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Shrivastava N, Som V, Kumar K. Study of Imaging Biomarkers as a Prognostic Factor and Guide in the Management of Diabetic Macular Oedema. Cureus 2024; 16:e73765. [PMID: 39677190 PMCID: PMC11646637 DOI: 10.7759/cureus.73765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2024] [Indexed: 12/17/2024] Open
Abstract
Background: Diabetic macular oedema (DME) is a major cause of vision impairment in individuals with diabetes mellitus, characterised by fluid accumulation in the macula due to increased vascular permeability. The growing prevalence of diabetes worldwide has led to an increasing burden of DME on healthcare systems. While current treatment options such as anti-vascular endothelial growth factor (anti-VEGF) injections, corticosteroids, and laser therapy exist, the variability in patient responses highlights the need for reliable prognostic tools. Imaging biomarkers, particularly those identified using optical coherence tomography (OCT) and fluorescein angiography (FA), play a critical role in diagnosing and managing DME. This study evaluates the prognostic significance of these biomarkers in predicting disease progression and treatment outcomes. Materials and methods: This prospective observational study was conducted at Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, from August 2022 to June 2024. A total of 123 patients with Type II diabetes mellitus diagnosed with DME were included through consecutive sampling. Comprehensive assessments, including visual acuity, slit-lamp examination, fundus evaluation, FA, and OCT, were performed. Key imaging biomarkers, such as central subfield thickness (CST), disorganisation of retinal inner layers (DRIL), intraretinal cysts, hyperreflective foci, and vitreomacular interface (VMI) abnormalities, were evaluated. Correlations between biomarkers, best-corrected visual acuity (BCVA), metabolic markers (HbA1c, serum cholesterol), and disease severity were analysed using statistical tools, including the chi-square test and Pearson's correlation. Results: The most common biomarkers observed were DRIL with external limiting membrane (ELM) disruption (38, 31%), intraretinal cysts with ELM disruption (36, 29.3%), and hyperreflective foci (28, 22.8%). VMI abnormalities were noted in 14 (11.4%) cases, while subretinal fluid with serous retinal detachment was present in seven patients (5.7%). Significant negative correlations were found between BCVA (LogMAR) and biomarkers, with intraretinal cysts (-0.526, p=0.003) and VMI abnormalities (-0.492, P=0.002) having the strongest associations. Higher glycosylated haemoglobin (HbA1c) levels were significantly associated with intraretinal cysts (P=0.014) and VMI abnormalities (P=0.042), while higher cholesterol levels correlated with hyperreflective foci (P=0.011) and subretinal fluid (P=0.014). Patients with proliferative diabetic retinopathy (PDR) exhibited worse visual outcomes and greater CST compared to those with non-proliferative diabetic retinopathy (NPDR). Conclusion: Imaging biomarkers, particularly DRIL, intraretinal cysts, and VMI abnormalities, significantly correlate with visual acuity and metabolic control in DME patients. These findings underscore the importance of OCT in the prognostic assessment of DME and highlight the need for personalised treatment approaches based on biomarker profiles. Future studies should focus on long-term follow-up and explore the potential for integrating these biomarkers into clinical decision-making to improve patient outcomes.
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Affiliation(s)
| | - Vivek Som
- Ophthalmology, Gandhi Medical College and Hamidia Hospital, Bhopal, IND
| | - Kavita Kumar
- Ophthalmology, Gandhi Medical College and Hamidia Hospital, Bhopal, IND
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Seesan T, Mukherjee P, Abd El-Sadek I, Lim Y, Zhu L, Makita S, Yasuno Y. Optical-coherence-tomography-based deep-learning scatterer-density estimator using physically accurate noise model. BIOMEDICAL OPTICS EXPRESS 2024; 15:2832-2848. [PMID: 38855681 PMCID: PMC11161371 DOI: 10.1364/boe.519743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 06/11/2024]
Abstract
We demonstrate a deep-learning-based scatterer density estimator (SDE) that processes local speckle patterns of optical coherence tomography (OCT) images and estimates the scatterer density behind each speckle pattern. The SDE is trained using large quantities of numerically simulated OCT images and their associated scatterer densities. The numerical simulation uses a noise model that incorporates the spatial properties of three types of noise, i.e., shot noise, relative-intensity noise, and non-optical noise. The SDE's performance was evaluated numerically and experimentally using two types of scattering phantom and in vitro tumor spheroids. The results confirmed that the SDE estimates scatterer densities accurately. The estimation accuracy improved significantly when compared with our previous deep-learning-based SDE, which was trained using numerical speckle patterns generated from a noise model that did not account for the spatial properties of noise.
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Affiliation(s)
- Thitiya Seesan
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Pradipta Mukherjee
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Ibrahim Abd El-Sadek
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
- Department of Physics, Faculty of Science, Damietta University, New Damietta City 34517, Damietta, Egypt
| | - Yiheng Lim
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Lida Zhu
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Shuichi Makita
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Yoshiaki Yasuno
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
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Huang X, Ai Z, Wang H, She C, Feng J, Wei Q, Hao B, Tao Y, Lu Y, Zeng F. GABNet: global attention block for retinal OCT disease classification. Front Neurosci 2023; 17:1143422. [PMID: 37332865 PMCID: PMC10272427 DOI: 10.3389/fnins.2023.1143422] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/19/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction The retina represents a critical ocular structure. Of the various ophthalmic afflictions, retinal pathologies have garnered considerable scientific interest, owing to their elevated prevalence and propensity to induce blindness. Among clinical evaluation techniques employed in ophthalmology, optical coherence tomography (OCT) is the most commonly utilized, as it permits non-invasive, rapid acquisition of high-resolution, cross-sectional images of the retina. Timely detection and intervention can significantly abate the risk of blindness and effectively mitigate the national incidence rate of visual impairments. Methods This study introduces a novel, efficient global attention block (GAB) for feed forward convolutional neural networks (CNNs). The GAB generates an attention map along three dimensions (height, width, and channel) for any intermediate feature map, which it then uses to compute adaptive feature weights by multiplying it with the input feature map. This GAB is a versatile module that can seamlessly integrate with any CNN, significantly improving its classification performance. Based on the GAB, we propose a lightweight classification network model, GABNet, which we develop on a UCSD general retinal OCT dataset comprising 108,312 OCT images from 4686 patients, including choroidal neovascularization (CNV), diabetic macular edema (DME), drusen, and normal cases. Results Notably, our approach improves the classification accuracy by 3.7% over the EfficientNetV2B3 network model. We further employ gradient-weighted class activation mapping (Grad-CAM) to highlight regions of interest on retinal OCT images for each class, enabling doctors to easily interpret model predictions and improve their efficiency in evaluating relevant models. Discussion With the increasing use and application of OCT technology in the clinical diagnosis of retinal images, our approach offers an additional diagnostic tool to enhance the diagnostic efficiency of clinical OCT retinal images.
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Affiliation(s)
- Xuan Huang
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zhuang Ai
- Sinopharm Genomics Technology Co., Ltd., Changzhou, Jiangsu, China
| | - Hui Wang
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chongyang She
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jing Feng
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qihao Wei
- Sinopharm Genomics Technology Co., Ltd., Changzhou, Jiangsu, China
| | - Baohai Hao
- AI-Farm (Nanjing) Big Data Services Co., Ltd., Nanjing, China
| | - Yong Tao
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yaping Lu
- Sinopharm Genomics Technology Co., Ltd., Changzhou, Jiangsu, China
| | - Fanxin Zeng
- Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan, China
- Department of Big Data and Biomedical AI, College of Future Technology, Peking University, Beijing, China
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von Hanno T, Hareide LL, Småbrekke L, Morseth B, Sneve M, Erke MG, Mathiesen EB, Bertelsen G. Macular Layer Thickness and Effect of BMI, Body Fat, and Traditional Cardiovascular Risk Factors: The Tromsø Study. Invest Ophthalmol Vis Sci 2022; 63:16. [PMID: 35960516 PMCID: PMC9396695 DOI: 10.1167/iovs.63.9.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to investigate associations between cardiovascular risk factors and the thickness of retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and outer retina layers (ORL). Methods In this population-based study, we included participants from the Tromsø Study: Tromsø6 (2007 to 2008) and Tromsø7 (2015 to 2016). Persons with diabetes and/or diagnosed glaucoma were excluded from this study. Retinal thickness was measured on optical coherence tomography (Cirrus HD-OCT) macula-scans, segmented on RNFL, GCIPL, and ORL and associations were analyzed cross-sectionally (N = 8288) and longitudinally (N = 2595). We used directed acyclic graphs (DAGs) for model selection, and linear regression to adjust for confounders and mediators in models assessing direct effects. Factors examined were age, sex, blood pressure, daily smoking, serum lipids, glycated hemoglobin, body mass index (BMI), total body fat percentage (BFP), and the adjustment variables refraction and height. Results The explained variance of cardiovascular risk factors was highest in GCIPL (0.126). GCIPL had a strong negative association with age. Women had thicker GCIPL than men at higher age and thinner ORL at all ages (P < 0.001). Systolic blood pressure was negatively associated with RNFL/GCIPL (P = 0.001/0.004), with indication of a U-shaped relationship with GCIPL in women. The negative association with BMI was strongest in men, with significant effect for RNFL/GCIPL/ORL (P = 0.001/<0.001/0.019) and in women for GCIPL/ORL (P = 0.030/0.037). BFP was negatively associated with GCIPL (P = 0.01). Higher baseline BMI was associated with a reduction in GCIPL over 8 years (P = 0.03). Conclusions Cardiovascular risk factors explained 12.6% of the variance in GCIPL, with weight and blood pressure the most important modifiable factors.
