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    1. Color Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography in Diagnosing Polypoidal Choroidal Vasculopathy

      Color Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography in Diagnosing Polypoidal Choroidal Vasculopathy

      Purpose To determine sensitivity and specificity of polypoidal choroidal vasculopathy (PCV) diagnosis using color fundus photography (CFP), optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) without indocyanine-green angiography (ICGA). Design Validity analysis. Methods Treatment-naïve eyes with serous/serosanguinous maculopathy undergoing CFP, OCT, FFA and ICGA imaging before treatment at a university-hospital in Thailand (January 2013 to June 2015) were identified. Images of each subject were categorized into 4 sets (set A: CFP; set B: CFP+OCT; set C: CFP+FFA; set D: CFP+OCT+FFA). Six graders, 3 from Thailand (PCV endemic area) and 3 from U.S ...

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    2. Optical Coherence Tomography Angiography in Optic Disc Swelling

      Optical Coherence Tomography Angiography in Optic Disc Swelling

      Purpose To compare optical coherence tomography angiography (OCT-A) of peripapillary total vasculature and capillaries in patients with optic disc swelling. Design Cross-sectional study. Methods Twenty nine eyes with acute nonarteritic anterior ischemic optic neuropathy (NAION), 44 eyes with papilledema, 8 eyes with acute optic neuritis, and 48 eyes of normal subjects were imaged using OCT-A. Peripapillary total vasculature information was recorded using a commercial vessel density map. Customized image analysis with major vessel removal was also used to measure whole-image capillary density and peripapillary capillary density (PCD). Results Mixed models showed that the peripapillary total vasculature density values were significantly ...

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    3. Automated segmentation of lesions including subretinal hyperreflective material in neovascular age-related macular degeneration

      Automated segmentation of lesions including subretinal hyperreflective material in neovascular age-related macular degeneration

      Purpose To evaluate an automated segmentation algorithm with a convolutional neural network (CNN) to quantify and detect intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), and subretinal hyperreflective material (SHRM) through analyses of spectral domain optical coherence tomography (SD-OCT) images from patients with neovascular age-related macular degeneration (nAMD). Design Reliability and validity analysis of a diagnostic tool. Methods We constructed a dataset including 930 B-scans from 93 eyes of 93 patients with nAMD. A CNN-based deep neural network was trained using 11550 augmented images derived from 550 B-scans. The performance of the trained network was evaluated using a ...

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    4. Spectral Domain Optical Coherence Tomography in Limbal Stem Cell Deficiency. A Case Control Study

      Spectral Domain Optical Coherence Tomography in Limbal Stem Cell Deficiency. A Case Control Study

      Purpose To evaluate the efficacy of optical coherence tomography as a non-contact method for imaging the ocular surface in limbal stem cell deficiency (LSCD) and normal eyes. Design Retrospective case-control study. Methods: Setting Institutional. Study population 22 eyes with LSCD (study group, 22 patients) and 10 normal eyes (control group, 10 patients). Observation procedures SD-OCT and confocal microscopy in both the limbal and central corneal zones. Main outcome measures Pachymetry data from the central cornea, presence of the palisades of Vogt, limbal crypts and clear transition between the hyporeflective corneal epithelium and the hyperreflective conjunctival epithelium assessed on cross-sections parallel ...

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      Mentions: Kate Grieve
    5. Dense B-scan Optical Coherence Tomography Angiography

      Dense B-scan Optical Coherence Tomography Angiography

      Purpose To describe a novel imaging technique, we call “dense B-scan optical coherence tomography angiography” (DB OCTA) in which thin dense raster scans are used to produce highly resolved structural B-scans with superimposed flow signal that provide precise correlation between retinal microstructure and blood flow. Design Observational case series Methods Normal eyes and eyes with macular findings of interest were imaged with DB OCTA in which 150-400 OCT B-scans were acquired within a narrow area (from a single line to 1°) with a width of 10 to 30°. B-scans containing 5-7 consecutive frames were processed for OCTA signal and then ...

