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 ...

PURPOSE: To evaluate the possible hemodynamic changes following strabismus surgery via optical coherence tomography angiography. METHODS: Thirty-two eyes of 16 patients who underwent strabismus surgery in one eye were included in the study. Fellow eyes were used as a control group. The vessel densities of the superficial and deep capillary plexus and superficial and deep foveal avascular zones were measured preoperatively and 3 months postoperatively. RESULTS: The mean superficial and deep foveal avascular zones measurements were 0.84 ± 0.09 and 0.76 ± 1.13 mm 2 , respectively. The mean vessel density of the superficial capillary plexus was 1.23 ...

The development of a no-contact, handheld OCT-A probe has allowed the first images to be captured of nonsedated infants, according to a speaker here. “It’s a real challenge to examine infants in clinic, let alone really image them. We came up with a unit that will allow us to image infants undergoing anesthesia. This particular unit is a portable, flex module that uses a modified tabletop system and is mounted on its armature. It can easily be pulled into the OR and image there. It allows us not only to obtain OCT, but OCTA, fluorescein angiography and ICG images ...

BACKGROUND AND OBJECTIVE: Detection of early vascular changes observed on optical coherence tomography angiography (OCTA) in children who have received external beam radiation and are at risk of developing radiation retinopathy (RR). PATIENTS AND METHODS: Eleven pediatric patients (20 eyes) with history of irradiation and nine healthy subjects (14 eyes) were retrospectively studied after dilated fundus exam and imaging. RESULTS: Four eyes of three patients had clinical RR. Eyes with radiation exposure but no RR had worse vision (no RR: logMAR 0.09 ± 0.14, Snellen 20/25) than controls (logMAR 0.01 ± 0.03, Snellen 20/21; P = .04 ...

A 34-year-old woman presented after recovering from a disseminated Coccidioides immitis infection of the lungs, blood, brain, and placenta. The patient was asymptomatic for visual complaints. Visual acuity was 20/20 in both eyes. Fundus examination demonstrated bilateral chorioretinal infiltrates worse in the left eye. Fluorescein angiography (FA) was unable to be performed as the patient was breastfeeding, prompting the use of optical coherence tomography angiography (OCTA) imaging to further investigate the infiltrates. OCTA imaging was able to detect all visualized chorioretinal infiltrates and showed an additional non-visualized deep choroidal lesion. OCTA is a valuable tool in detecting chorioretinal lesions ...

BACKGROUND AND OBJECTIVE: To identify the clinical and imaging characteristics of isolated retinal astrocytic hamartomas (IRAH). PATIENTS AND METHODS: A case series of eight patients diagnosed with IRAH. RESULTS: The average age at diagnosis was 32 years (range: 9 years to 80 years). After a median follow-up time of 59 months, none of the lesions had demonstrated any change or growth. Fundus fluorescein angiogram identified hyperfluorescence in five of six imaged lesions. Fundus autofluorescence (FAF) changes were seen in all eight cases. Ocular ultrasound was able to identify a lesion in only five of the seven cases. Optical coherence tomography ...

BACKGROUND AND OBJECTIVE: Choroidal vascularity index (CVI) is a noninvasive tool to assess choroidal structure. The objective of the current study was to compare the CVI measurements on swept-source optical coherence tomography (SS-OCT) and spectral-domain OCT (SD-OCT) scans using the same image binarization protocol. PATIENTS AND METHODS: This prospective study was conducted from July 2016 through January 2017 and involved 54 healthy volunteers at a tertiary referral eye care institute in Southern India. Choroidal scans were obtained using both SS- and SD-OCT machines. An automated binarization algorithm was used to compute CVI. RESULTS: The mean CVI with SS-OCT scans was ...

PURPOSE: To compare axial length measurements (and failure rate) of three swept-source optical coherence tomography (SS-OCT)–based biometers: IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany), OA-2000 (Tomey, Nagoya, Japan), and Argos (Movu Inc., Komaki, Japan) to those provided by a partial coherence interferometry (PCI)–based optical biometer (IOLMaster v5.4 [Carl Zeiss Meditec]). METHODS: A total of 119 patients (171 eyes) undergoing cataract surgery were enrolled. Axial length was measured with the four biometers in a random order. Chi-square analysis was used to determine whether statistically significant differences in success rates were found between biometers. Within-subject standard deviation (S w ...

