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    1. Intraoperative Optical Coherence Tomography-Assisted Descemet Membrane Endothelial Keratoplasty in the DISCOVER Study: First 100 Cases

      Intraoperative Optical Coherence Tomography-Assisted Descemet Membrane Endothelial Keratoplasty in the DISCOVER Study: First 100 Cases

      Purpose Intraoperative optical coherence tomography (iOCT) may facilitate successful transition to descemet membrane endothelial keratoplasty (DMEK) surgery via improved efficiency of tissue orientation. The purpose of this study is to report a large consecutive series of iOCT-assisted DMEK, inclusive of all learning curve cases. Design Prospective consecutive case series. Methods The Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery (DISCOVER) study is a single-site, multi-surgeon, IRB-approved investigational device prospective study. The first 100 consecutive iOCT-assisted DMEK surgeries performed by one attending corneal surgeon (JMG) and six novice surgeons (cornea ...

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    2. Correlations between Different Choriocapillaris Flow Deficit Parameters in Normal Eyes using Swept Source OCT Angiography

      Correlations between Different Choriocapillaris Flow Deficit Parameters in Normal Eyes using Swept Source OCT Angiography

      Purpose Choriocapillaris (CC) imaging of normal eyes with swept-source optical coherence tomography SS-OCTA was performed, and the percentage of CC flow deficits (FD%) and the average area of CC flow deficits (FDa) were compared within given macular regions. Design A prospective, cross-sectional study. Methods Subjects with normal eyes ranging in age from their 20s through their 80s were imaged with SS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec, Dublin, CA) using both 3x3 mm and 6x6 mm macular scan patterns. The CC images were generated using a previously published and validated algorithm. In both 3x3 mm and 6x6 mm scans, the ...

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    3. Macular Vascularity in Ischemic Optic Neuropathy Compared to Glaucoma by Projection-Resolved Optical Coherence Tomography Angiography

      Macular Vascularity in Ischemic Optic Neuropathy Compared to Glaucoma by Projection-Resolved Optical Coherence Tomography Angiography

      PURPOSE To compare macular vasculature in patients with primary open-angle glaucoma (POAG) POAG and atrophic non-arteritic anterior ischemic optic neuropathy (NAION). Design Prospective, cross-sectional study METHODS Thirty seven eyes with moderate and advanced POAG, 19 eyes with atrophic NAION, and 40 eyes of normal subjects were imaged using optical coherence tomography angiography (OCT-A). Macular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thicknesses were measured in addition to macular superficial and deep vasculature after projection removal using custom software. RESULTS Linear models showed that while averaged peripapillary RNFL and macular GCC were not different between NAION and ...

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      Mentions: Robert Ritch
    4. Two-Year Risk of Exudation in Eyes with Nonexudative Age-Related Macular Degeneration and Subclinical Neovascularization Detected with Swept Source Optical Coherence Tomography Angiography

      Two-Year Risk of Exudation in Eyes with Nonexudative Age-Related Macular Degeneration and Subclinical Neovascularization Detected with Swept Source Optical Coherence Tomography Angiography

      Purpose Swept source optical coherence tomography angiography (SS-OCTA) was used to study the prevalence, incidence, and natural history of subclinical macular neovascularization (MNV) in eyes with unilateral nonexudative age-related macular degeneration. Design Prospective cohort study. Methods Patients were imaged using 3- × 3-mm and 6- × 6-mm SS-OCTA scan patterns. MNV was detected using the outer retina to choriocapillaris en face slab. Prevalence and incidence of subclinical MNV, Kaplan–Meier cumulative estimates for the overall risk of exudation, and the association between neovascular lesion size and the risk of exudation were assessed through 2 years. Results From August 2014 through March 2018 ...

