Search Results (232)

Background/Objectives: Retinal optical coherence tomography (OCT) has emerged as a sensitive biomarker of neurodegeneration in multiple sclerosis (MS), yet eyes without overt optic neuritis (ON) are routinely pooled as “clinically unaffected” despite their heterogeneous histories. We evaluated whether never-ON eyes and fellow eyes after unilateral ON differ structurally and microvascularly using swept-source OCT (SS-OCT) and OCT angiography (OCTA). Methods: In this cross-sectional, single-center study, 126 clinically unaffected MS eyes—96 never-ON eyes and 30 fellow eyes after unilateral ON—were compared with 118 healthy control eyes. SS-OCT quantified ganglion cell–inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and macular RNFL (mRNFL) thickness, while OCTA measured superficial vascular plexus (SVP) vessel density. Between-group differences were assessed using generalized estimating equations with participant-level clustering, empirical (sandwich) standard errors, adjustment for age and sex, and false discovery rate correction. Results: Despite preserved visual acuity, both never-ON and fellow eyes showed structural retinal thinning relative to controls. GCIPL thickness followed a stepwise gradient—66.14 ± 4.31, 62.08 ± 7.03, and 58.03 ± 7.71 µm in controls, never-ON eyes, and fellow eyes, respectively (FDR-adjusted q = 0.020 for fellow vs. never-ON eyes)—and pRNFL and mRNFL showed a similar overall pattern. After false discovery rate correction, OCTA parameters did not differ significantly between groups. Conclusions: Clinically unaffected eyes in MS are not structurally normal, and fellow eyes after unilateral ON carry a greater burden of silent retinal damage than never-ON eyes. These two phenotypes should be analyzed separately in MS imaging research. Structural OCT measures, particularly GCIPL thickness, appear more sensitive than microvascular indices for detecting subclinical retinal involvement. Full article

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: Cystic fibrosis (CF) is a systemic genetic disorder characterized by chronic inflammation, hypoxia, and metabolic imbalance that may affect neural and microvascular structures. While previous studies have evaluated superficial optic nerve head (ONH) parameters in CF, deep ONH structures, particularly the lamina cribrosa (LC), remain insufficiently explored. This study aimed to assess both superficial and deep ONH morphology in adults with CF using swept-source optical coherence tomography (SS-OCT). Methods: This observational case–control study included 34 CF individuals and 34 age- and sex-matched healthy controls. CF patients were examined at baseline and after 12–18 months of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy. All participants underwent comprehensive ophthalmic examination and SS-OCT imaging. Assessed parameters included peripapillary retinal nerve fiber layer (RNFL) thickness, lamina cribrosa thickness (LCT), and lamina cribrosa depth (LCD). Between-group comparisons were performed using ANCOVA adjusted for axial length (AL) and IOP. Results: After adjustment for AL and IOP, total RNFL thickness did not differ significantly between the CF group and controls (F(1,92) = 0.363, p = 0.548). However, CF patients demonstrated significantly reduced central LCT (170.2 µm [95% CI 162.2–178.2] vs. 214.6 µm [95% CI 208.6–220.7]; F(1,91) = 72.205, p < 0.001) without markedly altered LCD (425.5 µm [95% CI 390.4–454.2] vs. 354.7 µm [95% CI 329.6–379.8]; F(1,94) = 10.090, p = 0.099) compared with controls. Intraocular pressure was also higher in CF patients (17.50 mmHg [95% CI 16.60–18.41] vs. 15.87 mmHg [95% CI 15.19–16.55]; F(1,83) = 7.660, p = 0.007). Longitudinally, total RNFL thickness decreased from 106.5 µm (IQR 15.25) to 102.0 µm (IQR 15.5) following therapy (z = 3.488, p < 0.001), while LCT (p = 0.364) and LCD (p = 0.660) remained stable. Conclusions: CF is associated with significant alterations in deep ONH structures, characterized by thinner LC, independent of ocular biometry. In contrast, superficial RNFL differences appear to be largely influenced by AL. LC parameters, particularly LCT, may represent potential structural markers of systemic involvement in CF, pending further validation. Full article

