Journal of Clinical Medicine

Editorial

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2 pages, 176 KiB

Open AccessEditorial

Optical Coherence Tomography Imaging: Advances in Ophthalmology

by Sumit Randhir Singh and Jay Chhablani

J. Clin. Med. 2022, 11(10), 2858; https://doi.org/10.3390/jcm11102858 - 18 May 2022

Cited by 6 | Viewed by 2126

Abstract

Since its advent in 1991, optical coherence tomography (OCT) has become the most commonly used imaging modality in vitreo-retina practice [...] Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

Research

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13 pages, 1568 KiB

Open AccessArticle

Evaluation of Retinal Nerve Fiber Layer and Macular Ganglion Cell Layer Thickness in Relation to Optic Disc Size

by Jens Julian Storp, Nils Hendrik Storp, Moritz Fabian Danzer, Nicole Eter and Julia Biermann

J. Clin. Med. 2023, 12(7), 2471; https://doi.org/10.3390/jcm12072471 - 24 Mar 2023

Cited by 3 | Viewed by 3423

Abstract

To investigate whether optic nerve ganglion cell amount is dependent on optic disc size, this trial analyzes the correlation between Bruch’s membrane opening area (BMOA) and retinal nerve fiber layer (RNFL) thickness as well as macular ganglion cell layer thickness (mGCLT). Additionally, differences [...] Read more.

To investigate whether optic nerve ganglion cell amount is dependent on optic disc size, this trial analyzes the correlation between Bruch’s membrane opening area (BMOA) and retinal nerve fiber layer (RNFL) thickness as well as macular ganglion cell layer thickness (mGCLT). Additionally, differences in RNFL and mGCLT regarding various optic disc cohorts are evaluated. This retrospective, monocentric study included 501 healthy eyes of 287 patients from the University Hospital Münster, Germany, who received macular and optic disc optical coherence tomography (OCT) scans. Rank correlation coefficients for clustered data were calculated to investigate the relationship between BMOA and thickness values of respective retinal layers. Furthermore, these values were compared between different optic disc groups based on BMOA. Statistical analysis did not reveal a significant correlation between BMOA and RNFL thickness, nor between BMOA and mGCLT. However, groupwise analysis showed global RNFL to be significantly decreased in small and large discs in comparison to medium discs. This was not observed for global mGCLT. This study extends existing normative data for mGCLT taking optic disc size into account. While the ganglion cell amount represented by the RNFL and mGCLT seemed independent of BMOA, mGCLT was superior to global RNFL in displaying optic nerve integrity in very small and very large optic discs. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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9 pages, 1368 KiB

Open AccessArticle

Multimodal Imaging Based Predictors for the Development of Choroidal Neovascularization in Patients with Central Serous Chorioretinopathy

by Sonny Caplash, Thamolwan Surakiatchanukul, Supriya Arora, Dmitrii S. Maltsev, Sumit Randhir Singh, Niroj Kumar Sahoo, Deepika Parameshwarappa, Alexei N. Kulikov, Claudio Iovino, Filippo Tatti, Ramkailash Gujar, Ramesh Venkatesh, Nikitha Gurram Reddy, Ram Snehith, Enrico Peiretti, Marco Lupidi and Jay Chhablani

J. Clin. Med. 2023, 12(5), 2069; https://doi.org/10.3390/jcm12052069 - 6 Mar 2023

Cited by 1 | Viewed by 1950

Abstract

This study evaluated predictors for choroidal neovascularization (CNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging. A retrospective multicenter chart review was conducted on 134 eyes of 132 consecutive patients with CSCR. Eyes were classified as per the multimodal imaging-based classification [...] Read more.

This study evaluated predictors for choroidal neovascularization (CNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging. A retrospective multicenter chart review was conducted on 134 eyes of 132 consecutive patients with CSCR. Eyes were classified as per the multimodal imaging-based classification of CSCR at baseline into simple/complex CSCR and primary episode/recurrent/resolved CSCR. Baseline characteristics of CNV and predictors were evaluated with ANOVA. In 134 eyes with CSCR, 32.8% had CNV (n = 44) with 72.7% having complex CSCR (n = 32), 22.7% having simple (n = 10) and 4.5% having atypical (n = 2). Primary CSCR with CNV were older (58 vs. 47, p = 0.00003), with worse visual acuity (0.56 vs. 0.75, p = 0.01) and of longer duration (median 7 vs. 1, p = 0.0002) than those without CNV. Similarly, recurrent CSCR with CNV were older (61 vs. 52, p = 0.004) than those without CNV. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. In conclusion, CNV associated with CSCR was more likely in complex CSCR and older age of presentation. Both primary and recurrent CSCR are implicated in CNV development. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. Multimodal imaging-based classification of CSCR supports detailed analysis of associated CNV. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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7 pages, 1677 KiB

Open AccessArticle

Optical Coherence Tomography Angiography in CRB1-Associated Retinal Dystrophies

by Firuzeh Rajabian, Alessandro Arrigo, Lorenzo Bianco, Alessio Antropoli, Maria Pia Manitto, Elisabetta Martina, Francesco Bandello, Jay Chhablani and Maurizio Battaglia Parodi

J. Clin. Med. 2023, 12(3), 1095; https://doi.org/10.3390/jcm12031095 - 31 Jan 2023

Cited by 1 | Viewed by 1646

Abstract

Aim of the study: To report optical coherence tomography angiography (OCTA) findings in patients affected by CRB1-associated retinal dystrophies. Method: Patients affected by a genetically confirmed CRB1-associated retinal dystrophy were prospectively enrolled in an observational study, along with age- and sex-matched [...] Read more.

