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    1. Multimodal imaging in paracentral acute middle maculopathy

      Multimodal imaging in paracentral acute middle maculopathy

      A 51-year-old male presented with the sudden appearance of a black spot in front of the left eye since 2 days. He had undergone an uneventful mitral valve replacement surgery 1 year back. BCVA was 6/6, N6 and 6/18, N9 in right and left eye, respectively. Anterior segment examination was unremarkable. Fundus evaluation of the left eye showed a grayish well-defined parafoveal intraretinal lesion, congruent to the clinical scotoma [Figure 1] . Multicolor composite image showed greenish hue in the ischemic area which was appreciated best on infrared (IR) reflectance channel [Figure 2] . Fundus autofluorescence showed hypoautofluorescence, and fundus ...

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    2. Microscope-integrated optical coherence tomography-aided intraoperative diagnosis and management of peripheral tractional retinoschisis

      Microscope-integrated optical coherence tomography-aided intraoperative diagnosis and management of peripheral tractional retinoschisis

      A 48-year-old male, diagnosed case of Eales' vasculitis, presented with best-corrected visual acuity (BCVA) of hand movements with a near-total combined retinal detachment in the right eye (OD) and BCVA 6/9 in the left eye (OS). OD fundus showed fibrovascular proliferation (FVP) nasally at the equator and a retinal break located inferior to the FVP [Figure 1] a and [Figure 1] b. Swept-source optical coherence tomography (OCT) (Topcon Corp, Tokyo, Japan) showed a grade 1 epiretinal membrane (ERM) in both eyes (OU). Preoperative fluorescein angiography OCT was performed. The patient underwent 23-gauge pars plana vitrectomy (PPV) with ERM peeling ...

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    3. Optical coherence tomography angiography of fleeting macroaneurysm in retinal racemose angioma

      Optical coherence tomography angiography of fleeting macroaneurysm in retinal racemose angioma

      We present a rare case of retinal racemose angioma complicated with fleeting macroaneurysm (MA). A 50-year-old female presented with diminution of vision in her right eye for 6 years. Fundus examination showed a racemose angioma with hemorrhagic MA temporal to the fovea in the right eye. On subsequent follow-ups, spontaneous thrombosis of MA was noted with the development of new MA inferior to the fovea, with intraretinal hemorrhage extending into the fovea. Focal laser to MA resulted in resolution of MA with improvement in vision. We report optical coherence tomography angiographic features of the fleeting MA in a case of ...

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    4. Retrospective study of changes in ocular coherence tomography characteristics after failed macular hole surgery and outcomes of fluid-gas exchange for persistent macular hole

      Retrospective study of changes in ocular coherence tomography characteristics after failed macular hole surgery and outcomes of fluid-gas exchange for persistent macular hole

      Purpose: The aim is to study the changes in ocular coherence tomography (OCT) parameters of large (≥400 μ) full-thickness macular holes (FTMHs) after a failed surgery and evaluate the outcome of fluid-gas exchange (FGE) in the treatment of persistent macular hole and role of OCT in predicting outcome after the secondary intervention. Methods: Changes occurring in the OCT parameters of FTMH after a failed vitrectomy were evaluated. FGE was done in an operating room with three pars plana sclerostomy ports. The anatomical and functional outcomes of FGE for these persistent macular holes were also assessed. Anatomical closure was defined as the ...

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    5. Optical coherence tomography angiography in acute unilateral nonarteritic anterior ischemic optic neuropathy: A comparison with the fellow eye and with eyes with papilledema

      Optical coherence tomography angiography in acute unilateral nonarteritic anterior ischemic optic neuropathy: A comparison with the fellow eye and with eyes with papilledema

      Purpose: The purpose of this study is to detect the optic nerve head (ONH) and peripapillary perfusion in eyes with acute nonarteritic anterior ischemic optic neuropathy (NAION) compared to the fellow normal eyes using optical coherence tomography angiography (OCTA) and to compare with nonischemic disc edema (papilledema). Methods: Retrospective analysis of patients with unilateral NAION who underwent OCTA was performed. All patients underwent comprehensive ocular examination including visual field testing. ONH was imaged using 6 mm × 6 mm scan by Topcon DRI Triton ® OCT system. Vascularity loss was analyzed using ImageJ software in diseased eyes in comparison to normal fellow ...

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    6. Artifact in swept source optical coherence tomography due to silicone oil

      Artifact in swept source optical coherence tomography due to silicone oil

      Silicone oil (polydimethylsiloxane) is one of the most commonly used intraocular tamponade agents in ophthalmic practice. [1] , [2] Optical coherence tomography (OCT) has been used to study the vitreoretinal interface or retinal changes in these oil-filled eyes. One of the common artifacts seen in these eyes is the presence of a crescentic hyperreflective focus above the fovea which represents the interface between posterior margin of silicone oil and retinal surface. [3] However, in our case, due to approximation in the peripheral retina, silicone oil led to an artifactual displacement of the retina on the scan, although the interface focus is ...

