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Bolletta E, De Simone L, Pellegrini M, Preziosa C, Mastrofilippo V, Adani C, Gentile P, Gozzi F, Cimino L. Optical Coherence Tomography in Inflammatory and Neoplastic Lesions Deforming the Choroidal Profile. Diagnostics (Basel) 2023; 13:1991. [PMID: 37370886 DOI: 10.3390/diagnostics13121991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
The choroid is the main part of the uvea, the vascular layer of the eye that lies between the retina and the sclera. The high vascular component of the choroid makes this structure susceptible to inflammation in multisystemic diseases, as well as the most common site of metastasis in the eye. Therefore, the choroid is involved in many pathological conditions, from uveitis to intraocular tumors. Differentiating between inflammatory and neoplastic lesions deforming the choroidal profile can sometimes be challenging. In addition, scleral disorders can also deform the choroidal profile. Choroidal imaging includes ophthalmic ultrasonography, indocyanine green angiography, and optical coherence tomography (OCT). Recent advances in choroidal imaging techniques, such as enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source optical coherence tomography (SS-OCT), have facilitated an in-depth analysis of the choroid. The purpose of this review article is to report on and highlight the most common OCT findings to help in the differential diagnosis between inflammatory and neoplastic lesions deforming the choroidal profile.
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Affiliation(s)
- Elena Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Luca De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Marco Pellegrini
- Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Chiara Preziosa
- Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | | | - Chantal Adani
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Pietro Gentile
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
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Grimes KR, Aloney A, Skondra D, Chhablani J. Effects of systemic drugs on the development and progression of age-related macular degeneration. Surv Ophthalmol 2023; 68:332-346. [PMID: 36731638 DOI: 10.1016/j.survophthal.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
Age-related macular degeneration (AMD) is the leading cause of severe loss of central vision among people over 50. The pathophysiology of the disease is multifactorial and can be attributed to genetics, aging, inflammation, environmental factors, and lifestyle factors including smoking, diet, obesity, and alcohol consumption. While there is no treatment for dry AMD, the current standard treatment for wet AMD is an intraocular injection of anti-vascular endothelial growth factor-an effective, yet expensive, therapy that requires ongoing treatment. As the aging population continues to grow, and AMD diagnoses continue to rise, new treatments should be explored to reduce vision complications and decrease treatment burdens. Many systemic conditions have progressive pathological changes that may affect AMD, particularly those affecting systemic vasculature like diabetes and cardiovascular status. Consequently, systemic drugs used to treat coexistent systemic diseases may influence some of the pathogenic mechanisms of AMD and lead its progression or delay. In this review we explore the current literature to summarize the findings of the reported effects of antihypertensive, immunosuppressants, cholesterol lowering agents, nonsteroidal anti-inflammatory drugs, dopamine precursors, hypoglycemic agents, and anticoagulants on AMD.
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Affiliation(s)
- Kara R Grimes
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Abhilasha Aloney
- Eye Care Institute, PBMA'S H.V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, IL, USA
| | - Jay Chhablani
- Department of Ophthalmology, The University of Pittsburgh, Pittsburgh, PA, USA.
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Importance of Optical Coherence Tomography and Optical Coherence Tomography Angiography in the Imaging and Differentiation of Choroidal Melanoma: A Review. Cancers (Basel) 2022; 14:cancers14143354. [PMID: 35884415 PMCID: PMC9316780 DOI: 10.3390/cancers14143354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/03/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Choroidal melanoma is a highly malignant intraocular neoplasm. It is the most prevalent intraocular tumor in adults and it derives from melanocytes; the liver is the most common site of its metastases. An early and noninvasive diagnosis is essential to enhance patients’ chances for early treatment. The OCT and OCTA-A are a noninvasive and noncontact methods used in the diagnostic process and support therapeutic decisions during control visits. These devices allow for detection and the real-time imaging of choroidal melanoma and its differentiation from metastasis and choroidal nevi. In addition to analyzing the currently utilized OCT and OCT-A methods, this review describes also the anatomy and imaging of specific vascular layers of the eye. Abstract Choroidal melanoma requires reliable and precise clinical examination and diagnosis to differentiate it from benign choroidal nevi. To achieve accurate diagnosis, as well as monitoring the progression of disease, various imaging modalities are used, including non-invasive optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). This review begins with a historical account of the development of OCT and OCTA and the methods of generation of images. This outlines the understanding of what OCT/OCTA images show, as well as how image artifacts arise. The anatomy and imaging of specific vascular layers of the eye are introduced. Then, anatomical aspects of choroidal melanoma, its diagnosis and differentiation from metastasis, and choroidal nevi are presented. The purpose of this review is to critically evaluate application of OCT and OCTA in the diagnosis of choroidal melanoma.