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      Mentions: K. Bailey Freund
    6. Inter-eye Asymmetry of Optical Coherence Tomography Angiography Vessel Density in Bilateral Glaucoma, Glaucoma Suspect, and Healthy Eyes

      Inter-eye Asymmetry of Optical Coherence Tomography Angiography Vessel Density in Bilateral Glaucoma, Glaucoma Suspect, and Healthy Eyes

      Purpose To investigate inter-eye retinal vessel density asymmetry in healthy, glaucoma suspect, and mild to moderate glaucoma subjects, and its potential utility for early detection of glaucomatous damage. Design Cross-sectional study. Methods 153 subjects including 55 healthy, 32 glaucoma suspect, and 66 glaucoma subjects enrolled in the Diagnostic Innovations in Glaucoma Study(DIGS). Vessel density was obtained from optical coherence tomography angiography (OCT-A) macular and optic nerve head scans. Thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (mGCC) was measured with spectral-domain optical coherence tomography (SD-OCT) scans. Inter-eye asymmetry was calculated by taking the absolute ...

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    7. Analysis of Retinal Thinning Using Spectral-domain Optical Coherence Tomography Imaging of Sickle Cell Retinopathy Eyes Compared to Age- and Race-Matched Control Eyes

      Analysis of Retinal Thinning Using Spectral-domain Optical Coherence Tomography Imaging of Sickle Cell Retinopathy Eyes Compared to Age- and Race-Matched Control Eyes

      Purpose To determine whether the retina is thinner in sickle cell patients than in race- and age-matched controls, and, if it is thinner, whether there is any association with systemic diseases. Methods Sickle cell and control (age- and race-matched) patients were prospectively enrolled from a university retina clinic into this observational study. Participants underwent visual acuity testing, slit-lamp biomicroscopy, dilated ophthalmoscopy, and spectral-domain optical coherence tomography imaging. Sickle cell retinal lesions, degree of vascular tortuosity, caliber of arteriovenous anastomosis, and stage of retinopathy were noted. Early Treatment Diabetic Retinopathy Study (ETDRS) subfield measurements were compared between sickle cell and control ...

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    8. Macular displacement after vitrectomy in eyes with idiopathic macular hole determined by optical coherence tomography angiography

      Macular displacement after vitrectomy in eyes with idiopathic macular hole determined by optical coherence tomography angiography

      Purpose To determine whether the macula is displaced after vitrectomy with internal limiting membrane (ILM) peeling in eyes with an idiopathic macular hole. Design A retrospective, observational case series Methods Optical coherence tomography angiography (OCTA) was used to obtain 3 mm × 3 mm en face images before and 2, 4, and 8 weeks after the vitrectomy with ILM peeling for 20 eyes of 20 patients with an idiopathic macular hole. The displacements of easily identifiable retinal vessel bifurcations were measured relative to the fovea and the optic disc. Results The distance between the optic disc and vessel bifurcations was significantly ...

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    9. Comparisons Between Histology and Optical Coherence Tomography Angiography of the Periarterial Capillary-Free Zone

      Comparisons Between Histology and Optical Coherence Tomography Angiography of the Periarterial Capillary-Free Zone

      Purpose To use the capillary-free zone along retinal arteries, a physiologic area of superficial avascularization, as an anatomic paradigm to investigate the reliability of optical coherence tomographic angiography (OCTA) for visualizing the deep retinal circulation. Design Validity analysis and laboratory investigation. Methods Five normal human donor eyes (mean age 69.8 years) were perfusion-labelled with endothelial antibodies and the capillary networks of the perifovea were visualized using confocal scanning laser microscopy. Regions of the capillary-free zone along the retinal artery were imaged using OCTA in 16 normal subjects (age range 24-51 years). 3x3mm scans were acquired using the RTVue XR ...

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    10. Assessment of lamellar macular hole and macular pseudohole with a combination of en face and radial B-scan optical coherence tomography imaging

      Assessment of lamellar macular hole and macular pseudohole with a combination of en face and radial B-scan optical coherence tomography imaging

      Purpose To investigate lamellar macular hole (LMH) and macular pseudohole (MPH) using a combination of en face and radial B-scan OCT. Design Retrospective observational case series. Methods Setting: Institutional study Patient Population En face and radial B-scan OCT images of 63 eyes of 60 patients diagnosed with LMH or MPH based on an international classification were reviewed. Observation Procedures Cases were classified using en face images based on the presence/absence of epiretinal membrane (ERM), retinal folds, parafoveal epicenter of contractile ERM (PEC-ERM), and retinal cleavage. We compared the en face imaging-based classification system with the international classification system using ...

