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1. Nilima Sinha Medical College and Hospital, Madhepura, Bihar, India
2. Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, USA

Dr. Jay Chhablani

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UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA 15213, USA

Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances

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closed (25 March 2025)

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26 May 2025

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Dear Colleagues,

From their use as a research tools to their commercial availability, optical coherence tomography (OCT) and OCT angiography (OCTA) have gained widespread acceptability as imaging modalities in our clinical practice. OCT provides a three-dimensional in vivo histological analysis of the retina with resolution reaching up to 5 µm or lower. OCTA, a non-invasive technique to image the chorioretinal microvasculature, provides three-dimensional details compared to dye-based angiography techniques such as fluorescein or indocyanine angiography. Both spectral and swept-source OCT and OCTA, with wavelengths 840 and 1050 nm, respectively, are commercially available. The inclusion of wide-field imaging techniques has improved our field of view from 20 degrees up to 220 degrees in wide-field OCT (i.e., the retinal periphery), helping diagnose peripheral retinal degeneration, retinoschisis, retinal detachment, and peripheral choroidal pathologies. Different algorithms such as split-spectrum amplitude-decorrelation angiography (SSADA), OCTA Ratio Analysis (OCTARA), and OCT-microangiography complex algorithm (OMAG) are available for OCTA imaging and to provide both qualitative and quantitative information. Further technical improvements in OCTA imaging have increased the scanned area from smaller 3*3 mm slabs to much larger 12*12 mm slabs. These images can be montaged to recreate vascular patterns extending to the equator. Both OCT and OCTA can be useful in assessing retinal vascular diseases, age-related macular degeneration, glaucoma, uveitic pathologies, and ocular tumors. Addressing concerns such as a multitude of artifacts, slower image acquisition speed, lower resolution, the high cost of wide-field OCT machines, and the variability in different OCTA machines related to proprietary algorithms may further enhance the appeal of OCT and OCTA. This Topic summarizes the recent advances in OCT and OCTA and their clinical application in various chorioretinal diseases. We plan to include prospective and retrospective original articles and a few review articles on this Topic.

Dr. Sumit Randhir Singh
Dr. Jay Chhablani
Topic Editors

Keywords

optical coherence tomography
OCT angiography
wide field OCT
central serous chorioretinopathy
choroidal vascularity index
choroidal disorders
choroidal neovascularization
AMD
diabetic macular edema
central serous chorioretinopathy

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Diagnostics diagnostics	3.0	4.7	2011	20.3 Days	CHF 2600	Submit
Journal of Clinical & Translational Ophthalmology jcto	-	-	2023	15.0 days *	CHF 1000	Submit
Journal of Clinical Medicine jcm	3.0	5.7	2012	16 Days	CHF 2600	Submit
Journal of Personalized Medicine jpm	-	4.1	2011	17.4 Days	CHF 2600	Submit
Tomography tomography	2.2	2.7	2015	23.8 Days	CHF 2400	Submit

* Median value for all MDPI journals in the second half of 2024.

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Published Papers (11 papers)

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18 pages, 1216 KiB

Open AccessSystematic Review

The Current Status of OCT and OCTA Imaging for the Diagnosis of Long COVID

by Helen Jerratsch, Ansgar Beuse, Martin S. Spitzer and Carsten Grohmann

J. Clin. Transl. Ophthalmol. 2024, 2(4), 113-130; https://doi.org/10.3390/jcto2040010 - 17 Oct 2024

Viewed by 1274

Abstract

(1) With persistent symptoms emerging as a possible global consequence of COVID-19, the need to understand, diagnose, and treat them is paramount. This systematic review aims to explore the potential of optical coherence tomography (OCT) and/or optical coherence tomography angiography (OCTA) in effectively diagnosing long COVID. (2) The database PubMed and, to reduce selection bias, the AI research assistant Elicit, were used to find relevant publications in the period between February 2021 and March 2024. Included publications on OCT and OCTA analysis of participants with acute COVID symptoms, those after recovery, and participants with long COVID symptoms were organized in a table. Studies with participants under the age of 18, case reports, and unrelated studies, such as pure slit-lamp examinations and subgroup analyses were excluded. (3) A total of 25 studies involving 1243 participants and 960 controls were reviewed, revealing several changes in the posterior eye. Long COVID participants displayed significant thinning in retinal layers in the OCT, including the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). Divergent findings in recovered cohorts featured mRNFL reduction, GCL increase and decrease, and GCL-IPL decrease. Long COVID OCTA results revealed reduced vessel density (VD) in the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). In recovered patients, SCP consistently showed a reduction, and DCP exhibited a decrease in five out of six publications. The foveal avascular zone (FAZ) was enlarged in five out of nine publications in recovered participants. (4) During various stages of COVID-19, retinal changes were observed, but a comparison between long COVID and recovered cohorts was aggravated by diverse inclusion and exclusion criteria as well as small sample sizes. Changes in long COVID were seen in most OCT examinations as thinning or partial thinning of certain retinal layers, while in OCTA a consistently reduced vessel density was revealed. The results suggest retinal alterations after COVID that are variable in OCT and more reliably visible in OCTA. Further research with larger samples is important for advancing long COVID diagnosis and management. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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6 pages, 6332 KiB

