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

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

      We greatly appreciate the interest that Sibony and associates 1 demonstrated in our study. The authors raised an important question regarding the definition of optic disc drusen (ODD) in our study. We know that the Optic Disc Drusen Studies Consortium defined ODD as hyporeflective lesions surrounded by hyperreflective capsules using optical coherence tomography (OCT). We previously showed that this kind of visible drusen can be observed especially in the eyes of the elderly associated with degenerative changes on OCT. 2 However, in young patients, ODD can be seen as a hyperreflective mass on OCT, located nasal to the optic disc ...

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    2. Validation of a Compensation Strategy used to Detect Choriocapillaris Flow Deficits Under Drusen with Swept Source OCT Angiography

      Validation of a Compensation Strategy used to Detect Choriocapillaris Flow Deficits Under Drusen with Swept Source OCT Angiography

      Purpose A compensation strategy that was developed to measure the choriocapillaris (CC) flow deficits (FDs) under drusen was tested in eyes with large drusen from age-related macular degeneration (AMD) before and after the drusen spontaneously resolved without evidence of disease progression. Design Prospective, observational consecutive case series. Methods Patients with AMD were enrolled in a prospective SS-OCT imaging study (PLEX® Elite 9000, Carl Zeiss Meditec). Consecutive eyes with large drusen were followed, and eyes that underwent spontaneous collapse of drusen without evidence of disease progression were identified retrospectively. The drusen-resolved regions were manually outlined. CC FDs were measured using a ...

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    3. Eliminating Visual Acuity and Dilated Fundus Exams Improves Cost Efficiency of Performing OCT-Guided Intravitreal Injections

      Eliminating Visual Acuity and Dilated Fundus Exams Improves Cost Efficiency of Performing OCT-Guided Intravitreal Injections

      Purpose The clinic efficiency and cost savings achieved by eliminating formal visual acuity (VA) and dilated fundus exams (DFEs) were assessed for established patients receiving OCT-guided intravitreal injections. Design Comparative cost analysis Methods Two different treatment models were evaluated. The first model included patients undergoing routine VA assessment, DFEs, OCT imaging, and intravitreal injections. The second model eliminated the routine VA assessment and DFE, while utilizing OCT imaging through an undilated pupil followed by the intravitreal injection. The two models incorporated both bevacizumab and aflibercept. The number of patients per clinic day, the cost per visit, and the daily revenues ...

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    4. Macular and Peripapillary OCTA Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data

      Macular and Peripapillary OCTA Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data

      Purpose To identify optical coherence tomography angiography (OCTA) derived vessel metrics of the macula and optic nerve head (ONH) that predict diabetic retinopathy (DR) disease progression. Design Secondary analysis of clinical trial data Methods This was a sub-analysis of prospectively collected data from 73 subjects that participated in the TIME-2b Study (Aerpio Pharmaceuticals), a multi-center clinical trial for patients with moderate to severe DR treated with AKB-9778 and followed over a 12-month period. Eligible subjects were tested every 3 months with color fundus photography, spectral domain OCT and slit-lamp biomicroscopy. OCTA of the macula and ONH was obtained for a ...

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    5. Diagnostic Accuracy of Wide-Field Map from Swept-Source Optical Coherence Tomography for Primary Open-Angle Glaucoma in Myopic Eyes

      Diagnostic Accuracy of Wide-Field Map from Swept-Source Optical Coherence Tomography for Primary Open-Angle Glaucoma in Myopic Eyes

      Purpose To compare the accuracy for glaucomatous defects and diagnostic power for primary open-angle glaucoma (POAG) between swept-source optical coherence tomography (SS-OCT) and spectral-domain optical coherence tomography (SD-OCT) in myopic eyes. Design Prospective, case-control study Methods One hundred and fifty (150) myopic POAG eyes and 100 healthy myopic eyes underwent SD-OCT and SS-OCT in random order, on the same day. The locations of glaucomatous defect on SD-OCT thickness and deviation maps and SS-OCT wide-field thickness (thickness surface) and SuperPixel maps were rated, and the maps’ accuracies were compared. The area under receiver operating characteristic (AUROC) of the peripapillary retinal nerve ...

