Search Results (2,841)

Objectives: We aimed to descriptively evaluate the feasibility and clinical utility of TowardPi BO (4K ultra-HD microscope integrated with a 400 kHz swept-source intraoperative optical coherence tomography (SS-iOCT) system) in managing various ophthalmic surgical conditions in a real-world setting. Methods: We analyzed surgical videos and data from 123 consecutive cases that underwent elective surgery with the assistance of this SS-iOCT system at Beijing Tongren Hospital between 2 September 2025 and 10 February 2026. Cases were included when the iOCT provided critical, real-time information that directly influenced surgical decision-making or technique modification. Cases were excluded if iOCT served only routine confirmatory or educational purposes without altering the surgical plan. Results: A total of 72 surgical cases were included, comprising 7 intraocular lens implantations with ciliary sulcus fixation, 19 macular holes, 3 cases of macular hole retinal detachment (MHRD), 4 cases of macular schisis with or without foveal detachment (MSRD), 12 cases of submacular hemorrhage, 20 cases of rhegmatogenous retinal detachment (RRD), and 7 intraocular mass lesions. The 400 kHz SS-iOCT significantly aided in surgical visualization, guided real-time decision-making, and prompted modifications in surgical techniques. Conclusions: To our knowledge, this is the first real-world study to evaluate the application of a 400 kHz SS-iOCT system across a wide spectrum of ophthalmic conditions, including its novel use in intraocular tumors. From routine to complex surgical cases, SS-iOCT enhances surgical precision and facilitates real-time decision-making, ultimately contributing to improved surgical outcomes. Full article

Background/Objectives: This review describes the advantages of new photonic-based approaches for assessing the activity of caries lesions. Many lesions have been arrested or are non-carious developmental defects, such as fluorosis, which do not require intervention. New methods are needed to assess lesion activity and avoid unnecessary removal of the tooth structure. Methods: At present, there are no reliable methods for assessing lesion activity in vivo. Nondestructive optical monitoring of lesion structure and the changes in light scattering that occur during drying offer the potential for lesion activity assessment during a single examination. Since optical diagnostic instruments exploit changes in the porosity and the permeability of the lesion, they have the potential to assess whether lesions are active and expanding or arrested and undergoing remineralization. Optical coherence tomography (OCT), Raman imaging and fluorescence loss, thermal and short-wavelength infrared (SWIR) reflectance measurements during lesion dehydration with forced air are presented. Results: Clinical studies have shown that optical coherence tomography is capable of showing distinct structural differences between active and arrested lesions on coronal and root surfaces. Differences in the kinetics of dehydration measured using reflectance measurements at SWIR wavelengths coincident with water absorption bands also show great potential. Conclusions: OCT and dehydration imaging at SWIR wavelengths have great potential for assessing lesion activity since they can also be used for caries screening, are safe for frequent monitoring and do not require the application of external agents. Full article

Optical coherence tomography (OCT) is an optical imaging modality that provides high-resolution cross-sectional imaging of biological tissues noninvasively. In Fourier-domain OCT, axial resolution is governed by both the center wavelength and the spectral bandwidth of the light source; therefore, limited or discontinuous bandwidth degrades depth resolution and introduces sidelobes and artifacts in OCT images. To address these issues in OCT image reconstruction from gapped spectra, a sparse parameter estimation approach based on Sparse Iterative Covariance-based Estimation (SPICE) is proposed in this study. By utilizing a sparse parameter estimation framework to directly resolve depth-dependent components from discontinuous interferograms, SPICE enhances axial resolution while suppressing sidelobe artifacts inherent in standard interpolation. Experiments on multi-layered tape, oral epithelium, and finger skin show that SPICE visually suppresses gap-induced sidelobe artifacts and improves structural interpretability under representative gap conditions. Quantitative evaluations on multi-layer tape and biological tissues show that SPICE reduces axial FWHM by 30–45%, increases SSIM by 0.15–0.25, and achieves significantly lower computational cost than GAPES (p < 0.01). Full article

