1. Articles in category: Ophthalmology

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    1. Ophthalmic imaging

      Ophthalmic imaging

      Introduction or background The last two decades have seen a revolution in ophthalmic imaging. In this review we present an overview of the breadth of ophthalmic imaging modalities in use today and describe how the role of ophthalmic imaging has changed from documenting abnormalities visible on clinical examination to the detection of clinically silent abnormalities which can lead to an earlier and more precise diagnosis. Sources of data This review is based on published literature in the fields of ophthalmic imaging and with focus on most commonly used imaging modalities. Areas of agreement New imaging techniques enable non-invasive evaluation of ...

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    2. Dual-Angle Protocol for Doppler Optical Coherence Tomography to Improve Retinal Blood Flow Measurement

      Dual-Angle Protocol for Doppler Optical Coherence Tomography to Improve Retinal Blood Flow Measurement

      Purpose: To compare the performance of two different multiple-scan protocols for total retinal blood flow (TRBF) measurement using Doppler optical coherence tomography (OCT). Methods: In the “single-angle” protocol, five Doppler scans were acquired at a single beam angle. In the “dual-angle” protocol, three scans were obtained with the OCT beam passing through the supranasal portion of the pupil and three through the infranasal portion. The data were analyzed using a custom software termed “Doppler OCT of Retinal Circulation” (DOCTORC) to generate TRBF measurements. In DOCTORC, the measurement of a vein was considered unreliable if the Doppler angle was less than ...

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    3. Trabecular-Iris Circumference Volume in Open Angle Eyes Using Swept-Source Fourier Domain Anterior Segment Optical Coherence Tomography

      Trabecular-Iris Circumference Volume in Open Angle Eyes Using Swept-Source Fourier Domain Anterior Segment Optical Coherence Tomography

      Purpose . To introduce a new anterior segment optical coherence tomography parameter, trabecular-iris circumference volume (TICV), which measures the integrated volume of the peripheral angle, and establish a reference range in normal, open angle eyes. Methods . One eye of each participant with open angles and a normal anterior segment was imaged using 3D mode by the CASIA SS-1000 (Tomey, Nagoya, Japan). Trabecular-iris space area (TISA) and TICV at 500 and 750  µ m were calculated. Analysis of covariance was performed to examine the effect of age and its interaction with spherical equivalent. Results . The study included 100 participants with a mean age ...

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    4. The Latest on Optical Coherence Tomography

      The Latest on Optical Coherence Tomography

      Beginning almost 25 years ago, optical coherence tomography (OCT) began its journey into the mainstream of ophthalmology.  Initially developed for retinal an vitro-retinal interface disease and glaucoma, this revolutionary technology has proven to ultimately have broader applications in neuro-ophthalmology and neurology, 2 specialties in which a better understating of OCT has led to more widespread investigation and clinical use.

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    5. Clinical trials to clinical use: using vision as a model for multiple sclerosis and beyond

      Clinical trials to clinical use: using vision as a model for multiple sclerosis and beyond

      Optical coherence tomography (OCT) has made possible the structure–function correlations that uniquely characterize the afferent visual pathway as a model for understanding multiple sclerosis (MS) and for developing new treatments. During the past decade, OCT measures of retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GCL + IPL) thickness have evolved from being a means to validate visual function tests, such as low-contrast letter acuity, to provide a window on the axonal and neuronal loss that are now widely recognized as contributors to permanent visual dysfunction in MS. Although acute optic neuritis (ON) leads to thinning of ...

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    6. Optical Coherence Tomography in Papilledema: What Am I Missing?

      Optical Coherence Tomography in Papilledema: What Am I Missing?

      Background: Grading of papilledema severity is subjective and based on monocular fundus features of the optic nerve. Interobserver agreement on grading the severity of papilledema is poor among expert observers, even using well-defined criteria such as the Frisen scale, which is a non-continuous ordinal scale of grading. Furthermore, non-expert clinicians often find it difficult to properly view and interpret features of the optic nerve using ophthalmoscopy, which can lead to failure to diagnose papilledema in non-ophthalmologic care settings. This may delay treatment, which can result in vision loss. Distinguishing papilledema from pseudopapilledema can also be difficult when surface drusen are ...

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    7. Optical Coherence Tomography Technologies: Which Machine Do You Want to Own?

      Optical Coherence Tomography Technologies: Which Machine Do You Want to Own?

      Optical coherence tomography (OCT) has evolved over the past decade to become one of the most important ancillary tests in ophthalmic practice. This noninvasive ocular imaging technique provides high-resolution, cross-sectional images of the retinal nerve fiber layer (RNFL), macular region, ganglion cell layer, and optic nerve head. With OCT, we can learn much about axonal–neuronal integrity in the anterior aspect of the afferent visual pathway and gain insights about mechanisms of brain injury in various central nervous system disorders.

