Methods of applying OCT angiography are disclosed. In particular, methods of detecting, visualizing and measuring the extent of retinal neovascularization are disclosed. Further disclosed are methods measuring retinal nonperfusion area and choriocapillaris defect area.
Optical coherence tomographic angiography (OCTA) is a novel technology capable of imaging retinal vasculature three-dimensionally at capillary scale without the need to inject any extrinsic dye contrast. However, projection artifacts cause superficial retinal vascular patterns to be duplicated in deeper layers, thus interfering with the clean visualization of some retinal plexuses and vascular pathologies. Projection-resolved OCTA (PR-OCTA) uses post-processing algorithms to reduce projection artifacts. With PR-OCTA, it is now possible to resolve up to 4 distinct retinal vascular plexuses in the living human eye. The technology also allows us to detect and distinguish between various retinal and optic nerve diseases ...
Objective To detect the plexus-specific retinal capillary avascular area in exudative age-related macular degeneration (EAMD) with projection-resolved optical coherence tomography angiography (PR-OCTA). Methods and analysis In this prospective cross-sectional single centre study, eyes with treatment-naïve EAMD underwent macular 3×3 mm OCTA with AngioVue system. OCTA scans were analysed and processed including three-dimensional projection artefact removal, retinal layer semi-automated segmentation and en face angiogram generation. Automated quantification of extrafoveal (excluding the central 1 mm circle) avascular area (EAA) were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), respectively. Results Nineteen eyes ...
Two postdoctoral research fellowship/research associate positions are immediately available in the Center for Ophthalmic Optics and Lasers www.COOLLab.net, Casey Eye Institute, Oregon Health & Science University. The fellowship will focus on interdisciplinary project in the field of optical imaging and image processing. Ph.D. in Optics, Biomedical Engineering, Electrical Engineering, Computing Science or a related field is required. Demonstrated excellence in one or more of the following areas is preferred: expertise in Optical Coherence Tomography, Scanning Laser Ophthalmoscope and Adaptive Optics, optical/electrical system design, prototyping and simulation, data acquisition and system control/synchronization, and C++/GPU programming ...
Purpose: To detect keratoconus using optical coherence tomography (OCT) corneal map parameters and patterns. Setting: Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA DESIGN:: Cross-sectional observational study. Methods: A spectral-domain OCT was used to acquire corneal and epithelial thickness maps in normal, manifest keratoconic, subclinical keratoconic, and forme fruste keratoconic (FFK) eyes. A two-step decision tree was designed. An eye will be classified as keratoconus if both decision tree conditions are met: First, at least one of the four quantitative corneal thickness (minimum, minimum-maximum, superonasal-inferotemporal) and epithelial thickness (standard deviation) map parameters exceed cutoff values. Second, presence of ...
PURPOSE: To develop a coincident thinning (CTN) index to differentiate between keratoconic and healthy corneas using optical coherence tomography (OCT) measurements of pachymetry and epithelial thickness. METHODS: Pattern deviation maps of pachymetry and epithelial thickness were generated using Fourier-domain OCT images of the cornea. The co-localized thinning of the two maps was quantified using a novel CTN index, which was calculated from Gaussian fits of the regions of maximum relative thinning. The CTN index was validated using k-fold cross-validation, and its classification performance was compared to minimum pachymetry and maximum keratometry. RESULTS: A total of 82 normal eyes and 133 ...
Amplitude decorrelation measurement is sensitive to transverse flow and immune to phase noise in comparison to Doppler and other phase-based approaches. However, the high axial resolution of OCT makes it very sensitive to the pulsatile bulk motion noise in the axial direction. To overcome this limitation, we developed split-spectrum amplitude-decorrelation angiography (SSADA) to improve the signal-to-noise ratio (SNR) of flow detection. The full OCT spectrum was split into several narrower bands. Inter-B-scan decorrelation was computed using the spectral bands separately and then averaged. The SSADA algorithm was tested on in vivo images of the human macula and optic nerve head ...
