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The Development and Application of Optical Coherence Tomography and Optical...
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The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 14 May 2024 | Viewed by 52130

Special Issue Editor

Dr. Fabio Scarinci

E-Mail Website
Guest Editor
San Giovanni Addolorata Hospital, UOC Oftalmologia, Banca degli Occhi, Rome, Italy
Interests: corneal surgery; cataract surgery; refractive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Optical coherence tomography (OCT) has become an important addition to the ophthalmic diagnostic armamentarium in clinical practice.

This tool has been unique in the management of wet age macular degeneration, diabetic macular edema, vitreomacular interface disorder, central serous chorioretinopathy, and several retinal diseases. Serial OCT images allow ophthalmologists to follow patients’ progress over time. Further, numerous studies have shown that OCT scan as well as segmentation of single retinal layer might be used in search of biomarkers of retinal diseases.

As OCT documents retinal thickness at micron-level resolution, recently, the introduction of the OCT angiography (OCTA) has allowed the visualization of blood flow in the retina and choroid. OCTA provides a new dimension of depth information to assess the severity of retinal ischemia. Many studies have been shown that this relatively new tool with a new non-invasive method can detect subclinical vascular changes that are noted in patients with minimal signs of diabetic retinopathy. Although commercially available devices have a limited field-of-view, including 3 x 3, 6 x 6, and 8 x 8 mm, larger fields are already available in the research field.

This Special Issue seeks to outline studies targeting the development and application of OCT as well as OCTA imaging and analysis in various retinal diseases.

Dr. Fabio Scarinci
Guest Editor

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Keywords

  • Optical coherence tomography
  • Optical coherence tomography angiography
  • Vitreoretinal diseases
  • Retinal imaging analysis
  • Biomarkers
  • Segmentation
  • Retinal ischemia
  • Retinal blood flow
  • Choroidal blood flow

Published Papers (20 papers)

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11 pages, 1164 KiB  
Article
Longitudinal Changes on Optical Coherence Tomography Angiography in Retinal Vein Occlusion
by Swetapadma Tripathy, Hong-Gam Le, Maria Vittoria Cicinelli and Manjot K. Gill
J. Clin. Med. 2021, 10(7), 1423; https://doi.org/10.3390/jcm10071423 - 1 Apr 2021
Cited by 7 | Viewed by 1749
Abstract
Background: To evaluate the longitudinal changes on optical coherence tomography angiography (OCTA) in retinal vein occlusion (RVO). Methods: Retrospective study of patients with RVO treated with intravitreal anti-vascular endothelial growth factors (VEGF) for macular edema. Foveal avascular zone (FAZ) area, vessel density (VD), [...] Read more.
Background: To evaluate the longitudinal changes on optical coherence tomography angiography (OCTA) in retinal vein occlusion (RVO). Methods: Retrospective study of patients with RVO treated with intravitreal anti-vascular endothelial growth factors (VEGF) for macular edema. Foveal avascular zone (FAZ) area, vessel density (VD), vessel length density (VLD), and adjusted flow index (AFI) were calculated. The unaffected eye of each participant was used as a control. Results: Twelve RVO eyes were included, receiving 6 ± 3 anti-VEGF injections over a follow-up of 10.4 ± 3.1 months. Compared to fellow eyes, RVO eyes had lower VD and VLD at inclusion (p = 0.07 and p = 0.04) and last visit (p = 0.002 and p < 0.001). VD, AFI, and VLD did not change over time, while FAZ area increased in RVO eyes (+0.016 ± 0.024 mm2, p = 0.04). AFI correlated with duration of disease (r = 0.63, p = 0.02). Visual acuity was inversely related to VD and VLD over the follow-up. Conclusions: OCTA parameters remained stable with sustained anti-VEGF treatment in RVO, while changes in the FAZ area may suggest capillary remodeling after RVO. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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18 pages, 3860 KiB  
Article
Analysis of the Choroid and Its Relationship with the Outer Retina in Patients with Diabetes Mellitus Using Binarization Techniques Based on Spectral-Domain Optical Coherence Tomography
by Ioana Damian, Gabriela Roman and Simona Delia Nicoară
J. Clin. Med. 2021, 10(2), 210; https://doi.org/10.3390/jcm10020210 - 8 Jan 2021
Cited by 10 | Viewed by 2443
Abstract
(1) Background: We aimed to reveal the relationship between the choroid and the outer retina with optical coherence tomography (OCT) in patients with diabetes mellitus (DM) with mild or no diabetic retinopathy (DR) in order to find early biomarkers for progressing retinopathy. [...] Read more.
(1) Background: We aimed to reveal the relationship between the choroid and the outer retina with optical coherence tomography (OCT) in patients with diabetes mellitus (DM) with mild or no diabetic retinopathy (DR) in order to find early biomarkers for progressing retinopathy. (2) Methods: We performed a prospective study including 61 eyes of patients with type 1 or type 2 DM and 36 eyes of healthy controls. All subjects were imaged with Spectralis OCT. The choroid was assesseed using enhanced depth imaging OCT (EDI-OCT). Binarization of subfoveal choroidal images was done with public domain software, ImageJ (version 1.53a; National Institutes of Health, Bethesda, Maryland, USA). (3) Results: Luminal area, stromal area and total choroidal area were significantly decreased in diabetic patients compared to control: 0.23 ± 0.07 vs. 0.28 ± 0.08, p = 0.012; 0.08 ± 0.03 vs. 0.10 ± 0.04, p = 0.026; 0.31 ± 0.09 vs. 0.38 ± 0.11, p = 0.008. The thickness of retinal pigment epithelium (RPE) correlated positively with the choroidal vascularity index (CVI). The correlations between outer nuclear layer (ONL), photoreceptors (PR) and foveal choroidal thickness (FChT) were moderately negative. (4) Conclusion: Thicker RPE and a thinner PR layer may be assigned the role of early biomarkers signaling the conversion time to progressing retinopathy. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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10 pages, 1097 KiB  
Article
Epiretinal Membrane Surgery: Structural Retinal Changes Correlate with the Improvement of Visual Function
by Andrea Cacciamani, Pamela Cosimi, Guido Ripandelli, Marta Di Nicola and Fabio Scarinci
J. Clin. Med. 2021, 10(1), 90; https://doi.org/10.3390/jcm10010090 - 29 Dec 2020
Cited by 7 | Viewed by 2010
Abstract
Several parameters have been studied for identifying the visual outcomes after pars plana vitrectomy (PPV) for epiretinal membrane (ERM) peeling. This retrospective study aimed to analyze structural retinal changes with spectral domain-optical coherence tomography (SD-OCT) and their correlations with visual acuity improvement in [...] Read more.