Aim of the study: To report optical coherence tomography angiography (OCTA) findings in patients affected by CRB1-associated retinal dystrophies. Method: Patients affected by a genetically confirmed CRB1-associated retinal dystrophy were prospectively enrolled in an observational study, along with age- and sex-matched healthy volunteers as control subjects. All study and control subjects received a complete ophthalmic examination and multimodal retinal imaging, including OCTA. Result: A total of 12 eyes from 6 patients were included in the study. The mean BCVA of patients was 0.42 ± 0.25 logMAR. Two patients showed large central atrophy, with corresponding definite hypo-autofluorescence on fundus autofluorescence (FAF). Another four patients disclosed different degrees of RPE mottling, with uneven FAF. On OCTA, the macular deep capillary plexus and choriocapillaris had a lower vessel density in eyes affected by CRB1-associated retinopathy when compared to healthy controls. On the other hand, vessel density at the peripapillary radial capillary plexus, superficial capillary plexus, and deep capillary plexus was significantly altered with respect to control eyes. Statistical analyses disclosed a negative correlation between the deep capillary plexus and both LogMAR best corrected visual acuity and central retinal thickness. Conclusion: Our study reveals that CRB1-associated retinal dystrophies are characterized by vascular alterations both in the macular and peripapillary region, as assessed by OCTA. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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15 pages, 3040 KiB

Open AccessArticle

Deep Learning with a Dataset Created Using Kanno Saitama Macro, a Self-Made Automatic Foveal Avascular Zone Extraction Program

by Junji Kanno, Takuhei Shoji, Hirokazu Ishii, Hisashi Ibuki, Yuji Yoshikawa, Takanori Sasaki and Kei Shinoda

J. Clin. Med. 2023, 12(1), 183; https://doi.org/10.3390/jcm12010183 - 26 Dec 2022

Cited by 2 | Viewed by 1623

Abstract

The extraction of the foveal avascular zone (FAZ) from optical coherence tomography angiography (OCTA) images has been used in many studies in recent years due to its association with various ophthalmic diseases. In this study, we investigated the utility of a dataset for [...] Read more.

The extraction of the foveal avascular zone (FAZ) from optical coherence tomography angiography (OCTA) images has been used in many studies in recent years due to its association with various ophthalmic diseases. In this study, we investigated the utility of a dataset for deep learning created using Kanno Saitama Macro (KSM), a program that automatically extracts the FAZ using swept-source OCTA. The test data included 40 eyes of 20 healthy volunteers. For training and validation, we used 257 eyes from 257 patients. The FAZ of the retinal surface image was extracted using KSM, and a dataset for FAZ extraction was created. Based on that dataset, we conducted a training test using a typical U-Net. Two examiners manually extracted the FAZ of the test data, and the results were used as gold standards to compare the Jaccard coefficients between examiners, and between each examiner and the U-Net. The Jaccard coefficient was 0.931 between examiner 1 and examiner 2, 0.951 between examiner 1 and the U-Net, and 0.933 between examiner 2 and the U-Net. The Jaccard coefficients were significantly better between examiner 1 and the U-Net than between examiner 1 and examiner 2 (p < 0.001). These data indicated that the dataset generated by KSM was as good as, if not better than, the agreement between examiners using the manual method. KSM may contribute to reducing the burden of annotation in deep learning. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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10 pages, 2561 KiB

Open AccessArticle

Retinal Macrophage-Like Cells as a Biomarker of Inflammation in Retinal Vein Occlusions

by Dmitrii S. Maltsev, Alexei N. Kulikov, Yaroslava V. Volkova, Maria A. Burnasheva and Alexander S. Vasiliev

J. Clin. Med. 2022, 11(24), 7470; https://doi.org/10.3390/jcm11247470 - 16 Dec 2022

Cited by 4 | Viewed by 1618

Abstract

Aim: To study the macrophage-like cells (MLC) of the inner retinal surface in eyes with retinal vein occlusions (RVO) and the association of MLC with clinical characteristics of RVO. Methods: In this retrospective cross-sectional study, the medical records and multimodal imaging data of [...] Read more.

Aim: To study the macrophage-like cells (MLC) of the inner retinal surface in eyes with retinal vein occlusions (RVO) and the association of MLC with clinical characteristics of RVO. Methods: In this retrospective cross-sectional study, the medical records and multimodal imaging data of treatment-naïve patients with unilateral RVO and no abnormalities of vitreoretinal interface electronic were reviewed and analyzed. To visualize MLC, structural projections of optical coherence tomography (OCT) angiography scans within a slab between two inner limiting membrane segmentation lines (with 0 and −9 µm offset) were evaluated. The density of MLC was calculated and compared between affected and fellow eyes of each patient with regards to OCT and clinical characteristics of RVO. Results: Thirty-six eyes (twenty-eight branch RVO and eight central RVO) of 36 patients (21 males and 15 females, mean age 48.9 ± 9.8 years) were included. The density of MLC in affected eye was statistically significantly higher than that of the fellow eye, 8.5 ± 5.5 and 4.0 ± 3.6 cells/mm², respectively (p < 0.001). The MLC density in the affected eye had a statistically significantly correlation with that of the fellow eye (r = 0.76, p = 0.0001), but with none of the OCT and clinical characteristics of the affected eye apart from the presence of subfoveal fluid. Eyes with subfoveal fluid had a statistically significantly higher mean number of MLC than that of eyes without subfoveal fluid, 12.6 ± 6.3 and 6.9 ± 4.0 cells/mm²_, respectively (p = 0.009). Conclusion: The number of MLC on the inner retinal surface increases in RVO eyes which may reflect the activation of inflammatory pathways. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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8 pages, 2730 KiB

Open AccessArticle

Iris Racemose Hemangioma Assessment with Swept Source Optical Coherence Tomography Angiography: A Feasibility Study and Stand-Alone Comparison

by Filippo Confalonieri, Huy Bao Ngo, Helga Halldorsdottir Petersen, Nils Andreas Eide and Goran Petrovski

J. Clin. Med. 2022, 11(21), 6575; https://doi.org/10.3390/jcm11216575 - 6 Nov 2022

Viewed by 2003

Abstract

Purpose: To evaluate arteriovenous malformations (AVM) with swept-source (SS) optical coherence tomography (OCT) angiography (OCTA) in iris racemose hemangioma and compare it with traditional intravenous iris fluorescein angiography (IVFA). Methods: A cross-sectional observational clinical study was conducted on patients with iris racemose hemangioma [...] Read more.