Optical coherence tomographic angiography (OCTA) can image the retinal blood flow but visualization of the capillary caliber is limited by the low lateral resolution. Adaptive optics (AO) can be used to compensate ocular aberrations when using high numerical aperture (NA), and thus improve image resolution. However, previously reported AO-OCTA instruments were large and complex, and have a small sub-millimeter field of view (FOV) that hinders the extraction of biomarkers with clinical relevance. In this manuscript, we developed a sensorless AO-OCTA prototype with an intermediate numerical aperture to produce depth-resolved angiograms with high resolution and signal-to-noise ratio over a 2 × 2 ...
Sensorless adaptive optics optical coherence tomography (AO-OCT) is a technology to image retinal tissue with high resolution by compensating ocular aberrations without wavefront sensors. In this Letter, a fast and robust hill-climbing algorithm is developed to optimize five Zernike modes in AO-OCT with a numerical aperture between that of conventional AO and commercial OCT systems. The merit function is generated in real time using graphics processing unit while axially tracking the retinal layer of interest. A new method is proposed to estimate the largest achievable field of view for which aberrations are corrected uniformly in sensorless AO-OCT.
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 ...
Described herein is an algorithm to remove decorrelation noise due to bulk motion in optical coherence tomography angiography (OCTA). OCTA B-frames are divided into segments within which the bulk motion velocity could be assumed constant. This velocity is recovered using linear regression of decorrelation versus the logarithm of reflectance in axial lines (A-lines) identified as bulk tissue by percentile analysis. The fitting parameters are used to calculate a reflectance-adjusted threshold for bulk motion decorrelation. Below this threshold, voxels are identified as non-flow tissue, and their flow values are set to zeros. Above this threshold, the voxels are identified as flow ...
Purpose: To map and measure the depths of corneal neovascularization (NV) using 3-dimensional optical coherence tomography angiography (OCTA) at 2 different wavelengths. Methods: Corneal NV of varying severity, distribution, and underlying etiology was examined. Average NV depth and vessel density were measured using 840-nm spectral-domain OCTA and 1050-nm swept-source OCTA. The OCTA results were compared with clinical slit-lamp estimation of NV depth. Results: Twelve eyes with corneal NV from 12 patients were imaged with OCTA. Clinically “superficial,” “midstromal,” and “deep” cases had an average vessel depth of 23%, 39%, and 66% on 1050-nm OCTA, respectively. Average vessel depth on OCTA ...
To construct an optical coherence tomography (OCT) nerve fiber layer (NFL) parameter that has maximal correlation and agreement with visual field (VF) mean deviation (MD). The NFL_MD parameter in dB scale was calculated from the peripapillary NFL thickness profile nonlinear transformation and VF area-weighted averaging. From the Advanced Imaging for Glaucoma study, 245 normal, 420 pre-perimetric glaucoma (PPG), and 289 perimetric glaucoma (PG) eyes were selected. NFL_MD had significantly higher correlation (Pearson R: 0.68 vs 0.55, p < 0.001) with VF_MD than the overall NFL thickness. NFL_MD also had significantly higher sensitivity in detecting PPG (0.14 vs ...
Purpose To simulate 24-2 visual field (VF) using optical coherence tomographic angiography (OCTA) for glaucoma evaluation. Design Cross-sectional study. Methods One eye each of 39 glaucoma and 31 age-matched normal participants was scanned using 4.5-mm OCTA scans centered on the disc. The peripapillary retinal nerve fiber layer plexus capillary density (NFLP_CD, %area) was measured. The NFLP_CD and 24-2 VF maps were divided into 8 corresponding sectors using an extension of Garway-Heath scheme. Results Sector NFLP_CD was transformed to a logarithmic dB scale and converted to sector simulated VF deviation maps. Comparing simulated and actual 24-2 VF maps, the worst ...