Several parameters have been studied for identifying the visual outcomes after pars plana vitrectomy (PPV) for epiretinal membrane (ERM) peeling. This retrospective study aimed to analyze structural retinal changes with spectral domain-optical coherence tomography (SD-OCT) and their correlations with visual acuity improvement in patients with ERM undergoing PPV. Twenty-one pseudophakic eyes were enrolled in the study. Ophthalmic evaluations included best corrected visual acuity (BCVA) and retinal layer thickness measurements with SD-OCT. The segmentation of the retina was divided into four parts: the inner retinal layer (IRL), composed of an internal limiting membrane, retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer; inner nuclear layer (INL); outer plexiform layer (OPL); and outer nuclear layer (ONL). Correlations between changes in retinal layer thicknesses and BCVA were explored over a 6 month follow-up period. The postoperative thickness decrease of the INL was significantly correlated with thickness changes in all other measured retinal layers (p < 0.001). Non-parametric linear regression showed that postoperative improvement in BCVA was associated with a postoperatively decreased thickness in the IRL (p = 0.021), INL (p = 0.039), and OPL (p = 0.021). In eyes undergoing PPV, postoperative thickness decreases of the IRL, INL, and OPL were correlated with visual acuity improvements. Re-compaction of these retinal layers after relieving ERM-induced traction may be an important factor in postoperative visual function improvement. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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11 pages, 2759 KiB  
Article
Comparison of Retinal Layer Thickness and Capillary Vessel Density in the Patients with Spontaneously Resolved Acute Central Serous Chorioretinopathy
by Kyu Jin Han, Hyeong Ju Kim, Je Moon Woo and Jung Kee Min
J. Clin. Med. 2021, 10(1), 45; https://doi.org/10.3390/jcm10010045 - 25 Dec 2020
Cited by 5 | Viewed by 1614
Abstract
We investigate retinal layer thickness and capillary vessel density (VD) in the patients with central serous chorioretinopathy (CSC) who recovered spontaneously and evaluate the correlation between the changes in these values and visual outcomes using swept-source optical coherence tomography (SS-OCT) and OCT angiography [...] Read more.
We investigate retinal layer thickness and capillary vessel density (VD) in the patients with central serous chorioretinopathy (CSC) who recovered spontaneously and evaluate the correlation between the changes in these values and visual outcomes using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). This retrospective case–control study included 34 eyes of 34 patients with spontaneously resolved acute CSC. The changes in retinal layer thickness and capillary VD were examined using SS-OCT and OCTA after complete resolution of subretinal fluid (SRF). The fellow eyes and 34 healthy eyes were used as controls. In the eyes with CSC, the outer retinal layer was significantly thinner than in the eyes of fellow and healthy controls. The foveal avascular zone area and VDs in the superficial and deep capillary plexus in the eyes with CSC were not significantly different from those in the eyes of fellow and healthy controls. The VD of the choriocapillaris in the eyes with CSC was significantly lower than that in the eyes of fellow and healthy controls. Correlation analyses revealed that the outer retinal layer thickness and initial visual acuity were positively correlated with the final visual acuity. Furthermore, the initial SRF area and height were negatively correlated with the outer retinal layer thickness after SRF resolution. Attenuation of outer retinal layer thickness and decreased VD of the choriocapillaris were observed in the eyes with spontaneously resolved acute CSC. The outer retinal layer thickness could be an important visual predictor of CSC. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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10 pages, 501 KiB  
Article
The Retinal Vessel Density as a New Vascular Biomarker in Multisystem Involvement in Fabry Disease: An Optical Coherence Tomography Angiography Study
by Gilda Cennamo, Daniela Montorio, Ciro Santoro, Sirio Cocozza, Letizia Spinelli, Teodolinda Di Risi, Eleonora Riccio, Camilla Russo, Giuseppe Pontillo, Roberta Esposito, Massimo Imbriaco and Antonio Pisani
J. Clin. Med. 2020, 9(12), 4087; https://doi.org/10.3390/jcm9124087 - 18 Dec 2020
Cited by 10 | Viewed by 1986
Abstract
In this study, we evaluated the possible relationship between the changes in retinal vessel density (VD) by optical coherence tomography angiography (OCTA) and the vascular alterations involving renal, cardiovascular and central nervous systems in patients affected by Fabry disease (FD). In 50 FD [...] Read more.
