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Archivos de La Sociedad Espanola de... Dec 2019Optical coherence tomography (OCT) has become an essential tool in paediatric ophthalmology. However, none of the currently available OCT devices include any kind of... (Review)
Review
INTRODUCTION
Optical coherence tomography (OCT) has become an essential tool in paediatric ophthalmology. However, none of the currently available OCT devices include any kind of normative database for the paediatric population, which can lead to important interpretation errors.
OBJECTIVE
To review the paediatric OCT normative databases.
MATERIAL AND METHODS
The applications and implications of the use of paediatric OCT normative databases are reviewed.
RESULTS
The paediatric normative databases that have been published so far in scientific literature with different OCT devices for Spanish and European population are presented.
CONCLUSIONS
The knowledge and interpretation of paediatric OCT normative databases in our daily clinical practice is crucial in order for the correct interpretation of OCT thickness maps.
Topics: Adolescent; Child; Child, Preschool; Databases, Factual; Europe; Humans; Nerve Fibers; Optic Disk; Pediatrics; Reference Values; Retinal Diseases; Spain; Tomography, Optical Coherence
PubMed: 31685301
DOI: 10.1016/j.oftal.2019.08.003 -
Retina (Philadelphia, Pa.) Dec 2016To evaluate the optic nerve head microvasculature in eyes with acute and chronic optic neuropathies using swept-source optical coherence tomography angiography. (Observational Study)
Observational Study
PURPOSE
To evaluate the optic nerve head microvasculature in eyes with acute and chronic optic neuropathies using swept-source optical coherence tomography angiography.
METHODS
In this cross-sectional, observational study, optical coherence tomography angiography images were obtained from the optic nerve heads of 21 eyes of 12 patients with optic disk edema, pseudoedema and atrophy, and 12 eyes of 6 healthy subjects using a 1,050-nm optical coherence tomography angiography (Topcon DRI OCT; Triton). Peripapillary vasculature was assessed within five horizontal slabs consisting of the nerve fiber layer (NFL), ganglion cell layer, inner nuclear layer, choroidal layer, and full-thickness retinal layer. In addition, prelaminar and laminar slabs were evaluated. Vessel density was measured within a 3.4-mm diameter circle centered on the optic disk.
RESULTS
The abnormalities of the peripapillary capillary network were most apparent in the NFL and total retinal slabs. In eyes with disk edema, an increase or decrease in the visibility of the peripapillary capillary network was observed. Eyes with optic atrophy had decreased visibility of peripapillary capillary network corresponding to the region or sector of NFL thinning. Prelaminar capillary network was dilated and tortuous in eyes with disk edema. The mean vessel density was statistically significantly lower and the mean NFL thickness was statistically significantly thinner in eyes with optic atrophy compared with normal eyes (both P < 0.001). Vessel density was significantly correlated with the peripapillary NFL thickness (P < 0.001).
CONCLUSION
Optical coherence tomography angiography provides high-resolution, noninvasive visualization of the microvasculature of the optic nerve head and peripapillary region. Changes in the microvasculature in this region may prove useful in better characterization of optic neuropathies.
Topics: Acute Disease; Adolescent; Adult; Aged; Chronic Disease; Computed Tomography Angiography; Cross-Sectional Studies; Female; Fluorescein Angiography; Humans; Male; Microvessels; Middle Aged; Multimodal Imaging; Optic Atrophy; Optic Disk; Optic Nerve Diseases; Papilledema; Tomography, Optical Coherence; Young Adult
PubMed: 28005675
DOI: 10.1097/IAE.0000000000001259 -
Optometry and Vision Science : Official... Sep 2020Scleral lenses (SLs) are increasing in scope, and understanding their ocular health impact is imperative. The unique fit of an SL raises concern that the landing zone...
SIGNIFICANCE
Scleral lenses (SLs) are increasing in scope, and understanding their ocular health impact is imperative. The unique fit of an SL raises concern that the landing zone causes compression of conjunctival tissue that can lead to resistance of aqueous humor outflow and increased intraocular pressure (IOP).
PURPOSE
This study aimed to assess changes in optic nerve head morphology as an indirect assessment of IOP and evaluate other IOP assessment methods during SL wear.
