1. Articles from Sharon F. Freedman

    1-24 of 33 1 2 »
    1. Overhead Mounted Optical Coherence Tomography in Childhood Glaucoma Evaluation

      Overhead Mounted Optical Coherence Tomography in Childhood Glaucoma Evaluation

      Précis: Overhead mounted spectral-domain optical coherence tomography enables high quality imaging of the optic nerve and macula in childhood glaucoma and is particularly useful when standard tabletop optical coherence tomography has failed or is not possible. Purpose: Tabletop optical coherence tomography, integral to adult glaucoma management, can be limited in childhood glaucoma patients due to young age, poor cooperation, and/or technical challenges. To address these imaging difficulties, we determined the feasibility and quality of an overhead mounted unit in childhood glaucoma . Secondary aims included evaluation of peripapillary retinal nerve fiber layer, parafoveal total retinal thickness, and parafoveal ganglion ...

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    2. Reversal of Cupping in an Infant, Shown by Optical Coherence Tomography

      Reversal of Cupping in an Infant, Shown by Optical Coherence Tomography

      A 10-month-old white male infant with primary congenital glaucoma underwent successful goniotomy in the right eye, lowering intraocular pressure from 34 mm Hg to 11 mm Hg and decreasing axial length from 23.4 mm to 22.8 mm. We used optical coherence tomography (HRA+OCT Spectralis with Flex module [Heidelberg Engineering]) to image the optic nerve preoperatively and at 1 month postoperatively. The cup-disc ratio decreased from 0.6 to 0.4. The reversal of cupping was associated with decreased cup depth and an anterior shift of the Bruch membrane on optical coherence tomography ( Figure ). Notably, the preoperative and ...

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    3. Longitudinal reproducibility of spectral domain optical coherence tomography in children with physiologic cupping and stable glaucoma

      Longitudinal reproducibility of spectral domain optical coherence tomography in children with physiologic cupping and stable glaucoma

      Purpose To determine whether Spectralis (Heidelberg, Germany) spectral domain optical coherence tomography (SD-OCT) measurements are reproducible over time in children with physiologic cupping and stable glaucoma. Methods Subjects were identified from a subset of participants in an earlier retrospective study conducted by our group and included children (<18 years of age) with physiologic cupping and stable primary congenital glaucoma (PCG) having had at least 2 SD-OCTs over a period of more than 1 between April 2010 and September 2015. Thicknesses of average peripapillary retinal nerve fiber layer (pRNFL) and six individual sectors and volumes of three segmented retinal layers and ...

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    4. Optical Coherence Tomography normative peripapillary retinal nerve fiber layer and macular data in children ages 0-5 years

      Optical Coherence Tomography normative peripapillary retinal nerve fiber layer and macular data in children ages 0-5 years

      Purpose To determine reference values for the peripapillary retinal nerve fiber layer (pRNFL) and macula in children ages 0-5 years. Design Prospective cross-sectional study Setting Single large academic pediatric ophthalmology practice Study Population Healthy, full-term children ages 0 to <6 years presenting for surgery under general anesthesia were prospectively recruited for participation. Excluded were children with systemic neurologic disease, optic nerve or retinal disease (even if unilateral), or any bilateral ocular disease process, and eyes with amblyopia, ocular disease, or spherical equivalent refractive error outside of -3.00 to +8.00 diopters. Observation Procedure Following general anesthesia, OCT scans of ...

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    5. Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children <5 Years

      Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children <5 Years

      Purpose Measurements of the ganglion cell complex (GCC), comprising the retinal nerve fiber (RNFL), ganglion cell, and inner plexiform layers, can be correlated with vision loss caused by optic nerve disease. Handheld optical coherence tomography (HH-OCT) can be used with sedation in children not amenable to traditional imaging. Purpose: to report GCC and RNFL measurements in normal children using HH-OCT. Design Prospective observational study of normal children ≤ 5-years of age. Methods Healthy, full-term children ≤5 years-old undergoing sedation or anesthesia were enrolled. Exclusion criteria: prematurity, pre-existing neurologic, genetic, metabolic or intraocular pathology. Demographic data, axial length (Master-Vu Sonomed Escalon, NY ...

