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    1. Retinal Imaging in the Twenty-First Century: State of the Art and Future Directions

      Retinal Imaging in the Twenty-First Century: State of the Art and Future Directions

      Assessment of chorioretinal disease is dependent on the ability to visualize pathologic changes occurring in the posterior segment of the eye using optical instruments, termed ophthalmoscopy . Ophthalmoscopy, in turn, has been enhanced greatly by the development of techniques that allow recording of these changes, termed retinal imaging . As well as documenting pathologic features, retinal and fundal imaging facilitates the identification of morphologic features not visible to the clinician on biomicroscopy. As such, advances in retinal imaging have proven fundamental to many paradigm shifts in our understanding and treatment of ocular disease. In the 1950s, with the advent of electronic flashes ...

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    2. Anterior Segment Optical Coherence Tomography in the Long-Term Follow-up and Detection of Glaucoma in Boston Type I Keratoprosthesis

      Anterior Segment Optical Coherence Tomography in the Long-Term Follow-up and Detection of Glaucoma in Boston Type I Keratoprosthesis

      Purpose To evaluate the role of anterior segment (AS) optical coherence tomography (OCT) as a standardized method of imaging Boston type I keratoprosthesis (KPro) after surgery, particularly in the visualization of iris and angle structures. Design Prospective case series. Participants Twenty patients who underwent KPro implantation in 1 eye. Methods Patients underwent AS OCT imaging before surgery. After KPro implantation, patients were imaged using the AS single, dual, and quad scans to obtain transverse images of the eye every 15° over 360°. High-resolution, corneal quad, and anterior chamber scans were also obtained. This imaging protocol allowed juxtaposition and comparison of ...

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    3. Assessment of Retinal Alterations after Intravitreal Ocriplasmin with Spectral Domain-Optical Coherence Tomography

      Assessment of Retinal Alterations after Intravitreal Ocriplasmin with Spectral Domain-Optical Coherence Tomography

      Ocriplasmin (Jetrea, Thrombogenics, Leuven, Belgium) was recently approved by the United States Food and Drug Administration for the treatment of symptomatic vitreomacular traction (VMT). The MIVI-TRUST phase III randomized, controlled trials revealed that intravitreal ocriplasmin had superior efficacy for VMT resolution compared with placebo vehicle injection. 1 Qualitative identification of outer retinal changes after ocriplasmin injection that were not previously recognized in the MIVI-TRUST trials have recently been described.

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    4. Long-term Assessment of Tilt of Glued Intraocular Lenses An Optical Coherence Tomography Analysis 5 Years after Surgery

      Long-term Assessment of Tilt of Glued Intraocular Lenses  An Optical Coherence Tomography Analysis 5 Years after Surgery

      Purpose Long-term assessment of the optic position of glued transscleral fixated intraocular lens (IOL) with optical coherence tomography (OCT). Design Prospective observational case series. Participants Patients with a minimum 5 years' follow-up after glued IOL surgery were included. Methods Postoperatively, IOL position was examined by anterior segment OCT (Carl Zeiss Meditec) and the scans were analyzed in 2 axes (180°–0° and 270°–90°) using MatLab (Mathworks). Best-corrected visual acuity (BCVA; Snellen's charts), Orbscan, retinoscopy, refraction, and slit-lamp biomicroscopy were performed. Main Outcome Measures The distance between the iris margin and the anterior IOL optic (D1, D2), slope of ...

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    5. Imaging of the Temporal Raphe with Optical Coherence Tomography

      Imaging of the Temporal Raphe with Optical Coherence Tomography

      There has been considerable debate about the arrangement and composition of the temporal raphe in the human retina. In postmortem studies, Vrabec 1 showed that axons of retinal ganglion cells temporal to the fovea are forced to take an arched course above and below the papillomacular bundle and that the temporal raphe generally represents a watershed midline. However, there is scarce published literature on the relationship between the orientation of the papillomacular bundle and the temporal raphe.

