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 ...

BACKGROUND AND OBJECTIVE: To describe depth-resolved macular microvasculature abnormalities in patients with familial exudative vitreoretinopathy (FEVR) using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Twenty-two eyes (11 eyes of six patients with FEVR and 11 control eyes) were imaged with OCTA. Graders qualitatively analyzed the OCTA images of the superficial and deep vascular complexes for abnormal vascular features and compared to fluorescein angiography (FA). RESULTS: Seven of 11 eyes with FEVR displayed abnormal macular vascular findings. Abnormalities in the superficial vascular complex included dilation, disorganization, straightening, heterogeneous vessel density, and curls/loops. In the deep vascular complex, abnormalities included ...

BACKGROUND AND OBJECTIVE: To correlate subfoveal choriocapillaris (CC) flow density with age using spectral-domain optical coherence tomography angiography (SD-OCTA). PATIENTS AND METHODS: One hundred eighty-three eyes of 94 subjects (66 female, 28 male) were enrolled. Included were healthy subjects between the ages of 21 and 82 years without any history of vitreoretinal disease. Measurements were obtained with software from the OCT device. Significance was defined as a P value of less than .05. RESULTS: The mean age was 43.43 years ± 17.63 years. Correlation between decreasing CC flow density and increasing age was significant ( P < .001), with a mean ...

BACKGROUND AND OBJECTIVE: To investigate choriocapillary blood flow in myopic eyes using optical coherence tomography angiography. PATIENTS AND METHODS: Seventy-eight myopic and 79 age-matched healthy eyes were included in this study, with myopia defined as a spherical equivalent refraction (SER) between −1 diopters (D) and −6 D. Quantitative measurements of the choriocapillaris were obtained using the Avanti RTVue XR with AngioVue. Choroidal thickness (CT) was assessed using the single-line enhanced high-definition scan of the same device. RESULTS: CT correlated positively with SER ( P = .017) and negatively with bulbus axial length (AL) ( P = .180). Subfoveal choriocapillary blood flow did not show ...

A 67-year-old female presented with vitreous hemorrhage and sub-internal limited membrane (ILM) hemorrhage in her right eye associated with ruptured retinal arterial macroaneurysm. During pars plana vitrectomy, intraoperative optical coherence tomography aided in the diagnosis of a small macular hole previously obscured by the sub-ILM hemorrhage. Nonexpansile gas was placed followed by postoperative prone positioning, and the hole closed successfully.

BACKGROUND AND OBJECTIVE: To compare the macular perfusion in the retina and choroidal layer between control subjects and Chinese patients with diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) and to evaluate the association of OCTA characteristics with the stage of DR. PATIENTS AND METHODS: A total of 200 eyes (normal controls = 40; mild non-proliferative diabetic retinopathy [NPDR] = 40; moderate NPDR = 40; severe NPDR = 40; and PDR [proliferative diabetic retinopathy] = 40) underwent OCTA imaging. OCTA parameters were vessel densities in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris, as well as foveal avascular zone (FAZ) area ...

A machine-to-machine method of deep learning may lead to a more accurate way to estimate the presence of glaucoma from photographs, according to a speaker. “We ophthalmologists know that we perform very poorly in diagnosing glaucoma from photographs. It’s a challenging task unless you have very advanced disease. It’s a challenging task to look at a picture and determine whether the nerve has glaucoma or not,” Felipe A. Medeiros , MD, MPH, of Duke University, said at the American Glaucoma Society annual meeting. SEE ALSO VIDEO: Technology allows ophthalmologists to detect… IOP decrease maintained with Xen45 Artificial intelligence, machine ...