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Clinical Research of Optical Coherence Tomography in Retinal Diseases

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

Deadline for manuscript submissions: closed (14 February 2023) | Viewed by 14806

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Special Issue Editors

Prof. Dr. Maged Alnawaiseh

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Guest Editor

Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
Interests: clinical ophthalmology; glaucoma; retinal diseases; OCT; cataract surgery; corneal diseases; cataract extraction; corneal topography; cataract; myopia

Prof. Dr. Haoyu Chen

E-Mail Website
Guest Editor

The Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
Interests: OCT; clinical ophthalmology; cataract surgery; retinal diseases; macular; eye diseases

Special Issue Information

Dear Colleagues,

Optical coherence tomography (OCT) has been a landmark advance in ophthalmology in recent 30 years. It provides high-speed, high-resolution cross-sectional imaging of tissue in vivo. The application of OCT in clinical research of retinal diseases has provided novel insight into the pathogenesis of retinal diseases and assistance in the diagnosis and management of the patients. There are more than 30,000 articles indexed on PubMed on the topic of retinal optical coherence tomography. The advances in image engineering and artificial intelligence techniques have recently allowed us to manage large amounts of information on OCT images and achieve automatic identification and quantification of retinal lesions, eventually facilitating retinal diseases screening, diagnosis, management and prognosis.

This issue welcomes both original articles and reviews on the clinical research of OCT in retinal diseases.

Topics of interest will include, but are not limited to, the following:

Understanding of new pathogenesis of retinal diseases using in OCT;
Quantitative analysis of retinal OCT images;
Artificial intelligence of retinal OCT images;
Application of OCT imaging on the intervention of retinal diseases;
Retinal OCT images for neurological diseases;
Screening of retinal diseases using OCT;
Retinal OCT imaging for systematic diseases.

Prof. Dr. Maged Alnawaiseh
Prof. Dr. Haoyu Chen
Guest Editors

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

optical coherence tomography
retina
artificial intelligence
image analysis

Published Papers (9 papers)

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Research

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11 pages, 3214 KiB

Open AccessArticle

Comparison of Automated Thresholding Algorithms in Optical Coherence Tomography Angiography Image Analysis

by David Prangel, Michelle Prasuhn, Felix Rommel, Salvatore Grisanti and Mahdy Ranjbar

J. Clin. Med. 2023, 12(5), 1973; https://doi.org/10.3390/jcm12051973 - 02 Mar 2023

Cited by 2 | Viewed by 878

Abstract

(1) Background: Calculation of vessel density in optical coherence tomography angiography (OCTA) images with thresholding algorithms varies in clinical routine. The ability to discriminate healthy from diseased eyes based on perfusion of the posterior pole is critical and may depend on the algorithm applied. This study assessed comparability, reliability, and ability in the discrimination of commonly used automated thresholding algorithms. (2) Methods: Vessel density in full retina and choriocapillaris slabs were calculated with five previously published automated thresholding algorithms (Default, Huang, ISODATA, Mean, and Otsu) for healthy and diseased eyes. The algorithms were investigated with LD-F2-analysis for intra-algorithm reliability, agreement, and the ability to discriminate between physiological and pathological conditions. (3) Results: LD-F2-analyses revealed significant differences in estimated vessel densities for the algorithms (p < 0.001). For full retina and choriocapillaris slabs, intra-algorithm values range from excellent to poor, depending on the applied algorithm; the inter-algorithm agreement was low. Discrimination was good for the full retina slabs, but poor when applied to the choriocapillaris slabs. The Mean algorithm demonstrated an overall good performance. (4) Conclusions: Automated threshold algorithms are not interchangeable. The ability for discrimination depends on the analyzed layer. Concerning the full retina slab, all of the five evaluated automated algorithms had an overall good ability for discrimination. When analyzing the choriocapillaris, it might be useful to consider another algorithm. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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12 pages, 7965 KiB

Open AccessArticle

Retinal Microvascular Signs in Pre- and Early-Stage Diabetic Retinopathy Detected Using Wide-Field Swept-Source Optical Coherence Tomographic Angiography

by Fabao Xu, Zhiwen Li, Yang Gao, Xueying Yang, Ziyuan Huang, Zhiwei Li, Rui Zhang, Shaopeng Wang, Xinghong Guo, Xinguo Hou, Xiaolin Ning and Jianqiao Li

