BACKGROUND AND OBJECTIVE: To assess the usefulness of optical coherence tomography angiography (OCTA) in cases of idiopathic choroidal neovascularization (iCNV). PATIENTS AND METHODS: Seven eyes with suspected iCNV were evaluated using OCT, OCTA, fluorescein angiography (FA), and indocyanine green angiography (ICGA) and were followed up between 3 weeks and 4 weeks following an intravitreal anti-vascular endothelial growth factor (VEGF) injection. The utility of OCTA in the diagnosis and characterization of morphology of iCNV at baseline and follow-up was assessed. RESULTS: Morphology of vasculature comprising iCNV could be detected in all cases (100%) on OCTA and in 57% cases on ICGA ...

BACKGROUND AND OBJECTIVE: To compare optical coherence tomography angiography (OCTA) images from three different devices. PATIENTS AND METHODS: This was a prospective, observational, cross-sectional study. All eyes (n = 24) were imaged thrice each time with swept-source OCT (DRI OCT Triton Plus; Topcon, Tokyo, Japan), spectral-domain OCTA (AngioVue; Optovue, Fremont, CA), and SD-OCT Angioplex (Cirrus HD-OCT 5000; Carl Zeiss Meditec, Jena, Germany). Outcome measures were foveal avascular zone (FAZ) area, vessel density, spacing between large vessels (SLV), and spacing between small vessels (SSV). They were calculated using local fractal analyses and Frangi filter. RESULTS: The vascular parameters showed good to excellent ...

The authors describe the imaging characteristics and progression of a type 2 choroidal neovascular membrane (CNV) using swept-source optical coherence tomography (SS-OCTA). A 27-year-old male presented with an active possible tubercular choroidal granuloma associated with exudative retinal detachment in the right eye. The patient received anti-tubercular drugs, oral corticosteroids, and intravitreal bevacizumab and showed complete resolution in 3 months. At the 7-month follow-up, SS-OCTA imaging revealed a type 2 CNV. SS-OCTA is a very useful tool to detect and monitor the growth of CNV in active and healed posterior uveitis without the risks of dye-based angiography.

Retinal acute toxicity may be produced by several etiologies. Iatrogenic toxicity is one of the most-feared complications related to vitreoretinal surgery. The authors report a case of retinal acute toxicity due to the use of perfluorooctane during an uneventful retinal detachment surgery done elsewhere. The aim of this report is to describe the clinical and optical coherence tomography features of this complication, which unfortunately occurred in more than 100 cases in Spain.

BACKGROUND AND OBJECTIVE: Advanced retinal imaging can improve understanding of retinal vein occlusion (RVO) pathology. The authors aimed to characterize the vascular pathology of RVO on en face optical coherence tomography (OCT) and OCT angiography (OCTA). PATIENT AND METHODS: This was a cross-sectional study including 17 eyes with RVO. The authors identified discordance between vasculature on en face OCT and flow on OCTA, which was correlated with structural findings at the corresponding location on OCT B-scans. RESULTS: Six eyes had vessels that were seen on OCT without flow on OCTA. The most clinically relevant finding was preserved inner retinal layers ...

BACKGROUND AND OBJECTIVE: To analyze the location of familial retinal arterial tortuosity (fRAT) in the three-dimensional structure of retinal capillaries. PATIENTS AND METHODS: Retrospective observational study. Twelve eyes of six patients (two of whom were brothers) were imaged by optical coherence tomography angiography (OCTA). The data from their ocular and systemic examinations were recorded. RESULTS: OCTA imaging clearly showed increased tortuosity of second- and third-order retinal arteries in all cases, visible in the superficial vascular plexus (SVP) up to the arteriole termination in the capillaries. No change was visible in the deep capillary plexus (DCP). CONCLUSIONS: OCTA shows that fRAT ...

The authors report the optical coherence tomography angiography (OCTA)-based comparative assessment of the retinal microvasculature in a rare pair of 96-year-old female monozygotic twins discordant for Alzheimer's disease (AD). Using automated mapping of the superficial capillary plexus, the authors observed that the twin with advanced AD had a significantly reduced vessel density and a larger foveal avascular zone in the superficial capillary plexus as well as a thinner choroid compared to the twin who was cognitively normal. This unique twin discordance report adds to the evidence supporting the use of retinal microvasculature changes in the superficial capillary plexus ...

The early clinical manifestations of macular infarction secondary to subconjunctival gentamicin (Gentak; Akorn, Lake Forest, IL) use in an aphakic eye were documented sequentially on swept-source optical coherence tomography (OCT) and fundus fluorescein angiography. The first recorded event after drug toxicity was macular detachment, along with disorganization of outer retinal layers in about 12 hours. The changes in inner retinal layers occurred after 36 hours had elapsed. OCT-documented initial damage to outer retinal layers could be due to the susceptibility of first order retinal neurons, followed by subsequent inner retinal layer involvement and ischemia. This helps in understanding pathogenesis of ...