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    6. Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children

      Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children

      Purpose Measurements of the ganglion cell complex (GCC), comprising the retinal nerve fiber (RNFL), ganglion cell, and inner plexiform layers, can be correlated with vision loss caused by optic nerve disease. Handheld optical coherence tomography (HH-OCT) can be used with sedation in children not amenable to traditional imaging. Purpose: to report GCC and RNFL measurements in normal children using HH-OCT. Design Prospective observational study of normal children ≤ 5-years of age. Methods Healthy, full-term children ≤5 years-old undergoing sedation or anesthesia were enrolled. Exclusion criteria: prematurity, pre-existing neurologic, genetic, metabolic or intraocular pathology. Demographic data, axial length (Master-Vu Sonomed Escalon, NY ...

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    7. Imaging infant retinal vasculature with optical coherence tomography angiography

      Imaging infant retinal vasculature with optical coherence tomography angiography

      Study of infant retinal vascular development has been limited to histopathological reports. We report herein depth-resolved visualization of full-term infant parafoveal microvasculature and their similarity to that of young children using a portable optical coherence tomography angiography system.

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    8. Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery

      Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery

      The authors report the use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT), capable of live four-dimensional (three-dimensional across time) intraoperative imaging, to directly visualize suture depth during lateral rectus resection. Key surgical steps visualized in this report included needle depth during partial and full-thickness muscle passes along with scleral passes.

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    9. Use of Optical Coherence Tomography in the Eyes of Children

      Use of Optical Coherence Tomography in the Eyes of Children

      OCT has found its niche within virtually all ophthalmic subspecialties, be it glaucoma, retina/vitreous, or anterior segment. OCT’s role in the diagnosis, management, and treatment of pediatric eye disease continues to evolve. Monumental gains have been made in our understanding of various physiologic principles and pathological processes as a result of this relatively new technology. While not intended to be an exhaustive catalogue of the opportunities afforded by OCT, this chapter should provide the well-rounded pediatric ophthalmologist with the appropriate framework to better appreciate this new technology and its role in pediatric eye disease.

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    10. Optical coherence tomography macular segmentation as predictor for optic atrophy in children with acute papilledema

      Optical coherence tomography macular segmentation as predictor for optic atrophy in children with acute papilledema

      New Spectralis (Heidelberg, Germany) segmentation software allows automatic quantitation of the thickness of each macular layer. We evaluated the role of Spectralis spectral domain optical coherence tomography (SD-OCT) segmentation in children during acute papilledema to predict the subsequent development of optic atrophy.

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    11. Evaluation of Optic Nerve Development in Preterm and Term Infants Using Handheld Spectral-Domain Optical Coherence Tomography

      Evaluation of Optic Nerve Development in Preterm and Term Infants Using Handheld Spectral-Domain Optical Coherence Tomography

      Purpose To evaluate effects of prematurity on early optic nerve (ON) development and the usefulness of ON parameters as indicators of central nervous system (CNS) development and pathology. Design Prospective, cross-sectional, longitudinal study. Participants Forty-four preterm infants undergoing retinopathy of prematurity (ROP) screening and 52 term infants. Methods We analyzed ON from portable handheld spectral-domain optical coherence tomography (SD-OCT) images (Bioptigen, Inc, Research Triangle Park, NC) of 44 preterm and 52 term infants. The highest-quality ON scan from either eye was selected for quantitative analysis. Longitudinal analysis was performed at 31–36 weeks and 37–42 weeks postmenstrual age (PMA ...

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    12. Racial variation in optic nerve head parameters quantified in healthy newborns by handheld spectral domain optical coherence tomography

      Racial variation in optic nerve head parameters quantified in healthy newborns by handheld spectral domain optical coherence tomography

      Purpose To characterize optic nerve head (ONH) morphology and parameters, including vertical disk diameter, vertical cup diameter, and vertical cup/disk ratio in healthy, full-term newborns using a handheld spectral domain optical coherence tomography (SD-OCT) device. Methods In this prospective observational case series, healthy white, black, and Hispanic full-term newborns delivered at the Duke Birthing Center between August 2010 and May 2011 underwent dilated fundus examination and SD-OCT imaging of the optic nerve in each eye. OCT parameters were calculated and compared for each group of infants. Results A total of 58 consecutive newborns of white (n = 22), black (n ...

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    13. Macular Findings in Healthy Full-term Hispanic Newborns Observed by Hand-held Spectral-Domain Optical Coherence Tomography

      Macular Findings in Healthy Full-term Hispanic Newborns Observed by Hand-held Spectral-Domain Optical Coherence Tomography

      BACKGROUND AND OBJECTIVE: To enhance understanding of ethnically diverse normal newborn retinal morphology, the authors report spectral-domain optical coherence tomography (SD-OCT) macular findings in healthy Hispanic newborns. PATIENTS AND METHODS: In this IRB-approved prospective, observational case series, 20 full-term Hispanic newborns had dilated retinal examinations and imaging by hand-held SD-OCT without sedation at the Duke Birthing Center. RESULTS: Of 20 newborns imaged (35% male; median gestational age: 39 weeks; range: 36 to 40 weeks), two (10%) had bilateral subfoveal fluid, including one case of bilateral double subretinal fluid pockets. Three eyes of two infants (10%) had retinal macular cystoid structures ...

