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    1. Optical Coherence Tomography Analysis Based Prediction of Humphrey 24-2 Visual Field Thresholds in Patients With Glaucoma

      Optical Coherence Tomography Analysis Based Prediction of Humphrey 24-2 Visual Field Thresholds in Patients With Glaucoma

      Purpose : A pilot study showed that prediction of individual Humphrey 24-2 visual field (HVF 24-2) sensitivity thresholds from optical coherence tomography (OCT) image analysis is possible. We evaluate performance of an improved approach as well as 3 other predictive algorithms on a new, fully independent set of glaucoma subjects. Methods : Subjects underwent HVF 24-2 and 9-field OCT (Heidelberg Spectralis) testing. Nerve fiber (NFL), and ganglion cell and inner plexiform (GCL+IPL) layers were cosegmented and partitioned into 52 sectors matching HVF 24-2 test locations. The Wilcoxon rank sum test was applied to test correlation R , root mean square error (RMSE ...

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    2. Optical Coherence Tomography Angiography of the Superficial Microvasculature in the Macular and Peripapillary Areas in Glaucomatous and Healthy Eyes

      Optical Coherence Tomography Angiography of the Superficial Microvasculature in the Macular and Peripapillary Areas in Glaucomatous and Healthy Eyes

      Purpose : To quantitatively evaluate the superficial microvasculature in the macular and peripapillary areas in glaucomatous and healthy eyes using optical coherence tomography angiography (OCT-A). Methods : We enrolled 26 eyes of medically managed primary open-angle glaucoma patients and 27 eyes of healthy subjects were enrolled in this prospective study. Measurements of OCT-A vessel density were acquired both in the macular and peripapillary areas. We compared vessel density values, the circumpapillary retinal nerve fiber layer (cpRNFL), the ganglion cell complex (GCC), and standard automated perimetry (SAP) parameters across study groups. Areas under the receiver operating characteristic (AUROC) curves were used to evaluate ...

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    3. Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography

      Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography

      Purpose : To examine posterior staphylomas by widefield optical coherence tomography (WF-OCT) and three-dimensional magnetic resonance imaging (3D-MRI). Methods : Highly myopic patients (myopic refractive error >8.0 diopters or axial length >26.5 mm) who had previously undergone orbital 3D-MRI were examined by WF-OCT. Results : The study included 100 eyes of 57 patients with a mean age of 67.9 ± 10.7 years (range, 44–85 years) and mean axial length of 30.0 ± 2.3 mm (range, 25.1–36.5 mm). All staphylomas detected on the 3D-MRI, except for two very large staphylomas, were visualized on the WF-OCT images ...

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    4. Indocyanine Green Angiography and Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-Related Macular Degeneration

      Indocyanine Green Angiography and Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-Related Macular Degeneration

      Purpose : To compare the capability of indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCTA) in detecting choroidal neovascularization (CNV). Methods : In this prospective study, patients with CNV detected with fluorescein angiography (FA) underwent ICGA and OCTA, spectral domain OCT (SD-OCT), and infrared or fundus color photographs. CNV lesions were outlined on ICGA and OCTA images, and the composition and size of the CNV was documented. Results : One hundred eighty-two eyes were included. With ICGA, well-defined lesions were observed in 37.9%, partly defined in 44.5%, and undefined in 17% of eyes. On OCTA, well-defined, partly defined, and ...

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    5. Reduced Retinal Vessel Density in Obstructive Sleep Apnea Syndrome Patients: An Optical Coherence Tomography Angiography Study

      Reduced Retinal Vessel Density in Obstructive Sleep Apnea Syndrome Patients: An Optical Coherence Tomography Angiography Study

      Purpose : To examine the retinal vasculature in patients with obstructive sleep apnea–hypopnea syndrome (OSAS) and to determine the correlation between retinal vascularity and the severity of OSAS. Design : Prospective, cross-sectional study. Methods : Sixty-nine consecutive subjects who underwent polysomnography were enrolled. Patients were divided into three groups according to the severity of OSAS, which was defined using the apnea-hypopnea index (AHI) as normal-to-mild (AHI <15), moderate (≥15 to <30), or severe (≥30). The vessel densities, and macular and retinal nerve fiber layer thicknesses were compared among the three groups. The correlations between clinical variables (age, heart rate, body mass index ...