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Affiliation(s)
- Therese von Hanno
- Department of Ophthalmology, Nordland Hospital Trust, Bodø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Lars Småbrekke
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Monica Sneve
- Hospital Administration, Bærum Hospital, Vestre Viken Hospital Trust, Bærum, Norway.,Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Maja Gran Erke
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.,Directorate of eHealth, Oslo, Norway
| | - Ellisiv Bøgeberg Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Geir Bertelsen
- Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Liu X, Zhao C, Wang L, Wang G, Lv B, Lv C, Xie G, Wang F. Evaluation of an OCT-AI-Based Telemedicine Platform for Retinal Disease Screening and Referral in a Primary Care Setting. Transl Vis Sci Technol 2022; 11:4. [PMID: 35254422 PMCID: PMC8914565 DOI: 10.1167/tvst.11.3.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose To evaluate the performance of a telemedicine platform integrated with optical coherence tomography (OCT) and artificial intelligence (AI) techniques for retinal disease screening and referral. Methods We constructed an OCT-AI–based telemedicine platform and deployed it at four primary care stations located in Jing'an district, Shanghai, to detect retinal disease cases among aged groups and refer them to Shanghai Tenth People's Hospital (TENTH Hospital). Two ophthalmologists jointly graded the data set collected from this pilot application, and then the performance of this platform was analyzed from multiple aspects. Results This study included 1257 participants between July 2020 and September 2020, of whom 394 had retinal pathologies and 146 were even considered urgent cases by the ophthalmologists. The OCT-AI models achieved a sensitivity of 96.6% (95% confidence interval [CI], 91.8%–98.7%) and specificity of 98.8% (95% CI, 98.0%–99.3%) for detecting urgent cases and a sensitivity of 98.5% (95% CI, 96.5%–99.4%) and specificity of 96.2% (95% CI, 94.6%–97.3%) for detecting both urgent and routine cases. Coupled with AI, our platform reduced the workload of human consultation by 96.2% for massive normal cases. The detected disease cases received online medical suggestions at an average time of 21.4 hours via this platform. Conclusions This platform can automatically identify patients with retinal disease with high sensitivity and specificity, support timely human consultation, and bring necessary referrals. Translational Relevance The OCT-AI–based telemedicine platform shows great practical value for retinal disease screening and referral in a real-world primary care setting.
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Affiliation(s)
- Xiaoqiang Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chun Zhao
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lilong Wang
- Ping An Healthcare Technology, Beijing, China
| | | | - Bin Lv
- Ping An Healthcare Technology, Beijing, China
| | | | - Guotong Xie
- Ping An Healthcare Technology, Beijing, China.,Ping An Healthcare and Technology Company Limited, Shanghai, China.,Ping An International Smart City Technology Company Limited, Shenzhen, China
| | - Fang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Hsu S, Ko M, Linn G, Chang M, Sheu M, Tsai R. Effects of age and disc area on optical coherence tomography measurements and analysis of correlations between optic nerve head and retinal nerve fibre layer. Clin Exp Optom 2021; 95:427-31. [DOI: 10.1111/j.1444-0938.2012.00765.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sheng‐yao Hsu
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan and Institute of Medicine and Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan,
| | - Mei‐lan Ko
- Department of Ophthalmology, National Taiwan University Hospital and Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsin Chu City, Taiwan,
| | - George Linn
- Department of Medicine, College of Medicine, Tzu Chi University and Director, Clinical Trial Center, Tzu Chi General Hospital, Hualien, Taiwan,
| | - Ming‐shien Chang
- Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei, Taiwan,
| | - Min‐muh Sheu
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital and Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan,
| | - Rong‐kung Tsai
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital and Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan,
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Hsu S, Chang M, Ko M, Harnod T. Retinal nerve fibre layer thickness and optic nerve head size measured in high myopes by optical coherence tomography. Clin Exp Optom 2021; 96:373-8. [DOI: 10.1111/cxo.12052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 08/25/2012] [Accepted: 09/05/2012] [Indexed: 01/31/2023] Open
Affiliation(s)
- Sheng‐yao Hsu
- Department of Ophthalmology, Tainan Municipal An‐Nan Hospital‐China Medical University, Tainan, Taiwan,
- Institute of Medicine and the Institute of Medical Sciences, College of Medicine, zu Chi University, Hualien, Taiwan,
| | - Ming‐shien Chang
- Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei, Taiwan,
| | - Mei‐lan Ko
- Department of Ophthalmology, National Taiwan University Hospital, Hsin Chu Branch and Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsin Chu City, Taiwan,
| | - Tomor Harnod
- Department of Neurosurgery, Buddhist Tzu Chi General Hospital and Department of Nursing and Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan,
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Grace P, Evans BJW, Edgar DF, Patel PJ, Thomas D, Mahon G, Blake A, Bennett D. Investigation of the efficacy of an online tool for improving the diagnosis of macular lesions imaged by optical coherence tomography. JOURNAL OF OPTOMETRY 2021; 14:206-214. [PMID: 33132077 PMCID: PMC8093527 DOI: 10.1016/j.optom.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 07/21/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Optical coherence tomography (OCT) is a non-invasive method for diagnosis and monitoring of retinal (typically, macular) conditions. The unfamiliar nature of OCT images can present considerable challenges for some community optometrists. The purpose of this research is to develop and assess the efficacy of a novel internet resource designed to assist optometrists in using OCT for diagnosis of macular disease and patient management. METHODS An online tool (OCTAID) has been designed to assist practitioners in the diagnosis of macular lesions detected by OCT. The effectiveness of OCTAID was evaluated in a randomised controlled trial comparing two groups of practitioners who underwent an online assessment (using clinical vignettes) based on OCT images, before (exam 1) and after (exam 2) an educational intervention. Participants' answers were validated against experts' classifications (the reference standard). OCTAID was randomly allocated as the educational intervention for one group with the control group receiving an intervention of standard OCT educational material. The participants were community optometrists. RESULTS Random allocation resulted in 53 optometrists receiving OCTAID and 65 receiving the control intervention. Both groups performed similarly at baseline with no significant difference in mean exam 1 scores (p = 0.21). The primary outcome measure was mean improvement in exam score between the two exam modules. Participants who received OCTAID improved their exam score significantly more than those who received conventional educational materials (p = 0.005). CONCLUSION Use of OCTAID is associated with an improvement in the combined skill of OCT scan recognition and patient management decisions.
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Affiliation(s)
- Paul Grace
- London South Bank University, UK; Institute of Optometry, London, UK.
| | - Bruce J W Evans
- London South Bank University, UK; Institute of Optometry, London, UK
| | - David F Edgar
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
| | - Praveen J Patel
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Wang L, Wang G, Zhang M, Fan D, Liu X, Guo Y, Wang R, Lv B, Lv C, Wei J, Sun X, Xie G, Wang M. An Intelligent Optical Coherence Tomography-based System for Pathological Retinal Cases Identification and Urgent Referrals. Transl Vis Sci Technol 2020; 9:46. [PMID: 32879756 PMCID: PMC7443122 DOI: 10.1167/tvst.9.2.46] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/02/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose This study aimed to develop an automated system with artificial intelligence algorithms to comprehensively identify pathologic retinal cases and make urgent referrals. Methods To build and test the intelligent system, this study obtained 28,664 optical coherence tomography (OCT) images from 2254 patients in the Eye and ENT Hospital of Fudan University (EENT Hospital) and Shanghai Tenth People's Hospital (TENTH Hospital). We applied a deep learning model with an adapted feature pyramid network to detect 15 categories of retinal pathologies from OCT images as common signs of various retinal diseases. Subsequently, the pathologies detected in the OCT images and thickness features extracted from retinal thickness measurements were combined for urgent referral using the random forest tool. Results The retinal pathologies detection model had a sensitivity of 96.39% and specificity of 98.91% from the EENT Hospital test dataset, whereas those from the TENTH Hospital test dataset were 94.89% and 98.76%, respectively. The urgent referral model achieved accuracies of 98.12% and 98.01% from the EENT Hospital and TENTH Hospital test datasets, respectively. Conclusions An intelligent system capable of automatically identifying pathologic retinal cases and offering urgent referrals was developed and demonstrated reliable performance with high sensitivity, specificity, and accuracy. Translational Relevance This intelligent system has great value and practicability in communities where exist increasing cases of retinal disease and a lack of ophthalmologists.