In this study, we evaluated the possible relationship between the changes in retinal vessel density (VD) by optical coherence tomography angiography (OCTA) and the vascular alterations involving renal, cardiovascular and central nervous systems in patients affected by Fabry disease (FD). In 50 FD patients, the retinal superficial capillary plexus (SCP) and deep capillary plexus (DCP) in macular region were evaluated by OCTA examination. The patients also underwent a brain magnetic resonance imaging scan, renal and echocardiographic examinations with quantification of systolic pulmonary arterial pressure (PAPs) and left atrial volume index (LAVi). The VD of SCP and DCP was inversely related with E/e’ ratio, LAVi, interventricular septal thickness, global longitudinal strain (GLS) and PAPs (p < 0.05). No relationship was found, with a multivariate analysis, between OCTA parameters and kidney function and neuroradiological signs of central nervous system involvement. OCTA could be a new vascular biomarker in FD, revealing a strong correlation between retinal capillary damage and myocardial impairment, possibly preceding both renal dysfunction and cerebrovascular involvement. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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11 pages, 639 KiB  
Article
Short-Term Results of Ocriplasmin versus Prompt Vitrectomy for Macular Hole. Which Performs Better?
by Andrea Cacciamani, Pamela Cosimi, Marta Di Nicola, Guido Ripandelli and Fabio Scarinci
J. Clin. Med. 2020, 9(12), 3972; https://doi.org/10.3390/jcm9123972 - 7 Dec 2020
Viewed by 1658
Abstract
In this retrospective study, we compared the anatomical and functional changes in patients with vitreomacular traction associated with macular holes between the following groups: (1) Patients who were treated with a single intravitreal injection of ocriplasmin (the OCRIALONE group); (2) those who failed [...] Read more.
In this retrospective study, we compared the anatomical and functional changes in patients with vitreomacular traction associated with macular holes between the following groups: (1) Patients who were treated with a single intravitreal injection of ocriplasmin (the OCRIALONE group); (2) those who failed the ocriplasmin treatment and underwent vitrectomy one month later (the OCRIVIT group); and (3) patients who directly underwent par plana vitrectomy (VITREALONE group). A total of 38 patients, 19 in the OCRIALONE group + OCRIVIT group (seven and 12 patients, respectively) and 19 in the VITREALONE group with focal vitreomacular adhesion associated with macular holes were evaluated with spectral domain optical coherence tomography. Functional examinations included best-corrected visual acuity (BCVA) and microperimetry analysis. Visual function changes were compared between the OCRIALONE group + OCRIVIT group and VITREALONE group up to three months. Furthermore, a subgroup analysis compared the OCRIVIT group and the VITREALONE group. BCVA values and the mean retinal sensitivity showed statistically significant improvement in all groups (p < 0.001). Specifically, the retinal sensitivity values at the end of the follow-up were significantly higher in the OCRIALONE group + OCRIVIT group than in the VITREALONE group. These functional findings were also confirmed when the statistical analysis was conducted between the OCRIVIT group and the VITREALONE group. Although the OCRIALONE group + OCRIVIT group exhibited faster retinal thinning than the VITREALONE group (p = 0.006), the analysis of the OCRIVIT group versus the VITREALONE group did not show any statistically significant difference. The better functional results and similar anatomical findings suggest that ocriplasmin can be used as a first-line treatment, and that prompt pars plana vitrectomy as primary surgery does not provide better outcomes in comparison with pars plana vitrectomy after ocriplasmin injection. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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15 pages, 7314 KiB  
Article
Reversed Neurovascular Coupling on Optical Coherence Tomography Angiography Is the Earliest Detectable Abnormality before Clinical Diabetic Retinopathy
by Yi Stephanie Zhang, Ilda Mucollari, Changyow C. Kwan, Gianna Dingillo, Jaspreet Amar, Gregory W. Schwartz and Amani A. Fawzi
J. Clin. Med. 2020, 9(11), 3523; https://doi.org/10.3390/jcm9113523 - 31 Oct 2020
Cited by 14 | Viewed by 2722
Abstract
Diabetic retinopathy (DR) has traditionally been viewed as either a microvasculopathy or a neuropathy, though neurovascular coupling deficits have also been reported and could potentially be the earliest derangement in DR. To better understand neurovascular coupling in the diabetic retina, we investigated retinal [...] Read more.
Diabetic retinopathy (DR) has traditionally been viewed as either a microvasculopathy or a neuropathy, though neurovascular coupling deficits have also been reported and could potentially be the earliest derangement in DR. To better understand neurovascular coupling in the diabetic retina, we investigated retinal hemodynamics by optical coherence tomography angiography (OCTA) in individuals with diabetes mellitus (DM) but without DR (DM no DR) and mild non-proliferative DR (mild NPDR) compared to healthy eyes. Using an experimental design to monitor the capillary responses during transition from dark adaptation to light, we examined 19 healthy, 14 DM no DR and 11 mild NPDR individuals. We found that the only structural vascular abnormality in the DM no DR group was increased superficial capillary plexus (SCP) vessel density (VD) compared to healthy eyes, while mild NPDR eyes showed significant vessel loss in the SCP at baseline. There was no significant difference in inner retinal thickness between the groups. During dark adaptation, the deep capillary plexus (DCP) VD was lower in mild NPDR individuals compared to the other two groups, which may leave the photoreceptors more susceptible to ischemia in the dark. When transitioning from dark to ambient light, both diabetic groups showed a qualitative reversal of VD trends in the SCP and middle capillary plexus (MCP), with significantly decreased SCP at 5 min and increased MCP VD at 50 s compared to healthy eyes, which may impede metabolic supply to the inner retina during light adaptation. Mild NPDR eyes also demonstrated DCP dilation at 50 s and 5 min and decreased adjusted flow index at 5 min in light. Our results show altered neurovascular responses in all three macular vascular plexuses in diabetic subjects in the absence of structural neuronal changes on high resolution imaging, suggesting that neurovascular uncoupling may be a key mechanism in the early pathogenesis of DR, well before the clinical appearance of vascular or neuronal loss. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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14 pages, 2463 KiB  
Article
Early Retinal Changes by OCT Angiography and Multifocal Electroretinography in Diabetes
by Luisa Frizziero, Giulia Midena, Evelyn Longhin, Marianna Berton, Tommaso Torresin, Raffaele Parrozzani and Elisabetta Pilotto
J. Clin. Med. 2020, 9(11), 3514; https://doi.org/10.3390/jcm9113514 - 30 Oct 2020
Cited by 21 | Viewed by 2690
Abstract
Background: To evaluate the earliest retinal morphological and functional changes in diabetic eyes without or with early signs of diabetic retinopathy (DR). Methods: Twenty-two eyes with no DR (noDR group), 22 eyes with mild DR (DR group), and 18 healthy nondiabetic eyes (controls) [...] Read more.