Background/Objectives: Granulomatous uveitis comprises a clinically heterogeneous group of inflammatory disorders, including ocular sarcoidosis, Vogt–Koyanagi–Harada disease, sympathetic ophthalmia, tuberculosis-associated uveitis, and syphilitic uveitis. Because these entities may share overlapping posterior segment findings, clinical examination alone is often insufficient for differential diagnosis, particularly when choroidal, retinal, or retinal vascular involvement predominates. Methods: This review provides a clinically oriented overview of multimodal imaging in granulomatous uveitis, including optical coherence tomography (OCT), enhanced-depth imaging OCT, swept-source OCT, OCT angiography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and ultrawidefield imaging. Results: Emphasis is placed on imaging patterns that help localize the predominant anatomic compartment of inflammation, distinguish major etiologies, identify diagnostic pitfalls, and assess disease activity over time. By integrating current evidence with representative multimodal imaging findings, we propose an anatomic and decision-oriented framework for interpreting granulomatous posterior segment inflammation. Conclusions: Particular attention is given to the distinction between active inflammation and irreversible structural damage, as this distinction may influence treatment escalation or tapering, timing of elective surgery, local corticosteroid therapy, and the need for diagnostic sampling in infectious or masquerade-like presentations. Full article

Background/Objectives: Intraoperative margin assessments of oral squamous cell carcinoma (SCC) are fundamentally limited by sampling errors and freezing artifacts inherent to standard frozen section analysis. We developed a mobile, multi-scale, wide field-of-view (FOV) swept-source optical coherence tomography/microscopy (SS-OCT/OCM) system operating in the Near-Infrared-II (NIR-II) window (1.68 μm) to provide a rapid, non-destructive, volumetric evaluation of excised oral mucosal tissues. Methods: To correlate optical images with histopathology, we engineered a custom 3D-printed tissue cassette that physically mitigates macroscopic shrinkage during scanning and subsequent tissue fixation. A three-axis motorized assembly extends the effective imaging FOV without compromising resolution, while a custom 3D multi-resolution pyramid stitching algorithm synthesizes wide-FOV mosaics. Results: The customized cassette enabled precise, one-to-one spatial correlation between optical volumes and histopathology sections. Crucially, a 3 × 3 mosaic scan acquired with a 10× objective balanced imaging resolution and acquisition time, providing sufficient structural clarity to visualize basement membrane loss—a hallmark of SCC invasion. Conclusions: This 1.68 μm, fully automatic, multiscale SS-OCT/OCM platform demonstrates the feasibility of serving as a rapid, three-dimensional imaging tool for potential future use as an adjunct to conventional frozen sections. Full article

Retinal detachment (RD) is a potentially sight-threatening condition that requires timely diagnosis and appropriate surgical management. In macula-off rhegmatogenous retinal detachment (RRD), visual recovery after successful reattachment remains highly variable, highlighting the need for reliable preoperative prognostic markers. This study focuses on the contribution of advanced retinal imaging to the preoperative assessment of macula-off RRD, summarizing current evidence on imaging-derived biomarkers associated with disease severity and postoperative functional outcome. In this narrative review, we analyze studies employing spectral-domain and swept-source optical coherence tomography (SD-OCT and SS-OCT), OCT angiography (OCT-A), and adaptive optics OCT (AO-OCT) to characterize microstructural and microvascular retinal alterations. Emerging approaches, including ultra-widefield OCT (UWF-OCT) and artificial intelligence-based image analysis, are also discussed for their potential role in refining diagnosis, supporting surgical planning, and improving prognostic stratification. While several imaging parameters appear promising, their prognostic value is not yet fully realized. Further prospective studies are required to validate clinically meaningful imaging biomarkers and to integrate advanced imaging into routine preoperative decision-making for macula-off RRD. Full article