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Affiliation(s)
- Lilong Wang
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | | | - Meng Zhang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Dongyi Fan
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | - Xiaoqiang Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Yan Guo
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | - Rui Wang
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | - Bin Lv
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | - Chuanfeng Lv
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | - Jay Wei
- Optovue Inc., Fremont, CA, USA
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Guotong Xie
- PingAn Technology (Shenzhen) Co., Ltd., Shenzhen, China
| | - Min Wang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Fujiwara K, Ikeda Y, Murakami Y, Tachibana T, Funatsu J, Koyanagi Y, Nakatake S, Shimokawa S, Yoshida N, Nakao S, Hisatomi T, Ishibashi T, Sonoda KH. Aqueous Flare and Progression of Visual Field Loss in Patients With Retinitis Pigmentosa. Invest Ophthalmol Vis Sci 2020; 61:26. [PMID: 32692839 PMCID: PMC7425686 DOI: 10.1167/iovs.61.8.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the association between aqueous flare and progression of visual field loss using the Humphrey Field Analyzer in patients with retinitis pigmentosa (RP). Methods We examined a total of 101 eyes of 101 patients who were diagnosed with typical RP. Sixty-one percent of the patients were female, and the mean age of the total group was 47.4 years. Aqueous flare, visual field (by an Humphrey Field Analyzer, the central 10-2 SITA-Standard program), and optical coherence tomography measurements were obtained for all patients. The slope, which was derived from serial values of mean deviation, macular sensitivity, or foveal sensitivity for each eye with univariate linear regression, was used for analysis. Results Aqueous flare values were significantly correlated with the mean deviation slope (r = −0.20, P = 0.046), macular sensitivity slope (r = −0.28, P = 0.005) and foveal sensitivity slope (r = −0.20, P = 0.047). The values of the retinal sensitivity slope significantly decreased as the aqueous flare level increased (all P < 0.05). These associations remained unchanged after adjustment for age, sex, and posterior subcapsular cataract, and epiretinal membrane. Conclusions Elevation of aqueous flare is a risk factor for the decline of central visual function in RP. Aqueous flare may be a useful marker for disease progression in RP.
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Silverstein SM, Demmin DL, Schallek JB, Fradkin SI. Measures of Retinal Structure and Function as Biomarkers in Neurology and Psychiatry. Biomark Neuropsychiatry 2020. [DOI: 10.1016/j.bionps.2020.100018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Celik M, Kalenderoglu A, Sevgi Karadag A, Bekir Egilmez O, Han-Almis B, Şimşek A. Decreases in ganglion cell layer and inner plexiform layer volumes correlate better with disease severity in schizophrenia patients than retinal nerve fiber layer thickness: Findings from spectral optic coherence tomography. Eur Psychiatry 2020; 32:9-15. [DOI: 10.1016/j.eurpsy.2015.10.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 01/30/2023] Open
Abstract
AbstractBackgroundOptic coherence tomography (OCT) is a new, contactless and fast neuroimaging method. Previous studies have observed thinning of the retinal nerve fibre layer (RNFL) in many neurodegenerative diseases, and researchers have suggested that correlations exist between the thinning of the RNFL and the neurodegeneration detected with other imaging methods or the severity of illness. More recently, OCT has been used in patients with schizophrenia. RNFL thinning has also been detected in these patients. With more sophisticated devices, segmentation of the retina and measurements of the ganglion cell layer (GCL) and internal plexiform layer (IPL) can be performed.MethodsWe measured the RNFL thickness and the GCL and IPL volumes in 40 treatment refractory patients with schizophrenia, 41 treatment responsive refractory patients and 41 controls using spectral-OCT, and we evaluated the correlations between the disease severity and OCT measurements.ResultsThe global RNFL thickness and GCL and IPL volumes were decreased in the patients with schizophrenia compared with the controls. In addition, the GCL and IPL volumes were lower in the treatment refractory patients with schizophrenia compared to the treatment responsive patients. Using parameters such as the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scores, the disease duration and number of hospitalizations, correlations between the GCL and IPL volumes and disease severity were stronger than the correlations between the RNFL and the disease parameters.ConclusionOur findings suggest that OCT can be used to detect neurodegeneration in schizophrenia and that the GCL and IPL volumes can also be used to monitor the progression of neurodegeneration.
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Zhao X, Ding X, Lyu C, Li S, Lian Y, Chen X, Tanumiharjo S, Zhang A, Lu J, Liang X, Jin C, Lu L. Observational study of clinical characteristics of dome-shaped macula in Chinese Han with high myopia at Zhongshan Ophthalmic Centre. BMJ Open 2018; 8:e021887. [PMID: 30580257 PMCID: PMC6318533 DOI: 10.1136/bmjopen-2018-021887] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate the prevalence of dome-shaped macula (DSM) in highly myopic eyes among Chinese Han and to detect the correlation with myopic maculopathy and macular complications. METHODS A total of 736 Chinese Han patients (1384 eyes) with high myopia (refractive error≤6.0 diopters or axial length ≥26.5 mm) are reviewed based on information entered into a high-myopia database at Zhongshan Ophthalmic Centre. Subfoveal choroidal thickness (SFCT) and parafoveal choroidal thickness (PFCT) are measured. The prevalence of DSM in patients with myopic maculopathy is categorised from C0 to C4. Clinical features, including macular complications, SFCT and PFCT, are compared between myopic eyes with and without DSM. RESULTS Among the 1384 eyes, 149 (10.77%) show DSM. In highly myopic eyes without macular complications, the best corrected visual acuity is significantly worse in patients with DSM (p=0.002), and the ratio between subfoveal and parafoveal choroidal thickness (S/PCT) is significantly elevated in patients with DSM (p=0.021). The proportion of foveal schisis (17.24% vs 62.86%) is much lower in eyes with DSM compared with those without DSM. However, the proportions of extrafoveal schisis (39.66% vs 5.37%), foveal serous retinal detachment (SRD) (5.17% vs 0) and epiretinal membrane (ERM) (24.14% vs 10.74%) are much higher in eyes with DSM. The proportion of DSM was lower in C0 and C1, but higher proportion of DSM was found in C3 and C4. CONCLUSIONS DSM is found in 10.77% of highly myopic eyes among Chinese Han. DSM might be a protective mechanism for foveal schisis and a risk factor for extrafoveal schisis, SRD and ERM.
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Affiliation(s)
- Xiujuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyan Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cancan Lyu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shiyi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yu Lian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaohong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Silvia Tanumiharjo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Aiyuan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jinge Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chenjin Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Lu W, Tong Y, Yu Y, Xing Y, Chen C, Shen Y. Deep Learning-Based Automated Classification of Multi-Categorical Abnormalities From Optical Coherence Tomography Images. Transl Vis Sci Technol 2018; 7:41. [PMID: 30619661 PMCID: PMC6314222 DOI: 10.1167/tvst.7.6.41] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/10/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To develop a new intelligent system based on deep learning for automatically optical coherence tomography (OCT) images categorization. METHODS A total of 60,407 OCT images were labeled by 17 licensed retinal experts and 25,134 images were included. One hundred one-layer convolutional neural networks (ResNet) were trained for the categorization. We applied 10-fold cross-validation method to train and optimize our algorithms. The area under the receiver operating characteristic curve (AUC), accuracy and kappa value were calculated to evaluate the performance of the intelligent system in categorizing OCT images. We also compared the performance of the system with results obtained by two experts. RESULTS The intelligent system achieved an AUC of 0.984 with an accuracy of 0.959 in detecting macular hole, cystoid macular edema, epiretinal membrane, and serous macular detachment. Specifically, the accuracies in discriminating normal images, cystoid macular edema, serous macular detachment, epiretinal membrane, and macular hole were 0.973, 0.848, 0.947, 0.957, and 0.978, respectively. The system had a kappa value of 0.929, while the two physicians' kappa values were 0.882 and 0.889 independently. CONCLUSIONS This deep learning-based system is able to automatically detect and differentiate various OCT images with excellent accuracy. Moreover, the performance of the system is at a level comparable to or better than that of human experts. This study is a promising step in revolutionizing current disease diagnostic pattern and has the potential to generate a significant clinical impact. TRANSLATIONAL RELEVANCE This intelligent system has great value in increasing retinal diseases' diagnostic efficiency in clinical circumstances.