Background/Objectives: Although vascular mechanisms are increasingly implicated in the etiology of sudden sensorineural hearing loss (SSNHL), the inability to directly visualize the labyrinthine artery remains a diagnostic obstacle. Sharing embryological and physiological parallels with the inner ear, the eye represents an accessible surrogate organ capable of reflecting systemic microvascular status. This study aimed to evaluate the diagnostic value of ocular hemodynamic and structural parameters in patients with acute unilateral idiopathic SSNHL. Methods: This prospective, comparative, cross-sectional study enrolled 30 patients with acute unilateral idiopathic SSNHL and 25 age and sex matched healthy controls. Three groups were defined: the affected eye, the contralateral eye, and the control eye. Retrobulbar hemodynamics (PSV, EDV, RI, PI) were assessed by color Doppler imaging; peripapillary choroidal thickness, RNFL, GCC+, and macular thickness by swept-source OCT; and macular microvascular perfusion by OCT angiography. Results: End diastolic velocity in the posterior ciliary arteries was significantly reduced in both patient eye groups relative to controls (p < 0.001), while RI and PI were significantly elevated (p = 0.001 and p = 0.004, respectively). Comparable hemodynamic impairment was observed in the ophthalmic artery. Peripapillary choroidal thickness was bilaterally reduced in the inferior and temporal quadrants in both patient groups (p = 0.003 and p = 0.010). No significant difference was detected between affected and contralateral eyes in any parameter. RNFL, GC+, and macular thickness remained comparable across all groups. Conclusions: The bilateral symmetry of hemodynamic impairment and choroidal thinning suggests that SSNHL arises against a background of systemic microvascular disease. The combined use of OCT and color Doppler ultrasonography holds clinical potential as a non-invasive biomarker panel for defining the vascular phenotype of the condition. Full article

Background/Objectives: Optical coherence tomography (OCT) and OCT angiography (OCT-A) provide detailed measurements of retinal structure and vasculature; however, age-related differences in how these parameters correlate with one another remain poorly understood. We hypothesized that vascular–structural integration in the macula is more pronounced in adults than in children. Our aim was to characterize correlation patterns in pediatric and adult populations to inform the development of age-specific clinical interpretation guidelines. Methods: This prospective cross-sectional observational study enrolled 37 healthy children (age 1–17 years) and 28 healthy adults (age 18–65 years). Eyes with ocular or systemic conditions affecting the retina or prior intraocular surgery were excluded. Standardized OCT and OCT-A acquisition protocols provided structural and vascular measures. Univariable correlation analyses applied a stringent threshold (p < 0.001) to identify robust associations. Significant univariable results were entered into multivariable regression models adjusting for age, gender, intraocular pressure, and axial length. A Group-wise Linkage Proportion quantified the percentage of potential significant correlations among eight predefined anatomical parameter groups. Results: Ninety univariable correlations met p < 0.001. Fourteen correlations were shared across age groups, notably foveal avascular zone metrics and vessel density, showing very large negative correlations (r = −0.70 to −0.87). The pediatric cohort displayed 40 unique correlations, primarily linking optic nerve head flow indices to retinal nerve fiber layer thickness. Adults exhibited 36 unique correlations, dominated by macular vascular–thickness coupling concentrated in the parafoveal region. After multivariable adjustment, 52 of 90 associations remained significant. Adult-specific associations lost significance more frequently (58%) than pediatric-specific associations (43%), whereas correlations shared across both groups showed complete stability (100%). The Group-wise Linkage Proportion indicated pronounced macular vascular–structural coupling in adults (48.4%) versus near absence in children (1.2%). Conclusions: Retinal parameter correlation patterns show fundamental differences between pediatric and adult eyes. While optic nerve head-macular thickness relationships remain consistent across ages, adults exhibit mature, localized integration of macular vascular and structural parameters absent in children. These findings suggest that pediatric and adult OCT/OCT-A measurements may benefit from separate reference standards, although prospective validation is required before clinical implementation. Full article

