1. 1-16 of 16
    1. Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Background Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation. We sought to establish whether or not a novel OCT-based stent sizing strategy would result in a minimum stent area similar to or better than that achieved with IVUS guidance and better ...

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    2. Optical coherence tomography: not quite ready

      Optical coherence tomography: not quite ready

      Intravascular imaging has revolutionised the way coronary intervention has been viewed. Both intravascular ultrasound (IVUS) and, to a greater degree, optical coherence tomography (OCT), allow exquisite assessment of the luminal wall and structure to a near-histological tissue assessment level. OCT also allows detailed assessment of stent characteristics and, in particular, of adequacy of deployment and early identification of procedural complications, such as edge dissections. Although this level of imaging provides invaluable information for the interventionalist, data are scarce for its use in clinical practice to improve outcomes.

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    3. Optical coherence tomography in multiple sclerosis

      Optical coherence tomography in multiple sclerosis

      In patients with multiple sclerosis, thinner peripapillary retinal nerve fibre layers (pRNFL) and retinal ganglion cell layers in eyes without previous optic neuritis, as measured with optical coherence tomography (OCT), have been associated with global brain atrophy and disability. Although most of the data so far have been obtained in cross-sectional studies, the idea to use OCT parameters as surrogate markers of neuroaxonal degeneration and multiple sclerosis disability has been put forth by Elena Martinez-Lapiscina and colleagues 1 in The Lancet Neurology .

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    4. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Background Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. Methods In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis, and progressive multiple sclerosis. Patients were recruited from centres in Spain, Italy, France, Germany ...

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    5. Validation of human small-airway measurements using endobronchial optical coherence tomography: an observational study

      Validation of human small-airway measurements using endobronchial optical coherence tomography: an observational study

      Background Small-airway remodelling is the cardinal pathological feature underlying chronic obstructive pulmonary disease (COPD). Identification of early-stage pathological changes is crucial for the diagnosis, treatment, and prognosis of respiratory diseases. Our study aimed to investigate the usefulness of endobronchial optical coherence tomography (EB-OCT) in assessment of small-airways morphology in patients with pulmonary nodules who were scheduled for lung resection surgery (four had COPD, four were smokers with normal lung function, and four were life-long non-smokers). Patients with respiratory diseases other than COPD were excluded. Methods 12 patients with pulmonary nodules scheduled for lung resection underwent spirometry, multidetector CT (MDCT), and ...

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      Mentions: Yu Chen Wei Wang
    6. Stable coronary artery disease: revascularisation and invasive strategies

      Stable coronary artery disease: revascularisation and invasive strategies

      Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and ...

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    7. New ophthalmologic imaging techniques for detection and monitoring of neurodegenerative changes in diabetes: a systematic review

      New ophthalmologic imaging techniques for detection and monitoring of neurodegenerative changes in diabetes: a systematic review

      Optical coherence tomography (OCT) of the retina and around the optic nerve head and corneal confocal microscopy (CCM) are non-invasive and repeatable techniques that can quantify ocular neurodegenerative changes in individuals with diabetes. We systematically reviewed studies of ocular neurodegenerative changes in adults with type 1 or type 2 diabetes and noted changes in the retina, the optic nerve head, and the cornea. Of the 30 studies that met our inclusion criteria, 14 used OCT and 16 used CCM to assess ocular neurodegenerative changes. Even in the absence of diabetic retinopathy, several layers in the retina and the mean retinal ...

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    8. Retinal development in albinism: a prospective study using optical coherence tomography in infants and young children

      Retinal development in albinism: a prospective study using optical coherence tomography in infants and young children

      Background Retinal development normally involves migration of the inner retinal layers away from the fovea, migration of the cone photoreceptors into the fovea, and elongation of the photoreceptors over time. This process is arrested prematurely in albinism. However, because retinal development continues at least until the age of 4 years, when development arrests in albinism is uncertain. In this study we outlined the time course of retinal development in children with albinism. Methods We studied 44 children with a diagnosis of albinism and 223 control participants. All participants were aged between 0 and 6 years. We obtained 219 mixed cross-sectional ...

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    9. Interpretation of optical coherence tomography images : The Lancet

      Interpretation of optical coherence tomography images : The Lancet

      We read with great interest the Clinical Picture reported by Dennis Wong and colleagues (Feb 8, p e11) 1 who took advantage of the unprecedented resolution of optical coherence tomography (OCT) to identify the culprit lesion and guide coronary stenting in a patient with acute myocardial infarction. Over the last decade, OCT has become the method of choice to investigate the mechanisms responsible for acute coronary syndromes. 2 In this report, 1 the authors describe a ruptured thin-cap fibroatheroma with overlying thrombus as cause of acute coronary syndrome. However, this observation raises some important issues. Plaque rupture is typically detected ...

