1. Articles from BJO Online

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    1. Quantitative OCT angiography of the retinal microvasculature and choriocapillaris in highly myopic eyes with myopic macular degeneration

      Quantitative OCT angiography of the retinal microvasculature and choriocapillaris in highly myopic eyes with myopic macular degeneration

      Purpose: To quantify retinal and choriocapillaris (CC) microvasculature in highly myopic (HM) eyes with myopic macular degeneration (MMD) using swept-source optical coherence tomography angiography (SS-OCTA). Methods: 162 HM eyes (spherical equivalent ≤ -6.0 dioptres or axial length (AL) ≥26.5 mm) from 98 participants were enrolled, including 60 eyes (37.0%) with tessellated fundus, 54 eyes (33.3%) with peripapillary diffuse chorioretinal atrophy (PDCA), 27 eyes (16.7%) with macular diffuse chorioretinal atrophy (MDCA) and 21 eyes (13.0%) with patchy or macular atrophy. PLEX Elite 9000 SS-OCTA was performed to obtain perfusion densities (PD) of the superficial and deep ...

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    2. OCTA versus dye angiography for the diagnosis and evaluation of neovascularisation in punctate inner choroidopathy

      OCTA versus dye angiography for the diagnosis and evaluation of neovascularisation in punctate inner choroidopathy

      Purpose: To compare the sensitivity and specificity of identifying and evaluating the choroidal neovascularisation (CNV) in punctate inner choroidopathy (PIC) by optical coherence tomography angiography (OCTA) versus dye angiography. Methods: Consecutive patients diagnosed with PIC were enrolled in this study from June 2016 to December 2019. During the same visit, each patient underwent comprehensive ophthalmological and multimodal imaging examinations. The diagnostic accuracy of different modalities was evaluated. Results: The study included 160 affected eyes from 123 patients. Ninety-five eyes (59.38%) were identified with secondary CNV by multimodal imaging. The sensitivity and specificity for CNV detection with OCTA alone were ...

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    3. Plexus-specific retinal capillary avascular area in exudative age-related macular degeneration with projection-resolved OCT angiography

      Plexus-specific retinal capillary avascular area in exudative age-related macular degeneration with projection-resolved OCT angiography

      Objective To detect the plexus-specific retinal capillary avascular area in exudative age-related macular degeneration (EAMD) with projection-resolved optical coherence tomography angiography (PR-OCTA). Methods and analysis In this prospective cross-sectional single centre study, eyes with treatment-naïve EAMD underwent macular 3×3 mm OCTA with AngioVue system. OCTA scans were analysed and processed including three-dimensional projection artefact removal, retinal layer semi-automated segmentation and en face angiogram generation. Automated quantification of extrafoveal (excluding the central 1 mm circle) avascular area (EAA) were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), respectively. Results Nineteen eyes ...

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    4. Swept-source OCTA quantification of capillary closure predicts ETDRS severity staging of NPDR

      Swept-source OCTA quantification of capillary closure predicts ETDRS severity staging of NPDR

      Purpose To test whether a single or composite set of parameters evaluated with optical coherence tomography angiography (OCTA), representing retinal capillary closure, can predict non-proliferative diabetic retinopathy (NPDR) staging according to the gold standard ETDRS grading scheme. Methods 105 patients with diabetes, either without retinopathy or with different degrees of retinopathy (NPDR up to ETDRS grade 53), were prospectively evaluated using swept-source OCTA (SS-OCTA, PlexElite, Carl Zeiss Meditec) with 15×9 mm and 3×3 mm angiography protocols. Seven-field photographs of the fundus were obtained for ETDRS staging. Eyes from age-matched healthy subjects were also imaged as control. Results In ...

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    5. Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

      Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

      Aims To compare the efficacy of diabetic retinal neovascularisation (NV) detection using the widefield swept-source optical coherence tomography angiography (WF SS-OCTA) vitreoretinal interface (VRI) Angio slab and SS-OCT VRI Structure slab. Methods A prospective, observational study was performed at Massachusetts Eye and Ear from January 2019 to June 2020. Patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy and patients with diabetes but without diabetic retinopathy were included. All patients were imaged with WF SS-OCTA using the 12×12 mm Angio scan protocol centred on the fovea and optic disc. The en-face SS-OCTA VRI Angio slab and SS-OCT ...

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    6. Development and validation of a deep learning system to screen vision-threatening conditions in high myopia using optical coherence tomography image

      Development and validation of a deep learning system to screen vision-threatening conditions in high myopia using optical coherence tomography image

      Background/aims To apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images. Methods In this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four ...

