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 ...

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 ...

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 ...

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 ...

Purpose To evaluate the glaucoma diagnostic performance of ganglion cell inner–plexiform layer (GCIPL) parameters used individually and in combination with retinal nerve fiber layer (RNFL) or optic nerve head (ONH) parameters measured with Cirrus HD-OCT (Carl Zeiss Meditec, Inc, Dublin, CA). Design Prospective cross-sectional study. Participants Fifty patients with early perimetric glaucoma and 49 age-matched healthy subjects. Methods Three peripapillary RNFL and 3 macular GCIPL scans were obtained in 1 eye of each participant. A patient was considered glaucomatous if at least 2 of the 3 RNFL or GCIPL scans had the average or at least 1 sector measurement ...

Purpose To evaluate the clinical utility of spectral domain optical coherence tomography (SD-OCT) in differentiating mild papilledema from buried optic nerve head drusen (ONHD). Design Comparative case series. Participants Sixteen eyes of 9 patients with ultrasound-proven buried ONHD, 12 eyes of 6 patients with less than or equal to Frisén grade 2 papilledema owing to idiopathic intracranial hypertension. Two normal fellow eyes of patients with buried ONHD were included. Methods A raster scan of the optic nerve and analysis of the retinal nerve fiber layer (RNFL) thickness was performed on each eye using SD-OCT. Eight eyes underwent enhanced depth ...

Objective To characterize en face features of the retinal pigment epithelium (RPE) and choroid in eyes with chronic central serous chorioretinopathy (CSCR) using a high-speed, enhanced-depth swept-source optical coherence tomography (SS-OCT) prototype. Design Consecutive patients with chronic CSCR were prospectively examined with SS-OCT. Participants Fifteen eyes of 13 patients. Methods Three-dimensional 6×6 mm macular cube raster scans were obtained with SS-OCT operating at 1050 nm wavelength and 100 000 A-lines/sec with 6 μm axial resolution. Segmentation of the RPE generated a reference surface; en face SS-OCT images of the RPE and choroid were extracted at varying depths every ...

Purpose To evaluate the thickness of the 10 retinal layers in the paramacular area of patients with multiple sclerosis (MS) compared with healthy subjects using the new segmentation technology of spectral domain optical coherence tomography (OCT). To examine which layer has better sensitivity for detecting neurodegeneration in patients with MS. Design Observational, cross-sectional study. Participants Patients with MS (n = 204) and age-matched healthy subjects (n = 138). Methods The Spectralis OCT system (Heidelberg Engineering, Inc., Heidelberg, Germany) was used to obtain automated segmentation of all retinal layers in a parafoveal scan in 1 randomly selected eye of each participant, using the ...

Objective To describe anterior segment optical coherence tomography (ASOCT) parameters during acute primary angle closure (APAC) before therapeutic interventions and comparative analyses of biometric parameters of APAC eyes with fellow eyes. Design Prospective, comparative case series. Participants Thirty-one consecutive patients with APAC. Methods All patients underwent ASOCT imaging of both eyes during the attack, before therapeutic interventions were administered. Custom software was used to measure anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber volume (ACV), iris curvature (I-Curv), iris area (I-Area), lens vault (LV), and angle opening distance (AOD750), trabecular iris space area (TISA750), and iris thickness (IT750 ...

Objective To investigate the feasibility of handheld (HH) ultra-high-resolution spectral-domain optical coherence tomography (SD-OCT) in young children with nystagmus, to determine its sensitivity and specificity in classifying foveal abnormalities, and to investigate its potential to determine the cause of infantile nystagmus with the use of foveal morphology. Design Prospective, case-control study. Participants and Controls A total of 50 patients with nystagmus and 50 healthy control subjects (mean age, 3.2 years; range, 0–8 years). Methods Each patient was scanned using HH SD-OCT (Bioptigen Inc., Research Triangle Park, NC) without sedation, and foveal morphology was classified into 1 of 4 ...

Purpose Phase-variance optical coherence tomography (PV-OCT) provides volumetric imaging of the retinal vasculature without the need for intravenous injection of a fluorophore. We compare images from PV-OCT and fluorescein angiography (FA) for normal individuals and patients with age-related macular degeneration (AMD) and diabetic retinopathy. Design This is an evaluation of a diagnostic technology. Participants Four patients underwent comparative retinovascular imaging using FA and PV-OCT. Imaging was performed on 1 normal individual, 1 patient with dry AMD, 1 patient with exudative AMD, and 1 patient with nonproliferative diabetic retinopathy. Methods Fluorescein angiography imaging was performed using a Topcon Corp (Tokyo, Japan ...