Background: To evaluate the earliest retinal morphological and functional changes in diabetic eyes without or with early signs of diabetic retinopathy (DR). Methods: Twenty-two eyes with no DR (noDR group), 22 eyes with mild DR (DR group), and 18 healthy nondiabetic eyes (controls) were enrolled. All eyes were studied by means of spectral domain optical coherence tomography (OCT), OCT angiography (OCTA), and multifocal electroretinogram (mfERG). Results: A significantly higher number of OCT hyperreflective intraretinal foci (HRF) was found in both noDR and DR groups versus controls, but not between DR groups. The OCTA parameters of the superficial vascular plexus (SVP) were significantly reduced in the noDR group both versus controls and DR group (p < 0.05). The OCTA parameters of the intermediate capillary plexus (ICP) were significantly reduced in the DR group versus controls. An increased number of altered hexagons on mfERG was found in the noDR versus the DR group (p = 0.0192). Conclusions: Retinal vascular and functional parameters are differently involved in diabetic eyes; major vascular changes in the SVP and functional alterations of the mfERG are present in diabetic eyes with no clinical microvascular signs of DR, while ICP is mainly involved when early ophthalmoscopic signs of DR are present. The integrated use of mfERG and OCTA provides new significant insights into the pathogenesis of diabetic related retinal disease. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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10 pages, 2663 KiB  
Article
Topographic Relationship between Telangiectasia and Cone Mosaic Disruption in Macular Telangiectasia Type 2
by Roya Zandi, Jessica Song, Paul S. Micevych and Amani A. Fawzi
J. Clin. Med. 2020, 9(10), 3149; https://doi.org/10.3390/jcm9103149 - 29 Sep 2020
Cited by 3 | Viewed by 2005
Abstract
In this cross-sectional observational study, we investigated the relationship between photoreceptor layer disruption and telangiectasia in patients diagnosed with early stage macular telangiectasia type 2 (MacTel). A total of 31 eyes (17 patients) with MacTel were imaged with adaptive optics scanning laser ophthalmoscopy [...] Read more.
In this cross-sectional observational study, we investigated the relationship between photoreceptor layer disruption and telangiectasia in patients diagnosed with early stage macular telangiectasia type 2 (MacTel). A total of 31 eyes (17 patients) with MacTel were imaged with adaptive optics scanning laser ophthalmoscopy (AOSLO) and optical coherence tomography angiography (OCTA). Confocal AOSLO was used to visualize dark regions of nonwaveguiding outer segments, which we refer to as “photoreceptor lesions”. En-face OCTA images of the deep capillary plexus (DCP) were used in conjunction with confocal AOSLO to evaluate the topographic relationship between areas of capillary telangiectasias and photoreceptor lesions. Among seven eyes with early stage MacTel (stage 0–2 based on OCT), we identified ten photoreceptor lesions, all of which were located within parafoveal quadrants containing DCP telangiectasia on OCTA. Seven of the lesions corresponded to the intact ellipsoid zone on spectral-domain OCT (SD-OCT), and three of these also corresponded to the intact interdigitation zone. This work demonstrates a topographic relationship between AOSLO photoreceptor lesions and DCP telangiectasias, and it also suggests that these lesions with normal SD-OCT appearance may represent areas of photoreceptors at risk for dysfunction. Thus, confocal AOSLO may have a meaningful role in detecting early photoreceptor abnormalities in eyes with MacTel. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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13 pages, 8522 KiB  
Article
Optical Coherence Tomography Angiography of Macula and Optic Nerve in Autism Spectrum Disorder: A Pilot Study
by Jose Javier Garcia-Medina, Elena Rubio-Velazquez, Maria Dolores Lopez-Bernal, Dolores Parraga-Muñoz, Alfonso Perez-Martinez, Maria Dolores Pinazo-Duran and Monica del-Rio-Vellosillo
J. Clin. Med. 2020, 9(10), 3123; https://doi.org/10.3390/jcm9103123 - 27 Sep 2020
Cited by 10 | Viewed by 2725
Abstract
The aim of this study was to compare retinal thicknesses and vascular parameters between autism spectrum disorder (ASD) and neurotypical (NT) individuals. Recruited ASD subjects and age- and sex-matched NT controls underwent 2 optical coherence tomography scans (OCT) (macular cube and optic nerve [...] Read more.