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Diagnostic of small choroidal metastasis. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.3.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Choroidal metastasis in 23–30 % of cases have multifocal growth. In 10–20 % of patients do not have subjective complaints, due to eccentrical localization of choroidal metastases. In these cases, they are detected by chance during examination. In the literature there is no information on the possibility of early diagnosis of “small” foci of metastatic lesions of the choroid using optical coherence tomography (OCT).The aim. To identify diagnostic signs of “small” choroidal metastases.Materials and methods. The study included 4 patients in whom “small” metastases (15 foci) were not visualized by ultrasound.Results. Choroidal metastases, which were not detected by ultrasound, mainly characterized by a multifocal growth pattern, and located mainly outside the central regions of the fundus. The OCT picture in these cases was characterized by the expansion of the choroidal complex up to 1300 μm with an asymmetric shape of the slopes, irregularities of its anterior surface with a moderate hyporeflective structure. At the same time, Bruch’s membrane was preserved, but a violation of the architectonics of the choriocapillary layer is characteristic with a flat profile of the anterior surface of the sclera. Secondary changes in the proper retina are represented by thickening of the retinal pigment epithelium, edema of the photoreceptor layer and of the nuclear layers, while neuroepithelium detachment (NED) appears mainly when the focus is more than 400 μm thick. Initially, choroidal metastasis can be detected by the fundus examination in MultiColor and OCT, as changes appear in the retina – edema of the photoreceptor layer with hyperreflective inclusions and NED, changes appear in the blue-peak autofluorescence (BAF) – hyperBAF with point hypoBAF inclusions, which leads to a change fundus pictures in MultiColor mode.Conclusion. For all patients with a burdened oncological history, even in the absence of visual complaints, in addition to an examination of the fundus of both eyes, it is necessary to provide an examination of the fundus in MultiColor and short-wave autofluorescence modes, followed by OCT in the zones of changes.
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Circumscribed choroidal haemangioma: Indocyanine green angiography features on scanning laser ophthalmoscopy versus traditional digital fundus photography. Eye (Lond) 2020; 35:1178-1186. [PMID: 32587385 DOI: 10.1038/s41433-020-1044-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Circumscribed choroidal haemangioma (CCH) has several characteristic clinical and angiographic features. We aimed to compare indocyanine green angiography (ICG) findings of CCH captured on a traditional digital camera system (DCS) to newer scanning laser ophthalmoscopy (SLO) platforms. STUDY DESIGN/MATERIALS AND METHODS A total of 35 patients over a 10-year period diagnosed with CCH using ICG were included (18 imaged with DCS and 17 with SLO). RESULTS On early ICG frames, intrinsic vessels were apparent in two-thirds (12/18; 67%) of the DCS group compared with all of eyes in the SLO group (p = 0.020). In addition, at maximal hyperfluorescence, most eyes imaged with DCS had a feathery appearance (16/18; 89%) compared with those in the SLO group which all (17/17; 100%) displayed a granular appearance (p < 0.001). The presence of hot spots at maximal hyperfluorescence was also more common in the SLO group (12/17; 71%) versus the DCS group (0/18; 0%) (p < 0.001). Finally, intrinsic vessels and vascular loops could be identified throughout the entire duration of the ICG in 100% of the SLO cases (17/17) versus only 11% (2/18) of DCS cases (p < 0.001). CONCLUSIONS The visualization of intrinsic vessels, vascular loops, and "hot spots" in CCH is significantly enhanced with SLO compared with DCS. Many characteristic mid-late angiographic findings of CCH are more optimally visualized on SLO which may negate the need for late frames (>30 min) without compromising diagnostic accuracy.
