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    1. Morphologic Features of Buried Optic Disc Drusen on En Face Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Morphologic Features of Buried Optic Disc Drusen on En Face Optical Coherence Tomography and Optical Coherence Tomography Angiography

      Purpose To evaluate and compare the morphologic characteristics of buried optic disc drusen (ODD) and optic disc edema (ODE) by using en face optical coherence tomography (OCT) and OCT angiography (OCTA) Design Retrospective, cross-sectional study Methods We reviewed the medical records of 61 patients (92 eyes) with buried ODD, 45 patients (62 eyes) with ODE, and 42 normal-appearing fellow eyes examined at one referral center between November 2017 and April 2019. Characteristic en face OCT and OCTA findings of buried ODD compared to those of ODE and normal optic discs were investigated. Results On en face OCT, All buried ODD ...

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    2. Automated diagnosis of diabetic retinopathy using clinical biomarkers, optical coherence tomography (OCT), and OCT angiography

      Automated diagnosis of diabetic retinopathy using clinical biomarkers, optical coherence tomography (OCT), and OCT angiography

      Purpose To determine if combining clinical, demographic, and imaging data improves automated diagnosis of nonproliferative diabetic retinopathy (NPDR). Design Cross-sectional imaging and machine learning study. Methods This was a retrospective study performed at a single academic medical center in the United States. Inclusion criteria were age > 18 and a diagnosis of diabetes mellitus (DM). Exclusion criteria were non-DR retinal disease and inability to image the macula. Optical coherence tomography (OCT) and OCT angiography (OCTA) were performed, and data on age, gender, hypertension, hyperlipidemia, and hemoglobin A1c were collected. Machine learning techniques were then applied. Multiple pathophysiologically important features were automatically ...

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    3. OCT Angiography Features of Neovascularization as Predictive Factors for Frequent Recurrence in Age-Related Macular Degeneration

      OCT Angiography Features of Neovascularization as Predictive Factors for Frequent Recurrence in Age-Related Macular Degeneration

      Purpose To investigate the features of neovascularization (NV) in eyes with neovascular age-related macular degeneration (NVAMD) using optical coherence tomography angiography (OCTA) according to the treatment interval of intravitreal aflibercept injection (IVI). Design Retrospective, interventional, comparative case series. Methods Patients with type 1 NV treated with the “pro-re-nata” regimen after three loading IVI were classified into two groups based on the numbers of treatments during 12 months, specifically a stable group who required less than two injections and an unstable group who required more than three injections. Quantitative features of OCTA including NV area, NV length, NV density, endpoint density ...

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    4. OCT Structural Abnormality Detection in Glaucoma using Topographically Correspondent Rim and Retinal Nerve Fiber Layer Criteria

      OCT Structural Abnormality Detection in Glaucoma using Topographically Correspondent Rim and Retinal Nerve Fiber Layer Criteria

      Purpose To evaluate the ability of topographically correspondent (TC) minimum rim width (MRW) and peripapillary retinal nerve fiber layer thickness (pRNFLT) criteria to detect optical coherence tomography (OCT) structural abnormality in glaucoma (GL) and glaucoma suspect (GLS) eyes. Design Retrospective cross-sectional study. Methods 196 GL, 150 GLS eyes and 303 Heathy eyes underwent PRNFL and 24 radial optic nerve head OCT imaging and manual correction of the internal limiting membrane, Bruch’s membrane opening (BMO) and outer pRNFL segmentations. MRW and pRNFLT were quantified in six Garway-Heath (GH) or twelve 30° (clock-hour) sectors. OCT abnormality for each parameter was defined ...

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    5. A Framework for Multiscale Quantitation of Relationships Between Choriocapillaris Flow Impairment and Geographic Atrophy Growth

      A Framework for Multiscale Quantitation of Relationships Between Choriocapillaris Flow Impairment and Geographic Atrophy Growth

      Purpose To develop a multiscale analysis framework for investigating the relationships between geographic atrophy (GA) growth rate and choriocapillaris (CC) blood flow impairment using optical coherence tomography (OCT) and OCT angiography (OCTA). Design Retrospective case series. Methods We developed an OCT/OCTA analysis framework that quantitatively measures GA growth rates at global and local scales, and CC impairment at global, zonal, and local scales. A geometric GA growth model was used to measure local GA growth rates. The utility of the framework was demonstrated on 7 eyes with GA imaged at two time points using a prototype 400 kHz, 1050 ...