The aim of this study was to compare retinal thicknesses and vascular parameters between autism spectrum disorder (ASD) and neurotypical (NT) individuals. Recruited ASD subjects and age- and sex-matched NT controls underwent 2 optical coherence tomography scans (OCT) (macular cube and optic nerve cube) and 2 OCT angiography (OCTA) scans (macular and optic nerve head (ONH) OCTA) with the device Cirrus 5000 (Zeiss). Concerning OCT, we considered full retina thickness in 9 macular sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) pattern and peripapillary retinal nerve fiber layer (pRNFL) thickness in 4 quadrants and 12 clock-hour sectors. Vessel density and capillary perfusion density in 9 sectors were measured using 6 × 6 mm macular OCTA. Foveal avascular zone (FAZ) parameters were also considered. ONH 4.5 × 4.5 mm OCTA estimated perfusion density and flux index in 4 peripapillary quadrants. Comparisons between groups of all these parameters were performed. ASD subjects showed higher ONH perfusion density and lower ONH flux index at the peripapillary inferior quadrant when compared with NT individuals (p < 0.05). Plus, a trend towards higher macular thicknesses, higher pRNFL thickness at inferior clock-hour sectors and higher macular vessel density and perfusion was observed in ASD. No differences were found in FAZ parameters. In conclusion, retinas of ASD subjects may present some structural and vascular differences when compared with retinas of NT individuals. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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11 pages, 3083 KiB  
Article
Choroidal Structure after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy
by Camilla Alovisi, Felice Cardillo Piccolino, Marco Nassisi and Chiara M. Eandi
J. Clin. Med. 2020, 9(9), 2734; https://doi.org/10.3390/jcm9092734 - 24 Aug 2020
Cited by 9 | Viewed by 1905
Abstract
The study aims to analyze the changes produced by half-dose photodynamic therapy (HD-PDT) in the choroid of eyes with chronic central serous chorioretinopathy (CSC) applying the binarization method to spectral domain optical coherence tomography (SDOCT) and OCT Angiography (OCTA) images. SDOCT and OCTA [...] Read more.
The study aims to analyze the changes produced by half-dose photodynamic therapy (HD-PDT) in the choroid of eyes with chronic central serous chorioretinopathy (CSC) applying the binarization method to spectral domain optical coherence tomography (SDOCT) and OCT Angiography (OCTA) images. SDOCT and OCTA were performed before, one hour, one week, and one month after HD-PDT. Binarization with a modified Niblack method and analysis by ImageJ were applied. An average ratio between luminal part and total structure was calculated. Twenty-two eyes of 21 patients (20 male and 1 female; mean age 54.8 years) were enrolled. A statistically significant reduction of the central choroidal thickness was observed one week (from 407 µm to 362 µm, p = 0.034) and one month (from 407 µm to 341.5 µm, p = 0.0004) after HD-PDT. The baseline average ratio between luminal part and total structure was 33.4% in SDOCT, and 61.1% in OCTA. These values were 35.3% and 61% one hour, 33.9% and 60.4% one week, and 34.5% and 60.6% one month after HD-PDT, respectively. Overall, PDT seems to produce short-term changes on the luminal component of both choriocapillaris and choroid, which return to baseline status after one month from treatment. However, choroid stays significantly thinner after one month, with both luminal and interstitial components significantly reduced. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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9 pages, 1173 KiB  
Article
Macular Perfusion Impairment in Von Hippel-Lindau Disease Suggests a Generalized Retinal Vessel Alteration
by Elisabetta Pilotto, Elisabetta Beatrice Nacci, Alfonso Massimiliano Ferrara, Gilda De Mojà, Stefania Zovato and Edoardo Midena
J. Clin. Med. 2020, 9(8), 2677; https://doi.org/10.3390/jcm9082677 - 18 Aug 2020
Cited by 6 | Viewed by 2143
Abstract
Background: To evaluate macular perfusion in patients with Von Hippel–Lindau (VHL) disease. Methods: VHL patients with or without peripheral retinal hemangioblastomas (RHs) were consecutively enrolled. A group of healthy subjects served as controls. Macular perfusion was analyzed by means of OCT angiography (OCTA) [...] Read more.
Background: To evaluate macular perfusion in patients with Von Hippel–Lindau (VHL) disease. Methods: VHL patients with or without peripheral retinal hemangioblastomas (RHs) were consecutively enrolled. A group of healthy subjects served as controls. Macular perfusion was analyzed by means of OCT angiography (OCTA) in the superficial vascular plexus (SVP), and in the intermediate (ICP) and deep retinal capillary (DCP) plexuses. The following OCTA parameters were measured: Vessel Area Density (VAD), Vessel Length Fraction (VLF), Vessel Diameter Index (VDI) and Fractal Dimension (FD). Results: Sixty-three VHL patients (113 eyes) and 28 healthy controls (56 eyes) were enrolled. All OCTA quantitative parameters were reduced in VHL patients vs. controls, reaching statistical significance for VAD of the SVP (0.348 ± 0.07 vs. 0.369 ± 0.06, p = 0.0368) and VDI of all plexuses (p < 0.03 for all). No significant differences were detected between eyes without or with peripheral RHs. Conclusions: Macular perfusion is reduced in VHL patients demonstrating retinal vessel changes that are independent of the presence of peripheral RHs. VHL gene mutations disrupt the hypoxia-induced (HIF)/vascular endothelium growth factors (VEGF) pathway and the Notch signaling, both essential for the normal retinal vasculogenesis and angiogenesis. Therefore, an anomalous generalized retinal vascular development may be hypothesized in VHL disease. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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11 pages, 967 KiB  
Article
Comparison of Drusen Volume Assessed by Two Different OCT Devices
by Marco Beck, Devika S. Joshi, Lieselotte Berger, Gerd Klose, Sandro De Zanet, Agata Mosinska, Stefanos Apostolopoulos, Andreas Ebneter, Martin S. Zinkernagel, Sebastian Wolf and Marion R. Munk
J. Clin. Med. 2020, 9(8), 2657; https://doi.org/10.3390/jcm9082657 - 17 Aug 2020
Cited by 4 | Viewed by 3862
Abstract
To compare drusen volume between Heidelberg Spectral Domain (SD-) and Zeiss Swept-Source (SS) PlexElite Optical Coherence Tomography (OCT) determined by manual and automated segmentation methods. Thirty-two eyes of 24 patients with Age-Related Macular Degeneration (AMD) and drusen maculopathy were included. In the central [...] Read more.