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    5. Detection of reduced retinal vessel density in eyes with geographic atrophy secondary to age-related macular degeneration using projection-resolved optical coherence tomography angiography

      Detection of reduced retinal vessel density in eyes with geographic atrophy secondary to age-related macular degeneration using projection-resolved optical coherence tomography angiography

      Purpose To compare retinal vessel density in eyes with geographic atrophy (GA) secondary to age-related macular degeneration (AMD) to age-matched healthy eyes using projection-resolved optical coherence tomography angiography (PR-OCTA). Design Prospective cross-sectional study. Methods Study participants underwent macular 3×3-mm OCTA scans with spectral domain OCTA. Reflectance-compensated retinal vessel densities were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Quantitative analysis using normalized deviation compared the retinal vessel density in GA regions, 500 μm GA rim regions, and non-GA regions to similar macular locations in control eyes. Results Ten eyes with GA ...

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    6. Impact of slab selection on quantification of choriocapillaris flow deficits by optical coherence tomography angiography

      Impact of slab selection on quantification of choriocapillaris flow deficits by optical coherence tomography angiography

      Purpose To assess the impact of slab selection on quantitative measurements of choriocapillaris (CC) flow deficits (FDs) using optical coherence tomography angiography (OCTA). Design Cross-sectional study Methods Using a swept-source OCTA device, en face slabs to isolate the CC were first generated using the manufacturer’s default setting: a 20 μm-thick slab starting 29 μm posterior to the centerline of the automatically segmented retinal pigment epithelium (RPE) band. The inner and or outer borders were then adjusted by 2 μm increments to generate CC slabs with a range of offsets relative to the center of the RPE band. FDs of ...

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    7. Retinal Thickness and Microvascular Changes in Children with Sickle Cell Disease Evaluated by Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Retinal Thickness and Microvascular Changes in Children with Sickle Cell Disease Evaluated by Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Purpose To compare the severity of macular vascular changes in children with sickle cell disease (SCD) versus age- and race-matched controls Design Cross-sectional study Methods Children (<18 years old) with HbSS and HbS variant (HbSC and HbS thalassemia) genotypes, and their age- and race-matched controls were recruited between January 2017 and December 2018. All subjects underwent optical coherence tomography angiography (OCTA) scans centered on the fovea and temporal macula (AngioVue; Optovue Inc). Retinal thickness, superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density (VD), and foveal avascular zone (FAZ) size were measured and compared between HbSS and HbS ...

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    8. Anterior Segment Optical Coherence Tomography Angiography in Patients Following Cultivated Oral Mucosal Epithelial Transplantation

      Anterior Segment Optical Coherence Tomography Angiography in Patients Following Cultivated Oral Mucosal Epithelial Transplantation

      Purpose To analyze corneal neovascularization using anterior segment optical coherence tomography angiography (AS-OCTA) in patients following cultivated oral mucosal epithelial sheet transplantation (COMET). Design Observational case series. Methods Nine eyes in 7 patients were analyzed. Four images of corneal quadrant were obtained by AS-OCTA from each patient during follow-up post-COMET in the Department of Ophthalmology at Osaka University Hospital. The depth of corneal neovascularization was evaluated using en face and B-scan images. Each quadrant image was classified as one of the following five types: stromal, predominantly stromal, epithelial, predominantly epithelial, or avascular. The image quality of slit-lamp photography and AS-OCTA ...

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    9. Reply to Correspondence: Impact of Binarization Thresholding and Brightness/Contrast Adjustment Methodology on Optical Coherence Tomography Angiography Image Quantification

      Reply to Correspondence: Impact of Binarization Thresholding and Brightness/Contrast Adjustment Methodology on Optical Coherence Tomography Angiography Image Quantification

      We thank Dr Rabiolo and associates for their interest in our work and their correspondence.1 We also applaud them for their valuable study that examined the effect of binarization thresholding on vessel area density (VAD) in retinal vascular optical coherence tomography angiography (OCTA) images.2 In their correspondence, they highlight several points regarding our results and conclusions compared with their own findings.