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    6. Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration

      Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration

      Purpose : Age-related macular degeneration (AMD) is a progressive disease with multifactorial etiology. There is a need to identify clinical features that are harbingers of advanced disease. We evaluated morphologic features of the retina and choroid on optical coherence tomography (OCT) to determine if they predict progression to advanced disease. Methods : Progressors transitioned from early or intermediate AMD to advanced disease ( n = 40 eyes), and were matched on baseline AMD grade and follow-up interval to nonprogressors who did not develop advanced AMD ( n = 40 eyes). Features of the neurosensory retina, photoreceptors, retinal pigment epithelium (RPE), and choroid were evaluated. Logistic regression ...

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    7. Optical Coherence Tomographic Imaging of Posterior Episclera and Tenon's Capsule

      Optical Coherence Tomographic Imaging of Posterior Episclera and Tenon's Capsule

      Purpose : To investigate structural features of the posterior episclera and Tenon's capsule in patients with high myopia. Methods : This hospital-based observational study included highly myopic eyes (myopic refractive error > −8 diopters or axial length ≥26.5 mm) in which the posterior sclera in its full thickness could be visualized on swept-source optical coherence tomography (OCT) images in all 12 radial scans centered on the fovea. We assessed the posterior episclera and Tenon's capsule. Results : The study included 278 eyes of 175 patients (mean age, 60.9 ± 11.4 years; range, 32–89 years; axial length, 30.7 ± 1 ...

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    8. Author Response: Biomechanical Responses of Lamina Cribrosa to Intraocular Pressure Change Assessed by Optical Coherence Tomography in Glaucoma Eyes

      Author Response: Biomechanical Responses of Lamina Cribrosa to Intraocular Pressure Change Assessed by Optical Coherence Tomography in Glaucoma Eyes

      Our recent publication 1 noted several features of change in anterior lamina depth (ALD) with change in intraocular pressure (IOP) in glaucoma patients. ALD changed more in the lower ranges of IOP than at higher ranges, which represents the expected increased stiffening of biomaterials in regions of higher stress. Some eyes exhibited movement of the lamina out of the eye at lower IOP—a behavior that is more likely when the peripapillary sclera is more compliant. This was more common in eyes with less glaucoma damage. The regions of the lamina that moved more were in its vertical poles, above ...

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    9. Biomechanical Responses of Lamina Cribrosa to Intraocular Pressure Change Assessed by Optical Coherence Tomography in Glaucoma Eyes

      Biomechanical Responses of Lamina Cribrosa to Intraocular Pressure Change Assessed by Optical Coherence Tomography in Glaucoma Eyes

      We read with great interest the paper by Quigley et al. 1 investigating the change in anterior lamina cribrosa depth (LCD) before and after several intraocular pressure (IOP)-lowering procedures. They found that the LC can move either anteriorly or posteriorly with IOP decrease, and this change was greater with lower IOP. Quantitative assessment of LCD depends on the reference plane from which the measurements are made, and it is significantly influenced by choroidal thickness (CT) when a Bruch's membrane opening (BMO) reference plane is used. 2 , 3 In the study by Quigley et al., 1 the anterior LCD ...

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    10. Structural Changes in Optical Coherence Tomography Underlying Spots of Increased Autofluorescence in the Perilesional Zone of Geographic Atrophy

      Structural Changes in Optical Coherence Tomography Underlying Spots of Increased Autofluorescence in the Perilesional Zone of Geographic Atrophy

      Purpose : To investigate structural correlates corresponding to the appearance of increased fundus autofluorescence (FAF) in the perilesional area of geographic atrophy (GA) secondary to age-related macular degeneration. Methods : Serial FAF images of 181 eyes with GA of 134 patients participating in the Directional Spread in Geographic Atrophy study (NCT02051998) were screened for increased FAF spots that had developed during the review period. Thickness and reflectivity of the retinal pigment epithelium (RPE)–basal lamina complex, as well as the integrity of the external limiting membrane (ELM) and the ellipsoid zone (EZ), respectively, in corresponding optical coherence tomography (OCT) scans were compared ...