Purpose: To evaluate arteriovenous malformations (AVM) with swept-source (SS) optical coherence tomography (OCT) angiography (OCTA) in iris racemose hemangioma and compare it with traditional intravenous iris fluorescein angiography (IVFA). Methods: A cross-sectional observational clinical study was conducted on patients with iris racemose hemangioma with the ZEISS PLEX Elite 9000 SS OCT & OCTA. Results: Three eyes of three patients were imaged. Iris racemose hemangiomas demonstrated a tortuous, well-defined, and continuous course of the AVM. The ZEISS PLEX Elite 9000 SS OCT & OCTA allowed for a detailed visualization of the ARM and was superior to IVFA in depicting small caliber, fine vessels. Conclusions: SS-OCTA may provide a dye-free, no-injection, cost-effective method comparable to spectral domain OCTA and IVFA for diagnosing and monitoring iris racemose hemangiomas for growth and vascularity. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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12 pages, 4927 KiB

Open AccessArticle

Structural Features of Patients with Drusen-like Deposits and Systemic Lupus Erythematosus

by Marc Kukan, Matthew Driban, Kiran K. Vupparaboina, Swen Schwarz, Alice M. Kitay, Mohammed A. Rasheed, Catharina Busch, Daniel Barthelmes, Jay Chhablani and Mayss Al-Sheikh

J. Clin. Med. 2022, 11(20), 6012; https://doi.org/10.3390/jcm11206012 - 12 Oct 2022

Cited by 5 | Viewed by 1928

Abstract

Background: The relevance of drusen-like deposits (DLD) in patients with systemic lupus erythematosus (SLE) is to a large extent uncertain. Their genesis is proposed to be correlated to immune-complex and complement depositions in the framework of SLE. The intention of this study was [...] Read more.

Background: The relevance of drusen-like deposits (DLD) in patients with systemic lupus erythematosus (SLE) is to a large extent uncertain. Their genesis is proposed to be correlated to immune-complex and complement depositions in the framework of SLE. The intention of this study was to determine potential morphological differences in the choroid and retina as well as potential microvascular changes comparing two cohorts of SLE patients divergent in the presence or absence of DLD using multimodal imaging. Methods: Both eyes of 16 SLE patients with DLD were compared to an age- and sex-matched control-group consisting of 16 SLE patients without detectable DLD. Both cohorts were treated with hydroxychloroquine (HCQ) and did not differ in the treatment duration or dosage. Using spectral-domain optical coherence tomography (SD-OCT) choroidal volume measures, choroidal vascularity indices (CVI) and retinal layer segmentation was performed and compared. In addition, by the exploitation of optical coherence tomography angiography vascular density, perfusion density of superficial and deep retinal capillary plexuses and the choriocapillaris were analyzed. For the choroidal OCT-scans, a subset of 51 healthy individuals served as a reference-group. Results: CVI measures revealed a significant reduction in eyes with DLD compared to healthy controls (0.56 (0.54–0.59) versus 0.58 (0.57–0.59) (p = 0.018) and 0.56 (0.54–0.58) versus 0.58 (0.57–0.60) (p < 0.001)). The photoreceptor cell layer presented significant thinning in both eyes of subjects with DLD compared to control subjects without DLD (68.8 ± 7.7 µm vs. 77.1 ± 7.3 µm for right eyes, p = 0.008, and 66.5 ± 10.5 µm vs. 76.1 ± 6.3 µm for left eyes, p = 0.011). OCTA scans revealed no significant changes, yet there could be observed numerically lower values in the capillary plexuses of the retina in eyes with DLD than in eyes without DLD. Conclusions: Our results illustrated significant alterations in the choroidal and retinal analyzes, suggesting a correlation between DLD and the progression of inflammatory processes in the course of SLE leading to retinal degeneration. For this reason, DLD could serve as a biomarker for a more active state of disease. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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11 pages, 1680 KiB

Open AccessArticle

Two Year Functional and Structural Changes—A Comparison between Trabeculectomy and XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography

by Caroline Bormann, Catharina Busch, Matus Rehak, Manuela Schmidt, Christian Scharenberg, Focke Ziemssen and Jan Darius Unterlauft

J. Clin. Med. 2022, 11(19), 5840; https://doi.org/10.3390/jcm11195840 - 1 Oct 2022

Cited by 4 | Viewed by 1514

Abstract

The aim of this study was to analyze retinal nerve fiber layer (RNFL) thickness after trabeculectomy (TE) versus XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) cases naïve to prior incisional glaucoma surgery. We examined 119 consecutive glaucoma patients retrospectively, who received [...] Read more.

