Rediscovering AMD with Swept-Source OCT Imaging: The 2022 Charles L. Schepens, MD, Lecture

PURPOSE

Swept-source optical coherence tomography angiography (SS-OCTA) scans of eyes with age-related macular degeneration (AMD) were used to replace color, autofluorescence, infrared reflectance, and dye-based fundus angiographic imaging for the diagnosis and staging of AMD. Through the use of different algorithms with the SS-OCTA scans, both structural and angiographic information can be viewed and assessed using both cross-sectional and en face imaging strategies.

DESIGN

Presented at the 2022 Charles L. Schepens, MD, Lecture at the American Academy of Ophthalmology Retina Subspecialty Day, Chicago, Illinois, on September 30, 2022 PARTICIPANTS: Patients with AMD METHODS: Review of published literature and ongoing clinical research using SS-OCTA imaging in AMD.

MAIN OUTCOME MEASURES

SS-OCTA imaging of AMD at different stages of disease progression.

RESULTS

Volumetric SS-OCTA dense raster scans were used to diagnose and stage both exudative and nonexudative AMD. In eyes with nonexudative AMD, a single SS-OCTA scan was used to detect and measure structural features in the macula such as the area and volume of both typical soft drusen and calcified drusen, the presence and location of hyperreflective foci, the presence of reticular pseudodrusen, also known as subretinal drusenoid deposits, the thickness of the outer retinal layer, the presence and thickness of basal laminar deposits, the presence and area of persistent choroidal hypertransmission defects, and the presence of treatment-naïve nonexudative macular neovascularization. In eyes with exudative AMD, the same SS-OCTA scan pattern was used to detect and measure the presence of macular fluid, the presence and type of macular neovascularization, and the response of exudation to treatment with vascular endothelial growth factor inhibitors. In addition, the same scan pattern was used to quantitate choriocapillaris (CC) perfusion, CC thickness, choroidal thickness, and the vascularity of the choroid.

CONCLUSIONS

Compared with using several different instruments to perform multimodal imaging, a single SS-OCTA scan provides a convenient, comfortable, and comprehensive approach for obtaining qualitative and quantitative anatomic and angiographic information to monitor the onset, progression, and response to therapies in both nonexudative and exudative AMD.

Hospital-Based Ocular Trauma: Factors, Treatment, And Impact Outcome

Background

Specific morbidities as blindness is a serious complication that commonly results from patients with ocular traumas and can significantly impair the patient's social and occupational abilities. This study is conducted due to the current lack of data on ocular injuries in developing countries and places near war regions and aims to investigate and evaluate the impact of ocular trauma.

Material and methods

After Institutional Review Board approval was obtained, we retrospectively identified 112 patients who were admitted due to eye trauma from January 2015 until October 2018. Information about demographics, diagnostic modalities, prognostic impact, and treatment interventions were retrieved, analyzed.

Results

One-hundred and twelve patients were included in the study. The majority of patients were males. The mean age for patients was 22.2. Road traffic accident (RTA) constituted the most common cause of trauma (60.7%). Gunshots and blast injuries were observed in 12.5% of patients. Workplace injuries were infrequent (8.1%). The gunshot was significantly associated with injury to two or more eyeball structures while the RTA was significantly related to one eyeball structure injury. RTA was associated with intact globe while gunshot was significantly associated with ruptured globes. The mean duration of admission was 8.1 days. Associated truncal injury is the most important independent factor affecting the duration of admission.

Conclusion

Majority of trauma cases occurred in young males involved in RTAs. The location of Jordan near the Syrian war increases the appearance of gunshot ocular trauma in specific and ocular trauma in general. Educating the public is essential if we wish to prevent eye injuries.