Background/Objectives: This study aimed to investigate the correlation between macular flow density (FD) as well as foveal avascular zone (FAZ) characteristics and optic disc size, quantified by Bruch’s membrane opening area (BMOA). In addition, potential differences in FD and FAZ parameters among optic disc size cohorts were evaluated. Methods: In this retrospective, single-centre study, 151 eyes from 151 healthy participants examined at the University Hospital Münster, Germany, were included. Each subject underwent macular and optic disc optical coherence tomography angiography (OCT-A). Rank correlation coefficients for clustered data were computed to assess associations between FD values and BMOA. Further analyses compared FD and FAZ parameters among three optic disc size groups based on their quantiles. Results: Statistical analysis revealed a significant negative correlation between FD in several macular subsectors and BMOA. When stratified by optic disc size, FD in the superficial capillary plexus (SCP) was significantly higher in eyes with the smallest discs compared with intermediate ones, and FD in the deep capillary plexus (DCP) was significantly higher in intermediate discs compared with the largest group. Additionally, both SCP and DCP showed higher absolute FD values in eyes with the smallest optic discs compared with those with the largest. No significant group differences were detected for foveal FD, FAZ area, or FAZ perimeter. Conclusions: This study contributes to normative OCT-A data by incorporating optic disc size as a variable. While FAZ parameters appeared independent of BMOA, eyes with smaller optic discs demonstrated higher FD values in both SCP and DCP. Full article

Objectives: To characterize the one-year functional, anatomical, and molecular responses to intravitreal Ranibizumab in treatment-naïve patients with neovascular age-related macular degeneration (nAMD), and to identify systemic immune and miRNA signatures associated with treatment response. Methods: This prospective longitudinal observational study included 44 treatment-naïve patients with nAMD. Patients received up to four monthly intravitreal Ranibizumab injections, followed by a treat-and-extend regimen. Best-corrected visual acuity using ETDRS letters, central retinal thickness by optical coherence tomography, fluorescein angiography, and OCT angiography were assessed at baseline and 12 months. Peripheral blood samples were collected at both time points to quantify seven circulating cytokines using an IMMULITE chemiluminescent immunoassay and to profile 37 candidate miRNAs by TaqMan OpenArray RT-qPCR from leukocyte-derived RNA. Treatment response was classified using composite anatomical and functional criteria, including intraretinal/subretinal fluid resolution, ≥25% central retinal thickness reduction, and a ≥5 ETDRS letter gain. Results: At one year, patients showed significant central retinal thickness reduction and overall visual stabilization, although good and poor responders differed according to composite response criteria. Statin use was numerically more frequent among poor responders, although this difference was not statistically significant. Soluble IL-2R increased significantly over time in the overall cohort, mainly driven by good responders who showed higher median levels at both visits. IL-8 also increased globally, without significant between-group differences. Among differentially expressed miRNAs, miR-3121 was the only candidate reaching statistical significance and was downregulated in good responders. ROC analysis showed moderate discriminative performance for miR-3121, with an AUC of 0.76. Conclusions: One-year response to Ranibizumab in nAMD may involve systemic immune activation and miRNA regulation. miR-3121 emerges as a candidate biomarker of treatment response, supporting further validation in larger independent cohorts. Full article

Accurate assessment of vitreous inflammation is essential for the diagnosis, monitoring and management of uveitis. Traditionally, vitritis has been evaluated using subjective clinical grading systems based on vitreous haze and cellular infiltration, which are limited by interobserver variability and poor reproducibility, particularly in cases of mild or subclinical inflammation. In recent years, advances in ocular imaging have enabled the development of more objective, quantitative approaches. Ultra-widefield imaging, optical coherence tomography (OCT) and ultrasound-based techniques have provided new insights into structural alterations within the vitreous. In parallel, automated image analysis and artificial intelligence (AI)-based methods have improved the detection and quantification of inflammatory biomarkers, including vitreous hyperreflective foci and signal intensity-based metrics. Despite these advances, important limitations remain, including a restricted field of view, a lack of standardized segmentation algorithms and an incomplete representation of the entire vitreous cavity. No single modality currently provides a comprehensive and fully reproducible assessment of vitreous inflammation. This review summarizes current qualitative and quantitative methods for evaluating vitreous inflammation, highlighting their respective strengths and limitations. In addition, emerging diagnostic strategies, including multimodal imaging integration, AI-driven analysis and molecular biomarker profiling, are discussed as potential tools to improve accuracy, standardization and clinical applicability. The transition from subjective grading toward objective quantification of inflammatory burden represents a key step in advancing both clinical management and research in ocular inflammatory diseases. Full article