The aim of this study was to analyze retinal nerve fiber layer (RNFL) thickness after trabeculectomy (TE) versus XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) cases naïve to prior incisional glaucoma surgery. We examined 119 consecutive glaucoma patients retrospectively, who received a TE or XEN for medically uncontrolled POAG. Intraocular pressure (IOP), amount of IOP-lowering medication, mean deviation of standard automated perimetry and peripapillary RNFL thickness were evaluated during the first 24 months after surgery. Fifty eyes were treated with TE and 69 eyes with XEN. Mean IOP decreased from 25.1 ± 0.8 to 13.3 ± 0.6 mm Hg (p < 0.01) and mean number of IOP-lowering eye drops from 3.2 ± 0.2 to 0.4 ± 0.1 (p < 0.01) 24 months after TE. In 69 eyes undergoing XEN, mean IOP dropped from 24.8 ± 0.6 to 15.0 ± 0.4 mm Hg (p < 0.01) and medication from 3.0 ± 0.1 to 0.6 ± 0.1 (p < 0.01) during the 24 months follow-up. Mean deviation of standard automated perimetry remained stable in TE (8.5 ± 0.7 to 8.1 ± 0.8 dB; p = 0.54) and XEN group (11,0 ± 0.5 to 11.5 ± 0.5 dB; p = 0.12) after 24 months, while mean RNFL thickness further deteriorated in the TE (−2.28 ± 0.65 µm/year) and XEN (−0.68 ± 0.34 µm/year) group. Postoperative RNFL loss develops after TE and XEN despite effective and significant lowering of IOP and amount of IOP-lowering medication. RNFL loss was more pronounced in the first year after glaucoma surgery. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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8 pages, 4702 KiB

Open AccessArticle

Association of Fundus Autofluorescence Abnormalities and Pachydrusen in Central Serous Chorioretinopathy and Polypoidal Choroidal Vasculopathy

by Timothy Y. Y. Lai, Ziqi Tang, Adrian C. W. Lai, Simon K. H. Szeto, Ricky Y. K. Lai and Carol Y. Cheung

J. Clin. Med. 2022, 11(18), 5340; https://doi.org/10.3390/jcm11185340 - 11 Sep 2022

Cited by 5 | Viewed by 1863

Abstract

A specific form of drusen, known as pachydrusen, has been demonstrated to be associated with pachychoroid eye diseases, such as central serous chorioretinopathy (CSC) and polypoidal choroidal vasculopathy (PCV). These pachydrusen have been found in up to 50% of eyes with CSC and [...] Read more.

A specific form of drusen, known as pachydrusen, has been demonstrated to be associated with pachychoroid eye diseases, such as central serous chorioretinopathy (CSC) and polypoidal choroidal vasculopathy (PCV). These pachydrusen have been found in up to 50% of eyes with CSC and PCV and may affect the disease progression and treatment response. This study aims to investigate the association between pachydrusen and changes in fundus autofluorescence (FAF) in eyes with CSC and PCV. A total of 65 CSC patients and 32 PCV patients were evaluated. Pachydrusen were detected using both color fundus photography and spectral-domain optical coherence tomography. The relationships between pachydrusen and FAF changes were then investigated. The prevalence of pachydrusen in CSC and PCV eyes was 16.7% and 61.8%, respectively. The mean age of patients with pachydrusen was significantly older than those without pachydrusen (CSC: 56.3 vs. 45.0 years, p < 0.001; PCV: 68.8 vs. 59.5 years, p < 0.001). No significant difference was found in the mean subfoveal choroidal thickness between eyes with or without pachydrusen. Eyes with pachydrusen were significantly associated with more extensive FAF changes in both CSC and PCV (p < 0.001 and p = 0.037, respectively). The study demonstrated that pachydrusen are more prevalent in PCV than CSC. Increasing age and more extensive abnormalities in FAF are associated with the presence of pachydrusen, suggesting that dysfunction of retinal pigment epithelial cells is associated with pachydrusen. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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11 pages, 3837 KiB

Open AccessArticle

Acute Idiopathic Blind Spot Enlargement Syndrome—New Perspectives in the OCT Era

by Julian A. Zimmermann, Nicole Eter and Julia Biermann

J. Clin. Med. 2022, 11(18), 5278; https://doi.org/10.3390/jcm11185278 - 7 Sep 2022

Cited by 1 | Viewed by 4588

Abstract

Acute idiopathic blind spot enlargement syndrome (AIBSES) is characterized by unilateral visual field loss in the blind spot area, acute onset photopsia, and funduscopically few or no optic disc changes. AIBSES predominantly affects young adults and is often misdiagnosed as optic neuritis because [...] Read more.

Acute idiopathic blind spot enlargement syndrome (AIBSES) is characterized by unilateral visual field loss in the blind spot area, acute onset photopsia, and funduscopically few or no optic disc changes. AIBSES predominantly affects young adults and is often misdiagnosed as optic neuritis because of low awareness. Optical coherence tomography (OCT) has become the gold standard in diagnosing AIBSES as a disease of the outer retina. In our case series, we present three consecutive patients with AIBSES followed prospectively with and without steroid therapy. The patients, aged 25 to 27 years, presented in our neuroophthalmology department between 2020 and 2021. We report their disease course and management and discuss therapeutic options, as no well-established procedures exist. Common pitfalls and diagnostic errors are analysed. Two women and one man showed unilateral acute-onset photopsia and blind spot enlargement on perimetry without visual acuity reduction. Spectral domain OCT (Heidelberg Engineering, Heidelberg, Germany) revealed marked peripapillary changes in the ellipsoid zone and autofluorescence in all patients, corresponding to faint blurring of the optic disc margin. Characteristically, there was no P100 latency delay in the visual evoked potential in any of the patients. Two patients received weight-adapted oral prednisolone, which was gradually tapered over six to eight weeks. Two patients showed full recovery of their symptoms at six and seven months after onset, while mild defect healing was seen in one treated patient after 12 months. Follow-up OCT showed restoration of the outer retinal layers 6–12 months after disease onset. Careful history taking and an unprejudiced ophthalmological workup helps in diagnosing AIBSES in young adults with unilateral acute visual field defects. While its etiology is still unclear, accurate diagnosis of AIBSES can be made with peripapillary OCT. In our cases, the disease course of AIBSES was much better than its reputation. Early corticosteroid treatment may support outer retinal reorganisation, which can be followed with OCT in accordance with visual field restoration. This should be addressed in a prospective study. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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9 pages, 1589 KiB