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    10. Correspondence: Impact of Binarization Thresholding and Brightness/Contrast Adjustment Methodology on Optical Coherence Tomography Angiography Image Quantification

      Correspondence: Impact of Binarization Thresholding and Brightness/Contrast Adjustment Methodology on Optical Coherence Tomography Angiography Image Quantification

      We read with interest the article by Mehta and colleagues titled “Impact of Binarization Thresholding and Brightness/Contrast Adjustment Methodology on Optical Coherence Tomography Angiography Image Quantification.” 1 The authors tested 5 methods to binarize optical coherence tomography angiography (OCT-A) en face angiocubes at the superficial capillary plexus (SCP) and choriocapillaris (CC) on a small cohort of healthy subjects. They found significant differences among the methods for the parameters studied, and the differences were more pronounced at the CC level.

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    11. Influence of Bruch’s Membrane Opening Area in Diagnosing Glaucoma with Neuroretinal Parameters from Optical Coherence Tomography

      Influence of Bruch’s Membrane Opening Area in Diagnosing Glaucoma with Neuroretinal Parameters from Optical Coherence Tomography

      Purpose To determine whether the glaucoma diagnostic accuracy of age and Bruch’s membrane opening area (BMOA) adjusted normative classifications of minimum rim width (MRW) and retinal nerve fibre layer thickness (RNFLT) is dependent on BMOA, in a European descent population. Design Retrospective, cross-sectional study. Methods We included 182 glaucoma patients and 166 healthy controls for the primary study, and 105 glaucoma patients in a second sample used for a replication study. Optical coherence tomography (Spectralis) measurements of BMOA, global MRW and RNFLT and normative classifications from the device software were exported for analysis. Sensitivity and specificity were calculated for ...

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    12. Quantification of choriocapillaris with OCTA: a comparison study

      Quantification of choriocapillaris with OCTA: a comparison study

      Purpose To demonstrate the variation in quantitative choriocapillaris (CC) metrics with various binarization approaches using optical coherence tomography angiography (OCTA). Design Retrospective, observational, cross-sectional case series. Methods 3x3 mm and 6x6 mm macular OCTA scans were obtained from normal eyes and from eyes with drusen secondary to AMD. The CC slab was extracted and the CC flow deficits (FDs) were segmented with two previously published algorithms: fuzzy C-means approach (FCM method) and Phansalkar’s local thresholding (Phansalkar method). Four different values for the radius were used in order to investigate the effect on the FD segmentation when using the Phansalkar ...

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    13. Optical Coherence Tomography normative peripapillary retinal nerve fiber layer and macular data in children ages 0-5 years

      Optical Coherence Tomography normative peripapillary retinal nerve fiber layer and macular data in children ages 0-5 years

      Purpose To determine reference values for the peripapillary retinal nerve fiber layer (pRNFL) and macula in children ages 0-5 years. Design Prospective cross-sectional study Setting Single large academic pediatric ophthalmology practice Study Population Healthy, full-term children ages 0 to <6 years presenting for surgery under general anesthesia were prospectively recruited for participation. Excluded were children with systemic neurologic disease, optic nerve or retinal disease (even if unilateral), or any bilateral ocular disease process, and eyes with amblyopia, ocular disease, or spherical equivalent refractive error outside of -3.00 to +8.00 diopters. Observation Procedure Following general anesthesia, OCT scans of ...

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    14. Prediction of Glaucoma Progression with Structural Parameters: Comparison of Optical Coherence Tomography and Clinical Disc Parameters

      Prediction of Glaucoma Progression with Structural Parameters: Comparison of Optical Coherence Tomography and Clinical Disc Parameters

      Purpose To test the hypothesis that baseline optical coherence tomography (OCT) measures predict visual field (VF) progression in a cohort of patients with suspected or established glaucoma and compare their performance to semiquantitative optic disc measures. Design Observational cohort study. Methods Setting: Academic institution. Study Population One-hundred seventy-one eyes of 95 patients with good-quality baseline retinal nerve fiber layer (RNFL) and macular OCT images and disc photographs with >2 years of follow-up and ≥5 VFs. Observation Procedures Baseline macular and RNFL OCT measures and cup-to-disc ratio and disc damage likelihood score. Main Outcome Measures Prediction of glaucomatous visual field deterioration ...