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    11. Axial Length Variation Impacts on Superficial Retinal Vessel Density and Foveal Avascular Zone Area Measurements Using Optical Coherence Tomography Angiography

      Axial Length Variation Impacts on Superficial Retinal Vessel Density and Foveal Avascular Zone Area Measurements Using Optical Coherence Tomography Angiography

      Purpose : To evaluate the impact of image magnification correction on superficial retinal vessel density (SRVD) and foveal avascular zone area (FAZA) measurements using optical coherence tomography angiography (OCTA). Methods : Participants with healthy retinas were recruited for ocular biometry, refraction, and RTVue XR Avanti OCTA imaging with the 3 × 3-mm protocol. The foveal and parafoveal SRVD and FAZA were quantified with custom software before and after correction for magnification error using the Littman and the modified Bennett formulae. Relative changes between corrected and uncorrected SRVD and FAZA were calculated. Results : Forty subjects were enrolled and the median (range) age of the ...

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    12. Author Response: Gap in Capillary Perfusion on Optical Coherence Tomography Angiograph

      Author Response: Gap in Capillary Perfusion on Optical Coherence Tomography Angiograph

      We appreciate the valuable comments from Huang and Sha 1 regarding our recent article. 2 Their comments raise an important point about image artifacts in optical coherence tomography angiography (OCTA). Image artifacts in OCTA are common and physicians should be aware of this problem. 3 As reported elsewhere, it is difficult to evaluate precise vascular abnormalities when macular edema is present. 4 Thus, in the current study, we described our OCTA protocol in cases in which macular edema persisted. 2 In eyes with persistent macular edema, OCTA was performed within 2 months after the last anti-VEGF treatment, when the macular ...

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    13. Gap in Capillary Perfusion on Optical Coherence Tomography Angiography

      Gap in Capillary Perfusion on Optical Coherence Tomography Angiography

      We read with great interest the recent article by Tsuboi et al.1 The authors used optical coherence tomography angiography (OCTA) and a threshold technique to evaluate correlations between persistent macular edema associated with branch retinal vein occlusion (BRVO), and the macular perfusion status in the superficial (SCP) and deep (DCP) capillary plexus. They found that the gap between the SCP and DCP (i.e., specifically the presence of isolated vessels in the SCP existing simultaneously with capillary loss in the DCP) was associated with persistent macular edema. We congratulate the authors for their excellent work and would like to ...

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    14. The Impact of Lens Opacity on SD-OCT Retinal Nerve Fiber Layer and Bruch's Membrane Opening Measurements Using the Anatomical Positioning System (APS)

      The Impact of Lens Opacity on SD-OCT Retinal Nerve Fiber Layer and Bruch's Membrane Opening Measurements Using the Anatomical Positioning System (APS)

      Purpose : To evaluate the impact of lens opacity on retinal nerve fiber layer thickness (RNFLT) and Bruch's membrane opening (BMO) measurements. Methods : Fifty-nine randomly selected patients without any other relevant ocular pathology undergoing elective routine cataract surgery in two specialized eye clinics were enrolled. RNFLT, BMO area, and BMO minimum rim width (BMO-MRW) were assessed with the Heidelberg Engineering Spectralis OCT using the anatomical positioning system (APS) prior to and 1 day after cataract surgery using a ring scan at different eccentricities of the disc (3.5, 4.1 and 4.7 mm). Lens opacity was quantified using densitometry ...