Background/Objectives: Dyslipidemia is increasingly linked to retinal microvascular changes, yet its impact in pediatric populations remains unclear. Given the retina’s role as a microvascular model, this review evaluates the association between dyslipidemia and retinal vascular alterations in children and adolescents. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to evaluate the association between lipid profiles, body composition, and retinal vascular parameters in individuals younger than 19 years. Four eligible studies were found. Results: Triglyceride (TG) levels, total cholesterol (TC) levels, low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (apoB) levels were associated with smaller retinal arteriole diameters (CRAE), whereas there was no consistent association between venular diameter (CRVE) and lipid levels. In addition, families with familial hypercholesterolemia (FH) had lower capillary densities and larger foveal avascular zone areas detected by optical coherence tomography angiography (OCT-A) compared to control subjects. The presence of both obesity and dyslipidemia resulted in greater degrees of arteriolar narrowing. Conclusions: These findings suggest that adverse metabolic profiles in childhood may be linked to early microvascular alterations. However, the limited number of heterogeneous studies highlights the need for larger longitudinal investigations. Full article

Purpose: This study aimed to validate a deep learning algorithm for automated segmentation and quantitative assessment of the ellipsoid zone (EZ) and the retinal pigment epithelium (RPE)–Bruch’s membrane (BM) complex in healthy eyes and geographic atrophy (GA) eyes. Methods: In this retrospective study, spectral-domain optical coherence tomography (SD-OCT) volume scans from 30 healthy eyes and 30 eyes with GA were analyzed. An NMI-Outer Retina Analyzer was used to segment the inner EZ, inner RPE, and outer BM. Average thicknesses of the EZ-RPE, EZ-BM, and RPE-BM were calculated from volumes and across nine ETDRS sectors. Manual segmentations were corrected by two masked expert graders and compared using intraclass correlation coefficients (ICCs). Dice coefficients (DCs), Pearson correlation coefficients, and absolute thickness differences were used to assess agreement between automated and manual segmentation. Heat maps were generated to visualize thickness. Results: Thirty healthy eyes and thirty GA eyes were included in the analysis. Mean EZ-RPE, EZ-BM, and RPE-BM thicknesses were 47.55 ± 6.75 µm, 69.49 ± 6.92 µm, and 21.94 ± 3.46 µm, respectively, in the healthy eyes and 15.65 ± 11.09 µm, 39.18 ± 23.28 µm, and 23.52 ± 16.21 µm, respectively, in GA eyes. The model demonstrated high segmentation accuracy, with a mean DC of 0.998 in healthy eyes and 0.995–0.998 in GA eyes. In healthy eyes, differences between automated and manual measurements were minimal (1.42 ± 3.39 μm (2.98%) for EZ-RPE, 1.31 ± 3.18 μm (1.88%) for EZ-BM, and 0.67 ± 1.71 μm (3.05%) for RPE-BM), all within 1.88–3.05% of the gold standard (manual corrections). In contrast, GA eyes showed greater variability (mean differences of 3.61 ± 8.62 μm (23.06%) for EZ-RPE, 4.28 ± 11.34 μm (10.92%) for EZ-BM, and 4.4 ± 10.45 μm (18.71%) for RPE-BM). Heat maps revealed increased variability in the junctional zone surrounding the atrophy. Automated and manual measurements showed strong correlations across all sectors in GA eyes (r = 0.97 for EZ-BM, 0.96 for EZ-RPE, and 0.89 for RPE-BM). Conclusions: The NMI-ORA enables accurate, automated segmentation and quantification of outer retinal layers, with performance comparable to that of expert graders. Full article