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    6. Capillary Density Measured by OCT Angiography in Glaucomatous Optic Disc Phenotypes

      Capillary Density Measured by OCT Angiography in Glaucomatous Optic Disc Phenotypes

      Purpose To compare optical coherence tomography angiography (OCTA) measured capillary density of the optic disc among four glaucomatous optic disc phenotypes. Design Cross-sectional study. Methods Circumpapillary capillary density (cpCD) of four glaucomatous optic disc phenotypes in 193 eyes of 141 glaucoma patients and cpCD in 92 eyes of 55 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were compared. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy among groups after adjusting for confounders. Results Four glaucoma phenotypes were assessed including focal ischemic (n=45), generalized cup enlargement (n=60), myopic glaucoma (n ...

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    7. Prognostic utility of optical coherence tomography for long-term visual recovery following pituitary tumor surgery

      Prognostic utility of optical coherence tomography for long-term visual recovery following pituitary tumor surgery

      Purpose To investigate the association between optical coherence tomography (OCT) parameters and long-term visual recovery following optic chiasm decompression surgery. Design Prospective cohort study. Methods Consecutive patients undergoing pituitary or parasellar tumor resection, between January 2009 to December 2018, were recruited in a single-centre, two-year prospective, longitudinal cohort study. Best-corrected visual acuity, visual fields, and OCT retinal nerve fibre layer (RNFL) thickness, macular thickness and volume were assessed pre-operatively, and at 6 weeks, 6 months, and 2 years post-operatively. Long-term visual field recovery and maintenance was defined as a mean deviation greater than -3 at 24 months, and visual acuity ...

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    8. Optical Coherence Tomography Findings in Tamoxifen Retinopathy

      Optical Coherence Tomography Findings in Tamoxifen Retinopathy

      Purpose To describe optical coherence tomography (OCT) findings in two cases of typical tamoxifen retinopathy. Design Observational cases report. Methods Two patients with tamoxifen retinopathy were imaged with fluorescein angiography and OCT 3. Results Fluorescein angiography showed foveolar hyperfluorescence. OCT revealed a foveolar cystoid space with focal disruption of the photoreceptor line. There was no evidence of macular edema or thickening. Conclusions In both cases, OCT findings are not consistent with previous descriptions of tamoxifen retinopathy, based on fundus examination and fluorescein angiography, which include a description of macular edema. This new imaging suggests that tamoxifen maculopathy may include a ...

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    9. Foveal crack sign: an optical coherence tomography sign preceding macular hole after vitrectomy for rhegmatogenous retinal detachment

      Foveal crack sign: an optical coherence tomography sign preceding macular hole after vitrectomy for rhegmatogenous retinal detachment

      Purpose To describe an optical coherence tomography (OCT) sign preceding macular hole (MH) formation after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Design Retrospective observational case series. Methods Patients who underwent PPV for RRD at Osaka Rosai Hospital between January 2014 and December 2017 were analyzed. First, the medical records of the patients who had secondary MH after RRD repair were examined, and their sequential changes of the OCT images until MH formation were evaluated. Second, the OCT findings and the medical records of all patients who underwent PPV for RRD were evaluated based on the findings of ...

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    10. 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

      We read with interest the work of Kim and associates 1 and their use of optical coherence tomography angiography (OCTA) to define peripapillary vascular structures in eyes with presumed optic disc drusen (ODD) and optic disc edema (ODE) in an effort to understand pathogenesis and local architecture. We leave the question of their definition of ODD to a separate letter for which we are co-authors and focus here on the reported vascular abnormalities in various etiologies of ODE including papilledema, optic neuritis, and nonarteritic anterior ischemic optic neuropathy (NAION). They report a significant qualitative decrease in retinal peripapillary capillary (RPC ...