J. Clin. Med. 2022, 11(15), 4332; https://doi.org/10.3390/jcm11154332 - 26 Jul 2022

Cited by 4 | Viewed by 1513

Abstract

Purpose Using a wide-field, high-resolution swept-source optical coherence tomographic angiography (OCTA), this study investigated microvascular abnormalities in patients with pre- and early-stage diabetic retinopathy. Methods 38 eyes of 20 people with diabetes mellitus (DM) type 2 without diabetic retinopathy (DR) and 39 eyes of 21 people with DR were enrolled in this observational and cross-sectional cohort study, and a refractive error-matched group consisting of 42 eyes of 21 non-diabetic subjects of similar age were set as the control. Each participant underwent a wide-field swept-source OCTA. On OCTA scans (1.2 cm × 1.2 cm), the mean central macular thickness (CMT), the vessel density of the inner retina, superficial capillary plexus (SCP), and deep capillary plexus (DCP) were independently measured in the whole area (1.2 cm diameter) via concentric rings with varying radii (0–0.3, 0.3–0.6, 0.6–0.9, and 0.9–1.2 cm). Results Patients whose eyes had pre-and early-stage DR showed significantly decreased vessel density in the inner retina, SCP, DCP and CMT (early-stage DR) compared with the control. In addition, compared with the average values upon wide-field OCTA, the decreases were even more pronounced for concentric rings with a radius of 0.9–1.2 cm in terms of the inner retina, SCP, DCP and CMT. Conclusions Widefield OCTA allows for a more thorough assessment of retinal changes in patients with pre- and early-stage DR.; retinal microvascular abnormalities were observed in both groups. In addition, the decreases in retinal vessel density were more significant in the peripheral concentric ring with a radius of 0.9–1.2 cm. The application of novel and wide-field OCTA could potentially help to detect earlier diabetic microvascular abnormalities. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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14 pages, 5046 KiB

Open AccessArticle

Quantitative Measurements of Vessel Density and Blood Flow Areas Primary Angle Closure Diseases: A Study of Optical Coherence Tomography Angiography

by Bingying Lin, Chengguo Zuo, Xinbo Gao, Danping Huang and Mingkai Lin

J. Clin. Med. 2022, 11(14), 4040; https://doi.org/10.3390/jcm11144040 - 13 Jul 2022

Cited by 1 | Viewed by 1593

Abstract

(1) Purpose: To measure the change in vessel density (VD) and the flow area (FA) on the retina of eyes with primary angle-closure diseases (PACD), including primary angle-closure suspect (PACS), primary angle-closure (PAC), acute primary angle-closure (APAC) and primary angle-closure glaucoma (PACG). (2) Methods: Patients with PACD were prospectively enrolled in this study. All participants underwent thorough ophthalmic examinations. The mean defect (MD), retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thickness, VD measurement, and blood FA were measured. (3) Results: A total of 147 eyes from 121 subjects were included in this study. The VD of the nerve head layer was significantly lower in PACG and APAC (all p < 0.001). APAC and PACG had lower FA of all layers, except for the choroid layer (p < 0.05). The macular VD of the whole image and blood FA in the superficial layer was significantly lower in PACG (all p < 0.001). The MD, RNFL, and GCC thickness demonstrated a strong correlation with whole image VD in the superficial layer (p < 0.001), while the inside disc VD did not show a significant correlation with MD, RNFL, and GCC thickness (p > 0.05). (4) Conclusions: There was a significant decrease in the VD and FA on the optic disc as well as the VD and FA of the superficial layer in the macular area in APAC and PACG. The changes in VD and FA are correlated with the severity of the glaucomatous structural damage and functional impairment. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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9 pages, 1722 KiB

Open AccessArticle

Effect of High Myopia on Delayed Absorption of Subretinal Fluid after Scleral Buckling Surgery

by Yongan Meng, Kejun Long, Jing Chen and Jing Luo

J. Clin. Med. 2022, 11(13), 3906; https://doi.org/10.3390/jcm11133906 - 05 Jul 2022

Cited by 1 | Viewed by 1699

Abstract

This study compared the absorption of subretinal fluid (SRF) in patients with rhegmatogenous retinal detachment (RRD) with and without high myopia after scleral buckling (SB) and investigated the effect of high myopia on SRF absorption. This retrospective study included patients with primary macula-off RRD grouped according to myopia and age. The optical coherence tomography (OCT) and OCT angiography indicators included subretinal fluid height (SRFH), subfoveal choroidal thickness (SFCT), and choroidal capillary blood flow density (CCFD) measured regularly. The presence of SRF 3 months after surgery was defined as delayed absorption. Overall, 90 eyes of 89 patients were enrolled, and 46 eyes (51.11%) had high myopia. In 43 eyes (47.78%), SRF absorption was delayed. There was no significant difference in SRF absorption after SB between the high and non-high myopia groups; younger patients (<35 years) had a higher probability of delayed absorption (p < 0.05). The SFCT in high myopia was significantly thinner than that in the non-high myopia group (p < 0.05); SFCT and SRFH were positively correlated (r_s = 0.275, p = 0.002), and there was a significant difference between the average CCFD with and without SRF (p < 0.05). High myopia had no significant effect on SRF absorption after SB. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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9 pages, 1196 KiB