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    14. Reproducibility of Spectral-Domain Optical Coherence Tomography Measurements in Adult and Pediatric Glaucoma

      Reproducibility of Spectral-Domain Optical Coherence Tomography Measurements in Adult and Pediatric Glaucoma

      Purpose: To determine the reproducibility of spectral-domain optical coherence tomography (OCT) measurements of peripapillary retinal nerve fiber layer (RNFL) and macular retinal thickness of the central 20-degree area of the posterior pole in adult and pediatric glaucoma and normal subjects. Methods: Normal, glaucoma suspect and glaucoma eyes of adult and pediatric subjects were recruited. Spectralis OCT scans were obtained 3 times on the same day (intravisit) and 4 weeks later (intervisit). Six individual sectors, average RNFL, and macular retinal thickness using an 8x8 mm grid centered on the foveal pit were measured for all the eyes. The central 16 square ...

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    15. Choroid Development and Feasibility of Choroidal Imaging in the Preterm and Term Infants Utilizing SDOCT

      Choroid Development and Feasibility of Choroidal Imaging in the Preterm and Term Infants Utilizing SDOCT

      Purpose: To determine whether choroidal imaging is feasible in preterm and term infants using an 840-nm portable spectral domain optical coherence tomography (SDOCT) system without the use of enhanced- depth imaging techniques and to assess choroidal development by comparing choroidal thickness of preterm infants, term infants, and adults. Methods: SDOCT images were obtained from 86 preterm infants, 59 term infants and 9 adults using a portable SDOCT (Bioptigen, Inc., NC, USA) system plus 9 adults using a tabletop system. An unprocessed image across the macula from one randomly selected eye of each participant was selected for determination of whether the ...

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    16. Optical coherence tomography in paediatric glaucoma: time domain versus spectral domain

      Optical coherence tomography in paediatric glaucoma: time domain versus spectral domain

      Background/aims Spectral-domain (SD)- Optical Coherence Tomography (OCT) can track eye movements, has faster acquisition time and higher resolution than time-domain(TD)-OCT. The aim of the study was to assess the utility of SD-OCT in paediatric glaucoma and determine its agreement with TD-OCT. Methods Children who had SD-OCT(Spectralis, Heidelberg-Engineering,Germany) were retrospectively and prospectively identified from Duke paediatric glaucoma clinic. The peripapillary retinal nerve fibre layer (RNFL) and macular thickness and volume (MV) were compared amongst four groups: normal eyes, eyes with physiologic cupping (C:D >0.5 and <0.8, IOP <21), mild glaucomatous eyes (C:D ...

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    17. Analysis of plus disease using handheld spectral-domain optical coherence tomography in nonsedated neonates

      Analysis of plus disease using handheld spectral-domain optical coherence tomography in nonsedated neonates

      Spectral Domain Optical Coherence Tomography (SDOCT) has only recently been explored in neonates with retinopathy of prematurity (ROP). Vessel architecture has not been studied. This study provides an SDOCT analysis of vascular features in plus disease in nonsedated neonates.

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    18. Spectral-Domain Optical Coherence Tomographic Assessment of Severity of Cystoid Macular Edema in Retinopathy of Prematurity

      Spectral-Domain Optical Coherence Tomographic Assessment of Severity of Cystoid Macular Edema in Retinopathy of Prematurity

      Objective  To investigate whether the severity of cystoid macular edema (CME) in neonates who were 31 to 36 weeks' postmenstrual age, as viewed by spectral-domain optical coherence tomography (SD-OCT) imaging, predicts the severity of retinopathy of prematurity (ROP) or is related to systemic health. Design  Of 62 prematurely born neonates in a prospective institutional review board–approved study, 42 met the following inclusion criteria: at least 1 SD-OCT imaging session prior to 37 weeks' postmenstrual age and prior to ROP laser treatment, if a laser treatment was performed, and an ophthalmic ROP examination at or after 41 weeks' postmenstrual age ...

