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Tomita R, Goto K, Ueno Y, Yamaguchi K, Takeuchi J, Akahori T, Kaneko H, Iwase T. Narrowing Ratio of Retinal Veins at Arteriovenous Crossing in Patients With Branch Retinal Vein Occlusion Versus That in Healthy Individuals. Invest Ophthalmol Vis Sci 2023; 64:22. [PMID: 37971732 PMCID: PMC10664725 DOI: 10.1167/iovs.64.14.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023] Open
Abstract
Purpose This cross-sectional study aimed to clarify the differences in the retinal venous narrowing ratio (VNR) at retinal arteriovenous crossing by optical coherence tomography (OCT) among the eyes with branch retinal vein occlusion (BRVO), fellow eyes of patients with BRVO, and eyes of individuals without BRVO and to determine factors that influence the VNR. Methods We studied 31 eyes of young participants, 54 eyes of an older control group, 56 fellow eyes of patients with BRVO, and 48 eyes with BRVO. Cross-sectional OCT images were used to determine the VNR at two arteriovenous crossings per eye. Results Overall, 378 arteriovenous crossings were analyzed. The VNR of arterial overcrossings of fellow eyes (27.7% ± 11.1%) and BRVO eyes (27.3% ± 9.76%) were significantly higher than those in the young (16.0% ± 7.9%, all P < 0.001) and control (22.0% ± 8.81%, P < 0.001, P = 0.003, respectively) groups. The VNR of arterial overcrossings was significantly larger than that of venous overcrossings (24.0% ± 10.5% vs. 20.6% ± 13.0%, P = 0.021). A linear mixed-effects model showed that the VNR was significantly higher in arterial overcrossings, crossings with larger arterial internal diameters, smaller venous internal diameters, and participants with older age and a BRVO history. Conclusions The VNR in arterial overcrossings was higher in BRVO eyes and even in the fellow eyes. Thus, a higher VNR in arterial overcrossings may contribute to BRVO development, and crossings with factors contributing to higher VNR might be associated with a risk of BRVO.
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Affiliation(s)
- Ryo Tomita
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Kensuke Goto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Yoshitaka Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Katsuya Yamaguchi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Jun Takeuchi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Tomohiko Akahori
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Hiroki Kaneko
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
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List W, Steinwender G, Glatz W, Riedl R, Wedrich A, Ivastinovic D. The impact of surgeon's experience and sex on the incidence of cystoid macular edema after uneventful cataract surgery. PLoS One 2022; 17:e0279518. [PMID: 36574394 PMCID: PMC9794095 DOI: 10.1371/journal.pone.0279518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/22/2022] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To assess the rate of pseudophakic cystoid macular edema (pCME) in uneventful cataract surgery in surgeons in training vs experienced surgeons and to analyze the rate of pCME according to surgeon's sex. METHODS Medical reports post phacoemulsification between 2010 and 2018 at the Department of Ophthalmology, Medical University of Graz, Austria, were reviewed for pCME. A running lifetime number of preceding cataract surgeries was used to express hands-on experience. A cut-off number of 300 surgeries was defined to distinguish between surgeons in training and experienced surgeons. Outcome parameters were incidence of pCME, patient's sex and age, laterality of eye, coexistence of pseudoexfoliation syndrome (PEX), duration of surgery and surgeon's sex. RESULTS 25.422 surgeries on 18.266 patients were included. The majority was performed by experienced surgeons (23.139, 91.0%) vs 2.283 (9.0%) by surgeons in training (25 surgeons, 9 (36%) female and 16 (64%) male). pCME occurred in 32 eyes (1.4%) following surgery by surgeons in training and in 152 eyes (0.7%) following surgery by experienced surgeons. Chance for pCME was 1.57 higher in training surgeries (95% CI 1.03-2.41, p = 0.034) and longer duration (OR = 1.04; 95% CI 1.02-1.07, p = 0.001). After excluding the first 100 surgeries for every surgeon in training similar results were observed. No difference in risk for pCME was found between female and male surgeons in both groups (training and experienced surgeons). CONCLUSION In conclusion, the rate for pCME after uneventful cataract surgery is significantly higher for surgeons in training but steadily decreasing and associated to surgical time. No difference in the risk for pCME was found between female and male surgeons.
