Peking University

Choroidal morphologic and vascular features in patients with unilateral idiopathic epiretinal membranes: An optical coherence tomography analysis integrated with assessment of retinal layers

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Introduction: Integrated analysis of retinal and choroidal morphologic and vascular features is urgently needed to examine whether and how these two elements interact with each other, thus contributing to visual impairment in patients with idiopathic epiretinal membranes (iERMs). Methods: An observational retrospective study consisting of 181 patients diagnosed with unilateral iERM between August 2019 and July 2022 was carried out at Peking University Third Hospital. All patients underwent a standardized set of ophthalmologic examinations, including EDI-OCT and OCTA scanning, and were subsequently categorized into four stages according to current classification schemes based on their OCT findings. Altogether, 15 qualitative and quantitative parameters of both the retina (full-layer, inner and outer layers) and choroid were identified. Results: The results revealed variations in the choroidal vascularity index (CVI) among different stages of iERMs (p < 0.001) for the first t...

Evaluation of biometric indicators of anterior segment parameters after ICL implantation by swept-source optical coherence tomography

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Purpose. To evaluate the anterior segment structure alteration after implantable collamer lens (ICL) implantation in myopic patients using swept-source quantitative optical coherence tomography (SS-OCT). Methods. This prospective study included 47 eyes of 24 patients with preoperative spherical equivalent ≥ -3.00 D. Patients underwent ICL implantation at Department of Ophthalmology, Peking University Third Hospital, from May 2021 to December 2022. SS-OCT was used to measure biometry including anterior chamber width (ACW), angle opening distance (AOD), angle recess area (ARA), trabecular iris area (TISA), trabecular-iris angle (TIA), iridotrabecular contact (ITC) area and ITC Index before ICL implantation surgery and at 1 month follow-up. Results. At one month following ICL implantation, the ITC area is 0.396 ± 0.37 mm2, and the ITC index is 8.143 ± 5.439 %. All angle parameters, with the exception of ACW, showed a statistically significant reduction on SS-OCT (P<0.05). Mean...

Comparison of 24×20 mm2 swept-source OCTA and fluorescein angiography for the evaluation of lesions in diabetic retinopathy

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Aim: To compare ultra-widefield (24×20 mm 2 ) swept-source optical coherence tomography angiography (SS-OCTA) and fluorescein angiography (FA) in the evaluation of diabetic retinopathy (DR) lesions. Methods: Forty-six eyes of 23 patients with treatment-naïve DR were included at Peking University People's Hospital from September 1, 2021, until December 31, 2021, as well as 23 age and gender matched healthy controls. Quantitative assessments of DR lesions on FA and SS-OCTA (superficial capillary plexus, SCP, 24×20 mm 2 ) were performed. Results: Area of fovea avascular zone (FAZ) was larger in DR cases than controls (0.34±0.069 mm 2 vs 0.287±0.108 mm 2 , P =0.006). In DR eyes, the mean FAZ area was 0.34±0.069 and 0.334±0.087 mm 2 on SS-OCTA and FA, respectively ( P =0.428), while the median FAZ perimeter was 2.382 (IQR, 2.201-2.59) and 2.333 (IQR, 2.138-2.6) mm on SS-OCTA and FA images ( P =0.733). There was no significant difference in the...

A novel optical coherence tomography‑based calcium scoring system can predict the stent expansion of moderate and severe calcified lesions

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Coronary calcified lesions can exert serious effects on stent expansion. A calcium scoring system, based on optical coherence tomography (OCT), has been previously developed to identify relatively mild calcified lesions that would benefit from plaque modification procedures. Therefore, the present study aimed to establish a novel OCT-based scoring system to predict the stent expansion of moderate and severe calcified lesions. A total of 33 patients who underwent percutaneous coronary intervention (PCI; 34 calcified lesions were observed using coronary angiography) were retrospectively included in the present study. Coronary angiography and OCT images were subsequently reviewed and analyzed. Furthermore, a calcium scoring system was developed based on the results of multivariate analysis before the optimal threshold for the prediction of stent underexpansion in patients with moderate and severe calcified lesions was determined. The mean age of the patients was 67±10 years. The...

Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield fluorescein angiography for the evaluation of lesions in retinal vein occlusion

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Background: To compare widefield swept-source optical coherence tomography angiography (SS-OCTA) with ultra-widefield fundus fluorescein angiography (UWF-FA) for detecting retinal vein occlusion (RVO) lesions. Methods: Thirty-four eyes of 32 patients with treatment-naïve RVO were enrolled at Peking University People's Hospital from September 2021 to March 2022. Patients were imaged with a UWF-FA (200°) and a widefield SS-OCTA using 24 × 20 mm scan single capture. Quantitative assessments of RVO lesions such as foveal avascular zone (FAZ) area and perimeter, non-perfusion areas (NPA), number of microaneurysms (MAs), capillary changes and collateral vessels were performed. Results: The measurement of FAZ area and perimeter were comparable between SS-OCTA and UWF-FA (0.373 (range, 0.277-0.48) mm 2 vs. 0.370 (range, 0.277-0.48) mm 2 , P = 0.818 and 2.480 (range, 2.011-2.998) vs. 2.330 (range, 2.027-2.807) mm, P = 0.536, respectively). Intraclass correlation coefficients (...