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    15. Two-Year Risk of Exudation in Eyes with Non-Exudative AMD and Subclinical Neovascularization Detected with Swept Source OCT Angiography

      Two-Year Risk of Exudation in Eyes with Non-Exudative AMD and Subclinical Neovascularization Detected with Swept Source OCT Angiography

      Purpose Swept source optical coherence tomography angiography (SS-OCTA) was used to study the prevalence, incidence, and natural history of subclinical macular neovascularization (MNV) in eyes with unilateral non-exudative age-related macular degeneration (AMD). Design Prospective cohort study. Methods Patients were imaged using 3x3 mm and 6x6 mm SS-OCTA scan patterns. MNV was detected using the outer retina to choriocapillaris en face slab. Prevalence and incidence of subclinical MNV, Kaplan-Meier cumulative estimates for the overall risk of exudation, and the association between neovascular lesion size and the risk of exudation were assessed through 2 years. Results From August 2014 through March 2018 ...

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    16. Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children

      Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children

      Purpose Measurements of the ganglion cell complex (GCC), comprising the retinal nerve fiber (RNFL), ganglion cell, and inner plexiform layers, can be correlated with vision loss caused by optic nerve disease. Handheld optical coherence tomography (HH-OCT) can be used with sedation in children not amenable to traditional imaging. Purpose: to report GCC and RNFL measurements in normal children using HH-OCT. Design Prospective observational study of normal children ≤ 5-years of age. Methods Healthy, full-term children ≤5 years-old undergoing sedation or anesthesia were enrolled. Exclusion criteria: prematurity, pre-existing neurologic, genetic, metabolic or intraocular pathology. Demographic data, axial length (Master-Vu Sonomed Escalon, NY ...

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    17. Retinal And Choroidal Optical Coherence Tomography Findings Of Carotid Cavernous Fistula

      Retinal And Choroidal Optical Coherence Tomography Findings Of Carotid Cavernous Fistula

      PURPOSE To define the retinal and choroidal imaging findings of carotid cavernous fistula (CCF) including central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI) parameters and tortuosity indexes (TI) as compared to a control group (CG). DESIGN Cross-sectional study MATERIALS AND METHODS The spectral domain enhanced-depth imaging optical coherence tomography (SD-EDI-OCT) images of 19 eyes of 19 consecutive patients with angiographically proven CCF and 19 eyes of 19 age- and sex- matched healthy control subjects were included. The patient group was divided according to CCF venous drainage pattern as anterior (A-CCF: draining into ophthalmic veins) and posterior ...

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    18. Differentiating veins from arteries on optical coherence tomography angiography by identifying deep capillary plexus vortices

      Differentiating veins from arteries on optical coherence tomography angiography by identifying deep capillary plexus vortices

      Purpose To introduce a simple method for differentiating retinal veins from arteries on optical coherence tomography angiography (OCTA). Design Cross-sectional pilot study. Methods Four default en face slabs including color depth encoded, greyscale full-thickness retina, superficial plexus, and deep capillary plexus (DCP) from 9 3x3 mm and 9 6x6 mm OCTA scans were exported and aligned. Nine ophthalmologists with minimum OCTA experience from 2 eye institutions were instructed to classify labeled vessels as arteries or veins in 3 stages. Classification was performed based on graders’ own assessment at Stage 1. Graders were taught that a capillary-free zone was an anatomic ...

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      Mentions: K. Bailey Freund
    19. Use of High-Resolution Optical Coherence Tomography in the Surgical Management of Ocular Surface Squamous Neoplasia: A Pilot Study

      Use of High-Resolution Optical Coherence Tomography in the Surgical Management of Ocular Surface Squamous Neoplasia: A Pilot Study

      Purpose To evaluate whether high-resolution optical coherence tomography (HR-OCT) can detect histologic tumor margins of ocular surface squamous neoplasia (OSSN). Methods Eight eyes of 8 patients with OSSN undergoing excision were studied prospectively. Immediately before surgery, the tumor was imaged using a commercially available HR-OCT (Bioptigen/Leica Microsystems, Buffalo Grove, IL) to identify the conjunctival margins of the neoplastic lesion. The tumor borders of the lesion determined by HR-OCT were mapped in relation to an anatomical reference point and transferred intraoperatively. The tumor was excised with 4 mm margins from the visible edge of the lesion with a “no-touch” technique ...

