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Vestnik Oftalmologii 2022The article presents five cases of various forms of hemangiomas of the optic nerve head (ONH) and juxtapapillary retina that were monitored and analyzed using ocular...
The article presents five cases of various forms of hemangiomas of the optic nerve head (ONH) and juxtapapillary retina that were monitored and analyzed using ocular visualization methods. The obtained data allowed a conclusion that capillary hemangioma of the ONH features clearly-seen boundaries of the lesion both on ophthalmoscopy and optical coherence tomography (OCT) images; on the other hand, juxtapapillary granuloma can be characterized by blurred outlines on ophthalmoscopy and a gradual transition of the altered retina on OCT images with secondary changes seen in the macular area. When comorbid, capillary hemangioma of the ONH and retina feature a combination of these visualization signs.
Topics: Hemangioma, Capillary; Humans; Ophthalmoscopy; Optic Disk; Retina; Tomography, Optical Coherence
PubMed: 35488564
DOI: 10.17116/oftalma202213802166 -
The British Journal of Ophthalmology May 2023The vascular supply of the optic nerve head is complex and remains incompletely delineated. Over the past 50 years, various investigators have attempted to clarify the... (Review)
Review
The vascular supply of the optic nerve head is complex and remains incompletely delineated. Over the past 50 years, various investigators have attempted to clarify the relative contributions of the choroid, the short posterior ciliary arteries and the central retinal artery to the vascular beds of the inner retinal, prelaminar, laminar and retrolaminar segments of the nerve head. Conflicting theories have evolved, in no small part due to differing techniques of study, involving both flow parameters and anatomical constructs. These have included studies, both in normal subjects and in those with optic nerve ischaemia, of histopathology, electron microscopic corrosion casting, orbital colour Doppler flow studies, fluorescein angiography, indocyanine green angiography, laser Doppler flow studies, laser speckle flowgraphy, microperfusion and labelling studies and optical coherence tomography angiography. The nature of the optic disc, peripapillary retina and choroid microvasculature has implications for the pathophysiology of ischaemic optic neuropathy.
Topics: Humans; Optic Disk; Retinal Artery; Retina; Fluorescein Angiography; Optic Neuropathy, Ischemic; Ischemia; Tomography, Optical Coherence
PubMed: 36261258
DOI: 10.1136/bjo-2022-322254 -
International Journal of Molecular... Jul 2022Glaucomatous optic neuropathy is the leading cause of irreversible blindness in the world. The chronic disease is characterized by optic nerve degeneration and vision... (Review)
Review
Glaucomatous optic neuropathy is the leading cause of irreversible blindness in the world. The chronic disease is characterized by optic nerve degeneration and vision field loss. The reduction of intraocular pressure remains the only proven glaucoma treatment, but it does not prevent further neurodegeneration. There are three major classes of cells in the human optic nerve head (ONH): lamina cribrosa (LC) cells, glial cells, and scleral fibroblasts. These cells provide support for the LC which is essential to maintain healthy retinal ganglion cell (RGC) axons. All these cells demonstrate responses to glaucomatous conditions through extracellular matrix remodeling. Therefore, investigations into alternative therapies that alter the characteristic remodeling response of the ONH to enhance the survival of RGC axons are prevalent. Understanding major remodeling pathways in the ONH may be key to developing targeted therapies that reduce deleterious remodeling.
Topics: Glaucoma; Humans; Intraocular Pressure; Optic Disk; Optic Nerve Diseases; Retinal Ganglion Cells
PubMed: 35897642
DOI: 10.3390/ijms23158068 -
Diabetic Medicine : a Journal of the... Mar 2021
Topics: Diabetes Mellitus, Type 2; Diabetic Retinopathy; Diagnosis, Differential; Fundus Oculi; Humans; Male; Middle Aged; Optic Disk; Papilledema
PubMed: 32985007
DOI: 10.1111/dme.14398 -
Vestnik Oftalmologii 2022Papilledema (choked disk) is a sign of intracranial hypertension (ICH) - condition that presents danger not only for patient's vision, but also for their life. Despite... (Review)
Review
Papilledema (choked disk) is a sign of intracranial hypertension (ICH) - condition that presents danger not only for patient's vision, but also for their life. Despite the fact that ICH is usually a neurosurgical pathology, sometimes an ophthalmologist is the first doctor such patients visit, most often in a primary healthcare clinic. At the same time, as practice shows, not all ophthalmologists are well aware about in this pathology; difficulties occur in differential diagnosis of papilledema against similar changes of the optic nerve head seen during ophthalmoscopic examination. This article reviews scientific literature on ICH, including benign ICH, diagnosis and differential diagnosis of papilledema. The authors also share their decades-long experience of working in a neurosurgical facility.
