scholarly journals Assessment of Vascular Change Using Swept-Source Optical Coherence Tomography Angiography: A New Theory Explains Central Visual Loss in Behcet’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Thanapong Somkijrungroj ◽  
Sritatath Vongkulsiri ◽  
Wijak Kongwattananon ◽  
Peranut Chotcomwongse ◽  
Sasivarin Luangpitakchumpol ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optical Coherence Tomography Angiography ◽  
Vision Loss ◽  
Age At Onset ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Capillary Plexus ◽  
Macular Ischemia

Objective. To evaluate retinal vascular structural change in ocular Behcet’s using optical coherence tomography angiography (OCTA) and fluorescein angiography (FA). Methods. An analytic cross-sectional study of 37 eyes of 21 Behcet’s uveitic patients was performed. Foveal retinal thickness (FRT), perifoveal hypoperfusion areas in superficial capillary plexus (SCP), and deep capillary plexus (DCP) were measured with swept-source optical coherence tomography and OCTA. FA images were used for assessing the vascular features and correlation. Results. Twenty-one patients were enrolled (52.4% males). The average age at onset was 36.7 ± 12.93 years. The median of disease duration was 5 years (1–25). FRT was 118.1 ± 52.35 μm, which correlated with visual acuity (95% CI −60.47, −13.92). Using OCTA, the area of hypoperfusion in SCP (0.47 ± 0.17 mm2) was smaller than that in DCP (1.94 ± 3.87 mm2) (p<0.001). Superficial to deep capillary plexus nonperfusion (SCP : DCP) ratio was 0.57 ± 0.27 which had the positive coefficient correlation with visual acuity (95% CI −0.644, −0.015). Conclusions. OCTA is an alternative noninvasive method to monitor macular ischemia in Behcet. Behcet’s uveitis affects DCP more than SCP. Decreasing SCP : DCP ratio and decrease FRT correlates with poor visual acuity. Macular ischemia and DCP loss can be found early and can explain vision loss in Behcet.

scholarly journals Retinal and choroidal circulation determined by optical coherence tomography angiography in patient with amyloidosis

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-228479 ◽  
Author(s):  
Masami Tei ◽  
Ichiro Maruko ◽  
Eiko Uchimura ◽  
Tomohiro Iida
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Optical Coherence ◽  
Severe Renal Failure ◽  
Cross Sectional ◽  
Swept Source ◽  
Amyloid Accumulation ◽  
Capillary Plexus

A 43-year-old woman who was diagnosed with the cryopyrine-associated periodic syndrome (CAPS) with severe renal failure and heart failure due to amyloid accumulation was examined by swept source optical cohernce tomography (OCT) (SS-OCT; DRI-OCT, Topcon, Tokyo, Japan) and optical coherence tomography angiography (OCTA) (RTVue XR Avanti, Optovue, Fremont, CA). Her best-corrected visual acuity was 20/40 OD and 20/25 OS. A hyporeflective band of about 100 µm thickness was seen just inferior to the retinal pigment epithelium in the cross-sectional SS-OCT images, but the deeper choroidal structures were clearly visible. In the OCTA images, the density of the retinal capillaries in the superficial and deep capillary plexus slabs were reduced, and no signals of the choroidal capillary slab was detected after removing the projection artefacts. The accumulation of amyloid can cause a reduction of both the retinal and choroidal capillary circulations although the circulation in the larger vessels are preserved.

scholarly journals Comparison of swept-source versus spectral-domain optical coherence tomography angiography for detection of macular neovascularization

2021 ◽  
Author(s):  
Anna Lentzsch ◽  
Laura Schöllhorn ◽  
Christel Schnorr ◽  
Robert Siggel ◽  
Sandra Liakopoulos
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
En Face ◽  
Increased Sensitivity ◽  
Sensitivity Specificity ◽  
Subretinal Hyperreflective Material

Abstract Purpose To compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV). Methods In this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA. Results Sensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices. Conclusion Both devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.

scholarly journals Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome

2019 ◽  
Vol 30 (3) ◽  
pp. NP14-NP17 ◽  
Author(s):  
Juan Francisco Santamaría Álvarez ◽  
Anna Serret Camps ◽  
Javier Aguayo Alvarez ◽  
Olga García García
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Hemolytic Uremic Syndrome ◽  
Optical Coherence Tomography Angiography ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Capillary Plexus ◽  
Uremic Syndrome ◽  
Best Corrected Visual Acuity