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    7. Characterisation of macular superficial vessel density alteration in preclinical ethambutol-induced optic neuropathy using optical coherence tomography angiography

      Characterisation of macular superficial vessel density alteration in preclinical ethambutol-induced optic neuropathy using optical coherence tomography angiography

      Aim To investigate the changes in macular vessel density (mVD) and its relationship to macular ganglion cell–inner plexiform layer (mGCIPL) thickness in patients receiving ethambutol (EMB) therapy for tuberculosis without recognisable clinical symptoms or signs of EMB-induced optic neuropathy (EON). Methods A total of 23 eyes of 13 patients using EMB therapy for 6 months without EON (preclinical EON) as the EMB group, 40 eyes of 23 healthy individuals as the normal control group and 18 eyes of 10 patients with tuberculosis before receiving EMB therapy as the blank control group were retrospectively analysed. The mean peripapillary retinal nerve ...

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    8. Deep learning-based classification and segmentation of retinal cavitations on optical coherence tomography images of macular telangiectasia type 2

      Deep learning-based classification and segmentation of retinal cavitations on optical coherence tomography images of macular telangiectasia type 2

      Aim: To develop a fully automatic algorithm to segment retinal cavitations on optical coherence tomography (OCT) images of macular telangiectasia type 2 (MacTel2). Methods: The dataset consisted of 99 eyes from 67 participants enrolled in an international, multicentre, phase 2 MacTel2 clinical trial ( NCT01949324 ). Each eye was imaged with spectral-domain OCT at three time points over 2 years. Retinal cavitations were manually segmented by a trained Reader and the retinal cavitation volume was calculated. Two convolutional neural networks (CNNs) were developed that operated in sequential stages. In the first stage, CNN1 classified whether a B-scan contained any retinal cavitations. In ...

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    9. OCT angiography measured changes in the foveal avascular zone area after glaucoma surgery

      OCT angiography measured changes in the foveal avascular zone area after glaucoma surgery

      Background/aims: To evaluate quantitative changes in the foveal avascular zone (FAZ) area after glaucoma surgery using swept-source optical coherence tomography angiography (SS-OCTA). Methods: Fifty-four consecutive patients with primary open-angle glaucoma (POAG) who met the inclusion criteria and underwent unilateral glaucoma surgery to reduce intraocular pressure (IOP) between April 2018 and July 2019.Eyes underwent IOP-lowering glaucoma surgery and their fellow (non-surgical) eyes were included. OCTA of the macula was performed in both eyes before glaucoma surgery and 3 months postoperatively. Two blinded examiners reviewed the image quality. Within- and between-group comparisons of the FAZ area and correlation of the ...

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    10. Disorganisation of retinal inner layers is associated with reduced contrast sensitivity in retinal vein occlusion

      Disorganisation of retinal inner layers is associated with reduced contrast sensitivity in retinal vein occlusion

      Background/Aims To determine if disorganisation of retinal inner layers (DRIL) is associated with reduced contrast sensitivity (CS) in patients with retinal vein occlusion (RVO) with a history of macular oedema (ME). Methods Prospective, observational cohort study. Patients with a history of ME secondary to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) from October 2017 to July 2019 at a single institution were included. Patients underwent complete ophthalmic examination, spectral domain optical coherence tomography (SD-OCT) and CS testing using the quick contrast sensitivity function (qCSF) method. Eyes with coexisting macular disease were excluded. SD-OCT images were ...

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    11. Deep learning algorithms to isolate and quantify the structures of the anterior segment in optical coherence tomography images

      Deep learning algorithms to isolate and quantify the structures of the anterior segment in optical coherence tomography images

      Background/Aims Accurate isolation and quantification of intraocular dimensions in the anterior segment (AS) of the eye using optical coherence tomography (OCT) images is important in the diagnosis and treatment of many eye diseases, especially angle-closure glaucoma. Method In this study, we developed a deep convolutional neural network (DCNN) for the localisation of the scleral spur; moreover, we introduced an information-rich segmentation approach for this localisation problem. An ensemble of DCNNs for the segmentation of AS structures (iris, corneosclera shell adn anterior chamber) was developed. Based on the results of two previous processes, an algorithm to automatically quantify clinically important ...

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    12. Referenced scans improve the repeatability of optical coherence tomography angiography measurements in normal and glaucoma eyes

      Referenced scans improve the repeatability of optical coherence tomography angiography measurements in normal and glaucoma eyes

      Aim To compare the repeatability of peripapillary perfusion density and flux index measurements on referenced and non-referenced optical microangiography (OMAG) scans in normal, glaucoma suspect and glaucoma eyes. Methods In a cross-sectional study, 48 eyes (33 subjects) underwent three repeat, non-referenced peripapillary OMAG scans in the same session and 43 eyes (25 subjects) underwent three referenced peripapillary OMAG scans. In the referenced scan group, repeat scans (second and the third scan) were acquired exactly on the baseline (first) scan using the ‘track to prior scan’ option on the device. Repeatability estimates of the mean and four-sector (temporal, superior, nasal and ...