Objective To assess eyes with unilateral choroidal melanocytosis using enhanced depth imaging (EDI) optical coherence tomography (OCT). Design Retrospective, observational case series. Participants Fifteen patients with unilateral choroidal melanocytosis. Methods Each patient was evaluated with EDI-OCT, and comparison was made of involved versus uninvolved foveal retinal and choroidal layers. Main Outcome Measures Enhanced depth imaging OCT features of choroidal melanocytosis. Results The mean patient age was 28 years (median, 23 years; range, 5–76 years). There were 9 male and 6 female patients. Best-corrected visual acuity ranged from 20/20 to 20/30. All patients had subfoveal involvement with choroidal ...

Objective To describe the imaging characteristics of congenital hypertrophy of the retinal pigment epithelium (CHRPE). Design Retrospective, observational case series. Participants Eighteen eyes of 18 patients with CHRPE. Methods Review of chart, fundus photography, ultrasonography, fundus autofluorescence, infrared reflectance (IR) imaging, and enhanced-depth imaging optical coherence tomography (EDI-OCT). Main Outcome Measures Features of CHRPE as analyzed by EDI-OCT. Results The mean age at diagnosis was 48 years (range, 13–73 years). There were 5 males and 13 females, and 17 Caucasian and 1 African American patients. The mean best-corrected visual acuity was 20/22 (range, 20/20–20/40). The ...

Objective To evaluate changes in peripapillary and macular choroidal thickness and volume after the water-drinking test (WDT) using swept-source optical coherence tomography (SS OCT). Design Prospective, cross-sectional, observational study. Participants Fifty-six eyes of 28 healthy volunteers. Methods Participants underwent a 3-dimensional optic disc and macula scanning protocol with a prototype SS OCT (Topcon, Inc., Tokyo, Japan) at baseline and 15, 30, 45, and 120 minutes after the start of the WDT. The WDT consisted of drinking 1000 ml of water within 5 minutes. Objective measurements of the choroid were obtained with automated segmentation of the choroidal boundaries. Main Outcome Measures ...

Objective To define quantitative indicators for the presence of intermediate age-related macular degeneration (AMD) via spectral-domain optical coherence tomography (SD-OCT) imaging of older adults. Design Evaluation of diagnostic test and technology. Participants and Controls One eye from 115 elderly subjects without AMD and 269 subjects with intermediate AMD from the Age-Related Eye Disease Study 2 (AREDS2) Ancillary SD-OCT Study. Methods We semiautomatically delineated the retinal pigment epithelium (RPE) and RPE drusen complex (RPEDC, the axial distance from the apex of the drusen and RPE layer to Bruch's membrane) and total retina (TR, the axial distance between the inner limiting ...

Objective To assess the published literature pertaining to the association between anterior segment imaging and gonioscopy and to determine whether such imaging aids in the diagnosis of primary angle closure (PAC). Methods Literature searches of the PubMed and Cochrane Library databases were last conducted on July 6, 2011. The searches yielded 371 unique citations. Members of the Ophthalmic Technology Assessment Committee Glaucoma Panel reviewed the titles and abstracts of these articles and selected 134 of possible clinical significance for further review. The panel reviewed the full text of these articles and identified 79 studies meeting the inclusion criteria, for which ...

Objective To study corneal morphologic changes in a large keratoconic population and to establish a structural optical coherence tomography (OCT) classification. Design Cross-sectional, observational study. Participants A total of 218 keratoconic eyes from 218 patients and 34 eyes from 34 normal subjects. Methods A Fourier-domain OCT system with 5-μm axial resolution was used. For each patient, 3 high-resolution scans were made across the keratoconus cone. All scans were analyzed by keratoconus specialists who were not given access to patients' clinical and topographic data, and who established an OCT classification. The reproducibility of the classification and its correlation with clinical ...

