University of Miami

Superficial and Deep Capillary Plexus Nonperfusion in Nonaccidental Injury on OCTA

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Purpose: To report OCTA findings in a case of nonaccidental injury (NAI). Methods: Retrospective review of a clinical case. Results: A 5-year-old White child with a history of NAI at age 1 year presented with reduced vision in the left eye resulting from a closed funnel retinal detachment. The right eye had optic nerve pallor, peripheral vascular attenuation, and leakage. Optical coherence tomography angiography (OCTA) showed significant parafoveal attenuation of the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus. This correlated with inner and middle retinal layer thinning temporal to the fovea and preservation of the ellipsoid zone. The peripapillary vascular plexus was preserved. Laser photocoagulation was performed to the nonperfused peripheral retina, and intravitreal bevacizumab was injected. Attenuation of the superficial, intermediate, and deep capillary plexuses might represent chronic ischemic retinal changes from traumatic injur...

Estimation of the full shape of the crystalline lens in-vivo from OCT images using eigenlenses

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Estimation of the full shape of the crystalline lens in-vivo from OCT images using eigenlenses Quantifying the full 3-D shape of the human crystalline lens is important for improving intraocular lens power or sizing calculations in treatments of cataract and presbyopia. In a previous work we described a novel method for the representation of the full shape of the ex vivo crystalline lens called eigenlenses, which proved more compact and accurate than compared state-of-the art methods of crystalline lens shape quantification. Here we demonstrate the use of eigenlenses to estimate the full shape of the crystalline lens in vivo from optical coherence tomography images, where only the information visible through the pupil is available. We compare the performance of eigenlenses with previous methods of full crystalline lens shape estimation, and demonstrate an improvement in repeatability, robustness and use of computational resources. We found that eigenlenses can be used to describe efficiently the crystalline lens full shape changes with accommodation and refractive error.

Estimation of the full shape of the crystalline lens in-vivo from OCT images using eigenlenses

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Quantifying the full 3-D shape of the human crystalline lens is important for improving intraocular lens power or sizing calculations in treatments of cataract and presbyopia. In a previous work we described a novel method for the representation of the full shape of the ex vivo crystalline lens called eigenlenses, which proved more compact and accurate than compared state-of-the art methods of crystalline lens shape quantification. Here we demonstrate the use of eigenlenses to estimate the full shape of the crystalline lens in vivo from optical coherence tomography images, where only the information visible through the pupil is available. We compare the performance of eigenlenses with previous methods of full crystalline lens shape estimation, and demonstrate an improvement in repeatability, robustness and use of computational resources. We found that eigenlenses can be used to describe efficiently the crystalline lens full shape changes with accommodation and refractive error.

Anterior segment optical coherence tomography characteristics of conjunctival papilloma as compared to papilliform ocular surface squamous neoplasia

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Purpose To describe the anterior segment optical coherence tomography (AS-OCT) appearance of conjunctival papilloma and identify differentiating features from papilliform ocular surface squamous neoplasia (OSSN). Method A retrospective chart review of individuals clinically diagnosed with conjunctival papilloma ( n  = 10) or papilliform OSSN ( n  = 10) based on slit lamp features. Data on demographics, tumour characteristics, and primary treatment were collected. AS-OCT features were assessed including epithelial thickness and reflectivity, a corrugated epithelial surface, presence of an overhanging edge, presence of intrinsic spaces and posterior shadowing. Histopathology was available in 5 papilloma and 3 OSSN specimens. Result Overall, the majority of individuals in both groups were white males. OSSN lesions were more likely to involve the limbus (80% vs.10%, p  = 0.005) and the bulbar conjunctiva (100% vs. 20%, p  < 0.00...

Impact of Reticular Pseudodrusen on Choriocapillaris Flow Deficits and Choroidal Structure on Optical Coherence Tomography Angiography

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Purpose: To examine the impact of reticular pseudodrusen (RPD) on choriocapillaris blood flow and choroidal structure in individuals with intermediate age-related macular degeneration (AMD). Methods: Individuals with bilateral large drusen underwent optical coherence tomography (OCT), color fundus photography, near-infrared reflectance, and fundus autofluorescence imaging to determine the presence of RPD. These participants also underwent swept-source OCT angiography (SS-OCTA) imaging to determine (1) choriocapillaris flow deficit (FD) parameters, including the percentage, mean size, and number of FDs present; and (2) choroidal structural parameters, including mean choroidal thickness and choroidal vascularity index. Differences in these parameters between eyes with and without coexistent RPD were examined with and without adjustment for potential key confounders such as drusen volume from the SS-OCTA scans and age. Results: This study included 102 eyes from 51 individuals with bila...

