Peripapillary microvasculature changes after vitrectomy in epiretinal membrane via swept-source OCT angiography
Purpose To evaluate the peripapillary microvasculature changes in patients with epiretinal membrane (ERM) following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling using swept-source optical coherence tomography angiography (SS-OCTA).
Method Medical records and multimodal imaging data of 33 eyes after PPV for ERM were retrospectively reviewed. Peripapillary SS-OCTA images of 6×6 mm2 were recorded at at pre- and post-operatively every 6 months for 1 year. A semi-automated method was used to analyzed SS-OCTA images, excluding the optic disc area, using the MATLAB software. The peripapillary vessel density (pVD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) was quantified in four quadrants (superior, inferior, nasal and temporal).
Result The mean pVD in SCP and DCP decreased at 6- and 12-months follow-up. In sectoral analysis, superior, inferior, and temporal quadrants pVD in SCP and DCP were significantly reduced at ...
Pathophysiology of outer retinal corrugations: Imaging dataset and mechanical models
This article presents high-resolution swept-source optical coherence tomography (SS-OCT) imaging data used to elaborate a mechanical model that elucidates the formation of outer retinal corrugations (ORCs) in rhegmatogenous retinal detachments (RRD). The imaging data shared in the repository and presented in this article is related to the research paper entitled “Outer Retinal Corrugations in Rhegmatogenous Retinal Detachment: The Retinal Pigment Epithelium-Photoreceptor Dysregulation Theory” (Muni et al., AJO, 2022). The dataset consists of 69 baseline cross-sectional SS-OCT scans from 66 patients that were assessed for the presence of ORCs and analyzed considering the clinical features of each case. From the 66 cases, we selected SS-OCT images of 4 RRD patients with visible ORCs and no cystoid macular edema (CME) to validate the mechanical model. We modelled the retina as a composite material consisting of the outer retinal layer (photoreceptor layer) and the inner retinal layer...
Three-dimensional imaging and quantification of mouse ovarian follicles via optical coherence tomography
Ovarian tissue cryopreservation has been successfully applied worldwide for fertility preservation. Correctly selecting the ovarian tissue with high follicle loading for freezing and reimplantation increases the likelihood of restoring ovarian function, but it is a challenging process. In this work, we explore the use of three-dimensional spectral-domain optical coherence tomography (SD-OCT) to identify different follicular stages, especially primary follicles, compare the identifications with H&E images, and measure the size and age-related follicular density distribution differences in mice ovaries. We use the thickness of the layers of granulosa cells to differentiate primordial and primary follicles from secondary follicles. The measured dimensions and age-related follicular distribution agree well with histological images and physiological aging. Finally, we apply attenuation coefficient map analyses to significantly improve the image contrast and the contrast-to-noise ra...
Optical Coherence Tomography as a Predictor of Visual Protection and Recovery in the Setting of Pituitary Apoplexy
Objective: Pituitary apoplexy is a clinical condition resulting in neurological and pituitary dysfunction as a result of pituitary tumor infarction or hemorrhage. Surgery is often recommended in the setting of acute visual loss. Preoperative RNFL thickness has previously been shown to be a prognosticator for long-term visual recovery following pituitary or parasellar tumor resection. The authors investigated if perioperative optical coherence tomography (OCT) could be used as a prognosticator of visual outcomes in pituitary apoplexy.
Methods: The authors retrospectively reviewed the medical records of 41 patients who had presented to their institution with pituitary apoplexy from 2013 to 2022. Six patients were identified that had perioperative optical coherence tomography in combination with Humphrey visual fields. All patients underwent preoperative MRI demonstrating pituitary apoplexy. All six patients underwent endoscopic transsphenoidal resection of their pituitary tumor. Hu...
Analyses of Foveal Avascular Zone in Patients with General Blunt Ocular Trauma Using Optical Coherence Tomography Angiography
To investigate the effect of blunt ocular trauma (BOT) on foveal circulation, and in particular the foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA).
This retrospective study consisted of 96 eyes (48 traumatized eyes and 48 nontraumatized eyes) from 48 subjects with BOT. We analyzed the FAZ area of deep capillary plexus (DCP) and superficial capillary plexus (SCP) immediately after BOT and at 2 weeks after BOT. We also evaluated the FAZ area of DCP and SCP in patients with and without blowout fracture (BOF).
There were no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP in the initial test. In traumatized eyes, the FAZ area at SCP was significantly reduced on follow-up when compared to initial test (p = 0.01). In case of eyes with BOF, there was no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP on initial test. No significant di...
