The cornerstone of glaucoma diagnosis and monitoring relies on an assessment of optic nerve structure and function. Advancements in OCT have allowed glaucoma care providers to evaluate optic nerve structure to an unparalleled degree. Principally, three OCT-derived parameter categories may be used for this purpose: retinal nerve fiber layer (RNFL), macular and optic nerve head. For good reason, more weight is typically placed on RNFL and macular parameters than on optic nerve head parameters. However, a novel optic nerve head parameter, Bruch’s membrane opening minimum rim width (BMO-MRW; Heidelberg Spectralis, Heidelberg Engineering), may also add value to one’s ...

Ocular surface squamous neoplasia encompasses the spectrum of pathological lesions ranging from preinvasive dysplasia to invasive squamous cell carcinoma. Recent advances in the evaluation and management of ocular surface squamous neoplasia (OSSN) have changed the trends in treatment protocols. There have been newer modalities of management such as immunotherapy and chemotherapy, but the gold standard is still surgical removal. However, there have always been setbacks due to unexplained recurrences.

PURPOSE: To compare angle-to-angle (ATA) distance and aqueous depth (AQD) readings produced by two different optical coherence tomography (OCT) devices and a Scheimpflug camera. METHODS: ATA distance and AQD were measured in 60 eyes using the Visante time-domain OCT (TD-OCT) (Carl Zeiss Meditec AG), the Anterion swept-source OCT (SS-OCT) (Heidelberg Engineering GmbH), and the Pentacam HR Scheimpflug camera (Oculus Optikgeräte GmbH). Moreover, ATA distance was measured along the horizontal and vertical meridians. Bland-Altman analysis was used to assess the agreement between devices. RESULTS: All three devices did not yield similar horizontal ATA distance: 11.96 ± 0.47 mm (TD-OCT ...

Researchers were able obtain high-quality images of Barrett’s esophagus using tethered capsule endomicroscopy, according to study results. Guillermo Tearney , MD, PhD, from the Wellman Center for Photomedicine at Massachusetts General Hospital, and colleagues wrote that the capsule, which uses optical coherence tomography, (OCT-TCE) provides 3D microscopic images of the esophagus for BE. “OCT-TCE does not require sedation, obtains microscopic images of the entire esophagus, and is a faster and more convenient procedure,” they wrote. “Our group and others have successfully conducted OCT-TCE in pilot, single-center studies showing exemplary images that demonstrate the potential of this technology to improve upper ...

Optical coherence tomography (OCT) has been used to image anterior and posterior structures of the eye, but it has not been used to image structures behind the sclera. 1,2 Extraocular muscles, especially when hypertrophied from thyroid eye disease, have been described with OCT anteriorly. 3 Patient 1 ( Figure 1A ) has a large staphyloma created by focal treatment of intraocular retinoblastoma. A horizontal cross-section was taken with Heidelberg Spectralis enhanced depth imaging OCT (EDI-OCT) (Heidelberg Engineering) and revealed details normally masked by the retina and choroid. The sclera (white arrow), Tenon's capsule (red arrow), long posterior ciliary nerve (yellow ...

Purpose: To investigate the effect of the gaze fixation position on measurement of the limbus and extraocular muscle (EOM) insertion site distance using anterior segment optical coherence tomography (AS-OCT). Methods: Patients undergoing horizontal EOM surgeries were enrolled in this prospective experimental study. The distance between the angle recess and the muscle insertion site was measured using AS-OCT while patients fixed their gaze laterally or medially at inner or outer gaze fixation. The distance between the limbus and muscle insertion was intraoperatively measured using calipers. Results: A total of 46 lateral rectus muscles and 36 medial rectus muscles of 44 patients ...

