To describe a new en face optical coherence tomography (OCT) imaging feature of type 2 choroidal neovascularization (CNV) and illustrate the OCT angiographic (OCTA) findings in these eyes. PATIENTS AND METHODS: Multimodal images of patients with type 2 CNV who displayed the typical “pitchfork” sign with cross-sectional OCT were reviewed. Corresponding en face structural OCT and OCTA images were analyzed to correlate the finding before and after anti-vascular endothelial growth factor (VEGF) therapy. RESULTS: Five eyes of five patients, including two females and three males with a median age of 13 years (range: 8 years to 84 years), were studied ...

BACKGROUND AND OBJECTIVE: The posterior segment of the eye has been investigated in the pathogenesis of amblyopia, but no abnormalities have yet been reported consistently. PATIENTS AND METHODS: In this prospective study, treatment-naïve amblyopes aged 6 years to 12 years with best-corrected visual acuity in the amblyopic eye between logMAR 0.3 and logMAR 0.7 and logMAR 0.1 or better in the contralateral eye were recruited. All patients underwent optical coherence tomography angiography (OCTA) imaging of the retina and choriocapillaris. RESULTS: The mean age of the 14 recruited patients was 10.26 years ± 1.31 years. The ...

BACKGROUND AND OBJECTIVE: To describe the presence of eyelashes artifact in ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA) images. PATIENTS AND METHODS: In this prospective, cross-sectional study, 52 healthy, young subjects were imaged with the SS-OCTA system. OCTA scans were taken in primary and extremes of gaze, and a montage was automatically created. The en face choriocapillaris images were then exported, and a semi-automated algorithm was used for subsequent quantitative analysis. RESULTS: The authors noted the presence of some linear regions of reduced brightness, which were assumed to represent a shadow effect due to patient eyelashes. In order to quantify ...

Optical coherence tomography angiography (OCTA) is a novel imaging modality, and its role in the clinical evaluation of patients remains to be defined. In this report, the authors describe a case of a retinal cavernous hemangioma and show that OCTA of the lesion recapitulates many structural features first described in previous histopathologic studies, including aneurysmal architecture, septated blood flow, and epiretinal membrane. Thus, OCTA provides a new, noninvasive means of studying retinal cavernous hemangioma structure, a unique capability that may also be clinically relevant to the evaluation of other pathologic retinal vascular tumors, such as capillary and racemose hemangiomas.

Researchers determined that minimum rim width measures on OCT can vary significantly from one 12-hour period to the next, so the test should be conducted at the same time of day to optimize repeatability, they said Laura P. Pardon, OD, MS, FAAO, an American Academy of Optometry Ezell Fellow, shared these study results during an academy-sponsored press conference here at the AAO meeting . “It’s important to understand changes in the optic nerve head throughout the day,” she said at the press conference, so she and her colleagues sought, “to determine repeatability for optic nerve OCT parameters within a given ...

BACKGROUND AND OBJECTIVE: To evaluate the flow characteristics and textural properties of choriocapillaris (CC) on optical coherence tomography angiography in eyes with resolved inflammatory choriocapillaropathies and Vogt-Koyanagi-Harada (VKH) disease. PATIENTS AND METHODS: A cohort of eyes with healed acute posterior multifocal placoid pigment epitheliopathy (APMPPE), serpiginous choroiditis (SC), and VKH disease were included. A 3 mm × 3 mm OCT angiogram of CC was acquired and graded for flow characteristics and textural properties. RESULTS: This study included 16 patients. Texture was heterogeneous in all eyes in the SC and VKH groups, and in four eyes (40%) in the APMPPE group. Most ...

Choroidal neovascularization (CNV) is a rare but severe complication in Best disease and autosomal recessive bestrophinopathy. However, the visualization of the neovascular membrane is difficult on fluorescein angiography (FA) and indocyanine green angiography (ICGA) because of dye leakage due to the accumulation of material. The authors' study reports a case series of pediatric Best disease where optical coherence tomography angiography (OCTA) contributed to the diagnosis of CNV and prompt treatment. Five eyes of three patients were included (two Best disease and one autosomal recessive bestrophinopathy). The mean age at diagnosis was 6.8 years ± 1.8 years (range: 5 years ...

PURPOSE: To assess the correlation between optical coherence tomography (OCT) and magnetic resonance imaging (MRI) measurements of extraocular rectus muscle thickness in patients with Graves' ophthalmopathy. METHODS: This was a cross-sectional observational study conducted in 62 eyes of 31 patients with Graves' ophthalmopathy. The disease phase was inactive in 20 patients and active in the remaining 11. The OCT measurements obtained were: medial rectus thickness at 7.2 and 9.2 mm from the limbus and lateral rectus thickness at 8.5 mm from the limbus. MRI measurements were maximum transversal diameter (T-MRI), craniocaudal diameter (CC-MRI), and muscle area (A-MRI ...