Optical coherence tomography-based assessment of macular vessel density, retinal layer metrics and sub-foveal choroidal thickness in COVID-19 recovered patients
The primary objective of the study was to assess the macular retinal vessel density, subfoveal choroidal thickness, and retinal layer metrics by optical coherence tomography angiography (OCTA), enhanced-depth imaging optical coherence tomography (EDI-OCT), and spectral domain optical coherence tomography (SD-OCT), respectively, in recovered COVID-19 patients and its comparison with the same in control subjects. The secondary objective was to evaluate differences in OCTA parameters in relation with the severity of COVID-19 disease and administration of corticosteroids.
A case–control study was performed that included patients who had recovered from COVID-19 and age-matched healthy controls. Complete ocular examination including OCTA, SD-OCT, and EDI-OCT were performed three months following the diagnosis.
Three hundred sixty eyes of 180 subjects were enrolled between the two groups. A decreased mean foveal avascular zone area in both superficial ca...
Self Distillation for Improving the Generalizability of Retinal Disease Diagnosis using Optical Coherence Tomography Images
Optical coherence tomography (OCT) imaging has become a point-of-care imaging modality for the diagnosis of retinal diseases. Varying speckle noise in the OCT images across datasets and scanners worsens the performance of existing artificial intelligence (deep learning) models, that have been trained mostly with images having a particular noise level. The existing deep learning models for predicting retinal diseases are heavy, requires a sophisticated computing environment to train and deploy. Generalized lightweight deep learning models that can provide an automated diagnosis on an edge platform are highly appealing in the clinic. This work proposes a self distillation framework based on lightweight deep learning models for building generalizable deep models for retinal disease diagnosis. The proposed approach with three different baseline models ResNet18, MobileNetV2 and ShuffleNetV2, has been validated on simulated and real-time noisy OCT B-scans spanning a range of SNRs from fou...
Current Applications and New Perspectives in Optical Coherence Tomography (OCT) Coronary Atherosclerotic Plaque Assessment: From PCI Optimization to Pharmacological Treatment Guidance
Since its ability to precisely characterized atherosclerotic plaque phenotypes, to tailor stent implantation, as well as to guide both complex percutaneous coronary interventions (PCI) and invasive diagnostic work-ups (e.g., spontaneous coronary dissections or myocardial infarction with non-obstructive arteries), the adoption of optical coherence tomography (OCT) was raised in the past decades in order to provide complementary information to the traditional angiography and to overcome its limitations. However, the impact of OCT on daily clinical practice is currently modest, firstly because of the lack of both standardized algorithms of PCI guidance and data from prospective clinical trials. Therefore, the aim of our narrative review is to provide a comprehensive overview of the basic OCT interpretation, to summarize the evidence supporting the OCT guidance procedures and applications, to discuss its current limitations, and to highlight the knowledge gaps that need to be filled wit...
Variability of Vascular Reactivity in the Retina and Choriocapillaris to Oxygen and Carbon Dioxide Using Optical Coherence Tomography Angiography
Purpose: To investigate the regional and layer-specific vascular reactivity of the healthy human retina and choriocapillaris to changes in systemic carbon dioxide or oxygen.
Methods: High-resolution 3 × 3-mm2 optical coherence tomography angiography (OCTA) images were acquired from the central macula, temporal macula, and peripapillary retina while participants were exposed to three gas breathing conditions—room air, 5%CO2, and 100% O2. OCTA from all three regions were extracted and the apparent skeletonized vessel density (VSD) was assessed. The mean flow deficit sizes (MFDSs) of the choriocapillaris were also assessed. Repeated-measures analysis of variance was used to compare the ratio of intrasubject VSD change induced by the gas conditions from baseline in the superficial retinal layer (SRL) and deep retinal layer (DRL) for each retinal region independently, as well as the MFDS of the choriocapillaris. We also compared the vessel reactivity between the retinal capillaries an...
Defining the relevance of surgical margins. Part two: Strategies to improve prediction of recurrence risk
Due to the complex nature of tumour biology and the integration between host tissues and molecular processes of the tumour cells, a continued reliance on the status of the microscopic cellular margin should not remain our only determinant of the success of a curative-intent surgery for patients with cancer. Based on current evidence, relying on a purely cellular focus to provide a binary indication of treatment success provides an incomplete interpretation of potential outcomes. A more holistic analysis of the cancer margin may be required. If we are to move ahead from our current situation - and allow treatment plans to be more intelligently tailored to meet the requirements of each individual tumour - we need to improve our utilisation of techniques that either improve recognition of residual tumour cells within the surgical field or enable a more comprehensive interrogation of tumour biology that identifies a risk of recurrence. In the second article in this series on defining ...
Using Ultrawide Field-Directed Optical Coherence Tomography for Differentiating Nonproliferative and Proliferative Diabetic Retinopathy
Purpose: To evaluate the ability of ultrawide field (UWF)–directed optical coherence tomography (OCT) to detect retinal neovascularization in eyes thought to have severe nonproliferative diabetic retinopathy (NPDR).