Quantitative analysis of choroidal vasculature in central serous chorioretinopathy using ultra-widefield swept-source optical coherence tomography angiography

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We aimed to quantitatively compare the choroid blood flow and choroid thickness at the periphery among eyes with central serous chorioretinopathy (CSC), fellow eyes and healthy eyes using ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA). Retrospective analysis of 49 patients with CSC (98 eyes, including unaffected fellow eyes) and 49 age and sex matched controls were included. We obtained 3-dimensional data of vertical 20 mm × horizontal 24 mm × scan depth 6 mm, comprising 9 subfields (superotemporal, upper, superonasal, temporal, central, nasal, inferotemporal, lower, inferonasal regions). CSC eyes presented with greater density of large-vessel choroidal layer in all the 9 subfields compared with controls. Compared with normal eyes, CSC eyes had greater choroidal thickness (superotemporal, upper, superonasal, temporal, central, nasal, inferotemporal, and inferonasal subfields) and choroidal volume (superotemporal, upper, superonasal, t...

Evaluation of the Effects of Pterygium and Aging on Limbal Structure Using Optical Coherence Tomography

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Previous studies suggest that regions of corneal limbus may possess structural differences. We aimed to investigate the limbal changes associated with pterygium and aging via optical coherence tomography (OCT). Palisades of Vogt epithelial thickness (POV-ET) and Bowman's membrane epithelial thickness (BM-ET) were measured at the nasal, temporal, superior, and inferior quadrants of patients with pterygium and healthy subjects of different ages. Values were expressed as a ratio that functioned as an index used to evaluate the change of limbus. Ratio values determined for quadrants of the corneal limbus were correlated highly in young healthy subjects. Further, parameter values were significantly greater than those of elder healthy subjects. In young subjects, the temporal and superior quadrants of patients with pterygium were significantly lower than those of healthy subjects. Temporal and superior quadrants of elder pterygium patients affected by both pterygium and age were significa...

Three-dimensional choroidal vascularity index in central serous chorioretinopathy using ultra-widefield swept-source optical coherence tomography angiography

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Background: To map and compare the three-dimensional choroidal vascularity index (3D-CVI) in eyes with unilateral central serous chorioretinopathy (CSC), fellow eyes and control eyes using ultra-widefield swept source optical coherence tomography (UWF SS-OCTA). Methods: In this prospective observational study, the 3D-CVIs were measured in 9 subfields or 1 × 1 mm grids by the UWF SS-OCTA with a viewing angle of horizontal 24 × vertical 20 mm. The proportions of vortex vein anastomoses and their corresponding CVI in the central regions were compared among the CSC, fellow and control eyes. Correlations of CVI and vascular density of the large choroidal vessel layer/choriocapillaris layer/choroidal thickness (CT) were also assessed. Results: Thirty-two eyes in 32 patients with unilateral CSC and 32 normal eyes were included in the study. The mean CVI in the eyes with CSC was significantly greater than that in the fellow eyes of CSC and control eyes (41.99 ± 3.56% vs. ...

Comparison of swept-source OCTA and indocyanine green angiography in central serous chorioretinopathy

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Background: To compare swept-source optical coherence tomography angiography (SS-OCTA) and indocyanine green angiography (ICGA) in patients with central serous chorioretinopathy (CSC). Methods: SS-OCTA and ICGA images of 39 eyes with symptomatic CSC were collected and aligned. Spatial overlap of the annotations of the coarse granulated high reflective area on choriocapillary OCTA and the hyperfluorescence area on mid-phase ICGA was calculated according to the Jaccard index (JI). SS-OCTA findings of fellow eyes and changes in SS-OCTA abnormalities during the follow-up were also analyzed. Results: Three main types of abnormalities in choriocapillaris SS-OCTA images were found: type A, coarse granulated high reflective area (39 eyes [100%]); type B, roundish dark halo around Type A (32 eyes [82.1%]); and type C, coarse granulated low reflective area (39 eyes [100%]). The mean JI of type A on SS-OCTA and the hyperfluorescence area on ICGA were 0.55 ± 0.15 for grader 1 and 0.49 &p...

Comparison of hyperreflective foci in macular edema secondary to multiple etiologies with spectral-domain optical coherence tomography: An observational study

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Background: Hyperreflective foci (HRF) features in macular edema associated with different etiologies may indicate the disease pathogenesis and help to choose proper treatment. The goal of this study is to investigate the retinal microstructural features of macular edema (ME) secondary to multiple etiologies with spectral-domain optical coherence tomography (SD-OCT) and analyze the origin of HRF in ME. Methods: This was a retrospective study. SD-OCT images were reviewed to investigate macular microstructural features such as the number and distribution of HRF and hard exudates and the internal reflectivity of the cysts. The differences in microstructural features between groups and the correlations between the number of HRF and other parameters were analyzed. Results: A total of 101 eyes with ME from 86 diabetic (diabetic macular edema, DME) patients, 51 eyes from 51 patients with ME secondary to branch retinal vein occlusion (branch retinal vein occlusion-macular edema, BRVO-ME), 5...

