Eleonora M. Lad

Robotic Optical Coherence Tomography Retinal Imaging for Emergency Department Patients: A Pilot Study for Emergency Physicians’ Diagnostic Performance

, , , , , , , , , , ,

Study objective To evaluate the diagnostic performance of emergency physicians’ interpretation of robotically acquired retinal optical coherence tomography images for detecting posterior eye abnormalities in patients seen in the emergency department. Methods Adult patients presenting to Duke University Hospital emergency department from November 2020 through October 2021 with acute visual changes, headache, or focal neurologic deficit(s) who received an ophthalmology consultation were enrolled in this pilot study. Emergency physicians provided standard clinical care, including direct ophthalmoscopy, at their discretion. Retinal optical coherence tomography images of these patients were obtained with a robotic, semi-autonomous optical coherence tomography system. We compared the detection of abnormalities in optical coherence tomography images by emergency physicians with a reference standard, a combination of ophthalmology consultation diagnosis and retina specialist optical cohe...

Baseline Microperimetry and OCT in the RUSH2A Study: Structure-Function Association and Correlation with Disease Severity

, , , , , , , , , , , , , , , , , , , , , , , ,

Purpose: To investigate baseline mesopic microperimetry (MP) and spectral domain optical coherence tomography (OCT) in the Rate of Progression in USH2A-related Retinal Degeneration (RUSH2A) study. Design: Natural history study SETTING: 16 clinical sites in Europe and North America STUDY POPULATION: Participants with Usher syndrome type 2 (USH2) (N=80) or autosomal recessive nonsyndromic RP (ARRP) (N=47) associated with biallelic disease-causing sequence variants in USH2A. Observation procedures: General linear models were used to assess characteristics including disease duration, MP mean sensitivity and OCT intact ellipsoid zone (EZ) area. The associations between mean sensitivity and EZ area with other measures, including best corrected visual acuity (BCVA) and central subfield thickness (CST) within the central 1 mm, were assessed using Spearman correlation coefficients. Main outcome measures: Mean sensitivity on MP; EZ area and CST on OCT RESULTS: All participants (N=127) had OCT...

Machine learning OCT predictors of progression from intermediate age-related macular degeneration to geographic atrophy and vision loss

, , , ,

Objective: To describe optical coherence tomography (SD-OCT) features, age, gender, and systemic variables that may be used in machine/deep learning studies to identify high-risk patient subpopulations with high risk of progression to geographic atrophy (GA) and visual acuity (VA) loss in the short term. Design: prospective, longitudinal study. Subjects: We analyzed imaging data from patients with iAMD (N= 316) enrolled in Age-Related Eye Disease Study 2 (AREDS2) Ancillary SD-OCT with adequate SD-OCT imaging for repeated measures. Methods: Qualitative and quantitative multimodal variables from the database were derived at each yearly visit over 5 years. Based on statistical analyses developed in the field of cardiology, an algorithm was developed and used to select person-years without GA on colour fundus photography or SD-OCT at baseline. The analysis employed machine learning approaches to generate classification trees. Eyes were stratified as low, average, above average and high ...

Local anatomic precursors to new onset geographic atrophy in age-related macular degeneration as defined on optical coherence tomography

, , , , , , , , , ,

Purpose In macula-wide analyses, spectral domain optical coherence tomography (SDOCT) features such as drusen volume, hyperreflective foci and OCT-reflective drusen substructures independently predict onset of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). We sought to identify SDOCT features in the location of new GA prior to its onset. Design Retrospective study Subjects Age-Related Eye Disease Study 2 Ancillary SDOCT Study Participants Methods We analyzed longitudinally-captured SDOCT and color photographs from 488 eyes (of 488 participants) with intermediate AMD at baseline. Sixty-two eyes with sufficient image quality demonstrated new onset GA on color photographs during study years two through seven. The area of new onset GA and one size-matched control region in the same eye were separately segmented and corresponding spatial volumes on registered SDOCT images at the GA incident year, and at two, three, and four years prior were defined. Differen...