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    6. Optical Coherence Tomography–Defined Changes Preceding the Development of Drusen-Associated Atrophy in Age-Related Macular Degeneration

      Optical Coherence Tomography–Defined Changes Preceding the Development of Drusen-Associated Atrophy in Age-Related Macular Degeneration

      Purpose To characterize the pathological changes preceding the development of drusen-associated atrophy in eyes with age-related macular degeneration (AMD) using spectral-domain optical coherence tomography (SD-OCT). Design Longitudinal and cross-sectional retrospective observational study. Participants A total of 181 participants with intermediate AMD in at least 1 eye (141 unilateral, 40 bilateral) were assessed longitudinally. A total of 230 participants with bilateral intermediate AMD (40 longitudinal participants with an additional 190 participants) were analyzed cross-sectionally. Methods Spectral-domain OCT, color fundus photography (CFP), near-infrared reflectance, and fundus autofluorescence imaging were performed in all participants at cross-section and every 3 months for up to ...

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    7. Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

      Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

      Purpose To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 patients with glaucoma were included. Methods One eye of each subject was scanned by a high-speed 1050-nm–wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used ...

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    8. Glaucoma Diagnostic Accuracy of Optical Coherence Tomography Parameters in Early Glaucoma with Different Types of Optic Disc Damage

      Glaucoma Diagnostic Accuracy of Optical Coherence Tomography Parameters in Early Glaucoma with Different Types of Optic Disc Damage

      Purpose To compare the initial visual field (VF) defect pattern and the spectral-domain optical coherence tomography (OCT) parameters and investigate the effects of distinct types of optic disc damage on the diagnostic performance of these OCT parameters in early glaucoma. Design Retrospective, observational study. Participants A total of 138 control eyes and 160 eyes with early glaucoma were enrolled. The glaucomatous eyes were subdivided into 4 groups according to the type of optic disc damage: focal ischemic (FI) group, myopic (MY) group, senile sclerotic (SS) group, and generalized enlargement (GE) group. Methods The values of total deviation (TD) maps were ...

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    9. In Vivo Imaging of Radial Keratoneuritis in Patients with Acanthamoeba keratitis by Anterior-Segment Optical Coherence Tomography

      In Vivo Imaging of Radial Keratoneuritis in Patients with Acanthamoeba keratitis by Anterior-Segment Optical Coherence Tomography

      Purpose To investigate in vivo corneal changes of radial keratoneuritis in early-stage Acanthamoeba keratitis (AK) using anterior-segment optical coherence tomography (AS-OCT). Design Single-center, prospective clinical study. Participants Four eyes (4 patients with a mean age of 28.5 years) with early-stage AK showing radial keratoneuritis were included in this study. Definitive diagnosis was made by confirmation of AK cysts using in vivo confocal microscopy and culture. Methods Anterior-segment OCT examination was performed on the initial visit and at follow-up visits paying special attention to radial keratoneuritis. Main Outcome Measures Selected AS-OCT images of the cornea were evaluated qualitatively for the ...

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    10. Vitreopapillary Traction in Eyes with Idiopathic Epiretinal Membrane: A Spectral Domain Optical Coherence Tomography Study

      Vitreopapillary Traction in Eyes with Idiopathic Epiretinal Membrane: A Spectral Domain Optical Coherence Tomography Study

      Purpose To investigate the prevalence of vitreopapillary traction (VPT) and its effect on peripapillary structure and visual function in eyes with idiopathic epiretinal membrane (ERM). Design Observational, comparative study. Participants Patients with idiopathic ERM (n = 116 eyes) and controls with similar age (n = 62 eyes). Methods Spectral domain optical coherence tomography (SD-OCT) axial optic disc scans were evaluated to identify VPT in eyes with idiopathic ERM. Based on VPT presence/absence, eyes were categorized as ERM with VPT (ERM +VPT , n = 52 eyes) or ERM without VPT (ERM −VPT , n = 64 eyes). Optic nerve head (ONH) parameters, average and sectoral ...