BACKGROUND AND OBJECTIVE: Swept-source optical coherence tomography (SS-OCT) imaging was performed on eyes with epiretinal membranes (ERMs), and the extent of the ERMs were compared between the 12 mm × 12 mm scans and the more routine 6 mm × 6 mm field of view (FOV). PATIENTS AND METHODS: Eyes containing ERMs were imaged using a 12 mm × 12 mm SS-OCT scan. En face images derived from vitreoretinal interface (VRI) slabs were reviewed to assess the full extent of the ERM. RESULTS: En face VRI slab images from 12 mm × 12 mm scans could visualize the full extent in eyes with ERMs ...

RPGR -associated retinitis pigmentosa (RP) is a progressive disease with retina degeneration. Optical coherence tomography angiography (OCTA) is an imaging technique that provides novel insights. The authors report two affected male siblings who underwent OCTA imaging. The area of the foveal avascular zone (FAZ) was measured. Although the younger sibling exhibited more advanced clinical disease, his visual acuity was superior to his older sibling. OCTA imaging revealed a better preserved FAZ in the younger sibling as the reason for this. It also highlighted attenuation of choriocapillaris / choroid layers as biomarkers for disease severity. This provides new insights into retinal degeneration ...

BACKGROUND AND OBJECTIVES: To report the acute and long-term choroidal findings in patients with chronic central serous chorioretinopathy (CCSC) undergoing half-fluence photodynamic therapy (PDT). PATIENTS AND METHODS: This is a prospective, consecutive, interventional, noncomparative case series at a tertiary referral vitreoretinal practice. Twenty-one eyes from 21 patients are included. RESULTS: Among 21 eyes, all had improved vision following PDT during a mean of 5.2 months ± 4.8 months of follow-up. The incidence of choroidal neovascular membranes was 19.0% (four in 21), with only one of these eyes (4.8%) requiring intravitreal anti-vascular endothelial growth factor injections. Changes in ...

Cost is likely the primary reason swept-source OCT, a technology with a lot of advantages, has not been as quickly adopted as spectral domain OCT by the retinal community, Jay S. Duker, MD, told colleagues at Retina 2019. Only two SS-OCT systems are available in 2019 in the U.S. — the Topcon Triton DRI and the Zeiss Plex Elite 9000. … Among clinical advantages of SS-OCT over SD-OCT are its higher speed (100,000 A-scans per second vs. 27,000 to 85,000 A-scans per second); less noise; no signal drop-off; longer imaging range (2.7 mm average vs. 2 mm ...

An investigational, portable spectral-domain optical coherence tomography (SD-OCT) unit revealed small hyperreflective opacities in both eyes of a patient with bilateral retinoblastoma. There was no evidence of vitreous seeding on ophthalmoscopy of either eye. Although the opacities may initially raise concern for potential vitreous seeding, this report suggests alternate potential etiologies for such opacities, which were also seen on imaging of a cohort of normal eyes in pediatric patients.

BACKGROUND AND OBJECTIVES: To analyze the panorama optical coherence tomography angiography (P-OCTA) characteristics of serpiginous-like choroiditis (SLC) and to correlate these findings with indocyanine green angiography (ICGA). PATIENTS AND METHODS: Prospective, observational study of 32 eyes of 24 patients. Twenty-seven eyes of 16 patients who met inclusion criteria were included in the final study. Multimodal imaging was performed using P-OCTA, OCT, fundus autofluorescence, fluorescein angiography, and ICGA. Morphologic features at the site of lesions were analyzed using P-OCTA and correlated with ICGA. RESULTS: P-OCTA in active phase revealed areas of large flow void, which correlated with hypofluorescent areas on ICGA ...

BACKGROUND AND OBJECTIVE: Swept-source optical coherence tomography angiography (SS-OCTA) and different boundary-specific segmentation strategies were used to distinguish type 1 macular neovascularization (MNV) from type 2 MNV in eyes with exudative age-related macular degeneration (AMD). PATIENTS AND METHODS: Eyes with exudative AMD were enrolled in a prospective study. Segmentation strategies included a slab from the outer retina (OR) to the choriocapillaris (CC) for the entire MNV, a slab from the retinal pigment epithelium (RPE) to the CC for the type 1 MNV, and a slab from the OR to the RPE for the type 2 MNV. RESULTS: In 13 eyes ...