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    8. Sensitivity and Specificity of Spectral Domain Optical Coherence Tomography in Detecting Idiopathic Polypoidal Choroidal Vasculopathy

      Sensitivity and Specificity of Spectral Domain Optical Coherence Tomography in Detecting Idiopathic Polypoidal Choroidal Vasculopathy

      Purpose To evaluate the efficacy of spectral-domain optical coherence tomography (SD-OCT) compared to indocyanine green angiography (ICGA) in detecting idiopathic polypoidal choroidal vasculopathy (PCV) and in differentiating between PCV and occult choroidal neovascularization (CNV). Design Retrospective observational case control study. Methods SD-OCTs of 51 eyes of 44 consecutive patients who presented with one or more pigment epithelial detachments (PEDs) due to either PCV or occult CNV were retrospectively reviewed by a grader masked to the final diagnosis. A qualitative analysis based on the following tomographic findings was performed: sharp PED peak, PED notch, hypo-reflective lumen within hyper-reflective lesions adherent to ...

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    9. Comparing Spectral-Domain Optical Coherence Tomography and Standard Automated Perimetry to Diagnose Glaucomatous Optic Neuropathy

      Comparing Spectral-Domain Optical Coherence Tomography and Standard Automated Perimetry to Diagnose Glaucomatous Optic Neuropathy

      Purpose: To compare the abilities of standard automated perimetry (SAP) and spectral-domain optical coherence tomography (SDOCT) in diagnosing eyes with glaucomatous optic neuropathy (GON). Methods: In a cross-sectional study, 280 eyes of 175 subjects referred to tertiary eye care center by general ophthalmologists for a glaucoma evaluation underwent retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) imaging with SDOCT. All subjects had at least 2 reliable and repeatable SAP. Two glaucoma experts masked to clinical and SAP results classified the optic nerves into GON and nonglaucomatous groups based on digital optic disc photographs. Ability of SDOCT parameters and ...

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      Mentions: Harsha L. Rao
    10. Optical Coherence Tomography of a Cystic Retinal Tuft

      Optical Coherence Tomography of a Cystic Retinal Tuft

      Cystic retinal tuft (CRT) is a developmental vitreoretinal abnormality found in 5% of autopsy eyes. Clinical examination reveals a focal, elevated gliotic lesion in the peripheral retina associated with vitreous traction (Figure, A and B). Histopathological analysis demonstrates a dome-shaped area with internal microcysts, glial cell proliferation, outer retinal degeneration, and photoreceptor loss.

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    11. Optical coherence tomography demonstrating macular retinal nerve fiber thinning in advanced optic disc drusen

      Optical coherence tomography demonstrating macular retinal nerve fiber thinning in advanced optic disc drusen

      Optic disc drusen (ODD) are extracellular proteinaceous excrescences in the optic nerve head. They enlarge over time and can cause damage to nerve fibers with resulting loss of visual field. The authors report a case of advanced ODD in which macular optical coherence tomography demonstrated retinal nerve fiber thinning. A single case report of a 42-year-old woman with known ODD presented to the eye clinic with worsening field of vision which was impacting on her daily life. The patient was subject to full ophthalmic examination as well as Goldmann visual field testing, optic disc photography and optical coherence tomography (OCT ...

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    12. Measurement of retinal nerve fiber layer and macular ganglion cell-inner plexiform layer with spectral-domain optical coherence tomography in patients with optic nerve head drusen

      Measurement of retinal nerve fiber layer and macular ganglion cell-inner plexiform layer with spectral-domain optical coherence tomography in patients with optic nerve head drusen

      Purpose To evaluate the effect of optic nerve head drusen (ONHD) on the retinal nerve fiber layer (RNFL) and macular ganglion cell–inner plexiform layer (GCIPL) using Cirrus optical coherence tomography (OCT). Methods Fifty-seven eyes of thirty patients with ONHD and thirty-eight eyes of twenty age-matched and sex-matched control subjects underwent circumpapillary and macular scanning using Cirrus OCT. The percentages of eyes with abnormal GCIPL and RNFL values according to the Cirrus normative data were analysed and compared. Results Overall, eyes with ONHD showed abnormally reduced values for average and minimum GCIPL thicknesses in 35 % and 45 % of cases compared ...

