Primary angle-closure disease (PACD) covers a spectrum that includes primary angle-closure suspect (PACS), primary angle-closure (PAC), primary angle-closure glaucoma (PACG), as well as acute primary angle closure (APAC). Accumulating evidence suggests that the pathogenesis of PACD is complex, with multiple contributory factors including variations in the anatomical or biometric characteristics of the angle segment structures. Advances in anterior segment optical coherence tomography (ASOCT) technology have further enhanced our understanding of the risk factors and mechanisms involved in the disease process. This review discusses the potential clinical role of the ASOCT in the diagnosis, mechanistic evaluation and as a predictor for ...

Purpose: We herein describe possible intraluminal obstruction due to a hyperreflective material found in anterior segment optical coherence tomography in 16 of 46 cases with XEN45 gel stent . Methods: This is a retrospective case series of 46 eyes of 39 patients with non-complicated XEN45 gel stent surgery, analyzed with anterior segment optical coherence tomography and slit-lamp photography after at least 6 postoperative months. Results: Possible luminal obstruction in the subconjunctival segment of the implant was observed in 16 eyes of 15 patients, characterized by hyperreflective material on anterior segment optical coherence tomography, which was not visible in slit-lamp photography. This ...

Purpose: To investigate the density of conjunctival blood vessels in normal eyes and in eyes with pinguecula or pterygium . Methods: In this cross-sectional study, the conjunctival blood vessel density of 15 normal eyes, 15 pinguecula eyes, and 15 pterygium eyes of 43 healthy adults was assessed using optical coherence tomography angiography with an anterior segment lens adapter. The nasal surface of each eye (3 × 3 mm) was scanned 3 times to a depth of 800 μm. Conjunctival vessel density was defined as the percent of the scanned volume occupied by vessels in which blood flow was measured. Results: The high ...

Purpose: To report a rare case of choroidal neovascularization (CNV) developed 2 years after successful treatment of ocular syphilis , identified by optical coherence tomography angiography . Methods: Case report. Results: A 31-year-old man with a history of syphilitic chorioretinitis developed a CNV 2 years after clinical remission of the infection. Structural optical coherence tomography (OCT) and optical coherence tomography angiography were helpful in providing detailed evidence of an extrafoveal CNV in an easy and noninvasive way. In comparison, the identification of CNV on fluorescein angiography was difficult because of the retinal blood barrier breakdown and intense choroidal background fluorescence for diffuse ...

Purpose: The aim of this study was to examine the hyperreflective dots seen in choroid on spectral domain optical coherence tomography ( SDOCT ) in eyes with diabetic macular edema (DME) and correlate it with visual acuity. Design: Consecutive, cross-sectional case series of patients with DME between January 2017 and December 2017. Methods: Eyes with DME having central foveal thickness ≥250 μm were included. SDOCT was performed using Spectralis system (Heidelberg Engineering, Germany). Hyperreflective choroidal foci (HCF) were defined as well-circumscribed dots within choroid having reflectivity equal to or higher than adjacent retinal pigment epithelium. HCF were counted manually within 1500 μm ...

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Purpose: To evaluate the morphologic appearance of keratic precipitates (KPs) with spectral domain anterior segment optical coherence tomography (AS-OCT) for the diagnosis of uveitic eyes of various etiologies. Methods: In all, 153 eyes of 153 patients with different types of uveitis were examined to investigate the morphologic appearance of KPs. The study included 63 eyes with herpetic iridocyclitis/endotheliitis, 58 eyes with ocular sarcoidosis, 5 eyes with Fuchs heterochromic iridocyclitis, and 27 eyes with masquerade syndrome with primary intraocular lymphoma (PIOL). AS-OCT was used to analyze the different KP types among various uveitic groups. Results: KPs were observed in 30 ...

Purpose: To investigate the imaging characteristics of early Type 3 neovascularization and propose a new pathophysiologic sequence for early disease. Methods: Patients were evaluated with a comprehensive ophthalmologic examination to include fundus photography, optical coherence tomography , optical coherence tomography angiography, fluorescein angiography, and volume-rendered optical coherence tomography angiography. Relevant literature was also reviewed. Results: There were 10 eyes of 9 patients who had a mean age of 87 (range 79–93) years and 7 were women. The patients were seen to have distributed areas of cystoid macular edema, not necessarily contiguous with areas of fluorescein or optical coherence tomography angiographic ...

