A 5-year-old boy with no family or personal history of retinoblastoma was incidentally noted to have a spot in the right eye. On examination, his visual acuity was 20/20 and there was a superior white intraretinal lesion ( Figure 1A ) with mild atrophy superiorly and no clinical vitreous seeding. Fluorescein angiography did not show any leakage and ultrasonography showed calcification suggestive of a retinocytoma. Optical coherence tomography (OCT) showed a clump of vitreous seeding ( Figure 1B ) branching off from the lesion. Retinocytoma is a rare benign variant of retinoblastoma, although malignant transformation has been reported. 1 Vitreous seeding secondary to ...

PURPOSE: To study corneal remodeling during the first 6 months after myopic small incision lenticule extraction (SMILE) with a 10% overcorrection nomogram, by spectral-domain optical coherence tomography (SD-OCT) and in vivo confocal microscopy (IVCM). METHODS: This prospective non-randomized observational study included 60 eyes from 30 patients treated by SMILE for low to moderate myopia. A 10% overcorrection nomogram was applied for all eyes. Epithelial and corneal thickness maps were obtained within the central 6 mm, by SD-OCT, at each visit. Lenticule thickness was calculated by subtracting the postoperative central stromal thickness from the preoperative central stromal thickness. IVCM was performed ...

BACKGROUND AND OBJECTIVE: Evaluate capillary perfusion density (CPD) in patients with diabetic macular edema (DME) undergoing fixed intravit-real aflibercept injections (IAI) through 24 months. PATIENTS AND METHODS: Prospective, interventional, single-arm study enrolling 20 patients with persistent DME. Patients received IAI every 4 weeks until DME resolution followed by extension to every 8 weeks. Optical coherence tomography angiography was obtained at baseline, 6, 12, and 24 months. RESULTS: Sixteen of 20 eyes completed the study. Baseline mean central subfield thickness was 420 µm, which improved to 251 µm ( P < .001). The mean best-corrected visual acuity (BCVA) improved by 5.5 letters ...

To investigate agreement between biometric measurements obtained from the Lenstar LS 900 (Haag-Streit AG) based on optical low-coherence reflectometry (OLCR) and the Tomey OA-2000 (Tomey Corporation) based on swept-source optical coherence tomography (SS-OCT) in dense cataracts. METHODS: In this prospective observational study, axial length, keratometry, anterior chamber depth (ACD), lens thickness, and central corneal thickness (CCT) were measured in 124 eyes of 76 patients. Intraocular lens prediction errors and absolute prediction errors were assessed based on postoperative manifest refraction. Analyses used were paired t test, Pearson correlation coefficient ( r ), and Bland-Altman plots. RESULTS: Failure in axial length measurements was noted ...

A novel artificial intelligence-based algorithm for automatic retinal fluid quantification in home OCT images performed comparably to human readers, according to a presentation from the virtual American Society of Retina Specialists meeting. This system was able to analyze fluid status, its dynamics and visualize the locations of fluid, Judy E. Kim, MD, professor of ophthalmology and visual sciences at Medical College of Wisconsin, said during the presentation. “Currently, much of our diagnosis and management of eyes with exudative AMD is dependent on OCT. At-home diagnostic testing systems, such as home OCT, offer an opportunity for personalizing AMD management by providing ...

Herein, the authors describe an initial case report of widefield swept-source optical coherence tomography angiography (SS-OCTA) in Vogt-Koyanagi-Harada (VKH) disease. When compared to fluorescent angiography, indocyanine green angiography, and enhanced-depth OCT — upon which the revised criteria for VHK are based — widefield SS-OCTA enables detection of vitreous inflammation, noninvasive identification of characteristic areas of flow void at the level of choriocapillaris in the acute phase and may be a novel valuable tool not only for noninvasive diagnosis and monitoring of disease progression, persistence, resolution, and recurrence to guide therapy in VKH disease in the future.

