Heidelberg Engineering

The corneo-scleral junction assessed with optical coherence tomography

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Purpose To evaluate corneo-scleral junction (CSJ) using anterior segment optical coherence tomography (AS-OCT) and describe the pattern of cornea and sclera interfusion based on tissue reflectivity. Methods This prospective observational study enrolled candidates for vision correction. Eyes with previous ocular surgery or irregular corneas were excluded. Temporal and nasal CSJ width and reflectivity patterns were assessed with AS-OCT horizontal scans. Correlations between manual and automated variables and multivariate linear regression analyses with age and spherical equivalent were performed. Results 101 right eyes were analysed. Temporal CSJ was wider (median 1.62; 1.13 to 2.22 mm) compared to the nasal side (median 1.18; 0.73 to 1.80 mm) ( p <.0001). The temporal CSJ width showed negative correlation with ipsilateral anterior chamber angle measurements and positive correlation with horizontal visible iris diameter (HVID). These relationships were not statistically significant...

Choroidal vascularity profile in diabetic eyes using wide field optical coherence tomography

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Purpose: To report the wide-field choroidal vascularity up to the mid-equator area in diabetic retinopathy (DR) subjects using wide-field optical coherence tomography (WF-OCT). Design: Prospective, Cross-sectional study. Participants: Forty-seven eyes of 25 DR subjects. Methods: WF-OCT images (55 degrees) were obtained using Spectralis HRA + OCT (Heidelberg Engineering, Germany) in extremes of gazes in all quadrants and manual montages were created to obtain wide field images up to mid equator. A previously reported semi-automated algorithm was used to calculate choroidal vascularity profile (CVI). Regression analysis was performed to identify the factors influencing CVI. Results: Forty-seven eyes from 25 patients were enrolled in the study. The mean age was 68.4 ± 10.6 years. The refractive error (spherical equivalent) ranged from -2.25 to +3.75 diopters. Most common DR grade among study subjects was moderate NPDR (29.41%) and 74.5% eyes had diabetic macular edema (DME). The...

Utility of multimodal imaging in amelanotic choroidal nevus

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An asymptomatic woman presented for a routine eye evaluation with a corrected distance visual acuity of 20/20 in both eyes. Her right ocular examination was within normal limits. Left eye anterior examination was normal and dilated fundus examination showed a well-defined circular flat yellow lesion measuring a 1-disc diameter in size located infero-temporal to the macula possibly at the level of the retinal pigment epithelium (RPE) ( figure 1A ). An enface composite multicolour image showed a dark green coloured region corresponding to the lesion and it appears as a well-defined dark area on the infrared reflectance channel ( figure 1B,C ). Blue wavelength enface fundus autofluorescence imaging was normal ( figure 1D ). Enhanced depth imaging-optical coherence tomography scan passing through the lesion showed a well-delineated area of hyporeflectivity extending from the overlying intact RPE layer deep to the inner sclera. The lesion measured 320 µm in depth and 1780 &m...

Normative Vascular Features on OCT Angiography in Healthy Nepalese Eyes

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Purpose: To establish normative data on morphological characteristics and quantitative parameters of Foveal Avascular Zone (FAZ) as well as their systemic and ocular associations using OCT angiography (OCT-A) in healthy Nepalese subjects. Patients and Methods: A prospective, cross-sectional, population-based study recruiting 210 healthy samples (420 eyes) aged 10 to 70 years was conducted. All the samples underwent detailed comprehensive eye examination followed by Optical Coherence Tomography Angiography (OCTA) and Enhanced Depth Imaging performed in each eye using Spectral Domain Optical Coherence Tomography. Foveal avascular zone area and vessel density in superficial and deep retinal plexus and Sub foveal Choroidal Thickness (SFCT) were evaluated. Ocular and systemic associations of these parameters were also studied in a multivariate analysis utilizing linear regression. Results: The mean superficial and deep FAZ area was 459.96 ± 124.75 μm (95% confidence interval [C...

Comparison of Spectral-Domain OCT versus Swept-Source OCT for the Detection of Deep Optic Disc Drusen

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Abstract: Deep optic disc drusen (ODD) are located below Bruch’s membrane opening (BMO) and may go undetected due to the challenges in imaging them. The purpose of this study is a head-to-head comparison of currently widely used imaging technologies: swept-source optical coherence tomography (SS-OCT; DRI OCT-1 Triton, Topcon) and enhanced depth imaging spectral- domain optical coherence tomography (EDI SD-OCT; Spectralis OCT, Heidelberg Engineering) for the detection of deep ODD and associated imaging features. The eyes included in this study had undergone high-resolution imaging via both EDI SD-OCT and SS-OCT volume scans, which showed at least one deep ODD or a hyperreflective line (HL). Grading was performed by three graders in a masked fashion. The study findings are based on 46 B-scan stacks of 23 eyes including a total of 79 81 scan s. For scan images with ODD located above or below the level of BMO, no significant difference was found between the two modalities compared...

