scholarly journals Multimodal imaging for the assessment of geographic atrophy in patients with ‘foveal’ and ‘no foveal’ sparing.

2020 ◽  
Author(s):  
Stamatina A. Kabanarou ◽  
Georgios Bontzos ◽  
Tina Xirou ◽  
Zoi Kapsala ◽  
Eleni Dimitriou ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Imaging Modalities ◽  
Separate Analysis ◽  
Imaging Protocol ◽  
Significant Difference ◽  
En Face Oct ◽  
En Face ◽  
Foveal Sparing

INTRODUCTION To evaluate the applicability of optical coherence tomography-angiography (OCT-A) for measuring geographic atrophy (GA) areas in age-related macular degeneration (AMD) patients with ‘foveal’ and ‘no foveal’ sparing disease and compare it to other imaging modalities. METHODS A multimodal imaging protocol was applied, using infrared imaging (IR), fundus autofluorescence (FAF), OCT-A and en-face OCT in 35 eyes of 23 AMD patients with GA. Patients were classified in two groups, with and without foveal sparing disease. GA area measurements for all imaging modalities were compared for each group separately. RESULTS The measured GA area was estimated 6.68 ± 3.18 mm2using IR; 6.99 ± 3.09 mm2 using FAF; 6.56 ± 3.11 mm2 using OCT-A and 6.65 ± 3.14 mm2using en-face OCT. There was no statistically significant difference in GA area between different modalities (p=0.977). When separate analysis was conducted for patients with ‘foveal’ and ‘no foveal’ sparing disease, although GA measurements in FAF imaging displayed higher numerical values compared to the other modalities, especially in patients with foveal sparing, no statistically significant difference in GA area was found between the different imaging modalities in either group (p=0.816 for foveal sparing; p=0.992 for no foveal sparing group). CONCLUSIONS OCT-A can be reliably used in the assessment of GA in AMD patients with and without foveal sparing disease. For both groups, measurements are comparable to IR, en-face OCT and FAF, despite the fact that the latter recorded larger area of GA, mainly in the foveal sparing cases.

scholarly journals En Face OCT Imaging for the Diagnosis of Outer Retinal Tubulations in Age-Related Macular Degeneration

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Benjamin Wolff ◽  
Alexandre Matet ◽  
Vivien Vasseur ◽  
José-Alain Sahel ◽  
Martine Mauget-Faÿsse
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Spectral Domain ◽  
Macular Disease ◽  
Spectral Domain Oct ◽  
Age Related ◽  
En Face Oct ◽  
En Face ◽  
Oct Imaging

Purpose. “En face” is an emerging imaging technique derived from spectral domain optical coherence tomography (OCT). It produces frontal sections of retinal layers, also called “C-scan OCT.” Outer retinal tubulations (ORTs) in age-related macular degeneration (AMD) are a recent finding evidenced by spectral-domain OCT. The aim of this study is to characterize the morphology of ORT according to the form of AMD, using “en-face” spectral domain OCT.Methods. “En face” OCT imaging was prospectively performed in 26 consecutive eyes with AMD that also had ORT.Results. There were 15 neovascular, 8 atrophic, and 3 eyes with a mixed (fibrotic and atrophic) form of AMD. Among the neovascular group, the most frequent tubulation pattern on “en-face” OCT was a branching network emanating from a fibrovascular scar; we term this pattern as “pseudodendritic.” It did not require treatment when observed as an isolated finding. In all cases of atrophic AMD, the tubular network was located at the edge of the geographic atrophy area, and formed a “perilesional” pattern. Six atrophic cases showed tubular invaginations inside this area.Conclusion. “En face” OCT is a valuable technique in the diagnosis and followup of macular disease. It revealed the main characteristic patterns of ORT associated with neovascular and atrophic AMD.

scholarly journals Outer retinal tubulation formation and clinical course of advanced age-related macular degeneration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alessandro Arrigo ◽  
Emanuela Aragona ◽  
Ottavia Battaglia ◽  
Andrea Saladino ◽  
Alessia Amato ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Müller Cells ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Advanced Age ◽  
Age Related ◽  
Dry Amd ◽  
Foveal Sparing ◽  
Wet Amd