Spectral Domain-Optical Coherence Tomography Measurements in Alzheimer’s Disease: A Systematic Review and Meta-analysis

, , , , , , , , , , , ,

Topic Optical coherence tomography (OCT) is a non-invasive tool to measure specific retinal layers in the eye. The relationship of retinal spectral domain-OCT (SD-OCT) measurements with Alzheimer’s Disease (AD) and mild cognitive impairment (MCI) remains unclear. Hence, we conducted a systematic review and meta-analysis to examine the SD-OCT measurements in AD and MCI. Clinical Relevance Current methods of diagnosing early AD are expensive and invasive. Retinal measurements of SD-OCT, which are non-invasive, technically simple and inexpensive, are potential biomarkers of AD. Methods We conducted a literature search in PubMed and EMBASE to identify studies published before 31 December 2017 which assessed the associations between AD, MCI and measurements of SD-OCT: ganglion cell-inner plexiform layer (GC-IPL), ganglion cell complex (GCC), macular volume and choroidal thickness, in addition to retinal nerve fibre layer (RNFL) and macular thickness. We used a random-effect model t...

Correlation Between Macular Integrity Assessment and Optical Coherence Tomography Imaging of Ellipsoid Zone in Macular Telangiectasia Type 2

, , , , , , , ,

Purpose : To correlate ellipsoid zone (EZ) defects on spectral-domain optical coherence tomography (SD-OCT) with retinal sensitivity loss on macular integrity assessment (MAIA) microperimetry in macular telangiectasia type 2 (MacTel). Methods : Macular SD-OCT volumes and microperimetry maps were obtained during the international, multicenter, randomized phase 2 trial of ciliary neurotrophic factor for type 2 MacTel on two visits within 5 days of one another. Software was developed to register SD-OCT to MAIA scanning laser ophthalmoscopy images and to overlay EZ defect areas on the microperimetry maps generated from microperimetry sensitivity values at specific points and from interpolated sensitivity values. A total of 134 eyes of 67 patients were investigated. Results : The semiautomated registration algorithm was found to be accurate, both qualitatively by visual inspection of the nearly perfect overlap of the retinal vessels and quantitatively as assessed by interobserver reliabi...

Retinal imaging in human autopsy eyes using a custom optical coherence tomography periscope

, , , , ,

Age-related macular degeneration (AMD) is a major cause of vision loss in the elderly. To better study the pathobiology of AMD, postmortem eyes offer an excellent opportunity to correlate optical coherence tomography (OCT) imaging characteristics with histopathology. However, postmortem eyes from autopsy present challenges to standard OCT imaging including opaque anterior segment structures and standard of care autopsy processing resulting in oblique views to the macula. To overcome these challenges, we report a custom periscope attached by a standard mount to an OCT sample arm and demonstrate high quality macular OCT acquisitions in autopsy-processed eyes. ( Read Full Article )

Wide-field retinal optical coherence tomography with wavefront sensorless adaptive optics for enhanced imaging of targeted regions

, , , , , , , ,

The peripheral retina of the human eye offers a unique opportunity for assessment and monitoring of ocular diseases. We have developed a novel wide-field (>70°) optical coherence tomography system (WF-OCT) equipped with wavefront sensorless adaptive optics (WSAO) for enhancing the visualization of smaller (<25°) targeted regions in the peripheral retina. We iterated the WSAO algorithm at the speed of individual OCT B-scans (~20 ms) by using raw spectral interferograms to calculate the optimization metric. Our WSAO approach with a 3 mm beam diameter permitted primarily low- but also high- order peripheral wavefront correction in less than 10 seconds. In preliminary imaging studies in five normal human subjects, we quantified statistically significant changes with WSAO correction, corresponding to a 10.4% improvement in average pixel brightness (signal) and 7.0% improvement in high frequency content (resolution) when visualizing 1 mm (~3.5°) B-scans of the peripheral...

Categories

Organizations in the News

OCT Companies in the News

Picture Gallery