Purpose To measure choroidal thickness (CT) in myopic eyes using enhanced depth imaging (EDI). Design A cross-sectional study. Participants Fifty-six consecutive patients with spherical equivalent refractive error of at least 6 diopters (D) were evaluated. Methods Enhanced depth imaging optical coherence tomography (OCT) images were obtained by positioning the spectral-domain OCT device close enough to the eye to acquire an enhanced signal of the choroidal layer. Choroidal depth was measured as the distance between the outer reflective retinal pigment epithelium (RPE) layer and the inner sclera border. Measurements were made in a horizontal fashion across the fovea at 500-μm ...

Objective To evaluate subclinical macular findings in premature patients at risk of retinopathy of prematurity (ROP) with the use of handheld spectral-domain optical coherence tomography (SD-OCT). Design Prospective, observational case series. Participants Forty-nine prematurely born neonates. Methods Forty-nine infants were imaged using a handheld SD-OCT. Images were acquired in nonsedated infants in the neonatal intensive care unit (NICU). Some patients were followed and reimaged over the course of several weeks. A total of 300 total images were acquired and evaluated for cystoid macular edema (CME) and persistence of inner retinal layers. Main Outcome Measures In vivo determination of foveal retinal ...

Purpose To develop a classification of parapapillary atrophy (PPA) based on its relationship with the location of Bruch's membrane (BM) termination in primary open-angle glaucoma (POAG) patients. Design Cross-sectional observational study. Participants This study analyzed 161 eyes from 161 POAG patients who had temporal β-zone PPA, the width of which was more than 200 μm on at least 1 horizontal scan image obtained by spectral-domain optical coherence tomography within the mid horizontal one third of the optic nerve. Methods Based on the extent of BM within the PPA area, eyes were categorized as group A (intact BM; 76 eyes ...

Purpose To assess the repeatability and reproducibility of 3 rotating Scheimpflug cameras, the Pentacam (Oculus, Wetzlar, Germany), Sirius (Costruzione Strumenti Oftalmici, Florence, Italy), and Galilei (Ziemer, Biel, Switzerland), and 1 Fourier-domain optical coherence tomography (FD-OCT) system, the RTvue-100 OCT (Optovue Inc., Fremont, CA), in measuring corneal thickness. Design Evaluation of diagnostic test. Participants Sixty-six right eyes of 66 healthy volunteers, whose mean age ± standard deviation (SD) was 35.39±10.06 years (range, 18–55 years). Methods Corneal thickness measurements obtained by each system included central corneal thickness (CCT), thinnest corneal thickness (TCT), and midperipheral corneal thickness (MPCT), measured at ...

Objective: To analyze the morphologic features and vasculature of the choroid in healthy eyes using spectral-domain (SD) optical coherence tomography (OCT).Design: Cross-sectional retrospective review.Participants: Forty-two healthy subjects (42 eyes) with no ocular disease who underwent high-definition scanning with Cirrus high-definition OCT (Carl Zeiss Meditec, Inc., Dublin, CA) at the New England Eye Center, Boston, Massachusetts, between November 2009 and September 2010.Methods: The SD OCT images were evaluated for morphologic features of the choroid, including the shape of the choroid–scleral border, location of the thickest point of choroid, and regions of focal choroidal thinning. Total choroidal thickness ...

Purpose To evaluate the features of the lamina cribrosa (LC) in pseudoexfoliation glaucoma (PXG) patients using enhanced depth imaging (EDI) of spectral-domain optical coherence tomography (SD OCT). The results were compared with those of patients with primary open-angle glaucoma (POAG). Design Cross-sectional study. Participants Patients with PXG (n = 21) and POAG (n = 35) matched for age and visual field mean deviation (VF MD). Methods Participants were imaged using SD OCT. Lamina cribrosa thickness (LT) and anterior lamina cribrosa depth (ALD) were determined at 3 areas (mid superior, center, and mid inferior) by 2 examiners using an EDI mode of the ...

