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    1. A practical guide to optical coherence tomography angiography interpretation

      A practical guide to optical coherence tomography angiography interpretation

      Background Optical coherence tomography angiography (OCTA) can image the retinal vasculature in vivo, without the need for contrast dye. This technology has been commercially available since 2014, however, much of its use has been limited to the research setting. Over time, more clinical practices have adopted OCTA imaging. While countless publications detail OCTA’s use for the study of retinal microvasculature, few studies outline OCTA’s clinical utility. Body This review provides an overview of OCTA imaging and details tips for successful interpretation. The review begins with a summary of OCTA technology and artifacts that arise from image acquisition. New ...

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    2. Optical coherence tomography angiography measured area of retinal neovascularization is predictive of treatment response and progression of disease in patients with proliferative diabetic retinopathy

      Optical coherence tomography angiography measured area of retinal neovascularization is predictive of treatment response and progression of disease in patients with proliferative diabetic retinopathy

      Background The purpose of this study was to evaluate the area of retinal neovascularization in patients with treatment-naïve proliferative diabetic retinopathy (PDR) as measured by optical coherence tomography angiography (OCT-A) as a marker of subsequent treatment response after panretinal photocoagulation (PRP), and to examine if this area correlated with area of retinal neovascularization as measured by fluorescein angiography (FA). Methods En face OCT-A scans (4.5 × 4.5 mm) of neovascularizations were obtained at baseline (BL) before PRP and at month (M) 3 and M6 after treatment. Progression of PDR were defined as lesion growth (assessed by ophthalmoscopy and ...

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    3. The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration

      The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration

      Background The short-term effects of anti-vascular endothelial growth factor (anti-VEGF) treatment on macular neovascularization (MNV) morphology is well described, but long-term studies on morphologic changes and correlation of such changes to the type of MNV have not been conducted. This study aims to determine if different types of MNVs in neovascular AMD (nAMD) behave differently with anti-VEGF treatment as visualized on optical coherence tomography angiography (OCTA). Methods Treatment-naïve nAMD patients were retrospectively screened for baseline and follow-up OCTA imaging 10 or more months after initial treatment. Images were graded for MNV type, area, activity, mature versus immature vessels, vessel ...

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    4. New findings useful for clinical practice using swept-source optical coherence tomography angiography in the follow-up of active ocular toxoplasmosis

      New findings useful for clinical practice using swept-source optical coherence tomography angiography in the follow-up of active ocular toxoplasmosis

      Background Ocular toxoplasmosis is one of the most common causes of intraocular inflammation and posterior uveitis in immunocompetent patients. This paper aims to investigate swept-source optical coherence tomography angiography (SS-OCTA) findings in eyes with active toxoplasmic retinochoroiditis. Methods This case series was conducted from November 2017 through October 2019 in two Brazilian centers. 15 eyes of 15 patients with active toxoplasmic retinochoroiditis were included, and were imaged at baseline and after at least 4 weeks of follow-up. All patients underwent ophthalmic examinations and multimodal imaging including SS-OCT and SS-OCTA before and after treatment of ocular toxoplasmosis. The differential diagnoses included ...

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    5. Optical coherence tomography angiography using the black-and-white pixel binarization histogram software: a new technique for evaluating healing of macular holes in two surgical techniques

      Optical coherence tomography angiography using the black-and-white pixel binarization histogram software: a new technique for evaluating healing of macular holes in two surgical techniques

      Background Many factors can influence the functional outcomes of macular hole surgery and some studies have tried to describe anatomical features that could predict successful treatment. The purpose of this study is to describe a new technique for evaluating the healing of macular holes after two surgical techniques using a black-and-white pixel binarization histogram software by optical coherence tomography angiography and its potential functional implications. Methods This was a retrospective, observational case series of patients who presented with idiopathic full-thickness macular holes and underwent vitreoretinal surgery for successful macular hole closure using the internal limiting membrane peeling technique or the ...

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    6. Optical coherence tomography features of neovascularization in proliferative diabetic retinopathy: a systematic review

      Optical coherence tomography features of neovascularization in proliferative diabetic retinopathy: a systematic review

      Background Diabetic retinopathy (DR) is a leading cause of blindness due to diabetic macular edema (DME) or complications of proliferative diabetic retinopathy (PDR). Optical coherence tomography (OCT) is a noninvasive imaging technique well established for DME but less used to assess neovascularization in PDR. Developments in OCT imaging and the introduction of OCT angiography (OCTA) have shown significant potential in PDR. Objectives To describe the tomographic features of PDR, namely of neovascularization, both of the optic disc (NVD) and elsewhere (NVE), intraretinal microvascular abnormalities (IRMA), retinal nonperfusion areas (NPA), status of the posterior vitreous, vitreoschisis and vitreous and subhyaloid/sub-ILM ...