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    11. Characterization of Punctate Inner Choroidopathy Using Enhanced Depth Imaging Optical Coherence Tomography

      Characterization of Punctate Inner Choroidopathy Using Enhanced Depth Imaging Optical Coherence Tomography

      Purpose To perform qualitative and quantitative analyses of retinal and choroidal morphology in patients with punctate inner choroidopathy (PIC) using enhanced depth imaging optical coherence tomography (EDI-OCT). Design Cross-sectional, consecutive series. Participants A total of 2242 patients attending 2 tertiary referral uveitis clinics at Moorfields Eye Hospital were screened; 46 patients with PIC diagnosis were identified, and 35 eyes (35 patients) had clinically inactive PIC had EDI-OCT images that met the inclusion criteria. Methods Punctate inner choroidopathy lesions were qualitatively assessed for retinal features, such as (1) focal elevation of the retinal pigment epithelium (RPE), (2) focal atrophy of the ...

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    12. Comparison of Optical Coherence Tomography Assessments in the Comparison of Age-Related Macular Degeneration Treatments Trials

      Comparison of Optical Coherence Tomography Assessments in the Comparison of Age-Related Macular Degeneration Treatments Trials

      Objective To determine agreement between spectral-domain (SD) and time-domain (TD) optical coherence tomography (OCT) image assessments by certified readers in eyes treated for neovascular age-related macular degeneration (AMD). Design Cross-sectional study within the Comparison of AMD Treatments Trials (CATT). Participants During year 2 of CATT, 1213 pairs of SD OCT and TD OCT scans were compared from a subset of 384 eyes. Methods Masked readers independently graded OCT scans for presence of intraretinal fluid (IRF), subretinal fluid (SRF), and sub-retinal pigment epithelium (RPE) fluid and performed manual measurements of retinal, SRF, and subretinal tissue complex thicknesses at the foveal center ...

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    13. Objective Measurement of Vitreous Inflammation Using Optical Coherence Tomography

      Objective Measurement of Vitreous Inflammation Using Optical Coherence Tomography

      Purpose To obtain measurements of vitreous signal intensity from optical coherence tomography (OCT) image sets in patients with uveitis, with the aim of developing an objective, quantitative marker of inflammatory activity in patients with this disease. Design Retrospective, observational case-control series. Participants Thirty patients (30 eyes) with vitreous haze secondary to intermediate, posterior, or panuveitis; 12 patients (12 eyes) with uveitis but without evidence of vitreous haze; and 18 patients (18 eyes) without intraocular inflammation or vitreoretinal disease. Methods Clinical and demographic characteristics were recorded, including visual acuity (VA), diagnosis, and anatomic type of uveitis. In each eye, the anterior ...

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    14. Evaluation of Optic Nerve Development in Preterm and Term Infants Using Handheld Spectral-Domain Optical Coherence Tomography

      Evaluation of Optic Nerve Development in Preterm and Term Infants Using Handheld Spectral-Domain Optical Coherence Tomography

      Purpose To evaluate effects of prematurity on early optic nerve (ON) development and the usefulness of ON parameters as indicators of central nervous system (CNS) development and pathology. Design Prospective, cross-sectional, longitudinal study. Participants Forty-four preterm infants undergoing retinopathy of prematurity (ROP) screening and 52 term infants. Methods We analyzed ON from portable handheld spectral-domain optical coherence tomography (SD-OCT) images (Bioptigen, Inc, Research Triangle Park, NC) of 44 preterm and 52 term infants. The highest-quality ON scan from either eye was selected for quantitative analysis. Longitudinal analysis was performed at 31–36 weeks and 37–42 weeks postmenstrual age (PMA ...

