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Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery
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Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery

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

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 42943

Special Issue Editor

Dr. Giacinto Triolo

E-Mail Website1 Website2
Guest Editor
Fatebenefratelli and Ophthalmic Hospital, Piazza Principessa Clotilde, 5 – 20121 Milan, Italy
Interests: optical coherence tomography; optical coherence tomography angiography; glaucoma; neurodegeneration; optic nerve; retina; retinal ganglion cells; retinal nerve fibers; glaucoma surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Optical Coherence Tomography (OCT) and OCT Angiography (OCT-A) have acquired a key role not only in understanding better the pathogenesis of several ocular conditions, but also as a helpful tool in the diagnosis, follow-up, and monitoring the response to medical or surgical treatments.

The present Special Issue aims to enlighten on the broad range of research and clinical applications that these technologies (OCT and OCT-A) can be applied to, according to the most updated developments in the field of ophthalmology.

Submissions are welcome primarily for original research articles showing innovative findings with the potential of enhancing the clinical capability of diagnosing and monitoring different ophthalmic conditions and treatments. Secondarily, we will consider high-interest review articles and case series of exceptional merit.

Dr. Giacinto Triolo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Macular diseases
  • Retinal diseases
  • Uveitis
  • Cornea
  • Glaucoma
  • Neuro-ophthalmology
  • Optic nerve degeneration
  • Glaucoma surgery
  • Vitreo-retinal surgery
  • Cornea surgery

Published Papers (15 papers)