Change In Choriocapillaris Flow Deficits Within Tears Of The Retinal Pigment Epithelium Imaged With SWEPT-SOURCE Optical Coherence Tomography Angiography

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Purpose: Choriocapillaris (CC) flow deficits (FDs) were measured in the areas exposed by tears of the retinal pigment epithelium (RPE) before and after their onset to determine their change over time. Methods: Patients enrolled in a prospective, swept-source optical coherence tomography angiography (SS-OCTA) study were retrospectively reviewed for RPE tears, and scans were evaluated before and after RPE tear formation. Choriocapillaris flow deficits were measured within the bed of the tear and within a symmetric control region. Results: Three patients with RPE tears were imaged before tear formation and for at least 16 months afterward. When the baseline and first posttear visit were compared, CC FDs decreased by 1.0% in the tear region and 1.7% in the control region ( P = 0.84). When the 16-month follow-up visits were compared with the first post-RPE tear visits, CC FDs decreased by 1.9% in tear regions and increased by 1.3% in control regions ( P = 0.37). Conclusion: No significan...

An Atlas of Optical Coherence Tomography (OCT): Elucidating In Vivo Differences of Scar Types Using OCT in Order to Guide Laser Treatment Parameters

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Objective. When using laser therapy to effectively treat scars, the choice of treatment parameters depends on the knowledge accuracy of the underlying scar pathology, which is often difficult to judge by gross physical exam. As such, more quantitative measures are needed. In recent years, optical coherencetomography (OCT) has shown promise as a real-time imaging technology of skin microstructure. A key step in developing a methodology for utilizing OCT to develop a comprehensive ‘atlas’ of OCT characteristics of a wide variety of scar types. This atlas may then be used as a tool for selecting the optimal treatment modality and parameters for each scar type. Methods. One hundred and fifty scars of a wide range of anatomical locations were imaged using OCT, capturing both vascular and structural data. A variety of scar etiologies (e.g. burn, surgical, traumatic) and types (e.g. hypertrophic, keloidal, atrophic) were included. Comparator scans were also taken from normal, unscarred ski...

Multi-Center Repeatability of Macular Capillary Perfusion Density Using Optical Coherence Tomography Angiography

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Background/Aims: This study was to determine the test–retest repeatability in quantifying macular capillary perfusion density (CPD, expressed as fractal dimension) using optical coherence tomography angiography (OCTA) in a multi-center setting. Methods: OCTA data were obtained in self-reported healthy subjects from Bascom Palmer Eye Institute at the University of Miami (UM, N = 18) and the University of Pennsylvania (UPenn, N = 22). The right eye of each subject was imaged twice at the first visit and then again at an interval of one week to assess intra-visit and inter-visit repeatability. The macular area of the OCTA-derived capillary perfusion density (OCTA-CPD) was analyzed by custom-made image processing and fractal analysis software. Fractal analysis was performed on the skeletonized microvascular network to yield OCTA-CPD by box-counting to the fractal dimension (Dbox) in the superficial vascular plexus (SVP). Repeatability was assessed by three measures: within-subject...

Normative Data and Conversion Equation for Spectral-Domain Optical Coherence Tomography in an International Healthy Control Cohort

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Background: Spectral-domain (SD-) optical coherence tomography (OCT) can reliably measure axonal (peripapillary retinal nerve fiber layer [pRNFL]) and neuronal (macular ganglion cell + inner plexiform layer [GCIPL]) thinning in the retina. Measurements from 2 commonly used SD-OCT devices are often pooled together in multiple sclerosis (MS) studies and clinical trials despite software and segmentation algorithm differences; however, individual pRNFL and GCIPL thickness measurements are not interchangeable between devices. In some circumstances, such as in the absence of a consistent OCT segmentation algorithm across platforms, a conversion equation to transform measurements between devices may be useful to facilitate pooling of data. The availability of normative data for SD-OCT measurements is limited by the lack of a large representative world-wide sample across various ages and ethnicities. Larger international studies that evaluate the effects of age, sex, and race/ethnicity on S...

A deep learning model for automated segmentation of geographic atrophy imaged with swept-source optical coherence tomography images

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Purpose: To present a deep-learning algorithm for the segmentation of geographic atrophy (GA) using en face swept-source optical coherence tomography (SS-OCT) images that is accurate and reproducible for the assessment of GA growth over time. Design: Retrospective review of images obtained as part of a prospective natural history study Subjects: Patients with GA (90), early/intermediate AMD (32), healthy controls (16) METHODS: An automated algorithm utilizing scan volume data to generate three image inputs characterizing the main OCT features of GA - hyper-transmission in sub RPE slab, regions of RPE loss, and loss of retinal thickness - was trained with 126 images (93 GA, 33 non-GA, from the same number of eyes) using a 5-fold cross-validation method and data augmentation techniques. It was tested in an independent set of 180 6x6 mm macular SS-OCT scans consisting of 3 repeated scans at baseline and follow-up from 30 eyes with GA as well as in 45 images from 42 eyes without GA. Mai...