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Affiliation(s)
- Wei Lu
- Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, Hubei, China
| | - Yan Tong
- Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, Hubei, China
| | - Yue Yu
- Wuhan Haixingtong Technology Limited Company, Wuhan, Hubei, China
| | - Yiqiao Xing
- Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, Hubei, China
| | - Changzheng Chen
- Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, Hubei, China
| | - Yin Shen
- Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, Hubei, China
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Testa F, Melillo P, Rossi S, Marcelli V, de Benedictis A, Colucci R, Gallo B, Brunetti-Pierri R, Donati S, Azzolini C, Marciano E, Simonelli F. Prevalence of macular abnormalities assessed by optical coherence tomography in patients with Usher syndrome. Ophthalmic Genet 2017; 39:17-21. [DOI: 10.1080/13816810.2017.1329445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paolo Melillo
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Settimio Rossi
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vincenzo Marcelli
- Audiology Unit, Department of Neuroscience, Reproductive and Odontostomatologic Science, University of Naples Federico II, Naples, Italy
| | - Antonella de Benedictis
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Raffaella Colucci
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Beatrice Gallo
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Raffaella Brunetti-Pierri
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Simone Donati
- Department of Surgical and Morphological Sciences, University of Insunbria, Varese, Italy
| | - Claudio Azzolini
- Department of Surgical and Morphological Sciences, University of Insunbria, Varese, Italy
| | - Elio Marciano
- Audiology Unit, Department of Neuroscience, Reproductive and Odontostomatologic Science, University of Naples Federico II, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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Segal O, Shapira Y, Gershoni A, Vainer I, Nemet AY, Geffen N, Mimouni M. Relationship between macular thickness measurement and signal strength using Stratus optical coherence tomography. Clin Ophthalmol 2016; 10:2259-2264. [PMID: 27956823 PMCID: PMC5113921 DOI: 10.2147/opth.s104153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine the relationship between signal strength and macular thickness as measured by Stratus optical coherence tomography (OCT)’s fast macular thickness protocol in healthy subjects. Methods In this prospective cross-sectional study 79 eyes of 42 healthy subjects were enrolled. The age, gender, and eye (right vs left) of each subject were recorded. The Stratus OCT fast macular thickness scan protocol was used and the macular thickness was measured with retinal thickness map analysis. Each eye was imaged at least six times to acquire images with signal strengths of 4, 5, 6, 7, 8, and 9 out of 10 via adjustment of the focusing knob. The OCT parameters included in the analysis were thickness in the central 1 mm and in the different quadrants in the 3-mm area. Results Overall 79 eyes of 42 patients with a mean age of 38.4±12.4 were included. There was no significant difference between the signal strength measurements obtained with different signal strengths in the central thickness (P=0.20). In the superior, nasal, inferior, and temporal quadrants, a signal strength of 8 demonstrated up to 3 µm thicker measurements than a signal strength of 5 (P<0.05). In general linear regression analysis, after accounting for age and gender, signal strength did not remain a significant predictor of thickness in any quadrant. Conclusions When using fast map macular measurements, a signal strength of 5 is clinically as efficient as a signal strength of 8 in measuring macular thickness in all quadrants. Insisting on higher signal strength may not be necessary.
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Affiliation(s)
- Ori Segal
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel and the Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - Yinon Shapira
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Assaf Gershoni
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel and the Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - Igor Vainer
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Arie Y Nemet
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel and the Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - Noa Geffen
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel and the Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
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EARLY CRT MONITORING USING TIME-DOMAIN OPTICAL COHERENCE TOMOGRAPHY DOES NOT ADD TO VISUAL ACUITY FOR PREDICTING VISUAL LOSS IN PATIENTS WITH CENTRAL RETINAL VEIN OCCLUSION TREATED WITH INTRAVITREAL RANIBIZUMAB: A Secondary Analysis of Trial Data. Retina 2016; 37:509-514. [PMID: 27548351 DOI: 10.1097/iae.0000000000001207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Our primary purpose was to assess the clinical (predictive) validity of central retinal thickness (CRT) and best corrected visual acuity (BCVA) at 1 week and 1 month after starting treatment with ranibizumab for central retinal vein occlusion. The authors also assessed detectability of response to treatment. METHODS The authors used data from 325 participants in the CRUISE study, which included measurement of time-domain CRT and BCVA at baseline, 1 week, 1 month, and 6 months postrandomization. Analysis of covariance models were fitted to assess clinical validity, and distributions of change were constructed to assess detectability of response. RESULTS There was no evidence that 1-week CRT, and very strong evidence that 1-week BCVA were associated with baseline-adjusted BCVA at 6 months (P = 0.17 and P < 0.001, respectively). There was strong evidence that both 1-month CRT and 1-month BCVA were associated with baseline-adjusted 6-month BCVA (P = 0.005 and P < 0.001, respectively), but simultaneous adjustment found evidence of independent association only for BCVA (P = 0.71 and P < 0.001 for CRT and BCVA, respectively). Detectability of response tended to be higher for CRT than BCVA at 1 week and 1 month but by 6 months these were equivalent for CRT and BCVA. CONCLUSION In this study, BCVA monitoring of treated central retinal vein occlusion patients seemed more informative than time-domain optical coherence tomography monitoring.
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Nie C, Zhang MN, Zhao HW, Olsen TD, Jackman K, Hu LN, Ma WP, Chen XF, Wang J, Zhang Y, Gao TS, Uehara H, Ambati BK, Luo L. Correlation of in vivo and in vitro methods in measuring choroidal vascularization volumes using a subretinal injection induced choroidal neovascularization model. Chin Med J (Engl) 2016; 128:1516-22. [PMID: 26021510 PMCID: PMC4733772 DOI: 10.4103/0366-6999.157681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In vivo quantification of choroidal neovascularization (CNV) based on noninvasive optical coherence tomography (OCT) examination and in vitro choroidal flatmount immunohistochemistry stained of CNV currently were used to evaluate the process and severity of age-related macular degeneration (AMD) both in human and animal studies. This study aimed to investigate the correlation between these two methods in murine CNV models induced by subretinal injection. METHODS CNV was developed in 20 C57BL6/j mice by subretinal injection of adeno-associated viral delivery of a short hairpin RNA targeting sFLT-1 (AAV.shRNA.sFLT-1), as reported previously. After 4 weeks, CNV was imaged by OCT and fluorescence angiography. The scaling factors for each dimension, x, y, and z (μm/pixel) were recorded, and the corneal curvature standard was adjusted from human (7.7) to mice (1.4). The volume of each OCT image stack was calculated and then normalized by multiplying the number of voxels by the scaling factors for each dimension in Seg3D software (University of Utah Scientific Computing and Imaging Institute, available at http://www.sci.utah.edu/cibc-software/seg3d.html). Eighteen mice were prepared for choroidal flatmounts and stained by CD31. The CNV volumes were calculated using scanning laser confocal microscopy after immunohistochemistry staining. Two mice were stained by Hematoxylin and Eosin for observing the CNV morphology. RESULTS The CNV volume calculated using OCT was, on average, 2.6 times larger than the volume calculated using the laser confocal microscopy. The correlation statistical analysis showed OCT measuring of CNV correlated significantly with the in vitro method (R 2 =0.448, P = 0.001, n = 18). The correlation coefficient for CNV quantification using OCT and confocal microscopy was 0.693 (n = 18, P = 0.001). CONCLUSIONS There is a fair linear correlation on CNV volumes between in vivo and in vitro methods in CNV models induced by subretinal injection. The result might provide a useful evaluation of CNV both for the studies using CNV models induced by subretinal injection and human AMD studies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ling Luo
- Department of Ophthalmology, The 306th Hospital of PLA, Beijing 100101, China
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Schönfeldt-Lecuona C, Kregel T, Schmidt A, Pinkhardt EH, Lauda F, Kassubek J, Connemann BJ, Freudenmann RW, Gahr M. From Imaging the Brain to Imaging the Retina: Optical Coherence Tomography (OCT) in Schizophrenia. Schizophr Bull 2016; 42:9-14. [PMID: 26048298 PMCID: PMC4681543 DOI: 10.1093/schbul/sbv073] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Optical Coherence Tomography (OCT) is a noninvasive imaging method, which provides an in vivo image of the retina. It allows for quantitative measurements of retinal and macular thickness, including single-layer analysis. Because the retinal nerve fibre layer comprises the first axons of the visual pathway and is unmyelinated, it can be considered a unique anatomical model, which may provide insight into the pathophysiological processes of diseases with a neurodegenerative character. In fact, past OCT studies have emphasized the role of the visual pathway as an ideal structure for exploring neurodegeneration and have demonstrated the potential of the method as an instrument for longitudinally monitoring structural changes in neurological disorders such as multiple sclerosis. Progress in signal processing and advancements to the OCT technique enables the illustration of structural changes in the retinal layers in a quick, reproducible, and objective manner with a spatial resolution comparable to those of histological slices.Findings from computer-based magnetic resonance imaging analyses and neuropathological studies support the hypothesis of a degenerative component of certain psychiatric disorders such as schizophrenia. Studies in schizophrenia incorporating OCT are currently rare and have yielded further heterogeneous results. This article elucidates the method of OCT and the retina's role as a "window to the brain". Furthermore, in delineating the degenerative components of schizophrenia, we discuss the possible applications of OCT in the schizophrenia population.