Background/Objectives: We evaluated whether resin infiltration treatment of demineralized enamel improves shear bond strength (SBS). Methods: Thirty permanent bovine incisor teeth were assigned randomly into three groups (n = 10 per group): control group, demineralized enamel pretreated with ICON^® resin infiltrant (Exp1 group), and demineralized enamel without pretreatment (Exp2). Demineralization was induced using a pH 4.5 solution for 21 days and was monitored using swept-source optical coherence tomography on days 0, 7, 14, and 21. The lesion depth (LD) was quantified and evaluated using ImageJ software. In the Exp1 group, ICON^® was applied prior to bracket bonding; no pretreatment was applied in the Exp2 group. In all groups, brackets were bonded using Super-Bond/Clear fluoride-free self-cure adhesive resin (4-META/MMA-TBB, Sun Medical) following Phosphoric acid (65%; Red Activator, Sun Medical). After debonding, enamel surfaces were evaluated to determine the adhesive remnant index (ARI). Results: No significant difference (p = 0.631) was noted in LD between Exp1 and Exp2 groups. The SBS values significantly differed (p < 0.05) between the control (4.1 ± 1.0 MPa) and Exp1 (5.5 ± 1.4 MPa) groups and between the Exp1 and Exp2 (3.8 ± 1.3 MPa) groups. However, SBS did not differ significantly between the control and Exp2 groups. Furthermore, ARI scores showed no significant difference between the control and Exp1 groups, whereas the Exp2 group recorded significantly elevated ARI scores relative to the control group (p = 0.0127). Conclusions: These findings suggest that resin infiltration with ICON^® may improve bracket adhesion on demineralized enamel. Full article

Background: Biofilm formation and associated tooth demineralization are key factors influencing the clinical performance of dental materials. Methods: This study compared the antibiofilm and demineralization preventive effects of two zinc-modified glass ionomer cements (Zn-GICs) with a conventional GIC. Disk-shaped specimens of Caredyne Restore (CR), ChemFil Rock (CFR), and Ketac Molar (KM) (n = 6) were evaluated in a multi-species biofilm model using an oral biofilm reactor. Early biofilm formation was analyzed by scanning electron microscopy (after 2 h and 4 h), bacterial accumulation and water-insoluble glucan (WIG) production were quantified (after 12 h). For demineralization assessment, restored human enamel and dentin specimens (n = 6) including an additional resin-based control group (Dura Seal, DS) were subjected to a 14-day biofilm challenge and lesion depth was measured using swept-source optical coherence tomography and confocal microscopy. Results: CR showed significantly lower bacterial accumulation and WIG production than the other materials (p < 0.05). CFR demonstrated lower bacterial levels than KM (p < 0.05), whereas no significant differences were observed between CFR and KM in WIG production (p > 0.05). CR produced the shallowest enamel and dentin lesions, whereas DS exhibited the deepest (p < 0.05); however, no statistically significant differences were observed between CFR and KM in lesion depth (p > 0.05). Conclusions: CR demonstrated superior biofilm suppression and reduced demineralization, whereas CFR showed limited differences compared with the conventional GIC. Full article

Background: Although minimally invasive glaucoma surgery (MIGS), including trabecular micro-bypass stent implantation, is safe, its surgical outcomes remain variable, with limited reliable success predictors. We evaluated whether preoperative trabecular meshwork (TM) thickness is associated with surgical outcomes after iStent inject^® W implantation. Methods: Patients with open-angle glaucoma (n = 28) who underwent iStent inject^® W implantation were included. Preoperative AS-SS-OCT was used to measure TM thickness and conventional angle parameters, including angle opening distance, angle recess area, trabecular–iris space area, and trabecular–iris angle. Surgical success was IOP ≤ 15 mmHg with ≥25% reduction or final IOP ≤ 12 mmHg under specified conditions. Logistic regression analyses were performed to identify factors associated with surgical outcomes. Results: At 12 months, 22 eyes (78.6%) achieved surgical success. Mean TM thickness was significantly greater in the unsuccessful than in the successful group (250.62 ± 32.05 μm vs. 180.75 ± 30.61 μm, p = 0.001), with similar findings for nasal and temporal TM thickness. Conventional angle parameters were not associated with surgical outcomes. In univariable analysis, both mean and nasal TM thickness were significantly associated with an increased risk of failure (per 10 μm increase; mean TM: OR = 2.77, 95% CI = 1.12–6.86, p = 0.027; nasal TM: OR = 1.64, 95% CI = 1.04–2.58, p = 0.034). Conclusions: Increased preoperative mean and nasal TM thickness was significantly associated with surgical failure following iStent inject^® W implantation. TM’s microstructural properties are more relevant than angular configuration in determining MIGS outcomes. Preoperative assessment of TM thickness using AS-SS-OCT may serve as a useful imaging biomarker for optimizing patient selection. Full article