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    15. Repeatability and Reproducibility of Retinal Blood Flow Measurement Using a Doppler Optical Coherence Tomography Flowmeter in Healthy Subjects

      Repeatability and Reproducibility of Retinal Blood Flow Measurement Using a Doppler Optical Coherence Tomography Flowmeter in Healthy Subjects

      Purpose : To evaluate the repeatability and reproducibility of retinal blood flow (RBF) measurements in humans by using new auto-alignment and measurement software in a commercially available Doppler optical coherence tomography (DOCT) system. Methods : The DOCT flowmeter assessed the intrasession repeatability and the intersession and interobserver reproducibility of the RBF measurements. For intrasession repeatability, the coefficients of variation (CVs) of five repeated RBF measurements were calculated at the retinal arteries and veins in 20 normal eyes of 20 healthy volunteers. For intersession reproducibility, two sets of three measurements obtained by one observer on 2 different days were compared. For interobserver reproducibility ...

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    16. Biomechanical Responses of Lamina Cribrosa to Intraocular Pressure Change Assessed by Optical Coherence Tomography in Glaucoma Eyes

      Biomechanical Responses of Lamina Cribrosa to Intraocular Pressure Change Assessed by Optical Coherence Tomography in Glaucoma Eyes

      Purpose : The purpose of this study was to measure change in anterior lamina cribrosa depth (ALD) globally and regionally in glaucoma eyes at different intraocular pressures (IOP). Methods : Twenty-seven glaucoma patients were imaged before and after IOP-lowering procedures using optical coherence tomography. The anterior lamina was marked in approximately 25 locations in each of six radial scans to obtain global and regional estimates of ALD. ALD and its change with IOP were compared with optic disc damage, nerve fiber layer thickness, and visual field loss. Results : Variables associated with deeper baseline ALD included larger cup/disc ratio, thinner rim area ...

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    17. Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

      Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

      Purpose : Optic disc drusen (ODD) are found in up to 2.4% of the population and are known to cause visual field defects. The purpose of the current study was to investigate how quantitatively estimated volume and anatomic location of ODD influence optic nerve function. Methods : Anatomic location, volume of ODD, and peripapillary retinal nerve fiber layer and macular ganglion cell layer thickness were assessed in 37 ODD patients using enhanced depth imaging optical coherence tomography. Volume of ODD was calculated by manual segmentation of ODD in 97 B-scans per eye. Anatomic characteristics were compared with optic nerve function using ...

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    18. Automated Staging of Age-Related Macular Degeneration Using Optical Coherence Tomography

      Automated Staging of Age-Related Macular Degeneration Using Optical Coherence Tomography

      Purpose : To evaluate a machine learning algorithm that automatically grades age-related macular degeneration (AMD) severity stages from optical coherence tomography (OCT) scans. Methods : A total of 3265 OCT scans from 1016 patients with either no signs of AMD or with signs of early, intermediate, or advanced AMD were randomly selected from a large European multicenter database. A machine learning system was developed to automatically grade unseen OCT scans into different AMD severity stages without requiring retinal layer segmentation. The ability of the system to identify high-risk AMD stages and to assign the correct severity stage was determined by using receiver ...

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    19. The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy

      The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy

      Purpose : Histologic details of progression routes to geographic atrophy (GA) in AMD are becoming available through optical coherence tomography (OCT). We studied the origins and evolution of an OCT signature called plateau in eyes with GA and suggested a histologic correlate. Methods : Serial eye-tracked OCT scans and multimodal imaging were acquired from eight eyes of seven patients with GA and plateau signatures over a mean follow-up of 7.7 years (range, 3.7–11.6). The histology of unrelated donor eyes with AMD was reviewed. Results : Drusenoid pigment epithelial detachment (PED) on OCT imaging progressed into wide-based mound-like signatures with ...