Method of processing optical coherence tomography (OCT) data and OCT data processing apparatus

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An exemplary aspect is a method of processing data acquired by applying an optical coherence tomography (OCT) scan to a sample. The method includes preparing a three dimensional data set acquired from a sample, creating a two dimensional map based on representative intensity values of a plurality of pieces of A-scan data included in the three dimensional data set, placing the three dimensional data set based on the two dimensional map, and executing a process based on at least a partial data set of the three dimensional data set on which placement based on the two dimensional map has been performed. ( Read Full Article )

PIPE-Net: A pyramidal-input-parallel-encoding network for the segmentation of corneal layer interfaces in OCT images

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Segmentation of corneal layer interfaces in optical coherence tomography (OCT) images is necessary to generate thickness maps used for cornea diagnosis. In this paper, we propose PIPE-Net, a fully convolutional neural network with a pyramidal input, parallel encoders, and a densely connected decoder to segment four corneal layer interfaces. The pyramidal input is encoded using parallel encoders, which allows the network to process a larger receptive field. The encoders are connected level-wise to the decoder through residual summations. The decoder is densely connected using residual summations between its levels to enhance the gradient flow. We use a linear growth rate for the number of feature maps to limit the network parameters, which allows the network to be trained using a small dataset. A dataset of 295 OCT images was obtained and manually segmented by experienced and trained operators. We implemented other related networks in the literature for comparison with our proposed n...

Effect of OCT B-scan density on sensitivity for detection of intraretinal hyperreflective foci in eyes with age-related macular degeneration

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Purpose To evaluate the impact of reducing the density of B-scans in an optical coherence tomography (OCT) volume on the sensitivity for detecting intraretinal hyperreflective foci (IHRF) in eyes with intermediate age-related macular degeneration (AMD) Methods A total of 165 eyes with intermediate AMD and IHRF were evaluated in this retrospective analysis. For each case, Cirrus HD-OCT volumes were imported into the reading center 3D-OCTOR software. The number of IHRF cases was assessed based on all 128 B-scans (spaced 47 μm apart), using a categorical scale (graded as 1–4, 5–9, 10–14, 15–19, and >20). Additionally, the B-scan densities in the volume were lowered to 64 B-scans (spaced 94 μm apart), 43 B-scans (spaced 140 μm apart), and 32 B-scans (spaced 188 μm apart). The number of eyes with any IHRF and the numerical category of IHRF in the eye were used to compare the sensitivity at each reduced B-scan density agai...

Optical Coherence Tomography Angiography Findings in Sclerochoroidal Calcification

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Optical coherence tomography angiography (OCT-A) is a modern non invasive imaging technique that may aid in the evaluation of retinal diseases through the assessment of chorioretinal vasculature. The literature regarding OCT-A in sclerochoroidal calcification is scarce. We present the case of a 57-year-old female who was referred to the clinic due to an atypical choroidal lesion in the right eye. OCT-A showed an apparent decrease in the vascular flow of the choroidal/choriocapillaris layers and an apparent increase in the vascular flow of the deep retinal layers. A mass effect may be seen in OCT-A en face imaging that may create artifactual vascular flow pattern. This case reports the first OCT-A findings of sclerochoroidal calcification. ( Read Full Article )

Swept-Source Optical Coherence Tomography Detection of Bruch’s Membrane and Choriocapillaris Abnormalities in Sorsby Macular Dystrophy

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Purpose: Swept-source optical coherence tomography angiography (SS-OCTA) was used to analyze Bruch's membrane (BM) and choriocapillaris (CC) abnormalities in undiagnosed family members with Sorsby macular dystrophy (SMD). Methods: In a family with SMD (TIMP3 Tyr191Cys), SS-OCTA imaging was performed using the 6X6mm scan patter and previously validated algorithms to detect abnormalities in BM and the CC, as well as the presence of reticular pseudodrusen (RPD) and macular neovascularization (MNV). Genetic analyses were performed for TIMP3 mutations. Results: Of eight family members, two were previously diagnosed with SMD and six were asymptomatic. SS-OCTA imaging of the 33-year-old proband revealed type 1 MNV in the left eye and bilateral RPD, thickening of BM, CC thinning, and increases in CC flow deficits (FDs). A TIMP3 mutation was confirmed. His niece, despite having no clinical evidence of SMD, showed BM thickening and CC thinning on SS-OCTA. A TIMP3 mutation was confirmed. The p...

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