Background and Objectives: Fibromyalgia syndrome (FMS) is frequently accompanied by autonomic symptoms and autonomic dysregulation, which may influence ocular blood flow regulation. The choroid is a densely vascular, autonomically innervated tissue, and optical coherence tomography (OCT)-derived markers have been used to explore potential ocular microvascular changes in FMS, with inconsistent findings. The choroidal vascularity index (CVI), defined as the proportion of luminal area within the total choroidal area, has been proposed as a potentially more robust marker of choroidal vascular status than thickness alone. We aimed to compare CVI and choroidal thickness between patients with FMS and healthy controls and examine the association between autonomic symptom burden and CVI in FMS. Materials and Methods: This single-centre observational cross-sectional case–control study enrolled adults aged 18–65 years. Swept-source OCT was performed; low-quality scans were excluded, and only right eyes were analysed. CVI, subfoveal maximum and mean choroidal thickness were obtained using an artificial intelligence-assisted analysis platform. Autonomic symptom burden, fibromyalgia impact, and central sensitization-related symptoms were assessed using the Composite Autonomic Symptom Score-31 (COMPASS-31), the Revised Fibromyalgia Impact Questionnaire (FIQ-R), and the Central Sensitization Inventory (CSI), respectively. Group comparisons, Spearman correlations, and multivariable linear regression were performed. Results: COMPASS-31, FIQ-R, and CSI scores were higher in the FMS group (all p < 0.001). CVI and choroidal thickness did not differ significantly between groups (CVI p = 0.124; maximum thickness p = 0.136; mean thickness p = 0.097). CVI was not correlated with COMPASS-31, FIQ-R, or CSI within either group. In adjusted models, age was independently associated with CVI (p < 0.001), whereas FMS status and COMPASS-31 total score were not. Conclusions: CVI and choroidal thickness were similar in FMS and controls, and CVI was not associated with self-reported autonomic symptom burden in FMS. Studies incorporating objective autonomic testing and dynamic vascular imaging paradigms are warranted. Full article

Background/Objectives: Anterior segment optical coherence tomography (AS-OCT) and optical coherence tomography angiography (AS-OCTA) have enhanced the evaluation of the cornea, ocular surface, and ocular surface diseases (OSD), offering high-resolution structural and anterior segment vascular imaging. This review summarizes recent advances in these modalities and their clinical applications. Methods: A comprehensive literature search was conducted using PubMed, Web of Science, and Google Scholar with the terms OCT, OCTA, anterior segment, and ocular surface disease. Studies published in the past five years were included, emphasizing more recent developments such as ultra-high-resolution AS-OCT (UHR-AS-OCT) and swept-source AS-OCTA technologies. Results: UHR-AS-OCT provides non-invasive, sub-micron imaging of the cornea and the ocular surface, including tear film morphology and epithelial thickness to correlate with clinical tests such as tear break-up time, and fluorescein staining. Advances in AS-OCTA allow dye-free, depth-resolved imaging of corneal and conjunctival vasculature. These vascular biomarkers have shown promising utility in conditions such as limbal stem cell deficiency, chemical ocular injury, and ocular surface squamous neoplasia. Improvements in image acquisition, motion correction, and segmentation algorithms have enhanced accuracy and repeatability, supporting broader clinical translation. Conclusions: AS-OCT and AS-OCTA have become useful adjunctive imaging tools for the cornea and ocular surface evaluation. Their non-invasive, quantitative, and reproducible metrics may enable earlier diagnosis, objective staging, and longitudinal monitoring of OSD. Integration of OCT-based imaging with artificial intelligence and multimodal data, including tear proteomics and meibography, may optimize personalized treatment for ocular surface disorders. Full article