To compare drusen volume between Heidelberg Spectral Domain (SD-) and Zeiss Swept-Source (SS) PlexElite Optical Coherence Tomography (OCT) determined by manual and automated segmentation methods. Thirty-two eyes of 24 patients with Age-Related Macular Degeneration (AMD) and drusen maculopathy were included. In the central 1 and 3 mm ETDRS circle drusen volumes were calculated and compared. Drusen segmentation was performed using automated manufacturer algorithms of the two OCT devices. Then, the automated segmentation was manually corrected and compared and finally analyzed using customized software. Though on SD-OCT, there was a significant difference of mean drusen volume prior to and after manual correction (mean difference: 0.0188 ± 0.0269 mm3, p < 0.001, corr. p < 0.001, correlation of r = 0.90), there was no difference found on SS-OCT (mean difference: 0.0001 ± 0.0003 mm3, p = 0.262, corr. p = 0.524, r = 1.0). Heidelberg-acquired mean drusen volume after manual correction was significantly different from Zeiss-acquired drusen volume after manual correction (mean difference: 0.1231 ± 0.0371 mm3, p < 0.001, corr. p < 0.001, r = 0.68). Using customized software, the difference of measurements between both devices decreased and correlation among the measurements improved (mean difference: 0.0547 ± 0.0744 mm3, p = 0.02, corr. p = 0.08, r = 0.937). Heidelberg SD-OCT, the Zeiss PlexElite SS-OCT, and customized software all measured significantly different drusen volumes. Therefore, devices/algorithms may not be interchangeable. Third-party customized software helps to minimize differences, which may allow a pooling of data of different devices, e.g., in multicenter trials. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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8 pages, 783 KiB  
Article
Deterioration of Retinal Blood Flow Parameters in Branch Retinal Vein Occlusion Measured by Doppler Optical Coherence Tomography Flowmeter
by Kengo Takahashi, Youngseok Song, Kenji Sogawa, Takafumi Yoshioka, Tomofumi Tani, Satoshi Ishiko and Akitoshi Yoshida
J. Clin. Med. 2020, 9(6), 1847; https://doi.org/10.3390/jcm9061847 - 13 Jun 2020
Cited by 1 | Viewed by 2569
Abstract
Background: Doppler optical coherence tomography (DOCT) flowmeter can be used to measure retinal blood flow (RBF) parameters, including vessel diameter, blood velocity, and the absolute value of RBF within 2.0 s. We investigated the RBF parameters in eyes with branch retinal vein occlusion [...] Read more.
Background: Doppler optical coherence tomography (DOCT) flowmeter can be used to measure retinal blood flow (RBF) parameters, including vessel diameter, blood velocity, and the absolute value of RBF within 2.0 s. We investigated the RBF parameters in eyes with branch retinal vein occlusion (BRVO) using a DOCT flowmeter. Methods: Seventeen patients with unilateral BRVO were enrolled. All subjects underwent comprehensive ophthalmologic examinations. The RBF parameters were assessed from three veins, i.e., (1) an occluded vein, (2) a non-occluded vein in the BRVO eyes, and (3) an equivalent (superior or inferior) vein in the fellow eye (non-affected vein), using prototype DOCT flowmeter (Topcon, Tokyo, Japan). Moreover, the correlation between RBF parameters and the best corrected visual acuity (BCVA) was examined. We investigated the correlation between (1) the RBF parameters and the time from the initial visit, (2) the RBF parameters and the time from the last injection, and (3) the RBF parameters and the number of anti-vascular endothelial growth factor injections (VEGF). Results: The diameter of the occluded vein (95.9 ± 24.7 µm) was smaller than that of the non-occluded vein (127.9 ± 23.7 µm) and that of the healthy veins (116.4 ± 13.9 µm). The RBF was lower in the occluded veins (4.7 ± 3.7 µL/min) than that in the non-occluded veins (10.3 ± 5.1 µL/min; p < 0.01) and in the fellow eyes (8.6 ± 4.0 µL/min; p = 0.013). In contrast, the blood velocity was not significantly different among the three types of veins. BCVA was correlated with the diameter of the occluded vein (ρ = 0.711, p = 0.001) but not with the RBF and blood velocity. The time from the initial visit, the time from the last injection, and the total number of anti-VEGF injections were not associated with any RBF parameters on the occluded vein. Conclusions: The RBF was significantly lower in the occluded veins than that in the other veins, and the diameter of the occluded vein was significantly smaller than that of the other veins in patients with BRVO. However, neither the time from the initial visit, nor the time from the last injection, nor the number of anti-VEGF injections were correlated with the RBF parameters on the occluded vein. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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11 pages, 1758 KiB  
Article
Ocular Blood Flow Changes Impact Visual Acuity Gain after Surgical Treatment for Idiopathic Epiretinal Membrane
by Felix Rommel, Max P. Brinkmann, Jan A. M. Sochurek, Michelle Prasuhn, Salvatore Grisanti and Mahdy Ranjbar
J. Clin. Med. 2020, 9(6), 1768; https://doi.org/10.3390/jcm9061768 - 7 Jun 2020
Cited by 13 | Viewed by 4360
Abstract
Background: Idiopathic epiretinal membrane (iERM) is a common eye disease, which can be treated by surgical removal of the fibrotic tissue. Morphological outcome is generally evaluated by optical coherence tomography (OCT). Here, we investigate the impact of surgery on hemodynamics of the posterior [...] Read more.