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Affiliation(s)
- Carlos Schönfeldt-Lecuona
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12-14, Ulm, Germany;
| | - Thomas Kregel
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12–14, Ulm, Germany;,These authors contributed equally to this article
| | - Arno Schmidt
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12–14, Ulm, Germany
| | - Elmar H. Pinkhardt
- Department of Neurology, University Clinic Ulm, Oberer Eselsberg 45, Ulm, Germany
| | - Florian Lauda
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12–14, Ulm, Germany;,Department of Neurology, University Clinic Ulm, Oberer Eselsberg 45, Ulm, Germany
| | - Jan Kassubek
- Department of Neurology, University Clinic Ulm, Oberer Eselsberg 45, Ulm, Germany
| | - Bernhard J. Connemann
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12–14, Ulm, Germany
| | - Roland W. Freudenmann
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12–14, Ulm, Germany
| | - Maximilian Gahr
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Leimgrubenweg 12–14, Ulm, Germany
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Dabasia PL, Edgar DF, Garway-Heath DF, Lawrenson JG. A survey of current and anticipated use of standard and specialist equipment by UK optometrists. Ophthalmic Physiol Opt 2015; 34:592-613. [PMID: 25160893 DOI: 10.1111/opo.12150] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 07/22/2014] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate current and anticipated use of equipment and information technology (IT) in community optometric practice in the UK, and to elicit optometrists' views on adoption of specialist equipment and IT. METHODS An anonymous online questionnaire was developed, covering use of standard and specialist diagnostic equipment, and IT. The survey was distributed to a random sample of 1300 UK College of Optometrists members. RESULTS Four hundred and thirty-two responses were received (response rate = 35%). Enhanced (locally commissioned) or additional/separately contracted services were provided by 73% of respondents. Services included glaucoma repeat measures (30% of respondents), glaucoma referral refinement (22%), fast-track referral for wet age-related macular degeneration (48%), and direct cataract referral (40%). Most respondents (88%) reported using non-contact/pneumo tonometry for intra-ocular pressure measurement, with 81% using Goldmann or Perkins tonometry. The most widely used item of specialist equipment was the fundus camera (74% of respondents). Optical Coherence Tomography (OCT) was used by 15% of respondents, up from 2% in 2007. Notably, 43% of those anticipating purchasing specialist equipment in the next 12 months planned to buy an OCT. 'Paperless' records were used by 39% of respondents, and almost 80% of practices used an electronic patient record/practice management system. Variations in responses between parts of the UK reflect differences in the provision of the General Ophthalmic Services contract or community enhanced services. There was general agreement that specialised equipment enhances clinical care, permits increased involvement in enhanced services, promotes the practice and can be used as a defence in clinico-legal cases, but initial costs and ongoing maintenance can be a financial burden. Respondents generally agreed that IT facilitates administrative flow and secure exchange of health information, and promotes a state-of-the-art practice image. However, use of IT may not save examination time; its dynamic nature necessitates frequent updates and technical support; the need for adequate training is an issue; and security of data is also a concern. CONCLUSION UK optometrists increasingly employ modern equipment and IT services to enhance patient care and for practice management. While the clinical benefits of specialist equipment and IT are appreciated, questions remain as to whether the investment is cost-effective, and how specialist equipment and IT may be used to best advantage in community optometric practice.
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Affiliation(s)
- Priya L Dabasia
- Centre for Public Health Research, School of Health Sciences, City University London, London, UK
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Kumar RS, Jariwala MU, V SA, Venugopal JP, Puttaiah NK, Balu R, Rao A S D, Shetty R. A Pilot Study on Feasibility and Effectiveness of Intraoperative Spectral-Domain Optical Coherence Tomography in Glaucoma Procedures. Transl Vis Sci Technol 2015; 4:2. [PMID: 25767745 DOI: 10.1167/tvst.4.2.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 01/13/2015] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To demonstrate the use of a spectral-domain optical coherence tomography (SDOCT) integrated surgical microscope in glaucoma surgery. METHODS An SDOCT system was used to interface directly with an ophthalmic surgical microscope, to allow real-time intraoperative SDOCT (iOCT) imaging during glaucoma procedures like phaco-trabeculectomy, Ahmed glaucoma valve (AGV) implantation, gonio-synechiolysis, and bleb needling. The various surgical steps during glaucoma surgeries where iOCT can be of potential help in guiding the surgeon were recorded. RESULTS High-resolution, cross-sectional images of the relevant structures were achieved with the iOCT system in all procedures. The surgeon could determine the depth of the scleral dissection, the intrastomal bed, the path of the AGV tube in the eye, the release of peripheral anterior synechiae and the efficacy of needling with respect to breakage of loculations; most of these are technically 'blind' procedures, where the outcomes are determined postoperatively. Metallic instruments cast a shadow on tissues below, thereby restricting the use of the device in its current state. CONCLUSIONS The iOCT system provided high quality, intraoperative, real-time imaging, which could possibly improve the safety and efficacy of the surgical procedures in glaucoma. Further studies and modifications to the iOCT are required to better understand and increase the uptake of this technology in daily practice. TRANSLATIONAL RELEVANCE The iOCT, with further advancements in its technology, could potentially provide the surgeon both quantitative and qualitative, real-time depth and tissue proximity details, thus improving the safety and accuracy of glaucoma surgery.
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Affiliation(s)
| | | | | | | | | | | | | | - Rohit Shetty
- Narayana Nethralaya Eye Hospital, Bangalore, India
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Lee SH, Kim SD, Kim YY. The Effect of Gas Tamponade with Vitrectomy in Lamellar Macular Hole. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.9.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Si Dong Kim
- Department of Ophthalmology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Yoon Young Kim
- Department of Ophthalmology, Catholic University of Daegu School of Medicine, Daegu, Korea
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Pang CE, Spaide RF, Freund KB. EPIRETINAL PROLIFERATION SEEN IN ASSOCIATION WITH LAMELLAR MACULAR HOLES. Retina 2014; 34:1513-23. [DOI: 10.1097/iae.0000000000000163] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Testa F, Rossi S, Colucci R, Gallo B, Di Iorio V, della Corte M, Azzolini C, Melillo P, Simonelli F. Macular abnormalities in Italian patients with retinitis pigmentosa. Br J Ophthalmol 2014; 98:946-50. [PMID: 24532797 PMCID: PMC4078675 DOI: 10.1136/bjophthalmol-2013-304082] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Aim To investigate the prevalence of macular abnormalities in a large Caucasian cohort of patients affected by retinitis pigmentosa (RP). Methods A retrospective study was performed by reviewing the medical records and optical coherence tomography (OCT) scans in a cohort of 581 RP patients in order to assess the presence of macular abnormalities —that is, cystoid macular oedema (CMO), epiretinal membrane (ERM), vitreo-macular traction syndrome, and macular hole. Results Macular abnormalities were observed in 524 (45.1%) out of the 1161 examined eyes. The most frequent abnormality was CMO, observed in 237 eyes (20.4%) from 133 patients (22.9%), followed by ERM, assessed in 181 eyes (15.6%) from 115 patients (19.8%). Moreover, vitreo-retinal abnormalities were significantly (p<0.05) associated with older age, cataract surgery, or cataract. CMO appeared to be significantly (p<0.05) associated with female gender, autosomic dominant inheritance pattern, and cataract. Conclusions Macular abnormalities are more frequent in RP compared to the general population. For that reason, screening RP patients with OCT is highly recommended to follow-up the patients, evaluate the natural history of disease, and identify those patients who could benefit from current or innovative therapeutic strategies.
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Affiliation(s)
- Francesco Testa
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Settimio Rossi
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Raffaella Colucci
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Beatrice Gallo
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Valentina Di Iorio
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Michele della Corte
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Claudio Azzolini
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Paolo Melillo
- Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
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Topcu-Yilmaz P, Kasim B, Kiratli H. Investigation of retinal nerve fiber layer thickness in patients with neurofibromatosis-1. Jpn J Ophthalmol 2014; 58:172-6. [DOI: 10.1007/s10384-014-0308-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 12/20/2013] [Indexed: 01/08/2023]
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Durkin JR, Fine JL, Sam H, Pugliano-Mauro M, Ho J. Imaging of Mohs micrographic surgery sections using full-field optical coherence tomography: a pilot study. Dermatol Surg 2014; 40:266-74. [PMID: 24433402 DOI: 10.1111/dsu.12419] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Full-field optical coherence tomography (FF-OCT) is a new noninvasive imaging technique that can see down to the cellular level without tissue preparation or contrast agents. OBJECTIVE To use FF-OCT to image Mohs micrographic surgery specimens and verify the ability of a dermatopathologist to identify or exclude malignancy. MATERIALS AND METHODS Two Mohs surgeons supplied 18 Mohs sections from 11 patients. Each section was scanned using the FF-OCT, and a dermatopathologist blinded to the diagnosis examined the images for malignancy. The FF-OCT images were then compared with the intraoperative hematoxylin and eosin (H&E)-stained frozen sections for concordance. RESULTS All 9 FF-OCT images interpreted as negative for malignancy were in agreement with the H&E frozen sections. Six of the remaining FF-OCT images were correctly interpreted as positive for malignancy, and three were deferred because malignancy could not be confirmed or excluded. CONCLUSION Malignancy in Mohs sections can correctly be identified or excluded using FF-OCT. Although not ready for clinical use in its current state, FF-OCT has the potential to be incorporated into the Mohs workflow in the future.