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    15. Proposed Lexicon for Anatomic Landmarks in Normal Posterior Segment Spectral-Domain Optical Coherence Tomography: The IN•OCT Consensus

      Proposed Lexicon for Anatomic Landmarks in Normal Posterior Segment Spectral-Domain Optical Coherence Tomography: The IN•OCT Consensus

      Purpose To develop a consensus nomenclature for the classification of retinal and choroidal layers and bands visible on spectral-domain optical coherence tomography (SD-OCT) images of a normal eye. Design An international panel with expertise in retinal imaging (International Nomenclature for Optical Coherence Tomography [IN•OCT] Panel) was assembled to define a consensus for OCT imaging terminology. Participants A panel of retina specialists. Methods A set of 3 B-scan images from a normal eye was circulated to the panel before the meeting for independent assignment of nomenclature to anatomic landmarks in the vitreous, retina, and choroid. The outputs were scrutinized, tabulated ...

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    16. Differentiation of Compressive from Glaucomatous Optic Neuropathy with Spectral-Domain Optical Coherence Tomography

      Differentiation of Compressive from Glaucomatous Optic Neuropathy with Spectral-Domain Optical Coherence Tomography

      Purpose To compare optic disc topography in eyes with compressive optic neuropathy (CON) and open-angle glaucoma (OAG) using spectral-domain (SD) optical coherence tomography (OCT) and Heidelberg retinal tomograph (HRT) (Heidelberg Engineering GmbH, Heidelberg, Germany). Design Cross-sectional, observational study. Participants A total of 200 eyes from 123 patients with CON (69 eyes) or OAG (58 eyes) and controls (73 eyes). Methods Univariate and multivariate analyses of HRT parameters, SD-OCT circumpapillary retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters. Main Outcome Measures Circumpapillary RNFL, OCT ONH parameters, and HRT parameters. Results The univariate analysis of OCT parameters demonstrated ...

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    17. Ganglion Cell-Inner Plexiform Layer Thickness after Epiretinal Membrane Surgery: A Spectral Domain Optical Coherence Tomography Study

      Ganglion Cell-Inner Plexiform Layer Thickness after Epiretinal Membrane Surgery: A Spectral Domain Optical Coherence Tomography Study

      Purpose To investigate postoperative macular ganglion cell-inner plexiform layer (GCIPL) thickness, determine the factors related to GCIPL thickness, and evaluate the association of GCIPL thickness with postoperative visual outcomes in patients with idiopathic epiretinal membrane (ERM). Design Retrospective, cohort study. Participants Sixty-two patients with unilateral idiopathic ERM who were followed for ≥6 months after surgery. Methods Ophthalmologic evaluations included best-corrected visual acuity (BCVA) assessment, spectral-domain optical coherence tomography, and macular visual field (VF) mean sensitivity (MS) as measured by Humphrey VF test. Macular GCIPL thickness in eyes with ERM was compared with that of the normal contralateral eyes 6 months ...

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    18. Quantitative Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-related Macular Degeneration

      Quantitative Optical Coherence Tomography Angiography of Choroidal Neovascularization in Age-related Macular Degeneration

      Purpose To detect and quantify choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography. Design Observational, cross-sectional study. Participants A total of 5 normal subjects and 5 subjects with neovascular AMD were included. Methods A total of 5 eyes with neovascular AMD and 5 normal age-matched controls were scanned by a high-speed (100 000 A-scans/seconds) 1050-nm wavelength swept-source OCT. The macular angiography scan covered a 3×3-mm area and comprised 200×200×8 A-scans acquired in 3.5 seconds. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were ...

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    19. Relationship between Retinal Microstructures on Optical Coherence Tomography and Microperimetry in Age-Related Macular Degeneration

      Relationship between Retinal Microstructures on Optical Coherence Tomography and Microperimetry in Age-Related Macular Degeneration

      Purpose: To determine the relationship between structural parameters of the outer retina on spectral-domain optical coherence tomography (SD-OCT) and microperimetric retinal sensitivity in early stages of age-related macular degeneration (AMD).Design: Prospective, observational study.Participants: Seventy-five eyes of 75 participants with early stages of AMD (drusen ≥125 μm, with/without pigmentary abnormalities) and 25 control participants of a similar age.Methods: Participants underwent microperimetry testing and high-resolution SD-OCT scans. Structural parameters at 5 central points (0°, 1°, and 2.33° nasal and temporal to the fovea along the horizontal axis) corresponding to areas tested by microperimetry were compared. Structural parameters ...