Optical coherence tomography (OCT) has been used for years as a non-invasive imaging technology to evaluate high-resolution cross-sectional images of the retina. It has become a standard of care for evaluating and treating many retinal conditions. In pediatric ophthalmology, it has been used for conditions such as retinal dystrophies, macular edema of prematurity, diseases of the optic nerve, amblyopia, and eye muscle locations. OCT has also been used in the analysis of choroidal thickness in patients with Graves' ophthalmopathy. In this issue, De-Pablo-Gómez-de-Liaño et al. found swelling at the insertion of the medial rectus muscle. Although magnetic resonance ...

PURPOSE: To assess the repeatability of epithelial, stromal, and total corneal thickness measurements with spectral-domain optical coherence tomography (SD-OCT; RTVue-XR; Optovue, Inc., Fremont, CA) in patients with myopia, keratoconus, and corneas after transepithelial photorefractive keratectomy (PRK), small incision lenticule extraction (SMILE), and femtosecond laser–assisted in situ keratomileusis (FS-LASIK). METHODS: A total of 352 eyes of 352 patients (75 myopic, 68 post-transepithelial PRK, 61 post-SMILE, 75 post-FS-LASIK, 20 mild keratoconus, and 53 advanced keratoconus eyes) were included. The epithelial, stromal, and total corneal thickness were recorded from the pachymetric map in the following four zones: (1) central 2-mm region, (2 ...

Screening the retina with OCT rules out preexisting conditions that would affect the outcomes of cataract surgery and helps select candidates for premium IOLs. “Premium IOLs require a premium macula,” David M. Brown, MD , said. “The optical compromises inherent to multifocal optics make them unsuitable for patients with a less than perfect retina who need all the light and contrast sensitivity they can get.” Seen on OCT, a “premium macula” shows up as a normal inner and outer retina, a normal foveal depth and normal foveal contour. The ellipsoid band, also known as the inner segment/outer segment (IS/OS ...

Glaucoma is traditionally characterized by progressive loss of the retinal ganglion cell layer, leading to visual field defects, advancing to central islands and, finally, total blindness. However, that may change in the future. The role of vascular contribution to ganglion cell loss is a current topic of research around the world. Compromised vascular function has been linked to open angle glaucoma (Leighton et al.), and systemic diseases that indicate defective vasoregulation, such as Raynaud’s phenomenon and migraines, have been correlated to normal tension glaucoma (Mallick et al.). In addition, several studies within the last 5 to 10 years have ...

BACKGROUND AND OBJECTIVE: Difficulty exists in the follow-up of proliferative macular telangiectasia type 2 (MacTel 2) cases after anti-vascular endothelial growth factor (VEGF) treatment due to staining in fluorescein angiography (FA) and alteration in retinal layers by optical coherence tomography (OCT). Herein, the authors report three cases in which OCT angiography (OCTA) could resolve this issue. PATIENTS AND METHODS: In this retrospective, observational case series, diagnosis of MacTel 2 was made based on clinical examination, FA, OCT, and OCTA at presentation. Regression of neovessels was monitored by OCT and OCTA. RESULTS: OCTA could delineate neovessels before treatment in all cases ...

BACKGROUND AND OBJECTIVE: To demonstrate the utility of widefield swept-source optical coherence tomography angiography (SS-OCTA) for the diagnosis and management of proliferative diabetic retinopathy (PDR). PATIENTS AND METHODS: Consecutive patients with vision-threatening diabetic retinopathy were imaged with widefield SS-OCTA using the 12 mm × 12 mm scan pattern. RESULTS: Twenty-four eyes of 12 patients underwent SS-OCTA imaging. In all 24 eyes, the en face total retinal flow images detected areas of decreased retinal perfusion, and the en face vitreoretinal interface (VRI) slabs detected foci of retinal neovascularization (NV). NV was treated and followed using the VRI images. CONCLUSIONS: Widefield SS-OCTA is ...

BACKGROUND AND OBJECTIVE: To describe retinal and choroidal findings in different stages of acute posterior multifocal placoid pigment epitheliopathy (APMPPE). PATIENTS AND METHODS: Retrospective, noncomparative case series studied by fundus biomicroscopy, fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomographic (SD-OCT), and swept-source OCT angiography (SS-OCTA). RESULTS: Six eyes of three patients with bilateral APMPPE were included. FAF showed multifocal, branched patches of hyperautofluorescence with areas of hypoautofluorescence; FA disclosed early hypofluorescence, with late-phase hyperfluorescence; ICGA showed early and late-phase hypofluorescence. SD-OCT imaging revealed bilateral retinal thinning, external limiting membrane (ELM) disruption, and severe alteration ...

