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Scientific Reports Apr 2021This study characterizes differences in glaucomatous eyes with and without high axial myopia using custom automated analysis of OCT images. 452 eyes of 277 glaucoma...
This study characterizes differences in glaucomatous eyes with and without high axial myopia using custom automated analysis of OCT images. 452 eyes of 277 glaucoma patients were stratified into non (n = 145 eyes), mild (n = 214 eyes), and high axial myopia (axial length (AL) > 26 mm, n = 93 eyes). Optic disc ovality index, tilt and rotation angle of Bruch´s membrane opening (BMO) and peripapillary choroidal thickness (PCT) were calculated using automated and deep learning strategies. High myopic optic discs were more oval and had larger BMO tilt than mild and non-myopic discs (both p < 0.001). Mean PCT was thinnest in high myopic eyes followed by mild and non-myopic eyes (p < 0.001). BMO rotation angle, global retinal nerve fiber layer (RNFL) thickness and BMO-minimum rim width (MRW) were similar among groups. Temporal RNFL was thicker and supranasal BMO-MRW was thinner in high myopic eyes. BMO tilt and PCT showed moderate and temporal RNFL and nasal BMO-MRW showed weak but significant associations with AL in multivariable analyses (all p < 0.05). Large BMO tilt angle and thin PCT are characteristics of highly myopic discs and were not associated with severity of glaucoma. Caution should be exercised when using sectoral BMO-MRW and RNFL thickness for glaucoma management decisions in myopic eyes.
Topics: Aged; Cross-Sectional Studies; Deep Learning; Female; Glaucoma; Humans; Male; Myopia; Optic Disk; Tomography, Optical Coherence; Visual Fields
PubMed: 33893383
DOI: 10.1038/s41598-021-88406-1 -
Ophthalmic Research 2022The main aim of this article was to study the retinal peripapillary and macular vascular structures in eyes with primary angle-closure suspects (PACS) using optical...
INTRODUCTION
The main aim of this article was to study the retinal peripapillary and macular vascular structures in eyes with primary angle-closure suspects (PACS) using optical coherence tomography angiography (OCTA).
METHODS
In this cross-sectional study, control and PACS subjects were recruited from a community screening. Only one eye per subject was used for analysis. All participants underwent a questionnaire survey, physical and ophthalmic examinations, ocular biometry measurements, and OCTA. We compared basic demographics and vessel structure parameters between control and PACS eyes. Univariate and multivariate linear regression analyses were performed to investigate factors associated with vascular parameters in both groups.
RESULTS
Data from 254 subjects including 155 PACS and 99 controls were analyzed. In the peripapillary region, PACS eyes showed similar retina nerve fiber layer (RNFL) and vessel densities (VDs) including and excluding large vessels compared to control eyes. Compared to control eyes, all macular OCTA parameters showed significant differences in PACS eyes, including decreased superficial VD (p = 0.006) and deep VD (p = 0.004), larger fovea avascular zone (FAZ) area (p = 0.006), and longer FAZ perimeter (p = 0.004). Gender (p = 0.039), age (p < 0.001), and Garway-Heath superior hemisphere RNFL (p < 0.001) were risk factors influencing optic disc VD excluding large vessels. Axial length was the major factor affecting macula superficial and deep VDs (p = 0.004 and 0.001 respectively), while PACS was an independent factor associated with larger FAZ perimeter (p = 0.046).
CONCLUSION
While PACS and control eyes have comparable RNFL and vascular structure around the optic nerve head, macular vascular structures are significantly different.
Topics: Humans; Cross-Sectional Studies; Macula Lutea; Optic Disk; Retinal Vessels; Tomography, Optical Coherence; Angiography
PubMed: 34649251
DOI: 10.1159/000520030 -
Ophthalmic Research 2024Anterior ischemic optic neuropathy (AION) can mimic glaucoma and consequently cause difficulties in differential diagnosis. The purpose of this paper was to summarize... (Review)
Review
INTRODUCTION
Anterior ischemic optic neuropathy (AION) can mimic glaucoma and consequently cause difficulties in differential diagnosis. The purpose of this paper was to summarize differences in diagnostic tests that can help perform a correct diagnosis.
METHODS
The search strategy was performed according to the PRISMA 2009 guidelines, and four databases were used: MEDLINE, Embase, Web of Science, and Cochrane. Totally, 772 references were eligible; 39 were included after screening with respect to inclusion criteria that included English language and published in the 20 years before search date.