METHODS
Twenty-six healthy adults wore SL on one randomly selected eye for 6 hours, whereas the fellow eye served as a control. Global minimum rim width (optical coherence tomography) and IOP (Icare, Diaton) were measured at baseline, 2 and 6 hours after SL application, and again after SL removal. Central corneal thickness, anterior chamber depth, and fluid reservoir depth were monitored.
RESULTS
Minimum rim width thinning was observed in the test (-8 μm; 95% confidence interval [CI], -11 to -6 μm) and control (-6 μm; 95% CI, -9 to -3 μm) eyes after 6 hours of SL wear (P < .01), although the magnitude of thinning was not significantly greater in the lens-wearing eyes (P = .09). Mean IOP (Icare) significantly increased +2 mmHg (95% CI, +1 to +3 mmHg) in the test eyes (P = .002), with no change in the control eyes. Mean IOP changes with Diaton were +0.3 mmHg (95% CI, -0.9 to +3.2 mmHg) in the test eyes and +0.4 mmHg (95% CI, -0.8 to +1.7 mmHg) in the control eyes. However, Diaton tonometry showed poor within-subject variation and poor correlation with Icare. No clinically significant changes were observed in central corneal thickness or anterior chamber depth.
CONCLUSIONS
This study suggests that SLs have a minimal effect on IOP homeostasis in the normal eye during SL wear and an insignificant impact on the optic nerve head morphology in healthy adult eyes.
Topics: Adult; Anterior Chamber; Contact Lenses; Cornea; Female; Humans; Intraocular Pressure; Male; Optic Disk; Sclera; Time Factors; Tomography, Optical Coherence; Tonometry, Ocular; Young Adult
PubMed: 32932395
DOI: 10.1097/OPX.0000000000001567 -
Journal of AAPOS : the Official... Feb 2020To compare the optic disks of children and adults with megalopapilla using optical coherence tomography (OCT). (Comparative Study)
Comparative Study
PURPOSE
To compare the optic disks of children and adults with megalopapilla using optical coherence tomography (OCT).
SUBJECTS AND METHODS
We conducted a case-control study of subjects with megalopapilla and normal sized disks seen between February 2013 and July 2015 at the Hospital da Luz, Lisbon. All subjects and controls were imaged with spectral domain OCT, and optic nerve head (ONH) parameters were evaluated. The main outcome measures were rim area, cup:disk ratio, and cup volume.
RESULTS
A total of 168 eyes of 168 subjects were included: 78 with megalopapilla (39 children/39 adults) and 90 (45/45) with normal sized disks. For the same ONH area, children had a higher rim area (P = 0.000), a smaller cup:disk ratio (P = 0.001), and a smaller cup volume (P = 0.001) than adults. For the same age group, megalopapilla had a larger cup:disk ratio (P = 0.000) and a larger cup volume (P = 0.000) than normal-sized disks.
CONCLUSIONS
In this study cohort, compared to adults with the same disk size, children (with megalopapilla or normal-sized disks) had a larger rim area and smaller cup. These findings suggest that enlargement of the cup of the optic disk and reduction of the rim area can occur through life.
Topics: Adolescent; Adult; Aging; Child; Female; Humans; Intraocular Pressure; Male; Middle Aged; Optic Disk; Optic Nerve Diseases; Retinal Ganglion Cells; Retrospective Studies; Tomography, Optical Coherence; Visual Fields; Young Adult
PubMed: 31926369
DOI: 10.1016/j.jaapos.2019.09.019 -
Retinal Cases & Brief Reports Jan 2022Optic disk pits (ODPs) are typically detected incidentally as small, gray, unilateral, oval-shaped excavation in the temporal optic disk on routine fundus examination....
PURPOSE
Optic disk pits (ODPs) are typically detected incidentally as small, gray, unilateral, oval-shaped excavation in the temporal optic disk on routine fundus examination. In this cross-sectional retrospective case series, we report optical coherence tomography angiography findings in patients with unilateral ODPs and describe changes in vessel perfusion associated with ODP.
METHODS
A total of eight eyes (four with ODP and four normal contralateral) were included in this study. Patients were excluded if any other optic disk abnormalities were present. Spectral-domain optical coherence tomography angiography (AngioVue; Optovue, Fremont, CA) imaging was conducted to map the vascularization of three layers in the optic nerve over a 4.5-mm × 4.5-mm region. The radial peripapillary capillaries, the nerve head capillaries, and the choriocapillaris were automatically segmented based on the OCT system software, and the capillary perfusion density (CPD) was quantified for each layer. Kruskal-Wallis one-way analysis of variance was used to compare CPD in normal and ODP eyes of four patients with monocular ODP.
