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Govetto A, Sebag J, Lucchini S, Ballabio C, Matteucci M, Ranno S, Carini E, Virgili G, Bacherini D, Radice P. IMAGING RHEGMATOGENOUS RETINAL LESIONS AND PERIPHERAL VITREORETINAL INTERFACE WITH WIDEFIELD OPTICAL COHERENCE TOMOGRAPHY. Retina 2024; 44:269-279. [PMID: 37856780 DOI: 10.1097/iae.0000000000003946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
PURPOSE Analyze the peripheral vitreoretinal interface with widefield optical coherence tomography. METHODS Retrospective chart analysis and widefield optical coherence tomography in 120 consecutive cases of rhegmatogenous pathology. RESULTS There were 166 lesions in 120 eyes, including 106 horseshoe tears, 22 operculated holes, 30 nonoperculated holes, six giant tears, and two peripheral lamellar defects followed for 6.1 ± 1.2 months. Posterior vitreous detachment was present in all eyes (101/101, 100%) with tears and operculated holes, but only in 5/19 eyes (26.3%) with nonoperculated holes ( P < 0.001). Axial vitreous traction was evident at the anterior edge of horseshoe tears (106/106, 100%), but not the posterior border (18/106, 17%, P < 0.001). Operculated holes located posterior to the vitreous base were free from vitreous traction, displaying a morphology similar to the macular hole. Nonoperculated holes were farther anterior with signs of tangential traction in 23/30 (76.7%) cases. Peripheral vitreoschisis was more often associated with nonoperculated holes (25/30, 83.3%), than horseshoe tears (17/106, 16%; P < 0.001). Horseshoe tears and nonoperculated holes were more often associated with retinal detachment (58/106 [54.7%] and 15/30 [50%], respectively) than operculated holes (5/22, 22.7%), P = 0.023. CONCLUSION Peripheral vitreoretinal interactions are similar to vitreomaculopathies, with axial and vitreoschisis-related tangential traction playing different roles in different rhegmatogenous pathologies. Peripheral optical coherence tomography improves understanding of pathophysiology and risks of retinal detachment.
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Affiliation(s)
- Andrea Govetto
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - J Sebag
- Doheny Eye Institute, UCLA, Pasadena, California
- Department of Ophthalmology, Geffen School of Medicine, UCLA, Los Angeles, California
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California; and
| | - Sara Lucchini
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
- Doheny Eye Institute, UCLA, Pasadena, California
- Department of Ophthalmology, Geffen School of Medicine, UCLA, Los Angeles, California
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California; and
- Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy
| | - Chiara Ballabio
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Martina Matteucci
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Stefano Ranno
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Elisa Carini
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Gianni Virgili
- Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy
| | - Daniela Bacherini
- Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy
| | - Paolo Radice
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
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Gawęcki M, Kiciński K. Advantages of the Utilization of Wide-Field OCT and Wide-Field OCT Angiography in Clinical Practice. Diagnostics (Basel) 2024; 14:321. [PMID: 38337837 PMCID: PMC10855083 DOI: 10.3390/diagnostics14030321] [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: 12/30/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Wide-field (WF) retinal imaging is becoming a standard diagnostic tool for diseases involving the peripheral retina. Technological progress elicited the advent of wide-field optical coherence tomography (WF-OCT) and WF-OCT angiography (WF-OCTA) examinations. This review presents the results of studies that analyzed the implementation of these procedures in clinical practice and refers to them as traditional and ultra-wide-field fluorescein angiography (UWF-FA). A PUBMED search was performed using the terms WF-OCT OR WF-OCTA OR UWF-FA AND the specific clinical entity, and another search for diabetic retinopathy (DR), retinal vein occlusion (RVO), Coats disease, peripheral retinal telangiectasia, peripheral retinal degeneration, lattice degeneration, and posterior vitreous detachment. The analysis only included the studies in which the analyzed field of view for the OCT or OCTA exam was larger than 55 degrees. The evaluation of the extracted studies indicates that WF imaging with OCT and OCTA provides substantial information on retinal disorders involving the peripheral retina. Vascular diseases, such as DR or RVO, can be reliably evaluated using WF-OCTA with results superior to standard-field fluorescein angiography. Nevertheless, UWF-FA provides a larger field of view and still has advantages over WF-OCTA concerning the evaluation of areas of non-perfusion and peripheral neovascularization. Detailed information on the vascular morphology of peripheral changes should be obtained via WF-OCTA and not angiographic examinations. WF-OCT can serve as a valuable tool for the detection and evaluation of vitreoretinal traction, posterior vitreous detachment, and peripheral retinal degeneration, and guide therapeutic decisions on a patient's eligibility for surgical procedures.
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Affiliation(s)
- Maciej Gawęcki
- Dobry Wzrok Ophthalmological Clinic, 80-822 Gdansk, Poland
- Department of Ophthalmology, Pomeranian Hospitals, 84-120 Wejherowo, Poland;
| | - Krzysztof Kiciński
- Department of Ophthalmology, Pomeranian Hospitals, 84-120 Wejherowo, Poland;
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Valentín-Bravo FJ. Vitreous opacities: A common but poorly understood phenomenon. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:47-48. [PMID: 37944643 DOI: 10.1016/j.oftale.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/26/2023] [Indexed: 11/12/2023]
Affiliation(s)
- F J Valentín-Bravo
- The Retina Clinic London, London, United Kingdom; Hospital Germans Trias i Pujol, Barcelona, Spain.
