Purpose of review: This article reviews reports on the prevalence of subsquamous intestinal metaplasia (SSIM) in patients with Barrett's esophagus, and the implications of SSIM in the neoplastic progression of Barrett's esophagus to esophageal adenocarcinoma. Recent findings: Endoscopic eradication therapy for dysplastic Barrett's esophagus has become an encouraging alternative to esophagectomy or continued endoscopic surveillance. However, the presence of SSIM before and after ablation is concerning because this tissue may have potential for malignant progression, is not visible by conventional endoscopy, and may evade detection by random esophageal biopsy sampling methods. Advances in endoscopic high-resolution three-dimensional optical ...

Purpose: Optic atrophy constitutes the final stage in the evolution of optic neuropathy. The aim of this study was to describe the presence of macular microcystic changes or pseudocysts in patients with advanced optic atrophy. Methods: The medical records of 24 patients who had retinal pseudocysts in association with optic atrophy have been analyzed. All patients underwent a complete neuro-ophthalmologic assessment; peripapillary retinal nerve fiber layer thickness and macular screening with spectral-domain optical coherence tomography and optical coherence tomography "en face" imaging analysis were also performed. Results: A total of 36 eyes were included in the study. Patients' mean age ...

Purpose: To analyze the multimodal imaging features of eyes with early Type 3 neovascularization showing primarily intraretinal proliferation without evidence of choroidal involvement. Methods: The multimodal imaging data for a consecutive series of patients with new onset stage 1 Type 3 neovascularization were reviewed and the changes at the site of early lesion development were analyzed. Results: Nineteen eyes of 19 patients (12 women, mean age 79.9 +/- 6.3 years) were included for analysis. Both fluorescein angiography and indocyanine green angiography showed a focal hyperfluorescence corresponding to the intraretinal vascular complex (early Type 3 neovascularization) and disclosed a single ...

Purpose: To analyze the outer retinal layers using spectral domain optical coherence tomography (SD-OCT) in patients with cone-rod dystrophy. Methods: The diagnosis of cone-rod dystrophy was determined by primary cone involvement or concomitant loss of both cones and rods. Electroretinography showed implicit time shift at 30-Hz flicker response and prevalent decrease of photopic over scotopic responses. Using SD-OCT, the outer retina was retrospectively evaluated in 24 eyes of 12 patients with cone-rod dystrophy. From the innermost to the outermost, the four studied hyperreflective outer retinal bands were labeled Band 1, the external limiting membrane; Band 2, the ellipsoid zone; Band ...

Purpose: To investigate the feasibility of trans-tamponade optical coherence tomography and evaluate factors contributing to image quality and acquisition success. Methods: Retrospective case series of eyes receiving Postoperative Day 1 optical coherence tomography imaging after vitrectomy and gas tamponade. The quality of the scans was graded by three independent expert readers. Clinical and surgical variables were recorded and correlated with scan quality. Results: Eighty eyes were included in the study. An image quality classification scheme was developed (0-4, 0 = no image and 4 = comparable quality to trans-fluid optical coherence tomography). In 51 scans (64%), visualization of the inner retina and ...

Purpose: In coronary computed tomographic angiography (CTA), low attenuation of coronary atherosclerotic plaque is associated with lipid-rich plaques. However, an overlap in Hounsfield units (HU) between fibrous and lipid-rich plaque as well as an influence of luminal enhancement on plaque attenuation was observed and may limit accurate detection of lipid-rich plaques by CTA. We sought to determine whether the quantitative histogram analysis improves accuracy of the detection of lipid-core plaque (LCP) in ex vivo hearts by validation against histological analysis. Materials and Methods: Human donor hearts were imaged with a 64-slice computed tomographic scanner using a standard coronary CTA protocol ...

Purpose: To describe the phenotype of three cases of Sjogren reticular dystrophy in detail, including high-resolution optical coherence tomography, autofluorescence imaging, and near-infrared reflectance imaging. Methods: Two unrelated teenagers were independently referred for ophthalmologic evaluation. Both underwent a full ophthalmologic workup, including electrophysiologic and extensive imaging with spectral-domain optical coherence tomography, autofluorescence imaging, and near-infrared reflectance imaging. In addition, mutation screening of ABCA4, PRPH2, and the mitochondrial tRNALeu gene was performed in Patient 1. Subsequently, the teenage sister of Patient 2 was examined. Results: Strikingly similar phenotypes were present in these three patients. Fundoscopy showed bilateral foveal pigment alterations, and ...

Background: To compare inner retinal layer (IRL) thickness measured by spectral-domain optical coherence tomography (SD-OCT) and contrast sensitivity (CS) in patients with Parkinson disease (PD) and in healthy control (HC) subjects. Methods: Consecutive patients with and without PD were prospectively analyzed using SD-OCT and Pelli-Robson CS testing. SD-OCT IRL (ganglion-cell complex) thickness, consisting of the nerve fiber layer, ganglion cell layer, and inner plexiform layer, was segmented using an RTVue Model-RT100 with an EMM5 scan parameter covering a 5.0 x 5.0 mm cube centered on the fovea. Thickness voxel measurements at 0.25-mm intervals at sequential radial distances ...