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Research

Jump to: Review

13 pages, 774 KiB  
Article
Swept Source Optical Coherence Tomography Analysis of the Selected Eye’s Anterior Segment Parameters
by Michał Dembski, Anna Nowińska, Klaudia Ulfik-Dembska and Edward Wylęgała
J. Clin. Med. 2021, 10(5), 1094; https://doi.org/10.3390/jcm10051094 - 05 Mar 2021
Cited by 9 | Viewed by 2044
Abstract
Background: The present study determined the mean reference values of the anterior segment parameters of the selected eye using swept source optical coherence tomography (SS-OCT) in healthy Caucasian participants. Methods: A total of 166 volunteers (age 54–79 years), women (n = 92) [...] Read more.
Background: The present study determined the mean reference values of the anterior segment parameters of the selected eye using swept source optical coherence tomography (SS-OCT) in healthy Caucasian participants. Methods: A total of 166 volunteers (age 54–79 years), women (n = 92) and men (n = 74), were analyzed. One eye of each subject was randomly selected for anterior segment imaging. The anterior segment of the eye was scanned with CASIA2. The analyzed anterior segment parameters were divided into three groups, namely parameters of the cornea, lens, and angle. Results: The OCT (e.g., Ks, Kf, pKf, pKs, and central corneal thickness) and Fourier parameters of the cornea were significantly different between females and males. The iridocorneal angle was the smallest in the upper quadrant for all distance from the apex of the angle (250, 500, and 750 µm). Conclusions: Therefore, SS-OCT enables the analysis of parameters of the cornea, anterior chamber, lens, and iridocorneal angle, highlighting its clinical utility. Sex-specific differences in the analyzed parameters should be taken into account during the diagnosis of corneal diseases. The configuration of the filtration angle is an important marker during glaucoma diagnosis and drainage implant surgery. Measurements with CASIA 2is characterized by very good repeatability. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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9 pages, 1534 KiB  
Article
Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study
by Małgorzata Rogaczewska, Sławomir Michalak and Marcin Stopa
J. Clin. Med. 2021, 10(4), 609; https://doi.org/10.3390/jcm10040609 - 05 Feb 2021
Cited by 17 | Viewed by 2294
Abstract
Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary [...] Read more.
Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary (RPC) vessel density in MS and NMOSD patients using optical coherence tomography angiography (OCTA). A total of 40 MS patients, 13 NMOSD patients, and 20 controls were included. The average RPC vessel density was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS−ON, NMOSD−ON) and in MS+ON, MS−ON, NMOSD+ON, and NMOSD−ON compared with the control group. In NMOSD+ON eyes, the vessel density in superior nasal, nasal superior, and inferior sectors was significantly more decreased than in MS+ON eyes. RPC reduction was also observed in inferior nasal and temporal superior sectors in MS−ON eyes compared with NMOSD−ON eyes. In conclusion, our findings indicate that optic neuritis is associated with a more significant RPC vessel density drop in NMOSD than in MS patients, and the predilection to superior and inferior sectors may be useful as a differential diagnostic marker. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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9 pages, 772 KiB  
Article
Correlation between Visual Acuity and Optical Coherence Tomography Angiography Parameters in Unilateral Idiopathic Epiretinal Membrane
by I-Mo Fang, Hsin-Yi Hsu, Wan-Ling Chiang, Yi-Ling Shih and Chia-Ling Han
J. Clin. Med. 2021, 10(1), 26; https://doi.org/10.3390/jcm10010026 - 24 Dec 2020
Cited by 5 | Viewed by 1771
Abstract
Background: The tangential traction by idiopathic epiretinal membrane (iERM) may alter the hemodynamics of the macula. We investigated the correlation between visual acuity and the optical coherence tomography angiography (OCTA) parameters in unilateral iERM. Methods: We included 61 eyes of 61 consecutive patients [...] Read more.
Background: The tangential traction by idiopathic epiretinal membrane (iERM) may alter the hemodynamics of the macula. We investigated the correlation between visual acuity and the optical coherence tomography angiography (OCTA) parameters in unilateral iERM. Methods: We included 61 eyes of 61 consecutive patients with unilateral iERM between January 2018 and December 2018. The flow area of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choroidal capillary plexus (CCP) were measured using OCTA. The normal fellow eyes were used for comparison. The iERM patients were divided into those with a presence of foveal concavity and those with a loss of foveal concavity. Results: When compared with fellow eyes, the flow areas showed a statistically significant decrease in the SCP and CCP of those with iERM (p = 0.037 and p = 0.011, respectively). In the DCP, no significant reduction in flow area was found in iERM (p = 0.054). The flow area of the CCP was the only factor significantly associated with best vision (p = 0.012). No significant differences in the flow areas of the SCP, DCP, and CCP were found between the presence and loss of foveal concavity. Conclusions: The flow area of the CCP is an important determinant of vision, emphasizing the crucial role of choroidal circulation in iERM. Moreover, mechanical stretch by iERM is not the only mechanism affecting the flow area. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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9 pages, 570 KiB  