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    13. Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm

      Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm

      Background The ability of deep learning (DL) algorithms to identify eyes with neovascular age-related macular degeneration (nAMD) from optical coherence tomography (OCT) scans has been previously established. We herewith evaluate the ability of a DL model, showing excellent performance on a Korean data set, to generalse onto an American data set despite ethnic differences. In addition, expert graders were surveyed to verify if the DL model was appropriately identifying lesions indicative of nAMD on the OCT scans. Methods Model development data set—12 247 OCT scans from South Korea; external validation data set—91 509 OCT scans from Washington, USA ...

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    14. Anterior segment optical coherence tomography angiography for iris vasculature in pigmented eyes

      Anterior segment optical coherence tomography angiography for iris vasculature in pigmented eyes

      Purpose To compare anterior segment optical coherence tomography angiography (AS-OCTA) systems in delineating normal iris vessels and iris neovascularisation (NVI) in eyes with pigmented irides. Methods Prospective study from January 2019 to June 2019 of 10 consecutive patients with normal pigmented iris, had AS-OCTA scans with a described illumination technique, before using the same protocol in five eyes with NVI (clinical stages 1–3). All scans were sequentially performed using a spectral-domain OCTA (SD-OCTA), and a swept-source OCTA (SS-OCTA, Plex Elite 9000). Images were graded by two masked observers for visibility, artefacts and NVI characteristics. The main outcome measure was ...

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    15. Evaluation of the clinical utility of optical coherence tomography angiography in age-related macular degeneration

      Evaluation of the clinical utility of optical coherence tomography angiography in age-related macular degeneration

      Background/Aims To evaluate the ability of optical coherence tomography angiography (OCTA) to identify the presence or absence of choroidal neovascularisation (CNV) and CNV activity in age-related macular degeneration (AMD). Methods Clinical parameters, fundus fluorescein angiogram and spectral-domain optical coherence tomography (SD-OCT) were used as the gold standard to determine disease activity. OCTA imaging was performed on the same day and was graded by two masked retina specialists for the presence or absence of CNV. Traditional multimodal imaging and OCTA findings were compared. Results One hundred and fifty-two eyes of 106 patients with AMD were retrospectively reviewed. Of these, 59 ...

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    16. Heritability of macular ganglion cell inner plexiform layer thickness as determined by optical coherence tomography: the Healthy Twin Study

      Heritability of macular ganglion cell inner plexiform layer thickness as determined by optical coherence tomography: the Healthy Twin Study

      Purpose To evaluate genetic influence on macular ganglion cell inner plexiform layer (GCIPL) thickness. Methods Macular GCIPL thickness was measured with optical coherence tomography in nine macular subfields defined by the E TDRS. Intraclass correlation coefficients (ICC) of GCIPL thickness by different types of family relationships were estimated to assess intrafamilial resemblance. Then, heritability of GCIPL thickness was estimated. Results Three hundred and sixty-one Korean adults from 89 families with normal healthy eyes were included. GCIPL thickness was highest in inner subfields and lowest in fovea. Monozygotic twin pairs showed significantly higher ICCs of GCIPL thickness in all subfields compared ...

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    17. Ultra-wide-field scanning laser ophthalmoscopy and optical coherence tomography in FEVR: findings and its diagnostic ability

      Ultra-wide-field scanning laser ophthalmoscopy and optical coherence tomography in FEVR: findings and its diagnostic ability

      Background/Aims To describe some novel vitreoretinal microstructural findings in patients with mild familial exudative vitreoretinopathy (FEVR) on ultra-wide-field scanning laser ophthalmoscopy (UWF-SLO) and UWF optical coherence tomography (UWF-OCT) and to evaluate their clinical significance. Methods A total of 32 patients and 32 healthy controls were studied. An additional independent 40 FEVR patients, 44 patients with non-FEVR retinopathies and 40 healthy controls participated in a diagnostic test to validate the abilities of novel findings in FEVR screening. Results A novel anatomic change, named Temporal Mid-Peripheral Vitreoretinal Interface Abnormality (TEMPVIA), was found on UWF-SLO in 88.3% of FEVR patients and ...

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    18. Standardisation of optical coherence tomography angiography nomenclature in uveitis: first survey results

      Standardisation of optical coherence tomography angiography nomenclature in uveitis: first survey results

      Aim To standardise the nomenclature for reporting optical coherence angiography (OCT-A) findings in the field of uveitis. Methods Members of the International Uveitis Study Group, of the American Uveitis Society and of the Sociedad Panamericana de Infermedades Oculares that choose to participate responded to an online questionnaire about their preferred terminology when reporting on OCT-A findings in uveitis. The response of individuals with several publications on OCT-A (experts) was compared with uveitis specialists (users) who have less than five publications on the field of uveitis and OCT-A. Results A total of 108 uveitis specialists who participated in the survey were ...