Open AccessArticle

Risk Factors for Progression of Age-Related Macular Degeneration: Population-Based Amish Eye Study

by Muneeswar G. Nittala, Federico Corvi, Jyotsna Maram, Swetha B. Velaga, Jonathan Haines, Margaret A. Pericak-Vance, Dwight Stambolian and SriniVas R. Sadda

J. Clin. Med. 2022, 11(17), 5110; https://doi.org/10.3390/jcm11175110 - 30 Aug 2022

Cited by 19 | Viewed by 2008

Abstract

Objective: To evaluate the optical coherence tomography (OCT)-based risk factors for progression to late age-related macular degeneration (AMD) in a population-based study of elderly Amish. Methods: A total of 1332 eyes of 666 consecutive subjects who completed a 2-year follow-up visit were included [...] Read more.

Objective: To evaluate the optical coherence tomography (OCT)-based risk factors for progression to late age-related macular degeneration (AMD) in a population-based study of elderly Amish. Methods: A total of 1332 eyes of 666 consecutive subjects who completed a 2-year follow-up visit were included in this multicenter, prospective, longitudinal, observational study. Imaging features were correlated with 2-year incidence of late AMD development. Odds ratios for imaging features were estimated from logistic regression. Baseline OCT images were reviewed for the presence of drusen volume ≥0.03 mm³ in the central 3 mm ring, intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDC), subretinal drusenoid deposits (SDD), and drusenoid pigment epithelium detachment (PED). Subfoveal choroidal thickness, drusen area, and drusen volume within 3 and 5 mm circles centered on the fovea were also assessed. Results: Twenty-one (1.5%) of 1332 eyes progressed to late AMD by 2 years. The mean age of the study subjects was 65 ± 10.17 (±SD) years and 410 subjects were female. Univariate logistic regression showed that drusen area and volume in both 3 mm and 5 mm circles, subfoveal choroidal thickness, drusen volume ≥ 0.03 mm³ in the 3 mm ring, SDD, IHRF, and hDC were all associated with an increased risk for development of late AMD. The multivariate regression model identified that drusen volume in the 3 mm ring (OR: 2.59, p = 0.049) and presence of IHRF (OR: 57.06, p < 0.001) remained as independent and significant risk factors for progression to late AMD. Conclusions: This population-based study confirms previous findings from clinic-based studies that high central drusen volume and IHRF are associated with an increased risk of progression to late AMD. These findings may be of value in risk-stratifying patients in clinical practice or identifying subjects for early intervention clinical trials. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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9 pages, 296 KiB

Open AccessArticle

Optical Coherence Tomography as a Biomarker for Differential Diagnostics in Nystagmus: Ganglion Cell Layer Thickness Ratio

by Khaldoon O. Al-Nosairy, Elisabeth V. Quanz, Julia Biermann and Michael B. Hoffmann

J. Clin. Med. 2022, 11(17), 4941; https://doi.org/10.3390/jcm11174941 - 23 Aug 2022

Cited by 5 | Viewed by 1507

Abstract

In albinism, with the use of optical coherence tomography (OCT), a thinning of the macular ganglion cell layer was recently reported. As a consequence, the relevant OCT measure, i.e., a reduction of the temporal/nasal ganglion cell layer thickness quotient (GCLTQ), is a strong [...] Read more.

In albinism, with the use of optical coherence tomography (OCT), a thinning of the macular ganglion cell layer was recently reported. As a consequence, the relevant OCT measure, i.e., a reduction of the temporal/nasal ganglion cell layer thickness quotient (GCLTQ), is a strong candidate for a novel biomarker of albinism. However, nystagmus is a common trait in albinism and is known as a potential confound of imaging techniques. Therefore, there is a need to determine the impact of nystagmus without albinism on the GCLTQ. In this bi-center study, the retinal GCLTQ was determined (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany) for healthy controls (n = 5, 10 eyes) vs. participants with nystagmus and albinism (N_albinism, n = 8, 15 eyes), and with nystagmus of other origins (N_other, n = 11, 17 eyes). Macular OCT with 25 horizontal B scans 20 × 20° with 9 automated real time tracking (ART) frames centered on the retina was obtained for each group. From the sectoral GCLTs of the early treatment diabetic retinopathy study (ETDRS) circular thickness maps, i.e., 3 mm and 6 mm ETDRS rings, GCLTQ I and GCLTQ II were determined. Both GCLTQs were reduced in N_albinism (GCLTQ I and II: 0.78 and 0.77, p < 0.001) compared to N_other (0.91 and 0.93) and healthy controls (0.89 and 0.95). The discrimination of N_albinism from N_other via GCLTQ I and II had an area under the curve of 80 and 82% with an optimal cutoff point of 0.86 and 0.88, respectively. In conclusion, lower GCLTQ in N_albinism appears as a distinguished feature in albinism-related nystagmus as opposed to other causes of nystagmus. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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8 pages, 3129 KiB

Open AccessArticle

Choroidal Vascularity Index in Central and Branch Retinal Vein Occlusion

by Pasquale Loiudice, Giuseppe Covello, Michele Figus, Chiara Posarelli, Maria Sole Sartini and Giamberto Casini

J. Clin. Med. 2022, 11(16), 4756; https://doi.org/10.3390/jcm11164756 - 15 Aug 2022

Cited by 5 | Viewed by 1794

Abstract

(1) Background: we aimed to evaluate choroidal vascularity change in eyes with central and branch retinal vein occlusion (RVO). (2) Methods: in this retrospective cross-sectional study, we reviewed the records of 47 patients with recent-onset, naïve, unilateral retinal vein occlusion. Enhanced-depth imaging optical [...] Read more.