Article
Effect of Gender, Age, and Ocular and Growth-Related Factors on Corneal Epithelial and Stromal Thickness in Children
by Wook Kyum Kim, Ik Hee Ryu, Jeongseo Yoo and Sun Woong Kim
J. Clin. Med. 2020, 9(12), 3849; https://doi.org/10.3390/jcm9123849 - 27 Nov 2020
Cited by 10 | Viewed by 1900
Abstract
Data on corneal epithelial and stromal thickness in school-aged children in relation to gender, age, and ocular and growth parameters are limited. In this retrospective study, we analyzed corneal epithelial and stromal thickness measured with the RTVue system (Optovue, Inc., Fremont, CA, USA) [...] Read more.
Data on corneal epithelial and stromal thickness in school-aged children in relation to gender, age, and ocular and growth parameters are limited. In this retrospective study, we analyzed corneal epithelial and stromal thickness measured with the RTVue system (Optovue, Inc., Fremont, CA, USA) in 122 male and 201 female Korean children (mean age 9.59 ± 2.18 years) with myopia. We used simple and multiple regression analysis to establish the relationships between gender, age, refractive status, axial length, anterior chamber depth (ACD), corneal refractive power, white-to-white corneal diameter (WTW), height, and body weight. Age, body weight, height, and central corneal thickness were positively associated with corneal epithelial thickness, whereas WTW was negatively associated. The multiple regression analysis showed corneal epithelial thickness was affected by sex, body weight, WTW, and central corneal thickness (CCT), while stromal thickness was influenced by age, sex, and WTW. Both corneal epithelial and stromal thickness were significantly greater in male than in female children and were affected by growth. Neither corneal epithelial nor stromal thickness were associated with the severity of myopia, corneal refractive power, or axial length. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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12 pages, 1263 KiB  
Article
Using the Thickness Map from Macular Ganglion Cell Analysis to Differentiate Retinal Vein Occlusion from Glaucoma
by Nam Ho Lee, Kee Sup Park, Han Min Lee, Jung Yeul Kim, Chang-sik Kim and Kyoung Nam Kim
J. Clin. Med. 2020, 9(10), 3294; https://doi.org/10.3390/jcm9103294 - 14 Oct 2020
Cited by 2 | Viewed by 2380
Abstract
Purpose: We hypothesized that the thickness map from macular ganglion cell analysis (GCA) acquired from spectral-domain optical coherence tomography can be used to differentiate retinal vein occlusion (RVO) from glaucoma. Methods: In this retrospective case control study, 37 patients with resolved RVO and [...] Read more.
Purpose: We hypothesized that the thickness map from macular ganglion cell analysis (GCA) acquired from spectral-domain optical coherence tomography can be used to differentiate retinal vein occlusion (RVO) from glaucoma. Methods: In this retrospective case control study, 37 patients with resolved RVO and 74 patients with primary open-angle glaucoma (POAG) were enrolled. Two independent examiners diagnosed patients with RVO or POAG based on the topographic pattern in the GCA thickness map. Inter-observer agreement for a decision between RVO and POAG was assessed using kappa statistics. Diagnostic specificity and accuracy were calculated. Results: Inter-observer agreement was good, with a kappa value of 0.765 (95% confidence interval, 0.634–0.896, p < 0.001). The diagnostic specificity of RVO from POAG using the GCA thickness map was 93.2% and diagnosis accuracy was 80.4%. Conclusions: An irregular GCA thickness map represents a simple and convenient differential diagnostic clue to distinguish RVO from POAG. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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12 pages, 1918 KiB  
Article
Prognostic Factor Analysis of Visual Outcome after Vitrectomy for Rhegmatogenous Retinal Detachment
by Polona Zaletel Benda, Bor Vratanar, Goran Petrovski, Ana Uršula Gavrić, Katja Matović, Ana Gornik, Katarina Vergot, Anila Lumi and Xhevat Lumi
J. Clin. Med. 2020, 9(10), 3251; https://doi.org/10.3390/jcm9103251 - 12 Oct 2020
Cited by 7 | Viewed by 2850
Abstract
Pars plana vitrectomy (PPV) is a surgical approach mainly chosen for complex rhegmatogenous retinal detachment (RRD) repair with highly variable functional results. The aim of this analysis was to evaluate the impact of preoperative factors and postoperative optical coherence tomography (OCT) macular findings [...] Read more.