Open AccessArticle

Changes in the Choroidal Thickness following Intravitreal Bevacizumab Injection in Chronic Central Serous Chorioretinopathy

by Yoo-Ri Chung, Su Jeong Lee and Ji Hun Song

J. Clin. Med. 2022, 11(12), 3375; https://doi.org/10.3390/jcm11123375 - 13 Jun 2022

Cited by 1 | Viewed by 1455

Abstract

We evaluated the effect of intravitreal bevacizumab injection (IVB) on choroidal thickness, and studied its association with the therapeutic response in chronic central serous chorioretinopathy (CSC). The clinical features of 78 eyes with chronic CSC treated with IVB from October 2014 to June 2020 were retrospectively evaluated. Visual acuity (VA), central retinal thickness (CRT), and sub-foveal choroidal thickness (SFCT) were analyzed at baseline, 1 month following initial IVB, and the last follow-up examination. Cases showing complete recovery (resolved eyes; n = 60) were compared with those with persistent subretinal fluid (refractory eyes; n = 18). The relationship between the potential risk factors and subretinal fluid resolution was examined using logistic regression. SFCT was significantly decreased along with the CRT following IVB at the resolved state. SFCT reduction following 1 month of IVB was notably greater in the resolved eyes. The association of refractory eyes with hypertension (p = 0.003) and a thinner baseline SFCT (p = 0.024) was significant. In most of the patients with chronic CSC, VA and CRT remarkably improved following treatment with IVB. Early changes in the SFCT following IVB were associated with the therapeutic response. Patients with hypertension and a thinner baseline SFCT could be unresponsive to IVB. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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10 pages, 2960 KiB

Open AccessArticle

Vitreomacular Interface Disorders in Proliferative Diabetic Retinopathy: An Optical Coherence Tomography Study

by Aidi Lin, Honghe Xia, Anlin Zhang, Xinyu Liu and Haoyu Chen

J. Clin. Med. 2022, 11(12), 3266; https://doi.org/10.3390/jcm11123266 - 07 Jun 2022

Cited by 5 | Viewed by 1850

Abstract

Vitreomacular interface plays an important role in the pathogenesis and progression of proliferative diabetic retinopathy (PDR). This study investigated the prevalence and risk factors of vitreomacular interface disorders (VMID) in PDR. The macular optical coherence tomography (OCT) scans of 493 eyes from 378 PDR patients were retrospectively reviewed to detect VMID, including vitreomacular adhesion (VMA), vitreomacular traction (VMT), epiretinal membrane (ERM), lamellar hole–associated epiretinal proliferation (LHEP), and macular hole (MH). The associations between VMID and baseline factors, intraretinal structure, and visual acuity were analyzed. The prevalence was 78.9% for ERM, 13.4% for VMT, 4.8% for MH, 2.2% for LHEP, and 2.0% for VMA, respectively. On multivariable analyses (odds ratio, 95% confidence interval), fibrovascular proliferation (FVP) was positively associated with MH (8.029, 1.873–34.420), VMT (3.774, 1.827–7.798), and ERM (2.305, 1.460–3.640). High-risk PDR was another risk factor of ERM (1.846, 1.101–3.090). Female gender was positively associated with MH (3.836, 1.132–13.006), while vitreous hemorrhage was negatively associated with MH (0.344, 0.133–0.890). Eyes with all VMID subtypes showed more frequent macular cysts and tractional retinal detachment with poorer visual acuity (p ≤ 0.001). Therefore, the prevalence of VMID was considerably high, indicating that this distinct entity should be considered in interventions for PDR. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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12 pages, 3504 KiB

Open AccessArticle

Prediction of the Short-Term Therapeutic Effect of Anti-VEGF Therapy for Diabetic Macular Edema Using a Generative Adversarial Network with OCT Images

by Fabao Xu, Shaopeng Liu, Yifan Xiang, Jiaming Hong, Jiawei Wang, Zheyi Shao, Rui Zhang, Wenjuan Zhao, Xuechen Yu, Zhiwen Li, Xueying Yang, Yanshuang Geng, Chunyan Xiao, Min Wei, Weibin Zhai, Ying Zhang, Shaopeng Wang and Jianqiao Li

