1. Articles from BJO Online

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    1. Vision and visual potential for perifoveal retinoblastoma after optical coherence tomographic-guided sequential laser photocoagulation

      Vision and visual potential for perifoveal retinoblastoma after optical coherence tomographic-guided sequential laser photocoagulation

      Background/aims To assess tumour control, vision and anatomical visual potential in eyes with perifoveal retinoblastoma treated by sequential photocoagulation from the antifoveal tumour edge inwards, avoiding treatment near the fovea. Patients were monitored for tumour control, foveal and perifoveal anatomy at each treatment session by optical coherence tomography (OCT) and treated for amblyopia when the other eye had better vision. Methods Eyes with perifoveal retinoblastoma treated between 1 January 2011 and 31 May 2017 with laser therapy after chemotherapy for juxtafoveal (fovea clear of tumour but <3000 µm from tumour edge) or foveolar retinoblastoma (tumour underlying fovea) were retrospectively ...

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    2. Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

      Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

      Aim To analyse the repeatability of vessel density (VD) measurements using optical coherence tomography angiography (OCTA) in patients with retinal diseases. Methods Two consecutive VD measurements using OCTA were analysed prospectively in patients with retinal diseases (diabetic macular oedema (DME), retinal vein occlusion (RVO) with macular oedema, epiretinal membrane (ERM), wet age-related macular degeneration (AMD)). The intraclass correlation coefficient (ICC), coefficient of variation (CV) and test-retest SD of VD measurements were assessed, and linear regression analyses were conducted to identify factors related to repeatability. Results A total of 134 eyes were analysed involving 20 eyes with DME, 44 eyes with ...

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    3. Quantitative retinal microvasculature in children using swept-source optical coherence tomography: the Hong Kong Children Eye Study

      Quantitative retinal microvasculature in children using swept-source optical coherence tomography: the Hong Kong Children Eye Study

      Aims To evaluate the distributions of quantitative optical coherence tomography angiography (OCT-A) metrics and its associated factors in children. Methods 1059 children aged 6–8 years were recruited from the Hong Kong Children Eye Study. All the participants underwent OCT-A with a swept-source OCT. Retinal microvasculature on superficial capillary plexus was assessed and quantified by a customised automated image analysis programme. Univariable and multiple linear regression analyses were performed to determine systemic (body mass index (BMI), waist circumference, head circumference and blood pressure), demographic and ocular (axial length (AL), macular thickness and volume, retinal nerve fibre layer (RNFL) thickness and ...

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    4. Morphological and topographical appearance of microaneurysms on optical coherence tomography angiography

      Morphological and topographical appearance of microaneurysms on optical coherence tomography angiography

      Aims To investigate retinal microaneurysms in patients with diabetic macular oedema (DME) by optical coherence tomography angiography (OCTA) according to their location and morphology in relationship to their clinical properties, leakage on fundus fluorescein angiography (FFA) and retinal thickening on structural OCT. Methods OCTA and FFA images of 31 eyes of 24 subjects were graded for the presence of microaneurysms. The topographical and morphological appearance of microaneurysms on OCTA was evaluated and classified. For each microaneurysm, the presence of focal leakage on FFA and associated retinal thickening on OCT was determined. Results Of all microaneurysms flagged on FFA, 295 out ...

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    5. Relationship of intercapillary area with visual acuity in diabetes mellitus: an optical coherence tomography angiography study

      Relationship of intercapillary area with visual acuity in diabetes mellitus: an optical coherence tomography angiography study

      Aim To examine the correlation of best-corrected visual acuity (BCVA) with intercapillary area (ICA) measured from optical coherence tomography angiography (OCT-A) in patients with diabetes, and to compare the strength of associations between BCVA with ICA and other OCT-A metrics. Methods A cross-sectional study involved 447 eyes from 299 patients with diabetes. All participants underwent OCT-A with a swept-source OCT (Triton DRI-OCT, Topcon, Tokyo, Japan). An automated customised MATLAB programme was used to quantify ICA (the mean of the 10 largest areas including foveal avascular zone (FAZ) area (ICA10_FAZ) and excluding FAZ area (ICA10_excFAZ)) and other OCT-A metrics (FAZ area ...