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    7. Outer retina changes on optical coherence tomography in vitamin A deficiency

      Outer retina changes on optical coherence tomography in vitamin A deficiency

      Background Vitamin A deficiency is rare in the United States and can be missed in patients with malabsorption syndromes without a high dose of suspicion. Ocular complications of hypovitaminosis A include xerosis and nyctalopia, and to a lesser extent reduction in visual acuity and color vision. Outer retinal changes, as seen on spectral domain optic coherence tomography (SD-OCT), in patients with vitamin A deficiency have previously not been documented. Case presentation We present two cases with symptoms of severe nyctalopia who were subsequently diagnosed with severe Vitamin A deficiency and their unique findings on SD-OCT of outer nuclear layer diffuse ...

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    8. Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

      Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

      Background Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the retinal and choroidal vasculature as well as perfusion state in healthy eyes. Choroidal perfusion is subject to diurnal variation, showing lowest perfusion in the morning and highest in the afternoon. In this index study, OCTA was used to investigate diurnal changes of the retinal perfusion in healthy adult eyes and to identify impacting factors since retinal perfusion is known to be mainly determined by autoregulatory mechanisms. Methods A prospective study was conducted on healthy volunteers, each of whom underwent repeated measurements of mean arterial pressure ...

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    9. Intraoperative optical coherence tomographic findings in patients undergoing subretinal gene therapy surgery

      Intraoperative optical coherence tomographic findings in patients undergoing subretinal gene therapy surgery

      Background To analyze intraoperative OCT (iOCT) findings during subretinal gene therapy. Methods A single-center, retrospective, observational, case series study of twenty one eyes submitted to subretinal gene therapy. Intrasurgical high definition videos were included for analyzes. Cases with absence of iOCT video or unsuccessful bleb creation were excluded. Sharp needle tip (SNT) or blunted needle tip (BNT) and their interaction with neurosensory retina were evaluated. Presence of subretinal air bubbles, visible opened retinotomy, and medication reflux were also correlated and analyzed. Results Nineteen of twenty-one eyes were included. Of the two excluded eyes, subretinal bleb creation was unsuccessful in one ...

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    10. Neurodegeneration in systemic lupus erythematosus: layer by layer retinal study using optical coherence tomography

      Neurodegeneration in systemic lupus erythematosus: layer by layer retinal study using optical coherence tomography

      Background Systemic lupus erythematosus (SLE) is a chronic, autoimmune and multisystemic disease. Recent studies with functional and structural magnetic resonance imaging and cognitive tests report an unexpectedly high frequency of central nervous system involvement, even in patients with asymptomatic SLE. The purpose of this study was to identify early signs of retinal neurodegeneration by comparing the thickness of the peripapillary retinal nerve fiber layer (pRNFL) and all macular layers between patients with SLE without ophthalmologic manifestations and healthy controls. The effect of disease duration and systemic comorbidities was also studied. Methods Cross-sectional study, in which all participants underwent a complete ...

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    11. Topographic analysis of macular choriocapillaris flow deficits in diabetic retinopathy using swept–source optical coherence tomography angiography

      Topographic analysis of macular choriocapillaris flow deficits in diabetic retinopathy using swept–source optical coherence tomography angiography

      Background The purpose of this study was to investigate the association between diabetic retinopathy (DR) severity and macular choriocapillaris (CC) flow deficit percentage (FD %) in different macular regions using swept-source optical coherence tomography angiography (SS-OCTA). Methods Diabetic patients with SS-OCTA images were graded by severity and retrospectively assessed. CC FD % was calculated in four different regions of the OCTA image: inner, middle, outer, and full-field region. The generalized estimating equations (GEE) approach for clustered eye data was used to determine effect size and significance of age and disease severity on FD % for each region. Results 160 eyes from 90 total ...

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    12. Impact of manual correction over automated segmentation of spectral domain optical coherence tomography

      Impact of manual correction over automated segmentation of spectral domain optical coherence tomography

      Objective To study the automated segmentation of retinal layers using spectral domain optical coherence tomography (OCT) and the impact of manual correction over segmentation mistakes. Methods This was a retrospective, cross-sectional, comparative study that compared the automated segmentation of macular thickness using Spectralis™ OCT technology (Heidelberg Engineering, Heidelberg, Germany) versus manual segmentation in eyes with no macular changes, macular cystoid edema (CME), and choroidal neovascularization (CNV). Automated segmentation of macular thickness was manually corrected by two independent examiners and reanalyzed by them together in case of disagreement. Results In total, 306 eyes of 254 consecutive patients were evaluated. No statistically ...