PURPOSE: To evaluate the agreement between measurements obtained with a new optical biometer (Argos; Movu Inc) using large coherence length swept-source optical coherence tomography (SS-OCT) and those obtained with an optical biometer with a rotating Scheimpflug camera, combined with partial coherence interferometry (PCI) (Pentacam AXL; Oculus Optikgeräte GmbH) in adults. METHODS: The following measurements were examined and evaluated: axial length, central corneal thickness (CCT), anterior chamber depth (ACD), mean keratometry, J 0 and J 45 vectors, and corneal diameter. Measurements with the two biometers were conducted in triplicate per instrument in a random order by the same examiner. Paired ...

PURPOSE: To evaluate the effect of intraocular lens (IOL) optic overlapping on IOL stability and to determine the relationship between the capsulorhexis and IOL movement with the three-dimensional method of swept-source optical coherence tomography (SS-OCT). METHODS: This study identified patients with age-related cataracts and divided them into two groups according to their anterior capsule and IOL optic relationship: total anterior capsule overlap (360°) and partial anterior capsule overlap (< 360°). Standard SS-OCT radial scanning was performed in all eyes at 1 day, 1 week, 1 month, and 3 months after cataract surgery, respectively. The obtained photographs were used for the postoperative ...

An artificial intelligence algorithm designed for the autonomous diagnosis of keratoconus was able to correctly differentiate all patients with keratoconus from healthy subjects, according to a speaker at the virtual American Society of Cataract and Refractive Surgery meeting. “The artificial intelligence algorithm is a novel technique with excellent accuracy, sensitivity and specificity in the diagnosis of keratoconus,” Eyüp Özcan, MD, FEBO, said. The algorithm was able to diagnose 42 of 43 keratoconic eyes, achieving an accuracy rate of 98%, a sensitivity rate of 95% and a specificity rate of 94%. No study before this had used anterior segment OCT ...

Intraoperative anterior segment OCT provides surgeons with heightened resolution of the structure of the eye and cross-sectional images of the anterior segment to provide extra detail during cataract and complex corneal surgeries. The enhanced visualization offered with anterior segment OCT gives surgeons a new dimension in surgical planning, Julie M. Schallhorn, MD , told Ocular Surgery News . “Normally during surgery, we are used to looking from a top-down view with broad light illumination. OCT provides a cross-sectional image that you can see much more easily the depth and configuration of what is happening in the cornea or anterior chamber during surgery ...

Repeated intravitreal injections may result in glaucomatous damage, according to research done at New York Eye and Ear Infirmary of Mount Sinai. In a retrospective observational clinical study of 40 eyes of 39 patients, Richard B. Rosen, MD, and colleagues used OCT angiography to demonstrate the acute changes in IOP that result from reduced macular and peripapillary perfusion density after intravitreal injection. “These injections cause eye pressure to temporarily go up three times normal levels, and while patients typically recover within minutes, we wanted to know the immediate impact on blood flow to the eye,” Rosen said in a press ...

Research continues to reveal additional uses for evolving technology in the realm of OCT and ERG. These diagnostic tools offer eye care providers noninvasive means to determine signs and features of retinal impairment to better inform prognosis and treatment. Details from a cross-sectional study published in Ophthalmology showed that patients with OCT images displaying a shallow, irregular retinal pigment epithelium elevation (SIRE) sign had a higher risk for nonexudative macular neovascularization (NE-MNV) and neovascular age-related macular degeneration. “SIRE can be detected on the more ubiquitously available structural OCT B-scans and indicate eyes at higher risk of NE-MNV and, thus, subsequently ...

BACKGROUND AND OBJECTIVE: To report the imaging features of different stages of retinal angiomatous proliferation (RAP) on optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Patients diagnosed with RAP were included in this study. All patients underwent fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and OCTA. The OCTA features were illustrated and compared with FA, ICGA, and OCT. OCTA was performed at baseline and after injection of anti-vascular endothelial growth factor (VEGF). RESULTS: A total of 12 eyes of 12 consecutive patients were included. Patients' ages ranged from 57 to 82 years. In all cases, the ...