Methods: Retrospective study of 20 consecutive patients diagnosed with severe NPDR by clinical examination. All patients underwent UWF color imaging (UWF-CI) and UWF-directed OCT following a prespecified imaging protocol to assess the mid periphery, 15/32 (46.9%) eyes underwent UWF–fluorescein angiography (FA). On OCT, new vessels elsewhere (NVE) were defined when vessels breached the internal limiting membrane.
Results: A total of 32 eyes of 20 patients were evaluated. Of the 45 suspected areas of intraretinal microvascular abnormalities (IRMA) on UWF-CI, 38 (84.4%) were imaged by UWF-directed OCT, and 9/38 IRMA (23.7%) were NVE by OCT. Furthermore, UWF-directed OCT identified seven additional NVE in three eyes not seen on UWF-CI. This resulted in a change in diabet...
Rapid Cellular-Resolution Skin Imaging with Optical Coherence Tomography Using All-Glass Multifocal Metasurfaces
Cellular-resolution optical coherence tomography (OCT) is a powerful tool offering noninvasive histology-like imaging. However, like other optical microscopy tools, a high numerical aperture (N.A.) lens is required to generate a tight focus, generating a narrow depth of field, which necessitates dynamic focusing and limiting the imaging speed. To overcome this limitation, we developed a metasurface platform that generates multiple axial foci, which multiplies the volumetric OCT imaging speed by offering several focal planes. This platform offers accurate and flexible control over the number, positions, and intensities of axial foci generated. All-glass metasurface optical elements 8 mm in diameter are fabricated from fused-silica wafers and implemented into our scanning OCT system. With a constant lateral resolution of 1.1 μm over all depths, the multifocal OCT triples the volumetric acquisition speed for dermatological imaging, while still clearly revealing features of stratum co...
A novel vessel segmentation algorithm for pathological en-face images based on matched filter
The vascular information in fundus images can provide important basis for detection and prediction of retina-related diseases. However, the presence of lesions such as Coroidal Neovascularization (CNV) can seriously interfere with normal vascular areas in optical coherence tomography (OCT) fundus images. In this paper, a novel method is proposed for detecting blood vessels in pathological OCT fundus images. First of all, an automatic localization and filling method is used in preprocessing step to reduce pathological interference. Afterwards, in terms of vessel extraction, a pore ablation method based on capillary bundle model is applied. The ablation method processes the image after matched filter feature extraction, which can eliminate the interference caused by diseased blood vessels to a great extent. At the end of the proposed method, morphological operations are used to obtain the main vascular features. Experimental results on the dataset show that the proposed method achie...
Early healing after treatment of coronary lesions by thin strut everolimus, or thicker strut biolimus eluting bioabsorbable polymer stents: The SORT-OUT VIII OCT study
Aims: Early healing after drug-eluting stent (DES) implantation may reduce the risk of stent thrombosis. The aim of this study was to compare patterns of early healing after implantation of the thin strut everolimus-eluting Synergy DES (Boston Scientific) or the biolimus-eluting Biomatix Neoflex DES (Biosensors).
Methods and results: A total of 160 patients with the chronic or acute coronary syndrome were randomized 1:1 to Synergy or Biomatrix DES. Optical coherence tomography (OCT) was performed at baseline and at either 1- or 3-month follow-up. The primary endpoint was a coronary stent healing index (CSHI), a weighted index of strut coverage, neointimal hyperplasia, malapposition, and extrastent lumen. A total of 133 cases had OCT follow-up and 119 qualified for matched OCT analysis. The median CSHI score did neither differ significantly between the groups at 1 month: Synergy 8.0 (interquartile range [IQR]: 3.0; 14.0) versus Biomatrix 8.5 (IQR: 4.0; 15.0) (p = 0.47) nor at 3 mo...
Efficacy of a new generation intracoronary optical coherence tomography imaging system with fast pullback
We sought to investigate whether a novel, fast-pullback, high-frequency optical coherence tomography (HF-OCT) imaging system enables data acquisition with a reduced amount of contrast agents while retaining the same qualitative and quantitative lesion assessment to conventional OCT.
The increased amount of administered contrast agents is a major concern when performing intracoronary OCT.
The present study is a single-center, prospective, observational study including 10 patients with stable coronary artery disease. A total of 28 individual coronary arteries were assessed by both fast-pullback HF-OCT and by conventional OCT.
The contrast volume used in each OCT run for the HF-OCT system was significantly lower than for the conventional OCT system (5.0 ± 0.0 mL vs. 7.8 ± 0.7 mL, respectively, with a mean difference of −2.84 [95% confidence interval [CI]: −3.10 to −2.58]). No significant difference was found in the median value of the clear ...