Many believe that Descemet's membrane endothelial keratoplasty (DMEK) surgery, as first described by Melles et al, provides faster and better visual rehabilitation compared with other posterior lamellar keratoplasty techniques. DMEK allows transplantation of the endothelium–Descemet's membrane layer with reconstruction of the corneal anatomy. An endothelium–Descemet's membrane layer stained with trypan blue usually displays a characteristic appearance with rolled edges indicating endothelial cells on the outside of the curved edge (, available at http://aaojournal.org). However, this may be difficult to observe during surgery while manipulating the graft in the anterior chamber, especially in patients with ...

Purpose To investigate the ability of clock-hour, deviation, and thickness maps of Cirrus high-definition spectral-domain optical coherence tomography (HD-OCT) in detecting retinal nerve fiber layer (RNFL) defects identified in red-free fundus photographs in eyes with early glaucoma (mean deviation >–6.0 dB). Design Cross-sectional study. Participants Two hundred ninety-five eyes with glaucomatous RNFL defects with clear margins observed in red-free fundus photographs and 200 age-, sex-, and refractive error–matched healthy eyes were enrolled. Methods The width and location of RNFL defects were evaluated by using the red-free fundus photograph. When a RNFL defect detected by red-free fundus photograph did ...

Objective To investigate the use of swept-source optical coherence tomography (OCT) for measuring the area and degree of peripheral anterior synechia (PAS) involvement in patients with angle-closure glaucoma. Design Cross-sectional study. Participants Twenty-three eyes with PAS (detected by indentation gonioscopy) from 20 patients with angle-closure glaucoma (20 eyes had primary angle-closure glaucoma and 3 eyes had angle-closure glaucoma secondary to chronic anterior uveitis [n = 2] and Axenfeld–Rieger syndrome [n = 1]). Methods The anterior chamber angles were evaluated with indentation gonioscopy and imaged by swept-source OCT (Casia OCT, Tomey, Nagoya, Japan) in room light and in the dark using the ...

Objective To assess the value of enhanced depth imaging optical coherence tomography (EDI OCT) in diagnosing and evaluating optic nerve head drusen (ONHD) compared with conventional diagnostic methods. Design Prospective, comparative, cross-sectional study. Participants Thirty-four patients with clinically visible or suspected ONHD in either eye based on dilated optic disc examination or optic disc stereophotography and without ocular comorbidity. Methods Spectral-domain OCT of the optic nerve head in both conventional (non-EDI) and EDI modes, ultrasound B-scan, and standard automated perimetry were performed on both eyes of all participants. Main Outcome Measures Detection and findings of ONHD between EDI OCT and ...

Purpose To report the fluorescein angiography (FA) and optical coherence tomography (OCT) results of a clinical trial of epimacular brachytherapy (EMBT) used for the treatment of neovascular age-related macular degeneration (AMD). Design Pivotal multicenter, active-controlled, randomized clinical trial. Participants A total of 494 participants with treatment-naïve, neovascular AMD. Methods Participants with classic, minimally classic, and occult lesions were randomized to receive (a) EMBT and 2 mandated monthly ranibizumab injections followed by pro re nata (PRN) ranibizumab or (b) 3 mandated monthly ranibizumab injections followed by mandated quarterly plus PRN ranibizumab. Participants underwent FA at screening and at months 1 ...

Purpose To compare the rate of change of circumpapillary retinal nerve fiber layer (cRNFL) thickness, macular volume and thickness, and optic nerve head (ONH) parameters assessed using spectral-domain optical coherence tomography (SD-OCT) between eyes with progressing and nonprogressing glaucoma. Design Longitudinal, observational study. Participants Two hundred seventy-nine eyes from 162 glaucoma patients followed for an average of 2.2 years. Methods Eyes were classified as progressors and nonprogressors according to assessment of optic disc and RNFL photographs and visual field progression analysis. Linear mixed effects models were used to evaluate the overall rate of change of cRNFL thickness, macular volume ...