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    10. Interpretation of optical coherence tomography images – Authors' reply

      Interpretation of optical coherence tomography images – Authors' reply

      We would like to express our gratitude for the feedback that we received following our Clinical Picture 1 on a potential ruptured plaque and intracoronary thrombus. We acknowledge the concerns raised about our initial interpretation of the optical coherence tomography (OCT) images. Image interpretation remains the Achilles' heel of interventional cardiology with invasive intracoronary imaging, but must also always be done in the context of the clinical scenario. In our Clinical Picture, 1 a patient who had a recent non-ST segment elevation myocardial infarction had a hazy severe stenosis in the first diagonal artery on coronary angiography. This was then ...

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    11. Identification of concomitant ruptured plaque and intracoronary thrombus by optical coherence tomography

      Identification of concomitant ruptured plaque and intracoronary thrombus by optical coherence tomography

      A 74-year-old man was admitted with a non-ST segment elevation myocardial infarction with no localising electrocardiogram changes. Coronary angiography showed a severe eccentric stenosis with possible overlying thrombus in a moderate caliber first diagonal artery, and severe stenosis in proximal left anterior descending artery. Optical coherence tomography (OCT) was done to assess whether the stenosis in the first diagonal artery was the culprit stenosis. A ruptured thin cap fibrous atheroma with overlying thrombus was identified in the first diagonal artery, showing an actively developing acute coronary syndrome ( figure ). The lesion was successfully stented, and excellent stent apposition was confirmed on ...

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    12. Identification of concomitant ruptured plaque and intracoronary thrombus by optical coherence tomography

      Identification of concomitant ruptured plaque and intracoronary thrombus by optical coherence tomography

      A 74-year-old man was admitted with a non-ST segment elevation myocardial infarction with no localising electrocardiogram changes. Coronary angiography showed a severe eccentric stenosis with possible overlying thrombus in a moderate caliber first diagonal artery, and severe stenosis in proximal left anterior descending artery. Optical coherence tomography (OCT) was done to assess whether the stenosis in the first diagonal artery was the culprit stenosis. A ruptured thin cap fibrous atheroma with overlying thrombus was identified in the first diagonal artery, showing an actively developing acute coronary syndrome ( figure ). The lesion was successfully stented, and excellent stent apposition was confirmed on ...

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    13. Eye can see a nest of worms!

      Eye can see a nest of worms!

      In October, 2010, a 38-year-old woman presented with creeping sensation in her right eye, but without any systemic or visual symptoms. Her medical history was notable only for an unknown insect flying into her right eye during farm work about 3 months earlier. On examination, a live worm was seen moving out from the nasal upper eyelid of the right eye above the conjunctiva (figure A). This was further viewed with anterior segment optical coherence tomography (figure B). When proxymetacaine eye-drops were administered, preparing the eye for surgical exploration, more than two worms were seen moving (figure C, D). The ...

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    14. Optical coherence tomography in multiple sclerosis: a systematic review and meta-analysis

      Optical coherence tomography in multiple sclerosis: a systematic review and meta-analysis

      Optical coherence tomography (OCT) is a new method that could aid analysis of neurodegeneration in multiple sclerosis (MS) by capturing thinning of the retinal nerve fibre layer (RNFL). Meta-analyses of data for time domain OCT show RNFL thinning of 20·38 μm (95% CI 17·91—22·86, n=2063, p<0·0001) after optic neuritis in MS, and of 7·08 μm (5·52—8·65, n=3154, p<0·0001) in MS without optic neuritis. The estimated RNFL thinning in patients with MS is greater than the extent expected in normal ageing, probably because of retrograde trans-synaptic degeneration ...

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    15. Interweaving neurology and ophthalmology

      Interweaving neurology and ophthalmology
      Neuro-ophthalmology—a subspecialty at the intersection of ophthalmology, neurology, neurosurgery, and general medicine—deals with ocular diseases as well as myriad neurological and systemic conditions with ophthalmic manifestations. More than ever before, successful practice of neuro-ophthalmology requires both careful clinical observation (aided by familiar tools such as slit-lamp microscopes and stereoscopic ophthalmoscopes) and use of increasingly sophisticated technologies, such as neuroradiological imaging and optical coherence tomography. New tools will never replace the need for clinical acumen, but they are helping to transform aspects of neuro-ophthalmology.
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    16. A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods

      A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods

      Background: Drug-eluting metallic coronary stents predispose to late stent thrombosis, prevent late lumen vessel enlargement, hinder surgical revascularisation, and impair imaging with multislice CT. We assessed the safety of the bioabsorbable everolimus-eluting stent (BVS). Methods: 30 patients with a single de-novo coronary artery lesion were followed up for 2 years clinically and with multiple imaging methods: multislice CT, angiography, intravascular ultrasound, derived morphology parameters (virtual histology, palpography, and echogenicity), and optical coherence tomography (OCT). Findings: Clinical data were obtained from 29 of 30 patients. At 2 years, the device was safe with no cardiac deaths, ischaemia-driven target lesion revascularisations, or ...

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    1-16 of 16
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