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    11. Who Could Know Who I Am? The Possibility of Patient Identification With Retinal Imaging

      Who Could Know Who I Am? The Possibility of Patient Identification With Retinal Imaging

      When fugitive Jean Valjean rhetorically asks, “Who am I?” in the musical version of Victor Hugo's Les Miserables , he feared what would happen if someone recognized his face and identified him by the convict number on his yellow passport. Almost 200 years later, digital imaging of unique biological characteristics has expanded the possible means of identification. Simon and Goldstein first described a unique patient-specific retinal vascular network for identification in 1935. 1 Since the concept's advent, several variations on the assessment of retinal vessels have been proposed to improve the accuracy of identification. 2 , 3 , 4 Hill developed ...

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    12. Optimizing the Repeatability of Choriocapillaris Flow Deficit Measurement from Optical Coherence Tomography Angiography

      Optimizing the Repeatability of Choriocapillaris Flow Deficit Measurement from Optical Coherence Tomography Angiography

      Purpose To evaluate impact of processing technique and slab selection on the repeatability of choriocapillaris (CC) flow deficit (FD) measurements as assessed using optical coherence tomography angiography (OCTA) Design: prospective, cross-sectional study Methods Healthy subjects were imaged with four consecutive 3x3mm OCTA using a swept source OCT (PLEX elite 9000, Carl Zeiss Meditec, Dublin, CA). OCTA images were generated using the Max projection, and three 10 μm-thick slabs starting 11, 21 and 31 μm posterior to the automatically segmented retinal pigment epithelium (RPE) band. The resultant images were binarized using Phansalkar’s method with a 43.94 μm radius and ...

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    13. OCT Optic Nerve Head Morphology in Myopia I: Implications of Anterior Scleral Canal Opening versus Bruch’s Membrane Opening Offset

      OCT Optic Nerve Head Morphology in Myopia I: Implications of Anterior Scleral Canal Opening versus Bruch’s Membrane Opening Offset

      Purpose To measure the magnitude and direction of anterior scleral canal opening (ASCO) offset relative to Bruch’s membrane opening (BMO) (ASCO/BMO offset) in order to characterize neural canal obliqueness and minimum cross-sectional area (NCMCA) in 69 highly myopic and 138 healthy, age-matched, control eyes. Design: Cross-sectional study. Methods Using Optic Coherence Tomography (OCT) scans of the optic nerve head (ONH), BMO and ASCO were manually segmented and their centroids, size and shape were calculated. ASCO/BMO offset magnitude and direction were measured after projecting the ASCO/BMO centroid vector onto the BMO plane. Neural canal axis obliqueness was ...

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    14. A Comparison Study of Polypoidal Choroidal Vasculopathy Imaged with Indocyanine Green Angiography and Swept Source OCT Angiography

      A Comparison Study of Polypoidal Choroidal Vasculopathy Imaged with Indocyanine Green Angiography and Swept Source OCT Angiography

      Purpose Indocyanine green angiography (ICGA) was compared with swept source optical coherence tomography angiography (SS-OCTA) for the detection of polypoidal choroidal vasculopathy (PCV). Design Retrospective, cross-sectional. Methods Patients with treatment-naïve PCV based on ICGA imaging underwent same day SS-OCTA imaging at Kyung Hee University Medical Center between April 2017 to November 2018. ICGA and SS-OCTA images were graded independently. SS-OCTA images were graded using both flow and structural information. Images were graded for the number of polypoidal lesions and the total lesion area, which included both the polypoidal lesions and the branching vascular networks (BVNs). Results A total of ...

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    15. The developmental changes of retinal microvasculature in children: a quantitative analysis using OCT angiography

      The developmental changes of retinal microvasculature in children: a quantitative analysis using OCT angiography

      Purpose To quantify the macular microvasculature in healthy children of various ages using optical coherence tomography angiography (OCTA) Design Prospective cross-sectional study. Methods 333 normal children aged from 4 to 16 years old were included. OCTA was performed on a 3 X 3 mm area centered on the macular region. Vascular density, perfusion density, fovea avascular zone (FAZ) area, FAZ perimeter and FAZ acircularity index (AI) were measured and adjusted for axial length. The differences were compared among various ages. Results Among the different age groups, macular vascular density and perfusion density both increased with age. (P<0.0001 and ...