RESULTS
Overall, CPD was lower in eyes with ODP compared with the contralateral normal eye in the radial peripapillary capillary (0.4521 ± 0.08 vs. 0.5505 ± 0.03, P = 0.08) and nerve head capillary layers (0.5461 ± 0.08 vs. 0.5989 ± 0.01, P = 0.08). Significantly lower CPD values were associated with ODP eyes in the radial peripapillary capillary layer within the disk (P = 0.04), inferior nasal (P = 0.04), and temporal (P = 0.02) regions and in the nerve head vessel layer within the disk region (P = 0.04). Significantly higher CPD values were associated with ODP eyes in the choriocapillaris layer within the nasal (P = 0.02), superior temporal (P = 0.02), and inferior temporal (P = 0.02) regions. Visual acuity was also decreased in ODP eyes at 0.4 ± 0.3 logarithm of the minimum angle of resolution units (20/50) compared with normal eyes at 0.1 ± 0.1 logarithm of the minimum angle of resolution units (20/25) (P = 0.12).
CONCLUSION
This study demonstrated that the presence of an ODP is associated with decreased vascular density in some regions of the optic disk and reduced visual acuity.
Topics: Cross-Sectional Studies; Eye Abnormalities; Fluorescein Angiography; Humans; Microvascular Density; Optic Disk; Retrospective Studies; Tomography, Optical Coherence
PubMed: 31688795
DOI: 10.1097/ICB.0000000000000908 -
Scientific Reports Jan 2024We aimed to determine the effect of optic disc tilt on deep learning-based optic disc classification. A total of 2507 fundus photographs were acquired from 2236 eyes of...
We aimed to determine the effect of optic disc tilt on deep learning-based optic disc classification. A total of 2507 fundus photographs were acquired from 2236 eyes of 1809 subjects (mean age of 46 years; 53% men). Among all photographs, 1010 (40.3%) had tilted optic discs. Image annotation was performed to label pathologic changes of the optic disc (normal, glaucomatous optic disc changes, disc swelling, and disc pallor). Deep learning-based classification modeling was implemented to develop optic-disc appearance classification models with the photographs of all subjects and those with and without tilted optic discs. Regardless of deep learning algorithms, the classification models showed better overall performance when developed based on data from subjects with non-tilted discs (AUC, 0.988 ± 0.002, 0.991 ± 0.003, and 0.986 ± 0.003 for VGG16, VGG19, and DenseNet121, respectively) than when developed based on data with tilted discs (AUC, 0.924 ± 0.046, 0.928 ± 0.017, and 0.935 ± 0.008). In classification of each pathologic change, non-tilted disc models had better sensitivity and specificity than the tilted disc models. The optic disc appearance classification models developed based all-subject data demonstrated lower accuracy in patients with the appearance of tilted discs than in those with non-tilted discs. Our findings suggested the need to identify and adjust for the effect of optic disc tilt on the optic disc classification algorithm in future development.
Topics: Male; Humans; Middle Aged; Female; Optic Disk; Deep Learning; Tomography, Optical Coherence; Eye Abnormalities; Glaucoma
PubMed: 38177229
DOI: 10.1038/s41598-023-50256-4 -
Archivos de La Sociedad Espanola de... Sep 2016Buried optic nerve head drusen are one of the most common causes of pseudo-papilloedema. In this review, we have chronologically addressed several useful traits in the... (Comparative Study)
Comparative Study Review
Buried optic nerve head drusen are one of the most common causes of pseudo-papilloedema. In this review, we have chronologically addressed several useful traits in the differential diagnosis of a true papilloedema, using the different features of optical coherence tomography (OCT). The specificity of these features has improved at the same time as the improvement in penetration capability and resolution of newer OCT devices. Spectral domain OCT, and more specifically the enhanced depth imaging (EDI) technology, represents a turning point in directly visualise drusen, to quantify their size and to recognise their impact on neighbouring structures inside the optic nerve head.