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    13. The effect of image quality on the reliability of OCT angiography measurements in patients with diabetes

      The effect of image quality on the reliability of OCT angiography measurements in patients with diabetes

      Background This study aimed to determine the relationship between image quality and measurement repeatability of optical coherence tomography angiography (OCTA) parameters in patients with non-proliferative diabetic retinopathy. Methods A total of 100 eyes of 50 patients were included in the study. Three OCTA images were obtained consecutively during one session of imaging in all patients using the RTVue AngioVue OCTA device. We applied the signal strength index (SSI) provided by the RTVue system to define scan quality. Superficial vessel density (VD) in the central 3 × 3 mm macular and in the perifoveal region, as well as foveal avascular zone (FAZ ...

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    14. Microperimetry and OCT angiography evaluation of patients with ischemic diabetic macular edema treated with monthly intravitreal bevacizumab: a pilot study

      Microperimetry and OCT angiography evaluation of patients with ischemic diabetic macular edema treated with monthly intravitreal bevacizumab: a pilot study

      Background Functional and anatomical evaluation of patients with ischemic diabetic macular edema after monthly injections of Bevacizumab. Methods Five eyes from five patients with diabetic macular edema associated with macular ischemia in fluorescein angiography (FA), received 6 monthly intravitreal injections of Bevacizumab. All subjects underwent SD-OCT, FA, OCT angiography (OCTA) and microperimetry at baseline and after 6 months follow-up. Primary outcome measures were improvement of best corrected visual acuity (BCVA), microperimetry and assessment of macular perfusion (foveal avascular zone size and capillary loss). Results Five patients completed the follow-up. BCVA improved from 20/180 to 20/74 ( p  = 0.01 ...

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    15. The use of anterior segment optical coherence tomography (ASOCT) in demonstrating recurrence of vitreoretinal lymphoma (VRL) in the anterior vitreous

      The use of anterior segment optical coherence tomography (ASOCT) in demonstrating recurrence of vitreoretinal lymphoma (VRL) in the anterior vitreous

      Background Primary vitreoretinal lymphoma (VRL) is a rare disease with 30–380 new cases in the United States per year. Its insidious process and spread to the central nervous system (CNS) leads to a mean 5-year survival rate from 41.4 to 71%. Medical treatment of VRL has been summarized extensively in the literature and involves intraocular rituximab and methotrexate as first line agents in unilateral VRL, with systemic chemotherapy to be considered in bilateral or CNS-involving disease. In addition, therapeutic “debulking” vitrectomy has been reported in the literature, with some limited success. Despite this, recurrence rate is high and ...

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    16. Choroidal thickness measured with swept source optical coherence tomography in posterior staphyloma strongly correlates with axial length and visual acuity

      Choroidal thickness measured with swept source optical coherence tomography in posterior staphyloma strongly correlates with axial length and visual acuity

      Purpose To measure the choroidal thickness in patients with high myopia from staphyloma using swept source OCT (SS-OCT) in Early Treatment Diabetic Retinopathy Study (ETDRS) fields and compare to normal cohort. The study also evaluated the correlation between choroidal thickness with axial length and best-corrected visual acuity (BCVA). Methods In this prospective cross sectional study, 37 eyes of 20 patients with high myopia from staphyloma and 86 eyes of 43 normal subjects were included. In each eye, horizontal scans centered on the fovea (12 × 9 mm) were performed using SS-OCT (DRI-OCT, Topcon, Japan). Choroidal thickness in 9 ETDRS subfields, including ...

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    17. Mapping diurnal variations in choroidal sublayer perfusion in patients with idiopathic epiretinal membrane: an optical coherence tomography angiography study

      Mapping diurnal variations in choroidal sublayer perfusion in patients with idiopathic epiretinal membrane: an optical coherence tomography angiography study

      Background Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the choroidal vasculature and perfusion state. In this index study, OCTA was used to investigate diurnal changes in choroidal sublayer perfusion in eyes with idiopathic epiretinal membrane (ERM) and to identify impacting factors. Methods A prospective study was conducted on volunteers with symptomatic ERM, each of whom underwent repeated measurements of subfoveal choroidal thickness (SFCT) using enhanced-depth imaging optical coherence tomography and perfusion of choroidal vascular sublayers using OCTA at 7 a.m., 12 p.m., 4 p.m., and 8 p.m. Possible interactions between ...

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    18. Quantitative measurement of vascular density and flow using optical coherence tomography angiography (OCTA) in patients with central retinal vein occlusion: Can OCTA help in distinguishing ischemic from non-ischemic type?

      Quantitative measurement of vascular density and flow using optical coherence tomography angiography (OCTA) in patients with central retinal vein occlusion: Can OCTA help in distinguishing ischemic from non-ischemic type?