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Stoyukhina AS. [Local choroiditis after influenza vaccination (a clinical case study)]. Vestn Oftalmol 2019; 135:108-112. [PMID: 31215541 DOI: 10.17116/oftalma2019135021108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The article describes a difficult case of differential diagnosis of local choroiditis developed after influenza (flu) vaccination in a patient with bronchial asthma who receives systemic steroid therapy.
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Affiliation(s)
- A S Stoyukhina
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
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Ung C, Laíns I, Silverman RF, Woods R, Lane AM, Papakostas TD, Husain D, Miller JW, Gragoudas ES, Kim IK, Miller JB. Evaluation of choroidal lesions with swept-source optical coherence tomography. Br J Ophthalmol 2018; 103:88-93. [PMID: 29605814 DOI: 10.1136/bjophthalmol-2017-311586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/11/2018] [Indexed: 12/18/2022]
Abstract
AIMS The aim of our study was to image choroidal lesions with swept-source optical coherence tomography (SS-OCT) and to identify the morphological characteristics associated with optimal visualisation. METHODS This was a prospective, cross-sectional study. Patients with choroidal melanocytic lesions <3 mm in thickness on B-scan ultrasonography were recruited. All participants underwent SS-OCT. On SS-OCT we evaluated qualitative (eg, lesion outline, detection of scleral-choroidal interface and quality of the image) and quantitative (measurement of maximum lesion thickness and the largest basal diameter) parameters. Probability of optimal image quality was examined using ordered logistic regression models. The main outcome measure was quality of the choroidal lesion images on SS-OCT, defined as: optimal, suboptimal or poor. RESULTS We included 85 choroidal lesions of 82 patients. There were 24 choroidal lesions (29%) for which image quality was classified as optimal, 31 lesions (37%) as suboptimal and 30 lesions (36%) as poor. The factors associated with optimal image quality were distance closer to the fovea (OR 0.76, p<0.001), posterior pole location (OR 3.87, p=0.05), lower ultrasonography thickness (OR 0.44, p=0.04), lighter lesion pigmentation (OR 0.12, p=0.003) and smaller lesion diameter (OR 0.73, p<0.001). In the multivariable analysis, closer distance to the fovea (OR 0.81, p=0.005), lighter lesion pigmentation (OR 0.11, p=0.01) and smaller lesion diameter (OR 0.76, p=0.006) remained statistically significant. CONCLUSION SS-OCT is useful in imaging most choroidal melanocytic lesions. Image quality is best when the choroidal lesion is closer to the fovea, has a smaller diameter and a lighter choroidal pigmentation.
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Affiliation(s)
- Cindy Ung
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rebecca F Silverman
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell Woods
- Department of Ophthalmology, Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Anne Marie Lane
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Thanos D Papakostas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Evangelos S Gragoudas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
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Nair AG, Fell D, Raouf S, Kaliki S. Imaging of Retinal and Choroidal Metastases. RETINAL AND CHOROIDAL IMAGING IN SYSTEMIC DISEASES 2018:153-161. [DOI: 10.1007/978-981-10-5461-7_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Chhablani PP, Ambiya V, Nair AG, Bondalapati S, Chhablani J. Retinal Findings on OCT in Systemic Conditions. Semin Ophthalmol 2017. [DOI: 10.1080/08820538.2017.1332233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Preeti Patil Chhablani
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Vikas Ambiya
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Akshay G. Nair
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Jay Chhablani
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
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Kaur G, Anthony SA. Multimodal imaging of suspicious choroidal neoplasms in a primary eye-care clinic. Clin Exp Optom 2017; 100:549-562. [PMID: 28370509 DOI: 10.1111/cxo.12537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/05/2017] [Indexed: 11/28/2022] Open
Abstract
Small suspicious choroidal neoplasms commonly present a diagnostic challenge in primary eye-care clinics, where they are most likely to present. Differentiating benign from malignant choroidal neoplasms is essential for facilitating early diagnosis and treatment, potentially decreasing the risk of metastasis and vision loss in some cases. The purpose of this review is to describe the clinical, spectral-domain optical coherence tomography and fundus autofluorescence features of suspicious choroidal neoplasms in a case series of patients presenting to a primary eye-care clinic at the Veterans Health Administration, Cleveland, Ohio, USA.