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    11. Implantable Collamer Lens-sizing Method based on Swept Source Anterior Segment Optical Coherence Tomography

      Implantable Collamer Lens-sizing Method based on Swept Source Anterior Segment Optical Coherence Tomography

      Purpose To develop and evaluate the accuracy of a size -determination formula using anterior segment optical coherence tomography (AS-OCT) parameters. Design Interventional case series Methods This study included 46 eyes of 23 patients with implantable collamer lens (ICL). Preoperatively, the anterior segment parameters were measured using high-frequency ultrasound biomicroscopy and AS-OCT. Three-months postoperatively, the vaults were measured and the optimal ICL size was calculated using a previously published method. Stepwise multiple regression analysis was performed using the optimal ICL size as a dependent variable; the NK-formula was obtained. Thereafter, 35 eyes of 18 patients were implanted with ICL after calculating ...

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    12. Retinal Vascular Impairment in Best Vitelliform Macular Dystrophy Assessed by Means of Optical Coherence Tomography Angiography

      Retinal Vascular Impairment in Best Vitelliform Macular Dystrophy Assessed by Means of Optical Coherence Tomography Angiography

      Purpose To evaluate vascular abnormalities at superficial (SCP), deep (DCP) capillary plexuses and choriocapillaris (CC) in patients with Best vitelliform macular dystrophy (BVMD) by means of optical coherence tomography angiography (OCT-A). Design Cross-sectional case series. Methods Sixty-six eyes of 33 patients with BVMD (sixteen males) and 33 controls were consecutively enrolled. Patients were subdivided in classic stages and underwent best-corrected visual acuity (BCVA), fundus autofluorescence and spectral domain-optical coherence tomography (Spectralis HRA+OCT; Heidelberg Engineering), and 4.5x4.5-mm Swept Source OCT-A (Triton DRI OCT; Topcon Corporation). Choroidal neovascularization (CNV) and capillary dilations were qualitatively assessed by two masked ophthalmologists ...

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    13. Long-term Progression of Type 1 Neovascularization in Age-related Macular Degeneration Using Optical Coherence Tomography Angiography

      Long-term Progression of Type 1 Neovascularization in Age-related Macular Degeneration Using Optical Coherence Tomography Angiography

      Purpose To analyze the long-term growth patterns of type 1 neovascularization (NV) in eyes with age-related macular degeneration (AMD) receiving anti-vascular endothelial growth factor (VEGF) therapy. Design : Retrospective cohort study. Methods Patients were enrolled from two eye centers and underwent optical coherence tomography angiography (OCTA) imaging with follow-up greater than 1 year. Choroidal neovascularization (CNV) was manually segmented on OCTA images and compared between time points. CNV growth was sub-divided into three categories based on OCTA area measurement: CNV doubling, modest growth of less than 50%, and shrinkage. These growth rates were correlated with OCTA morphologic features. Results : Forty-one eyes ...

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    14. Spending Money to Save Money on Patient Care—The Development of Ocular Coherence Tomography

      Spending Money to Save Money on Patient Care—The Development of Ocular Coherence Tomography

      The rising costs of medical care affect individuals' insurance coverage, shape the medical plans offered by companies, and challenge national policymakers. Several factors drive inflation, including the development and application of potent pharmaceuticals, interventional technologies, and advanced imaging. Ophthalmology patients have benefited tremendously from the novel application of new laser technologies, improved phacoemulsification machines, advanced intraocular lenses, and minimally invasive glaucoma surgery.

