Purpose: The purpose of this study is to compare the thickness and depth measurements of the lamina cribrosa (LC) obtained using a swept-source optical coherence tomography (SS-OCT) device in idiopathic intracranial hypertension (IIH) patients and healthy subjects. Methods: This retrospective, cross-sectional observational study included 16 eyes with IIH and 20 control eyes. The LC measurements with serial horizontal B scans of the optic nerve head were obtained using SS-OCT (Topcon 3D DRI OCT Triton). The anterior lamina surface (ALS) depth, posterior lamina surface (PLS) depth, and LC thickness measurements were evaluated. Results: In patients with IIH, the mean ALS depth ...

Purpose: Diagnosis of choroidal neovascular membrane (CNVM) is difficult in chronic central serous chorioretinopathy (CCSC) due to overlapping features of both on conventional dye angiography. Optical coherence tomography angiography (OCTA) allows a quick and noninvasive detection of CNVM in these eyes. We compared the fluorescein angiography (FA) features of CNVM with those of OCTA to assess the role of FA in detecting CNVM in CCSC eyes. Methods: Patients with CCSC undergoing FA, spectral domain (SD)-OCT, and OCTA were identified (March 2015–June 2015). Four retina specialists individually reviewed FA images (without OCTA and SD-OCT) to determine whether CNVM was ...

A 65-year-old white woman was referred to us to rule out a nematode infestation in the right eye. She was asymptomatic, and best-corrected visual acuity was 20/20 in both eyes. On examination, there were no signs of active inflammation in either eye, and intraocular pressure was 15 mmHg in both eyes. Past medical history was unremarkable and the patient denied recent travel to endemic areas. Fundus examination revealed a deep serpentine shaped subretinal track at the posterior pole of the right eye. Multimodal retinal imaging, including fundus autofluorescence, enhanced-depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), and indocyanine ...

Retained intraocular graphite foreign bodies are uncommon and generally remain inert in the eye. A 16-year-old girl complained of a black spot on her right eye since 3 months following pencil tip trauma. Examination revealed a subconjunctival greyish-black nodular mass with a metallic sheen on the 5 O' clock limbus with involvement of the adjacent corneal stroma and endothelium [Figure 1] a. Optical coherence tomography revealed subconjunctival [ [Figure 1] b arrow], corneal stromal, and endothelial [ [Figure 1] b arrowhead] hyporeflective material with intense backshadowing. This visual impression will help differentiate pigmented conjunctivo--corneal lesion from other reported mimickers such as melanoma ...

Montage techniques using SD-OCT have been tried in idiopathic macular holes, [1] normal subjects, diabetic retinopathy and Vogt-Koynagi-Harada disease. [2] We present a wide-field montage image from macula to the fundus periphery in a case of polypoidal choroidal vasculopathy (PCV) by using spectral domain optical coherence tomography (SD-OCT) [Figure 1] a. While the SD-OCT features in the macula for PCV are well defined [Figure 1] b and [Figure 1] c, there is a paucity of data concerning the peripheral SD-OCT changes. Merging the SD-OCT the scan length obtained was 26 mm. This enables us to visualize the pathology in relation ...

LETTER TO THE EDITOR

This special issue of the Indian Journal of Ophthalmolog y on pediatric retina has been carefully curated to bring you the hot topics in this niche field of ophthalmology. By far the most common etiology that comes to mind when we imagine the pediatric retina is retinopathy of prematurity (ROP) which has been dealt with in great detail in this issue, including its epidemiology, pathogenesis, risk factors, imaging, screening, treatment, and outcomes by some of the masters in this field. In addition, pediatric tumors such as retinoblastoma, medulloepithelioma, and diseases inherently common in children such as Coats disease have been ...

Purpose: To compare different macular thickness parameters and peripapillary retinal nerve fiber layer (RNFL) thickness between recently diagnosed cases of multiple sclerosis (MS) without optic neuropathy (ON) and healthy individuals. Methods: This cross-sectional study was performed between June 2014 and June 2015. All subjects underwent ocular and retinal examination. Spectral domain optical coherence tomography (SD-OCT) was used to measure the thickness of different layers of the retina at macular and peripapillary regions and at different quadrants. Between groups comparison was performed with P < 0.05 indicating statistical significance. Results: There were 32 eyes in the MS group and 74 eyes ...

In this series, we discuss the role of optical coherence tomography angiography (OCTA) in assessing response to treatment in intraocular vascular tumors. This is a series of two cases: Multiple retinal capillary hemangioblastoma (RCH) treated with laser photocoagulation and diffuse choroidal hemangioma (DCH) with radiotherapy. In large RCH and DCH, optical coherence tomography (OCT) showed significant reduction of subretinal and intraretinal fluid. But post-treatment mean tumor vascular density (MTVD) was slightly reduced. In one small RCH, vascular loop was seen suggesting minimal residual disease. So, OCTA helps in identifying treatment inadequacy and understanding alternate mechanism involved in treatment response in ...