BACKGROUND AND OBJECTIVE: To investigate the displacement of foveal retinal layers in surgically closed macular holes (MHs) after removal of the internal limiting membrane (ILM). PATIENTS AND METHODS: Medical records of 26 consecutive patients who underwent vitrectomy and removal of the ILM for idiopathic MH were retrospectively reviewed. En face optical coherence tomography images were exported at the level of the choroid, ellipsoid zone (EZ), and inner plexiform layer (IPL) at baseline and at 1, 3, and 6 months. The foveal center of the EZ and IPL was marked in the choroid en face image. The choroidal images were overlapped ...

BACKGROUND AND OBJECTIVE: To understand the microvascular abnormalities in cystoid macular edema (CME) in gyrate atrophy. PATIENTS AND METHODS: Spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCTA) were used in four consecutive female patients (eight eyes) with clinically and biochemistry-confirmed cases of gyrate atrophy and associated CME. Foveal avascular zone (FAZ) area and macular vessel density percentage were calculated and compared with normal subjects. RESULTS: The average age was 20 years (range: 13 years to 32 years). The mean refractive error was −6.5 diopters (D) (range: −1.0 D to −11.0 D). The average central macular thickness ...

Expanded urgent care access to automated OCT shows promise in increasing accuracy and timeliness of diagnosis as well as providing immediate documentation of pathology to further substantiate medical decision making, according to a study published in BM J Open Ophthalmology. Access to skilled imaging personnel and diagnostic equipment is virtually nonexistent after normal working hours in most clinics, according to study authors. OCT has the ability to reveal more subtle macular changes, including those in the nerve fiber layer or outer retina, that would be imperceptible on clinical examination. “Other ophthalmic imaging modalities such as ocular ultrasound and nonmydriatic fundus ...

asy-to-use automated OCT systems can enhance patient care in high-volume after-hours clinics when traditional scans are typically not available, according to a study. Limited access to diagnostic equipment and skilled imaging personnel can make patient care during after-hours difficult. An automated OCT system available for after-hours use in a high-volume clinic can greatly improve patient care and empower ophthalmologists to make accurate diagnoses, study co-author Richard L. Rosen, MD, ScD(Hon), FACS, FASRS, CRA, told Ocular Surgery News . Automated OCT is designed to look at specific areas and indicate whether or not there is an abnormality. It is not a ...

BACKGROUND AND OBJECTIVE: To investigate the variability in optical coherence tomography angiography (OCTA) image interpretation in a cohort of retina specialists. PATIENTS AND METHODS: A survey consisting of a study set of images from 12 eyes examined by OCTA was created. Eight multiple-choice answers were provided as response options for each case. The survey was sent to 100 retina specialists, with instructions to complete the survey only if they had facility with the interpretation of OCTA images. Thirty-eight physicians completed the survey. Data generated were subsequently analyzed and interpreted. RESULTS: Krippendorff's alpha coefficients of agreement and their associated 95 ...

A 27-year-old woman with type 2 diabetes mellitus had mild diabetic retinopathy (DR) during the early gestation period. Optical coherence tomography angiography (OCTA) showed microaneurysms and small capillary nonperfusion with little change until before delivery. The patient later developed pregnancy-induced hypertension, which continued after delivery, and the DR worsened markedly. OCTA showed onset and recovery of paracentral acute middle maculopathy. Macular edema (ME) also developed, and OCTA showed irregular dilation in the radial peripapillary capillaries. After starting antihypertensive therapy, the capillary dilation and ME decreased. OCTA enables close follow-up of DR related to pregnancy during the perinatal period.

The author presents two cases of macular hole (MH) retinal detachment in non-myopic eyes for which optical coherence tomography demonstrated a detached macula and a nearly full-thickness MH with only the elongated outer segments connecting at the fovea. Such images have rarely been observed in cases of MH retinal detachment in highly myopic eyes or secondary to vitreomacular traction. This implies that MH may form secondary to a macula-off rhegmatogenous retinal detachment, as it may result from the pushing forces of the subretinal fluid involving the macula.

Yoshihiko Katayama, PhD, of Heidelberg Engineering, discusses the company’s Xtreme Research Award, which was awarded to two ophthalmologists working in fluorescence lifetime imaging ophthalmoscopy, at the Association for Research in Vision and Ophthalmology meeting.

BACKGROUND AND OBJECTIVE: To show the morphologic changes on the foveal avascular zone (FAZ) in patients with epiretinal membrane (ERM) using optical coherence tomography angiography (OCTA) and to demonstrate the correlation between distortion of FAZ and features of the ERM. PATIENTS AND METHODS: FAZ eccentricity index (longest diameter of FAZ/shortest diameter of FAZ) was measured in 52 patients with ERM and compared with 27 healthy subjects' values. The density of the ERM was quantified using a grading scale (0–3) on multicolor scanning laser images, and spectral-domain OCT characteristics of the eyes were assessed. RESULTS: Of the 52 eyes ...