Open AccessBrief Report

Changes in Macular Pigment Optical Density after Intravitreal Faricimab in Neovascular Age-Related Macular Degeneration: A Pilot Study

by Gilda Cennamo, Michele Rinaldi, Flavia Chiosi and Ciro Costagliola

J. Clin. Med. 2024, 13(16), 4893; https://doi.org/10.3390/jcm13164893 - 19 Aug 2024

Viewed by 1100

Abstract

Background: This study aimed to evaluate the effects of faricimab intravitreal injections in patients with exudative age macular degeneration (nAMD) after the loading dose using spectral domain optical coherence tomography (SD-OCT) and macular pigment optical density (MPOD). Methods: In this observational prospective study, we enlisted a total of 12 consecutive eyes of 12 patients (six females, six males; mean age 70.47 ± 2.46 years) affected by nAMD who consecutively presented to the Eye Clinic of the University of Naples “Federico II” and Monaldi Hospital of Naples, from June 2023 to December 2023. All patients received four once-monthly intravitreal injections of faricimab (6 mg/0.05 mL) (loading phase). At baseline and 1 month after the fourth faricimab monthly injection, all patients underwent assessment of best correct visual acuity (BCVA) and ophthalmic examination, including slit-lamp biomicroscopy, intraocular pressure (IOP), fundus biomicroscopy, SD-OCT, and MPOD. Results: A total of 12 eyes of 12 patients (six women, six men; mean age 70.47 ± 2.46 years) were included in this study. A statistically significant raise in BCVA and MOPD parameters was shown between baseline and after the loading phase (p < 0.001). Conclusions: Intravitreal injections of faricimab led in the short term to a significant functional and MPOD improvement along with a decrease in central macular thickness (CMT) and thus appears to be an effective treatment option without relevant adverse effects. MOPD may be considered as a prognostic factor associated with a good visual prognosis after intravitreal injections treatment. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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26 pages, 3025 KiB

Open AccessReview

Non-Neovascular Age-Related Macular Degeneration Assessment: Focus on Optical Coherence Tomography Biomarkers

by Daniela Adriana Iliescu, Ana Cristina Ghita, Larisa Adriana Ilie, Suzana Elena Voiculescu, Aida Geamanu and Aurelian Mihai Ghita

Diagnostics 2024, 14(7), 764; https://doi.org/10.3390/diagnostics14070764 - 3 Apr 2024

Cited by 3 | Viewed by 2019

Abstract

The imagistic evaluation of non-neovascular age-related macular degeneration (AMD) is crucial for diagnosis, monitoring progression, and guiding management of the disease. Dry AMD, characterized primarily by the presence of drusen and retinal pigment epithelium atrophy, requires detailed visualization of the retinal structure to assess its severity and progression. Several imaging modalities are pivotal in the evaluation of non-neovascular AMD, including optical coherence tomography, fundus autofluorescence, or color fundus photography. In the context of emerging therapies for geographic atrophy, like pegcetacoplan, it is critical to establish the baseline status of the disease, monitor the development and expansion of geographic atrophy, and to evaluate the retina’s response to potential treatments in clinical trials. The present review, while initially providing a comprehensive description of the pathophysiology involved in AMD, aims to offer an overview of the imaging modalities employed in the evaluation of non-neovascular AMD. Special emphasis is placed on the assessment of progression biomarkers as discerned through optical coherence tomography. As the landscape of AMD treatment continues to evolve, advanced imaging techniques will remain at the forefront, enabling clinicians to offer the most effective and tailored treatments to their patients. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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12 pages, 522 KiB

Open AccessArticle

Interocular Symmetry of Choroidal Parameters in Patients with Diabetic Retinopathy with and without Diabetic Macular Edema

by Anna Raciborska, Patryk Sidorczuk, Joanna Konopińska and Diana Anna Dmuchowska