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    20. Gap in Capillary Perfusion on Optical Coherence Tomography Angiography Associated With Persistent Macular Edema in Branch Retinal Vein Occlusion

      Gap in Capillary Perfusion on Optical Coherence Tomography Angiography Associated With Persistent Macular Edema in Branch Retinal Vein Occlusion

      Purpose : To evaluate correlations between persistent macular edema associated with branch retinal vein occlusion (BRVO) and the macular perfusion status in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) using optical coherence tomography angiography (OCTA). Methods : Retrospective, case-control study. Twenty patients with BRVO followed for 12 months or more were enrolled. Persistent macular edema was defined as central retinal thickness exceeding 300 μm that persisted or recurred less than 3 months after the final treatment. We compared two groups (i.e., seven eyes with persistent macular edema and 13 eyes without macular edema). The macular perfusion status was ...

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    21. Choroidal Vascular Flow Area in Central Serous Chorioretinopathy Using Swept-Source Optical Coherence Tomography Angiography

      Choroidal Vascular Flow Area in Central Serous Chorioretinopathy Using Swept-Source Optical Coherence Tomography Angiography

      Purpose : To report the choroidal vascular flow area in eyes with central serous chorioretinopathy (CSC) compared with healthy subjects and unaffected fellow eyes using swept-source (SS) optical coherence tomography (OCT) angiography. Methods : Prospective case series of 19 eyes of 19 consecutive patients affected by CSC, compared with 15 unaffected fellow eyes and 20 eyes of 10 healthy subjects. Patients underwent SS-OCT angiography in order to evaluate the choroidal vascular flow area of choriocapillaris (CC) and deeper choroidal layers. Results : The choroidal vascular flow area was higher in eyes with CSC than in control eyes (53.4 ± 5.8% vs. 49 ...

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    22. Retinal Microvasculature and Visual Acuity in Eyes With Branch Retinal Vein Occlusion: Imaging Analysis by Optical Coherence Tomography Angiography

      Retinal Microvasculature and Visual Acuity in Eyes With Branch Retinal Vein Occlusion: Imaging Analysis by Optical Coherence Tomography Angiography

      Purpose : To investigate microvascular changes in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in eyes with resolved branch retinal vein occlusion (BRVO) and their association with best-corrected visual acuity (BCVA). Methods : Eighty-five eyes (82 consecutive patients) with BRVO after resolution of the macular edema were retrospectively evaluated. All patients underwent optical coherence tomography angiography (OCTA) for assessment of microvascular changes, including capillary telangiectasia, microaneurysm, and disruption of the foveal avascular zone (FAZ). The areas of vascular perfusion and FAZ in the SCP and DCP were quantitatively evaluated. Best-corrected visual acuity was measured on the same day as ...

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    23. Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

      Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

      Purpose : To investigate whether the area and shape of the foveal avascular zone (FAZ) as assessed by optical coherence tomography angiography (OCTA) are altered in glaucomatous eyes with central visual field defects (CVFDs). Methods : A total of 78 patients with open-angle glaucoma with central or peripheral visual field defects (PVFDs) confined to a single hemifield were studied retrospectively. Foveal avascular zone area and circularity were measured using OCTA images from the superficial retinal layer. Central retinal visual field (VF) sensitivity using Swedish Interactive Threshold Algorithm 24-2 VF and macular ganglion cell–inner plexiform layer (mGCIPL) thickness were measured. The FAZ ...

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    24. Underlying Microstructure of Parapapillary Deep-Layer Capillary Dropout Identified by Optical Coherence Tomography Angiography

      Underlying Microstructure of Parapapillary Deep-Layer Capillary Dropout Identified by Optical Coherence Tomography Angiography

      Purpose : To characterize the microstructure underlying the parapapillary deep-layer microvasculature dropout (MvD) identified by optical coherence tomography (OCT) angiography (OCTA) in eyes with primary open-angle glaucoma (POAG). Methods : Parapapillary MvD was defined as a focal sectoral capillary dropout without any visible microvascular network identified in deep-layer en face images obtained using swept-source OCTA. The peripapillary microstructure was characterized in 188 POAG patients with MvD in the parapapillary deep layer. Twelve radial optic nerve images were obtained using swept-source OCT to examine the peripapillary structure and measure the juxtapapillary choroidal thickness (JPCT). The JPCT was also measured in 72 age-matched POAG ...

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