Objective To quantify 3-dimensionally the anterior segment geometry, biometry, and lens position and alignment in patients before and after implantation of the Crystalens-AO (Bausch & Lomb, Rochester, NY) accommodating intraocular lens (A-IOL). Design Prospective, observational study. Participants Ten patients (20 eyes) with cataract before and after implantation of the Crystalens-AO A-IOL. Methods Custom full anterior segment 3-dimensional (3-D) spectral optical coherence tomography (OCT) provided with quantification tools was used to image the cornea, iris, and natural lens preoperatively and intraocular lens postoperatively. Measurements were obtained under phenylephrine preoperatively and under natural viewing conditions and phenylephrine (for accommodative efforts ranging from 0 ...

Objective To study corneal morphologic changes in a large keratoconic population and to establish a structural optical coherence tomography (OCT) classification. Design Cross-sectional, observational study. Participants A total of 218 keratoconic eyes from 218 patients and 34 eyes from 34 normal subjects. Methods A Fourier-domain OCT system with 5-μm axial resolution was used. For each patient, 3 high-resolution scans were made across the keratoconus cone. All scans were analyzed by keratoconus specialists who were not given access to patients' clinical and topographic data, and who established an OCT classification. The reproducibility of the classification and its correlation with clinical ...

Purpose To identify subgroups of primary angle-closure suspects (PACS) based on anterior segment optical coherence tomography (AS-OCT) and biometric parameters. Design Cross-sectional study. Participants We evaluated 243 PACS subjects in the primary group and 165 subjects in the validation group. Methods Participants underwent gonioscopy and AS-OCT (Carl Zeiss Meditec, Dublin, CA). Customized software (Zhongshan Angle Assessment Program, Guangzhou, China) was used to measure AS-OCT parameters. An agglomerative hierarchical clustering method was first used to determine the optimum number of parameters to be included in the determination of subgroups. The best number of subgroups was then determined using Akaike Information Criterion ...

Objective To describe and interpret a multilaminar sub-retinal pigment epithelium (RPE) intense hyper-reflectivity observed in vivo in eyes clinically diagnosed with regressing drusen. Design Observational case series. Participants Twenty-three consecutive patients clinically diagnosed with regressing calcific drusen due to nonneovascular age-related macular degeneration (AMD). Methods Patients were submitted to confocal scanning laser ophthalmoscopy (cSLO) fundus imaging and “eye-tracked” spectral-domain optical coherence tomography (SD-OCT). Main Outcome Measures Localization and possible origin and composition of the multilaminar sub-RPE hyperreflectivity. Results Thirty eyes of 23 consecutive patients (8 male and 15 female; mean age, 82.7±10.1 years) showing on SD-OCT an ...

Purpose To examine the features of myopia-related optical coherence tomography (OCT) findings in a population-based setting. Design Population-based study. Participants The Beijing Eye Study 2011 included 3468 subjects with an age of 50 years or more. Methods The participants underwent a detailed ophthalmic examination including OCT with enhanced depth imaging of the macula. Main Outcome Measures Optical coherence tomography features of the macula in highly myopic eyes defined by a refractive error of −6 diopters or less or an axial length of 26.5 mm or more. Results Readable OCT images were available for 6530 eyes (94.5%) of 3278 ...

Objective To measure iris volume and anterior segment parameters using a swept-source anterior segment optical coherence tomography (OCT) and investigate factors associated with iris volume and iris volume change after pupil dilation in eyes with open angles and angle closure. Design Cross-sectional study. Participants A total of 86 eyes, including 31 eyes from 21 patients with primary angle closure (PAC) or PAC suspect, 31 eyes from 20 patients with primary open-angle glaucoma (POAG), and 24 eyes from 15 normal subjects, were included. Methods The anterior segment parameters and iris were imaged and measured by the Casia SS-1000 OCT (Tomey, Nagoya ...

Purpose To use spectral domain optical coherence tomography (SD-OCT) to investigate risk factors predictive for the development of atrophy of drusenoid lesions (DLs) (drusen and drusenoid pigment epithelium detachment) in eyes with non-neovascular age-related macular degeneration (NNVAMD). Design Cohort study. Participants Forty-one eyes from 29 patients with NNVAMD. Methods Patients with NNVAMD who underwent registered SD-OCT imaging over a minimum period of 6 months were reviewed. Drusenoid lesions that were accompanied by new atrophy onset at 6 months or last follow-up (FUL) were further analyzed. Detailed lesion change was described throughout the study period. Odds ratios (ORs) and risk for ...