AbstractOuter retinal tubulations (ORT) are a relatively new finding characterizing outer retinal atrophy. The main aim of the present study was to describe ORT development in advanced age-related macular degeneration (AMD) and to assess its relationship with disease’s severity. Patients with advanced AMD characterized either by macular neovascularization or geographic atrophy, showing signs of outer retinal disruption or retinal pigment epithelium atrophy on structural optical coherence tomography (OCT) at the inclusion examination were prospectively recruited. All the patients underwent complete ophthalmologic evaluation, structural OCT scans and fundus autofluorescence imaging. The planned follow-up was of 3-years. Main outcome measures were ORT prevalence, mechanism of ORT formation, mean time needed for complete ORT formation, best-corrected visual acuity (BCVA), definitely decreased autofluorescence (DDAF) area, questionably decreased autofluorescence (QDAF) area, retinal layer thickness, foveal sparing, number of intravitreal injections. We also assessed the possible role of external limiting membrane (ELM) and Müller cells in ORT pathogenesis. Seventy eyes (70 patients) were included; 43 showed dry AMD evolving to geographic atrophy, while 27 displayed the features of wet AMD. Baseline BCVA was 0.5 ± 0.5 LogMAR, decreasing to 0.9 ± 0.5 LogMAR at the 3-year follow-up (p < 0.01). We detected completely formed ORT in 26/70 eyes (37%), subdivided as follows: 20 eyes (77%) wet AMD and 6 eyes (23%) dry AMD (p < 0.01). ORT took 18 ± 8 months (range 3–35 months) to develop fully. We described the steps leading to ORT development, characterized by progressive involvement of, and damage to the photoreceptors, the ELM and the RPE. Eyes displaying ORT were associated with a smaller QDAF area, less retinal layers damage and lower rate of foveal sparing than eyes free of ORT (p < 0.01). We also described pigment accumulations simulating ORT, which were detected in 16/70 eyes (23%), associated with a greater loss of foveal sparing, increased DDAF area and smaller QDAF area at the 3-year follow-up (p < 0.01). In conclusion, this study provided a description of the steps leading to ORT development in AMD. ELM and Müller cells showed a role in ORT pathogenesis. Furthermore, we described a subtype of pigment hypertrophy mimicking ORT, evaluating its clinical utility.

scholarly journals Percentage of Foveal versus Total Macular Geographic Atrophy as a Predictor of Visual Acuity in Age-related Macular Degeneration

2019 ◽  
Author(s):  
Saghar Bagheri ◽  
Ines Lains ◽  
Rebecca Silverman ◽  
Ivana Kim ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Fundus Autofluorescence ◽  
Cross Sectional Study ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Age Related ◽  
The Impact ◽  
Foveal Sparing

AbstractObjectivesTo investigate the relationship between visual acuity (VA), total area of geographic atrophy (GA) and percentage of foveal GA.MethodsMulticenter, retrospective cross-sectional study of patients with GA due to age-related macular degeneration. Demographics, VA, fundus autofluorescence (FAF) and optical coherence tomography (OCT) images were collected. Using FAF images aided by OCT, foveal sparing status, GA pattern, total GA size, and percentage of GA covering the foveal area - area within a 1.5 mm diameter circle centered on the fovea centralis - were assessed. Univariable and multiple linear regression analyses were performed.Results54 eyes (mean age 78.7 ±7.7 (SD), 60.0% female) were studied. Mean VA was 0.8 ± 0.6 logMAR, mean total GA 8.8 ± 6.7 mm2 and mean percentage of foveal GA was 71.5 ± 30.9%. Of all assessed eyes, 48.2% (n = 26) presented with multifocal GA, and 18.5% (n = 10) had foveal sparing. Multiple regression analysis revealed that, controlling for age and GA pattern, the percentage of foveal GA presented a statistically significant association with VA (ß = 0.41, P = 0.004). No significant associations were observed with mean total GA size, while controlling for the same variables (ß = 0.010, P = 0.440).ConclusionPercentage of foveal GA was significantly associated with VA impairment, while the same was not verified for total GA area. These findings suggest that percentage of foveal GA may represent a more useful tool for assessing the impact of GA on VA. Further validation is needed in larger cohorts.