Pars plana vitrectomy (PPV) is a surgical approach mainly chosen for complex rhegmatogenous retinal detachment (RRD) repair with highly variable functional results. The aim of this analysis was to evaluate the impact of preoperative factors and postoperative optical coherence tomography (OCT) macular findings on the functional outcome of patients undergoing primary PPV for RRD. A retrospective analysis was performed on 88 eyes of 88 patients with complex RRD managed by PPV. A swept source OCT was used to obtain images at the postoperative visit at least 6 months after PPV. Hierarchical linear regression model was used to evaluate the influence of preoperative factors related to patient, ocular clinical and postoperative OCT macular findings on functional outcomes of PPV for RRD. Duration of symptoms (p = 0.031) and discontinuity of the ellipsoid zone (EZ) on OCT (p = 0.024) showed statistically significant negative correlation, while preoperative best-corrected visual acuity (BCVA; p < 0.001) showed statistically significant positive correlation to postoperative BCVA. Preoperative BCVA and duration of symptoms can be used as prognostic factors for visual outcome in patients undergoing PPV for RRD. Discontinuity of the EZ was the only postoperative OCT variable related to worse postoperative visual outcome. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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10 pages, 1117 KiB  
Article
Effect of Angle Opening Parameters on Corneal Endothelial Cell Density and Intraocular Pressure after Posterior Chamber Phakic Intraocular Lens Implantation
by Kazutaka Kamiya, Wakako Ando, Tatsuhiko Tsujisawa, Masahide Takahashi and Nobuyuki Shoji
J. Clin. Med. 2020, 9(9), 2704; https://doi.org/10.3390/jcm9092704 - 21 Aug 2020
Cited by 5 | Viewed by 2098
Abstract
This study aimed to investigate the time courses of angle opening parameters and the relationships of these with the corneal endothelial cell density (ECD) and the intraocular pressure (IOP) after posterior chamber phakic intraocular lens (Visian ICLTM, STAAR Surgical) implantation. We [...] Read more.
This study aimed to investigate the time courses of angle opening parameters and the relationships of these with the corneal endothelial cell density (ECD) and the intraocular pressure (IOP) after posterior chamber phakic intraocular lens (Visian ICLTM, STAAR Surgical) implantation. We evaluated 116 eyes of 59 consecutive patients (mean age ± standard deviation, 34.0 ± 8.8 years) who underwent V5 implantable collamer lens (ICL) implantation. Preoperatively and 1 day, 1 week, and 1, 3, and 18 months postoperatively, we quantitatively measured the angle opening distance at 500 µm (AOD500), the trabecular-iris space area (TISA500), and the trabecular iris angle (TIA500), using anterior segment optical coherence tomography (CASIA 2, Tomey), and assessed the relationships of these measurements with ECD and IOP in ICL-implanted eyes. All angle parameters (AOD500, TISA500, and TIA500) significantly decreased 1 day postoperatively but remained stable thereafter. At 18 months postoperatively, we found no significant correlations of the angle parameters with ECD (Pearson correlation coefficient r = −0.108, p = 0.249 for AOD500; r = −0.162, p = 0.083 for TISA500; r = −0.022, p = 0.815 for TIA500) or between the angle parameters and IOP (r = −0.106, p = 0.256 for AOD500; r = −0.021, p = 0.826 for TISA500; r = −0.018, p = 0.850 for TIA500). The angle opening metrics significantly decreased immediately after ICL implantation but remained stable thereafter. Narrowing of the angle did not significantly affect ECD or IOP in ICL-implanted eyes during the 18-month postoperative period. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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10 pages, 1765 KiB  
Article
Hyperreflective Material in Optical Coherence Tomography Images of Eyes with Myopic Choroidal Neovascularization May Affect the Visual Outcome
by Yasuaki Mushiga, Sakiko Minami, Atsuro Uchida, Norihiro Nagai, Misa Suzuki, Toshihide Kurihara, Hideki Sonobe, Norimitsu Ban, Kazuhiro Watanabe, Hajime Shinoda, Kazuo Tsubota and Yoko Ozawa
J. Clin. Med. 2020, 9(8), 2394; https://doi.org/10.3390/jcm9082394 - 27 Jul 2020
Cited by 3 | Viewed by 1782
Abstract
The visual outcome of myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor (anti-VEGF) therapy varies among individuals. We retrospectively analyzed the data of 24 eyes (24 patients) with treatment-naïve myopic CNV who underwent anti-VEGF monotherapy following a pro-re-nata regimen at the Division [...] Read more.
The visual outcome of myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor (anti-VEGF) therapy varies among individuals. We retrospectively analyzed the data of 24 eyes (24 patients) with treatment-naïve myopic CNV who underwent anti-VEGF monotherapy following a pro-re-nata regimen at the Division of Medical Retina Clinic, Department of Ophthalmology, Keio University Hospital between May 2014 and December 2017. The mean age was 70.6 ± 2.1 years, and 16 (66.7%) patients were female. Overall, the mean best-corrected visual acuity (BCVA) improved (p = 0.034), and the mean height of the hyperreflective material (HRM), involving the CNV lesion recorded by optical coherence tomography, decreased (p < 0.01) 12 months after the initial treatment. Fifteen eyes (62.5%) achieved a BCVA of better than 0.10 in LogMAR at 12 months; they had a better BCVA (p = 0.015) and lower HRM intensity (p = 0.033) at baseline than the others. Remarkably, the BCVA improved (p < 0.05) and the HRM height (p < 0.01) decreased only in eyes with a final BCVA better than 0.10 as early as 1 month after the initial treatment, which was still present at 12 months. The HRM height and intensity, not only the BCVA, would be valuable in evaluating the prognosis of myopic CNV after anti-VEGF therapy, although further study is required. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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12 pages, 1219 KiB  