Background: Idiopathic epiretinal membrane (iERM) is a common eye disease, which can be treated by surgical removal of the fibrotic tissue. Morphological outcome is generally evaluated by optical coherence tomography (OCT). Here, we investigate the impact of surgery on hemodynamics of the posterior pole, using OCT angiography (OCTA). Methods: Patients with unilateral iERM and indication for treatment were included. OCT and OCTA images of the posterior pole were obtained preoperatively and 3-months after 23G vitrectomy with membrane peeling. Parameters of interest included full retinal perfusion, choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion, which were evaluated longitudinally and also compared to unaffected fellow eyes. Using these parameters, multiple regression analyses were used to predict visual outcomes. Results: Sixty-three iERM eyes were recruited, which initially showed a significant bigger central retinal thickness (p < 0.001) and total macular volume (TMV) (p < 0.001) compared to fellow eyes, while perfusion parameters were alike. Three months later, treated eyes had a statistically significant thicker subfoveal choroid (p = 0.006) and showed an increase of CCP (p = 0.003), while SLP decreased (p = 0.014). Lower preoperative TMV and higher SLP were associated with better postoperative visual outcome. Conclusion: In this OCTA study, iERM itself does not affect the choroidal circulation. However, preoperative choroidal circulation will be a biomarker to know the influence on the choroidal circulation after ERM surgery and may be considered as a predictor for visual outcome. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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13 pages, 1690 KiB  
Article
Macular Thickness Decrease in Asymptomatic Subjects at High Genetic Risk of Developing Alzheimer’s Disease: An OCT Study
by Inés López-Cuenca, Rosa de Hoz, Elena Salobrar-García, Lorena Elvira-Hurtado, Pilar Rojas, José A. Fernández-Albarral, Ana Barabash, Juan J. Salazar, Ana I. Ramírez and José M. Ramírez
J. Clin. Med. 2020, 9(6), 1728; https://doi.org/10.3390/jcm9061728 - 3 Jun 2020
Cited by 23 | Viewed by 5469
Abstract
In this case control study, we examined the retinal thickness of the different layers in the macular region and peripapillary retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT) in healthy cognitive subjects (from 51 to 74 years old) at high genetic [...] Read more.
In this case control study, we examined the retinal thickness of the different layers in the macular region and peripapillary retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT) in healthy cognitive subjects (from 51 to 74 years old) at high genetic risk for developing Alzheimer’s disease (AD). Thirty-five subjects with a family history of Alzheimer disease (AD) (FH+) and ApoE ɛ4 carriers and 29 age-matched control subjects without a family history of AD (FH−) and ApoE ɛ4 non-carriers were included. Compared to FH− ApoE ɛ4 non-carriers, in FH+ ApoE ɛ4 carriers, there were statistically significant decreases (p < 0.05) in (i) the foveal area of mRNFL; (ii) the inferior and nasal sectors in the outer and inner macular ring in the inner plexiform layer (IPL); (iii) the foveal area and the inferior sector in the outer macular ring in the inner nuclear layer (INL); and (iv) the inferior sector of the outer macular ring in the outer plexiform layer (OPL). However, no statistically significant differences were found in the peripapillary thickness of RNFL between both study groups. In subjects with cognitive health and high genetic risk for the development of AD, initial changes appeared in the macular area. OCT could be a promising, cost-effective and non-invasive test useful in early AD, before the onset of clinical symptoms. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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15 pages, 954 KiB  
Article
Cone Dystrophies: An Optical Coherence Tomography Angiography Study
by Lisa Toto, Maurizio Battaglia Parodi, Rossella D’Aloisio, Stefano Mercuri, Alfonso Senatore, Luca Di Antonio, Guido Di Marzio, Marta Di Nicola and Rodolfo Mastropasqua
J. Clin. Med. 2020, 9(5), 1500; https://doi.org/10.3390/jcm9051500 - 16 May 2020
Cited by 5 | Viewed by 2013
Abstract
Background: This study investigates the relationship between retinal vascularization and macular function in patients with cone dystrophies (CDs). Methods: Twenty CD patients (40 eyes) and 20 healthy controls (20 eyes) were enrolled in this prospective case-control study. Patients underwent full ophthalmological examination, microperimetry, [...] Read more.
Background: This study investigates the relationship between retinal vascularization and macular function in patients with cone dystrophies (CDs). Methods: Twenty CD patients (40 eyes) and 20 healthy controls (20 eyes) were enrolled in this prospective case-control study. Patients underwent full ophthalmological examination, microperimetry, full-field, pattern and multifocal electroretinogram (ERG, PERG, mfERG) and optical coherence tomography angiography (OCTA). Main outcome measures were as follows: foveal and parafoveal inner and outer retinal thickness; microperimetry sensitivity in the central 4° and 8°, ERG b wave amplitudes and peak times, PERG P50 and N95 amplitudes and latencies, and mfERG N1 to P1 amplitudes; and superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillary (CC) plexus vessel densities, divided into foveal and parafoveal region. Results: Retinal thickness, SCP and DCP densities were significantly related to PERG. A significant relationship was found between foveal and parafoveal retinal thicknesses and foveal SCP density (p < 0.001 and p = 0.018, respectively) and between parafoveal retinal thickness and parafoveal SCP density (p = 0.002). Foveal and parafoveal retinal thicknesses were significantly related to parafoveal DCP density (p = 0.007 and p < 0.001). Foveal and parafoveal retinal thicknesses, foveal SCP and parafoveal DPC densities were significantly reduced in CD patients compared to controls (p < 0.001; p = 0.010 and p = 0.008, respectively). PERG and mfERG amplitudes were significantly reduced in CD patients compared to controls (p < 0.01). Conclusions: CD eyes showed reduced retinal thickness significantly related to reduced vessel density, possibly caused by a decreased metabolic demand. In addition, vessel density significantly correlated with loss of function. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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10 pages, 1047 KiB  
Article
Macular Ganglion Cell Layer Thickness after Macula-Off Rhegmatogenous Retinal Detachment Repair: Scleral Buckling versus Pars Plana Vitrectomy
by Magda Gharbiya, Giuseppe Maria Albanese, Andrea Maria Plateroti, Michela Marcelli, Marco Marenco and Alessandro Lambiase
J. Clin. Med. 2020, 9(5), 1411; https://doi.org/10.3390/jcm9051411 - 10 May 2020
Cited by 7 | Viewed by 2370
Abstract
(1) Background: We evaluated macular ganglion cell layer–inner plexiform layer (GCL-IPL) thickness in patients with primary macula-off rhegmatogenous retinal detachment (RRD) treated with scleral buckling (SB) or pars plana vitrectomy (PPV) using spectral domain optical coherence tomography (SD-OCT). (2) Methods: In this retrospective, [...] Read more.