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    13. Retinal vessel diameter measurements by spectral domain optical coherence tomography

      Retinal vessel diameter measurements by spectral domain optical coherence tomography

      Purpose To describe a spectral domain optical coherence (OCT)-assisted method of measuring retinal vessel diameters. Methods All Patients with an OCT circle scan centered at the optic nerve head using a Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany) were retrospectively reviewed. Individual retinal vessels were identified on infrared reflectance (IR) images and given unique labels both on IR and spectral domain OCT (SD-OCT). Vessel width and vessel types obtained by IR were documented as ground truth. From OCT, measurements of each vessel, including horizontal vessel contour diameter, vertical vessel contour diameter, horizontal hyperreflective core diameter, and reflectance shadowing width, were ...

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    14. System and method with refractive corrections for controlled placement of a laser beam's focal point

      System and method with refractive corrections for controlled placement of a laser beam's focal point

      A methodology is provided for correcting the placement of a laser beam's focal point. Specifically, this correction is done to compensate for displacements of the focal point that may be caused when implant material (e.g. an Intraocular Lens (IOL)) is positioned on the optical path of the laser beam. The methodology of the present invention then determines a deviation of the laser beam's refracted target position (uncompensated) from its intended target position. A calculation of the deviation includes considerations of the laser beam's wavelength and refractive/diffractive characteristics introduced by the implant material. This deviation is ...

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    15. Dome-Shaped Macular Configuration: Longitudinal Changes in the Sclera and Choroid by Swept-Source Optical Coherence Tomography Over Two Years

      Dome-Shaped Macular Configuration: Longitudinal Changes in the Sclera and Choroid by Swept-Source Optical Coherence Tomography Over Two Years

      Purpose To study longitudinal changes in the posterior pole in eyes with dome-shaped macular configuration within the staphyloma. Design Prospective, longitudinal study. Methods We prospectively examined the macular area in 35 eyes (26 patients) with dome-shaped macular configuration and high myopia (mean spherical equivalent, −14.83 ± 4.50 diopters) using swept-source optical coherence tomography. Scleral and choroidal thicknesses were measured at the fovea and four parafoveal locations 2000 μm from the foveal center. Height of the macular bulge was measured as well. Results During the mean follow-up of 24.8 ± 2.5 months, the scleral thickness significantly decreased at the ...

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    16. SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN LONG-TERM SILICONE OIL-RELATED VISUAL LOSS

      SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN LONG-TERM SILICONE OIL-RELATED VISUAL LOSS

      Purpose: To investigate spectral domain optical coherence tomography findings in long-term silicone oil-related visual loss. Methods: Four symptomatic patients were reviewed 4 years to 9 years after vitrectomy with silicone oil tamponade for macula-on retinal detachment. Three lost vision with oil in situ, with one at the time of oil removal. Eleven control eyes with good vision were included. Patients underwent assessment of best-corrected visual acuity, contrast sensitivity, Farnsworth-Munsell 100 Hue testing, static perimetry, and spectral domain optical coherence tomography imaging of the macula and disk. Results: Long-term best-corrected visual acuity was significantly reduced in affected eyes (range, 0.44-1 ...

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    17. Anterior segment optical coherence tomography measurement after neodymium yttrium aluminum garnet laser capsulotomy

      Anterior segment optical coherence tomography measurement after neodymium yttrium aluminum garnet laser capsulotomy

      Purpose To evaluate changes in anterior chamber depth (ACD) and angle width after Neodymium: yttrium aluminum garnet (Nd: YAG) laser capsulotomy. Design Prospective interventional case series. Methods In a single institution, 43 eyes of 43 consecutive pseudophakic patients with symptomatic posterior capsule opacification (PCO) underwent Nd: YAG laser capsulotomy. Anterior chamber depth and angle width in pseudophakic eyes with posterior capsule opacification were measured with Anterior Segment Optical Coherence Tomography (AS-OCT) before and three days after Nd:YAG laser capsulotomy. Pre-operative and post-operative measurements of anterior chamber depth and angle width included the angle opening distance, measured as the perpendicular ...

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    18. Three-dimensional automated choroidal volume assessment on standard spectral-domain optical coherence tomography and correlation with the level of diabetic macular edema

      Three-dimensional automated choroidal volume assessment on standard spectral-domain optical coherence tomography and correlation with the level of diabetic macular edema

      Purpose To measure choroidal thickness on spectral-domain optical coherence tomography (SD-OCT) images using automated algorithms and to correlate choroidal pathology with retinal changes due to diabetic macular edema (DME). Design Post-hoc analysis of multicenter clinical trial baseline data. Methods SD-OCT raster scans/fluorescein angiograms were obtained from 284 treatment naïve eyes of 142 patients with clinically significant DME and from 20 controls. Three-dimensional (3D) SD-OCT images were evaluated by a certified independent reading center analyzing retinal changes associated with diabetic retinopathy. Choroidal thicknesses were analyzed using a fully automated algorithm. Angiograms were assessed manually. Multiple endpoint correction according to ...