(1) Background: we aimed to evaluate choroidal vascularity change in eyes with central and branch retinal vein occlusion (RVO). (2) Methods: in this retrospective cross-sectional study, we reviewed the records of 47 patients with recent-onset, naïve, unilateral retinal vein occlusion. Enhanced-depth imaging optical coherence tomography scans were binarized using the ImageJ software; luminal area (LA) and total choroidal area (TCA) were measured. The choroidal vascularity index (CVI) was calculated as the proportion of LA to TCA. Depending on the pattern of macular oedema, eyes were classified as having no macular oedema (nME), cystoid macular oedema (CME), cystoid macular oedema with serous retinal detachment (mixed). (3) Results: CVI, TCA and LA were greater in eyes with RVO than in fellow, unaffected eyes. No difference was found between central and branch RVO except for central macular thickness (CMT). When compared with controls, eyes with CME presented a significant increase in subfoveal choroidal thickness, CMT, TCA, LA and CVI; eyes with mixed macular oedema had greater CMT and CVI than contralateral eyes; no significant differences in any of the considered parameters were observed in eyes with nME. (4) Conclusions: The results suggest that RVO alters the vascularity of the choroid that varies according to the type of macular oedema. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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11 pages, 2393 KiB

Open AccessArticle

Large Amplitude Iris Fluttering Detected by Consecutive Anterior Segment Optical Coherence Tomography Images in Eyes with Intrascleral Fixation of an Intraocular Lens

by Makoto Inoue, Takashi Koto and Akito Hirakata

J. Clin. Med. 2022, 11(15), 4596; https://doi.org/10.3390/jcm11154596 - 6 Aug 2022

Cited by 2 | Viewed by 1983

Abstract

Saccadic eye movements induce movements of the aqueous and vitreous humor and iris fluttering. To evaluate iris fluttering during eye movements, anterior segment optical coherence tomography (AS-OCT) was used in 29 eyes with pars plana vitrectomy (PPV) and intrascleral fixation of an intraocular [...] Read more.

Saccadic eye movements induce movements of the aqueous and vitreous humor and iris fluttering. To evaluate iris fluttering during eye movements, anterior segment optical coherence tomography (AS-OCT) was used in 29 eyes with pars plana vitrectomy (PPV) and intrascleral fixation of an intraocular lens (ISF group) and 15 eyes with PPV and an IOL implantation into lens capsular bag (control group). The height of the iris from the iris plane (the line between the anterior chamber angles) was compared every 0.2 s after the eye had moved from a temporal to the primary position (time 0). The height of the nasal iris in the ISF group decreased to −0.68 ± 0.43 mm at 0 s (p < 0.001) and returned to −0.06 ± 0.23 mm at 0.2 s. The height of the temporal iris increased to 0.45 ± 0.31 mm at 0 s (p < 0.001) and returned to −0.06 ± 0.18 mm at 0.2 s. The height of the nasal iris at 0 s in the ISF group was significantly lower, and that of the temporal iris was significantly higher than the control (−0.05 ± 0.09 mm, 0.03 ± 0.06 mm, p < 0.001, respectively). Iris fluttering can act as a check valve for aqueous and vitreous humor movements and can be quantified by consecutive AS-OCT images. Large amplitude iris fluttering in eyes with intrascleral fixation is important because it can lead to a reverse pupillary block. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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13 pages, 742 KiB

Open AccessArticle

Correlation between Choroidal Vascularity Index and Outer Retina in Patients with Diabetic Retinopathy

by Patryk Sidorczuk, Iwona Obuchowska, Joanna Konopinska and Diana A. Dmuchowska

J. Clin. Med. 2022, 11(13), 3882; https://doi.org/10.3390/jcm11133882 - 4 Jul 2022

Cited by 9 | Viewed by 1931

Abstract

The choroid supplies blood to the outer retina. We quantified outer retinal and choroidal parameters to understand better the pathogenesis of diabetic retinopathy (DR) and diabetic macular edema (DME). The retrospective cross-sectional single-center study included 210 eyes from 139 diabetic patients and 76 [...] Read more.

The choroid supplies blood to the outer retina. We quantified outer retinal and choroidal parameters to understand better the pathogenesis of diabetic retinopathy (DR) and diabetic macular edema (DME). The retrospective cross-sectional single-center study included 210 eyes from 139 diabetic patients and 76 eyes from 52 healthy controls. Spectral-domain optical coherence tomography (OCT) was carried out with a Spectralis HRA + OCT imaging device. The outer retinal layer (ORL), outer nuclear layer (ONL), and choroidal thicknesses were assessed along with the choroidal vascularity index (CVI). The presence of DR, whether with DME or without, was associated with choroidal thinning (p < 0.001). Compared with the controls, patients with DR without DME presented with lower ORL and ONL thickness (p < 0.001), whereas those with DR and DME had higher values of both parameters (p < 0.001). Significant correlations between outer retinal and choroidal parameters were found only in patients with DR without DME (ORL with choroidal thickness: p = 0.003, rho = 0.34; ORL with CVI: p < 0.001, rho = 0.49, ONL with CVI: p < 0.027, rho = 0.25). No correlations between choroidal and outer retinal parameters were observed in the controls and patients with DR and concomitant DME. Aside from diabetic choroidopathy, other pathogenic mechanisms seem to predominate in the latter group. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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8 pages, 717 KiB

Open AccessArticle

Evaluation of Radial Peripapillary Capillary Density in G6PD Deficiency: An OCT Angiography Pilot Study

by Rita Serra, Giuseppe D’Amico Ricci, Stefano Dore, Florence Coscas and Antonio Pinna

J. Clin. Med. 2022, 11(12), 3282; https://doi.org/10.3390/jcm11123282 - 8 Jun 2022

Cited by 1 | Viewed by 1608

Abstract

Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is an inherited enzymatic disorder causing hemolytic anemia. The purpose of this pilot study was to compare vascular density (VD) values of the radial peripapillary capillary (RPC) plexus in G6PD-deficient and G6PD-normal men, using optical coherence tomography angiography (OCTA). Methods: [...] Read more.

Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is an inherited enzymatic disorder causing hemolytic anemia. The purpose of this pilot study was to compare vascular density (VD) values of the radial peripapillary capillary (RPC) plexus in G6PD-deficient and G6PD-normal men, using optical coherence tomography angiography (OCTA). Methods: 46 G6PD-deficient men and 23 age-matched male controls were included. A complete ophthalmological evaluation, consisting of slit-lamp biomicroscopy, best-corrected visual acuity, intra-ocular pressure measurement, structural optical coherence tomography, and OCTA scanning of the optic nerve head, was performed. The en-face angioflow images were carefully analyzed and the VD values of the RPC plexus were measured using the AngioAnalytics™ software embedded in the OCTA device. Medical conditions, including systemic hypertension, hypercholesterolemia, and diabetes mellitus, were also investigated. Results: G6PD-deficient eyes showed higher values of VD in all peripapillary sectors, but a statistical significance (p = 0.03) was reached only in the infero-temporal sector. There were no significant differences in terms of hypercholesterolemia, systemic arterial hypertension, and diabetes mellitus between the two study groups. Conclusion: Results show that VD values of the RPC plexus are higher in G6PD-deficient men than in G6PD-normal subjects, but a statistically significant difference was found only in the inferior temporal sector. Overall, our preliminary findings support the hypothesis that the RPC layer of G6PD-deficient men consists of a denser vascular network, which may contribute to offering protection against ocular atherosclerotic vasculopathies. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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11 pages, 1944 KiB

Open AccessArticle

Correlating Ocular Physiology and Visual Function with Mild Cognitive Loss in Senior Citizens in Taiwan

by Kuo-Chen Su, Hong-Ming Cheng, Yu Chu, Fang-Chun Lu, Lung-Hui Tsai and Ching-Ying Cheng

J. Clin. Med. 2022, 11(9), 2624; https://doi.org/10.3390/jcm11092624 - 6 May 2022

Viewed by 2058

Abstract

Purpose: The transition of Taiwan from an aging to a super-aging society has come with a cost as more elderly now suffer from cognitive impairment. The main purpose of our study was to investigate if early detection can be developed so that timely [...] Read more.

Purpose: The transition of Taiwan from an aging to a super-aging society has come with a cost as more elderly now suffer from cognitive impairment. The main purpose of our study was to investigate if early detection can be developed so that timely intervention can be instituted. We analyzed the correlation of cognitive function with ocular physiology and visual functions between senior citizens aged 60 years or older in Taiwan. Methods: Thirty-six healthy subjects were recruited for the study. Addenbrooke’s cognitive examination III (ACE-III), binocular functions (including objective and subjective refraction, distance and near dissociated phoria, stereopsis, contrast sensitivity, adult developmental eye movement (ADEM), and ocular physiology (by using optical coherence tomography, OCT, and macular pigment measurement, MPS) were performed, and the data were analyzed via independent t-test, chi-square test, Pearson correlation, linear regression, and ROC (receiver operating characteristic) curve. Results: Data analysis showed that (1) patients with poor eye movement had a strong correlation with the total score and all dimensions of cognitive functions, (2) the thickness of the macula had a strong correlation with attention and memory, and (3) patients with poor eye movement and poor stereopsis in combination with thinner inferior macula appeared to have lower cognitive abilities. Discussion and Conclusions: Cognitive dysfunction is not readily identified during the early stage of cognitive decline. The use of simple and inexpensive ADEM or stereopsis test and comparing the OCT results that are popular in optometry clinics for reference can be diagnostic in identifying patients with mild cognitive impairments. With the combined use of macular pigment density or retinal thickness measurements, it was possible to effectively predict the early degradation of cognition. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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9 pages, 1221 KiB

Open AccessArticle

OCT Angiography Fractal Analysis of Choroidal Neovessels Secondary to Central Serous Chorioretinopathy, in a Caucasian Cohort

by Rita Serra, Antonio Pinna, Francine Behar-Cohen and Florence Coscas

J. Clin. Med. 2022, 11(5), 1443; https://doi.org/10.3390/jcm11051443 - 6 Mar 2022

Cited by 5 | Viewed by 2202

Abstract

Central serous chorioretinopathy (CSCR) can be complicated by different types of choroidal neovascularization (CNV). The purpose of this study was to investigate the incidence and quantitative optical coherence tomography angiography (OCT-A) features of CSCR-related CNVs. Methods: This was a retrospective multicenter study including [...] Read more.

Central serous chorioretinopathy (CSCR) can be complicated by different types of choroidal neovascularization (CNV). The purpose of this study was to investigate the incidence and quantitative optical coherence tomography angiography (OCT-A) features of CSCR-related CNVs. Methods: This was a retrospective multicenter study including 102 eyes of 102 Caucasian patients with acute or complex CSCR. All patients underwent a comprehensive ophthalmological examination. Quantitative OCT-A parameters, including vascular perfusion density (VPD), fractal dimension (FD), and lacunarity (LAC), were measured in CNV eyes. Results: Forty eyes (39.2%) had acute CSCR, whereas the remaining sixty-two (60.8%) had complex CSCR. CNV was observed in 37 (36.27%) eyes, all of which had the complex form. CNVs were classified as type 1 CNV in 11/37 (29.73%) cases and as polypoidal choroidal vasculopathy (PCV) in the remaining 26/37 (70.27%). Overall, the mean VPD, FD, and LAC of CSCR-related CNVs were 0.52 ± 0.20%, 1.44 ± 0.12, and 2.40 ± 1.1, respectively. No significant difference between type 1 CNV and PCV was found. Conclusion: Complex CSCR is often complicated by type 1 CNV and PCV with similar neovascular architecture and branching complexity, a finding supporting the idea that they might be different stages of the same neovascular process. Future OCT-A fractal analysis-based studies that also include other relevant parameters, such as demographics, presentation, morphology on multimodal imaging, and response to treatment, are necessary before drawing any definitive conclusions. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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11 pages, 1173 KiB