Purpose: To determine the comparability of anterior chamber biometric measurements in primary angle closure disease (PACD) patients using two commercially available anterior segment optical coherence tomography machines (ASOCT): Visante and Casia. Methods: This was a cross-sectional observational study, which included clinically, diagnosed cases of PACD. Anterior segment biometric measurements were done using Casia and Visante ASOCT. Parameters studied were central corneal thickness (CCT), anterior chamber depth (ACD), nasal (N) and temporal (T) angle opening distance at 500 μm (AOD500) and 750 μm (AOD750), and N and T trabecular iris space area at 500 μm (TISA500) and 750 μm (TISA750). Results ...

Purpose: To evaluate the superficial retinal vascular plexus density using optical coherence tomography angiography (OCTA) in cases of strabismic amblyopia. Methods: Ten eyes of 10 patients with purely strabismic amblyopia underwent detailed ocular evaluation followed by the assessment of the superficial retinal plexus vascular density using OCTA (Topcon DRI OCT Triton, Swept Source OCT, Topcon, Japan). Ten contralateral normal eyes of the same patients were considered as control. All these 20 eyes underwent a 4.5 × 4.5 mm cube scan OCTA centered at the fovea. Using the Topcon propriety software all 20 eyes were assessed for the capillary plexus ...

We report the natural course of the accidental injection of trypan blue into the corneal stroma while performing a routine cataract surgery by a resident during a training session. The corneal staining resolved with conservative medical treatment over 7 weeks. This case describes the anterior segment optical coherence tomography (ASOCT) features of corneal staining. It emphasizes on the relatively benign nature of this dye and the follow-up course. Causes that may be responsible for this untoward complication are highlighted with the necessary preventive measures that need to be taken care are also discussed.

Retinal cavernous hemangiomas is a rare vascular tumor, isolated and non-progressive. This tumor is incidentally diagnosed on fundus examination and visual impairment can be rare presentation from vitreous hemorrhage, pre-retinal traction, hyphema, or macular scarring. The tumor has typical appearance of grape-like clusters of dilated vascular sacs with variable surface gliosis. Characteristic imaging findings aids in diagnosis. Newly emerged imaging tool is optical coherence tomography angiography (OCT A) which obtains high-resolution visualization of retinal vasculature in non-invasive fashion. In the present case report, we analyzed various diagnostic tool available for retinal cavernous hemangiomas; illustrating on the OCT A features.

Congenital hypertrophy of retinal pigment epithelium (CHRPE) is a benign, pigmented, flat lesion arising from the retinal pigment epithelium (RPE). In this study, we describe optical coherence tomography angiography (OCTA) features of two eyes with solitary CHRPE. We found that the retinal vasculature over CHRPE was normal in both cases. We observed that in solitary CHRPE, segmentation artifacts can interfere in the interpretation of retinal vasculature due to thinning of the outer retina. Visualization of the underlying choroidal vasculature was obscured to some extent by masking effect of the hyperpigmented RPE. The choroidal vasculature was better appreciated on en face ...

Purpose: To study the epiretinal membrane (ERM) profile on the spectral-domain optical coherence tomography (SDOCT) in eyes with uveitis. Methods: In this prospective observational study, macula of uveitic eyes were evaluated by SDOCT (Cirrus, model 5000) for ERM. ERM was quantified (in microns) and were followed up along with the best-corrected visual acuity (BCVA) and treatment profile for 1 year. ERM morphology (focal, global, or mixed) and characteristics (thickness at fovea, maximum thickness, and location of maximum thickness in relation to fovea) were documented. Changes in altered foveal contour, cystoid macular edema (CME), and central foveal thickness were also noted ...

Paracentral acute middle maculopathy (PAMM) refers to retinal lesions with changes in the inner nuclear layer on spectral domain optical coherence tomography (OCT). PAMM is associated with retinal vascular pathology involving the deep capillary plexus. We report two cases of PAMM in Indian subjects using multimodal imaging highlighting the OCT angiography (OCTA) findings. The first case is of a middle-aged female with a paracentral scotoma with SS-OCT (swept-source optical coherence tomography) and OCTA findings suggestive of “chronic” PAMM. The second case presented with sudden decreased vision, and multiple creamy white lesions suggestive of “acute” PAMM, imaging features depicting a possible ...