Purpose To determine if optical coherence tomography (OCT) at baseline or month 3 in the Treatment of Macular Edema following Branch Retinal Vein Occlusion: Evaluation of Efficacy and Safety (BRAVO) and Treatment of Macular Edema following Central Retinal Vein Occlusion: Evaluation of Efficacy and Safety (CRUISE) studies provides information that predicts visual outcome. Design Post hoc analysis from 2 prospective, randomized, controlled clinical trials. Participants Three hundred ninety-seven patients from the BRAVO study and 392 patients from the CRUISE study. Methods Time-domain OCT imaging data were analyzed. Main Outcome Measures Mean change from baseline best-corrected visual acuity (BCVA) letter score ...

Objective To determine the long-term reproducibility of the retinal nerve fiber layer (RNFL) thickness deviation map in glaucoma patients. Design Retrospective, longitudinal study. Participants One hundred two eyes of 102 glaucoma patients. Methods From a total of 318 screened glaucoma patients who had undergone at least 3 serial Cirrus HD optical coherence tomography sessions during an 18-month or longer follow-up period, 102 eyes with localized RNFL defects on red-free photographs that did not progress during this period based on stereoscopic disc photography, red-free photography, and standard automated perimetry (SAP) were included. The angular widths from the RNFL thickness deviation maps ...

Purpose To evaluate in vivo features of Schlemm's canal (SC) in patients with primary open-angle glaucoma (POAG) with spectral-domain optical coherence tomography (SD-OCT) and to investigate the relationship of SC size with intraocular pressure (IOP) and glaucoma severity. Design Prospective, comparative study. Participants Fifty Chinese patients with newly diagnosed POAG who had not undergone surgery and 50 normal Chinese subjects from a population-based, cross-sectional study in Shanghai. Methods All participants underwent SD-OCT. The diameter and area of SC were examined in the temporal and nasal sections and measured with customized software. Main Outcome Measures Patient demographics, repeatability and reproducibility ...

Objective The current study investigated the internal structure of blebs using anterior-segment optical coherence tomography (AS-OCT) in patients who had undergone Ahmed glaucoma valve (AGV) (New World Medical Inc, Rancho Cucamonga, CA) implantation and compared the differences between successful and failed surgeries. Design Cross-sectional, observational study. Participants A total of 76 patients who had undergone AGV implantation. Methods The blebs after AGV implantation were examined using AS-OCT. The relationship between intraocular pressure (IOP) or the number of glaucoma medications and intrableb parameters was evaluated. Success was defined as IOP ≤21 mmHg with a maximum of 2 glaucoma medications, and the ...

Purpose To assess the use of ultra–high-resolution (UHR) optical coherence tomography (OCT) in the diagnosis of ocular surface lesions. Design Prospective, noncomparative, interventional case series. Participants Fifty-four eyes of 53 consecutive patients with biopsy-proven ocular surface lesions: 8 primary acquired melanosis lesions, 5 amelanotic melanoma lesions, 2 nevi, 19 ocular surface squamous neoplasia lesions, 1 histiocytosis lesion, 6 conjunctival lymphoma lesions, 2 conjunctival amyloidosis lesions, and 11 pterygia lesions. Intervention Ultra–high-resolution OCT imaging of the ocular surface lesions. Main Outcome Measures Clinical course and photographs, UHR OCT image, and histopathologic findings. Results Ultra–high-resolution OCT images of all ...

Objective: To determine whether foveal swelling exists in patients with foveal sparing and geographic atrophy (GA) secondary to dry age-related macular degeneration (AMD) and to establish the contribution of different foveal layers to this condition by use of spectral-domain optical coherence tomography (SD-OCT). Design: Prospective comparative case series. Participants: We assessed patients from a longitudinal study with foveal sparing and GA secondary to AMD. Of an initial sample of 108 patients, 13 eyes of 10 patients complied with the inclusion criteria to study eyes in which apparent swelling would not be questionable. We used a control group of 13 healthy ...