Optical coherence tomography assessment of axonal and neuronal damage of the retina in patients with familial and sporadic multiple sclerosis

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Objective: To assess axonal and neuronal damage of the retina in patients with familial (fMS) and sporadic multiple sclerosis (sMS). Methods: 87 relapsing-remitting MS patients (45 patients with sMS, 42 patients with fMS) and 30 healthy controls were included in the study. Optical coherence tomography (OCT) was performed with the spectral domain optical coherence tomography (SD-OCT, Heidelberg Engineering, Germany). The peripapillary retinal nerve fiber layer (pRNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, total macular volume (TMV) and the inner nuclear layer (INL) thickness were measured. Results: A significant reduction of the pRNFL thickness was detected in sMS and fMS compared to the control group (86.29 (+/- 16.13) μm in sMS, 84.78 (+/- 12.92) μm in fMS, 98.93 (+/- 6.71) μm in control group; p < 0.001). There was no significant difference in the pRNFL thickness between sMS and fMS ( p = 0.5239). The GCIPL thickness was significantly decrea...

RetinAI establishes presence in the US market

Founded in 2017, RetinAI develops software solutions for experts in ophthalmology to accelerate clinical, research and pharmaceutical workflows globally using advanced machine learning and computer vision. Its CE-marked data management platform (RetinAI Discovery) and models, including AI models for Geographic Atrophy progression prediction, analyse datasets at-scale to gain a deep understanding on biomarker profiles and patient subgroups or outcomes. Building on its success in Switzerland, the company is now setting foot in the US with an office in Boston. This expansion will support further growth within the U.S. market, building upon existing collaborations with U.S.-based pharmaceutical companies and its partnership with Heidelberg Engineering to distribute RetinAI’s Disease AI Apps for research use in the U.S. “Our team is delighted about this natural expansion into the U.S.,” said Carlos Ciller, CEO of RetinAI. “Building on our milestones earlier this y...

Volumetric subfield analysis of cynomolgus monkey’s choroid derived from hybrid machine learning optical coherence tomography segmentation

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This study aimed to provide volumetric choroidal readings regarding sex, origin, and eye side from healthy cynomolgus monkey eyes as a reference database using optical coherence tomography (OCT) imaging. A machine learning (ML) algorithm was used to extract the choroid from the volumetric OCT data. Classical computer vision methods were then applied to automatically identify the deepest location in the foveolar depression. The choroidal thickness was determined from this reference point. A total of 374 eyes of 203 cynomolgus macaques from Asian and Mauritius origin were included in the analysis. The overall subfoveolar mean choroidal volume in zone 1, in the region of the central bouquet, was 0.156 mm 3 (range, 0.131–0.193 mm 3 ). For the central choroid volume, the coefficient of variation (CV) was found of 6.3%, indicating relatively little variation. Our results show, based on analyses of variance, that monkey origin (Asian or Mauritius) does not influence choroid volumes. ...

Distribution Pattern of Total Corneal Thickness in Keratoconus versus Normal Eyes Using an Optical Coherence Tomography

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Purpose: To evaluate the total corneal thickness distribution pattern using a high-resolution spectral-domain optical coherence tomography (HR SD-OCT) for distinguishing normal eyes from keratoconus (KCN). Methods: One hundred and forty-four patients were enrolled in three groups (55 normal, 45 mild KCN, and 44 moderate-to-severe KCN eyes) in this prospective diagnostic test study. Total corneal thickness was measured in 8 semi-meridians using HR SD-OCT (Heidelberg Engineering, Heidelberg, Germany) in 5 and 7 mm zones. The central corneal thickness (CCT), corneal focal thinning (minimum thickness [Min], min minus median and maximum [Min-Med, Min-Max]), and asymmetry indices (inferior minus superior [I-S] and supranasal minus infratemporal [SN-IT]) were calculated. One-way analysis of variance and the area under the receiver operating characteristic curve (AUC) were used for the analysis. Results: Thinner CCT, lower Min thickness, more negative Min-Max, Min-Med, and greater I-S and S...

Acute Idiopathic Blind Spot Enlargement Syndrome-New Perspectives in the OCT Era

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Acute idiopathic blind spot enlargement syndrome (AIBSES) is characterized by unilateral visual field loss in the blind spot area, acute onset photopsia, and funduscopically few or no optic disc changes. AIBSES predominantly affects young adults and is often misdiagnosed as optic neuritis because of low awareness. Optical coherence tomography (OCT) has become the gold standard in diagnosing AIBSES as a disease of the outer retina. In our case series, we present three consecutive patients with AIBSES followed prospectively with and without steroid therapy. The patients, aged 25 to 27 years, presented in our neuroophthalmology department between 2020 and 2021. We report their disease course and management and discuss therapeutic options, as no well-established procedures exist. Common pitfalls and diagnostic errors are analysed. Two women and one man showed unilateral acute-onset photopsia and blind spot enlargement on perimetry without visual acuity reduction. Spectral domain OCT (He...