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    6. Acute macular neuroretinopathy: pathogenetic insights from optical coherence tomography angiography

      Acute macular neuroretinopathy: pathogenetic insights from optical coherence tomography angiography

      Aim To describe the optical coherence tomography angiography (OCT-A) features of patients affected by acute macular neuroretinopathy (AMN). Methods This is a prospective, observational, cross-sectional study. Multimodal imaging, including spectral domain OCT (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany) and 6×6 mm swept source OCT-A (ZEISS PLEX Elite 9000; ZEISS, Dublin, California), was performed on all patients. The primary outcome measure was assessment of the vascular alterations of the superficial (SCP) and deep (DCP) capillary plexuses and choriocapillaris (CC). A segmentation of the AMN lesions using enface OCT images of photoreceptors-retinal pigment epithelium complex was used to discriminate intralesional ...

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    7. Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

      Repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography macular metrics in healthy subjects

      Purpose To investigate the repeatability, interocular correlation and agreement of quantitative swept-source optical coherence tomography angiography (SS-OCTA) metrics in healthy subjects. Methods Thirty-three healthy normal subjects were enrolled. The macula was scanned four times by an SS-OCTA system using the 3 mm×3 mm mode. The superficial capillary map images were analysed using a MATLAB program. A series of parameters were measured: foveal avascular zone (FAZ) area, FAZ perimeter, FAZ circularity, parafoveal vessel density, fractal dimension and vessel diameter index (VDI). The repeatability of four scans was determined by intraclass correlation coefficient (ICC). Then the averaged results were analysed for ...

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    8. Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

      Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

      Background/aims Split-spectrum amplitude decorrelation angiography for spectral-domain optical coherence tomography has enabled detailed, non-invasive assessment of vascular flow. This study evaluates choriocapillaris and retinal capillary perfusion density (CPD) in diabetic eyes using optical coherence tomography angiography (OCTA). Methods Records of 136 eyes that underwent OCTA imaging at a single institution were reviewed. Eyes were grouped as non-diabetic controls (37 eyes), patients with diabetes mellitus (DM) without diabetic retinopathy (DM without DR, 31 eyes), non-proliferative diabetic retinopathy (NPDR, 41 eyes) and proliferative diabetic retinopathy (PDR, 27 eyes). Quantitative CPD analyses were performed on OCTA images for assessing perfusion density of ...

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    9. Quantifying vascular density and morphology using different swept-source optical coherence tomography angiographic scan patterns in diabetic retinopathy

      Quantifying vascular density and morphology using different swept-source optical coherence tomography angiographic scan patterns in diabetic retinopathy

      Aims To evaluate quantitative metrics of the retinal microvasculature in eyes with diabetic retinopathy (DR) using various en face swept-source optical coherence tomography angiography (SS-OCTA) image sizes. Methods Non-segmented and segmented images were acquired using an SS-OCTA device (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, California, USA). The scanning protocols included the 3×3 mm, 6×6 mm and 12×12 mm fields of view. Quantitative analysis of the perfusion density (PD), vessel length density (VLD) and fractal dimension (FD) was performed. The area under the receiver operating characteristic curve was estimated to assess the ability of each image size ...