Article
Strong Correlation of Renal Function with Choroidal Thickness in Patients with Type 2 Diabetes: Retrospective Cross-Sectional Study
by Min Gyu Choi and Jee Taek Kim
J. Clin. Med. 2020, 9(7), 2171; https://doi.org/10.3390/jcm9072171 - 09 Jul 2020
Cited by 6 | Viewed by 2124
Abstract
The purpose of this study was to analyze the correlation between renal function and subfoveal choroidal thickness (SFChT) in treatment-naïve proliferative diabetic retinopathy (PDR) patients. This study included 85 eyes of 52 treatment-naïve PDR patients who underwent kidney function testing and urinalysis and [...] Read more.
The purpose of this study was to analyze the correlation between renal function and subfoveal choroidal thickness (SFChT) in treatment-naïve proliferative diabetic retinopathy (PDR) patients. This study included 85 eyes of 52 treatment-naïve PDR patients who underwent kidney function testing and urinalysis and 42 eyes of 33 age-matched controls. Treatment-naïve eyes with PDR were categorized into pachychoroid and leptochoroid groups based on the SFChT of the control group. Kidney function profiles were compared between pachychoroid and leptochoroid groups; the relationship between kidney function profile and SFChT was evaluated using regression analysis. Compared with the pachychoroid group, the leptochoroid group had significantly higher serum creatinine (p = 0.026), cystatin C (p = 0.004), and phosphorus (p < 0.001) levels and a lower estimated glomerular filtration rate (eGFR) (p < 0.001). Multivariate linear regression analyses showed that SFChT was positively correlated with eGFR (Cystatin C) (p = 0.007) and negatively correlated with serum phosphorus (p = 0.001). SFChT of patients with eGFR < 30 mL/min/1.73 m2 and serum phosphorus level ≥4.0 mg/dL was less than that of patients with higher eGFR and lower serum phosphorus level. The choroidal thickness of treatment-naïve PDR patients is closely affected by renal function. Kidney function test should be considered if SFChT of patients with treatment-naïve PDR is reduced. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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14 pages, 1496 KiB  
Article
Development and Validation of a Deep Learning System for Diagnosing Glaucoma Using Optical Coherence Tomography
by Ko Eun Kim, Joon Mo Kim, Ji Eun Song, Changwon Kee, Jong Chul Han and Seung Hyup Hyun
J. Clin. Med. 2020, 9(7), 2167; https://doi.org/10.3390/jcm9072167 - 09 Jul 2020
Cited by 26 | Viewed by 3314
Abstract
This study aimed to develop and validate a deep learning system for diagnosing glaucoma using optical coherence tomography (OCT). A training set of 1822 eyes (332 control, 1490 glaucoma) with 7288 OCT images, an internal validation set of 425 eyes (104 control, 321 [...] Read more.
This study aimed to develop and validate a deep learning system for diagnosing glaucoma using optical coherence tomography (OCT). A training set of 1822 eyes (332 control, 1490 glaucoma) with 7288 OCT images, an internal validation set of 425 eyes (104 control, 321 glaucoma) with 1700 images, and an external validation set of 355 eyes (108 control, 247 glaucoma) with 1420 images were included. Deviation and thickness maps of retinal nerve fiber layer (RNFL) and ganglion cell–inner plexiform layer (GCIPL) analyses were used to develop the deep learning system for glaucoma diagnosis based on the visual geometry group deep convolutional neural network (VGG-19) model. The diagnostic abilities of deep learning models using different OCT maps were evaluated, and the best model was compared with the diagnostic results produced by two glaucoma specialists. The glaucoma-diagnostic ability was highest when the deep learning system used the RNFL thickness map alone (area under the receiver operating characteristic curve (AUROC) 0.987), followed by the RNFL deviation map (AUROC 0.974), the GCIPL thickness map (AUROC 0.966), and the GCIPL deviation map (AUROC 0.903). Among combination sets, use of the RNFL and GCIPL deviation map showed the highest diagnostic ability, showing similar results when tested via an external validation dataset. The inclusion of the axial length did not significantly affect the diagnostic performance of the deep learning system. The location of glaucomatous damage showed generally high level of agreement between the heatmap and the diagnosis of glaucoma specialists, with 90.0% agreement when using the RNFL thickness map and 88.0% when using the GCIPL thickness map. In conclusion, our deep learning system showed high glaucoma-diagnostic abilities using OCT thickness and deviation maps. It also showed detection patterns similar to those of glaucoma specialists, showing promising results for future clinical application as an interpretable computer-aided diagnosis. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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14 pages, 2316 KiB  