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    19. Dynamics of Human Foveal Development after Premature Birth

      Dynamics of Human Foveal Development after Premature Birth
      Purpose: To determine the dynamic morphologic development of the human fovea in vivo using portable spectral domain-optical coherence tomography (SD-OCT).Design: Prospective, observational case series.Paticipants: Thirty-one prematurely born neonates, 9 children, and 9 adults.Methods: Sixty-two neonates were enrolled in this study. After examination for retinopathy of prematurity (ROP), SD-OCT imaging was performed at the bedside in nonsedated infants aged 31 to 41 weeks postmenstrual age (PMA) (= gestational age in weeks + chronologic age) and at outpatient follow-up ophthalmic examinations. Thirty-one neonates met eligibility criteria. Nine children and nine adults without ocular pathology served as control groups. Semiautomatic retinal layer ...
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    20. Subfoveal Fluid in Healthy Full-term Newborns Observed by Handheld Spectral-Domain Optical Coherence Tomography

      Subfoveal Fluid in Healthy Full-term Newborns Observed by Handheld Spectral-Domain Optical Coherence Tomography
      Purpose: To report retinal findings for healthy newborn infants imaged with handheld spectral-domain optical coherence tomography (SD OCT). Design: Prospective, observational case series. Methods: Thirty-nine full-term newborn infants underwent dilated retinal examinations by indirect ophthalmoscopy and retinal imaging by handheld SD OCT, without sedation, at the Duke Birthing Center. Results: Of the 39 infants imaged, 44% (17/39) were male. Race and ethnicity composition was 56% white, 38% black, 3% Asian, and 3% Hispanic. Median gestational age was 39 weeks (range, 36 to 41 weeks). Six (15%) of the 39 infants had bilateral subfoveal fluid on SD OCT not seen ...
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    21. Macular Features From Spectral-Domain Optical Coherence Tomography As An Adjunct To Indirect Ophthalmoscopy in Retinopathy of Prematurity

      Macular Features From Spectral-Domain Optical Coherence Tomography As An Adjunct To Indirect Ophthalmoscopy in Retinopathy of Prematurity
      Purpose: To compare vitreoretinal pathology imaged with portable handheld spectral-domain optical coherence tomography (SD-OCT) to conventional indirect ophthalmoscopic examination in neonates undergoing screening for retinopathy of prematurity. Methods: Spectral-domain optical coherence tomography images were collected from 76 eyes of 38 neonates during 118 routine retinopathy of prematurity examinations. Imaging sessions in the Neonatal Intensive Care Unit were performed immediately after the subjects underwent a standard ophthalmic examination with indirect ophthalmoscopic by a pediatric ophthalmologist. Masked certified SD-OCT graders evaluated scans for preretinal and retinal findings including material in the vitreous, epiretinal membrane, intraretinal cystoid structures and deposits, optic nerve and ...
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    22. Optical coherence tomography (OCT) measurements in black and white children with large cup-to-disc ratios

      Optical coherence tomography (OCT) measurements in black and white children with large cup-to-disc ratios
      Children with large optic nerve head cups often pose diagnostic difficulty due to concern over possible glaucoma. This study's purpose was to evaluate optical coherence tomography (OCT) measurement of the peripapillary retinal nerve fiber layer (RNFL) and macular thickness in healthy eyes of black and white children, comparing values for eyes with large cup-to-disc ratios against those with small cup-to-disc ratios (normal controls). Using Stratus OCT (OCT 3) (Carl Zeiss Meditec, Dublin, CA) a fast macular thickness and fast RNFL 3.4 protocol were performed on normal eyes of normal children. Included were children (aged 5-17 years) with normal ...
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    23. Differentiating Glaucomatous from Non-Glaucomatous Optic Nerve Cupping by Optical Coherence Tomography

      Differentiating Glaucomatous from Non-Glaucomatous Optic Nerve Cupping by Optical Coherence Tomography
      Abstract: Background: In clinical practice, the differentiation of glaucomatous from non-glaucomatous cupping can be difficult, even for experienced observers. The purpose of this study was to evaluate the role of optical coherence tomography (OCT) in differentiating glaucomatous from non-glaucomatous optic nerve cupping in a cross-sectional pilot study. Methods: Eleven consecutive patients presenting to the Duke Eye Center from September 2007 to July 2008 with nonglaucomatous optic nerve cupping and 12 patients with glaucomatous optic nerve cupping were identified. All patients underwent Stratus® OCT imaging: fast macular map, fast retinal nerve fiber layer (RNFL) 3.4 thickness, and fast optic disc ...
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    1-24 of 33 1 2 »
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