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    20. Correlation of Outer Retinal Degeneration and Choriocapillaris Loss in Stargardt Disease Using En Face Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Correlation of Outer Retinal Degeneration and Choriocapillaris Loss in Stargardt Disease Using En Face Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Purpose This study measured and correlated degeneration of the junction between the inner and outer segments (IS/OS), the retinal pigment epithelium (RPE), and the choriocapillaris (CC) in Stargardt disease (STGD). Design Prospective cross-sectional study. Methods This study was conducted at the Casey Eye Institute. A total of 23 patients with STGD were enrolled and underwent optical coherence tomography angiography (OCTA). Scans were centered on the fovea. OCT slab projections and en face boundary maps were used to create masks to measure total IS/OS loss or RPE atrophy as well as regions of isolated IS/OS loss, isolated RPE ...

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    21. Anterior Segment Optical Coherence Tomography Angiography Imaging of Conjunctiva and Intrasclera in Treated Primary Open-Angle Glaucoma

      Anterior Segment Optical Coherence Tomography Angiography Imaging of Conjunctiva and Intrasclera in Treated Primary Open-Angle Glaucoma

      Purpose To investigate conjunctival and intrascleral vasculature in glaucoma eyes using anterior segment (AS)-optical coherence tomography angiography (OCTA) and assess the factors contributing to the vessel density in AS-OCTA images. Design Prospective, cross-sectional study. Methods Thirty-four patients with primary open-angle glaucoma and 20 healthy subjects were included. A swept-source OCT system was used to obtain AS-OCTA images of the corneal limbus at the nasal and temporal quadrants. Vessel densities were measured in the superficial (from the conjunctival epithelium to a depth of 200 μm) and deep (from a depth of 200 μm to 1000 μm) layers. The vessel density ...

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    22. Longitudinal Macular Structure-Function Relationships in Glaucoma and Their Sources of Variability

      Longitudinal Macular Structure-Function Relationships in Glaucoma and Their Sources of Variability

      Purpose 1) Review central structure-function (SF) relationships in glaucoma; 2) compare contributions of within-session and between-session variability to total variability of macular optical coherence tomography (OCT) thickness measurements; and 3) test the hypothesis that longitudinal within-eye variability of central SF relationships is smaller than between-individual variability. Methods We reviewed the pertinent literature on central SF relationships in glaucoma. Thirty-eight eyes (20 normal or glaucoma subjects) had ×3 macular images per session over 3 sessions and superpixels thickness measurements for ganglion cell layer (GCL), ganglion cell/inner plexiform layer (GCIPL), ganglion cell complex (GCC) and full macular thickness (FMT) were exported ...

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    23. Improved Macular Capillary Flow On Optical Coherence Tomography Angiography After Panretinal Photocoagulation For Proliferative Diabetic Retinopathy

      Improved Macular Capillary Flow On Optical Coherence Tomography Angiography After Panretinal Photocoagulation For Proliferative Diabetic Retinopathy

      Purpose To evaluate the macular microvascular changes in eyes with proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP) Methods Using OCT angiography, we prospectively studied 10 eyes of 10 subjects with high risk PDR immediately before, 1 month and 3-6 months following PRP, using 3x3mm OCTA scan at each visit. The following parameters were calculated for the superficial (SCP), middle (MCP), and deep capillary plexuses (DCP): parafoveal vessel density, adjusted flow index (AFI) and percent area of non-perfusion (PAN). Parafoveal SCP vessel length density (VLD) was also evaluated. We performed univariate and multivariable statistics, adjusting for age and signal strength ...

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