Topics: Diagnosis, Differential; Humans; Ischemia; Optic Disk; Optic Disk Drusen; Papilledema; Tomography, Optical Coherence
PubMed: 27079766
DOI: 10.1016/j.oftal.2016.02.022 -
Journal Francais D'ophtalmologie Jun 2021
Topics: Fluorescein Angiography; Humans; Optic Disk; Retinal Hemorrhage
PubMed: 33610394
DOI: 10.1016/j.jfo.2020.09.021 -
Retina (Philadelphia, Pa.) Nov 2019To report a cohort with optic disk pit maculopathy (ODPM) presenting with neurosensory macular detachment that were initially misdiagnosed and mistreated; and to...
PURPOSE
To report a cohort with optic disk pit maculopathy (ODPM) presenting with neurosensory macular detachment that were initially misdiagnosed and mistreated; and to describe structural features on spectral domain optical coherence tomography in misdiagnosed and all other consecutive cases of ODPM.
METHODS
Multicenter international retrospective cohort study.
PARTICIPANTS
59 eyes from 59 patients with ODPM.
MAIN OUTCOME MEASURES
1) Proportion of patients with ODPM initially misdiagnosed, inaccurate diagnosis and treatment. 2) Morphologic features on spectral domain optical coherence tomography: other causes of subretinal and/or intraretinal fluid, inner/outer retinoschisis, communication with optic disk pit, and retinal pigment epithelium alterations. 3) Visual and anatomical outcomes 6 months after proper treatment.
RESULTS
Fifteen patients (25.4%) with ODPM were correctly diagnosed initially and those were significantly younger than misdiagnosed cases (age 33.8 ± 15.2 vs. 58.7 ± 15.8 years, P < 0.0001). Forty of forty-four misdiagnosed eyes (90.9%) were treated for their presumed diagnosis before referral. Eyes with initial misdiagnosis had significantly more outer retinoschisis at baseline (88.4 vs. 40.0%, P = 0.0002) and more retinal pigment epithelium alterations (90.0 vs. 27.3%, P < 0.0001) 6 months after proper treatment.
CONCLUSION
Optic disk pit maculopathy is an underdiagnosed entity and can mimic other causes for subretinal fluid. Awareness and identification of pertinent spectral domain optical coherence tomography features can help avoid inappropriate and delayed treatment.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Eye Abnormalities; Female; Humans; Macula Lutea; Macular Degeneration; Male; Middle Aged; Optic Disk; Reproducibility of Results; Retrospective Studies; Tomography, Optical Coherence; Young Adult
PubMed: 30045135
DOI: 10.1097/IAE.0000000000002270 -
Experimental Eye Research Aug 2020The lamina cribrosa is the initial site of glaucomatous injury. Pathological changes to the lamina cribrosa include posterior displacement of the lamina cribrosa, loss...
The lamina cribrosa is the initial site of glaucomatous injury. Pathological changes to the lamina cribrosa include posterior displacement of the lamina cribrosa, loss of trophic support, and remodeling of the extracellular matrix. Optic nerve head (ONH) astrocytes and lamina cribrosa cells synthesize extracellular matrix proteins to support and maintain the lamina cribrosa under physiological conditions. During glaucoma, these cells respond to mechanical strain and other stimuli, which leads to pathological remodeling of the ONH. Although ONH astrocytes and lamina cribrosa cells have been previously cultured, there is no well-accepted, straightforward technique to isolate both cell types from a single dissected human ONH. To better understand the pathophysiology of glaucoma, we obtained and cultured lamina cribrosa explants from human donor eyes. Initially, cells that grew out from the explant were ONH astrocytes and lamina cribrosa cells. Using a specialized medium, we isolated pure populations of lamina cribrosa cells and ONH astrocytes. ONH astrocytes expressed glial fibrillary acidic protein (GFAP). Lamina cribrosa cells expressed alpha-smooth muscle actin (α-SMA), but were negative for GFAP. This method of ONH cell isolation and cell-culture will provide a technique to better understand the molecular and cell-specific changes in glaucomatous damage to the ONH.
Topics: Astrocytes; Blotting, Western; Cells, Cultured; Extracellular Matrix Proteins; Glial Fibrillary Acidic Protein; Humans; Optic Disk
PubMed: 32522476
DOI: 10.1016/j.exer.2020.108103