Undetectable Macular Neovascularization on OCT Angiography in Age Related Macular Degeneration: Comparison between Different Devices

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Background and Objectives : The aim of this study was to report the characteristics of macular neovascularization (MNV) with undetectable flow on optical coherence tomography angiography (OCTA) in neovascular age related macular degeneration (nAMD), and compare them with the characteristics of detectable MNV. Materials and Methods : Patients with a diagnosis of nAMD who underwent dye imaging and OCTA in the same day were included and divided into two groups: undetectable and detectable flow on OCTA. Three OCTA devices were used, two with spectral-domain technology (AngioVue, RTVue 100xAvanti, Optovue, Freemont, CA, USA and Heidelberg OCT2 Beta Angiography Module, Heidelberg Engineering, Germany) and one swept-source OCTA (PlexElite 9000; Carl Zeiss Meditec, Inc., Dublin, CA, USA). We studied the demographics, neovascularization characteristics, and OCTA device and acquisition characteristics for both groups. Results : A global comparison between Group 1 and Group 2 was made, followe...

Diagnostic Ability and Capacity of Optical Coherence Tomography-Angiography to Detect Retinal and Vascular Changes in Patients with Fibromyalgia

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Background . To evaluate the neuroretina and retinal vasculature of fibromyalgia (FM) patients and calculate a linear discriminant function (LDF) to improve retinal parameters’ contribution to FM diagnosis. Methods . Fifty FM patients and 232 healthy controls underwent retinal evaluation using swept-source optical coherence tomography (SS-OCT) angiography (Triton plus; Topcon) and spectral domain OCT (SD-OCT) (Spectralis; Heidelberg). The macular (m) and peripapillary (p) retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) were assessed, as was the macular vascular density. A logistic regression analysis was performed, and an LDF was calculated to evaluate OCT’s contribution to FM diagnosis. Results . With Triton OCT, the patients presented pRNFL thinning in the temporal sector ( ). Spectralis OCT measurements showed decreased pRNFL in patients in the following sectors: superonasal, ; nasal, ; inferonasal, ; temporal, ; and inferotemporal, . No significant dif...

Clinical usefulness of layer-by-layer deviation maps of Spectralis OCT: comparison with Cirrus OCT

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Background/aims: To compare the diagnostic abilities of Spectralis (Heidelberg Engineering, Heidelberg, Germany) and Cirrus (Carl Zeiss Meditec, Dublin, California, USA) spectral domain-optical coherence tomography (OCT) for retinal nerve fibre layer (RNFL) defect detection among patients with preperimetric glaucoma (PPG) and early glaucoma (EG). Methods: In this cross-sectional study, a total of 144 eyes (47 healthy, 43 PPG, 54 EG; MD≥-6 dB) of 144 participants underwent Spectralis and Cirrus OCT on the same day. The presence of RNFL defect on red-free RNFL photography and the respective deviation maps of Spectralis and Cirrus OCT was rated. Areas under the receiver operating characteristic curves (AUCs), sensitivities and specificities were analysed for each deviation layer to discriminate healthy eyes from PPG and EG eyes. Results: The RNFL, ganglion cell layer (GCL) and retinal layers of Spectralis OCT and the RNFL and macular ganglion cell-inner plexiform layer of Cirrus OCT...

Comparison of Diagnostic Ability Between Wide-Field Swept-Source Optical Coherence Tomography Imaging Maps and Heidelberg Retina Tomograph 3 Optic Nerve Head Assessment to Discriminate Glaucomatous and Non-glaucomatous Eyes

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Background In this study, we aimed to determine the diagnostic performance of optic nerve head (ONH), macular, and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements of wide-field maps (12 × 9 mm) using swept-source optical coherence tomography (SS-OCT) compared to measurements of the ONH and RNFL parameters measured by Heidelberg Retina Tomograph (HRT3). Methodology This case-control study included 39 eyes of 39 glaucoma patients and 36 eyes of 36 normal subjects (control group). All participants underwent standard automated perimetry (SAP) as well as structural measurements by SS-OCT (DRI-OCT, Triton; Topcon Inc., Tokyo, Japan) and HRT3 (Heidelberg Engineering, Heidelberg, Germany). The abilities of the continuous parameters to discriminate between glaucoma and control groups were assessed using areas under the receiver operating characteristic curves (AUCs). To assess the glaucoma diagnostic abilities of each of the categorical variables, sensitivity,...

Optical Coherence Tomography Position Analysis of Retropupillary Iris-Fixated Intraocular Lens in Iris Tissue

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Purpose . The aim of this study was to evaluate a micrometer-accurate analysis of the retropupillary Verisyse® intraocular lens (IOL) (Ophtec, Groningen NL; Santa Ana, USA) enclavation in the iris tissue. Methods . A retrospective consecutive case series was conducted at the Department of Ophthalmology, University Hospital Mainz. Patients with an optical coherence tomography (Spectralis®, Heidelberg Engineering®; Heidelberg, Germany) examination after retropupillary Verisyse® IOL implantation were included retrospectively. The enclavation geometry was measured using the Eye-Explorer® from Heidelberg Engineering® (Heidelberg, Germany). Seventeen measuring positions were determined nasally and temporally at the corresponding enclavation points. Results . 72 eyes of 67 patients after implantation of a retropupillary Verisyse® IOL were analyzed. The average age was 68 ± 17.2 years (63% female; 38% male). The analysis of the position of th...

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