Purpose: To describe spectral domain optical coherence tomography (SD-OCT) findings in an Amish cohort to assess SD-OCT markers for early age-related macular degeneration (AMD). Methods: The authors performed a family-based prospective cohort study of 1,146 elderly Amish subjects (age range 50–99 years) (2,292 eyes) who had a family history of at least 1 individual with AMD. All subjects underwent complete ophthalmic examinations, SD-OCT using both Cirrus and Spectralis (20 × 20° scan area) instruments, fundus autofluorescence, infrared imaging, and color fundus photography. Spectral domain optical coherence tomography characteristics were analyzed in subjects with AMD (with and without subretinal ...

SIGNIFICANCE Causes of papilledema can be life-threatening; however, distinguishing papilledema from pseudopapilledema is often challenging. The conventional optical coherence tomography (OCT) scan for assessing the optic nerve often fails to detect mild papilledema. Our study suggests that parameters derived from volumetric OCT scans can provide additional useful information for detecting papilledema. PURPOSE Optical coherence tomography analysis of the optic nerve commonly measures retinal nerve fiber layer thickness (RNFLT) along a 1.73-mm-radius scan path. This conventional scan, however, often fails to detect mild papilledema. The purpose of this study was to evaluate additional OCT-derived measures of the optic nerve head ...

Purpose: To determine whether internal limiting membrane peeling in primary rhegmatogenous retinal detachment prevents epiretinal membrane (ERM) development. Secondarily, we propose a classification system for postoperative ERMs. Methods: Retrospective, interventional, comparative case series. Consecutive eyes with primary rhegmatogenous retinal detachment (n = 140) treated by a single surgeon. The presence of postoperative ERMs was assessed with swept-source optical coherence tomography . Results: An ERM was detected in 26 eyes (46.4%) in the nonpeeling group and in one eye (1.8%) in the internal limiting membrane peeling group ( P ≤ 0.001). The median visual acuity significantly improved in both groups ( P ≤ 0 ...

Purpose: To describe the vascular anatomy and intraluminal flow characteristics of segmental retinal arteritis (SRA) using structural and angiographic optical coherence tomography (OCT). Methods: Retrospective case series of consecutive patients presenting with SRA. All patients were evaluated at presentation with fundus photography, spectral domain OCT, and OCT angiography. One patient was imaged with dense B-scan OCT angiography. Results: Three eyes of three male patients were evaluated. All examinations were consistent with reactivation of ocular toxoplasmosis with an area of active retinochoroiditis adjacent to a focal chorioretinal scar. Spectral domain OCT through areas of SRA noted on clinical examination demonstrated areas ...

Purpose: To report optical coherence tomography angiography findings obtained in two patients with solar retinopathy . Methods: Two case reports. Results: Two patients presented with blurry vision after sun gazing during the recent solar eclipse and were found to have characteristic foveal lesions on examination and optical coherence tomography consistent with solar retinopathy . Optical coherence tomography angiography showed a focal area of nonperfusion of the choriocapillaris in the affected eyes. Conclusion: Changes to the choriocapillaris layer on optical coherence tomography angiography in two patients with solar retinopathy suggest that damage is not limited to the retina.

Purpose: The treatment of acute corneal hydrops due to keratoconus has so far been limited to awaiting the spontaneous resorption of corneal edema, supportive care, and finally keratoplasty. A recent publication describes the surgical reattachment of Descemet Membrane (DM) facilitated by pre-Descemetic sutures and anterior chamber air/gas filling. Here, we present a novel microscope-integrated intraoperative optical coherence tomography ( MI-OCT )-guided technique for the immediate reattachment of DM in corneal hydrops due to keratoconus in 2 male patients with small central DM defects. Methods: Case series of 2 consecutive patients with acute corneal hydrops due to keratoconus. The novel technique ...

Purpose: This study aimed to predict the best-corrected visual acuity (BCVA) based on swept-source optical coherence tomography (SS-OCT) parameters in eyes with keratoconus . Methods: We retrospectively reviewed 135 eyes of 135 patients with keratoconus (mean age: 31.9 ± 12.4 years). The average keratometry value and BCVA (logarithm of the minimal angle of resolution [Snellen]) were 48.68 ± 5.44 diopter and 0.20 ± 0.36 (20/25), respectively. Eleven parameters were calculated using SS-OCT. Apart from the corneal height and elevation, all the other parameters were calculated from both anterior and posterior corneal OCT data. The patients were divided ...

Objective: Spectral-domain optical coherence tomography (SD-OCT) of the eye has become a valuable high-resolution imaging technique for the evaluation of retinal layer volumes in a variety of diseases such as glaucoma and age-related macular degeneration, but also neurodegenerative diseases such as multiple sclerosis or Parkinson's disease. The aim of this study was to characterize age-related neuronal retinal alterations and thereby identify risk factors for the process of retinal ageing. Design and method: This was an observational single center study including 62 healthy subjects – 25 young (aged <40 years) and 37 elderly healthy individuals (aged >/= 40 years). Macular retinal layer ...