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    7. Traumatic optic nerve head avulsion: Multimodal imaging

      Traumatic optic nerve head avulsion: Multimodal imaging

      A 6-year-old boy presented with sudden vision loss after close globe injury with iron rod. Best-corrected visual acuity (BCVA) was Perception of light (PL). Fundus examination showed an area of the optic nerve head (ONH) excavation and filled with hemorrhage with blood emanating into the vitreous [Figure 1] a. The patient underwent MRI orbit which confirms the diagnosis of ONH avulsion. The patient received intravenous steroids, but partial avulsion converted into full [Figure 1] b with BCVA no PL. Optical coherence tomography showed avulsion at ONH section [Figure 1] c. An area of hypolucency on ultrasound was seen at ONH ...

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    8. Intercalary membrane as the inner wall overlying optic and chorio-retinal colobomas. Deep penetration Swept Source-OCT study

      Intercalary membrane as the inner wall overlying optic and chorio-retinal colobomas. Deep penetration Swept Source-OCT study

      Five eyes of four patients were studied to analyze the structure of the inner wall of optic and chorioretinal colobomas using swept-source optical coherence tomography (SS-OCT). The colobomatous cavities and their relationship with adjacent structures were examined. SS-OCT permitted the study of the colobomatous cavities in all cases. In four of those cases, a Y-shaped intercalary membrane (ICM) was identified, with an origin in the retinal nerve fiber layer (RNFL), which covered the coloboma and in one case the coloboma was in contact with the vitreous cavity. Vitreous adhesion to the internal wall of the coloboma was found in three ...

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    9. Multimodal imaging of Bietti's crystalline dystrophy

      Multimodal imaging of Bietti's crystalline dystrophy

      etti's crystalline dystrophy (BCD) is a rare autosomal recessive retinal dystrophy characterized by deposition of crystals in the retina. The purpose of this article is to describe retinal abnormalities in BCD using multimodal imaging. An 18-year-old girl presented with decrease of vision and nyctalopia. She was assessed with color fundus picture, red-free photographs, short-wave autofluorescence, spectral-domain optical coherence tomography (OCT) and en face OCT and was diagnosed to have BCD based on typical presentation. Retinal crystals were better visualized on en face OCT as compared to conventional B scan OCT.

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    10. Continuous intraoperative optical coherence tomography-guided shield ulcer debridement with tuck in multilayered amniotic membrane transplantation

      Continuous intraoperative optical coherence tomography-guided shield ulcer debridement with tuck in multilayered amniotic membrane transplantation

      Purpose: The aim of this study is to describe a modified surgical technique of continuous intraoperative optical coherence tomography (iOCT)-guided shield ulcer debridement with tuck-in multilayered Amniotic membrane transplantation (ML AMT) in vernal keratoconjunctivitis (VKC) with shield ulcer with plaque. Methods: Seven eyes of seven patients presenting with VKC with shield ulcer with plaque were enrolled in this prospective case series and planned for shield ulcer debridement with ML AMT. Debridement of the ulcer base with double-layered AMT was done under the continuous guidance of iOCT. The main outcome measure was the time for complete reepithelialization. Statistical analysis was ...

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    11. Swept source optical coherence tomography-angiography of an infarct of a small intra-neural branch of central retinal artery simulating cilio-retinal artery

      Swept source optical coherence tomography-angiography of an infarct of a small intra-neural branch of central retinal artery simulating cilio-retinal artery

      A 56-year-old man with episodic transient visual loss in right eye (OD), of 2 days duration. He was not symptomatic at presentation and was using anti-coagulants for cardiovascular disease. Visual acuity was 6/6 both eyes (OU). Intra-ocular pressure and anterior segment were normal OU. OD had a finger like area of macular whitening sparing the fovea. This area corresponded to the vascular bed of a clinically appearing cilio-retinal artery (cilio-RA) [Figure 1] a. However, on fluorescein angiography, the artery filled along with branches of central RA (CRA) [Figure 1] b and [Figure 1] c. Swept source optical coherence tomography ...

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    12. Anterior segment optical coherence tomography of intraocular lens opacification

      Anterior segment optical coherence tomography of intraocular lens opacification

      Postoperative opacification of a hydrophilic acrylic intraocular lens (IOL) is an uncommon complication. A 57-year-old diabetic female who had undergone phacoemulsification with IOL implantation in her right eye 16 years back presented with diminution of vision in the same eye for 3 years. Significant IOL opacification was observed clinically and anterior segment optical coherence tomography clearly delineated the intraoptic deposits, sparing the haptics, and edges of the optic. IOL explant and exchange was performed leading to restoration of visual acuity to 6/9. Histochemical evaluation of the IOL confirmed that the hydrophilic acrylic IOL optic had calcium deposits.