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    19. Diagnostic validity of optic nerve head colorimetric assessment and optical coherence tomography angiography in patients with glaucoma

      Diagnostic validity of optic nerve head colorimetric assessment and optical coherence tomography angiography in patients with glaucoma

      Background/Aims The aim of this study was to assess the optic nerve head (ONH) and macular vessel density with optical coherence tomography angiography (OCT-A) and the ONH haemoglobin (ONH Hb) amount with Laguna ONhE program in open-angle glaucoma (OAG) patients. Methods In this prospective observational cross-sectional study, 67 OAG patients and 41 healthy age-sex frequency matched subjects were examined with OCT-A and retinal photos. The circumpapillary (wcpVD), optic nerve head (iVD) and macular (wmVD) capillary vessel density of OCT-A and ONH colorimetric assessment to determine the ONH Hb amount using the Laguna ONhE program were evaluated. Results Significant differences ...

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    20. Different effect of media opacity on automated and manual measurement of foveal avascular zone of optical coherence tomography angiographies

      Different effect of media opacity on automated and manual measurement of foveal avascular zone of optical coherence tomography angiographies

      Background Optical coherence tomography angiography (OCTA) provides not only visualisation but also quantitative measurement of foveal avascular zone (FAZ). Media opacity is common in elderly subjects with cataracts. This study aimed to investigate the impact of media opacity on automated and manual FAZ measurement. Methods Cirrus 5000 OCTA and Triton OCTA were used to image FAZ using a 3×3 mm scanning protocol from 30 eyes of 30 healthy normal subjects. Media opacity was simulated with neutral-density filters (optical density (OD): 0.10–0.48 in Cirrus 5000 and 0.15–0.51 in Triton). Signal strength (SS) and signal ...

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    21. Peripapillary vessel parameters and mean ocular perfusion pressure in young healthy eyes: OCT angiography study

      Peripapillary vessel parameters and mean ocular perfusion pressure in young healthy eyes: OCT angiography study

      Background To investigate the relationship between estimated mean ocular perfusion pressure (MOPP) and peripapillary perfusion density (PD) or vessel density (VD) as measured by spectral-domain optical coherence tomography angiography (OCTA) in young healthy eyes. Methods 132 healthy participants (264 eyes) under 45 years of age underwent optic disc OCTA scan sized 3×3 mm to acquire PD and VD in the superficial vascular complex (SVC). Optic nerve head (ONH) parameters including retinal nerve fibre layer (RNFL) thickness, rim area and disc area were measured. MOPP was estimated from systemic blood pressure and intraocular pressure (IOP). A linear mixed model was ...

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    22. Deep learning model to predict visual field in central 10° from optical coherence tomography measurement in glaucoma

      Deep learning model to predict visual field in central 10° from optical coherence tomography measurement in glaucoma

      Background/Aim To train and validate the prediction performance of the deep learning (DL) model to predict visual field (VF) in central 10° from spectral domain optical coherence tomography (SD-OCT). Methods This multicentre, cross-sectional study included paired Humphrey field analyser (HFA) 10-2 VF and SD-OCT measurements from 591 eyes of 347 patients with open-angle glaucoma (OAG) or normal subjects for the training data set. We trained a convolutional neural network (CNN) for predicting VF threshold (TH) sensitivity values from the thickness of the three macular layers: retinal nerve fibre layer, ganglion cell layer+inner plexiform layer and outer segment+retinal ...

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    23. Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy

      Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy

      Aims To compare widefield swept-source optical coherence tomography angiography (WF SS-OCTA) with ultra-widefield colour fundus photography (UWF CFP) and fluorescein angiography (UWF FA) for detecting diabetic retinopathy (DR) lesions. Methods This prospective, observational study was conducted at Massachusetts Eye and Ear from December 2018 to October 2019. Proliferative DR, non-proliferative DR and diabetic patients with no DR were included. All patients were imaged with a WF SS-OCTA using a Montage 15×15 mm scan. UWF CFP and UWF FA were taken by a 200°, single capture retinal imaging system. Images were independently evaluated for the presence or absence of DR ...

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    24. Effect of baseline test selection on glaucoma progression detection by optical coherence tomography-guided progression analysis

      Effect of baseline test selection on glaucoma progression detection by optical coherence tomography-guided progression analysis

      Purpose To evaluate the effect of baseline test selection on progression detection of circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) in glaucomatous eyes by optical coherence tomography (OCT)-guided progression analysis (GPA). Methods A total of 53 eyes with either RNFL or GCIPL progression determined using OCT-GPA were included. Three different baseline conditions were created by dividing eight serial OCT tests from each eye into three sets. Specifically, these sets presented baseline tests at exams 1–2 (1st set), 2–3 (2nd set) and 3–4 (3rd set), respectively. Agreement on progression detection was ...

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