BACKGROUND AND OBJECTIVE: To report a unique case series of diffuse unilateral subacute neuroretinitis (DUSN) patients imaged with optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: In this retrospective case series, multimodal imaging was performed in four patients with DUSN at the time of patient visit. The study patients underwent standard clinical treatment for DUSN. RESULTS: The clinical findings were consistent with the diagnosis of DUSN. Cross-sectional OCT showed disruption of outer retinal layers in the foveal area and an irregular structure of the outer plexiform layer. En face OCT revealed hyperreflective spots and a large hyperreflective lesion in the ...

PURPOSE: To evaluate the retinal vascular structure in amblyopic eyes by optical coherence tomography angiography (OCTA). METHODS: Thirty-seven eyes of 37 patients with anisometric amblyopia were compared with 37 eyes of 37 age- and gender-matched control subjects by OCTA in terms of superficial capillary plexus vessel density, deep capillary plexus vessel density, and foveal avascular zone. RESULTS: The mean age was 12 ± 4.2 years in patients with amblyopia and 13 ± 6.1 years in individuals without amblyopia. Foveal superficial capillary plexus vessel densities were 20.49% ± 3.27%, 19.70% ± 3.82%, and 19.96% ± 3.84%, and parafoveal ...

BACKGROUND AND OBJECTIVE: To describe the microvascular features of treated, clinically regressed, or reactivated retinoblastoma lesions using an investigational portable optical coherence tomography angiography (OCTA) system. PATIENTS AND METHODS: Single-center, prospective, cross-sectional, consecutive case-series of children with previously treated retinoblastoma who underwent portable OCTA of posterior retinoblastoma lesions. RESULTS: Eight tumors from seven eyes of five children with retinoblastoma were included. Tumors with types 1 (calcified remnant, n = 3), 2 (non-calcified remnant, n = 1), and 3 (both calcified and noncalcified remnants, n = 1) regression revealed persistent intrinsic superficial vasculature on OCTA (five of five lesions; 100%). Lesions with type 4 ...

BACKGROUND AND OBJECTIVE: To evaluate the optical coherence tomography angiography (OCTA) features of patients with Behçet disease (BD) without ocular involvement. PATIENTS AND METHODS: Twenty-three patients with BD without ocular involvement and 29 healthy age/sex-matched control subjects were involved. The authors measured foveal avascular zone (FAZ) area, vessel density in the parafoveal region, and flow area (fovea-centered 3-mm radius area) in the superficial and deep capillary plexuses evaluated by OCTA. RESULTS: FAZ area was significantly larger in eyes with BD in both the superficial and deep capillary plexuses (0.331 vs. 0.240 mm 2 [ P = .004] and ...

At Retina 2020, SriniVas Sadda, MD , discusses his daily clinical experience using the Spectralis OCT platform (Heidelberg Engineering).

Even though OCT angiography is a helpful diagnostic tool, there are practical challenges to implementing this technology in practice. According to the ASRS 2019 Preferences and Trends survey, only 28.6% of U.S. respondents said they used OCTA in clinical practice and found it useful. Thirty-two percent said they did not have access, nor did they intend to gain access any time soon. “It is a great technology, and it can be helpful in ambiguous cases, but the key takeaway about OCT angiography is: Be patient,” Roger A . Goldberg , MD, MBA, said in a presentation giving a “real-world” perspective ...

BACKGROUND AND OBJECTIVE: To describe a method for averaging ocular coherence tomography angiography (OCTA) images using a commercially available photo editing software: Adobe Photoshop CC 2017. PATIENTS AND METHODS: This single-center study assessed the feasibility of using Adobe Photoshop as an OCTA image averaging tool. Three 3.0 mm × 3.0 mm OCTA images from each eye were obtained using commercially available OCTA devices. Captured OCTA images were exported in high-resolution TIFF format, imported as an image stack, aligned using an automated function, and averaged by creating a Smart Object using Photoshop CC 2017 software. In conjunction with qualitative assessment ...

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.