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Affiliation(s)
- John R Durkin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Skarecky DW, Brenner M, Rajan SS, Rodriguez E, Narula N, Melgoza F, Ahlering TE. Zero positive surgical margins after radical prostatectomy: is the end in sight? Expert Rev Med Devices 2014; 5:709-17. [DOI: 10.1586/17434440.5.6.709] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Douglas W Skarecky
- Department of Urology, University of California at Irvine, Orange, CA, USA
| | - Matthew Brenner
- Department of Medicine, University of California at Irvine, Orange, CA, USA
| | - Sudhir S Rajan
- Department of Medicine, University of California at Irvine, Orange, CA, USA
| | - Esequiel Rodriguez
- Department of Urology, University of California at Irvine, Orange, CA, USA
| | - Navneet Narula
- Department of Pathology, University of California at Irvine, Orange, CA, USA
| | - Frank Melgoza
- Department of Pathology, University of California at Irvine, Orange, CA, USA
| | - Thomas E Ahlering
- Department of Urology, University of California, Irvine Medical Center, 333 City Blvd West, Suite 2100, Orange, CA 92868, USA
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Sharma R, Sharma A, Arora T, Sharma S, Sobti A, Jha B, Chaturvedi N, Dada T. Application of anterior segment optical coherence tomography in glaucoma. Surv Ophthalmol 2013; 59:311-27. [PMID: 24138894 DOI: 10.1016/j.survophthal.2013.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 02/02/2023]
Abstract
Optical coherence tomography (OCT) is a cross-sectional, three-dimensional, high-resolution imaging modality that uses low coherence interferometry to achieve axial resolution in the range of 3-20 μm. Two OCT platforms have been developed: time domain (TD-OCT) and spectral (or Fourier) domain (SD/FD-OCT). Visante anterior segment OCT (Carl Zeiss Meditec) is a TD-OCT widely used for anterior segment imaging. The SD-OCT systems with both posterior and anterior segment imaging capabilities include the RTVue, iVue (Optovue), the Cirrus (Carl Zeiss Meditec), and the Spectralis (Heidelberg Engineering, Inc.). Each of the SD-OCTs has a wavelength in the range of 820-879 nm. Anterior segment OCT is a non-contact method providing high resolution tomographic cross-sectional imaging of anterior segment structures. Anterior segment OCT provides qualitative and quantitative assessment of the anterior segment structures important to the pathogenesis and the anatomical variations of glaucoma, and the approach to and success of treatment. We summarize the clinical applications of anterior segment OCT in glaucoma.
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Affiliation(s)
- Reetika Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tarun Arora
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sourabh Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Sobti
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bhaskar Jha
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Chaturvedi
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tanuj Dada
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Weis AJ, Huxlin KR, Callan CL, DeMagistris MA, Hindman HB. Keratocyte apoptosis and not myofibroblast differentiation mark the graft/host interface at early time-points post-DSAEK in a cat model. PLoS One 2013; 8:e75623. [PMID: 24098706 PMCID: PMC3787047 DOI: 10.1371/journal.pone.0075623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/16/2013] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate myofibroblast differentiation as an etiology of haze at the graft-host interface in a cat model of Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK). METHODS DSAEK was performed on 10 eyes of 5 adult domestic short-hair cats. In vivo corneal imaging with slit lamp, confocal, and optical coherence tomography (OCT) were performed twice weekly. Cats were sacrificed and corneas harvested 4 hours, and 2, 4, 6, and 9 days post-DSAEK. Corneal sections were stained with the TUNEL method and immunohistochemistry was performed for α-smooth muscle actin (α-SMA) and fibronectin with DAPI counterstain. RESULTS At all in vivo imaging time-points, corneal OCT revealed an increase in backscatter of light and confocal imaging revealed an acellular zone at the graft-host interface. At all post-mortem time-points, immunohistochemistry revealed a complete absence of α-SMA staining at the graft-host interface. At 4 hours, extracellular fibronectin staining was identified along the graft-host interface and both fibronectin and TUNEL assay were positive within adjacent cells extending into the host stroma. By day 2, fibronectin and TUNEL staining diminished and a distinct acellular zone was present in the region of previously TUNEL-positive cells. CONCLUSIONS OCT imaging consistently showed increased reflectivity at the graft-host interface in cat corneas in the days post-DSAEK. This was not associated with myofibroblast differentiation at the graft-host interface, but rather with apoptosis and the development of a subsequent acellular zone. The roles of extracellular matrix changes and keratocyte cell death and repopulation should be investigated further as potential contributors to the interface optical changes.
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Affiliation(s)
- Adam J Weis
- University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
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Jhanji V, Yang B, Yu M, Ye C, Leung CKS. Corneal thickness and elevation measurements using swept-source optical coherence tomography and slit scanning topography in normal and keratoconic eyes. Clin Exp Ophthalmol 2013; 41:735-45. [PMID: 23566209 DOI: 10.1111/ceo.12113] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 02/22/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND To compare corneal thickness and corneal elevation using swept source optical coherence tomography and slit scanning topography. DESIGN Prospective study. PARTICIPANTS 41 normal and 46 keratoconus subjects. METHODS All eyes were imaged using swept source optical coherence tomography and slit scanning tomography during the same visit. Mean corneal thickness and best-fit sphere measurements were compared between the instruments. MAIN OUTCOME MEASURES Agreement of measurements between swept source optical coherence tomography and scanning slit topography was analyzed. Intra-rater reproducibility coefficient and intraclass correlation coefficient were evaluated. RESULTS In normal eyes, central corneal thickness measured by swept source optical coherence tomography was thinner compared with slit scanning topography (p < 0.0001) and ultrasound pachymetry (p = < .0001). Ultrasound pachymetry readings had better 95% limits of agreement with swept source optical coherence tomography than slit scanning topography. In keratoconus eyes, central corneal thickness was thinner on swept source optical coherence tomography than slit scanning topography (p = 0.081) and ultrasound pachymetry (p = 0.001). There were significant differences between thinnest corneal thickness, and, anterior and posterior best-fit sphere measurements between both instruments (p < 0.05 for all). Overall, reproducibility coefficients and intraclass correlation coefficients were significantly better with swept source optical coherence tomography for measurement of central corneal thickness, anterior best-fit sphere and, posterior best-fit sphere (all p < 0.001). CONCLUSIONS Corneal thickness and elevation measurements were significantly different between swept source optical coherence tomography and slit scanning topography. With better reproducibility coefficients and intraclass correlation coefficients, swept source optical coherence tomography may provide a reliable alternative for measurement of corneal parameters.
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Affiliation(s)
- Vishal Jhanji
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
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31
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Zheng Y, Sahni J, Campa C, Stangos AN, Raj A, Harding SP. Computerized assessment of intraretinal and subretinal fluid regions in spectral-domain optical coherence tomography images of the retina. Am J Ophthalmol 2013; 155:277-286.e1. [PMID: 23111180 DOI: 10.1016/j.ajo.2012.07.030] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 07/27/2012] [Accepted: 07/31/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate a new computerized segmentation technique for the quantification of intraretinal and subretinal fluid in spectral-domain optical coherence tomography (SD OCT) images of the retina. DESIGN Prospective, cross-sectional study. METHODS Thirty-seven B-scan images of 37 patients with exudative age-related macular degeneration were chosen randomly from SD OCT volume scans (1 per volume scan). All hyporeflective areas in the image first were segmented automatically as candidate regions by the program. Researchers who were masked to the candidate region information selected each fluid region from the original image using a single mouse click. The program then delineated the boundary of each region selected and calculated quantitative parameters, including total area of fluid regions if multiple regions were selected. The performance of our technique was validated by comparing the results with the measurements obtained from boundaries manually delineated by 2 masked observers. Time efficiency, agreement with manual delineation, and intraobserver and interobserver agreement of using the program were evaluated. RESULTS The proposed technique reduced the average processing time per image approximately 6-fold (15 seconds for computerized segmentation vs 90 seconds for manual delineation). There was good agreement between computerized segmentation and manual delineation measured by intraclass correlation coefficient (range, 0.897 to 0.979) and the Dice coefficient (range, 0.721 to 0.785). The proposed technique has excellent intraobserver and interobserver agreement (intraclass correlation coefficient range, 0.998 to 0.999; Dice coefficient range. 0.959 to 0.981). CONCLUSIONS This computerized segmentation method allows for accurate and fast quantification of fluid in retinal SD OCT images and could assist in monitoring disease progression and evaluating therapeutic intervention.
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Ohmi M, Kuwabara M, Haruna M. Dynamic imaging of a small artery underneath skin surface of a human finger by optical coherence tomography. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jbise.2013.63030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Almazan A, Tsai S, Miller PE, Lee SS, Vilupuru AS, Burke JA, Robinson MR. Iridocorneal angle measurements in mammalian species: normative data by optical coherence tomography. Vet Ophthalmol 2012; 16:163-6. [DOI: 10.1111/j.1463-5224.2012.01030.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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35
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Salem W, Fraser-Bell S, Gillies M. Clinical development of new treatments for diabetic macular oedema. Clin Exp Optom 2012; 95:297-305. [PMID: 22428627 DOI: 10.1111/j.1444-0938.2012.00723.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The benchmark treatment for diabetic macular oedema, the major cause of visual impairment in patients with diabetes mellitus, has traditionally been laser photocoagulation; however, as laser treatment does not always improve vision or even prevent further loss in many cases, several new pharmacotherapies that are injected into the vitreous for diabetic macular oedema have been successfully trialled over the past decade. Others are currently being evaluated. The two major classes of these drugs are steroids and vascular endothelial growth factor antagonists. In this article we briefly review the major clinical studies recently conducted in this field.