J. Clin. Med. 2024, 13(1), 176; https://doi.org/10.3390/jcm13010176 - 28 Dec 2023

Cited by 3 | Viewed by 1321

Abstract

This study focuses on the interocular comparison of choroidal parameters in diabetic patients with diabetic retinopathy (DR) with and without diabetic macular edema (DME), as well as in patients with unilateral DME (present in only one eye). The aim of this study was to determine the symmetry in order to obtain better insights into the pathophysiology of diabetic choroidopathy. This retrospective single-center cross-sectional study included 170 eyes from 85 patients (61 with DR and 24 controls), divided into subgroups depending on the presence of DME. The patients underwent fluorescein angiography and spectral domain optical coherence tomography examination, and the analysis included various choroidal parameters: choroidal thickness, volume, and the choroidal vascularity index (CVI). In terms of the choroidal thickness, one eye of a patient with DR, regardless of the presence, absence, or unilaterality of DME, may be treated as representative for that patient. CVI proved symmetrical for controls and patients with DR without DME. However, there was some asymmetry of CVI in patients with bilateral or unilateral DME. There was no straightforward relationship between choroidopathy and DME. Other mechanisms were also involved in the pathogenesis. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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13 pages, 2983 KiB

Open AccessArticle

Correlation between Topographic Vessel Density and Retinal Thickness Changes in Patients with Diabetic Macular Edema Treated with Anti-VEGF Therapy: Is It a Suitable OCTA Biomarker?

by Juan Santamaría, José María Caminal, Estefanía Cobos, Marc Biarnes, Ramon Rodriguez-Leor, Rahul Morwani, Manel García-Mendieta, Daniel Lorenzo, Pere García-Bru and Luis Arias

J. Pers. Med. 2023, 13(12), 1718; https://doi.org/10.3390/jpm13121718 - 16 Dec 2023

Cited by 3 | Viewed by 1935

Abstract

The objective of this study was to determine the correlation between topographic vessel density (VD) and retinal thickness (RT) reductions induced by vascular endothelial growth factor inhibitors (anti-VEGF) in patients with diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). This was a prospective, interventional case series. VD and RT measurements were separately taken in four parafoveal subfields at baseline and after six months of treatment. This correlation was statistically assessed using Spearman’s rho correlation coefficient after adjustment for multiple comparisons. The study included a total of 48 eyes in the final analysis. Mean VD decreased from baseline to month 6 (from 45.2 (±3.5) to 44.6% (±3.2) in the superficial capillary plexus and from 50 (±3.3) to 49% (±3.9) in the deep capillary plexus). Statistically significant reductions in RT were observed in all ETDRS sectors (p < 0.0001). No significant association was found between RT and VD, even when analyzing responders and non-responders separately. After six months of anti-VEGF treatment, no significant correlation was observed between the topographic VD and RT values. These findings suggest that reductions in VD values may not solely result from a reduction in microaneurysms, also being affected by the repositioning of displaced vessels due to edema and a reduction in their caliber. Therefore, VD changes may not be a suitable indirect OCTA biomarker of microaneurysm turnover and treatment response. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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11 pages, 4385 KiB

Open AccessReview

The State of Intraoperative OCT in Vitreoretinal Surgery: Recent Advances and Future Challenges

by Nicolò Ciarmatori, Marco Pellegrini, Francesco Nasini, Pietro Maria Talli, Laura Sarti and Marco Mura

Tomography 2023, 9(5), 1649-1659; https://doi.org/10.3390/tomography9050132 - 1 Sep 2023

Cited by 10 | Viewed by 2705

Abstract

Since its first introduction more than 30 years ago, optical coherence tomography (OCT) has revolutionized ophthalmology practice, providing a non-invasive in vivo cross-sectional view of the structures of the eye. Mostly employed in the clinical setting due to its tabletop configuration requiring an upright patient positioning, the recent advent of microscope-integrated systems now allows ophthalmologists to perform real-time intraoperative OCT (iOCT) during vitreoretinal surgical procedures. Numerous studies described various applications of this tool, such as offering surgeons feedback on tissue–instrument interactions in membrane peeling, providing structural images in macular hole repair, and showing residual subretinal fluid or perfluorocarbon in retinal detachment surgery. This narrative review aims at describing the state of the art of iOCT in vitreoretinal procedures, highlighting its modern role and applications in posterior segment surgery, its current limitations, and the future perspectives that may improve the widespread adoption of this technology. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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15 pages, 4508 KiB