Purpose: To evaluate the accuracy of anterior segment optical coherence tomography (AS-OCT) for locating horizontal extraocular muscle (EOM) insertion after strabismus surgery. Methods: The distance from the limbus to the postoperative muscle insertion was measured with calipers intraoperatively and by AS-OCT during the postoperative visit of adults undergoing strabismus surgery. Images were collected by masked technicians. Intraclass correlation coefficients (ICC) were used to evaluate the agreement between measurements. Results: Twenty-eight patients were recruited. Measurements were taken from 31 eyes, including 17 lateral and 14 medial rectus muscles. EOM insertion was successfully identified by AS-OCT for 14 (45%) cases. The ICC ...

BACKGROUND AND OBJECTİVE: The purpose of this study is to compare the morphological features of type 1 choroidal neovascularization (CNV) in eyes with age-related macular degeneration (AMD) and pachychoroid neovasculopathy (PNV) using optical coherence tomography angiography (OCTA). PATİENTS AND METHODS: Nineteen eyes of 17 patients with PNV and 30 eyes of 30 patients with AMD were evaluated. The size and area of CNV and morphological patterns during a 6-month period were analyzed using optical coherence tomography angiography. RESULTS: The presence of a feeder vessel was more common in AMD than in PNV. Indistinct pattern was more common in PNV than ...

Background and objective: Posterior vitreous detachment (PVD) is a separation of the posterior hyaloid from the retina that manifests as photopsias and floaters. Optical coherence tomography (OCT) has demonstrated posterior vitreous opacities (PVOs) that may correlate with Shaffer's sign, which may correlate with retinal breaks. Patients and methods: Patients with symptomatic PVDs were retrospectively reviewed at a single institution by a single provider. Masked qualitative review of SD-OCTs by a single reviewer determined presence of PVOs. Results: Among 78 patients, PVOs were found in 32 of the patients (41%), and 19 (59%) had retinal breaks. In those without PVOs ...

Purpose: To quantify the vessel density of the macula and optic disc and foveal avascular zone (FAZ) in healthy children and to evaluate the effects of age, gender, axial length, body mass index (BMI), and refractive errors on vessel density and FAZ. Methods: This study enrolled 92 eyes of 92 participants (42 boys and 50 girls). Optical coherence tomography angiography (OCTA) was performed using AngioVue (Avanti; Optivue). FAZ area, nonflow area, superficial and deep vessel density, FAZ perimeter, acircularity index of FAZ, foveal density, and radial peripapillary capillary vessel density were analyzed by gender. Correlations between the investigated OCTA parameters ...

PURPOSE: To develop a coincident thinning (CTN) index to differentiate between keratoconic and healthy corneas using optical coherence tomography (OCT) measurements of pachymetry and epithelial thickness. METHODS: Pattern deviation maps of pachymetry and epithelial thickness were generated using Fourier-domain OCT images of the cornea. The co-localized thinning of the two maps was quantified using a novel CTN index, which was calculated from Gaussian fits of the regions of maximum relative thinning. The CTN index was validated using k-fold cross-validation, and its classification performance was compared to minimum pachymetry and maximum keratometry. RESULTS: A total of 82 normal eyes and 133 ...

The Notal Vision home OCT system performed well in real-world situations in which patients themselves prompted and used the machine in their home environment. “They had the OCT delivered, had to unpack it, set it up, establish all the connections and use it according to the instructions given in a 2-minute tutorial,” Anat Loewenstein, MD, MHA , said at the virtual Euretina meeting. Home OCT is a technology that allows cloud-based information generated at home by the patients to be automatically analyzed by a machine-learning algorithm. If retinal fluid is detected, a report is generated and conveyed to the treating physician ...

PURPOSE: To analyze corneal and epithelial remodeling differences between SmartSurfACE reverse transepithelial PRK (SCHWIND eye-tech-solutions) and Streamlight (Alcon Laboratories, Inc) transepithelial PRK procedure using optical coherence tomography (OCT) and artificial intelligence (AI). METHODS: This was a prospective, interventional, and longitudinal study. A contralateral eye study was conducted in which one eye was assigned to the SmartSurfACE group and the fellow eye was assigned to the Streamlight group. OCT was performed preoperatively and 1, 3, and 6 months after surgery. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and residual refractive error was measured only preoperatively and at 3 and 6 ...

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 ...