Purpose: To describe findings in spectral-domain optical coherence tomography (SD-OCT) for four patients with acute foveal photoreceptor damage. Case Report: Four patients with acute foveal photoreceptor damage were evaluated by color photography and SD-OCT during follow-up. All four cases were Japanese patients with high myopia. Three were women aged 28, 29, and 46 years and one was a boy aged 17 years. The follow-up ranged from 2 weeks to 3 months. On presentation, four eyes had orange-yellow foveal granularity with visual acuities that varied from 1.2 to 0.5. Spectral-domain optical coherence tomography revealed a disrupted photoreceptor layer. All ...

Purpose: To analyze posterior pole retinal thickness using the new Spectralis HRA + OCT protocol and compare two commercially available spectral-domain optical coherence tomography instruments (Spectralis HRA + OCT and Cirrus HD-OCT) in young healthy eyes. Methods: Retinal thickness in 178 young healthy eyes was measured using the volume scan mode and Posterior Pole Asymmetry Analysis of the Spectralis HRA + OCT and the macular cube 512 x 128 protocol of the Cirrus HD-OCT. Topologic differences in posterior pole retinal thickness between the two spectral-domain optical coherence tomographies were compared, and the relationship between retinal thickness and age or refractive error/axial length ...

Purpose: To evaluate ultrastructural macular changes during rhegmatogenous retinal detachment repair using intraoperative optical coherence tomography (iOCT). Methods: A multisurgeon, single-center consecutive case series of 9 eyes undergoing surgical repair for macula-involving rhegmatogenous retinal detachment with iOCT imaging using a custom microscope-mounted spectral domain OCT system. All patients underwent combined vitrectomy/scleral buckle repair. Imaging characteristics were analyzed, including persistence of subclinical intraoperative subretinal fluid and architectural changes associated with intraoperative maneuvers. Clinical characteristics were analyzed. Results: Nine eyes of nine patients were identified that underwent iOCT imaging during macula-involving rhegmatogenous retinal detachment repair. Persistent subclinical subretinal fluid was identified ...

Purpose: Myopic chorioretinal atrophy is a debilitating condition that causes severe loss of primary vision. However, its mechanisms and pathologic course are not well understood. We performed volumetric measurements of the posterior choroid via three-dimensional analysis of the choroid in patients with high myopia to understand its structure, and we compared the measurements with those of normal subjects. Methods: Twenty-five highly myopic but otherwise normal eyes and 25 nonmyopic eyes were evaluated. Enhanced depth imaging optical coherence tomography (EDI-OCT) was performed using 20 x 20-degree raster scans consisting of 25 high-speed line scans. Three-dimensional retinal and choroidal thickness maps were ...

Background: Patients with ST-elevation myocardial infarction (STEMI) are at substantial risk of suboptimal procedural results and late adverse events. Angiography and optical coherence tomography (OCT) studies have identified residual coronary thrombus and microcirculatory injury as potential culprits for these adverse outcomes. We hypothesized that coronary thrombectomy and local infusion of glycoprotein IIb/IIIa inhibitors by means of a dedicated infusion device can synergistically improve results of percutaneous coronary intervention (PCI) for STEMI, as appraised by OCT. Methods: A total of 128 patients with STEMI will be randomized, to one of the following: abciximab infusion with the ClearWay coronary catheter (C ...

Purpose: To describe small hyperreflective areas using spectral-domain optical coherence tomography (SD-OCT) imaging in eyes that have had silicone oil tamponade. Methods: Retrospective case series of 11 eyes of 11 patients. The authors retrospectively identified patients who underwent vitrectomy and silicone oil tamponade secondary to a rhegmatogenous retinal detachment (nine patients), panuveitis with retinal necrosis (one patient), or recurrent full-thickness macular hole surgery (one patient) who had manifestations of silicone oil emulsion on SD-OCT imaging. Patients were monitored during the postoperative period by clinical examination and using SD-OCT. A model eye in which emulsified silicone oil had been injected in ...

Purpose: To evaluate serially long-term macular morphologic changes after successful macula-involving rhegmatogenous retinal detachment repair and correlate changes with macular function. Methods: Repeat Fourier domain optical coherence tomography (FD OCT) imaging and microperimetry (MP-1) testing of 8 of the initial cohort of 17 eyes studied 5 years earlier. Results: The mean follow-up after rhegmatogenous retinal detachment repair was 3.4 months (range, 1-8.5 months) for the first FD OCT and 5 years (range, 3.75-5.75 years) for the follow-up FD OCT. The final postoperative best-corrected visual acuity mean was 20/201 (range, 20/20 to counting fingers). Six ...

Purpose: To evaluate postoperative spectral-domain optical coherence tomography findings after macular hole surgery. Methods: Retrospective, interventional, nonrandomized study. Overall, 164 eyes of 157 patients diagnosed with macular hole were operated on by vitrectomy and internal limiting membrane peeling. Preoperative and postoperative best-corrected visual acuity and spectral-domain optical coherence tomography images were obtained. Two groups were considered on the basis of the postoperative integrity of the back reflection line from the ellipsoid portion of the photoreceptor inner segment: group A (disruption of ellipsoid portion of the inner segment line, 60 eyes) and group B (restoration of ellipsoid portion of the inner ...