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    19. Wound Healing Process After Corneal Stromal Thinning Observed With Anterior Segment Optical Coherence Tomography

      Wound Healing Process After Corneal Stromal Thinning Observed With Anterior Segment Optical Coherence Tomography

      Purpose: The aim of this study was to observe the wound healing process after corneal stromal thinning by using anterior segment optical coherence tomography (AS-OCT) and a slit lamp. Methods: Four patients with corneal stromal thinning (2 patients: corneal iron foreign bodies; 2 patients: keratitis) were included. Serial AS-OCT and slit-lamp examinations were used to follow up the progress of these patients. The thicknesses of the whole cornea and the corneal stroma were measured with AS-OCT and compared with the findings observed during the slit-lamp examination. Results: AS-OCT showed that epithelial hypertrophy and hyperplasia initially occurred in the area of ...

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    20. Evaluation of the Macular Choroidal Thickness Using Spectral Optical Coherence Tomography in Pseudoexfoliation Glaucoma

      Evaluation of the Macular Choroidal Thickness Using Spectral Optical Coherence Tomography in Pseudoexfoliation Glaucoma

      Purpose: To evaluate the choroidal thickness (CT) in pseudoexfoliative (PEX) glaucoma and age-matched healthy subjects using spectral optical coherence tomography (SD-OCT). Patients and Methods: In this prospective study, 32 eyes of 32 PEX glaucoma patients and 30 eyes of 30 age-matched healthy subjects were enrolled. The CT is measured perpendicularly (from the outer edge of the hyperreflective retinal pigment epithelium to the inner sclera) at the fovea, and 1.5 mm temporal, 3.0 mm temporal, 1.5 mm nasal, and 3.0 mm nasal to the fovea using SD-OCT (RTVue-100). Results: The groups were similar regarding the mean age ...

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    21. SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY-GUIDED LASER TREATMENT OF CENTRAL SEROUS CHORIORETINOPATHY IN A PREGNANT WOMAN

      SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY-GUIDED LASER TREATMENT OF CENTRAL SEROUS CHORIORETINOPATHY IN A PREGNANT WOMAN

      Purpose: To report a case of central serous chorioretinopathy treated with focal laser photocoagulation guided by spectral domain optical coherence tomography (SD-OCT) without fluorescein angiography. Methods: In this interventional case report, a 27-year-old pregnant lady with central serous chorioretinopathy was evaluated with fundus photography and SD-OCT. She was treated with focal laser photocoagulation to the area of micro rip on the summit of pigment epithelial detachment identified by SD-OCT. Results: Successful treatment of serous macular detachment using SD-OCT in a pregnant lady. Conclusion: We report a case of central serous chorioretinopathy evaluated and treated successfully with SD-OCT without the use ...

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    22. Retinal nerve fibre layer thickness measurements by optical coherence tomography in patients with sleep apnoea syndrome

      Retinal nerve fibre layer thickness measurements by optical coherence tomography in patients with sleep apnoea syndrome

      Background The study aims to investigate whether retinal nerve fibre layer (RNFL) abnormalities can be detected in patients with obstructive sleep apnoea/hypopnoea syndrome with normally appearing optic disc. Design This is an observational case-control study. Participants One hundred and eight consecutive patients with moderate or severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS) as determined by overnight polysomnography and normal looking discs and 108 age-matched healthy controls were included in the study. Methods All patients underwent RNFL examinations by optical coherence tomography using fast retinal nerve fibre layer thickness scan. Main Outcome Measures The main outcome measure was RNFL thickness ...

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    23. Biometry of Anterior Segment of Human Eye on Both Horizontal and Vertical Meridians during Accommodation Imaged with Extended Scan Depth Optical Coherence Tomography

      Biometry of Anterior Segment of Human Eye on Both Horizontal and Vertical Meridians during Accommodation Imaged with Extended Scan Depth Optical Coherence Tomography

      Purpose To determine the biometry of anterior segment dimensions of the human eye on both horizontal and vertical meridians with extended scan depth optical coherence tomography (OCT) during accommodation. Methods Twenty pre-presbyopic volunteers, aged between 24 and 30, were recruited. The ocular anterior segment of each subject was imaged using an extended scan depth OCT under non- and 3.0 diopters (D) of accommodative demands on both horizontal and vertical meridians. All the images were analyzed to yield the following parameters: pupil diameter (PD), anterior chamber depth (ACD), anterior and posterior surface curvatures of the crystalline lens (ASC and PSC ...

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