1. Articles from Steven T. Bailey

    1-23 of 23
    1. Detecting and measuring areas of choriocapillaris low perfusion in intermediate, non-neovascular age-related macular degeneration

      Detecting and measuring areas of choriocapillaris low perfusion in intermediate, non-neovascular age-related macular degeneration

      Age-related macular degeneration (AMD) is a vision-threatening disease that affects the outer retina and choroid of elderly adults. Because photoreceptors are found in the outer retina and rely primarily on the trophic support of the underlying choriocapillaris, imaging of flow or lack thereof in choriocapillaris by optical coherence tomography angiography (OCTA) has great clinical potential in AMD assessment. We introduce a metric using OCTA, named “focal perfusion loss” (FPL) to describe the effects of age and non-neovascular AMD on choriocapillaris flow. Because OCTA imaging of choriocapillaris is vulnerable to artifacts—namely motion, projections, segmentation errors, and shadows—they are removed ...

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    2. 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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    3. 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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    4. Detection of Non-exudative Choroidal Neovascularization and Progression to Exudative Choroidal Neovascularization Using Optical Coherence Tomography Angiography

      Detection of Non-exudative Choroidal Neovascularization and Progression to Exudative Choroidal Neovascularization Using Optical Coherence Tomography Angiography

      Objective To detect non-exudative choroidal neovascularization (CNV) in age-related macular degeneration with optical coherence tomography angiography (OCTA) and determine risk of developing exudative CNV compared to eyes without non-exudative CNV. Design Prospective longitudinal observational study Participants Consecutive patients with drusen and pigmentary changes in the study eye and exudative neovascular AMD in the fellow eye. Methods Study participants underwent spectral domain OCTA (AngioVue, Optovue, Inc), clinical exam, and structural OCT at baseline and six-month intervals for two years. OCTA images were exported for custom processing to remove projection artifact and calculate CNV vessel area. Main Outcome Rate of developing exudation ...

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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. Classification of Choroidal Neovascularization Using Projection-Resolved Optical Coherence Tomographic Angiography

      Classification of Choroidal Neovascularization Using Projection-Resolved Optical Coherence Tomographic Angiography

      Purpose : To evaluate if projection-resolved optical coherence tomographic angiography (PR-OCTA) reduces projection artifact with less attenuation of choroidal neovascularization (CNV) flow signal compared to conventional OCTA with slab subtraction. Methods : In this retrospective cross-sectional study, participants with subfoveal treatment-naïve CNV secondary to age-related macular degeneration underwent OCTA. Scans were exported for custom processing including manual segmentation as necessary, application of slab subtraction and PR-OCTA algorithm, and calculation of CNV vascular area and connectivity. CNV was classified as type 1, minimally type 2, or predominantly type 2 based on fluorescein angiography (FA) and OCT. Two masked retina specialists independently classified ...

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    7. 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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    8. Projection-resolved optical coherence tomography angiography exhibiting early flow prior to clinically observed retinal angiomatous proliferation

      Projection-resolved optical coherence tomography angiography exhibiting early flow prior to clinically observed retinal angiomatous proliferation

      Purpose The purpose of this study is to analyze early retinal angiomatous proliferation (RAP) utilizing a novel imaging modality, Projection-Resolved Optical Coherence Tomography Angiography (PR-OCTA). Observations Five months prior to the diagnosis of a RAP lesion, cross-sectional PR-OCTA demonstrated flow in the outer retina contiguous with the deep retinal capillary plexus (DCP) and adjacent to a small pigment epithelial detachment. After development of a clinically visible RAP lesion, cross-sectional PR-OCTA demonstrated the RAP lesion connecting DCP and sub-retinal pigment epithelial neovascularization. Conclusions & Importance This is the first report of PR-OCTA demonstrating abnormal flow in the outer retina prior to the ...

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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. Optical coherence tomography angiography of non-exudative choroidal neovascularization

      Optical coherence tomography angiography of non-exudative choroidal neovascularization

      Age-related macular degeneration (AMD) has been classified in two groups, neovascular and non-neovascular, which historically has been synonymous with exudative and non-exudative, respectively. Neovascular AMD occurs when pathologic blood vessels, choroidal neovascularization (CNV), arise from the choroid and extend above Bruch’s membrane toward the outer retina. Often these vessels are exudative in nature, resulting in leakage of fluid, lipid exudate, or blood causing vision loss. The exudation from CNV allows detection as leakage with dye based angiography and as fluid with structural optical coherence tomography (OCT). In 2013, Querques et al. used multimodel imaging to detect treatment naïve ...