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    13. Comparison of optical coherence tomography angiography and fundus fluorescein angiography features of retinal capillary hemangioblastoma

      Comparison of optical coherence tomography angiography and fundus fluorescein angiography features of retinal capillary hemangioblastoma

      The aim of this study is to compare the optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA) features of retinal capillary hemangioblastoma (RCH). This is an observational case series of three patients with von Hippel–Lindau (VHL) disease and one patient with juxtapapillary RCH. All patients underwent FFA with a mydriatic fundus camera and OCTA with swept-source angio OCT. The FFA and OCTA characteristics of tumors were compared. In our series, FFA could identify tumors as small as the width of a third-order retinal artery, which was missed on clinical examination. OCTA identified these tiny tumors, but only ...

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    14. Commentary: Comparison of optical coherence tomography angiography and fundus fluorescein angiography features of retinal capillary hemangioblastoma

      Commentary: Comparison of optical coherence tomography angiography and fundus fluorescein angiography features of retinal capillary hemangioblastoma

      Retinal hemangioblastoma or retinal capillary hemangioma (RCH) is benign vascular tumors of the retina clinically characterized by an orange-red nodular mass associated with a dilated feeding arteriole and a draining venule, either juxtapapillary or peripheral in location. RCH can be either sporadic (usually unifocal) or associated with von Hippel–Lindau disease (bilateral and multifocal). [1] RCH can cause diminution of vision with involvement of the macula, intraretinal, or subretinal exudation. Diagnosis of RCH is primarily clinical based on fundus examination by slit lamp biomicroscopy and indirect ophthalmoscopy. However, clinical examination can commonly miss early smaller lesion, when they are most ...

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    15. Discriminating ability of Cirrus and RTVue optical coherence tomography in different stages of glaucoma

      Discriminating ability of Cirrus and RTVue optical coherence tomography in different stages of glaucoma

      Purpose: The aim of this study is to determine which parameter of Cirrus and RTVue optical coherence tomography (OCT) has the highest ability to discriminate between early, moderate, and advanced glaucoma. Simultaneously, to compare the performance of the two OCT devices in terms of their ability to differentiate the three stages of glaucoma. Further, to analyze the macular parameters of both devices and compare them with the conventional retinal nerve fiber layer (RNFL) parameters. Methods: One hundred and twenty eyes (30 healthy and 90 glaucomatous [30 mild, 30 moderate, and 30 advanced glaucoma]) of 65 participants (15 healthy, 50 glaucomatous ...

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    16. Anterior segment optical coherence tomography of microsporidial keratoconjunctivitis

      Anterior segment optical coherence tomography of microsporidial keratoconjunctivitis

      A 17-year-old male patient presented with irritation and redness in the right eye of 1-week duration. He gave a history of rainwater entering the right eye on the day of the onset of symptoms. Corneal examination of the right eye revealed multiple, whitish, coarse punctate corneal epithelial lesions of variable sizes [Figure 1] . Anterior segment optical coherence tomography (AS-OCT) showed intense hyper-reflective epithelial lesions raised above the surface of the epithelium [Figure 2] a. Corneal scraping revealed microsporidia. He was started on 0.5% moxifloxacin eye drops one drop six times a day along with lubricating drops and lubricating gel ...

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    17. Rapid regression of retinal neovascularization following intravitreal bevacizumab in branch retinal vein occlusion imaged by optical coherence tomography angiography

      Rapid regression of retinal neovascularization following intravitreal bevacizumab in branch retinal vein occlusion imaged by optical coherence tomography angiography

      Retinal neovascularization developing secondary to ischemic branch retinal vein occlusion (BRVO) is conventionally treated with sector panretinal photocoagulation (PRP). Elevated levels of the vascular endothelial growth factor (VEGF) play an important role in the development of these new vessels [1] and thus administration of anti-VEGF agents has been reported to be of therapeutic use as well. [2] , [3] We present a case of BRVO in a 55-year-old female, previously treated with PRP that had persistent neovascularization that was treated with a single anti-VEGF injection. The authors report the use of optical coherence tomography-angiography (OCT-A) as a noninvasive imaging platform to ...

