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.

Optical Coherence Tomography Angiography (OCTA) is a novel, non-invasive, dyeless imaging modality that has emerged as an indispensable tool in the fields of optometry and ophthalmology. OCTA provides three-dimensional volumetric images of the retinal and choroidal vasculature by using a motion-contrast decorrelation algorithm. This cutting-edge imaging technology has widespread clinical utility as a non-invasive alternative for visualizing microvasculature in detail, but there are no textbooks dedicated to its use and the interpretation of scans. To fill this need, Optical Coherence Tomography Angiography Atlas: A Case Study Approach , by Dr. Julie A. Rodman, is a richly illustrated, practical guide to OCTA ...

BACKGROUND AND OBJECTIVE: To evaluate the repeatability of retinal thickness and vascular density measurements using split-spectrum amplitude-decorrelation angiography (SSADA) with optical coherence tomography (OCT). PATIENTS AND METHODS: Forty patients were divided into seven categories according to their diagnosis: no retinopathy (control), retinal vein occlusion, diabetes with no retinopathy, diabetes with retinopathy, non-exudative age-related macular degeneration (AMD), exudative AMD, and epiretinal membrane. Capillary density and retinal thickness measurements were taken and evaluated for reliability by determination of statistically significant differences and coefficient of variability (CoV) between measurements. RESULTS: No significant differences ( P > .05) were found in any of the within-visit measurements ...

BACKGROUND AND OBJECTIVE: To evaluate a stereological method in optical coherence tomography (OCT) as an in vivo volume measurement of laser-induced choroidal neovascularization (L-CNV) lesion size. PATIENTS AND METHODS: Laser photocoagulation was applied in rats to rupture Bruch's membrane and induce L-CNV. In vivo OCT images of neovascular lesions were acquired with a spectral-domain OCT system at days 0, 3, 7, 10, and 14 after laser surgery. A stereological image-processing method was used to calculate lesion volumes from the OCT images. Rats were euthanized at day 14, and confocal microscopy was used to obtain accurate volume measurements of the ...

BACKGROUND AND OBJECTIVE: To evaluate anatomical changes of idiopathic macular hole (MH) after internal limiting membrane removal and after passive suction at the hole's borders using microscope-integrated intraoperative optical coherence tomography (iOCT). PATIENTS AND METHODS: Five eyes of five subjects with full-thickness idiopathic MH underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy, and internal limiting membrane (ILM) removal. iOCT was performed after ILM removal and after passive suction at the hole's borders. RESULTS: iOCT showed decreased MH diameter after ILM removal in all cases. Passive suction achieved complete apposition of borders. All cases presented successful postsurgical closure. CONCLUSIONS ...

BACKGROUND AND OBJECTIVE: To evaluate the retinal morphologic characteristics of patients with macropsia caused by epiretinal membrane (ERM) based on spectral-domain optical coherence tomography (SD-OCT). PATIENTS AND METHODS: A cross-sectional, non-interventional study was performed to compare the characteristics of retinal structures in eyes with ERM according to the presence or absence of macropsia. Twenty-six patients with ERM and macropsia were defined as the macropsia group and 26 age-matched patients with ERM without macropsia were the control group. All participants underwent a full ophthalmologic examination and SD-OCT examination. Macropsia was diagnosed and quantified using a double dot chart. The thickness of ...

The authors report the widefield montage swept-source optical coherence tomography angiography (OCTA) findings in a 36-year-old male with sympathetic ophthalmia and illustrate the presence of multiple small areas of choriocapillaris flow voids that likely correspond to areas of choriocapillaris ischemia. Using sequential imaging, the authors observed that these flow voids improved following initiating of steroid and immunosuppressive therapy and almost completely resolved following 6 months of therapy with corresponding improvement in visual acuity. This report highlights the role of widefield montage OCTA to detect these likely ischemic changes within the choriocapillaris in sympathetic ophthalmia and demonstrates that they can be ...

The authors present a case of a 29-year-old man who presented to the Department of Ophthalmology at their institution to complete a peripheral laser treatment in his left eye for familial exudative vitreoretinopathy complicated by tractional macular edema.

BACKGROUND AND OBJECTIVE: The aim of the study was to determine optical coherence tomography angiography (OCTA) findings and to identify mutations in the RS1 gene in a three-generation family with X-linked juvenile retinoschisis (XLRS). PATIENTS AND METHODS: Clinical and genetic assessments were performed in 12 family members. OCTA was performed at baseline (12 members including cases and carriers) and after acetazolamide administration (three cases). Twenty healthy subjects (20 eyes, controls) were chosen for comparison. Molecular genetic analysis of the RS1 gene was performed in all family members. RESULTS: Deep capillary plexus density was reduced in cases compared with controls ( P ...

PURPOSE: To examine extraocular rectus muscle tendons in patients with Graves' ophthalmopathy using optical coherence tomography (OCT). METHODS: This was a cross-sectional observational study conducted with 55 healthy controls, 45 patients with clinically inactive Graves' ophthalmopathy, and 12 patients with clinically active Graves' ophthalmopathy. Scanning was performed at the 3- and 9-o'clock positions. The medial rectus tendon thickness was measured at 7.2 and 9.2 mm from the limbus and the lateral rectus tendon thickness was measured at 8.5 and 10.5 mm from the limbus. RESULTS: The 9.2-mm medial rectus, 8.5-mm lateral rectus, and ...

Paracentral acute middle maculopathy (PAMM) refers to band-like hyperreflective lesions seen on spectral-domain optical coherence tomography, mostly confined to the inner nuclear layer. It has been previously demonstrated to involve the deep capillary plexus (DCP) using optical coherence tomography angiography (OCTA). A 29-year-old female presented with PAMM and was investigated using a new OCTA system that shows not just the superficial capillary plexus and DCP, but also the four vascular plexuses as previously demonstrated in histology. Using this system, involvement of the DCP was shown, but also of more superficial layers, including the intermediate capillary plexus