Optovue recently announced that industry veteran John Hawley, senior vice president of global sales, will retire on July 1 and remain with the company in an advisory role. Hawley joined Optovue in 2008 at the beginning of its entry into the ophthalmic and optometric OCT markets as vice president of business development. Within 6 months, he was heading the U.S. organization, according to a press release from Optovue. His accomplished career spans more than 35 years in ophthalmic diagnostic instrumentation, service, sales, marketing and strategic planning. “Thirty years ago, I heard that optometry was going to be the gatekeeper ...

Swept-source optical coherence tomography angiography (SS-OCTA) was used to diagnose choroidal neovascularization (CNV) arising from a choroidal nevus. A 61-year-old woman initially presented with submacular hemorrhage. She was diagnosed with neovascular age-related macular degeneration (AMD) and received three injections of bevacizumab (Avastin; Genentech, South San Francisco, CA). At a follow-up visit, SS-OCTA showed that the CNV appeared to arise from an adjacent choroidal nevus. This is the first report of using SS-OCTA to diagnose CNV associated with a choroidal nevus masquerading as neovascular AMD.

BACKGROUND AND OBJECTIVE: To analyze the foveal avascular zone (FAZ) area in superficial and deep retinal layers in patients with macular hole (MH) before and after surgery. PATIENTS AND METHODS: The authors studied 14 patients with unilateral MH. They examined a 3 mm × 3 mm area at the fovea before and 6 months after surgery using spectral-domain optical coherence tomography angiography. RESULTS: In eyes affected by MH, the mean preoperative superficial FAZ (0.45 ± 0.09 mm 2 ) and deep FAZ (0.79 ± 0.39 mm 2 ) were significantly larger than the postoperative superficial FAZ (0.25 ± 0.09 mm ...

A 58-year-old man with bilateral pigmented paravenous retinochoroidal atrophy (PPRCA) associated with macular coloboma in the right eye underwent color fundus photography and fundus autofluorescence with the California ultra-widefield retinal imaging system (Optos, Dunfermline, UK), spectral-domain optical coherence tomography (SD-OCT) (Heidelberg Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany), and en face OCT angiography (OCTA) (AngioPlex, Cirrus HD-OCT 5000; Carl Zeiss Meditec, Dublin, CA). The patient presented with a visual acuity of counting fingers in the right eye and 20/32 in the left eye. Fundus examination and SD-OCT showed typical PPRCA alterations in both eyes and a macular coloboma in ...

Optos plc, part of Nikon Corp., announced the U.S. launch of Monaco, the first ultra-widefield imaging device combined with optical coherence tomography. Monaco is a compact desktop UWF retinal imaging device , which provides greater imaging functionality, according to a company press release. “The addition of OCT to our ultra-widefield imaging device offers a more comprehensive array of imaging tools in one machine, enabling eye care practitioners to see and treat retinal pathology earlier and more effectively,” Robert Kennedy, CEO of Optos, said in the release. The device is the company’s first combined imaging device with ultra-widefield color imaging ...

Incontinentia pigmenti (IP) is a rare X-linked dominant disorder that can cause retinal nonperfusion, neovascularization, and retinal detachment. Evaluation of the peripheral retinal vasculature and appropriate treatment can reduce the risk of blindness. The authors report the use of a handheld prototype optical coherence tomography angiography (OCTA) and ultra-widefield OCT (UWF-OCT) during exam under anesthesia of a 2-year-old with a history of severe early onset IP. UWF-OCT and OCTA may be used as noninvasive imaging modalities for IP and similar retinal vascular disorders in supine young children.

Best vitelliform macular dystrophy (VMD) is an autosomal dominant inherited dystrophy, most frequently caused by mutations in the BEST1 gene. The authors describe “choroidal caverns,” a previously unreported optical coherence tomography finding in the choriocapillary and choroid of Best VMD. Histopathologic examination in eyes with Best VDM shows extensive deposition of lipofuscin in the retinal pigment epithelium (RPE) throughout the retina and accumulation of fibrillar material under the RPE and in the choroid. This supports the hypothesis that choroidal caverns could be a sign of the degenerative process involving the choroid in eyes with Best VMD.

OCT imaging may be appropriate for nonprofessional photographers to administer to undilated patients and in quantitative parameters for adequate screening in a community setting, according to researchers. Researchers reported that patients with open angle glaucoma underwent OCT imaging with the Cirrus SD-OCT (Carl Zeiss Meditec Inc.) as part of their routine care on that day. A clinical examination by a glaucoma specialist was also performed to rule out other conditions that could affect the optic disc or retinal nerve fiber layer (RNFL) and to confirm that the observed disc changes and field deficits were due to glaucoma, according to researchers ...