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    11. Optical coherence tomographic angiography of choroidal neovascularization ill-defined with fluorescein angiography

      Optical coherence tomographic angiography of choroidal neovascularization ill-defined with fluorescein angiography

      Purpose To evaluate the morphological structure of ill-defined choroidal neovascularisation (CNV) with traditional fluorescein angiography (FA) compared with optical coherence tomographic angiography (OCTA). Methods A retrospective case series study of 11 eyes with ill-defined CNV on FA was performed. Eyes were scanned with commercially available spectral-domain optical coherence tomography (OCT) (70 000 A-scans/s). The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to distinguish blood flow from static tissue. En face OCT angiograms were compared with FA. Results Eleven cases of ill-defined CNV on FA were identified from 10 study participants. Mean age of the participants was 74.5±6 ...

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    12. 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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    13. Quantification of choroidal neovascularization vessel length using optical coherence tomography angiography

      Quantification of choroidal neovascularization vessel length using optical coherence tomography angiography

      Quantification of choroidal neovascularization (CNV) as visualized by optical coherence tomography angiography (OCTA) may have importance clinically when diagnosing or tracking disease. Here, we present an automated algorithm to quantify the vessel skeleton of CNV as vessel length. Initial segmentation of the CNV on en face angiograms was achieved using saliency-based detection and thresholding. A level set method was then used to refine vessel edges. Finally, a skeleton algorithm was applied to identify vessel centerlines. The algorithm was tested on nine OCTA scans from participants with CNV and comparisons of the algorithm’s output to manual delineation showed good agreement

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    14. 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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    15. 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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    16. 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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    17. 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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    18. 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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    19. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF DIABETIC RETINOPATHY

      OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF DIABETIC RETINOPATHY

      Purpose: To describe the optical coherence tomography angiography features of diabetic retinopathy. Methods: Using a 70 kHz optical coherence tomography and the split-spectrum amplitude decorrelation angiography algorithm, 6 mm x 6 mm 3-dimensional angiograms of the macula of 4 patients with diabetic retinopathy were obtained and compared with fluorescein angiography for features cataloged by the Early Treatment of Diabetic Retinopathy Study. Results: Optical coherence tomography angiography detected enlargement and distortion of the foveal avascular zone, retinal capillary dropout, and pruning of arteriolar branches. Areas of capillary loss obscured by fluorescein leakage on fluorescein angiography were more clearly defined on optical ...

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    20. Automated choroidal neovascularization detection algorithm for optical coherence tomography angiography

      Automated choroidal neovascularization detection algorithm for optical coherence tomography angiography

      Optical coherence tomography angiography has recently been used to visualize choroidal neovascularization (CNV) in participants with age-related macular degeneration. Identification and quantification of CNV area is important clinically for disease assessment. An automated algorithm for CNV area detection is presented in this article. It relies on denoising and a saliency detection model to overcome issues such as projection artifacts and the heterogeneity of CNV. Qualitative and quantitative evaluations were performed on scans of 7 participants. Results from the algorithm agreed well with manual delineation of CNV area.

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    21. 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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    22. 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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    23. Quantitative Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-related Macular Degeneration

      Quantitative Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-related Macular Degeneration

      Purpose To detect and quantify choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography. Design Observational, cross-sectional study. Participants A total of 5 normal subjects and 5 subjects with neovascular AMD were included. Methods A total of 5 eyes with neovascular AMD and 5 normal age-matched controls were scanned by a high-speed (100 000 A-scans/seconds) 1050-nm wavelength swept-source OCT. The macular angiography scan covered a 3×3-mm area and comprised 200×200×8 A-scans acquired in 3.5 seconds. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were ...

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    1-23 of 23
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    1. (23 articles) Oregon Health & Science University
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    Quantitative Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-related Macular Degeneration 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 Automated choroidal neovascularization detection algorithm for optical coherence tomography angiography OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF DIABETIC RETINOPATHY 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 Visualization of 3 Distinct Retinal Plexuses by Projection-Resolved Optical Coherence Tomography Angiography in Diabetic Retinopathy Optical coherence tomographic angiography of choroidal neovascularization ill-defined with fluorescein angiography Human versus Machine: Comparing a Deep Learning Algorithm to Human Gradings for Detecting Glaucoma on Fundus Photographs Absolute linear-in-k spectrometer designs enabled by freeform optics