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    16. Quantitative Analysis of the Choriocapillaris in Uveitis Using en face Swept Source Optical Coherence Tomography Angiography

      Quantitative Analysis of the Choriocapillaris in Uveitis Using en face Swept Source Optical Coherence Tomography Angiography

      Purpose To perform a quantitative analysis of choriocapillaris (CC) flow deficits (FDs) in patients with uveitis. Design Retrospective cross-sectional study Methods Swept-source optical coherence tomography based angiography (SS-OCTA) macular volume scans (3x3 mm and 6x6 mm) were obtained using the PLEX® Elite 9000: En face CC images were generated and analyzed using an automated flow deficit identification algorithm. Three quantitative metrics were determined for each eye: FD number (FDN), mean FD size (MFDS), and FD density (FDD). Quantitative metrics were compared between uveitis and control eyes. The uveitis cohort was further subdivided by the presence or absence of choroidal involvement ...

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    17. Accuracy of new generation intraocular lens calculation formulas in vitrectomized eyes

      Accuracy of new generation intraocular lens calculation formulas in vitrectomized eyes

      Purpose To compare the prediction accuracy of new intraocular lens (IOL) calculation formulas (Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO), Kane and Ladas Super formula) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) with Wang-Koch (WK) axial length (AL) adjustment in vitrectomized eyes. Design Retrospective consecutive case-series study. Methods 111 eyes of 111 patients underwent uneventful phacoemulsification and enVista MX60 implantation following vitrectomy were enrolled and divided into four groups according to whether the vitreous cavity was filled with silicone oil. The performance of each formula was evaluated with or without lens constant optimization. Results Before ...

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    18. Predicting the glaucomatous central 10 degrees visual field from optical coherence tomography using deep learning and tensor regression

      Predicting the glaucomatous central 10 degrees visual field from optical coherence tomography using deep learning and tensor regression

      Purpose To predict the visual field (VF) of glaucoma patients within the central 10 degrees from optical coherence tomography (OCT) measurements using deep learning and tensor regression. Design cross-sectional study Method Humphrey 10-2 VFs and OCT measurements were carried out in 505 eyes of 304 glaucoma patients and 86 eyes of 43 normal subjects. VF sensitivity at each test point was predicted from OCT-measured thicknesses of macular ganglion cell layer + inner plexiform layer, retinal nerve fiber layer, and outer segment + retinal pigment epithelium. Two convolutional neural network (CNN) models were generated: (1) ‘CNN-PR’ which simply connects the output of the ...

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    19. Virtual Ophthalmology: Telemedicine in a COVID-19 Era

      Virtual Ophthalmology: Telemedicine in a COVID-19 Era

      Purpose To discuss the effects of the severe acute respiratory syndrome coronavirus 2 betacoronavirus on ambulatory ophthalmology practices, the value proposition of telemedicine, teleophthalmology implementation methodologies, and the accelerated future of telemedicine. Design Review of the current telehealth landscape including usage, policies, and techniques for ambulatory practice integration. Methods We provide author-initiated review of recent trends in telehealth, governmental recommendations for health care delivery during the COVID-19 pandemic, and a PubMed Central query for telemedicine in ophthalmology or teleophthalmology. In addition, the authors' comprehensive experience in telemedicine design and implementation is provided. Results We provide a summary describing the present ...

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    20. Optical coherence tomography angiography avascular area association with one-year treatment requirement and disease progression in diabetic retinopathy

      Optical coherence tomography angiography avascular area association with one-year treatment requirement and disease progression in diabetic retinopathy

      Purpose To assess the association between optical coherence tomography angiography (OCTA) quantified avascular areas (AA) and diabetic retinopathy (DR) severity, progression and treatment requirement in the following year. Design Prospective cohort study. Methods We recruited diabetic patients from tertiary academic retina practice and obtained 3x3-mm macular OCTA scans with AngioVue system and standard 7-field color photographs at baseline and 1-year visit. A masked grader determined the DR severity from the color photographs using the Early Treatment of Diabetic Retinopathy (ETDRS) scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1mm circle in projection-resolved superficial vascular complex (SVC), intermediate ...