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    10. Optical coherence tomography angiography in comparison with other multimodal imaging techniques in punctate inner choroidopathy

      Optical coherence tomography angiography in comparison with other multimodal imaging techniques in punctate inner choroidopathy

      Aims To characterise punctate lesions and choroidal neovascularisation (CNV) in eyes with punctate inner choroidopathy (PIC) using current standard multimodal imaging techniques and optical coherence tomography angiography (OCTA). Methods In our prospective, single-centre study, 20 individuals with PIC underwent imaging with spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), indocyanine green angiography, fundus autofluorescence, fundus colour photography and OCTA. Results Thirty-two eyes of 20 patients were affected. Eight (20%) eyes revealed typical punctate lesions, while 24 (60%) eyes had confirmed CNV on SD-OCT and FA in addition to punctate lesions. Of these 24 eyes with CNV, a reoccurrence of active ...

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    11. Evaluation of choroidal lesions with swept-source optical coherence tomography

      Evaluation of choroidal lesions with swept-source optical coherence tomography

      Aims The aim of our study was to image choroidal lesions with swept-source optical coherence tomography (SS-OCT) and to identify the morphological characteristics associated with optimal visualisation. Methods This was a prospective, cross-sectional study. Patients with choroidal melanocytic lesions <3 mm in thickness on B-scan ultrasonography were recruited. All participants underwent SS-OCT. On SS-OCT we evaluated qualitative (eg, lesion outline, detection of scleral-choroidal interface and quality of the image) and quantitative (measurement of maximum lesion thickness and the largest basal diameter) parameters. Probability of optimal image quality was examined using ordered logistic regression models. The main outcome measure was quality ...

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    12. Early OCT angiography changes of type 1 CNV in exudative AMD treated with anti-VEGF

      Early OCT angiography changes of type 1 CNV in exudative AMD treated with anti-VEGF

      Aims To investigate, with optical coherence tomography angiography (OCTA), short-term changes of type 1 choroidal neovascularisation (CNV), secondary to exudative age-related macular degeneration, after anti-vascular endothelial growth factor (VEGF) treatment. Methods Patients affected by type 1 CNV treated with intravitreal anti-VEGF were consecutively enrolled. All patients underwent OCTA examination before and 48 hours after anti-VEGF treatment. Quantitative and qualitative vascular and morphological macular changes were evaluated. Results Sixteen eyes were included (11 treated with aflibercept and 5 with ranibizumab). Both CNV mean area and pigment epithelium detachment significantly reduced (p=0.0004 and p=0.0007, respectively) after treatment. Cystoid ...

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    13. Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes

      Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes

      Background To investigate the long-term visual and optical coherence tomography (OCT) anatomical outcomes of type 3 neovascularisation (NV) and to identify any baseline predictors of poor outcomes. Methods In this retrospective study, patients diagnosed with treatment naïve type 3 NV were identified and categorised into two groups: good or poor vision based on final vision at 1 year. Baseline demographic features and visual acuity (VA) and baseline and 1-year spectral domain OCT (SD-OCT) anatomical findings were studied and correlated with good versus poor visual outcomes. Results Ten of 25 eyes were classified as having a poor visual outcome (20 ...

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    14. Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema: qualitative and quantitative evaluation of retinal vasculature

      Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema: qualitative and quantitative evaluation of retinal vasculature

      Aims To describe optical coherence tomography angiography (OCT-A) abnormalities of patients with pseudophakic cystoid macular oedema (PCMO) before and after pharmacological resolution, compared with diabetic macular oedema (DMO) and normal eyes. Methods In this retrospective, observational study, 44 eyes (30 patients) were included: 15 eyes (15 patients) affected by PCMO; 14 healthy fellow eyes used as negative control group; 15 eyes (15 age-matched and sex-matched patients) with DMO used as positive control group. All patients underwent a complete ophthalmological examination at baseline, including OCT-A scans of the macula through AngioPlex CIRRUS-5000 (Carl Zeiss Meditec, Dublin, USA). Patients with PCMO and ...