Article
The Area and Number of Intraretinal Cystoid Spaces Predict the Visual Outcome after Ranibizumab Monotherapy in Diabetic Macular Edema
by Norihiro Nagai, Misa Suzuki, Atsuro Uchida, Toshihide Kurihara, Norimitsu Ban, Sakiko Minami, Hajime Shinoda, Kazuo Tsubota and Yoko Ozawa
J. Clin. Med. 2020, 9(5), 1391; https://doi.org/10.3390/jcm9051391 - 08 May 2020
Cited by 13 | Viewed by 2881
Abstract
Visual outcomes in diabetic macular edema (DME) after anti-vascular endothelial growth factor therapy vary across individuals. We retrospectively reviewed the clinical records for 46 treatment-naive eyes of 46 patients with DME who underwent intravitreal ranibizumab (IVR) monotherapy with a pro re nata regimen [...] Read more.
Visual outcomes in diabetic macular edema (DME) after anti-vascular endothelial growth factor therapy vary across individuals. We retrospectively reviewed the clinical records for 46 treatment-naive eyes of 46 patients with DME who underwent intravitreal ranibizumab (IVR) monotherapy with a pro re nata regimen for 12 months. Overall, mean best-corrected visual acuity (BCVA) improved. Multivariate analyses adjusted for age and baseline BCVA showed that the area ratio, compared with the retinal area, and the number of intraretinal cystoid spaces evaluated on OCT (optical coherence tomography) images at baseline positively correlated with LogMAR BCVA and the extents of ellipsoid zone and external limiting membrane disruption at 12 months, and negatively correlated with central retinal thickness at the time of edema resolution. Therefore, a high area ratio and large number of intraretinal cystoid spaces resulted in a disorganized outer retinal structure at 12 months, a thin and atrophic retina after edema resolution, and a worse visual outcome. The area ratio and number of intraretinal cystoid spaces on initial OCT images were predictors of the visual outcome after IVR therapy in DME irrespective of baseline age and BCVA. The factors were related to retinal neurodegenerative changes in DME and could help in obtaining proper informed consent before treatment. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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10 pages, 3496 KiB  
Article
The Role of Subthreshold Micropulse Yellow Laser as an Alternative Option for the Treatment of Refractory Postoperative Cystoid Macular Edema
by Tommaso Verdina, Rossella D’Aloisio, Andrea Lazzerini, Cecilia Ferrari, Edoardo Valerio, Rodolfo Mastropasqua and Gian Maria Cavallini
J. Clin. Med. 2020, 9(4), 1066; https://doi.org/10.3390/jcm9041066 - 09 Apr 2020
Cited by 8 | Viewed by 2785
Abstract
Background: To evaluate the efficacy and the safety of subthreshold micropulse yellow laser (SMYL) in the treatment of chronic postoperative cystoid macular edema (PCME), which is refractory to standard therapies. Methods: A retrospective chart review of ten eyes of ten patients affected by [...] Read more.
Background: To evaluate the efficacy and the safety of subthreshold micropulse yellow laser (SMYL) in the treatment of chronic postoperative cystoid macular edema (PCME), which is refractory to standard therapies. Methods: A retrospective chart review of ten eyes of ten patients affected by refractory PCME who underwent SMYL was performed. Five PCME cases were subsequent to uncomplicated cataract surgery (CS), two cases to complicated CS (CCS) with posterior capsule rupture and three cases occurred after retinal detachment surgery (RD). All conditions were refractory to conventional treatments prior to SMYL interventions for at least 4 months, including nonsteroidal anti-inflammatory eyedrops, topical steroids, oral indomethacin, sub-Tenon’s triamcinolone injections and Dexamethasone intravitreal implants. All patients underwent one or more treatments with 577 nm SMYL photo-stimulation, with 7 × 7 grids with confluent spots and a 5% duty cycle covering the whole edematous retina, including the foveal center. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were obtained using OCT, and evaluated before and after the treatment at 1, 2, 3 and 6-month follow-ups. Results: A complete subfoveal macular edema resolution was observed in all of the eyes, with statistically significant improvements in terms of BCVA and CMT in all of the follow-up timelines (at 6 months, p = 0.002 and p = 0.005, respectively). The mean number of laser treatments was 1.3. At the final follow-up, a complete subfoveal edema reabsorption was observed in all patients with visual acuity improvement. No complications were observed in any case. Conclusions: SMYL seems to be a safe and effective treatment for the long-term resolution of refractory PCME and may be a useful alternative to expensive and invasive therapeutic options. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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Review