RESULTS
Ninety percent (n = 35) of included studies used optical coherence tomography (OCT). Glaucomatous eyes had a significantly greater cup area, volume and depth, cup-to-disk ratio, a lower rim volume and area, and a thinner Bruch's membrane opening-minimum rim width. Retinal nerve fiber layer (RNFL) thinning in glaucomatous eyes occurred primarily at the superotemporal, inferotemporal, and inferonasal sectors, while AION eyes demonstrated mostly superonasal thinning. Glaucoma eyes showed greater macular ganglion cell layer thickness, except at the inferotemporal sector. OCT angiography measurements demonstrated a significant decrease in superficial and deep macular vessel density (VD) in glaucoma compared to AION with similar degree of visual field damage; the parapapillary choroidal VD was spared in AION eyes compared to glaucomatous eyes.
CONCLUSION
By use of OCT imaging, optic nerve head parameters seem most informative to distinguish between glaucoma and AION. Although both diseases affect the RNFL thickness, it seems to do so in different sectors. Differences in structure and vascularity of the macula can also help in making the differential diagnosis.
Topics: Humans; Optic Neuropathy, Ischemic; Diagnosis, Differential; Tomography, Optical Coherence; Nerve Fibers; Retinal Ganglion Cells; Optic Disk; Glaucoma; Visual Fields; Intraocular Pressure
PubMed: 38262372
DOI: 10.1159/000535568 -
Investigative Ophthalmology & Visual... Feb 2020The clinical phenotype of retinal gliosis occurs in different forms; here, we characterize one novel genetic feature, (i.e., signaling via BMP-receptor 1b).
PURPOSE
The clinical phenotype of retinal gliosis occurs in different forms; here, we characterize one novel genetic feature, (i.e., signaling via BMP-receptor 1b).
METHODS
Mouse mutants were generated within a recessive ENU mutagenesis screen; the underlying mutation was identified by linkage analysis and Sanger sequencing. The eye phenotype was characterized by fundoscopy, optical coherence tomography, optokinetic drum, electroretinography, and visual evoked potentials, by histology, immunohistology, and electron-microscopy.
RESULTS
The mutation affects intron 10 of the Bmpr1b gene, which is causative for skipping of exon 10. The expression levels of pSMAD1/5/8 were reduced in the mutant retina. The loss of BMPR1B-mediated signaling leads to optic nerve coloboma, gliosis in the optic nerve head and ventral retina, defective optic nerve axons, and irregular retinal vessels. The ventral retinal gliosis is proliferative and hypertrophic, which is concomitant with neuronal delamination and the reduction of retinal ganglion cells (RGCs); it is dominated by activated astrocytes overexpressing PAX2 and SOX2 but not PAX6, indicating that they may retain properties of gliogenic precursor cells. The expression pattern of PAX2 in the optic nerve head and ventral retina is altered during embryonic development. These events finally result in reduced electrical transmission of the retina and optic nerve and significantly reduced visual acuity.
CONCLUSIONS
Our study demonstrates that BMPR1B is necessary for the development of the optic nerve and ventral retina. This study could also indicate a new mechanism in the formation of retinal gliosis; it opens new routes for its treatment eventually preventing scar formation in the retina.
Topics: Animals; Bone Morphogenetic Protein Receptors, Type I; Coloboma; Gliosis; Mice; Mutation; Optic Disk; Retinal Diseases
PubMed: 32106289
DOI: 10.1167/iovs.61.2.44 -
BMC Ophthalmology Oct 2020Optic disc melanocytoma (ODMC) was a benign pigmented intraocular tumor with the rare potential malignant transformation. This study was designed to evaluate tumor...
BACKGROUND
Optic disc melanocytoma (ODMC) was a benign pigmented intraocular tumor with the rare potential malignant transformation. This study was designed to evaluate tumor vasculature with optical coherence tomography angiography (OCTA) in ODMC.
METHODS
Eyes of healthy individuals in a control group and of patients with ODMC were imaged by OCTA systems operating at 840 nm wavelengths and examined. The main outcome measures were OCTA images, qualitative evaluation of optic disc and tumor vasculature, quantitative vascular density (VD) and perfusion density (PD).