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    15. Retinal vascular alterations in reticular pseudodrusen with and without outer retinal atrophy assessed by optical coherence tomography angiography

      Retinal vascular alterations in reticular pseudodrusen with and without outer retinal atrophy assessed by optical coherence tomography angiography

      Purpose To investigate the intraretinal structural and vascular alterations in patients featuring reticular pseudodrusen (RPD), RPD with outer retinal atrophy (ORA), and drusen. Design Observational cross-sectional study. Methods Clinical practice study including 68 eyes of 57 patients (22 eyes of 17 patients with RPD; 24 eyes of 21 patients with RPD+ORA; 22 eyes of 19 patients with drusen). Each patient underwent spectral-domain optical coherence tomography (OCT) and OCT angiography (OCT-A). Measurement of retinal layers’ thickness was obtained by the automated segmentation protocol of the Spectralis OCT (Heidelberg Eye Explorer V.1.9.10.0). The superficial capillary plexus (SCP ...

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    16. Automated diabetic retinopathy detection using optical coherence tomography angiography: a pilot study

      Automated diabetic retinopathy detection using optical coherence tomography angiography: a pilot study

      Background Optical coherence tomography angiography (OCTA) is increasingly being used to evaluate diabetic retinopathy, but the interpretation of OCTA remains largely subjective. The purpose of this study was to design a computer-aided diagnostic (CAD) system to diagnose non-proliferative diabetic retinopathy (NPDR) in an automated fashion using OCTA images. Methods This was a two-centre, cross-sectional study. Adults with type II diabetes mellitus (DMII) were eligible for inclusion. OCTA scans of the macula were taken, and the five vascular maps generated per eye were analysed by a novel CAD system. For the purpose of classification/diagnosis, three different local features—blood vessel ...

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    17. Peripapillary vascular changes in radiation optic neuropathy: an optical coherence tomography angiography grading

      Peripapillary vascular changes in radiation optic neuropathy: an optical coherence tomography angiography grading

      Aims To investigate peripapillary vascular changes secondary to radiation optic neuropathy (RON) using optical coherence tomography angiography (OCT-A) and to propose a clinical grading of RON based on OCT-A findings. Methods Thirty-four patients affected by RON were consecutively included. Each patient underwent best corrected visual acuity measurement (ETDRS score) and OCT-A (Nidek RS-3000 Advance device, Nidek, Gamagori, Japan). The radial peripapillary capillary plexus (RPCP) and the entire peripapillary capillary bed (EPCB) were analysed. Quantitative analysis of the OCT-A images was performed using open-source available ImageJ software (National Institutes of Health, Bethesda, Maryland, USA). Qualitative analysis based on the proposed clinical ...

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    18. Characteristic optical coherence tomography findings in patients with primary vitreoretinal lymphoma: a novel aid to early diagnosis

      Characteristic optical coherence tomography findings in patients with primary vitreoretinal lymphoma: a novel aid to early diagnosis

      Background The diagnosis of primary vitreoretinal lymphoma (PVRL) poses significant difficulties; presenting features are non-specific and confirmation usually necessitates invasive vitreoretinal biopsy. Diagnosis is often delayed, resulting in increased morbidity and mortality. Non-invasive imaging modalities such as spectral domain optical coherence tomography (SD-OCT) offer simple and rapid aids to diagnosis. We present characteristic SD-OCT images of patients with biopsy-positive PVRL and propose a number of typical features, which we believe are useful in identifying these lesions at an early stage. Methods Medical records of all patients attending Moorfields Eye Hospital between April 2010 and April 2016 with biopsy-positive PVRL were ...

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    19. Optical coherence tomography angiography analysis of foveal microvascular changes and inner retinal layer thinning in patients with diabetes

      Optical coherence tomography angiography analysis of foveal microvascular changes and inner retinal layer thinning in patients with diabetes

      Aim To evaluate the correlation between inner retinal layer thinning and the foveal microvasculature in type 2 diabetes using optical coherence tomography angiography (OCTA). Methods A cross-sectional study involved 155 diabetic eyes. All patients were divided into two groups based on diabetic retinopathy (DR) grade: no DR (NDR, n=80) and mild-to-moderate non-proliferative DR (NPDR, n=75). Foveal avascular zone (FAZ) area, FAZ circularity index, FAZ perimeter, vessel density and perfusion index of parafoveal and perifoveal area were calculated using OCTA. The thickness of the macular ganglion cell/inner plexiform layer (mGCIPL) was measured using OCT. Results In both superficial ...