In Vivo Imaging of Foveal Sparing in Geographic Atrophy Secondary to Age-Related Macular Degeneration

2009 ◽  
Vol 50 (8) ◽  
pp. 3915 ◽  
Author(s):  
Steffen Schmitz-Valckenberg ◽  
Monika Fleckenstein ◽  
Hans-Martin Helb ◽  
Peter Charbel Issa ◽  
Hendrik P. N. Scholl ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
In Vivo Imaging ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Foveal Sparing

scholarly journals OCT Angiography and En Face OCT Reflectance Aid in Monitoring Subclinical Inflammation in Serpiginous Choroidopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Carl S. Wilkins ◽  
Jorge S. Andrade Romo ◽  
Toco Y. P. Chui ◽  
Richard B. Rosen ◽  
Stephanie Llop
Keyword(s):  
Disease Progression ◽  
Transition Zone ◽  
Multimodal Imaging ◽  
Primary Site ◽  
Subclinical Inflammation ◽  
Case Presentation ◽  
Normal Retina ◽  
Subclinical Disease ◽  
En Face Oct ◽  
En Face

Introduction. We present a case of serpiginous choroidopathy (SC) with novel OCTA and en face OCT reflectance findings which help identify subclinical disease progression. Case Presentation. En face OCT reflectance images demonstrated outer retinal tubules (ORT) at the serpiginous lesion margins of affected and unaffected retina on multimodal imaging. OCTA findings demonstrate variable dropout of choriocapillaris in “normal” retina beyond lesion borders which was not visible on standard imaging and which demonstrated a clear transition zone beyond the ORT. Discussion. This is the first report of choriocapillaris atrophy identified on OCTA not identified on traditional multimodal imaging in serpiginous choroidopathy. Damage to vasculature only visible with OCTA may help characterize the distribution of inflammation, aiding in monitoring of suppression not illustrated by traditional imaging and which may threaten the central macula. ORT in SC suggest death and reorganization of outer segments from dysfunction of the choriocapillaris and RPE, as well as serve to demarcate the area of chronic or old inflammation, supporting the hypothesis that the choriocapillaris is the primary site of inflammation in SC. Based on these findings, we recommend OCTA on all patients with serpiginous choroidopathy to monitor underlying state of inflammation and help determine immunosuppressive threshold.

scholarly journals Foveal-Sparing Scotomas in Advanced Dry Age-Related Macular Degeneration

2008 ◽  
Vol 102 (10) ◽  
pp. 600-610 ◽  
Author(s):  
Janet S. Sunness ◽  
Gary S. Rubin ◽  
Abraham Zuckerbrod ◽  
Carol A. Applegate
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Good Visual Acuity ◽  
Age Related ◽  
Foveal Sparing

Foveal-sparing scotomas are common in advanced dry macular degeneration (geographic atrophy). Foveal preservation may be present for a number of years. Despite good visual acuity, these patients have reduced reading rates. Magnification may not be effective if the text becomes too large to “fit” within the central spared area.

scholarly journals Choroidal caverns in pachychoroid neovasculopathy

2021 ◽  
Vol 6 (6-1) ◽  
pp. 237-243
Author(s):  
E. K. Pedanova
Keyword(s):  
Pigment Epithelium ◽  
Diagnostic Techniques ◽  
Posterior Pole ◽  
Age Related Macular Degeneration ◽  
Oct Angiography ◽  
Age Related ◽  
Retinal Pathology ◽  
En Face Oct ◽  
En Face ◽  
Pachychoroid Neovasculopathy