RESULTS
One eye of ten normal volunteers and ten patients with ODMC were imaged. Eyes affected by ODMC as compared to the eyes of the control group (all P < 0.05). The healthy optic disc had radially-oriented vessels within the retina on OCTA. Optic disc melanocytoma was characterized by globular, demonstrated tortuous blood vessels, uneven thickness, and relatively disorganized intratumoral vasculature. The VD and PD within ODMC were significantly higher (12.360% ± 4.175, 0.316% ± 0.119%, P < 0.0001) than in normal optic discs (4.160% ± 2.290, 0.102% ± 0.0, 56%, P < 0.0001). No significant differences were established of the VD and PD in each single measurement zone (P > 0.05) between the ODMC and the control eyes. At 840 nm, OCTA could provide sufficient visualization of the tumor vasculature and better penetration through thicker tumors. The full thickness was visualized even in thicker tumors and highly pigmented lesions (> 2 mm). Interpretable OCTA images were obtained in 96% of the participants in whom imaging was attempted.
CONCLUSIONS
OCTA may provide a noninvasive, safe, and efficient technique for evaluating a variety of neoplasms including the growth and vascularity in ODMC. OCTA could facilitate the evaluation of the vascular abnormalities of tumors and the effect of melanin on the penetration of the OCTA beam was not significant.
Topics: Fluorescein Angiography; Humans; Neoplasms; Optic Disk; Retinal Vessels; Tomography, Optical Coherence
PubMed: 33109124
DOI: 10.1186/s12886-020-01676-7 -
Ophthalmology Jan 2021Normal tissue complication probability (NTCP) models could aid the understanding of dose dependence of radiation-induced toxicities after eye-preserving radiotherapy of...
PURPOSE
Normal tissue complication probability (NTCP) models could aid the understanding of dose dependence of radiation-induced toxicities after eye-preserving radiotherapy of choroidal melanomas. We performed NTCP-modeling and established dose-response relationships for visual acuity (VA) deterioration and common late complications after treatments with proton therapy (PT).
DESIGN
Retrospective study from single, large referral center.
PARTICIPANTS
We considered patients from Nice, France, diagnosed with choroidal melanoma and treated primarily with hypofractionated PT (52 Gy physical dose in 4 fractions). Complete VA deterioration information was available for 1020 patients, and complete information on late complications was available for 991 patients.
METHODS
Treatment details, dose-volume histograms (DVHs) for relevant anatomic structures, and patient and tumor characteristics were available from a dedicated ocular database. Least absolute shrinkage and selection operator (LASSO) variable selection was used to identify variables with the strongest impact on each end point, followed by multivariate Cox regressions and logistic regressions to analyze the relationships among dose, clinical characteristics, and clinical outcomes.
MAIN OUTCOME MEASURES
Dose-response relationship for VA deterioration and late complications.
RESULTS
Dose metrics for several structures (i.e., optic disc, macula, retina, globe, lens, ciliary body) correlated with clinical outcome. The near-maximum dose to the macula showed the strongest correlation with VA deterioration. The near-maximum dose to the retina was the only variable with clear impact on the risk of maculopathy, the dose to 20% of the optic disc had the largest impact on optic neuropathy, dose to 20% of cornea had the largest impact on neovascular glaucoma, and dose to 20% of the ciliary body had the largest impact on ocular hypertension. The volume of the ciliary body receiving 26 Gy was the only variable associated with the risk of cataract, and the volume of retina receiving 52 Gy was associated with the risk of retinal detachment. Optic disc-to-tumor distance was the only variable associated with dry eye syndrome in the absence of DVH for the lachrymal gland.
CONCLUSIONS
VA deterioration and specific late complications demonstrated dependence on dose delivered to normal structures in the eye after PT for choroidal melanoma. VA deterioration depended on dose to a range of structures, whereas more specific complications were related to dose metrics for specific structures.
Topics: Aged; Choroid Neoplasms; Female; Follow-Up Studies; Humans; Lens, Crystalline; Macula Lutea; Male; Melanoma; Middle Aged; Optic Disk; Proton Therapy; Radiotherapy Dosage; Retrospective Studies; Visual Acuity
PubMed: 32574763
DOI: 10.1016/j.ophtha.2020.06.030 -
Indian Journal of Ophthalmology May 2018Optic nerve aplasia (ONA) is a congenital optic nerve anomaly characterized by the absence of optic nerve head, retinal blood vessels, retinal ganglion cells, and optic...
Optic nerve aplasia (ONA) is a congenital optic nerve anomaly characterized by the absence of optic nerve head, retinal blood vessels, retinal ganglion cells, and optic nerve fibers in a malformed eye. Clinically, the condition presents with the absence of perception of light, afferent pupillary defect and a fundus appearance of absent optic nerve head, and retinal vessels with associated ocular and nonocular abnormalities. Systemic anomalies have been reported with bilateral ONA, whereas unilateral ONA is seen in otherwise healthy individuals. We report three cases of ONA with varied clinical presentations.