Background: Swept-source optical coherence tomography angiography (SS-OCTA) enables rapid assessment of retinal microvasculature. However, cross-platform comparability remains limited by device-specific acquisition and image quality characteristics. This study prospectively compared two novel SS-OCTA systems, DREAM (200 kHz) and BMizar (400 kHz). Methods: Fifty eyes from 25 healthy participants underwent 3 mm × 3 mm macular OCTA imaging with both devices in a single session. Images were analysed using OCTAVA to extract foveal avascular zone (FAZ) area, vessel area density (VAD), total vessel length (TVL), node counts, fractal dimension (FD), median vessel length (MVL) in SCP, and mean vessel diameter (MVD) in DCP. Image quality was assessed using FAZ-noise rate, contrast-to-noise ratio (CNR), and FAZ noise-floor standard deviation. Paired comparisons were performed using Wilcoxon signed-rank tests and Cliff’s delta. Results: BMizar acquisition time was shorter than DREAM for the evaluated 3 × 3 mm protocol (median 5.36 s vs. 9.93 s), reflecting differences in A-scan rate and protocol implementation; acquisition time is therefore reported descriptively. In the SCP, DREAM yielded lower VAD (41.9% vs. 48.8%) and fewer nodes (1547 vs. 1879) but exhibited markedly less background noise (noise-floor SD 4.1 vs. 57.9) and substantially higher CNR (16.7 vs. 0.82). DREAM also showed longer MVL (45 vs. 39 µm) and higher FD (1.98 vs. 1.97; δ = 0.90). In the DCP, DREAM demonstrated smaller FAZ areas (0.27 vs. 0.42 mm²), thinner MVD (14 vs. 25 µm), higher node counts (3144 vs. 2301), longer TVL (223.6 vs. 206.2 mm), and higher FD (1.98 vs. 1.97), whereas VAD was higher on BMizar (32.96% for DREAM vs. 49.93% for BMizar). FAZ-noise rates were consistently higher for BMizar in both plexuses. Conclusions: Both devices provide reliable SS-OCTA imaging, but with distinct strengths. DREAM delivers higher vascular continuity and more reliable FAZ and DCP quantification, whereas BMizar achieves faster acquisition at the cost of noise, inflating SCP density and distorting FAZ-based metrics. Awareness of these characteristics is essential to ensure the valid use of OCTA biomarkers in clinical and research applications. Full article

Background: This research compared the relationship between foveal optical coherence tomography (OCT) parameters and two age measures—biological and chronological—in healthy adults. Methods: This cross-sectional study analyzed swept-source optical coherence tomography (OCT) data from 308 eyes of 154 healthy adults aged 22–89 years. Parameters assessed: foveal thickness, foveal pit depth and diameter, pit slope steepness, and the presence or absence of the foveal bulge. Biological age was calculated using the PhenoAge algorithm. Results: The core geometry of the foveal pit showed no significant dependence on either type of age (all p ≥ 0.66). In contrast, the foveal bulge prevalence declined significantly with age (adjusted p = 0.011 for chronological age, p = 0.005 for biological age; OR per year ≈0.95, 95% CI 0.92–0.98 for both age models). Model-predicted prevalence decreased from approximately 93% in younger adults to 60–68% in the 60–74-year-old group. Conclusion: The foveal architecture remains structurally stable throughout adulthood. The foveal bulge emerges as a sensitive qualitative marker of age-related changes. Biological age does not provide additional predictive value over chronological age for foveal structural parameters under physiological aging conditions. Full article

