison. Patent macro- and microvascular densities ...

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    5. Neuroimaging diagnostic and monitoring approaches in ophthalmology

      Neuroimaging diagnostic and monitoring approaches in ophthalmology

      Purpose of review We review new applications of optical coherence tomography (OCT) technology in neuro-ophthalmology. We also describe new technologies for visualizing the extracranial vessels in the diagnosis of giant cell arteritis (GCA). Recent findings Newer OCT modalities are expanding the evaluation of the optic disc, and are being applied to a number of neurologic conditions such as demyelinating and neurodegenerative disease. Swept-source OCT and enhanced-depth imaging OCT are refining the fine-grained analysis of the optic nerve head in the diagnosis of papilledema and optic nerve drusen. OCT-angiography is opening up new avenues to the study of the vasculature of ...

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    6. Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis

      Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis

      Aims We set out to determine the optical coherence tomographic angiography (OCT-A) characteristics of arteritic anterior ischaemic optic neuropathy (AAION) in the context of giant cell arteritis (GCA). Methods This is an observational case series of four patients with AAION secondary to GCA, three with unilateral AAION and one with bilateral AAION. We reviewed the charts, fundus photography, visual fields, fluorescein angiography (FA) and OCT-A images for all patients to identify a unifying theme in a range of AAION clinical severity. Imaging of two healthy control eyes from two patients of similar age to the patients in our series were ...

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    7. Congenital anomalies of the optic disc: insights from optical coherence tomography imaging

      Congenital anomalies of the optic disc: insights from optical coherence tomography imaging

      Purpose of review Congenital anomalies of the optic nerve are rare but significant causes of visual dysfunction in children and adults. Accurate diagnosis is dependent on a thorough funduscopic examination, but can be enhanced by imaging information garnered from optical coherence tomography (OCT). We review common congenital optic nerve anomalies, including optic disc pit, optic nerve coloboma, morning glory disc anomaly, and hypoplasia of the optic nerve, review their systemic associations, and discuss insights from OCT imaging. Recent findings Optic disc pits are a result of a defect in the lamina cribrosa and abnormal vitreomacular adhesions have been shown to ...

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    8. Focal Capillary Dropout Associated With Optic Disc Drusen Using Optical Coherence Tomographic Angiography

      Focal Capillary Dropout Associated With Optic Disc Drusen Using Optical Coherence Tomographic Angiography

      Optic disc drusen may be a cause of visual field defects and visual loss. The mechanism by which this occurs is unclear. We report a patient who developed decreased vision in the right eye and was found to have a heavy burden of superficial optic disc drusen. Optical coherence tomography (OCT) confirmed focal retinal nerve fiber layer thinning that corresponded with the distribution of drusen. OCT angiography, with superficial laminar segmentation, showed focal capillary attenuation overlying the most prominent drusen. These findings demonstrate alterations in the superficial retinal capillary network associated with optic disc drusen.

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    9. Peripapillary Capillary Dilation in Leber Hereditary Optic Neuropathy Revealed by Optical Coherence Tomographic Angiography

      Peripapillary Capillary Dilation in Leber Hereditary Optic Neuropathy Revealed by Optical Coherence Tomographic Angiography

      Leber hereditary optic neuropathy (LHON) is caused by mitochondrial mutations that lead to sequential, subacute vision loss with incomplete penetrance and variable expressivity. 1 The most common mutations involve complex I subunits of the electron transport chain causing an energy production-demand mismatch that preferentially affects retina ganglion cells. The fundus can show only subtle vascular changes or appear normal, posing a diagnostic challenge in the acute phase of the disease.

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    10. The Use of Fourth-generation Optical Coherence Tomography in Multiple Sclerosis: A Review

      The Use of Fourth-generation Optical Coherence Tomography in Multiple Sclerosis: A Review

      Optical coherence tomography (OCT) has been routinely used to obtain high spatial resolution images of the retina and choroid non-invasively. Within the past decade, a fourth-generation OCT device using Fourier domain (FD) analysis has been developed that provides higher velocity and higher axial resolution images with better reproducibility than the previous generation time domain (TD) OCT technology. This review addresses the use of fourth-generation, FD ocular OCT in patients with multiple sclerosis.

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    1-10 of 10
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    The Use of Fourth-generation Optical Coherence Tomography in Multiple Sclerosis: A Review Peripapillary Capillary Dilation in Leber Hereditary Optic Neuropathy Revealed by Optical Coherence Tomographic Angiography Focal Capillary Dropout Associated With Optic Disc Drusen Using Optical Coherence Tomographic Angiography Congenital anomalies of the optic disc: insights from optical coherence tomography imaging Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis Neuroimaging diagnostic and monitoring approaches in ophthalmology Quantitative analysis of optical coherence tomographic angiography Ophthalmic manifestations of dementing disorders Juxtapapillary Choroidal Neovascular Membrane as a Complication of Optic Disc Drusen: Multimodal Imaging With Swept Source-Optical Coherence Tomography and Optical Coherence Tomography Angiography Peripapillary Vessel Density in Relation to Optic Disc Drusen: A Multimodal Optical Coherence Tomography Study Asynchronous feature regularization and cross-modal distillation for OCT based glaucoma diagnosis Developments and Clinical Applications of Noninvasive Optical Technologies for Skin Cancer Diagnosis