J. Clin. Med. 2022, 11(10), 2878; https://doi.org/10.3390/jcm11102878 - 19 May 2022

Cited by 4 | Viewed by 1519

Abstract

Purpose: To generate and evaluate individualized post-therapeutic optical coherence tomography (OCT) images that could predict the short-term response of anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME) based on pre-therapeutic images using generative adversarial network (GAN). Methods: Real-world imaging data were collected at the Department of Ophthalmology, Qilu Hospital. A total of 561 pairs of pre-therapeutic and post-therapeutic OCT images of patients with DME were retrospectively included in the training set, 71 pre-therapeutic OCT images were included in the validation set, and their corresponding post-therapeutic OCT images were used to evaluate the synthetic images. A pix2pixHD method was adopted to predict post-therapeutic OCT images in DME patients that received anti-VEGF therapy. The quality and similarity of synthetic OCT images were evaluated independently by a screening experiment and an evaluation experiment. Results: The post-therapeutic OCT images generated by the GAN model based on big data were comparable to the actual images, and the response of edema resorption was also close to the ground truth. Most synthetic images (65/71) were difficult to differentiate from the actual OCT images by retinal specialists. The mean absolute error (MAE) of the central macular thickness (CMT) between the synthetic OCT images and the actual images was 24.51 ± 18.56 μm. Conclusions: The application of GAN can objectively demonstrate the individual short-term response of anti-VEGF therapy one month in advance based on OCT images with high accuracy, which could potentially help to improve treatment compliance of DME patients, identify patients who are not responding well to treatment and optimize the treatment program. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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10 pages, 2092 KiB

Open AccessArticle

Association between Different Grades of Myopic Tractional Maculopathy and OCT-Based Macular Scleral Deformation

by Jingyang Feng, Ruonan Wang, Jiayi Yu, Qiuying Chen, Jiangnan He, Hao Zhou, Yuchen Du, Chen Liu, Weijun Wang, Xun Xu, Xian Xu and Ying Fan

J. Clin. Med. 2022, 11(6), 1599; https://doi.org/10.3390/jcm11061599 - 14 Mar 2022

Cited by 2 | Viewed by 1800

Abstract

Purpose: To investigate the characteristics of macular outward scleral height (MOSH) in different grades of myopic tractional maculopathy (MTM) and explore the risk factors for MTM. Methods: A total of 188 eyes (188 participants) with high myopia were divided into the no MTM (nMTM) group and the MTM group, which was further graded into foveoschisis, foveal detachment, full-thickness macular hole, and macular hole with retinal detachment. Swept-source optical coherence tomography was used to measure the MOSH. Results: No significant differences were found in axial length between the nMTM and MTM groups (p = 0.295). The MOSH was significantly higher in the MTM group (p < 0.001), which was identified as a risk factor for MTM (OR = 1.108, p < 0.001). The proportion of eyes with severe atrophic myopic maculopathy (AMM) was higher in the MTM group (28.48%) (p = 0.003). The macular hole with foveoschisis (MH/FS+) subgroup presented a higher average MOSH (p = 0.012) and more severe AMM (p = 0.009) than the macular hole without foveoschisis (MH/FS−) subgroup. Conclusion: MOSH would be more suitable for estimating MTM occurrence than axial length. The grading of AMM helps to evaluate the severity of MTM. The categorization of MH/FS− as a distinct grade from MH/FS+ might be preferable. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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Review

Jump to: Research

17 pages, 3864 KiB

Open AccessReview

Research Trends and Hotspots of Retinal Optical Coherence Tomography: A 31-Year Bibliometric Analysis

by Aidi Lin, Xiaoting Mai, Tian Lin, Zehua Jiang, Zhenmao Wang, Lijia Chen and Haoyu Chen

J. Clin. Med. 2022, 11(19), 5604; https://doi.org/10.3390/jcm11195604 - 23 Sep 2022

Cited by 2 | Viewed by 1567

Abstract

The emergence of optical coherence tomography (OCT) over the past three decades has sparked great interest in retinal research. However, a comprehensive analysis of the trends and hotspots in retinal OCT research is currently lacking. We searched the publications on retinal OCT in the Web of Science database from 1991 to 2021 and performed the co-occurrence keyword analysis and co-cited reference network using bibliometric tools. A total of 25,175 publications were included. There has been a progressive increase in the number of publications. The keyword co-occurrence network revealed five clusters of hotspots: (1) thickness measurements; (2) therapies for macular degeneration and macular edema; (3) degenerative retinal diseases; (4) OCT angiography (OCTA); and (5) vitrectomy for macular hole and epiretinal membrane. The co-citation analysis displayed 26 highly credible clusters (S = 0.9387) with a well-structured network (Q = 0.879). The major trends of research were: (1) thickness measurements; (2) therapies for macular degeneration and macular edema; and (3) OCTA. Recent emerging frontiers showed a growing interest in OCTA, vessel density, choriocapillaris, central serous chorioretinopathy, Alzheimer’s disease, and deep learning. This review summarized 31 years of retinal OCT research, shedding light on the hotspots, main themes, and emerging frontiers to assist in future research. Full article

(This article belongs to the Special Issue Clinical Research of Optical Coherence Tomography in Retinal Diseases)

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