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    20. Choriocapillaris flow deficit in Bietti crystalline dystrophy detected using optical coherence tomography angiography

      Choriocapillaris flow deficit in Bietti crystalline dystrophy detected using optical coherence tomography angiography

      Background/Aims This study aimed to evaluate blood flow in the choriocapillaris in patients with Bietti crystalline dystrophy (BCD) with CYP4V2 mutations using optical coherence tomography angiography (OCTA), and to explore the parameters associated with visual function. Methods This prospective case-series study included 13 eyes of 13 consecutive patients with BCD with CYP4V2 mutations and 20 healthy eyes. Using OCTA, we obtained en face images of blood flow in the choriocapillaris. The residual choriocapillaris area on en face images in a 10°×10° macular cube was manually measured and graded according to whether the choriocapillaris remained at the subfovea. We ...

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    21. Wide-field en face swept-source optical coherence tomography angiography using extended field imaging in diabetic retinopathy

      Wide-field en face swept-source optical coherence tomography angiography using extended field imaging in diabetic retinopathy

      Aims To examine the feasibility of wide-field en face swept-source optical coherence tomography angiography (SS-OCTA) with extended field imaging (EFI) for evaluation of the retinal vasculature in diabetic retinopathy (DR). Methods This study included 37 eyes of 27 patients (age, 65±10 years; male patients, 18; female patients, 9) with DR. All patients underwent comprehensive ophthalmological examination, including OCTA and fluorescein angiography (FA). The imaging methods were compared for visible field of view, presence and extent of non-perfused areas (NPAs), presence and number of new blood vessels (NVs), vessel density (VD) and patient comfort level measured by Visual Analogue Scale ...

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    22. Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study

      Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study

      Aims To investigate macular vascular integrity using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for idiopathic epiretinal membrane (ERM) removal and to determine its association with structural and visual outcomes. Methods Forty-three patients with unilateral ERM who were followed for ≥6 months after surgery were included. Ophthalmological evaluations included best-corrected visual acuity (BCVA) and spectral-domain OCT (SD-OCT) before surgery and 6 months after surgery. We obtained en face OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) for both eyes 6 months after ERM removal. We compared eyes with ERM to unaffected fellow eyes ...

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    23. Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis

      Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis

      Aims We set out to determine the optical coherence tomographic angiography (OCT-A) characteristics of arteritic anterior ischaemic optic neuropathy (AAION) in the context of giant cell arteritis (GCA). Methods This is an observational case series of four patients with AAION secondary to GCA, three with unilateral AAION and one with bilateral AAION. We reviewed the charts, fundus photography, visual fields, fluorescein angiography (FA) and OCT-A images for all patients to identify a unifying theme in a range of AAION clinical severity. Imaging of two healthy control eyes from two patients of similar age to the patients in our series were ...

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    24. Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma

      Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma

      The macular area is important to the detection of glaucomatous retinal ganglion cell (RGC) damage. Macular thickness complementary to peripapillary retinal nerve fibre layer (RNFL) thickness can well reflect glaucomatous damage, given that the macula contains more than 50% of the RGCs in a multilayered pattern and larger RGC bodies compared with their axons. Thus, macular ganglion cell thickness parameters recently have been considered to be an effective glaucoma-diagnostic tool comparable to RNFL thickness parameters. Furthermore, spectral-domain optical coherence tomography ganglion cell–inner plexiform layer thickness and deviation maps can provide additional information essential for distinguishing glaucomatous changes from other ...

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