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11 pages, 2305 KiB  
Review
The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence
by Giacinto Triolo, Piero Barboni, Giacomo Savini, Francesco De Gaetano, Gaspare Monaco, Alessandro David and Antonio Scialdone
J. Clin. Med. 2021, 10(2), 231; https://doi.org/10.3390/jcm10020231 - 11 Jan 2021
Cited by 10 | Viewed by 5078
Abstract
The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with [...] Read more.
The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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16 pages, 325 KiB  
Review
Optical Coherence Tomography Angiography in Neurodegenerative Disorders
by Marco Pellegrini, Aldo Vagge, Lorenzo Ferro Desideri, Federico Bernabei, Giacinto Triolo, Rodolfo Mastropasqua, Chiara Del Noce, Enrico Borrelli, Riccardo Sacconi, Claudio Iovino, Antonio Di Zazzo, Matteo Forlini and Giuseppe Giannaccare
J. Clin. Med. 2020, 9(6), 1706; https://doi.org/10.3390/jcm9061706 - 02 Jun 2020
Cited by 48 | Viewed by 4476
Abstract
Retinal microcirculation shares similar features with cerebral small blood vessels. Thus, the retina may be considered an accessible ‘window’ to detect the microvascular damage occurring in the setting of neurodegenerative disorders. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality providing depth [...] Read more.
Retinal microcirculation shares similar features with cerebral small blood vessels. Thus, the retina may be considered an accessible ‘window’ to detect the microvascular damage occurring in the setting of neurodegenerative disorders. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality providing depth resolved images of blood flow in the retina, choroid, and optic nerve. In this review, we summarize the current literature on the application of OCT-A in glaucoma and central nervous system conditions such as Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Future directions aiming at evaluating whether OCT-A can be an additional biomarker for the early diagnosis and monitoring of neurodegenerative disorders are also discussed. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
24 pages, 5677 KiB  
Review
What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review
by Chiara Posarelli, Francesco Sartini, Giamberto Casini, Andrea Passani, Mario Damiano Toro, Giovanna Vella and Michele Figus
J. Clin. Med. 2020, 9(6), 1682; https://doi.org/10.3390/jcm9061682 - 02 Jun 2020
Cited by 19 | Viewed by 4204
Abstract
Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature [...] Read more.
Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 81 studies discussing MI-OCT applications in ophthalmology were included. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. Applications range from corneal transplant to macular surgery, including cataract surgery, glaucoma surgery, paediatric examination, proliferative diabetic retinopathy surgery, and retinal detachment surgery. Conclusion: The use of MI-OCT in ophthalmic surgery is becoming increasingly prevalent and has been applied in almost all procedures. However, there are still limitations to be overcome and the technology involved remains difficult to access and use. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Clinic Diagnosis, Therapy and Surgery)
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