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    20. Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

      Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

      Purpose To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 patients with glaucoma were included. Methods One eye of each subject was scanned by a high-speed 1050-nm–wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used ...

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    21. Quantitative Assessment of Retinal Nerve Fiber Layer Defect Depth Using Spectral-Domain Optical Coherence Tomography

      Quantitative Assessment of Retinal Nerve Fiber Layer Defect Depth Using Spectral-Domain Optical Coherence Tomography

      Purpose To assess quantitatively the depth of retinal nerve fiber layer (RNFL) defects using a Cirrus high-definition (HD) optical coherence tomography (OCT)–derived RNFL thickness deviation map. Design Prospective, cross-sectional study. Participants Three-hundred fifteen eyes with localized and diffuse RNFL defects of 315 glaucoma patients and 217 eyes of 217 healthy subjects. Methods For the glaucoma subjects, the severity of the RNFL defect was graded on red-free fundus photographs by 2 observers using a standardized protocol with a 3-level grading system. The RNFL defect depth on the RNFL thickness deviation map was expressed as an RNFL defect depth percentage index ...

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    22. The Premacular Bursa's Shape Revealed In Vivo by Swept-Source Optical Coherence Tomography

      The Premacular Bursa's Shape Revealed In Vivo by Swept-Source Optical Coherence Tomography

      Objective To resolve the controversy surrounding the shape and relationship of posterior vitreous spaces by characterizing the connections between the premacular bursa, the area of Martegiani, and Cloquet's canal. Design Comprehensive posterior vitreous maps were created using swept-source optical coherence tomography (SS OCT) in a cross-sectional study. Participants The posterior vitreous of 102 eyes of 51 volunteers 21 to 54 years of age without ocular pathologic features was imaged using SS OCT. Methods The DRI OCT-1 Atlantis 3D SS OCT (Topcon Medical Systems, Oakland, NJ) was used to acquire scans of the posterior vitreous over an 18×18-mm area ...

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    23. Disparity between Visual Fields and Optical Coherence Tomography in Hydroxychloroquine Retinopathy

      Disparity between Visual Fields and Optical Coherence Tomography in Hydroxychloroquine Retinopathy

      Purpose American Academy of Ophthalmology recommendations for screening for hydroxychloroquine (HCQ) retinopathy advise objective measures, such as spectral-domain optical coherence tomography (SD-OCT) and multifocal electroretinography (mfERG) along with visual fields. However, the relative sensitivity and specificity of screening tests have not been fully resolved. We characterize a subset of patients with toxicity who show unusual disparity between fields and SD-OCT and thus have implications for screening practice. Design Review of charts and clinical data. Participants Patients at Stanford and Kaiser Permanente who had used HCQ with greater than 1000 g cumulative exposure. There were more than 2000 such individuals, among ...

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    24. Clinical and Spectral-Domain Optical Coherence Tomography Findings in Patients with Focal Choroidal Excavation

      Clinical and Spectral-Domain Optical Coherence Tomography Findings in Patients with Focal Choroidal Excavation

      Objective To describe the clinical and spectral-domain optical coherence tomography (SD-OCT) findings in patients with focal choroidal excavation (FCE). Design Retrospective case series. Participants Forty-one eyes of 38 patients with FCE identified in 2 tertiary medical centers in Korea. Methods Clinical features, SD-OCT findings, and associated macular disorders of FCE were analyzed and detailed. Main Outcome Measures Statistical associations among clinical features, including lesion type, size, and choroidal thickness, and frequency of association with central serous chorioretinopathy (CSC), choroidal neovascularization (CNV), and polypoidal choroidal vasculopathy (PCV). Results Mean patient age was 50.1 years (range, 25–76 years). The mean ...

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