Purpose To measure low perfusion areas (LPA) and focal perfusion loss (FPL) in the peripapillary retina using optical coherence tomographic angiography (OCTA) in glaucoma. Design Prospective observation study. Participants Forty-seven primary open angle glaucoma (POAG) patients and 36 normal subjects were analyzed. Methods One eye of each subject was scanned using AngioVue 4.5-mm OCTA scan centered on the disc. En face nerve fiber layer plexus angiogram was generated. Using custom software, capillary density map was obtained by computing the fraction of area occupied by flow pixels within each superpixel containing 21×21-pixels. The low-perfusion map is defined by local ...
Dear Colleagues: As you know, the International Congress on OCT Angiography, En Face OCT and Advances in OCT that Professor Bruno Lumbroso initiated few years ago will be in its 7th Year this December 2019 in Rome. Certainly, this global Congress has become one of the most successful, most-attended, and most educational meetings in the field of retinal imaging. Every December during the past six years, more than 1,000 of us have enjoyed spending few days in Rome learning the latest advances in retinal imaging, from OCT to OCTA to adaptive optics to microperimetry, among others, and meeting new ...
Disclosed are methods and systems for measuring areas of nonperfusion in the retina using OCT imaging. The disclosed methods and systems allow for the automated segmentation and quantification of avascular areas of the retina utilizing information obtained from both structural OCT and OCT angiography (OCTA) data. The disclosed methods include filtering approaches which enhance vessel structure while suppressing noise, dynamic thresholding approaches to mitigate the detrimental effects of within-scan variability and low scan quality, and distance transform-based approaches to improve detection of ischemic regions. When combined with methods such as projection-resolved OCTA, the sensitivity to detect nonperfusion within different plexuses ...
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 ...
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 ...
Quantitative analysis of the peripapillary retinal layers and capillary plexuses from optical coherence tomography (OCT) and OCT angiography images depend on two segmentation tasks – delineating the boundary of the optic disc and delineating the boundaries between retinal layers. Here, we present a method combining a neural network and graph search to perform these two tasks. A comparison of this novel method’s segmentation of the disc boundary showed good agreement with the ground truth, achieving an overall Dice similarity coefficient of 0.91 ± 0.04 in healthy and glaucomatous eyes. The absolute error of retinal layer boundaries segmentation in the ...
Elevated intraocular pressure (IOP) is an important risk factor for glaucoma. However, the role of IOP in glaucoma progression, as well as retinal physiology in general, remains incompletely understood. We demonstrate the use of visible light optical coherence tomography to measure retinal responses to acute IOP elevation in Brown Norway rats. We monitored retinal responses in reflectivity, angiography, blood flow, oxygen saturation (sO2 ), and oxygen metabolism over a range of IOP from 10 to 100 mmHg. As IOP was elevated, nerve fiber layer reflectivity was found to decrease. Vascular perfusion in the three retinal capillary plexuses remained steady until IOP ...
The International Ocular Circulation Society (IOCS) was co-founded by a group of leading researchers in America, Asia, and Europe in 2018. The inaugural meeting of the new Society will be hosted by David Huang, M.D. and Yali Jia, Ph.D. of the Casey Eye Institute in Portland Oregon on August 10, 2019. The meeting will present 28 papers and 35 posters on technologies on the topics of imaging and measurement of ocular blood flow and oxygen metabolism, vascular anatomy and physiology, and the roles of ocular circulation in retina, optic nerve, neurological, and systemic diseases. The Oregon Health & Science ...
To detect plexus-specific peripapillary retinal perfusion defects in glaucoma using projection-resolved optical coherence tomography angiography (PR-OCTA).
Purpose This study measured and correlated degeneration of the junction between the inner and outer segments (IS/OS), the retinal pigment epithelium (RPE), and the choriocapillaris (CC) in Stargardt disease (STGD). Design Prospective cross-sectional study. Methods This study was conducted at the Casey Eye Institute. A total of 23 patients with STGD were enrolled and underwent optical coherence tomography angiography (OCTA). Scans were centered on the fovea. OCT slab projections and en face boundary maps were used to create masks to measure total IS/OS loss or RPE atrophy as well as regions of isolated IS/OS loss, isolated RPE ...