Objective Neuroretinal rim assessment based on the clinical optic disc margin (DM) lacks a sound anatomic basis for 2 reasons: (1) The DM is not reliable as the outer border of rim tissue because of clinically and photographically invisible extensions of Bruch's membrane (BM) inside the DM and (2) nonaccountability of rim tissue orientation in the optic nerve head (ONH). The BM opening-minimum rim width (BMO-MRW) is a parameter that quantifies the rim from its true anatomic outer border, BMO, and accounts for its variable orientation. We report the diagnostic capability of BMO-MRW. Design Case control. Participants Patients with ...

Objective To determine the diagnostic ability of laminar thickness obtained using enhanced depth imaging (EDI) of the Heidelberg Spectralis optical coherence tomography (OCT) system (Heidelberg Engineering, Heidelberg, Germany) and the factors related to laminar thickness in patients with glaucoma. Design Evaluation of a diagnostic test. Participants A total of 144 patients with glaucoma (68 with primary open-angle glaucoma [POAG], 76 with normal-tension glaucoma [NTG]), and 65 healthy controls. Methods All patients underwent retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) scanning with the Spectralis OCT system. Mean laminar thickness was defined at the center of the mid-superior ...

Objective To describe the imaging characteristics of solitary idiopathic choroiditis (SIC). Design Retrospective, observational case series. Participants Ten eyes in 10 patients with SIC. Methods Review of chart, fundus photography, ultrasonography, fundus autofluorescence (FAF), infrared reflectance (IR) imaging, and enhanced depth imaging optical coherence tomography (EDI OCT). Main Outcome Measures Scleral, choroidal, and retinal features of SIC as analyzed by EDI OCT. Results The mean age at diagnosis was 47 years (range, 7–76 years). There were 4 male patients and 6 female patients. The mean best-corrected visual acuity was 20/25 (range, 20/20–20/150). The SIC lesions ...

Purpose To evaluate the clinical features of peripapillary choroidal cavitation (PCC) detected by optical coherence tomography (OCT). Design Retrospective, observational case series. Participants One hundred twenty-two eyes from 83 patients diagnosed with PCC by OCT database review were included in this study. Methods Stereoscopic color fundus photographs from eyes with PCC were reviewed by 2 independent ophthalmologists. They were masked to the refractive error, axial length, and OCT findings. Main Outcome Measures Chart review and data analysis included gender, age, best-corrected visual acuity (BCVA), refractive error, axial length, clinical appearance of the peripapillary area, and associated funduscopic abnormalities. Results One ...

Purpose To report the optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) results of the Macular Epiretinal Brachytherapy in Treated Age-Related Macular Degeneration study. Design Prospective, multicenter, interventional, noncontrolled clinical trial. Participants Fifty-three eyes of 53 participants with chronic, active neovascular age-related macular degeneration (AMD) requiring frequent anti–vascular endothelial growth factor retreatment. Methods Participants underwent pars plana vitrectomy with a single 24-gray dose of epimacular brachytherapy (EMB), delivered with an intraocular, handheld, cannula containing a strontium 90/yttrium 90 source positioned over the active lesion. Participants were retreated with ranibizumab administered monthly as needed, using predefined retreatment criteria ...

Purpose: To compare the central and peripheral pachymetry measurements determined using Orbscan IIz (Bausch & Lomb, Rochester, NY), Visante optical coherence tomography (OCT; Carl Zeiss Meditec, Dublin, CA), and RTVue OCT (Oculus Technologies, Wynwood, WA) with ultrasound pachymetry in eyes with established keratoconus and to evaluate the agreement between them. Design: Evaluation of diagnostic technologies. Participants: One hundred six eyes of 67 consecutive patients with a clinical diagnosis of keratoconus ranging in age from 12 to 40 years. Methods: Central corneal thickness (CCT) was determined by all the 4 techniques. Peripheral corneal thicknesses were determined using Orbscan IIz, Visante OCT, and ...