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Affiliation(s)
- Wolfgang List
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
- * E-mail:
| | | | - Wilfried Glatz
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
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Scarinci F, Cacciamani A, Ripandelli G, Parravano M. Branch retinal artery occlusion caught in the act by an optical coherence tomography angiography image: case report. BMC Ophthalmol 2022; 22:303. [PMID: 35836145 PMCID: PMC9284791 DOI: 10.1186/s12886-022-02517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/01/2022] [Indexed: 05/31/2023] Open
Abstract
Background Retinal artery occlusion is a vascular entity caused by the temporary blockage of retinal arterioles. Case presentation We present the case of a 57-year-old woman a partial visual loss in the right eye due to a cilioretinal artery occlusion. Ophthalmoscopy revealed a focal area of retinal whitening superior to the optic nerve in the right eye, while the left eye was within the limit. Retinal imaging, in particular optical coherence tomography angiography (OCTA), showed a capillary drop out of the superficial capillary plexus and the corresponding b-scan showed a round hyporeflective grey dot (optical empty) corresponding to the dark grey spot on the enface view at the level of the retinal whitening area. Conclusion Although the images did not allow the differentiation between vasospasm or retinal emboli, the OCTA imaging might help to identify and to caught in the act the specific region causing the retinal impairment. Also, the possible formation of small microcavity should be considered in case with branch retinal artery occlusion. The use of this new imaging technology might help to evaluate the efficacy of the therapy in vivo.
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Affiliation(s)
- Fabio Scarinci
- IRCCS - Fondazione Bietti, Via Livenza, 3, 00198, Rome, Italy.
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Foulsham W, Chien J, Lenis TL, Papakostas TD. Optical Coherence Tomography Angiography: Clinical Utility and Future Directions. JOURNAL OF VITREORETINAL DISEASES 2022; 6:229-242. [PMID: 37008547 PMCID: PMC9976135 DOI: 10.1177/24741264221080376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Purpose This work aims to review the principles of optical coherence tomography angiography (OCTA), to survey its clinical utility, and to highlight the strengths of this technology as well as barriers to adoption. Methods A literature review with editorial discussion of the current applications for OCTA is presented. Results There have been recent advances in multiple domains in OCTA imaging, including devices, algorithms, and new observations pertaining to a range of pathologies. New devices have improved the scanning speed, signal-to-noise ratio, and spatial resolution and offer an increased field of view. New algorithms have been proposed to optimize image processing and reduce artifacts. Numerous studies employing OCTA have been published describing changes to the microvasculature in diabetic retinopathy, age-related macular degeneration, central serous chorioretinopathy, retinal vein occlusion, and uveitis. Conclusions OCTA provides noninvasive, high-resolution volumetric scans of the retinal and choroidal vasculature. OCTA can provide valuable data to augment traditional dye-based angiography in a range of chorioretinal diseases.
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Affiliation(s)
- William Foulsham
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - Jason Chien
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - Tamara Lee Lenis
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - Thanos D. Papakostas
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
- The Retina Institute, St Louis, MO, USA
- Thanos D. Papakostas, MD, The Retina Institute, 2201 S Brentwood Blvd, St Louis, MO 63144, USA.