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Bravo FJV, Ayliffe W, Stanga SFE, Reinstein UI, Moxham R, Tariq Z, Downes SM, Stanga PE. New Imaging Technology for Simultaneous Multiwavelength-UWF Fundus Fluorescein Angiography and Indocyanine Green Angiography With Navigated Central and Peripheral SS-OCT. Ophthalmic Surg Lasers Imaging Retina 2023:1-10. [PMID: 37418670 DOI: 10.3928/23258160-20230607-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
OBJECTIVE Our aim was to assess central and peripheral retinal and choroidal diseases using novel simultaneous multiwavelength-ultra-widefield (MW-UWF) fundus fluorescein angiography (FFA)/indocyanine green angiography (ICGA) with navigated central and peripheral swept-source optical coherence tomography (SS-OCT) technology. METHODS Retrospective evaluation was carried out of 30 consecutive patients (60 eyes) who underwent UWF red/green (RG), infrared (IR), FFA and ICGA with simultaneous navigated SS-OCT using Optos Silverstone (Optos PLC). Angiographic retinal and choroidal findings in vascular pathologies and their relationship with the vitreoretinal interface (VRI) were assessed. RESULTS Simultaneous FFA with navigated SSOCT was performed in all patients and simultaneous FFA-ICGA with SS-OCT in 18 eyes (30%). Cross-sectional central and peripheral changes in the retina, choroid, and VRI corresponding with angiographic findings in several diseases were imaged. CONCLUSION First-in-human study of a new technology providing UWF RG/FFA/ICGA with simultaneous navigated central and peripheral SS-OCT can guide clinical management and provide new insights and understanding of central and peripheral retinal and choroidal disease. [Ophthalmic Surg Lasers Imaging Retina 2023;54:xx-xx.].
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Stanga PE, Valentin Bravo FJ, Reinstein UI, Stanga SFE, Marshall J, Archer TJ, Reinstein DZ. New Terminology and Methodology for the Assessment of the Vitreous, Its Floaters and Opacities, and Their Effect on Vision: Standardized and Kinetic Anatomical and Functional Testing of Vitreous Floaters and Opacities (SK VFO Test). Ophthalmic Surg Lasers Imaging Retina 2023; 54:306-315. [PMID: 37184989 DOI: 10.3928/23258160-20230412-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To introduce VFO and SK VFO Test: new, more representative terminology for symptoms of vitreous floaters/opacities (VFO) and new standardized kinetic (SK) anatomical-functional assessment. MATERIALS AND METHODS Eight eyes underwent before-after limited vitrectomy (LV): best-corrected visual acuity, low-luminance visual acuity, Minnesota Low Vision Reading Chart near visual acuity in logMAR, contrast sensitivity function (CV1000E), and straylight measurements (SM) (HDA/LDA/C-Quant). SK infrared confocal scanning laser ophthalmoscopy (SK IRcSLO) and swept-source widefield optical coherence tomography (SS-WF-OCT) identified VFO and posterior vitreous detachment (PVD). SK IRcSLO was performed with gaze directed towards the extreme superior, inferior, and lateral directions. RESULTS Anatomical-functional results after LV improved in 7 eyes (87.5%): objective scatter index (27.34%), disturbance index (47.97%) and C-Quant Log units (2.26%). Pre-LV SK IRcSLO and SS-WFOCT imaging identified dynamic well-defined VFO and PVD status (100%). A residual asymptomatic anterior cortical vitreous-induced shadowing ripple effect was detected post-LV. CONCLUSIONS This is the first objective-standardized test accounting for VFO kinesis and intermittent effect. There is potential for personalizing treatment and establishing best candidates for laser or surgery. [Ophthalmic Surg Lasers Imaging Retina 2023;54:306-315.].
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Nicolini N, Tombolini B, Barresi C, Pignatelli F, Lattanzio R, Bandello F, Cicinelli MV. Assessment of Diabetic Choroidopathy Using Ultra-Widefield Optical Coherence Tomography. Transl Vis Sci Technol 2022; 11:35. [PMID: 35353150 PMCID: PMC8976931 DOI: 10.1167/tvst.11.3.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose The purpose of this study was to investigate a confocal scanning laser ophthalmoscopy (cSLO) ultra-widefield (UWF) swept-source optical coherence tomography (S-SOCT) in assessment of diabetic choroidopathy and to evaluate the agreement of measurements with a spectral-domain OCT (SD-OCT) instrument. Methods We conducted a cross-sectional study of patients with diabetes evaluating the choroidal vascularity index (CVI) in the nasal, temporal, and central macula segments of a UWF SS-OCT scan centered to the fovea. UWF pseudocolored fundus images were used for diabetic retinopathy (DR) severity staging. The CVI values were compared between different degrees of severity of DR and different posterior-pole sectors with linear mixed models. Central macula CVI measurements were repeated on SD-OCT scans; the interobserver intraclass coefficient (ICC) was calculated between SS-OCT and SD-OCT. Results A total of 151 eyes of 85 patients were included. The CVI values decreased from nonproliferative DR to proliferative DR, with high-risk proliferative DR having significantly lower CVI values than moderate to severe nonproliferative DR (P = 0.03). The central macula region was the most evidently affected; the nasal sector was the least affected. The agreement between SS-OCT and SD-OCT was moderate (ICC = 0.50). Conclusions Diabetic choroidopathy progresses with worsening of DR toward proliferative disease; choroidal depletion is more prominent in the macula. Caution is recommended in comparing CVI values between different devices. Translational Relevance Choroidal vascularity informs about the severity of DR and its complications, such as macular edema. The agreement between readers and between instruments may be suboptimal in certain cases.
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Affiliation(s)
- Nicolò Nicolini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Beatrice Tombolini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Costanza Barresi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Rosangela Lattanzio
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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