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      Mentions: Duke University
    18. Optical coherence tomography angiography features of choroidal hemangioma

      Optical coherence tomography angiography features of choroidal hemangioma

      This is an observational case series of four cases of choroidal hemangioma. All cases underwent OCT angiography with swept source OCTA (Topcon DRI OCT Triton plus) 6 mm * 6 mm protocol. OCTA at the level of large choroidal vessels demonstrated peculiar vascular pattern in all four eyes. Patterns observed were bag of worms, spaghetti like and vessels with terminal bulbs. In eye with diffuse choroidal hemangioma comparison of choroidal vascular pattern with the contralateral eyes showed significant difference in the vascular architecture. OCTA is an excellent non invasive tool in assessing the choroidal vascular pattern in eyes with choroidal hemangioma.

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    19. Multimodal imaging of choroidal nodules in neurofibromatosis type-1

      Multimodal imaging of choroidal nodules in neurofibromatosis type-1

      Choroidal nodules in neurofibromatosis type-1 are common and are best imaged with near-infrared reflectance (NIR) imaging. The authors describe swept-source optical coherence tomography angiography (SSOCTA) of choroidal nodules. These nodules are seen as hyperflow areas on SSOCTA and correlate well to bright patches on NIR imaging. The utility of multicolor scanning laser imaging in detecting these abnormalities is also described.

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    20. Anterior segment optical coherence tomography for evaluation of cornea and ocular surface

      Anterior segment optical coherence tomography for evaluation of cornea and ocular surface

      Current corneal assessment technologies make the process of corneal evaluation extremely fast and simple. Several devices and technologies allow to explore and manage patients better. Optical coherence tomography (OCT) technology has evolved over the years, and hence a detailed evaluation of anterior segment (AS) structures such as cornea, conjunctiva, tear meniscus, anterior chamber, iris, and crystalline lens has been possible in a noncontact and safe procedure. The purpose of this special issue is to present and update in the evaluation of cornea and ocular surface, and this paper reviews a description of the AS-OCT, presenting the technology and common clinical ...

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    21. Spectral domain optical coherence tomography evaluation of macular changes in Eales disease

      Spectral domain optical coherence tomography evaluation of macular changes in Eales disease

      Purpose: The purpose of the study was to describe macular changes in treatment-naïve eyes with Eales disease using spectral domain optical coherence tomography (SD-OCT). Methods: A cross-sectional study was done on 79 eyes of 66 patients with Eales disease. Best-corrected visual acuity (BCVA), slit-lamp biomicroscopy (SLB), indirect ophthalmoscopy, fundus fluorescein angiography (FFA), and quantitative (central macular thickness [CMT]) and qualitative analysis on SD-OCT were performed. Results: Forty-six (58.2%) eyes had macular involvement as assessed with SD-OCT, while in 33 (41.8%) eyes, macula was not affected. Macular edema was the most common feature when macula was affected followed ...

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    22. High-resolution optical coherence tomography in a case of descemetocele managed with amniotic membrane transplantation

      High-resolution optical coherence tomography in a case of descemetocele managed with amniotic membrane transplantation

      Nilufer Sultana, Sunita Chaurasia, Muralidhar Ramappa Indian Journal of Ophthalmology 2018 66(2):315-317 Amniotic membrane transplantation is a useful in the management of corneal melts and descemetocele. We describe high-resolution anterior segment optical coherence tomography (OCT) (Optovue) in a patient with descemetocele who was managed surgically with amniotic membrane transplantation. A 60-year-old female presented with a corneal melt in the right eye.

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    23. Optical coherence tomography: A guide to interpretation of common macular diseases

      Optical coherence tomography: A guide to interpretation of common macular diseases

      Optical coherence tomography (OCT) is an optical analog of ultrasound imaging that uses low coherence interferometry to produce cross-sectional images of the retina. It captures optical scattering from the tissue to decode spatial details of tissue microstructures. It uses infrared light from a super-luminescent diode that is divided into two parts: one of which is reflected from a reference mirror and the other is scattered from the biological tissue. The two reflected beams of light are made to produce interference patterns to obtain the echo time delay and their amplitude information that makes up an A-Scan. A-Scans that are captured ...

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    24. Age and myopia associated optical coherence tomography of retina and choroid in pediatric eyes

      Age and myopia associated optical coherence tomography of retina and choroid in pediatric eyes

      Purpose: To evaluate the association between retinal and choroidal thickness and volume along with choroidal vessel volume in children using optical coherence tomography (OCT) images. Methods: 113 normal eyes of children ranging from 5-17 years of age were imaged with a clinical OCT scanner (Optovue Inc., Fremont, USA). The retina, choroid and choroidal vessels were automatically segmented with algorithms. Parameters evaluated were thickness and volume. Location specific analyses of thickness were also performed at a distance of 2.5 mm from foveal center. Multivariate analyses of variance were used to analyze the effect of age and myopia. Manual segmentation of ...

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      Mentions: Optovue
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