Background. Choroid plays an important role in the pathogenesis of retinal pathology. Choroidal cavern, a recently identifi ed fi nding of optical coherent tomography (OCT), has been described in some degenerative and atrophic forms of retinal pathology. In the literature, there are only a few studies of choroidal cavers in pachychoroid neovasculopathy, newly described form of age related macular degeneration.The aim: to perform a detailed analysis of choroidal structure on OCT scans of patients with pachychoroid neovasculopathy and to reveal the frequency of choroidal caverns identifi cation.Material and methods. The data of 30 patients (30 eyes) aged 64.4 ± 5.6 years with pachychoroid neovascularization were retrospectively analyzed. The patients underwent spectral OCT and OCT-angiography (OCTA) using a Spectralis device (Heidelberg Engineering, Germany). The protocol was “Posterior Pole”, consisting of 61 scans. To assess the structure of the choroid, an enhanced image depth (EDI) module was used. OCT angiography was performed with a scan area of 6 × 6 mm. These methods were compared to identify choroidal caverns.Results. On OCT subretinal type 1 neovascularization was revealed as a fl at detachment of the pigment epithelium and visualization of blood flow on OCTA in the lesion as angled vessels (21 eyes) or a seafan (9 eyes). On OCT-EDI scans, there was diffuse or local choroidal thickening of choroid with an increase in the vessels of the Haller’s layer and thinning of the choriocapillaries. Choroidal caverns appeared on OCT and en-face OCT as areas with low optical density, round or irregular, located in different layers of the chorioid, without hyperrefl ective boundaries. A typical sign of choroidal cavern is the tail of hypertransmission after the cavern toward the sclera. Choroidal caverns were found in 4 of 30 eyes (13.3 %) and were located both near the choroidal neovascularization lesion and beyond this area.Conclusion. The prevalence of choroidal cavities, a new choroidal biomarker, in pachychoroid neovasculopathy was 13.3 %. Identification of these changes is possible with the use of modern diagnostic techniques (OCT-EDI, OCTA and en-face OCT) that allow visualization the state of the choroid. The prognostic signifi cance of choroidal cavities requires further study.

scholarly journals Choriocapillaris impairment around the atrophic lesions in patients with geographic atrophy: a swept-source optical coherence tomography angiography study

2018 ◽  
Vol 103 (7) ◽  
pp. 911-917 ◽  
Author(s):  
Marco Nassisi ◽  
Yue Shi ◽  
Wenying Fan ◽  
Enrico Borrelli ◽  
Akihito Uji ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Signal Loss ◽  
Swept Source ◽  
Age Related ◽  
En Face ◽  
Wide Ring

AimsTo evaluate the choriocapillaris (CC) flow alterations around geographic atrophy (GA) in eyes with dry age-related macular degeneration.MethodsUsing a swept-source optical coherence tomography angiography (SS-OCTA) device, two volume 6×6 mm scans were acquired in patients with GA presenting between June and December 2017 at the Doheny-UCLA Eye Centers. The area of GA was delineated on the en face structural OCT fundus images. For each eye, the en face OCTA slabs at the level of the CC from the two acquisitions were averaged and compensated for signal loss using the corresponding structural en face images. The resulting images were binarised and analysed for the percentage of flow voids in the para-atrophy zone (a 500 µm wide ring around the immediate edge of the atrophy) and in the peri-atrophy zone (a 500 µm wide ring around the para-atrophy zone edge), the latter considered as a reference in the comparative analysis.ResultsThirty eyes of 20 patients were enrolled. The percentage of flow voids in the para-atrophy zone was 27.23%±6.29% and was significantly higher than in the surrounding peri-atrophy zone (23.4%±6.01%; p<0.001). There was no significant correlation between the flow void percentage in these regions and age, visual acuity, extent of the atrophic area or central choroidal thickness.ConclusionsA significant impairment of the CC flow is present in the zone immediately surrounding the GA lesions strengthening the hypothesis that CC alterations may be relevant to the progression of GA.

scholarly journals Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in Patients With Dry Age-Related Macular Degeneration Over Time

2017 ◽  
Vol 179 ◽  
pp. 118-128 ◽  
Author(s):  
Ramzi Gilbert Sayegh ◽  
Stefan Sacu ◽  
Roman Dunavölgyi ◽  
Maria Elisabeth Kroh ◽  
Philipp Roberts ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Foveal Sparing ◽  
Over Time
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