Topics: Child; Child, Preschool; Female; Humans; Infant; Magnetic Resonance Imaging; Optic Disk; Optic Nerve Diseases; Tomography, X-Ray Computed; Ultrasonography
PubMed: 29676329
DOI: 10.4103/ijo.IJO_1108_17 -
Journal of Biomechanical Engineering Jun 2022A comprehensive characterization of the three-dimensional (3D) vascular network of the optic nerve head (ONH) is critical to understanding eye physiology and pathology....
A comprehensive characterization of the three-dimensional (3D) vascular network of the optic nerve head (ONH) is critical to understanding eye physiology and pathology. Current in vivo imaging technologies, however, do not have simultaneous high spatial resolution and imaging depth to resolve the small vessels deep within the ONH. We describe a workflow for the 3D reconstruction and quantitative morphological analysis of the ONH vasculature. The vessels of a normal monkey ONH were perfusion labeled. Serial cryosections of the ONH were imaged using fluorescence microscopy (FM) and instant polarized light microscopy (IPOL) to visualize the labeled vessels and label-free collagen, respectively. The IPOL images were registered and used to form a stack of FM images from which the vessels were segmented and skeletonized to reconstruct the 3D vascular network. The network consisted of 12,966 vessel segments, 7989 branching points, and 1100 terminal points at the boundaries. For each vessel segment, we measured its length, tortuosity, inclination (θ), and polar orientation (φ). The length followed a lognormal distribution, whereas the distribution of the tortuosity followed an exponential decay. The vessels were mainly oriented toward the coronal plane (θ = 90 deg). For orientation, there were nearly as many vessels aligned circumferentially (φ = 90 deg) and radially (φ = 0 deg). Our results demonstrate the workflow for 3D eye-specific reconstruction and quantification of the monkey ONH vascular network. This is a critical first step to analyze the blood flow and oxygenation within the ONH, which will help understand the role of vascular dysfunction in glaucoma.
Topics: Animals; Glaucoma; Haplorhini; Imaging, Three-Dimensional; Intraocular Pressure; Optic Disk; Workflow
PubMed: 35266993
DOI: 10.1115/1.4054056 -
Scientific Reports Jul 2022Glaucoma is an eye condition that leads to loss of vision and blindness if not diagnosed in time. Diagnosis requires human experts to estimate in a limited time subtle...
Glaucoma is an eye condition that leads to loss of vision and blindness if not diagnosed in time. Diagnosis requires human experts to estimate in a limited time subtle changes in the shape of the optic disc from retinal fundus images. Deep learning methods have been satisfactory in classifying and segmenting diseases in retinal fundus images, assisting in analyzing the increasing amount of images. Model training requires extensive annotations to achieve successful generalization, which can be highly problematic given the costly expert annotations. This work aims at designing and training a novel multi-task deep learning model that leverages the similarities of related eye-fundus tasks and measurements used in glaucoma diagnosis. The model simultaneously learns different segmentation and classification tasks, thus benefiting from their similarity. The evaluation of the method in a retinal fundus glaucoma challenge dataset, including 1200 retinal fundus images from different cameras and medical centers, obtained a [Formula: see text] AUC performance compared to an [Formula: see text] obtained by the same backbone network trained to detect glaucoma. Our approach outperforms other multi-task learning models, and its performance pairs with trained experts using [Formula: see text] times fewer parameters than training each task separately. The data and the code for reproducing our results are publicly available.
Topics: Deep Learning; Fundus Oculi; Glaucoma; Humans; Optic Disk
PubMed: 35858986
DOI: 10.1038/s41598-022-16262-8 -
Romanian Journal of Ophthalmology 2015Glaucoma is a progressive optic neuropathy, characterized by loss of retinal ganglion cells and retinal nerve fiber layer as well as visual field loss. Therefore, in... (Review)
Review
Glaucoma is a progressive optic neuropathy, characterized by loss of retinal ganglion cells and retinal nerve fiber layer as well as visual field loss. Therefore, in glaucoma, the correlation between structure and function is important, since it can be useful for tracking glaucomatous changes and for following the progression of the disease.
Topics: Disease Progression; Glaucoma; Humans; Optic Disk; Retinal Ganglion Cells; Retinal Neurons; Tomography, Optical Coherence; Visual Field Tests
PubMed: 26978878
DOI: No ID Found