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Affiliation(s)
- Gurpinderjeet Kaur
- Optometry Clinic, Louis Stokes Cleveland Veterans Affairs Medical Centre, Cleveland, Ohio, USA
| | - Scott A Anthony
- Optometry Clinic, Louis Stokes Cleveland Veterans Affairs Medical Centre, Cleveland, Ohio, USA
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Konstantinidis L, Damato B. Intraocular Metastases--A Review. Asia Pac J Ophthalmol (Phila) 2017; 6:208-214. [PMID: 28399345 DOI: 10.22608/apo.201712] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/29/2017] [Indexed: 11/08/2022] Open
Abstract
Intraocular metastases almost invariably arise in the uveal tract, mostly in the posterior choroid. They are the most common type of intraocular malignancy and often the first sign of tumor dissemination. Choroidal metastases generally appear as a creamy white or pale yellow mass associated with subretinal fluid and may be multifocal and bilateral. The most common primary sites are breast and lung. Diagnosis is aided by a variety of tests, particularly ultrasonography and optical coherence tomography. Intraocular biopsy is useful in patients with clinical suspicion of uveal metastasis but no evidence of primary malignancy despite systemic evaluation. If systemic treatment fails to control the ocular tumor, a good response is usually achieved with local therapies such as external beam radiation therapy, photodynamic therapy, and transpupillary thermotherapy. The life expectancy of patients with choroidal metastases is generally poor but has been improving thanks to the therapeutic advances taking place.
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Affiliation(s)
| | - Bertil Damato
- Ocular Oncology Service, University of California, San Francisco, San Francisco, California
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Shields CL, Manalac J, Das C, Saktanasate J, Shields JA. Review of spectral domain enhanced depth imaging optical coherence tomography of tumors of the choroid. Indian J Ophthalmol 2015; 63:117-21. [PMID: 25827541 PMCID: PMC4399119 DOI: 10.4103/0301-4738.154377] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 10/18/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Spectral domain enhanced depth imaging optical coherence tomography (EDI-OCT) can provide anatomic localization of intraocular tumors. AIMS The aim was to identify topographical and intrinsic patterns of choroidal tumors on EDI-OCT. SETTINGS AND DESIGN Retrospective review. MATERIALS AND METHODS Analysis of published reports and personal observations using office based EDI-OCT. RESULTS Using EDI-OCT, choroidal nevus displayed a smooth, dome-shaped topography with overlying retinal pigment epithelium alterations, drusen, and occasional subretinal cleft demonstrating photoreceptor loss. Small choroidal melanoma showed smooth, moderately dome-shaped topography, commonly with overlying shallow subretinal fluid that often depicted "shaggy" photoreceptors. Choroidal metastasis showed a minimally "lumpy, bumpy" surface topography and with overlying subretinal fluid and shaggy photoreceptors. Choroidal hemangioma showed a smooth, dome-shaped topography, with expansion of the affected small, medium, and large choroidal vessels. Choroidal lymphoma showed varying topography with increasing tumor thickness as "flat, rippled, or undulating (seasick)" surface. Choroidal osteoma displayed a smooth undulating surface with visible intralesional horizontal lines suggestive of bone lamellae and occasional horizontal and vertical tubules with intralesional "spongy" flecks. Choroidal melanocytosis appeared as uniformly thickened choroid with increased stromal density surrounding the normal choroidal vascular structures. CONCLUSIONS Enhanced depth imaging-OCT can depict characteristic patterns that are suggestive of various choroidal tumors.