Open AccessArticle

Characterizing Foveal Hypoplasia Using Optical Coherence Tomography Angiography: Evaluation of Microvascular Abnormalities and Clinical Significance

by Jens Julian Storp, Julian Alexander Zimmermann, Moritz Fabian Danzer, Maged Alnawaiseh, Nicole Eter and Sami Al-Nawaiseh

J. Clin. Med. 2023, 12(15), 4992; https://doi.org/10.3390/jcm12154992 - 29 Jul 2023

Viewed by 3024

Abstract

This study aimed to evaluate foveal avascular zone (FAZ) features and macular flow density (FD) in various retinal layers in a cohort of patients with foveal hypoplasia (FH) using optical coherence tomography angiography (OCTA), in order to characterize microvascular abnormalities and explore their potential clinical significance. FAZ parameters and FD, as well as retinal thickness and volume values were analyzed and compared between patients with FH and an age- and gender-matched control cohort. Correlations between disease severity and visual acuity (VA), as well as between disease severity and FAZ features were evaluated. A total of 19 eyes with FH and 19 control eyes were included. The study group showed significantly higher FD values in the foveal sectors of the superficial and deep capillary plexus compared to controls. FAZ area, perimeter, and acircularity index (ACI) were noticeably altered in eyes with FH; however, they did not correlate with disease severity. Visual acuity was negatively correlated with disease severity. The results of this study provide evidence of altered microvasculature architecture specifically in the foveal sectors of patients with FH. The higher FD values in the foveal sectors of FH patients suggest a potential compensatory response of the retinal microvasculature. FAZ parameters and FD values of the foveal sectors could be used as part of an OCTA-based grading system in FH patients. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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10 pages, 1640 KiB

Open AccessArticle

Retinal Thickness Deviation: A New OCT Parameter for Assessing Diabetic Macular Edema

by Paola Marolo, Enrico Borrelli, Francesco Gelormini, Giacomo Boscia, Guglielmo Parisi, Matteo Fallico, Costanza Barresi, Giorgio Lari, Alessandro Berni, Francesco Bandello and Michele Reibaldi

J. Clin. Med. 2023, 12(12), 3976; https://doi.org/10.3390/jcm12123976 - 11 Jun 2023

Cited by 3 | Viewed by 1657

Abstract

(1) Purpose: To determine the “retinal thickness deviation” (RTD) in diabetic macular edema (DME) eyes treated with intravitreal therapy and to establish associations between RTD and best-corrected visual acuity (BCVA). (2) Methods: We conducted a retrospective study, including consecutive patients with DME eyes undergoing intravitreal therapy with two years of follow-up. BCVA and central subfield thickness (CST) were collected at baseline and at 12 months and 24 months of follow-up. RTD was calculated as the absolute difference between measured and normative CST values at each time point. Linear regression analyses were performed between RTD and BCVA and between CST and BCVA. (3) Results: One hundred and four eyes were included in the analysis. The RTD was 177.0 (117.2) μm at baseline, 97.0 (99.7) μm at 12 months and 89.9 (75.3) μm at 24 months of follow-up (p < 0.001). RTD showed a moderate association with BCVA at baseline (R² = 0.134, p < 0.001) and 12 months (R² = 0.197, p < 0.001) and a substantial association at 24 months (R² = 0.272, p < 0.001). The CST showed a moderate association with BCVA at baseline (R² = 0.132, p < 0.001) and 12 months (R² = 0.136, p < 0.001), while the association was weak at 24 months (R² = 0.065, p = 0.009). (4) Conclusions: RTD showed a good association with visual outcome in patients with DME eyes undergoing intravitreal treatment. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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12 pages, 2424 KiB

Open AccessArticle

Evaluation of Ocular Perfusion in Patients with End-Stage Renal Disease Receiving Hemodialysis Using Optical Coherence Tomography Angiography

by Larissa Lahme, Jens Julian Storp, Elena Marchiori, Eliane Esser, Nicole Eter, Natasa Mihailovic and Maged Alnawaiseh