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Bek T, Jeppesen SK. Reduced Oxygen Extraction in the Retinal Periphery When the Arterial Blood Pressure Is Increased by Isometric Exercise in Normal Persons. Invest Ophthalmol Vis Sci 2021; 62:11. [PMID: 33683296 PMCID: PMC7960864 DOI: 10.1167/iovs.62.3.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose Recent evidence suggests that the smaller retinal vessels are significantly involved in the regulation of retinal blood flow and that this regulation may differ among the macular area and the retinal periphery. An alternative to studying blood flow regulation in smaller retinal vessels that are difficult to resolve is to assess the metabolic consequences of changes in the microcirculation using oximetry. Methods In 20 normal persons aged (mean ± SD, range) 30.1 ± 3.8 (24–37) years, the oxygen saturation and diameter of retinal arterioles and venules to the macular area and the retinal periphery were studied before and during an increase in the arterial blood pressure induced by isometric exercise. Results The isometric exercise increased the mean arterial blood pressure by (mean ± SEM) 10.0 ± 1.1 mm Hg but induced no significant changes in the diameter of the arterioles (P = 0.83). The isometric exercise had no significant effect on the oxygen saturation in the arterioles supplying the macular area and the retinal periphery (P > 0.42 for both comparisons). However, there was a significant increase in the oxygen saturation in venules draining the retinal periphery to reduce the oxygen extraction from (mean ± SEM) 36.0% ± 2.3% to 30.6% ± 2.1% (P = 0.002) but no significant change in the preexisting low oxygen extraction in the macular area that changed from (mean ± SEM) 18.2% ± 3.0% to 16.2% ± 1.9% (P = 0.37). Conclusions Minor changes in the arterial blood pressure can induce changes in retinal rheology with significant regional variation. The finding may help explain regional variations in manifestations of retinal vascular disease such as hyperpermeability in the macular area and capillary occlusion in the retinal periphery.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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Kim TH, Le D, Son T, Yao X. Vascular morphology and blood flow signatures for differential artery-vein analysis in optical coherence tomography of the retina. BIOMEDICAL OPTICS EXPRESS 2021; 12:367-379. [PMID: 33520388 PMCID: PMC7818960 DOI: 10.1364/boe.413149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 05/09/2023]
Abstract
Differential artery-vein (AV) analysis is essential for retinal study, disease detection, and treatment assessment. This study is to characterize vascular reflectance profiles and blood flow patterns of retinal artery and vein systems in optical coherence tomography (OCT) and OCT angiography (OCTA), and establish them as robust signatures for objective AV classification. A custom designed OCT was employed for three-dimensional (3D) imaging of mouse retina, and corresponding OCTA was reconstructed. Radially resliced OCT B-scans revealed two, i.e. top and bottom, hyperreflective wall boundaries in retinal arteries, while these wall boundaries were absent in OCT of retinal veins. Additional OCTA analysis consistently displayed a layered speckle distribution in the vein, which may indicate the venous laminar flow. These OCT and OCTA differences offer unique signatures for objective AV classification in OCT and OCTA.
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Affiliation(s)
- Tae-Hoon Kim
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - David Le
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Taeyoon Son
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Xincheng Yao
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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Richter D, Fard AM, Straub J, Wei W, Zhang Q, Wang RK. Relative retinal flow velocity detection using optical coherence tomography angiography imaging. BIOMEDICAL OPTICS EXPRESS 2020; 11:6710-6720. [PMID: 33282519 PMCID: PMC7687964 DOI: 10.1364/boe.408481] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 05/25/2023]
Abstract
Optical coherence tomography angiography (OCTA) imaging is a valuable tool for the visualization of retinal vasculature at an unprecedented level of details. However, due to relatively long time-interval between repeated scans in the conventional OCTA scanning protocol, the OCTA flow signal suffers from low dynamic range and loss of velocity-intensity correlation. The ability to distinguish fast and slow flow in the retina may provide a powerful tool for the assessment of early-stage retinal diseases such as vein occlusion. Here, we report a method to detect relative flow velocity in human retina using a 67.5 kHz spectral-domain OCTA device. By adapting the selection of A-scan time-intervals within a single OCTA acquisition and combining the resulting OCTA images, we expand the detectable velocity range. After a quantitative validation of this method performing microchannel flow experiments with varying flow velocities, we demonstrate this approach on human eyes using CIRRUS HD-OCT 5000 with AngioPlex (ZEISS, Dublin, CA) through a prototype scanning pattern.
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Affiliation(s)
- Dmitry Richter
- Carl Zeiss Meditec, Inc., Dublin, CA 94568, USA
- Current Address: Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ali M Fard
- Carl Zeiss Meditec, Inc., Dublin, CA 94568, USA
| | | | - Wei Wei
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
- Department of Ophthalmology, University of Washington, Seattle, WA 98109, USA
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Wartak A, Beer F, Desissaire S, Baumann B, Pircher M, Hitzenberger CK. Investigating spontaneous retinal venous pulsation using Doppler optical coherence tomography. Sci Rep 2019; 9:4237. [PMID: 30862956 PMCID: PMC6414623 DOI: 10.1038/s41598-019-40961-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/26/2019] [Indexed: 12/26/2022] Open
Abstract
We demonstrate the advantages of optical coherence tomography (OCT) imaging for investigation of spontaneous retinal venous pulsation (SRVP). The pulsatile changes in venous vessel caliber are analyzed qualitatively and quantitatively using conventional intensity-based OCT as well as the functional extension Doppler OCT (DOCT). Single-channel and double-channel line scanning protocols of our multi-channel OCT prototype are employed to investigate venous pulsatile caliber oscillations as well as venous flow pulsatility in the eyes of healthy volunteers. A comparison to recordings of scanning laser ophthalmoscopy (SLO) – a standard en-face imaging modality for evaluation of SRVP – is provided, emphasizing the advantages of tomographic image acquisition. To the best of our knowledge, this is the first quantitative time-resolved investigation of SRVP and associated retinal perfusion characteristics using OCT.
