New Perspectives in Ophthalmic Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 2488

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Guest Editor
Department of Ophthalmology & Vision Science, University of California Davis, Davis, CA 95616, USA
Interests: biophotonics; biomedical optical imaging; optical coherence tomography; confocal fluorescence imaging; retinal imaging; biomedical instrumentation; optical engineering; optoelectronics; adaptive optics; digital image processing; machine learning; deep learning; artificial intelligence
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Special Issue Information

Dear Colleagues,

Welcome to a Special Issue on the cutting-edge realm of ophthalmic imaging, which offers a profound glimpse into the future of vision science. This Special Issue explores the innovative techniques and technologies revolutionizing our understanding and treatment of ocular diseases. From advanced optical coherence tomography to super-resolution microscopy, we delve into the latest imaging modalities, discussing their potential to enhance diagnosis and prognosis. Join us in this exciting journey as we usher in a new era of ophthalmic imaging.

Dr. Ratheesh Kumar Meleppat
Guest Editor

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Keywords

  • optical coherence tomography
  • retinal imaging
  • ophthalmic imaging
  • OCT
  • diagnosis of eye diseases

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Published Papers (3 papers)

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Research

9 pages, 2939 KiB  
Article
The Vascular Architecture of Macular Neovascularization in Age-Related Macular Degeneration as a Predictor of Therapy Requirements: A 3-Year Longitudinal Analysis
by Michael Grün, Kai Rothaus, Martin Ziegler, Clemens Lange, Albrecht Lommatzsch and Henrik Faatz
Diagnostics 2025, 15(8), 982; https://doi.org/10.3390/diagnostics15080982 - 12 Apr 2025
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Abstract
Background: Anti-Vascular Endothelial Growth Factor (VEGF) therapy is an effective therapy for improving and stabilizing the vision of patients with neovascular age-related macular degeneration (nAMD). However, the treatment requirements, particularly the number of intraocular injections, can vary significantly among patients. This study aimed [...] Read more.
Background: Anti-Vascular Endothelial Growth Factor (VEGF) therapy is an effective therapy for improving and stabilizing the vision of patients with neovascular age-related macular degeneration (nAMD). However, the treatment requirements, particularly the number of intraocular injections, can vary significantly among patients. This study aimed to analyze the vascular characteristics of macular neovascularizations (MNVs) to identify potential biomarkers that could predict the required injection frequency throughout the disease course. Methods: In all patients, the initial diagnosis of nAMD was confirmed using optic coherence tomography (OCT), fluorescein angiography, and OCT angiography (OCTA). MNVs detected using OCTA were subjected to quantitative vascular analysis of their area, total vascular length (sumL), fractal dimension (FD), and flow density. These results were then correlated with the number of intravitreal anti-VEGF treatments administered during the first 3 years of treatment. Additionally, the relationship between the parameters and visual acuity progression was analyzed. Results: A total of 68 treatment-naïve eyes were included in the study, comprising 31 eyes with type 1 MNV, 19 eyes with type 2 MNV, and 18 eyes with type 3 MNV. The average MNV area at baseline was 1.11 mm2 ± 1.18 mm2, the mean total vascular length was 12.95 mm ± 14.24 mm, the mean fractal dimension was 1.26 ± 0.14, and the mean flow density was 41.19 ± 5.87. On average, patients in our cohort received 19.8 ± 8.5 intravitreal injections (IVIs). A significant correlation was found between the number of administered IVIs in the first 3 treatment years and the MNV area (p < 0.005), sumL (p < 0.005), and FD (p < 0.05), while no correlation was found with flow density. Additionally, there was no significant association between MNV type and treatment requirements, nor between MNV vascular architecture and visual acuity progression. Conclusions: The results suggest that the specific vascular structure of untreated MNV may serve as a predictor of long-term treatment demand. With the emergence of new drug classes and advancements in imaging techniques, these parameters could offer valuable insights for forecasting treatment requirements. Full article
(This article belongs to the Special Issue New Perspectives in Ophthalmic Imaging)
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12 pages, 2402 KiB  
Article
Foveal Hypoplasia Grading with Optical Coherence Tomography: Agreement and Challenges Across Experience Levels
by Riddhi Shenoy, Gail D. E. Maconachie, Swati Parida, Zhanhan Tu, Abdullah Aamir, Chung S. Chean, Ayesha Roked, Michael Taylor, George Garratt, Sohaib Rufai, Basu Dawar, Steven Isherwood, Ryan Ramoutar, Alex Stubbing-Moore, Esha Prakash, Kishan Lakhani, Ethan Maltyn, Jennifer Kwan, Ian DeSilva, Helen J. Kuht, Irene Gottlob and Mervyn G. Thomasadd Show full author list remove Hide full author list
Diagnostics 2025, 15(6), 763; https://doi.org/10.3390/diagnostics15060763 - 18 Mar 2025
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Abstract