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Affiliation(s)
- Wedad Salem
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
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36
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Choi WS, Kim SW, Lee WS, Moon SJ, Yoon HS. Visual and Surgical Outcomes of Lamellar Macular Hole. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.9.1291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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37
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Flores-Rodríguez P, Gili P, Martín-Ríos MD. Ophthalmic Features of Optic Disc Drusen. Ophthalmologica 2012; 228:59-66. [DOI: 10.1159/000337842] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Accepted: 02/22/2012] [Indexed: 11/19/2022]
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38
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Greenberg BM, Frohman E. Optical coherence tomography as a potential readout in clinical trials. Ther Adv Neurol Disord 2011; 3:153-60. [PMID: 21179607 DOI: 10.1177/1756285610368890] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Optical coherence tomography (OCT) is a noninvasive tool used for measuring tissue at micrometer resolution. It has been extensively applied to ocular pathologies and is now being studied as a biomarker in various neurologic conditions. The retina represents a unique environment for study, with unmyelinated axons that directly synapse into the central nervous system. When trying to quantify axonal degradation in neurologic disease, the currently used imaging modalities are limited in sensitivity and specificity. Early data suggest that several neurologic conditions have pathologic changes in the retinal nerve fiber layer of the eye, creating a potential surrogate marker for neurodegeneration. OCT has the potential to become a noninvasive, reproducible test for axonal degeneration that could become an invaluable tool for measuring the efficacy of potential neuroprotective agents. If the natural history of neurodegeneration, as measured by OCT, can be documented in diseases such as Alzheimer's, Parkinson's and multiple sclerosis, then OCT can be used to measure alterations in the rate of degeneration when treatment is applied. Thus, OCT represents a new, promising technology for documenting outcomes in neuroprotection trials.
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Affiliation(s)
- Benjamin M Greenberg
- Department of Neurology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235, USA
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39
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Shukla R, Abidi WM, Richards-Kortum R, Anandasabapathy S. Endoscopic imaging: How far are we from real-time histology? World J Gastrointest Endosc 2011; 3:183-94. [PMID: 22013499 PMCID: PMC3196726 DOI: 10.4253/wjge.v3.i10.183] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 07/15/2011] [Accepted: 08/30/2011] [Indexed: 02/05/2023] Open
Abstract
Currently, in gastrointestinal endoscopy there is increasing interest in high resolution endoscopic technologies that can complement high-definition white light endoscopy by providing real-time subcellular imaging of the epithelial surface. These ‘optical biopsy’ technologies offer the potential to improve diagnostic accuracy and yield, while facilitating real-time decision-making. Although many endoscopic techniques have preliminarily shown high accuracy rates, these technologies are still evolving. This review will provide an overview of the most promising high-resolution imaging technologies, including high resolution microendoscopy, optical coherence tomography, endocytoscopy and confocal laser endoscopy. This review will also discuss the application and current limitations of these technologies for the early detection of neoplasia in Barrett’s esophagus, ulcerative colitis and colorectal cancer.
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Affiliation(s)
- Richa Shukla
- Richa Shukla, Wasif M Abidi, Sharmila Anandasabapathy, Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, United States
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Larina IV, Larin KV, Justice MJ, Dickinson ME. Optical Coherence Tomography for live imaging of mammalian development. Curr Opin Genet Dev 2011; 21:579-84. [PMID: 21962442 DOI: 10.1016/j.gde.2011.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 08/24/2011] [Accepted: 09/06/2011] [Indexed: 02/08/2023]
Abstract
Understanding the nature and mechanism of congenital defects of the different organ systems in humans has heavily relied on the analysis of the corresponding mutant phenotypes in rodent models. Optical Coherence Tomography (OCT) has recently emerged as a powerful tool to study early embryonic development. This non-invasive optical methodology does not require labeling and allows visualization of embryonic tissues with single cell resolution. Here, we will discuss how OCT can be applied for structural imaging of early mouse and rat embryos in static culture, cardiodynamic and blood flow analysis, and in utero embryonic imaging at later stages of gestation, demonstrating how OCT can be used to assess structural and functional birth defects in mammalian models.
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Affiliation(s)
- Irina V Larina
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States.
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Young M, Lebed E, Jian Y, Mackenzie PJ, Beg MF, Sarunic MV. Real-time high-speed volumetric imaging using compressive sampling optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2011; 2:2690-7. [PMID: 21991557 PMCID: PMC3184877 DOI: 10.1364/boe.2.002690] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 08/19/2011] [Accepted: 08/19/2011] [Indexed: 05/25/2023]
Abstract
Volumetric imaging of the Optic Nerve Head (ONH) morphometry with Optical Coherence Tomography (OCT) requires dense sampling and relatively long acquisition times. Compressive Sampling (CS) is an emerging technique to reduce volume acquisition time with minimal image degradation by sparsely sampling the object and reconstructing the missing data in software. In this report, we demonstrated real-time CS-OCT for volumetric imaging of the ONH using a 1060nm Swept-Source OCT prototype. We also showed that registration and averaging of CS-recovered volumes enhanced visualization of deep structures of the sclera and lamina cribrosa. This work validates CS-OCT as a means for reducing volume acquisition time and for preserving high-resolution in volume-averaged images. Compressive sampling can be integrated into new and existing OCT systems without changes to the optics, requiring only software changes and post-processing of acquired data.
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Affiliation(s)
- Mei Young
- School of Engineering Science, Simon Fraser University, Canada
| | - Evgeniy Lebed
- School of Engineering Science, Simon Fraser University, Canada
| | - Yifan Jian
- School of Engineering Science, Simon Fraser University, Canada
| | - Paul J. Mackenzie
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Canada
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Coxson HO, Eastwood PR, Williamson JP, Sin DD. Phenotyping airway disease with optical coherence tomography. Respirology 2011; 16:34-43. [PMID: 21044229 DOI: 10.1111/j.1440-1843.2010.01888.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Airway diseases are a major concern around the world. However, the pace of new drug and biomarker discovery has lagged behind those of other common disorders such as cardiovascular diseases and diabetes. One major barrier in airway research has been the inability to accurately visualize large or small airway remodelling or dysplastic/neoplastic (either pre or early cancerous) changes using non- or minimally invasive instruments. The advent of optical coherence tomography (OCT) has the potential to revolutionize airway research and management by allowing investigators and clinicians to visualize the airway with resolution approaching histology and without exposing patients to harmful effects of ionizing radiation. Thus, with the aid of OCT, we may be able to accurately determine and quantify the extent of airway remodelling in asthma and chronic obstructive pulmonary disease, detect early pre-cancerous lesions in smokers for chemoprevention, study the upper airway anatomy of patients with obstructive sleep apnea in real time while they are asleep and facilitate optimal selection of stents for those with tracheal obstruction. In this paper, we review the current state of knowledge of OCT and its possible application in airway diseases.
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Affiliation(s)
- Harvey O Coxson
- Providence Heart and Lung Institute and The UBC James Hogg Research Center, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Syed SH, Larin KV, Dickinson ME, Larina IV. Optical coherence tomography for high-resolution imaging of mouse development in utero. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:046004. [PMID: 21529073 PMCID: PMC3081861 DOI: 10.1117/1.3560300] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 02/01/2011] [Accepted: 02/09/2011] [Indexed: 05/19/2023]
Abstract
Although the mouse is a superior model to study mammalian embryonic development, high-resolution live dynamic visualization of mouse embryos remain a technical challenge. We present optical coherence tomography as a novel methodology for live imaging of mouse embryos through the uterine wall thereby allowing for time lapse analysis of developmental processes and direct phenotypic analysis of developing embryos. We assessed the capability of the proposed methodology to visualize structures of the living embryo from embryonic stages 12.5 to 18.5 days postcoitus. Repetitive in utero embryonic imaging is demonstrated. Our work opens the door for a wide range of live, in utero embryonic studies to screen for mutations and understand the effects of pharmacological and toxicological agents leading to birth defects.
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Affiliation(s)
- Saba H Syed
- Department of Biomedical Engineering, University of Houston, 4800 Calhoun Road, 3605 Cullen Boulevard, Houston, Texas 77204, USA
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44
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Newton RC, Kemp SV, Shah PL, Elson D, Darzi A, Shibuya K, Mulgrew S, Yang GZ. Progress Toward Optical Biopsy: Bringing the Microscope to the Patient. Lung 2011; 189:111-9. [DOI: 10.1007/s00408-011-9282-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 01/28/2011] [Indexed: 11/29/2022]
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Abstract
Anterior segment optical coherence tomography (OCT) is currently used for investigating the distribution of the corneal thickness, shape of the stromal interface after lamellar corneal surgery, association between host and corneal graft in keratoplasty, dimension of the anterior chamber, and lesions of the corneal diseases. In addition, the advances of OCT technology has enabled three-dimensional imaging, tissue imaging, cell imaging, and topographic analysis. In this review, examples of tissue imaging with 840-nm spectral-domain OCT, cell imaging with full-field OCT, and corneal topographic analysis with 1,310-nm swept-source OCT were introduced.