J. Clin. Med. 2023, 12(11), 3836; https://doi.org/10.3390/jcm12113836 - 3 Jun 2023

Cited by 5 | Viewed by 1664

Abstract

Hemodialysis (HD) is known to affect ocular blood flow. This case-control study aims to evaluate macular and peripapillary vasculature in patients with end-stage renal disease (ESRD) receiving HD in comparison to matched controls. A total of 24 eyes of 24 ESRD patients receiving HD and 24 eyes of 24 healthy, age- and gender-matched control subjects were prospectively included in this study. Optical coherence tomography angiography was used to image the superficial (SCP), deep (DCP), and choriocapillary (CC) macular vascular plexus, as well as the radial peripapillary capillaries (RPC) of the optic disc. In addition, retinal thickness (RT) and retinal volume (RV) were compared between both groups. Flow density (FD) values of each retinal layer and data of parameters related to the foveal avascular zone (FAZ), as well as RT and RV, were analyzed using Mann–Whitney U tests. There was no significant difference in FAZ parameters between the two groups. Whole en face FD of the SCP and CC was noticeably reduced in the HD group in comparison to the control group. FD was negatively correlated with the duration of HD treatment. RT and RV were significantly smaller in the study group than in controls. Retinal microcirculation appears altered in patients with ESRD undergoing HD. Concurrently, the DCP appears more resilient towards hemodynamic changes in comparison to the other microvascular retinal layers. OCTA is a useful, non-invasive tool to investigate retinal microcirculation in ESRD patients. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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13 pages, 16405 KiB

Open AccessEditor’s ChoiceArticle

Morphological and Optical Coherence Tomography Aspects of Non-Carious Cervical Lesions

by Andreea Stănuşi, Monica Mihaela Iacov-Crăițoiu, Monica Scrieciu, Ioana Mitruț, Bogdan Costin Firulescu, Mihaela Roxana Boțilă, Diana Elena Vlăduțu, Adrian Ştefan Stănuşi, Veronica Mercuț and Eugen Osiac

J. Pers. Med. 2023, 13(5), 772; https://doi.org/10.3390/jpm13050772 - 29 Apr 2023

Cited by 5 | Viewed by 3706

Abstract

Non-carious cervical lesions (NCCLs) are considered the irreversible losses of dental hard tissues at the cemento–enamel junction, in the absence of acute trauma and dental caries. The aim of this study was to highlight the presence of NCCLs in cervical areas based on specific macroscopic aspects in order to establish their clinical form, size and location and to confirm the role of optical coherence tomography (OCT) examination in the early diagnosis of these lesions. For this study, 52 extracted teeth were used, which did not have endodontic treatments, fillings or carious lesions in the cervical area. All teeth were examined macroscopically and OCT was used to evaluate the degree of occlusal wear, the presence and clinical form of NCCLs. Most NCCLs were identified on the buccal surfaces of the premolars. The most frequently encountered clinical form was the wedge-shaped form, with a radicular location. NCCLs present most frequently in the wedge-shaped form. Teeth that presented several NCCLs were identified. The OCT examination is an adjunct method to evaluate the clinical forms of NCCL. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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16 pages, 4416 KiB

Open AccessReview

Prognostic Optical Coherence Tomography Biomarkers in Neovascular Age-Related Macular Degeneration

by Baraa Nawash, Joshua Ong, Matthew Driban, Jonathan Hwang, Jeffrey Chen, Amrish Selvam, Sashwanthi Mohan and Jay Chhablani

J. Clin. Med. 2023, 12(9), 3049; https://doi.org/10.3390/jcm12093049 - 22 Apr 2023

Cited by 10 | Viewed by 4341

Abstract

Optical coherence tomography has revolutionized the diagnosis and management of neovascular age-related macular degeneration. OCT-derived biomarkers have the potential to further guide therapeutic advancements with anti-vascular endothelial growth factor; however, the clinical convergence between these two tools remains suboptimal. Therefore, the aim of this review of literature was to examine the current data on OCT biomarkers and their prognostic value. Thirteen biomarkers were analyzed, and retinal fluid had the strongest-reported impact on clinical outcomes, including visual acuity, clinic visits, and anti-VEGF treatment regimens. In particular, intra-retinal fluid was shown to be associated with poor visual outcomes. Consistencies in the literature with regard to these OCT prognostic biomarkers can lead to patient-specific clinical decision making, such as early-initiated treatment and proactive monitoring. An integrated analysis of all OCT components in combination with new efforts toward automated analysis with artificial intelligence has the potential to further improve the role of OCT in nAMD therapy. Full article

(This article belongs to the Topic Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances)

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Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Diagnostics diagnostics	3.0	4.7	2011	20.3 Days	CHF 2600
Journal of Clinical & Translational Ophthalmology jcto	-	-	2023	15.0 days *	CHF 1000
Journal of Clinical Medicine jcm	3.0	5.7	2012	16 Days	CHF 2600
Journal of Personalized Medicine jpm	-	4.1	2011	17.4 Days	CHF 2600
Tomography tomography	2.2	2.7	2015	23.8 Days	CHF 2400

* Median value for all MDPI journals in the second half of 2024.

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Optical Coherence Tomography (OCT) and OCT Angiography – Recent Advances

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