Background/Objectives: The diagnosis and prognosis of arrested foveal development or foveal hypoplasia (FH) can be made using the Leicester grading system for FH and optical coherence tomography (OCT). In clinical practice, ophthalmologists and ophthalmic health professionals with varying experience consult patients with [...] Read more.
Background/Objectives: The diagnosis and prognosis of arrested foveal development or foveal hypoplasia (FH) can be made using the Leicester grading system for FH and optical coherence tomography (OCT). In clinical practice, ophthalmologists and ophthalmic health professionals with varying experience consult patients with FH; however, to date, the FH grading system has only been validated amongst experts. We compare the inter-grader and intra-grade agreement of healthcare professionals against expert consensus across all grades of FH. Methods: Handheld and table-mounted OCT images (n = 341) were graded independently at a single centre by experts (n = 3) with over six years of experience and “novice” medical and allied health professionals (n = 5) with less than three years of experience. Sensitivity, specificity, and Cohen’s kappa scores were calculated for each grader, and expert vs. novice performance was compared. Results: All graders showed high sensitivity (median 97% (IQR: 94–99)) and specificity (median 94% (IQR: 90–95)) in identifying the presence or absence of FH. No significant difference was seen in specificity between expert and novice graders, but experts had significantly greater diagnostic sensitivity (median difference = 5.3%, H = 5.00, p = 0.025). Expert graders had the highest agreement with the ground truth and novice graders showed great variability in grading uncommon grades, such as atypical FH. The proposed causes of misclassification included macular decentring in handheld OCT scans in children. Conclusions: Ophthalmologists of varying experience and allied health professionals can accurately identify FH using handheld and table-mounted OCT images. FH identification and paediatric OCT interpretation can be improved in wider ophthalmic clinical settings through the education of ophthalmic staff. Full article
(This article belongs to the Special Issue New Perspectives in Ophthalmic Imaging)
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11 pages, 2766 KiB  
Article
The Importance of the Type of Posterior Staphyloma in the Development of Myopic Maculopathy
by Jorge Ruiz-Medrano, Mariluz Puertas, Ignacio Flores-Moreno, Elena Almazán-Alonso, María García-Zamora, Bachar Kudsieh and José M. Ruiz-Moreno
Diagnostics 2024, 14(15), 1581; https://doi.org/10.3390/diagnostics14151581 - 23 Jul 2024
Cited by 1 | Viewed by 1142
Abstract
The objective of this paper was to determine how different types of posterior staphyloma (PS) may affect the appearance and degree of myopic maculopathy. A cross-sectional study was conducted, in which 467 eyes from 246 highly myopic patients [axial length (AL) ≥ 26 [...] Read more.
The objective of this paper was to determine how different types of posterior staphyloma (PS) may affect the appearance and degree of myopic maculopathy. A cross-sectional study was conducted, in which 467 eyes from 246 highly myopic patients [axial length (AL) ≥ 26 mm] were studied. A complete ophthalmic exploration was carried out on all patients, including imaging tests. The presence of macular PS was established as the main comparison variable between groups (macular PS vs. non-macular PS vs. non-PS). The variables analyzed included age, AL, decimal best-corrected visual acuity (BCVA), Atrophy (A)/Traction (T)/Neovascularization (N) components according to the ATN grading system, and the presence of severe pathologic myopia (PM). Out of the total, 179 eyes (38.3%) presented macular PS, 146 eyes presented non-macular PS (31.2%), and 142 eyes showed no PS (30.4%). The group without PS was significantly younger than macular PS and non-macular PS groups (53.85 vs. 66.57 vs. 65.20 years; p < 0.001 each, respectively). There were no age differences between PS groups. Eyes with macular PS (31.47 ± 2.30 mm) were significantly longer than those with non-macular PS (28.68 ± 1.78 mm, p < 0.001) and those without PS (27.47 ± 1.34 mm, p < 0.001). BCVA was significantly better in the non-PS group (0.75 ± 0.27) compared to the non-macular PS (0.56 ± 0.31) and macular PS groups (0.43 ± 0.33), with p < 0.001 each. Eyes without PS showed significantly lower A and T components (1.31 ± 0.96 and 0.30 ± 0.53, respectively) than non-macular PS (2.21 ± 0.75 and 0.71 ± 0.99, respectively, p < 0.001 each) and macular PS eyes (2.83 ± 0.64 and 1.11 ± 1.10, respectively, p < 0.001 each). The N component was lower in non-PS eyes vs. non-macular PS eyes (0.20 ± 0.59 vs. 0.47 ± 0.83, p < 0.001) and as compared to the macular PS group (0.68 ± 0.90, p < 0.01). Additionally, the N component was significantly lower in the non-macular PS group than in the macular PS one (p < 0.05). The prevalence of severe PM was different between groups (p < 0.001). It was higher among macular PS eyes (138/179) when compared to other groups (p < 0.001, each), followed by the non-macular PS eyes (40/146) and being the lowest in the non-PS group (20/142). To conclude, macular PS is associated with a more advanced maculopathy, worse vision, and higher rates of severe PM. Full article
(This article belongs to the Special Issue New Perspectives in Ophthalmic Imaging)
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