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Kang SW, Lim JW, Chung SE, Yi CH. Outer foveolar defect after surgery for idiopathic macular hole. Am J Ophthalmol 2010; 150:551-7. [PMID: 20643393 DOI: 10.1016/j.ajo.2010.04.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 04/22/2010] [Accepted: 04/27/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the clinical implications of outer foveolar defects on optical coherence tomography (OCT) in eyes treated surgically for macular hole (MH). DESIGN Retrospective observational case series. METHODS Ninety-six eyes of 93 subjects who had undergone surgery for the treatment of idiopathic MH were included. Clinical data, including OCT prior to and at follow-up visits ranging from 3 to 32 months after surgery, were analyzed. Incidence, risk factors, and clinical outcomes of outer foveolar defect were evaluated. RESULTS Outer foveolar defects were noted on postoperative OCT in 44 of the 96 eyes (45.8%). The mean preoperative diameter of MH in the eyes (333.5 ± 126.3 μm) evidencing outer foveolar defects was significantly smaller than those that did not (504.2 ± 155.6 μm) (P < .0001). The mean disappearance time of the defect was estimated to be 182 days after surgery. The mean postoperative visual acuity (logMAR) improved to 0.40 ± 0.26 from 0.58 ± 0.23 after the disappearance of outer foveolar defects. CONCLUSIONS Outer foveolar defects were detected predominantly after surgery for small MHs. The defect decreases gradually in size and eventually disappears completely approximately 6 months after surgery.
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Affiliation(s)
- Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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47
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Pysz MA, Gambhir SS, Willmann JK. Molecular imaging: current status and emerging strategies. Clin Radiol 2010; 65:500-16. [PMID: 20541650 PMCID: PMC3150531 DOI: 10.1016/j.crad.2010.03.011] [Citation(s) in RCA: 370] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 03/25/2010] [Indexed: 02/07/2023]
Abstract
In vivo molecular imaging has a great potential to impact medicine by detecting diseases in early stages (screening), identifying extent of disease, selecting disease- and patient-specific treatment (personalized medicine), applying a directed or targeted therapy, and measuring molecular-specific effects of treatment. Current clinical molecular imaging approaches primarily use positron-emission tomography (PET) or single photon-emission computed tomography (SPECT)-based techniques. In ongoing preclinical research, novel molecular targets of different diseases are identified and, sophisticated and multifunctional contrast agents for imaging these molecular targets are developed along with new technologies and instrumentation for multi-modality molecular imaging. Contrast-enhanced molecular ultrasound (US) with molecularly-targeted contrast microbubbles is explored as a clinically translatable molecular imaging strategy for screening, diagnosing, and monitoring diseases at the molecular level. Optical imaging with fluorescent molecular probes and US imaging with molecularly-targeted microbubbles are attractive strategies as they provide real-time imaging, are relatively inexpensive, produce images with high spatial resolution, and do not involve exposure to ionizing irradiation. Raman spectroscopy/microscopy has emerged as a molecular optical imaging strategy for ultrasensitive detection of multiple biomolecules/biochemicals with both in vivo and ex vivo versatility. Photoacoustic imaging is a hybrid of optical and US techniques involving optically-excitable molecularly-targeted contrast agents and quantitative detection of resulting oscillatory contrast agent movement with US. Current preclinical findings and advances in instrumentation, such as endoscopes and microcatheters, suggest that these molecular imaging methods have numerous potential clinical applications and will be translated into clinical use in the near future.
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Affiliation(s)
- Marybeth A. Pysz
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
| | - Sanjiv S. Gambhir
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Jürgen K. Willmann
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
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Falkner-Radler CI, Glittenberg C, Hagen S, Benesch T, Binder S. Spectral-domain optical coherence tomography for monitoring epiretinal membrane surgery. Ophthalmology 2010; 117:798-805. [PMID: 20045567 DOI: 10.1016/j.ophtha.2009.08.034] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Revised: 08/21/2009] [Accepted: 08/25/2009] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To assess prognostic factors in epiretinal membrane (ERM) surgery using spectral-domain (SD) optical coherence tomography (OCT). DESIGN Prospective, interventional case series. PARTICIPANTS Forty-one patients. METHODS Patients with a diagnosis of ERM were examined with spectral-domain and time-domain (TD) OCT before and after surgery. MAIN OUTCOME MEASURES Main outcome measures were functional results and predefined OCT patterns. Cofactors analyzed were the type of ERM, the duration and grading of subjective metamorphopsia, simultaneous cataract surgery, the type of dyes used, the duration of surgery, gender, and age. A multivariate regression analysis was performed. RESULTS Thirty-nine patients (95%) showed an improved or stable best-corrected distance visual acuity (DVA) at 3 months, whereas 36 patients (88%) showed an improved or stable best-corrected near visual acuity (NVA) at 3 months. Significant correlations (P>0.4) were found between the course of central retinal thickness (CRT) assessed using SD OCT and TD OCT (P<0.02). No clinically relevant correlations (P<0.3) were seen between CRT and VA (P>0.1). Baseline DVA and NVA were found to be significant prognostic values for the postoperative decrease in CRT in both OCT systems (P<0.04) as well as for the visual outcomes (P<0.007) at 3 months. In addition, the integrity of the junction between the photoreceptor inner segment and outer segment (IS/OS) significantly influenced the visual outcomes at 3 months (P<0.038). The baseline profile of the internal limiting membrane (ILM) significantly influenced the NVA at 3 months (P<0.009), whereas the postoperative foveal contour significantly influenced the DVA at 3 months (P<0.025). The type of ERM, subjective metamorphopsia, simultaneous cataract surgery, the type of dyes used, the duration of surgery, gender, or age had no significant influence on patient outcome (P>0.05). Compared with TD OCT, SD OCT allowed for a more precise differentiation between the ERM and the retinal surface and for a better evaluation of the IS/OS line. CONCLUSIONS Besides the baseline VA, the integrity of the IS/OS line, better visualized by SD OCT, can be used to predict the functional outcomes after surgery. Additionally, analyzing the ILM profile and the foveal contour may help to understand limited visual outcomes after surgery. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Christiane I Falkner-Radler
- The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria.
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Optical coherence tomography: another useful tool in a neuro-ophthalmologist's armamentarium. Curr Opin Ophthalmol 2009; 20:462-6. [PMID: 19696668 DOI: 10.1097/icu.0b013e3283313d4e] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Optical coherence tomography (OCT) affords clinicians the ability to quantify the thickness of the retinal nerve fiber layer (RNFL), which is useful in managing diseases of the optic nerve. The purpose of this review is to coalesce the current literature on the use of OCT in neuro-ophthalmology to enhance its use in clinical practice. RECENT FINDINGS OCT's advancement into spectral domain refined its ability to measure the RNFL by increasing scanner speed. Although OCT was shown to be superior to other instruments in measuring the RNFL in certain conditions, it lacks laser polarimetry's ability to detect microtubule changes. Moreover, OCT's measurements cannot be used interchangeably with other instruments' assessments of the RNFL. OCT has been studied in several neuro-ophthalmic conditions, including anterior ischemic optic neuropathy, optic neuritis/multiple sclerosis, neuromyelitis optica, pseudotumor cerebri, migraine, optic nerve head drusen, compressive optic neuropathy, and Leber's hereditary optic neuropathy. SUMMARY OCT's wide use in evaluating the optic nerve and the visual system has revolutionized our assessment, management, research, and understanding of neuro-ophthalmic diseases.
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Falkner-Radler CI, Glittenberg C, Binder S. Spectral domain high-definition optical coherence tomography in patients undergoing epiretinal membrane surgery. Ophthalmic Surg Lasers Imaging Retina 2009; 40:270-6. [PMID: 19485291 DOI: 10.3928/15428877-20090430-08] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVE To evaluate possible advantages of spectral domain optical coherence tomography (SD-OCT) in epiretinal membranes. PATIENTS AND METHODS Patients with idiopathic epiretinal membranes (ERMs) were examined before and after vitreoretinal surgery. Cirrus SD high-definition (HD)-OCT was compared with Stratus time domain OCT to find correlations with visual acuity (VA) and metamorphopsia. RESULTS Five consecutive patients were enrolled. With Cirrus HD-OCT, it was possible to differentiate between the ERM and the retinal surface in all patients. In areas where the ERM was adherent, this differentiation was severely limited with Stratus OCT. We found no significant correlations between Cirrus OCT and Stratus OCT for retinal thickness and VA. However, we found a relationship between metamorphopsia and topographic maps of the internal limiting membrane. CONCLUSION Cirrus HD-OCT improved the preoperative evaluation of ERMs, offered a topographic reconstruction of the vitreomacular interface, and improved identification of retinal structures.
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Affiliation(s)
- Christiane I Falkner-Radler
- The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria
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