      Background To evaluate microvascular changes and quantitative parameters in patients with central retinal vein occlusion (CRVO) by using optical coherence tomography angiography (OCTA) and finding difference between presumably ischemic and non ischemic CRVO. Methods Patients with CRVO (31) and healthy control (20) were enrolled in this observational case control study. The OCTA was done for each patient and control subject. In macular area 2 images were taken for each eye (3 × 3 mm and 8 × 8 mm). The images were analyzed at three capillary plexuses (superficial and deep retinal capillary layers and choriocapillaris layer). Results Thirty-one patients with CRVO (mean ...

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    19. Diurnal variation of choriocapillaris vessel flow density in normal subjects measured using optical coherence tomography angiography

      Diurnal variation of choriocapillaris vessel flow density in normal subjects measured using optical coherence tomography angiography

      Background Vessel flow density (VFD) may provide important information regarding perfusion status. Diurnal variation in VFD of choriocapillaris has not been reported in literature. In the index study, optical coherence tomography angiography (OCTA) was used to assess the diurnal variation of the VFD in the choriocapillaris of subjects with no known ocular disease. Methods Fifty eyes with no known ocular disease (25 subjects) were included. OCTA images were acquired using AngioVue (Optovue, Fremont, CA, USA) at two different time points on a single day: 9:00 AM and 6:00 PM. Macular cube scan protocol (3 × 3 mm) centered on ...

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    20. Comparison between optical coherence tomography angiography and fluorescein angiography findings in retinal vasculitis

      Comparison between optical coherence tomography angiography and fluorescein angiography findings in retinal vasculitis

      Background To describe optical coherence tomography angiography (OCT-A) findings in patients with retinal vasculitis and to compare them to current fluorescein angiography (FA) findings. Methods This was an observational case series. Nineteen eyes in 10 patients with retinal vasculitis of various etiologies were imaged with FA (TRC-50DX, Topcon) and OCT-A (SD-OCT, Optovue). The images were reviewed and analyzed. Results The mean age was 36 years (range 24–67 years); there were three males and seven females. The primary vessels involved were veins (89%). Fourteen eyes (74%) had active inflammatory disease during the study period, with signs of vascular sheathing and ...

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    21. Resistive index of ophthalmic artery correlates with retinal pigment epithelial alterations on spectral domain optical coherence tomography in diabetic retinopathy

      Resistive index of ophthalmic artery correlates with retinal pigment epithelial alterations on spectral domain optical coherence tomography in diabetic retinopathy

      Background Retinal pigment epithelium (RPE) plays a significant role in maintenance of integrity of retinal photoreceptors and choriocapillaries. RPE derives its blood supply through ophthalmic artery (OA) via choriocapillaries. RPE topographic alterations have been observed to be associated with severity of retinopathy. The present study was undertaken to assess the correlation between resistive index (RI) of the OA with RPE topographic alterations on Spectral-Domain optical coherence tomography (SD-OCT), to our knowledge, it is for the first time. Methods A tertiary care center based cross-sectional study was undertaken after informed consent. Sample size was calculated using 95% confidence interval. Seventy five ...

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      Mentions: Sandeep Saxena
    22. Submillimeter retinoblastoma monitoring following transpupillary thermotherapy using hand-held optical coherence tomography

      Submillimeter retinoblastoma monitoring following transpupillary thermotherapy using hand-held optical coherence tomography

      Background Precise, submillimeter visualization of retinal microstructures is useful for treatment monitoring of retinoblastoma. Herein, we report the use of hand-held optical coherence tomography (HH-OCT) to document a nearly-invisible retinoblastoma and monitor tumor response to transpupillary thermotherapy (TTT). Case presentation A 3-week-old boy was diagnosed with unilateral familial retinoblastoma in the left eye, classified as group B, and treated with intravenous chemoreduction. At 13-month follow-up, the tumor in the left eye was regressed, and evaluation of the right eye revealed a microscopic, nearly invisible tumor measuring 372 µm in thickness and 1.51 mm in basal dimension. The tumor was ...

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    23. Early changes in macular optical coherence tomography parameters after Ranibizumab intravitreal injection in patients with exsudative age-related macular degeneration

      Early changes in macular optical coherence tomography parameters after Ranibizumab intravitreal injection in patients with exsudative age-related macular degeneration

      Background Evaluation of the impact of different macular optical coherence parameters on visual acuity as early as 1 day after injection of ranibizumab in patients with subfoveal exsudative age-related macular degeneration. Methods This was an interventional, non randomized, open label prospective study, where we evaluated 20 eyes of 20 patients affected by exudative age-related macular degeneration. These patients were treated with injections of ranibizumab between February 2013 and January 2015. The primary endpoint of this study was to evaluate the early changes in optical coherence tomography parameters (retinal thickness, central and total retinal volume) and impact on best-corrected visual acuity ...

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    1-24 of 36 1 2 »
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