Torpedo maculopathy is characterized by a congenital, unilateral, and torpedo-shaped chorioretinal lesion with unclear pathogenesis and evolution. Although the optical coherence tomography angiography (OCTA) characteristics have already been defined in literature, the authors describe for the first time the presence of choroidal neovascularization (CNV) on the temporal edge of this lesion in a 36-year-old woman with a history of altered visual field in her left eye. The authors' investigation supports the hypothesis of an aberrant choroidal circulation underlying the pathogenesis of this condition, and proves the advantage conferred by OCTA in CNV detection over the other angiographic techniques.

Swept source OCT has many benefits over spectral domain OCT, but its biggest obstacle today is cost, according to Jay S. Du k er at the American Academy of Optometry annual meeting. SS-OCT is a form of fourier domain detection, which is how the echo time delay is calculated in the device, he said. The SS light source is a tunable laser that rapidly changes the wavelength, which is very expensive, he added. The reflections of depth are detected with photodetectors, not with a camera as with SD-OCT. The longer wavelength of SS-OCT images (1,000 nm to 1,300 ...

At the Ophthalmology Innovation Summit at AAO, Kfir Azoulay , head of corporate strategy at Heidelberg Engineering, discusses the launch of the company’s OCT angiography module for the Spectralis as well as other innovations taking place.

BACKGROUND AND OBJECTIVES: To describe the imaging characteristics of polypoidal choroidal vasculopathy (PCV) in optical coherence tomography angiography (OCTA) and demonstrate its use as diagnostic method for this pathology in a Latin American population. PATIENTS AND METHODS: A case series. RESULTS: Fourteen eyes were evaluated. At baseline, the most frequent morphology was the “oval” type (76.9%), obtaining a reduction of 53.8% after treatment. The intrinsic finding of the polyps was hyporeflective content prior to treatment (80.8%), which reduced after treatment (7.7%) ( P = .016). CONCLUSIONS: OCTA is a useful imaging tool for detecting findings that can guide ...

The authors report a case of a female patient affected by primary vitreoretinal lymphoma (PVRL) showing retinal involvement. In particular, multiple subretinal hyperreflective infiltrates were found on optical coherence tomography (OCT). These alterations appeared hyperautofluorescent on fundus autofluorescence images. Interestingly, they also appeared hyperreflective on OCT angiography images. This case report underlined the high utility of OCT-based methodologies in accurately detecting and describing PVRL features.

PURPOSE: To quantify the foveal avascular zone and the whole, parafoveal, and foveal vessel density of superficial and deep capillary plexus in amblyopic eyes and age-matched controls and to compare the measurements. METHODS: This cross-sectional study involved 49 eyes from 17 patients with amblyopia and 21 healthy children (aged 6 to 16 years). Optical coherence tomography angiography was performed for all participants and superficial capillary plexus, deep capillary plexus, and foveal avascular zone were evaluated. Data from amblyopic eyes, fellow eyes with unilateral amblyopia, and control eyes were compared using the Mann–Whitney U test. RESULTS: The mean patient age ...

A 73-year-old woman with 2 weeks of progressive painless vision loss was found to have bilateral corneal edema, jaw claudication, and temporal headache. Multimodal imaging revealed an Amalric choroidal infarct in the left eye visualized by widefield indocyanine green angiography and swept-source optical coherence tomography angiography (SS-OCTA). Prompt intravenous corticosteroid treatment resulted in 20/20 vision, and giant cell arteritis (GCA) was confirmed by a temporal artery biopsy. The case underscores the use of widefield SS-OCTA as a non-invasive test to aid in the diagnosis of GCA, as well as bilateral cornea edema as a rare presentation of GCA.

More than half of the world’s population is now online. According to 2018 data, the number of unique mobile subscribers around the world has surpassed 5 billion. North America and Europe still have the highest rate of internet penetration, but Southern Asia and Central Africa are rapidly catching up and are currently seeing the fastest growth in internet adoption. In this scenario, telemedicine, portable devices and mobile applications have the potential to revolutionize eye care, making high-quality services sustainable and accessible to all.

Next-level imaging puts optometry on front line of diabetes diagnosis Primary Care Optometry News, October 2018 Add Emerging imaging technologies are improving evaluation, diagnosis and management of patients with diabetes and leading to earlier detection. These next-level technologies fall into three buckets: high-resolution, expanded field fundus photography; OCT angiography; and widefield imaging.