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    6. Retinal Vessel Density in Exudative and Non-Exudative Age-Related Macular Degeneration on Optical Coherence Tomography Angiography

      Retinal Vessel Density in Exudative and Non-Exudative Age-Related Macular Degeneration on Optical Coherence Tomography Angiography

      Importance Although the choroid contributes to the pathogenesis of age-related macular degeneration (AMD), the role of retinal perfusion is unclear. Purpose To compare retinal vascular measurements between eyes with non-exudative and exudative AMD using optical coherence tomography angiography (OCT-A). Design Retrospective, cross-sectional study. Methods OCT-A images were analyzed from 310 eyes of 182 patients (mean age 78.8±8.8) with non-exudative (54.2%) and exudative (45.8%) AMD to measure retinal vessel density (VD) from the superficial capillary plexus in the foveal, parafoveal, and full macular regions and foveal avascular zone (FAZ) area, perimeter, and circularity. Multivariate regressions were ...

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    7. Trends in Retina Specialist Imaging Utilization from 2012 to 2016 in the United States Medicare Fee-for-Service Population

      Trends in Retina Specialist Imaging Utilization from 2012 to 2016 in the United States Medicare Fee-for-Service Population

      Purpose To characterize temporal trends and regional variance in retinal imaging utilization in the United States Medicare fee-for-service population from 2012–2016. Design Cross-sectional, retrospective database analysis. Methods This study addresses office or operating-room based retinal imaging. Our study population included retina specialists, defined as ophthalmologists performing either intravitreal anti–vascular endothelial growth factor injections or posterior segment laser photocoagulation and no neodymium-doped yttrium aluminum garnet laser capsulotomy. We recorded fundus photography, optical coherence tomography (OCT), intravenous fluorescein angiography (IVFA), indocyanine-green angiography, and ophthalmic ultrasound (B-scan) billed in the Medicare fee-for-service population from 2012–2016. Imaging obtained on any platform ...

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    8. Correspondence: Trends in Retina Specialist Imaging Utilization From 2012 to 2016 in the United States Medicare Fee-for-Service Population

      Correspondence: Trends in Retina Specialist Imaging Utilization From 2012 to 2016 in the United States Medicare Fee-for-Service Population

      We read with great interest the recent report by Wibbelsman and associates titled “Trends in Retina Specialist Imaging Utilization from 2012 to 2016 in the USA Medicare fee-for-service Population.”1 Despite the prominent role of optical coherence tomography (OCT) in ophthalmic practice, there is a surprising scarcity of published literature on the frequency of its application.

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    9. Comparison of Short- And Long-Term Variability On Standard Perimetry and Spectral Domain Optical Coherence Tomography in Glaucoma

      Comparison of Short- And Long-Term Variability On Standard Perimetry and Spectral Domain Optical Coherence Tomography in Glaucoma

      Purpose To assess short-term and long-term variability on standard automated perimetry (SAP) and spectral domain optical coherence tomography (SD-OCT) in glaucoma. Design Prospective cohort. Methods Ordinary least squares linear regression of SAP mean deviation (MD) and SD-OCT global retinal nerve fiber layer (RNFL) thickness were fitted over time for sequential tests conducted within 5 weeks (short-term testing) and annually (long-term testing). Residuals were obtained by subtracting the predicted and observed values and each patient’s standard deviation (SD) of the residuals was used as a measure of variability. Wilcoxon signed-rank test was performed to test the hypothesis of equality between ...

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    10. Chronic Neovascular Central Serous Chorioretinopathy: A Stress/Rest Optical Coherence Tomography Angiography Study

      Chronic Neovascular Central Serous Chorioretinopathy: A Stress/Rest Optical Coherence Tomography Angiography Study

      Purpose To compare optical coherence tomography–angiography performed during physical exercise (stress OCT-A) to the basal examination (rest OCT-A) in the imaging of choroidal neovascularization (CNV) in patients with chronic central serous chorioretinopathy (CSCR). Design Prospective, cohort study. Methods This multicenter study included 29 consecutive patients with chronic CSCR and flat irregular pigment epithelium detachments (FIPEDs). All patients underwent rest and stress OCT-A (i.e., hand-grip test [HGT]). Systemic hemodynamic data were recorded during the examinations. Rest and stress OCT-angiograms in the en-face and cross-sectional views were qualitatively compared to establish the degree of evidence of flow signals due to ...

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    11. Comment on: Border Tissue Morphology Is Spatially Associated With Focal Lamina Cribrosa Defect and Deep-Layer Microvasculature Dropout in Open-Angle Glaucoma

      Comment on: Border Tissue Morphology Is Spatially Associated With Focal Lamina Cribrosa Defect and Deep-Layer Microvasculature Dropout in Open-Angle Glaucoma

      We congratulate Han and associates1 for their study and appreciate their effort to identify focal lamina cribrosa (LC) defect and the microvascular dropout (MvD) as the biomarkers to reflect glaucoma severity. However, we have a few queries and seek your kind attention.

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    12. 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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    13. 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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    14. 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
    15. 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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    16. 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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    17. 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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    18. 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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      Mentions: Optovue
    19. 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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    20. 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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    21. 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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    22. 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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    23. 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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    24. 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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