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    15. Estimating Public and Patient Savings From Basic Research—A Study of Optical Coherence Tomography in Managing Antiangiogenic Therapy

      Estimating Public and Patient Savings From Basic Research—A Study of Optical Coherence Tomography in Managing Antiangiogenic Therapy

      Purpose To compare patient and Medicare savings from the use of optical coherence tomography (OCT) in guiding therapy for neovascular age-related macular degeneration (nvAMD) to the research investments made in developing OCT by the National Institutes of Health (NIH) and the National Science Foundation (NSF). Design Observational cohort study. Methods Main outcome measures were spending by Medicare as tracked by Current Procedural Terminology codes on intravitreal injections (67028), retinal OCT imaging (92134), and anti–vascular endothelial growth factor (anti-VEGF) treatment–specific J-codes (J0178, J2778, J9035, J3490, and J3590). These claims were identified from the Medicare Provider Utilization and Payment Data ...

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    16. Impacts of Implantable Collamer Lens V4c Placement on Angle Measurements Made by Optical Coherence Tomography: Two-Year Follow-up

      Impacts of Implantable Collamer Lens V4c Placement on Angle Measurements Made by Optical Coherence Tomography: Two-Year Follow-up

      We appreciate the comments made by Galvis and associates regarding our recently published article in which we report anterior chamber angle narrowing in response to implantable collamer lens (ICL) placement. The mean angle narrowing observed was approximately 39%–41% for the whole population. In response to the first question, in patients with a vault larger than 750 μm, angle reduction was 55.2%–56.7%, compared with 34.7%–38.3% produced in patients with a vault ≤ 750 μm. It is well known that vault is an important determinant of anterior chamber angle, and, as we describe in our article ...

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    17. Reproducibility of vessel density, fractal dimension and foveal avascular zone using 7 different optical coherence tomography angiography devices

      Reproducibility of vessel density, fractal dimension and foveal avascular zone using 7 different optical coherence tomography angiography devices

      Purpose To evaluate the reproducibility of parafoveal microvascular anatomy of 7 different optical coherence tomography angiography (OCT-A) devices by comparing vessels density (VD), fractal dimension (FD) and foveal avascular zone (FAZ) of superficial and deep capillary plexus in healthy volunteers. Design Reliability analysis. Methods Consecutive healthy volunteers presenting at the Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan in the same clinic visit were imaged by 7 different OCT-A devices: Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA), prototype Spectralis OCT-A (Spectralis Heidelberg Engineering, Heidelberg, Germany), AngioPlex (Cirrus 5000 HD-OCT, Carl Zeiss Meditec, Inc ...

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    18. High Resolution Imaging in male germ cell associated kinase (MAK)-related Retinal Degeneration

      High Resolution Imaging in male germ cell associated kinase (MAK)-related Retinal Degeneration

      Purpose To describe the characteristics of MAK -related retinal degeneration using optical coherence tomography angiography (OCTA) and adaptive optics scanning laser ophthalmoscopy (AOSLO). Design Cross-sectional study. Methods Six patients with rod-cone degeneration and disease-causing mutations in MAK were evaluated with visual acuity, spectral domain OCT, confocal AOSLO and OCTA. Foveal avascular zone (FAZ) area, vessel densities and perfusion densities of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the central macula in all 6 patients were compared with 5 normal subjects. Cone spacing was measured in 4 patients from AOSLO images and compared with 37 normal subjects ...

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    19. Assessment of Optical Coherence Tomography Color Probability Codes in Myopic Glaucoma Eyes After Applying a Myopic Normative Database

      Assessment of Optical Coherence Tomography Color Probability Codes in Myopic Glaucoma Eyes After Applying a Myopic Normative Database

      We thank Drs Qiu and Zhang for their interest in our article. 1 Their comments focused on the possible influence of age, axial length, and disc size on the diagnostic performance of peripapillary retinal nerve fiber layer (RNFL) measurements. In this correspondence, we would like to expand our discussion in response to the comments raised by Drs Qiu and Zhang.