(1) Background: We evaluated macular ganglion cell layer–inner plexiform layer (GCL-IPL) thickness in patients with primary macula-off rhegmatogenous retinal detachment (RRD) treated with scleral buckling (SB) or pars plana vitrectomy (PPV) using spectral domain optical coherence tomography (SD-OCT). (2) Methods: In this retrospective, observational study, we reviewed the medical records of patients undergoing SB or PPV surgery for macula-off RRD. SD-OCT was performed at three and 12 months after surgery. The central and parafoveal GCL-IPL thicknesses in treated eyes were compared with those of healthy fellow eyes. OCT measurements between the SB and PPV group were also compared using the analysis of covariance. (3) Results: Seventy-one eyes of 71 patients with a mean age of 61.2 ± 11.7 years were included. The parafoveal GCL-IPL thickness of the PPV group was significantly reduced, with respect to fellow eyes, at three and 12 months (p < 0.01). After adjusting for age, axial length, spherical equivalent, RD extent, preoperative intraretinal cysts, duration of symptoms and postoperative IOP, the parafoveal GCL-IPL thickness in the PPV group was significantly reduced with respect to the SB group, both at three and 12 months (F = 11.45, p = 0.001 and F = 12.37, p = 0.001, respectively). (4) Conclusions: In conclusion, the GCL-IPL is reduced in thickness in eyes with macula-off RRD treated with vitrectomy and is significantly thinner compared to eyes undergoing scleral buckling surgery. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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Graphical abstract

12 pages, 1652 KiB  
Article
Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age
by Seung Hun Park, Heeyoon Cho, Sun Jin Hwang, Beomseo Jeon, Mincheol Seong, Hosuck Yeom, Min Ho Kang, Han Woong Lim and Yong Un Shin
J. Clin. Med. 2020, 9(3), 883; https://doi.org/10.3390/jcm9030883 - 24 Mar 2020
Cited by 26 | Viewed by 2598
Abstract
In this cross-sectional study, we examined age-related changes in the retinal vessels of 100 healthy participants, aged from 5 to 80 years, and divided into four groups (G1, under 20 years of age; G2, from 20 to 39 years of age; G3, from [...] Read more.
In this cross-sectional study, we examined age-related changes in the retinal vessels of 100 healthy participants, aged from 5 to 80 years, and divided into four groups (G1, under 20 years of age; G2, from 20 to 39 years of age; G3, from 40 to 59 years of age; G4, age 60 years or older). All subjects underwent swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). The vascular density (VD) of the superficial (SCP) and deep capillary plexus (DCP), and choriocapillaris (CCP) were measured using OCTA. The vascular density of each capillary layer, foveal avascular zone (FAZ) area, ganglion cell-inner plexiform layer (GC-IPL) thickness, retinal thickness (RT), and choroidal thickness (CT) were compared between age groups. Most OCT variables were correlated with OCTA variables. The FAZ area; VD of the SCP, DCP, and CCP; GC-IPL thickness; RT; and CT showed significant difference (p < 0.001) between G1 + G2 and G3 + G4, except for central GC-IPL thickness (p = 0.14) and central RT (p = 0.25). Density of the retinal capillary vasculature reduced and FAZ area increased after age 40, which represents the onset of middle age. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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Review

Jump to: Research

15 pages, 15065 KiB  
Review
Chorioretinal Side Effects of Therapeutic Ocular Irradiation: A Multimodal Imaging Approach
by Giulia Midena, Raffaele Parrozzani, Luisa Frizziero and Edoardo Midena
J. Clin. Med. 2020, 9(11), 3496; https://doi.org/10.3390/jcm9113496 - 29 Oct 2020
Cited by 6 | Viewed by 2002
Abstract
Radiation chorioretinopathy, radiation maculopathy, and radiation optic neuropathy are the major complications of ophthalmic radiotherapy. Optical coherence tomography (OCT) and OCT angiography (OCTA) are revolutionary imaging methods, allowing the visualization of the retinal cellular architecture and the retinal vascular system, respectively. In recent [...] Read more.
Radiation chorioretinopathy, radiation maculopathy, and radiation optic neuropathy are the major complications of ophthalmic radiotherapy. Optical coherence tomography (OCT) and OCT angiography (OCTA) are revolutionary imaging methods, allowing the visualization of the retinal cellular architecture and the retinal vascular system, respectively. In recent years this multimodal imaging approach has been applied to several retinal disease, but its role in the clinical characterization of retinal complications secondary to ophthalmic radiotherapy has not yet been defined. The purpose of this review is to critically evaluate the role of OCT and OCTA in the clinical assessment of radiation-induced chorioretinopathy, maculopathy, and optic neuropathy. Full article
(This article belongs to the Special Issue The Development and Application of Optical Coherence Tomography and Optical Coherence Tomography Angiography in Retinal Diseases)
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