Background and Objectives: Accurate anterior segment measurements are central to intraocular lens (IOL) power calculation and toric planning, yet different optical platforms may yield non-interchangeable values. This study compared keratometry, astigmatism metrics, and ocular biometry obtained with a swept-source OCT biometer (Argos), an optical low-coherence interferometry biometer (Aladdin), and a combined Scheimpflug–Placido topographer (Schwind Sirius). Methods: This is a retrospective observational study (January 2022–June 2024) including eyes undergoing uncomplicated cataract surgery. All eyes were measured in a single session by one examiner. Outcomes included K1, K2, cylinder, astigmatism axis (degrees; device-reported corneal cylinder axis, labeled “Powerful Angle” in the Sirius export), vector components (J0 and J45), and—where available—lens thickness (LT), axial length (AL), anterior chamber depth (ACD), white-to-white (WTW) distance, and central corneal thickness (CCT). Friedman tests assessed 3-device differences, and pairwise comparisons were evaluated using Wilcoxon signed-rank tests (paired data). Results: A total of 170 eyes (102 patients) were analyzed (mean age: 69.12 ± 10.26 years). Significant inter-device differences were detected for K1 (Argos: 43.45 ± 1.64 D; Aladdin: 43.41 ± 1.70 D; overall: p < 0.001; Argos vs. Aladdin: p = 0.019), K2 (Argos: 44.45 ± 1.67 D; Aladdin: 44.34 ± 1.71 D; overall and pairwise: p < 0.001), and cylinder (Argos: −0.83 ± 0.74 D, Aladdin: −0.77 ± 0.76 D; Sirius: −0.68 ± 0.75 D; overall: p < 0.001). “Powerful Angle” differed across devices (p = 0.003) but not between Argos and Aladdin (p = 0.512). J0 (p = 0.277) and J45 (p = 0.084) did not differ significantly. Argos reported higher ACD (3.19 ± 0.42 vs. 3.13 ± 0.41 mm, p < 0.001) and WTW (11.95 ± 0.42 vs. 11.65 ± 0.39 mm, p < 0.001) values than Aladdin. CCT was similar between Aladdin and Sirius (540.27 ± 33.44 vs. 540.47 ± 33.78 µm, p = 0.169). Conclusions: Several keratometric and biometric parameters differed significantly by device, indicating limited interchangeability—particularly relevant for toric and premium IOL planning—while vector astigmatism components and CCT showed better agreement. Full article

Background/Objectives: To analyze the agreement between two swept-source optical coherence tomography (SS-OCT) devices in assessing glistening on intraocular lenses (IOL). Methods: Patients who had previously undergone cataract surgery were included. They were sequentially examined using two SS-OCT devices: Anterion (Heidelberg Engineering Inc., Heidelberg, Germany) and Triton (Topcon, Inc., Tokyo, Japan). Six corresponding scans from both devices were compared, and glistening, observed as hyperreflective foci (HRF), was manually counted. The total number of HRF and the degree of glistening were measured and categorized into four groups. The agreement between the two devices was analyzed using the intraclass correlation coefficient (ICC). Results: A total of 333 eyes from 285 patients were evaluated. The mean age was 76.5 ± 8.0 years (range: 45–95). The median number of HRF detected in a single scan was 1.1 (IQR 0.0–10.2, range 0–176) using Triton and 2.7 (IQR 0.2–20.1, range 0–250) using Anterion. The ICC across different scans ranged from 0.8 to 0.9, indicating strong agreement between the two devices. Bland–Altman plots showed better concordance in lenses with low glistening grades, while higher grades revealed greater discrepancies, with Anterion detecting significantly more HRF than Triton. Among all factors studied, only postsurgical time was associated with glistening. Conclusions: Two different SS-OCT devices can detect and quantify glistening in IOLs. The concordance between them was high, particularly for lower glistening grades. However, in higher grades, Anterion detected significantly more HRF than Triton. Full article