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    20. Use of a Neural Net to Model the Impact of Optical Coherence Tomography Abnormalities on Vision in Age-Related Macular Degeneration

      Use of a Neural Net to Model the Impact of Optical Coherence Tomography Abnormalities on Vision in Age-Related Macular Degeneration

      Purpose To develop a neural network for the estimation of visual acuity from optical coherence tomography (OCT) images of patients with neovascular age related macular degeneration and to demonstrate its use to model the impact of specific controlled OCT changes on vision. Design Artificial Intelligence (neural network) study. Methods We assessed 1400 OCT scans of patients with neovascular age related macular degeneration (AMD). 15 physical features for each eligible OCT as well as patient age were used as input data and corresponding recorded visual acuity as the target data to train, validate and test a supervised neural network. We then ...

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    21. Macular fluid reduces reproducibility of choroidal thickness measurements on enhanced depth optical coherence tomography

      Macular fluid reduces reproducibility of choroidal thickness measurements on enhanced depth optical coherence tomography

      Purpose To determine if different types of retinal fluid in the central macula affect the reproducibility of choroidal thickness (CT) measurements on enhanced depth imaging optical coherence tomography (EDI-OCT) Design retrospective, reliability analysis Methods EDI-OCT images were obtained and the choroidal-scleral junction was analyzed through semi-automated segmentation. CT was measured at the fovea and averaged across the central 3 mm horizontal segment. Demographic data, central macular thickness and type of fluid present were recorded. Intragrader and intergrader repeatability were assessed using the intraclass correlation coefficient (ICC) and coefficient of repeatability (CR). Results Of 124 eyes analyzed, 60 (48.4%) had ...

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    22. Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy with Swept-Source Optical Coherence Tomography

      Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy with Swept-Source Optical Coherence Tomography

      Purpose To compare choroidal vascular density (CVD) and volume (CVV) in diabetic eyes and controls, using en face swept-source optical coherence tomography (SS-OCT). Design Prospective cross-sectional study. Methods ▪▪▪ Setting Multicenter Patient Population 143 diabetic eyes – 27 with no diabetic retinopathy (DR), 47 with nonproliferative DR (NPDR), 51 with NPDR and diabetic macular edema (DME), and 18 with proliferative DR (PDR), and 64 age-matched non-diabetic control eyes. Observation procedures Complete ophthalmologic examination and SS-OCT imaging. En face SS-OCT images of the choroidal vasculature were binarized. Main outcome measures CVD, calculated as the percent area occupied by choroidal vessels in the central ...

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    23. Optical Coherence Tomography Protocols for Screening of Hydroxychloroquine Retinopathy in Asian Patients

      Optical Coherence Tomography Protocols for Screening of Hydroxychloroquine Retinopathy in Asian Patients

      Purpose To investigate the distribution of outer retinal changes in hydroxychloroquine (HCQ) retinopathy and explore optical coherence tomography (OCT) protocols to maximize the sensitivity of HCQ retinopathy detection in Asian patients. Design Diagnostic validity assessment Methods Setting : Institutional Patient Population : Forty-eight eyes (24 patients) with HCQ retinopathy underwent 6-mm horizontal and vertical line scans and 6 × 6-mm 2 volume scans using spectral-domain OCT (SD-OCT), and 9-mm line scans and 6 × 6-mm 2 and 12 × 9-mm 2 volume scans using swept-source OCT (SS-OCT). Observation Procedures : Distances from the fovea to the defective photoreceptors were measured in the temporal, nasal, superior, and ...

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    24. Differences in OCT Assessment of Bruch Membrane Opening Compared to Stereoscopic Photography for Estimating Cup-to-Disc Ratio

      Differences in OCT Assessment of Bruch Membrane Opening Compared to Stereoscopic Photography for Estimating Cup-to-Disc Ratio

      Purpose To compare the vertical and horizontal cup-to-disc ratio (VCDR, HCDR) by an updated optical coherence tomography (OCT) Bruch’s membrane opening (BMO) algorithm and stereoscopic optic disc photograph readings by glaucoma specialists. Design Reliability analysis. Methods 195 eyes (116 glaucoma and 79 glaucoma suspects) of 99 patients with stereoscopic photos and OCT scans of the optic discs taken during the same visit were compared. Optic disc photos were read by two masked glaucoma specialists for VCDR and HCDR estimation. Intraclass correlation coefficient (ICC) and Bland-Altman plots were used to assess the agreement between photo reading and OCT in estimating ...

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