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Affiliation(s)
- Andreas Wartak
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, 1090, Austria.
| | - Florian Beer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, 1090, Austria
| | - Sylvia Desissaire
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, 1090, Austria
| | - Bernhard Baumann
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, 1090, Austria
| | - Michael Pircher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, 1090, Austria
| | - Christoph K Hitzenberger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, 1090, Austria
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Pi S, Camino A, Wei X, Simonett J, Cepurna W, Huang D, Morrison JC, Jia Y. Rodent retinal circulation organization and oxygen metabolism revealed by visible-light optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2018; 9:5851-5862. [PMID: 30460167 PMCID: PMC6238898 DOI: 10.1364/boe.9.005851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 05/06/2023]
Abstract
Visible light optical coherence tomography (vis-OCT) is an emerging label-free and high-resolution 3-dimensional imaging technique that can provide retinal oximetry, angiography, and flowmetry in one modality. In this paper, we studied the organization of the arterial and venous retinal circulation in rats using vis-OCT. Arterioles were found predominantly in the superficial vascular plexus whereas veins tended to drain capillaries from the deep capillary plexus. After that, we determined the oxygen metabolic rate supported by retinal microcirculation by combining retinal vessel oxygen saturation and blood flow measurements. The ability to visualize and monitor retinal circulation organization and oxygen metabolism by vis-OCT may provide new opportunities for understanding the pathology of ocular diseases.
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Affiliation(s)
- Shaohua Pi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Acner Camino
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Xiang Wei
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Joseph Simonett
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - William Cepurna
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - John C. Morrison
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
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Colligris P, Perez de Lara MJ, Colligris B, Pintor J. Ocular Manifestations of Alzheimer's and Other Neurodegenerative Diseases: The Prospect of the Eye as a Tool for the Early Diagnosis of Alzheimer's Disease. J Ophthalmol 2018; 2018:8538573. [PMID: 30151279 PMCID: PMC6091327 DOI: 10.1155/2018/8538573] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/07/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
Dementia, including Alzheimer's disease (AD), is a major disorder, leading to several ocular manifestations amongst the elderly population. These visual disorders may be due to retinal nerve degenerative changes, including nerve fibre layer thinning, degeneration of retinal ganglion cells, and changes to vascular parameters. There is no cure for Alzheimer's, but medicines can slow down the development of many of the classic symptoms, such as loss of memory and communication skills, mood swings, and depression. The disease diagnosis is difficult, and it is only possible through PET scans of the brain, detecting evidence of the accumulation of amyloid and tau. PET is expensive and invasive, requiring the injection of radioactive tracers, which bind with these proteins and glow during scanning. Recently, scientists developed promising eye-scan techniques that may detect Alzheimer's disease at its earliest stage, before major symptoms appear, leading to improved management of the disease symptoms. In this review, we are discussing the visual abnormalities of Alzheimer's and other neurodegenerative diseases, focused on ocular functional-visual-structural biomarkers, retinal pathology, and potential novel diagnostic tools.
