In the article by Castillo et al 1 (see page 399 ), the authors provide a thoughtful review of “the accuracy of optical coherence tomography (OCT) [compared] with alternative tests for monitoring neovascular age-related macular degeneration (nAMD) and detecting disease activity among eyes previously treated for this condition.” The topic is important. The article focuses mainly on whether OCT can replace fluorescein angiography (FA) because OCT is safer, more convenient, and less costly. Their conclusion is that OCT cannot replace FA: “There is a substantial disagreement between OCT and FA findings in detecting active disease in patients with nAMD who are ...

Mwanza et al 1 evaluated the performance of ganglion cell inner-plexiform layer (GCIPL) parameters used alone or in combination with retinal nerve fiber layer (RNFL) and optic nerve head parameters for the early diagnosis of glaucoma. They also provide positive (PLR) and negative (NLR) likelihood ratios (LR) that are valuable for clinical use.

Purpose To describe the prevalence and interrelationships of epiretinal membranes (ERMs), vitreomacular traction (VMT), macular cysts, paravascular cysts (PVCs), lamellar macular holes (LMHs), full-thickness macular holes (FTMHs), and visual impairment in a population-based study of older adults. Design Cross-sectional study. Participants There were 1913 participants aged 63 to 102 years at the 20-year Beaver Dam Eye Study follow-up examination in 2008–2010, of whom 1540 (2980 eyes) had gradable spectral-domain optical coherence tomography (SD OCT) scans of the macula in at least 1 eye. Methods The presence of ERMs and other retinal lesions was determined by standardized grading of macular ...

Purpose To determine whether annual decline in visual field sensitivity is greater in the transition zone at the edge of the frequency-domain optical coherence tomography (fdOCT) inner segment ellipsoid zone (EZ) than at other locations in the visual field. Design Prospective, longitudinal, observational study. Participants Forty-four patients with X-linked retinitis pigmentosa (XLRP) resulting from a mutation in the RPGR gene. Methods Static perimetric fields (Humphrey 30-2; Carl Zeiss Meditec, Dublin, CA) were obtained annually for 4 years. Beginning with year 2, fdOCT scans were obtained annually with a Heidelberg Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany). Main Outcome Measures The ...

In 2011, revised guidelines for screening chloroquine and hydroxychloroquine (HCQ) retinopathy recommended spectral-domain optical coherence tomography (SD OCT), fundus autofluorescence, or multifocal electroretinogram in addition to ophthalmologic examination and 10-2 perimetry. 1 To date, the qualitative features of SD OCT in chloroquine and HCQ retinopathy have been reported in <60 patients, most of whom had established retinopathy. Also, thinning of parafoveal retina has been documented, 2,3 occurring even when cross-sectional scans are equivocal.

Purpose To investigate the change in posterior corneal elevation up to 1 year after myopic femtosecond-assisted LASIK and photorefractive keratectomy (PRK). Design Prospective, longitudinal, comparative study. Participants Patients undergoing femtosecond-assisted LASIK or PRK. Methods Corneal imaging was performed using swept-source optical coherence tomography at baseline and at each postoperative follow-up. A 2-way analysis of variance model with repeated measures and a linear mixed effect model were used to compare the differences in posterior corneal elevation between LASIK and PRK at different points after adjusting for the preoperative spherical equivalent (SEQ), central corneal thickness (CCT), thinnest corneal thickness (TCT), residual bed ...

Purpose To determine the ability of motion-corrected optical coherence tomography (OCT) to measure the corneal refractive power change due to LASIK. Design Evaluation of a diagnostic test or technology in a cohort. Subjects A total of 70 eyes from 37 subjects undergoing LASIK were measured preoperatively. A total of 39 eyes from 22 subjects were measured postoperatively and completed the study. Methods Consecutive patients undergoing LASIK at the Duke Eye Center who consented to participate were imaged with Placido-ring topography, Scheimpflug photography, and OCT on the day of their surgery. Patients were then reimaged with the same imaging systems at ...

Objective To evaluate optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) measurements in patients with active and quiescent uveitis with and without glaucoma and compare results to the published age-adjusted normative data. Design Comparative, retrospective pilot study. Participants Consecutive patients with uveitis who underwent OCT RNFL measurements between December 2011 and October 2012 were identified: 76 uveitic eyes without glaucoma and 135 uveitic eyes with glaucoma. Intervention We conducted OCT of the RNFL. Main Outcome Measures Global and sectoral RNFL thickness measurements. Results In 19 nonglaucomatous, uveitic eyes with active inflammation, mean global and all sectoral RNFL measurements were ...

With great interest we read the article by Garcia-Martin et al.1 The authors were able to include an impressively large number of patients and this dataset provides an excellent opportunity to evaluate retinal layer affection in multiple sclerosis. However, after carefully reading the article, we are concerned that there are discrepancies in the document that require clarification.

Topic To compare the accuracy of optical coherence tomography (OCT) with alternative tests for monitoring neovascular age-related macular degeneration (nAMD) and detecting disease activity among eyes previously treated for this condition. Clinical Relevance Traditionally, fundus fluorescein angiography (FFA) has been considered the reference standard to detect nAMD activity, but FFA is costly and invasive. Replacement of FFA by OCT can be justified if there is a substantial agreement between tests. Methods Systematic review and meta-analysis. The index test was OCT. The comparator tests were visual acuity, clinical evaluation (slit lamp), Amsler chart, color fundus photographs, infrared reflectance, red-free images and ...

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 ...

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 ...

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.

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 ...

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.

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...