BACKGROUND AND OBJECTIVE: To evaluate structural changes in the choroid of patients with retinitis pigmentosa (RP) using swept-source optical coherence tomography (OCT) scans. PATIENTS AND METHODS: A prospective study was conducted comparing 35 eyes of 35 patients with RP and 26 eyes of 26 normal patients. OCT images of the choroid were binarized into luminal and stromal areas to derive choroidal vascularity index (CVI). Subfoveal choroidal thickness (CT) was also measured and compared. RESULTS: There was a significant decrease in the mean CVI among eyes with RP as compared to normal eyes (56.91 ± 1.43% vs. 59.47 ± 1 ...

To avoid fluorescein angiography in a pregnant woman diagnosed with a central retinal vein occlusion (CRVO), swept-source optical coherence tomography angiography (SS-OCTA) was performed and showed no evidence of decreased central retinal perfusion leading to the diagnosis of a nonischemic CRVO. Five months after an intravitreal injection of steroid, both her vision and the retinal appearance had returned to normal. This case demonstrates how a noninvasive, safe, 12 mm × 12 mm SS-OCTA image of a CRVO is useful in evaluating the retinal perfusion at presentation and follow-up during pregnancy.

Swept-source optical coherence tomography angiography (SS-OCTA) is a promising new imaging modality for assessing retinal and choroidal vasculature. Faster scanning speed, large number of A-scan acquisition, and enhanced depth penetration has enhanced the detailed analysis of retinal layers. The authors discuss SS-OCTA features of a rare case of retinal arteriovenous malformation. Image analysis revealed the anomalous large-caliber vessels occupying up to the entire retinal thickness with associated echolucent changes in the inner retinal layers surrounding the retinal vessels, along with disruption of the outer retinal layers, including the inner/outer segments of photoreceptors beneath the large tortuous vessels outside the ...

BACKGROUND AND OBJECTIVE: To evaluate enhanced depth imaging optical coherence tomography (EDI-OCT) features of choroidal hemangioma and changes following photodynamic therapy (PDT). PATIENTS AND METHODS: Retrospective review of 21 choroidal hemangiomas. RESULTS: On EDI-OCT, choroidal hemangioma showed low internal reflectivity in 47% of lesions and high internal reflectivity in 53%. The most common associated features were normal-looking honeycomb-like pattern in choriocapillaris in all lesions, inner segment/outer segment abnormality in 62%, photoreceptor outer segment abnormality in 62%, subretinal fluid with speckles in 62%, and shaggy photoreceptors in 57% of lesions. Internal reflectivity changed from low to high in 67% of ...

The retinal lesion known as the presumed solitary circumscribed retinal astrocytic proliferation (pSCRAP) is a benign retinal tumor. Although many of the clinical characteristics of the lesion have been described, much about the pathogenesis of this uncommon tumor is not yet known. Here, the authors report a pSCRAP lesion in the fovea with secondary vision loss occurring in middle age. Structural optical coherence tomography (OCT) scans indicate that the lesion arises from the deep retina or retinal pigment epithelium (RPE), whereas OCT angiography characteristics of the lesion show a lack of intrinsic or paralesional vascular flow, indicating that this lesion ...

High-Definition Optical Coherence Tomography of the Macula in Deprivational Amblyopia Christiane Al-Haddad, MD; Carl-Joe Mehanna, MD; Karine Ismail, MSc Ophthalmic Surgery, Lasers and Imaging Retina. 2018;49(3):198-204 This study evaluated macular thickness in deprivational amblyopia and compared it to matched controls. PATIENTS AND METHODS: The authors present a cross-sectional study of patients with amblyopia from pediatric cataract and matched controls.

At the American Glaucoma Society meeting here, Christopher A. Girkin , MD, MSPH, discusses the launch of the Glaucoma Imaging Atlas (Heidelberg Engineering) to educate clinicians in using OCT in glaucoma assessment and management

BACKGROUND AND OBJECTIVE: To demonstrate the feasibility of retinal and anterior segment intraoperative widefield imaging using an ultrahigh-speed, swept-source optical coherence tomography (SS-OCT) surgical microscope attachment. PATIENTS AND METHODS: A prototype post-objective SS-OCT using a 1,050-nm wavelength, 400 kHz A-scan rate, vertical cavity surface-emitting laser (VCSEL) light source was integrated to a commercial ophthalmic surgical microscope after the objective. Each widefield OCT data set was acquired in 3 seconds (1,000 × 1,000 A-scans, 12 × 12 mm 2 for retina and 10 × 10 mm 2 for anterior segment). RESULTS: Intraoperative SS-OCT was performed in 20 eyes of 20 patients ...