Purpose: To report a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome and the changes seen in the optical coherence tomography angiography before and after treatment with eculizumab. Case description: A 22-year-old man with an unremarkable medical history presented with acute, bilateral blurred vision and headache of 1-week duration. Best corrected visual acuity of 20/50 and 20/40, respectively, in the patient’s right eye and left eye. Funduscopy revealed multiple cotton-wool spots associated with intrarretinal fluid. Swept source optical coherence tomography revealed multifocal retinal detachments with increased choroidal thickness. Optical coherence tomography angiography showed areas of ischemia in both capillary plexus. Due to concurrent symptoms and laboratory analysis, he was diagnosed with atypical hemolytic uremic syndrome and secondary Purtscher-like retinopathy; therefore, treatment with eculizumab was initiated. After 2 months revascularization of the previous ischemic areas was seen in the optical coherence tomography angiography that were correlated with best corrected visual acuity improvement. Conclusion: Our findings suggest that evaluation of the macular capillary plexus revascularization by optical coherence tomography angiography during the disease could help to predict an improvement of best corrected visual acuity in these patients and the measurement of choroidal thickness could give us information about the resolution of the pathologic process.

scholarly journals Comparison of two different optical coherence tomography angiography devices in detecting healthy versus glaucomatous eyes – an observational cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. R. Kee ◽  
V. C. H. Yip ◽  
E. L. T. Tay ◽  
C. W. Lim ◽  
J. Cheng ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diagnostic Accuracy ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Retest Reliability ◽  
Significant Difference ◽  
Test Retest Reliability

Abstract Background To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability. Methods A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated. Results A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761–1.000) compared to Swept Source (0.113–0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source. Conclusions AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.

scholarly journals Comparison of the Repeatability of Macular Vascular Density Measurements Using Four Optical Coherence Tomography Angiography Systems

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Youxin Chen
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Vessel Density ◽  
Vascular Density ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Capillary Plexus ◽  
Scan Pattern

The aim of this study was to compare the repeatability of optical coherence tomography angiography (OCT-A) measurements of macular vessel density using four OCT-A systems, including Heidelberg Spectralis HRA, Optovue RTVue XR, Zeiss Cirrus HD-OCT 5000, and Topcon DRI OCT Triton. A cross-sectional design was used for this study. The vascular density and vascular length density of the superficial and deep retinal capillary plexuses were imaged with OCT-A using 3 mm and 6 mm scan patterns and were calculated using ImageJ. Comparisons of intraclass correlation coefficients (ICC) were conducted. We found that the OCT-A systems had various levels of repeatability. Zeiss had better repeatability for vessel density than the other systems (overall ICC = 0.936). Optovue had better repeatability for vessel length density when the 6 mm scan pattern was used (ICC = 0.680 and 0.700 for retinal superficial and deep capillary plexus, respectively). We concluded that repeatability varied when different scan patterns of various OCT-A systems were used for imaging the superficial retinal and deep capillary plexuses. Results should be seen as valid only for a given method. The repeatability of various OCT-A systems should be considered in clinical practice and in clinical trials that use OCT-A metrics as outcome measures.

scholarly journals Early Retinal Flow Changes after Vitreoretinal Surgery in Idiopathic Epiretinal Membrane Using Swept Source Optical Coherence Tomography Angiography

2019 ◽  
Vol 8 (12) ◽  
pp. 2067 ◽  
Author(s):  
Rodolfo Mastropasqua ◽  
Rossella D’Aloisio ◽  
Pasquale Viggiano ◽  
Enrico Borrelli ◽  
Carla Iafigliola ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Epiretinal Membrane ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Vascular Changes ◽  
Ilm Peeling ◽  
Swept Source ◽  
Idiopathic Epiretinal Membrane ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