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Affiliation(s)
- Pade Colligris
- Universidad Alfonso X, Madrid, Spain
- Ocupharm Diagnostics SL, Madrid, Spain
| | | | - Basilio Colligris
- Ocupharm Diagnostics SL, Madrid, Spain
- Universidad Complutense de Madrid, Madrid, Spain
| | - Jesus Pintor
- Ocupharm Diagnostics SL, Madrid, Spain
- Universidad Complutense de Madrid, Madrid, Spain
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Glatz W, Steinwender G, Tarmann L, Malle EM, Schörkhuber M, Wackernagel W, Petrovski G, Wedrich A, Ivastinovic D. Vitreous hyper-reflective dots in pseudophakic cystoid macular edema assessed with optical coherence tomography. PLoS One 2017; 12:e0189194. [PMID: 29244855 PMCID: PMC5731694 DOI: 10.1371/journal.pone.0189194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 11/21/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose This study compares the presence of vitreous hyper-reflective dots (VHDs) detected with optical coherence tomography (OCT) between eyes with pseudophakic cystoid macular edema (CME) and those with no CME after cataract surgery. In addition, we evaluated the impact of VHDs on the responsiveness of pseudophakic CME to cortisone treatment. Setting Department of Ophthalmology, Medical University of Graz, Austria. Design Retrospective, monocenter case-controlled study. Methods Inclusion criteria for the study group and the control group were CME and no CME within 12 weeks following uneventful phacoemulsification in otherwise healthy eyes, respectively. VHDs (number and size) and the macular thickness were assessed with OCT. Furthermore, the number of peribulbar or intravitreal steroid injections was assessed. Results A total of 284 eyes from 267 patients were analyzed, among which 119 met the inclusion criteria for the study (n = 63) and the control group (n = 56). VHDs were observed in 54 (85.7%) study eyes and 21 (37.5%, p = 0.013) control eyes. The number of VHDs was 3.9±3.4 in the study group and 0.7±1 in the control group (p<0.001). The size of the VHDs was 33.5±9.1 μm and 36.6±17.9 μm in the study and control groups, respectively (p = 0.978). Overall, the number of VHDs correlated with central subfield thickness (r = 0.584, p<0.001), cube volume (r = 0.525, p<0.001), and postoperative best-corrected visual acuity (BCVA) (r = -0.563, p<0.001). The number of VHDs did not correlate with the frequency of peribulbar or intravitreal steroid injections. Conclusion VHDs occurred more often in eyes with CME than in eyes without CME following cataract surgery. In addition, the number of VHDs had an impact on the extent of macular thickening and subsequently postoperative BCVA. No correlation was found between the number of VHDs and the frequency of required peribulbar or intravitreal steroid injections.
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Affiliation(s)
- Wilfried Glatz
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
- * E-mail:
| | | | - Lisa Tarmann
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Eva Maria Malle
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | | | - Goran Petrovski
- Centre of Eye Research, Department of Ophthalmology, and Norwegian Center for Stem Cell Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
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Diabetic Microaneurysms Internal Reflectivity on Spectral-Domain Optical Coherence Tomography and Optical Coherence Tomography Angiography Detection. Am J Ophthalmol 2017; 179:90-96. [PMID: 28483496 DOI: 10.1016/j.ajo.2017.04.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE To correlate the appearance of microaneurysms (MAs) on structural spectral-domain optical coherence tomography (SDOCT) with their detection on OCT angiography (OCTA) in patients with nonproliferative diabetic retinopathy (NPDR). DESIGN Interinstrument reliability study. METHODS Sixteen patients with NPDR without macular edema underwent SDOCT and OCTA. To compare MAs seen on OCTA with those on SDOCT, we superimposed the OCTA superficial capillary plexus (SCP) vascular landmarks onto those of the near infrared. Two observers masked to patient groupings evaluated reflectivity of MAs on SDOCT scans, graded as hyporeflective, moderate, or hyperreflective, and their visualization at the level of SCP and deep capillary plexus (DCP) on OCTA. RESULTS Among 145 MAs imaged with SDOCT, 47 (32.4%) appeared as hyperreflective, 71 (49.0%) as moderately reflective, and 27 (18.6%) as hyporeflective. After excluding 3 eyes (10 MAs) because of poor-quality OCTA scans, 135 MAs were evaluated on OCTA; 76 (56.3%) were visible only in the DCP, 9 (6.7%) only in the SCP, 29 (21.5%) were visible in both SCP and DCP; and 21 (15.6%) were not visible on OCTA. Compared with MAs with hyperreflectivity or moderate reflectivity, MAs with hyporeflectivity on structural SDOCT were significantly less likely to be detected on OCTA (odds ratio [OR]: 4.6; 95% confidence interval [CI]: 1.5-14.0, P = .008; and OR: 4.2, 95% CI: 1.2-14.2, P = .022, respectively). CONCLUSIONS MAs that appear hyporeflective on structural SDOCT have a lower detection rate on OCTA. The results of this study may help further understand the different blood flow dynamics pattern in MAs.
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