Purpose: To analyze the morphological changes in the iris-knot complex configuration using spectral-domain optical coherence tomography (SD-OCT) following the single pass four throw (SFT) pupilloplasty. Methods: In this retrospective case series, eyes with SFT pupilloplasty were examined by SD-OCT (Optovue). Iris morphology compared to the normal iris, presence of specific patterns (single hump, double humps, peaks and valleys, tethering), prolene suture, knot complex (length and orientation), and intraocular lens (IOL) vault were evaluated. Results: Overall, 41 knots of 26 patients with a mean time duration of 3.1 ± 2 months from surgery were analyzed. Iris configurations seen were single hump ...

Purpose: The purpose of this study is to provide normative database for subfoveal choroidal thickness in Indian eyes using swept-source optical coherence tomography. Methods: This is a cross-sectional study based at a tertiary eye care center in Northern India. Two hundred and thirty eight eyes of 119 healthy subjects were examined in terms of axial length, spherical equivalent, and choroidal thickness. Inclusion criteria included age 19–60 years, no retinal or choroidal disorder, and patients with clear media and good fixation. Patients with high hypermetropia (>4 D) or myopia (>6 D) or any systemic disease likely to affect choroidal thickness ...

In this issue of Indian Journal of Ophthalmology , the authors have performed a large study with 119 healthy patients (238 eyes) with an aim to establish a normative database of subfoveal choroidal thickness in Asian Indian eyes using the technology of swept-source (SS) optical coherence tomography (OCT). [1] The authors included subjects with a mean age of 28.7 years (range: 19–45 years). The authors concluded that the mean subfoveal choroidal thickness (in the central 1 mm) was 299.10 ± 131.2 μm compared with 294.8 ± 46.5 μm obtained using spectral-domain (SD) technology. [1] In the era ...

The intraocular manifestations of rickettisial retinitis include retinal vasculitis, maculopathy, optic neuritis, and neurosensory detachment. Extensive leakage of dye on the fundus fluorescein angiography may obscure visualization in eyes with retinitis. We report the vascular changes in eyes with rickettsial retinitis and its response to treatment using optical coherence tomography angiography. The microvascular abnormalities we noted were, capillary drop out areas corresponding to retinitis patches, vascular loops, and pruning of vessels. The choriocapillary slabs showed signal void areas. Post-treatment there was vascular remodeling with decrease in non-perfused area, appearance of new vascular lateral branching, and appearance of collaterals.

Purpose: The aim of this study was to present an experimental optical coherence tomography (OCT)–guided anterior segment (AS) imaging chick embryo model. Through this model, we aimed to reveal similarities and differences between human cornea, AS tissues, and chick embryo tissues by quantitative image analysis. Methods: Ex vivo , the chick embryos' globes were determined by detailed AS camera of spectral-domain (SD)-OCT in 10 fertilized specific pathogen-free eggs on the 20 th day. Quantitative image analysis of anterior chamber tissues was performed with SD-OCT in detail. After imaging, cross sections of the chick embryo globes containing cornea with anterior ...

Purpose: To identify optical coherence tomography-angiography (OCT-A) findings to predict treatment response during anti-vascular endothelial growth factor (VEGF) therapy in eyes with para foveal telangiectasia (PFT) group II. Methods: In this retrospective series, Twelve eyes of seven patients diagnosed with PFT group II without evidence of sub-retinal neovascular membrane (SRNVM) clinically or on spectral domain-OCT (SD-OCT) were included. All patients underwent OCT-A on the Topcon DRI OCT Triton ® with 4.5 mm macula scans. The patients with abnormal vascular nets were further classified into type A and B nets and administered intravitreal anti-VEGF therapy. Visual acuity and size of type ...

A 40-year-old female with iridocorneal endothelial syndrome was referred after Ahmed glaucoma valve (AGV) implantation 3 months ago. The patient was on oral acetazolamide 250 mg tds, topical timolol 0.5% bd, and brimonidine 0.2% bd with intraocular pressure 40 mmHg in the right eye (RE) and 16 mmHg in the left eye (LE). The patient's visual acuity was 1/60 RE and 6/6 in LE with a relative afferent pupillary defect in RE. Anterior segment biomicroscopy revealed supracorneal AGV tube lying within pseudocorneal groove in RE and iridocorneal adhesions just beneath corneal perforation [Figure 1] a ...

Four years after phacoemulsification and implantation of intraocular lens (IOL) in the capsular bag, this patient developed anterior-capsular phimosis and small focal shiny areas within IOL [IOL glistening, [Figure 1] ]. The anterior segment optical coherence tomography [ASOCT, [Figure 2] ] showed a distended posterior capsule (PC) and focal areas of hyperreflectivity within the IOL