(1) Background: The aim of this observational cross-sectional work was to investigate early retinal vascular changes in patients undergoing idiopathic epiretinal membrane (iERM) surgery using swept source optical coherence tomography angiography (SS-OCTA); (2) Methods: 24 eyes of 24 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling were evaluated pre- and postoperatively using SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 6x6-mm OCTA volume scans were acquired by two observers independently. The en face images of superficial capillary plexus (SCP) were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. Perfusion density (PD), vessel length density (VLD), vessel diameter index (VDI) and vessel tortuosity (VT) of SCP were evaluated in both the parafoveal (2.5 mm diameter) and perifoveal areas (5.5 mm diameter); (3) Results: At OCTA analysis statistically significant differences were found between controls and diseased eyes for all parameters in parafoveal and perifoveal regions (p < 0.001; p < 0.05) except for perifoveal VLD. During 6-month follow up, both anatomical/perfusion and functional parameters showed a statistically significant improvement if compared to preoperative values. In detail, at one-month post vitrectomy, VLD and VT significantly changed in parafoveal region (p = 0.043; p = 0.045), while PD and VDI showed a trend of increase in both parafoveal and perifoveal region. At 6 months after surgery, PD, VLD and VT of parafoveal region significantly improved (p = 0.021, p = 0.018, p = 0.047 respectively). (4) Conclusions: SS-OCTA provides a quantitative and qualitative analysis of the superficial capillary plexus allowing for early vascular changes assessment after vitrectomy with iERM and ILM peeling.

scholarly journals Paramacular Acute Middle Maculopathy Associated with Glyceryl Trinitrate

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Tryfon Rotsos ◽  
Ioannis Giachos ◽  
Konstantinos Tyrlis ◽  
Chrysanthos Symeonidis ◽  
Ekaterini Mani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Glyceryl Trinitrate ◽  
Vision Loss ◽  
Optical Coherence ◽  
Swept Source ◽  
Nitroglycerin Ointment ◽  
Vascular Abnormalities ◽  
Venous Dilatation ◽  
Capillary Plexus ◽  
Plexiform Layers

An unusual case of nitroglycerin-induced Paracentral Acute Middle Maculopathy (PAMM) is presented. A 50-year-old patient with sudden vision loss and scotoma was followed up with swept-source optical coherence tomography (SS-OCT), optical coherence tomography-angiography (OCT-A), and fluorescein angiography (FA). An anal fissure treated with glyceryl trinitrate (GTN) 0.2% ointment with headache and dizziness after application was reported. Fundoscopy OS revealed mild retinal venous dilatation and tortuosity with scattered blot hemorrhages and subtle, parafoveal, whitish lesions in the outer retina. SS-OCT revealed diffuse, hyperreflective lesions in the inner plexiform (IPL), inner nuclear (INL), and outer plexiform layers (OPL). OCT-A revealed focal dropout in the deep capillary plexus. FA showed masking due to blot hemorrhages and early punctuate leakage in the inner retina. This entity was identified as nitroglycerin-induced PAMM. Over the following 8 months, after discontinuation of the ointment application, the patient was symptom-free with stable visual acuity. OCT revealed INL/OPL thinning and confirmed complete lesion resolution. This first report of retinal vascular abnormalities due to nitrite ointment provides an insight into an unknown side effect of nitroglycerin ointment use. A dose-dependent correlation between GTN application and retinal vascular abnormalities remains to be confirmed.

Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

2020 ◽  
pp. bjophthalmol-2020-317983
Author(s):  
Edward S Lu ◽  
Ying Cui ◽  
Rongrong Le ◽  
Ying Zhu ◽  
Jay C Wang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optic Disc ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Vitreoretinal Interface ◽  
Cross Sectional ◽  
Swept Source ◽  
Detection Rates

AimsTo compare the efficacy of diabetic retinal neovascularisation (NV) detection using the widefield swept-source optical coherence tomography angiography (WF SS-OCTA) vitreoretinal interface (VRI) Angio slab and SS-OCT VRI Structure slab.MethodsA prospective, observational study was performed at Massachusetts Eye and Ear from January 2019 to June 2020. Patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy and patients with diabetes but without diabetic retinopathy were included. All patients were imaged with WF SS-OCTA using the 12×12 mm Angio scan protocol centred on the fovea and optic disc. The en-face SS-OCTA VRI Angio slab and SS-OCT VRI Structure slab were evaluated for the presence or absence of NV. SS-OCTA B-scan was used to classify NV according to cross-sectional morphology (forward, tabletop or flat). All statistical analyses were performed using SPSS V.26.0.ResultsOne hundred and forty-two eyes of 89 participants were included in the study. VRI Angio detected NV at higher rates compared with VRI Structure (p<0.05). Combining VRI Angio and Structure improved detection rates compared with VRI Angio alone (p<0.05). Due to segmentation errors of the internal limiting membrane, NV with flat morphological classification had lower rates of detection on VRI Angio compared with NV with forward and tabletop morphology (p<0.05).ConclusionsWF SS-OCTA 12×12 mm VRI Angio and SS-OCT VRI Structure imaging centred on the fovea and optic disc detected NV with high sensitivity and low false positives. The VRI slab may be useful to diagnose and monitor PDR in clinical practice.