Background: Hydroxychloroquine (HCQ) is widely used in systemic lupus erythematosus (SLE), yet cumulative exposure may result in progressive retinal toxicity. Structural biomarkers capable of identifying subclinical damage remain incompletely defined. Methods: In this cross-sectional controlled study, 60 female SLE patients receiving HCQ for ≥5 years (22 with clinically detectable maculopathy and 38 without) and 30 healthy controls underwent a comprehensive ophthalmologic assessment including spectral-domain optical coherence tomography (SD-OCT). Peripapillary retinal nerve fiber layer (RNFL) and macular thickness parameters were analyzed. Logistic regression and ROC analysis evaluated exposure-related risk. Results: Patients with clinically detectable maculopathy demonstrated significant superior and temporal RNFL thinning compared with patients with clinically undetectable maculopathy and controls (p ≤ 0.021). Inferior quadrant thinning was detectable in patients without ophthalmoscopic changes, suggesting subclinical neuroaxonal involvement. Parafoveal macular thinning was observed exclusively in the clinically detectable maculopathy group (p = 0.041). Cumulative dose >1000 g independently predicted toxicity (OR 3.84; 95% CI 1.72–8.56). The combined structural–exposure model demonstrated strong discrimination (AUC 0.89). Conclusions: HCQ-related retinal structural changes may be detectable on OCT in the absence of clinically apparent retinal findings. Our results support the concept of a dose-associated structural continuum in HCQ-related retinal injury, involving both inner retinal neuroaxonal parameters and parafoveal macular alterations. However, the cross-sectional design does not allow determination of the temporal sequence of inner versus outer retinal changes. Further longitudinal studies with combined inner and outer retinal layer-specific analysis are required before these findings can inform modifications to current screening strategies. Full article

Background/Objectives: The objective of this study was to evaluate macular perfusion changes after intracameral injection (ICI) of cefuroxime at the end of phacoemulsification. Methods: Patients who underwent routine phacoemulsification were enrolled. Subjects in the case group had ICI 1 mg/0.1 mL cefuroxime at the end of surgery. Using optical coherence tomography angiography (OCT-A), macular perfusions were assessed at T0 (before surgery), T1, T10, T30, and T90 (days after surgery). Perfusion parameters were calculated in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP). Independent t-tests were used to compare the changes from baseline in each parameter between groups. Results: A total of 33 eyes in the case group and 27 eyes in the control group were enrolled. After surgery, the case group showed a less pronounced reduction in the foveal avascular zone (FAZ) in the DCP at T10 (−0.06 ± 0.23 vs. −0.18 ± 0.18 mm², p = 0.041) and T30 (−0.04 ± 0.20 vs. −0.16 ± 0.24 mm², p = 0.050). At T90, there was no statistically significant difference in the FAZ change in the DCP between the groups. The postoperative changes in the vessel density, skeleton density, and acircularity index of the FAZ in the SCP and DCP, central retinal thickness, and best-corrected visual acuity were similar between the groups in all 3 months. Conclusions: Our findings indicate that intraoperative ICI low-dose cefuroxime is associated with a temporary deceleration in FAZ reduction in the DCP during the first postoperative month. From a personalized medicine perspective, these layer-specific microanatomic variations suggest that, while prophylactic cefuroxime is globally safe—demonstrating no evidence of inducing capillary dropout, aggravating macular thickening, or compromising visual outcomes within this cohort—preoperative and postoperative OCT-A monitoring can serve as an individualized screening framework to track subclinical perfusion dynamics, especially in patients with compromised retinal baselines. Full article