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Affiliation(s)
- Carol L Shields
- Department of Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Janet Manalac
- Department of Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Chandana Das
- Department of Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jarin Saktanasate
- Department of Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jerry A Shields
- Department of Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
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Anastasiadis P, Mojica KDA, Allen JS, Matter ML. Detection and quantification of bacterial biofilms combining high-frequency acoustic microscopy and targeted lipid microparticles. J Nanobiotechnology 2014; 12:24. [PMID: 24997588 PMCID: PMC4113671 DOI: 10.1186/1477-3155-12-24] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 06/24/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Immuno-compromised patients such as those undergoing cancer chemotherapy are susceptible to bacterial infections leading to biofilm matrix formation. This surrounding biofilm matrix acts as a diffusion barrier that binds up antibiotics and antibodies, promoting resistance to treatment. Developing non-invasive imaging methods that detect biofilm matrix in the clinic are needed. The use of ultrasound in conjunction with targeted ultrasound contrast agents (UCAs) may provide detection of early stage biofilm matrix formation and facilitate optimal treatment. RESULTS Ligand-targeted UCAs were investigated as a novel method for pre-clinical non-invasive molecular imaging of early and late stage biofilms. These agents were used to target, image and detect Staphylococcus aureus biofilm matrix in vitro. Binding efficacy was assessed on biofilm matrices with respect to their increasing biomass ranging from 3.126 × 103 ± 427 UCAs per mm(2) of biofilm surface area within 12 h to 21.985 × 103 ± 855 per mm(2) of biofilm matrix surface area at 96 h. High-frequency acoustic microscopy was used to ultrasonically detect targeted UCAs bound to a biofilm matrix and to assess biofilm matrix mechanoelastic physical properties. Acoustic impedance data demonstrated that biofilm matrices exhibit impedance values (1.9 MRayl) close to human tissue (1.35 - 1.85 MRayl for soft tissues). Moreover, the acoustic signature of mature biofilm matrices were evaluated in terms of integrated backscatter (0.0278 - 0.0848 mm(-1) × sr(-1)) and acoustic attenuation (3.9 Np/mm for bound UCAs; 6.58 Np/mm for biofilm alone). CONCLUSIONS Early diagnosis of biofilm matrix formation is a challenge in treating cancer patients with infection-associated biofilms. We report for the first time a combined optical and acoustic evaluation of infectious biofilm matrices. We demonstrate that acoustic impedance of biofilms is similar to the impedance of human tissues, making in vivo imaging and detection of biofilm matrices difficult. The combination of ultrasound and targeted UCAs can be used to enhance biofilm imaging and early detection. Our findings suggest that the combination of targeted UCAs and ultrasound is a novel molecular imaging technique for the detection of biofilms. We show that high-frequency acoustic microscopy provides sufficient spatial resolution for quantification of biofilm mechanoelastic properties.
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Affiliation(s)
- Pavlos Anastasiadis
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA
- Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
- Mechanical Engineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Kristina D A Mojica
- Department of Oceanography, School of Ocean and Earth Sciences and Technology, University of Hawaii at Manoa, Honolulu, HI, USA
- Current address: Department of Biological Oceanography, Royal Netherlands Institute for Sea Research (NIOZ), P.O. Box 59, 1790 AB Den Burg, Texel, The Netherlands
| | - John S Allen
- Mechanical Engineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
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CHOROIDAL LYMPHOMA SHOWS CALM, RIPPLED, OR UNDULATING TOPOGRAPHY ON ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY IN 14 EYES. Retina 2014; 34:1347-53. [DOI: 10.1097/iae.0000000000000145] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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