Purpose: To evaluate the safety of oral fluorescein angiography (FA) and to compare its efficacy in detection of macular edema (ME) with spectral-domain optical coherence tomography (SD-OCT). Methods: Results of imaging studies for 1,928 eyes of 1,019 patients who had simultaneously undergone both oral FA and SD-OCT by a confocal laser ophthalmoscope were reviewed. Sensitivity in detecting ME, discrepancy rate, and "kappa" agreement were determined for both the techniques and with eyes stratified by disease diagnosis. Results: No allergic reactions occurred after oral FA. Mild gastric discomfort was noted in <1% of the patients; 1,840 eyes (95 ...

Purpose: To assess the dimensions of hyporeflective choroidal lumina and choroidal thickness in patients with polypoidal choroidal vasculopathy (PCV) without subretinal hemorrhage. Methods: Chinese patients with PCV and without subretinal hemorrhage and subjects of a control group underwent enhanced depth imaging by optical coherence tomography. Choroidal thickness and the largest diameter of choroidal hyporeflective lumina as surrogates for choroidal vessels were measured. Results: The study included 18 eyes of Chinese patients with PCV and 19 subjects of a control group, with no significant difference in age (P = 0.10) or refractive error (P = 0.89) between the groups. Mean subfoveal ...

Purpose: To evaluate drusenoid retinal pigment epithelial detachments (DPED) secondary to age-related macular degeneration (AMD) using spectral-domain optical coherence tomography imaging. Methods: In this prospective natural history study, eyes from patients with the diagnosis of nonexudative AMD and DPEDs were followed for at least 6 months. Eyes were scanned using the Cirrus spectral-domain optical coherence tomography instrument and the 200 x 200 A-scan raster pattern. A custom software was used to quantify volumetric changes in DPEDs and to detect the evolution and formation of geographic atrophy and choroidal neovascularization. Changes in DPED area and volume and development of the advanced ...

Purpose: To report an orbital cyst underlying a chorioretinal coloboma in an otherwise normal eye, detected by spectral domain optical coherence tomography imaging. To the authors' knowledge, this is the first case of a chorioretinal colobomatous cyst in the normal eye to be reported. Methods: A descriptive case report of a patient with a chorioretinal coloboma with an underlying orbital cyst. Results: A 59-year-old woman presented with a floater affecting her left visual field. Fundoscopy revealed a pale lesion inferotemporal to fixation at the left macula. Spectral domain optical coherence tomography revealed a retinochoroidal coloboma with an associated scleral hole ...

Purpose: In vivo analysis of corneal modifications after traditional and transepithelial corneal cross-linking (CXL). Methods: Forty eyes of 35 patients underwent traditional or transepithelial CXL; there was randomization of 20 eyes to each group. By means of in vivo confocal microscopy and anterior segment ocular coherence tomography, we evaluated corneal alterations at 1 week, 1 month, and 3, 6, and 12 months after the treatment. Results: During follow-up, in vivo confocal microscopy showed a significant decrease in anterior keratocyte density (P = 0.001) and more evident stromal edema and keratocyte activation (P = 0.001) in the traditional group, whereas in ...

Purpose: To report a case of biopsy-proven corneal intraepithelial neoplasia (CIN) diagnosed and followed clinically using high-resolution anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM). Methods: Observational case report. Results: A 57-year-old man presented with decreased vision in the right eye for 2 months before presentation. His best-corrected visual acuity was 20/70 in the affected eye, and the slit-lamp examination revealed superficial opacification of the anterior cornea originating from the temporal limbus with a "leopard-spot" pattern more centrally. The lesion was excised at his 2-month follow-up, and the histological examination revealed squamous dysplasia consistent with ...

Purpose: To evaluate the depth of the stromal demarcation line after corneal collagen cross-linking (CXL) using anterior segment optical coherence tomography. Methods: In this prospective, interventional case series, 23 patients (27 eyes) with progressive keratoconus were enrolled. All patients underwent uneventful CXL treatment. Corneal stromal demarcation line depth was measured centrally, 3 mm temporally, and 3 mm nasally by 2 independent observers using anterior segment optical coherence tomography at 1 month postoperatively in all patients. Results: Mean depth of the corneal stromal demarcation line measured by the first observer was 310.67 +/- 31.04 [mu]m (range, 258-364 [mu]m ...

Purpose: To evaluate the Descemet stripping automated endothelial keratoplasty (DSAEK) graft deturgescence in preservation medium after microkeratome cut using Fourier domain optical coherence tomography. Methods: The central and peripheral thickness of DSAEK grafts was measured by Fourier domain optical coherence tomography immediately after microkeratome cuts and 1, 2, 3, and 4 hours afterward. All measurements were taken when the grafts were stored in 4[degrees]C preservation medium. The hourly change in central graft thickness and graft shape (peripheral graft thicknes - central graft thickness) was calculated and tracked over time. Results: Five DSAEK grafts were measured. The average central graft ...