Purpose: To characterize structural and angiographic findings in macular telangiectasia Type 2 (MacTel 2) and examine associations with visual acuity. Methods: MacTel 2 patients with complete ophthalmologic examination, including fundus photography, autofluorescence, spectral-domain optical coherence tomography, and projection-resolved optical coherence tomography angiography , were retrospectively evaluated. Results: There were 43 eyes of 22 patients with a mean age 63.9 (±10.3) years. Six patients had diabetes. Twenty-one eyes (48.8%) had retinal–choroidal anastomoses (RCAs) without any evidence of neovascularization extending laterally in a plane above or below the retinal pigment epithelium. None of the eyes had hemorrhage, lipid, or ...

Getting histologic images of the esophagus and other parts of the digestive tract may soon be as easy as getting patients to swallow pill-sized cameras. Called tethered capsule endomicroscopy (TCE), the technology can take multiple microscope images and it shows promise for diagnosing and monitoring Barrett's esophagus. The cameras allow for getting real-time histological images of tissue without requiring anesthesia or endoscopy in what some researchers are referring to as optical or digital tissue biopsy. TCE cameras were initially developed at The Tearney Lab at Massachusetts General Hospital and prototypes of several versions are under development. TCE is also ...

bjectives: To highlight the clinical characteristics, and visual and corneal tomographic outcomes of central toxic keratopathy (CTK) after contact lens (CL) wear and mechanical debridement . Methods: A retrospective observational case series with literature review. Results: Four patients (4 eyes) were included in this study; 3 (75%) females, mean age 29.3±8.1 years. The mean follow-up was 13.5±7.5 months. Early central or paracentral stromal opacification, assuming an inverse dome-shaped pattern observed under anterior-segment optical coherence tomography, with corneal flattening (K mean 40.4±1.3 D) and thinning (mean thinnest pachymetry=404.8±29.4 microns ...

Precis: 3D spectral domain OCT volume scans of the optic nerve head and the peripapillary area are useful in the management of glaucoma in patients with a type I or II Boston Keratoprosthesis (KPro). Purpose: To report the use of spectral domain optical coherence tomography (OCT) in the management of glaucoma in patients with a type I or II Boston Keratoprosthesis (KPro). Methods: Observational case series. Four consecutive patients with KPro’s were referred for glaucoma evaluation. A comprehensive eye exam was performed which included disc photography, visual field testing, and high-density spectral domain OCT volume scans of the optic ...

Précis: The diagnostic capability of peripapillary retinal volume is similar to peripapillary retinal nerve fiber layer thickness for diagnosing glaucoma, but with fewer artifacts. Purpose: To compare the diagnostic capability of three-dimensional (3D) peripapillary retinal volume (RV) versus two-dimensional (2D) peripapillary retinal nerve fiber layer (RNFL) thickness for open-angle glaucoma . Patients and Methods: A retrospective cross-sectional analysis was conducted. A total of 180 subjects [113 open-angle glaucomas (OAG), 67 normal participants] had spectral domain optical coherence tomography (OCT) volume scans and RNFL thickness measurements. Peripapillary RV values were calculated using a custom-designed program with 4 circumpapillary annuli (CA): CA1 ...

Précis: Thinning of the macular retinal nerve fiber layer and ganglion cell complex in the papillomacular bundle area contributed significantly to visual acuity decline in advanced glaucoma patients after trabeculectomy . Purpose: To identify structural parameters that could predict visual acuity (VA) decline after trabeculectomy in patients with advanced open-angle glaucoma. Patients and Methods: Retrospective review of 74 eyes of 74 patients with advanced glaucoma (defined as mean deviation (MD) −12▒dB or worse) and best-corrected VA (BCVA) of ≥40/200. All patients underwent trabeculectomy between 2013 and 2016. Measurements included intraocular pressure, BCVA, visual field parameters and optical coherence ...

Purpose: Choroideremia is a rare degenerative retinal disease that causes incurable blindness. It occurs as a result of the deficiency of the X-linked CHM gene, which encodes the Rab escort protein 1 (REP1). Gene therapy has been developed to treat CHM using adeno-associated viral vectors and is currently undergoing clinical trials. Expression of the CHM gene is ubiquitous throughout the retina, and it is therefore important to identify which retinal layers are affected in the disease process. The purpose of this study was to assess in particular the choriocapillaris using optical coherence tomography angiography because this layer is difficult to ...