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    21. Corneal Epithelial Thickness Measured Using AS-OCT as a Diagnostic Parameter for Limbal Stem Cell Deficiency

      Corneal Epithelial Thickness Measured Using AS-OCT as a Diagnostic Parameter for Limbal Stem Cell Deficiency

      Objective Using anterior segment optical coherence tomography (AS-OCT), we investigated the epithelial thickness (ET) of the central cornea and limbal regions in patients with limbal stem cell deficiency (LSCD) as a diagnostic and staging parameter. Design Prospective, cross-sectional study Methods The central corneal epithelium thickness (CET) and maximum limbal epithelium thickness (mLET) were measured in the superior, inferior, nasal, and temporal limbus on AS-OCT images of the normal and eyes with LSCD. CET was obtained by 1-point (OCT-CET1) and 3-point measurement (OCT-CET3). The values of OCT-CET1 and OCT-CET3 were compared to the CET obtained with in vivo confocal microscopy (IVCM-CET ...

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    22. Clinical Assessment of Scleral Canal Area in Glaucoma Using Spectral Domain Optical Coherence Tomography

      Clinical Assessment of Scleral Canal Area in Glaucoma Using Spectral Domain Optical Coherence Tomography

      Purpose To investigate anterior scleral canal (ASC) area in the eyes with glaucoma using spectral-domain optical coherence tomography (SD-OCT). Design Cross-sectional study. Methods This study included 206 eyes of 103 patients with glaucoma classified as 66 eyes of 33 patients with unilateral glaucoma and 140 eyes of 70 patients with bilateral glaucoma. Radial scan enhanced depth imaging SD-OCT centered on the optic disc was performed, and parameters that present ASC area such as ASC opening and the largest ASC area were obtained in each eye. The largest ASC area was the largest cross-sectional area of the ASC region identified between ...

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      Mentions: Makoto Araie
    23. Quantitative Analysis of Anterior Chamber Inflammation Using the Novel CASIA2 Optical Coherence Tomography

      Quantitative Analysis of Anterior Chamber Inflammation Using the Novel CASIA2 Optical Coherence Tomography

      Purpose We evaluated the clinical utility of a novel anterior segment optical coherence tomography (AS-OCT) device, CASIA2, to evaluate parameters indicative of anterior chamber (AC) inflammation severity in uveitis, including AC cell number, flare, and keratic precipitates (KPs). Design Prospective evaluation of a diagnostic device. Methods Uveitis eyes were classified into active and inactive groups. The number of hyper-reflective dots representing AC cells and optical density ratio (aqueous-to-air relative intensity [ARI] index) for flare qualification were calculated from AS-OCT images. Additionally, a program was designed to quantify the posterior corneal surface smoothness (PCSS) of each image for KPs evaluation. The ...

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    24. Accuracy of swept source optical coherence tomography and ultrasound biomicroscopy for evaluation of posterior lens capsule in traumatic cataract

      Accuracy of swept source optical coherence tomography and ultrasound biomicroscopy for evaluation of posterior lens capsule in traumatic cataract

      Purpose To assess the efficacy of swept source optical coherence tomography (SS-OCT) and ultrasound biomicroscopy (UBM) in detecting posterior capsule (PC) defect in patients with traumatic cataract. Design Observational case-series Methods Sixty-seven eyes from 67 patients, without age limitation and with traumatic cataract severe enough to prevent slit lamp evaluation of the PC, included in a simple sequence without randomization. Patients underwent both 50 MHz UBM and SS-OCT evaluation of the PC by different operators. Then, cataract surgery was performed using a single technique. Results Sixty-seven eyes from 67 patients including 60 men and 7 women were studied. The mean ...

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