Open AccessArticle

Topographic Relationships among Deep Optic Nerve Head Parameters in Patients with Primary Open-Angle Glaucoma

by Do-Young Park, Hoon Noh, Changwon Kee and Jong-Chul Han

J. Clin. Med. 2022, 11(5), 1320; https://doi.org/10.3390/jcm11051320 - 27 Feb 2022

Cited by 1 | Viewed by 2267

Abstract

Purpose: To investigate the topographic relationships among the deep optic nerve head (ONH) parameters representing myopic axial elongation or changes in the lamina cribrosa (LC) in patients with primary open-angle glaucoma (POAG). Methods: Among patients with POAG who visited the clinic between January [...] Read more.

Purpose: To investigate the topographic relationships among the deep optic nerve head (ONH) parameters representing myopic axial elongation or changes in the lamina cribrosa (LC) in patients with primary open-angle glaucoma (POAG). Methods: Among patients with POAG who visited the clinic between January 2015 and March 2017, the following deep ONH parameters were measured using spectral-domain optical coherence tomography (SD-OCT): externally oblique border tissue (EOBT) length, ONH tilt angle, optic canal (OC) obliqueness, and anterior LC insertion depth (ALID). In addition, the angular locations of the maximal value of each parameter were measured. We analyzed the correlations between the parameters, correlations with axial length (AL), and the spatial correspondence with glaucomatous ONH damage. Results: A total of 100 eyes with POAG were included in the analysis. The EOBT length, ONH tilt angle, and OC obliqueness were correlated with each other and with AL, whereas ALID showed less correlation with the other parameters and AL. The angular location where the three AL-related parameters had maximum values was also correlated with the predominant region of the glaucomatous ONH damage, while the angular location of the deepest ALID showed less correlation. Conclusions: Among the deep ONH parameters, the AL-related parameters EOBT length, ONH tilt angle, and OC obliqueness showed strong spatial correspondence with glaucomatous ONH damage, whereas the LC-related parameter ALID was less correlated with both AL and the region with glaucomatous ONH damage. Further studies are needed to determine how these differences affect glaucomatous ONH change. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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Review

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13 pages, 268 KiB

Open AccessReview

Optical Coherence Tomography Findings in Rhegmatogenous Retinal Detachment: A Systematic Review

by Carla Danese and Paolo Lanzetta

J. Clin. Med. 2022, 11(19), 5819; https://doi.org/10.3390/jcm11195819 - 30 Sep 2022

Cited by 8 | Viewed by 2533

Abstract

Rhegmatogenous retinal detachment is a sight-threatening condition that may lead to blindness if left untreated. Surgical treatments may vary and are tailored to a single patient. Anatomical and functional results may vary, due to factors that are currently under study. Optical coherence tomography [...] Read more.

Rhegmatogenous retinal detachment is a sight-threatening condition that may lead to blindness if left untreated. Surgical treatments may vary and are tailored to a single patient. Anatomical and functional results may vary, due to factors that are currently under study. Optical coherence tomography (OCT) allows a detailed visualization of the retinal structure. Some studies have been performed using OCT on eyes with retinal detachment. We performed a review on the subject. Several data have been obtained using different OCT applications. Some alterations may represent potential biomarkers since they are associated with visual and anatomical prognoses. Increased knowledge on the subject may be helpful to choose among different surgical strategies and endotamponades. More research on the topic is needed. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

20 pages, 5303 KiB

Open AccessReview

Advances in Optical Coherence Tomography Imaging Technology and Techniques for Choroidal and Retinal Disorders

by Joshua Ong, Arman Zarnegar, Giulia Corradetti, Sumit Randhir Singh and Jay Chhablani

J. Clin. Med. 2022, 11(17), 5139; https://doi.org/10.3390/jcm11175139 - 31 Aug 2022

Cited by 23 | Viewed by 7544

Abstract

Optical coherence tomography (OCT) imaging has played a pivotal role in the field of retina. This light-based, non-invasive imaging modality provides high-quality, cross-sectional analysis of the retina and has revolutionized the diagnosis and management of retinal and choroidal diseases. Since its introduction in [...] Read more.

Optical coherence tomography (OCT) imaging has played a pivotal role in the field of retina. This light-based, non-invasive imaging modality provides high-quality, cross-sectional analysis of the retina and has revolutionized the diagnosis and management of retinal and choroidal diseases. Since its introduction in the early 1990s, OCT technology has continued to advance to provide quicker acquisition times and higher resolution. In this manuscript, we discuss some of the most recent advances in OCT technology and techniques for choroidal and retinal diseases. The emerging innovations discussed include wide-field OCT, adaptive optics OCT, polarization sensitive OCT, full-field OCT, hand-held OCT, intraoperative OCT, at-home OCT, and more. The applications of these rising OCT systems and techniques will allow for a closer monitoring of chorioretinal diseases and treatment response, more robust analysis in basic science research, and further insights into surgical management. In addition, these innovations to optimize visualization of the choroid and retina offer a promising future for advancing our understanding of the pathophysiology of chorioretinal diseases. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Imaging: Advances in Ophthalmology)

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