Diurnal changes of retinal microvascular circulation and RNFL thickness measured by optical coherence tomography angiography in patients with obstructive sleep apnea-hypopnea

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Purpose: To evaluate capillaries perfusion and retinal nerve fiber layer (RNFL) thickness diurnal changes of macular/optic disc regions among participants with or without obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA). Methods: In this study, we enrolled a cohort of 35 participants including 14 patients with mild-to-moderate OSA, 12 patients with severe OSA, and 9 healthy individuals. All participants had Berlin questionnaire filled. At 20:00 and 6:30, right before and after the polysomnography examination, a comprehensive ocular examination was conducted. The systemic and ocular clinical characteristics were collected, and OCTA scans were performed repeatedly. Blood flow and RNFL thickness parameters were then exported using built-in software and analyzed accordingly. Results: After sleep, the overall vessel density (VD) variables, especially macular and choriocapillaris VDs, were relatively comparative and stable. One e...

Triplet Cross-Fusion Learning for Unpaired Image Denoising in Optical Coherence Tomography

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Optical coherence tomography (OCT) is a widely-used modality in clinical imaging, which suffers from the speckle noise inevitably. Deep learning has proven its superior capability in OCT image denoising, while the difficulty of acquiring a large number of well-registered OCT image pairs limits the developments of paired learning methods. To solve this problem, some unpaired learning methods have been proposed, where the denoising networks can be trained with unpaired OCT data. However, majority of them are modified from the cycleGAN framework. These cycleGAN-based methods train at least two generators and two discriminators, while only one generator is needed for the inference. The dual-generator and dual-discriminator structures of cycleGAN-based methods demand a large amount of computing resource, which may be redundant for OCT denoising tasks. In this work, we propose a novel triplet cross-fusion learning (TCFL) strategy for unpaired OCT image denoising. The model complexity of o...

Automated Analysis of Choroidal Sublayer Morphologic Features in Myopic Children Using EDI-OCT by Deep Learning

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Purpose: The purpose of this study was to analyze the choroidal sublayer morphologic features in emmetropic and myopic children using an automatic segmentation model, and to explore the relationship between choroidal sublayers and spherical equivalent refraction (SER). Methods: We collected data on 92 healthy children (92 eyes) from the Ophthalmology Department of Peking University First Hospital. The data were allocated to three groups: emmetropia (+0.50 diopters [D] to -0.50 D), low myopia (-0.75 D to -3.00 D), and moderate myopia (-3.25 D to -5.75 D). We performed standardized optical coherence tomography (OCT) and developed a new segmentation technique to measure choroidal thickness (CT), large-vessel choroidal layer (LVCL), medium-vessel choroidal layer (MVCL), and small-vessel choroidal layer thickness (SVCL), and evaluated the choroidal vascular system (choroidal vascular volume [VV], choroidal vascular index [CVI], and choroidal vascular density [CVD]). Results: All choroida...

Culprit-Plaque Morphology and Residual SYNTAX Score Predict Cardiovascular Risk in Acute Myocardial Infarction: An Optical Coherence Tomography Study

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Aims: Culprit-plaque morphology [plaque rupture (PR) and plaque erosion (PE)] and high-risk plaques (HRP) identified by optical coherence tomography (OCT) and residual SYNTAX score (rSS) have been reported to influence clinical outcomes. Thus, in this study, we aimed to investigate the prognostic implication of culprit-plaque morphology and rSS for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: Based on plaque morphology and rSS, 274 STEMI patients were divided into 4 groups: PE/low-rSS (n=61), PE/high-rSS (n=58), PR/low-rSS (n=55), and PR/high-rSS (n=100). According to HRP and rSS, patients were stratified to non-HRP/low-rSS (n=97), non-HRP/high-rSS (n=109), HRP/low-rSS (n=19), and HRP/high-rSS (n=49). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke, and unplanned revascularization of any coronary artery. Results: During the follow-up of 2.2 years, 47 (17.2%) ...

Comparison of optical coherence tomography-guided and intravascular ultrasound-guided rotational atherectomy for calcified coronary lesions

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Background: To compare the effect and outcomes of optical coherence tomography (OCT)-guided rotational atherectomy (RA) with intravascular ultrasound (IVUS)-guided RA in the treatment of calcified coronary lesions. Methods: Data of calcified coronary lesions treated with RA that underwent OCT-guided or IVUS-guided from January 2016 to December 2019 at a single-center registry were retrospectively analyzed. The effect and outcomes between underwent OCT-guided RA and IVUS-guided RA were compared. Results: A total of 33 lesions in 32 patients received OCT-guided RA and 51 lesions in 47 patients received IVUS-guided RA. There was no significant difference between OCT-guided RA group and IVUS-guided RA group in clinical baselines characteristics. Comparing the procedural and lesions characteristics of the two groups, the contrast volume was larger [(348.8 ± 110.6) ml vs. (275.2 ± 76.8) ml, P = 0.002] and the scoring balloon was more frequently performed (33.3% vs. 3.9%, P =...

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