Background and Objectives: Non-invasive biomarkers reflecting neurodegeneration are increasingly important in multiple sclerosis (MS). Optical coherence tomography (OCT) provides quantitative measures of retinal structure, most commonly peripapillary retinal nerve fiber layer (pRNFL) thickness. However, the potential clinical relevance of optic nerve head morphology, including cup-to-disc ratio (CDR), remains insufficiently explored. We investigated associations between OCT-derived parameters, subjective visual vertical (SVV), and disability in MS. Materials and Methods: In this retrospective study, 100 patients with MS were included. OCT parameters (pRNFL thickness and area-based CDR) were analyzed at baseline and follow-up. Clinical disability was assessed using the Expanded Disability Status Scale (EDSS). Detailed optic neuritis history was not consistently available in the retrospective clinical records and therefore could not be systematically accounted for in the analyses. SVV was evaluated in 37 patients using a virtual reality–based protocol. Associations were assessed using Spearman correlation and linear regression analyses. Multivariable regression models were adjusted for age, sex, and follow-up duration. Results: pRNFL thickness was not associated with baseline EDSS (rho = −0.06, p = 0.55) or annualized EDSS change. Baseline CDR correlated with both baseline EDSS (rho = 0.30, p = 0.0065) and follow-up EDSS (rho = 0.46, p < 0.0001). In univariable regression analysis, baseline CDR was associated with follow-up EDSS (B = 3.33, R² = 0.23, p < 0.0001), remaining significant after adjustment for age, sex, and follow-up duration (B = 2.59, 95% CI 1.26–3.92, p = 0.0002). No significant associations were observed between OCT parameters and SVV measures. Conclusions: Higher CDR values, but not pRNFL thickness, were associated with disability measures in this exploratory MS cohort. However, these findings should be interpreted cautiously because optic neuritis history could not be systematically accounted for and physiological optic disc variability may substantially influence CDR measurements. Full article

(1) Background: Ultra-early optical coherence tomography (OCT) changes following intravitreal injection may reflect transient mechanical compression rather than pharmacologic effects; however, this temporal profile has not been rigorously characterised with appropriate statistical methodology. (2) Methods: In this prospective observational study, 40 eyes of 40 consecutive patients (one per patient) with macular edema secondary to neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or chronic central serous retinopathy (CSR) underwent intravitreal bevacizumab (n = 35) or triamcinolone acetonide (n = 5). Goldmann applanation tonometry and spectral-domain OCT were performed at baseline, 2–5 min, 15 ± 5 min, 24 h, and 48 h post-injection. Repeated-measures ANOVA with Greenhouse–Geisser correction, linear regression, and Spearman rank correlation were applied. (3) Results: Central subfield thickness (CST) decreased markedly at 15 ± 5 min (mean −24.8 ± 11.5%; 95% CI: −28.5% to −21.1%; p < 0.001; partial η² = 0.70), with near-complete rebound by 48 h (−1.0%; p = 0.400). Peak intraocular pressure (IOP) elevation correlated with CST reduction (Spearman r_s = 0.61; 95% CI: 0.39–0.77; p < 0.001), and baseline CST predicted thinning magnitude (R² = 0.52; p < 0.001). (4) Conclusions: Ultra-early OCT thinning after intravitreal injection is consistent with transient mechanical compression. Retinal thickness measurements within 48 h post-injection should be interpreted with caution when assessing treatment response, as early anatomic reduction may not reflect pharmacologic efficacy. Full article

Rapid and non-contact surface inspection is essential for quality control in modern production. Optical coherence tomography (OCT) can image a surface without contact, but turning those images into roughness parameters usually requires specialized processing software. This study examined whether a multimodal large language model (LLM) could estimate roughness parameters directly from OCT B-scans as a screening tool. The study was designed as a controlled macro-scale proof of concept using periodic, analytically defined phantoms rather than as validation on stochastic industrial micro-roughness. Five test surfaces with exactly known geometries were designed, 3D-printed, and scanned with a spectral-domain OCT system. For each surface, roughness values were computed from the theoretical shape, extracted from the OCT image using MATLAB, and also estimated by the LLM from the same image. The repeatability of the LLM was checked by running the same prompt ten times per surface. On a sawtooth profile, the LLM estimates varied by 3.8% for Ra, 4.2% for Rq, 3.5% for Rp, 2.8% for Rv, and 3.1% for Rt. Across all five surfaces, the variation in Ra and Rq was around 3–5%, and for Rt, it stayed below 5%. The results show that a generative AI approach can produce repeatable roughness estimates that are useful for comparative screening. This method offers a flexible option for surface comparison and AI-assisted quality control when calibrated measurements are not required. Full article