scholarly journals Retinal Sensitivity Loss Correlates with Deep Capillary Plexus Impairment in Diabetic Macular Ischemia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Fabio Scarinci ◽  
Monica Varano ◽  
Mariacristina Parravano
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Optical Coherence ◽  
Type 2 Diabetic Patients ◽  
Sensitivity Loss ◽  
Capillary Plexus ◽  
Macular Ischemia ◽  
Sd Oct

Purpose. To assess retinal sensitivity and retinal morphologic changes of capillary nonperfused areas in diabetic macular ischemia. Methods. Observational cross-sectional study. Patients were examined at IRCCS—Bietti Foundation, Rome, Italy. Fourteen consecutive diabetic eyes showing outer retinal changes on spectral domain optical coherence tomography B-scan were included. Ten eyes of ten diabetic patients with normal outer retinal structure on SD-OCT were included as controls. All eyes underwent optical coherence tomography angiography (OCTA) and MP1 microperimetry. To explore the outer retina findings and localized areas of capillary nonperfusion at the superficial and deep capillary plexus, we used the Spectralis HRA + OCTA (Heidelberg Engineering, Heidelberg, Germany). The B-scans as either normal or having outer retinal disruption and the enface images at the level of the superficial and/or deep capillary plexus were evaluated to identify areas of capillary nonperfusion. Results. Fourteen eyes of 12 consecutive type 2 diabetic patients with outer retinal disruption on SD-OCT showed that areas of capillary nonperfusion of the deep capillary plexus were colocalized to areas of reduced retinal sensitivity. Conclusions. On optical coherence tomography angiography, areas of capillary nonperfusion of deep capillary plexus due to macular ischemia are associated with photoreceptor structural abnormalities and retinal sensitivity loss on microperimetry. This highlights that the health status of deep capillary plexus and not only the choroid is important to the oxygen requirements of the photoreceptors in patients with diabetic macular ischemia. Also, the anatomical and functional consequences of these findings might help to explore the efficacy of new therapy into the macular area in clinical practice.

Reproducibility of macular and optic nerve head vessel density measurements by swept-source optical coherence tomography angiography

2019 ◽  
Vol 30 (4) ◽  
pp. 756-763 ◽  
Author(s):  
José Ignacio Fernández-Vigo ◽  
Bachar Kudsieh ◽  
Ana Macarro-Merino ◽  
Pedro Arriola-Villalobos ◽  
José María Martínez-de-la-Casa ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Central Zone ◽  
Vessel Density ◽  
Optical Coherence ◽  
Outer Retina ◽  
Swept Source ◽  
Capillary Plexus

Purpose: To assess the reproducibility of swept-source optical coherence tomography angiography (SS-OCTA) for macular and optic nerve head (ONH) vessel density (VD). Methods: Cross-sectional study using the Triton OCTA (Topcon, Tokyo, Japan), for VD (%) measurements in 40 eyes of 40 healthy subjects on two 6 × 6 mm scans of the macula and ONH across five subfields (central, superior, inferior, temporal, and nasal) at different segmentation levels: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris. Reproducibility values were summarized as intraclass correlation coefficients (ICCs) and coefficients of variations (CV). Results: ICCs for the macular VD measurements in the central zone were 0.874, 0.770, 0.575, 0.718 at the levels SCP, DCP, outer retina, and choriocapillaris, respectively, while worse ICCs were obtained for the parafoveal subfields (ICC ⩽ 0.589); CVs were 2.8%–6.7%. The reproducibility of the ONH superficial VD was ICC = 0.941 for the papillary region and was ICC = 0.499–0.853 for the peripapillary zone; CVs ranged from 4.8% to 17%. Peripapillary VD showed an ICC = 0.533–0.770 in the DCP layer, and 0.572–0.828 in the choriocapillaris. Lowest VD were obtained for the macular SCP and DCP (23% and 22%, respectively), in the foveal zone, while greatest VD were recorded in the nasal and temporal peripapillary subfields at the level of the choriocapillaris (both 68%). Conclusions: The new SS-OCTA software served to quantify macular and ONH VD with a reproducibility that was good in the central zones (foveal and papillary, respectively) and moderate in the peripheral zones (parafoveal and peripapillary).

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