Topics: Diagnosis, Differential; Humans; Intracranial Hypertension; Ophthalmoscopy; Optic Disk; Papilledema
PubMed: 36004596
DOI: 10.17116/oftalma202213804187 -
Computerized Medical Imaging and... Jun 2022Optic disc localization, a key preprocessing step in the analysis of color fundus images for diagnoses of eye diseases and the localization of various anatomical...
Optic disc localization, a key preprocessing step in the analysis of color fundus images for diagnoses of eye diseases and the localization of various anatomical structures, is particularly challenging when input retina images contain abnormalities. In such cases, the disc can be confused with other anatomical structures such as fovea, exudates, vessel tree extraction, and retinopathy-related lesions. Herein, we present a method for effective optic disc detection and localization based on color and blur analysis. In this method, the input color fundus image is converted to CIE L*a*b* color space to enhance optic disc appearance and contrast, and the accumulated directional blur and extended-maxima transform are then applied to precisely extract optic disc candidates. Subsequently, radial blur is applied to each candidate to obtain better profiles and thus distinguish the optic disc from other candidates. Finally, the full width at 80% maximum (FW80M) metric is used to select the optic disc. The performance of the proposed method is evaluated using well-studied data sets, and comparison of the obtained results with those of state-of-the-art techniques reveals the effectiveness of our method and shows that it can precisely locate the disc position not only in normal cases but also in the presence of exudates and abnormalities.
Topics: Algorithms; Diabetic Retinopathy; Exudates and Transudates; Fundus Oculi; Humans; Optic Disk; Retinal Diseases
PubMed: 35397336
DOI: 10.1016/j.compmedimag.2022.102058 -
Indian Journal of Ophthalmology Mar 2023: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the...
BACKGROUND AND PURPOSE
: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the radial peripapillary capillary (RPC) network in congenital optic disk anomalies with optical coherence tomography-angiography (OCTA) can shed light on its pathogenesis. This video describes the OCTA findings of optic nerve head and RPC network using the angio-disk mode in five cases of congenital cavitary optic disk anomalies.
SYNOPSIS
The video presents characteristic RPC network alterations in two eyes of ODP, one eye of optic disk coloboma, and two eyes of noncontractile MGDA.
HIGHLIGHTS
OCTA in ODP and coloboma shows absence of RPC microvascular network and a region of capillary dropout. This finding is in contrast to MGDA, where the microvascular network is dense. OCTA is an effective imaging modality to study vascular plexus and RPC and their alteration in congenital disk anomalies, which could provide information about the structural differences among them.
VIDEO LINK
https://youtu.be/TyZOzpG4X4U.
Topics: Humans; Optic Disk; Coloboma; Eye Abnormalities
PubMed: 36872758
DOI: 10.4103/IJO.IJO_2743_22 -
Survey of Ophthalmology 2023Glaucoma is a leading cause of irreversible vision impairment globally, and cases are continuously rising worldwide. Early detection is crucial, allowing timely... (Review)
Review
Glaucoma is a leading cause of irreversible vision impairment globally, and cases are continuously rising worldwide. Early detection is crucial, allowing timely intervention that can prevent further visual field loss. To detect glaucoma an examination of the optic nerve head via fundus imaging can be performed, at the center of which is the assessment of the optic cup and disc boundaries. Fundus imaging is noninvasive and low-cost; however, image examination relies on subjective, time-consuming, and costly expert assessments. A timely question to ask is: "Can artificial intelligence mimic glaucoma assessments made by experts?" Specifically, can artificial intelligence automatically find the boundaries of the optic cup and disc (providing a so-called segmented fundus image) and then use the segmented image to identify glaucoma with high accuracy? We conducted a comprehensive review on artificial intelligence-enabled glaucoma detection frameworks that produce and use segmented fundus images and summarized the advantages and disadvantages of such frameworks. We identified 36 relevant papers from 2011 to 2021 and 2 main approaches: 1) logical rule-based frameworks, based on a set of rules; and 2) machine learning/statistical modeling-based frameworks. We critically evaluated the state-of-art of the 2 approaches, identified gaps in the literature and pointed at areas for future research.
Topics: Humans; Artificial Intelligence; Fundus Oculi; Glaucoma; Optic Disk; Machine Learning
PubMed: 35985360
DOI: 10.1016/j.survophthal.2022.08.005 -
Neurology Jan 2023The distinction of papilledema from other optic nerve head (ONH) lesions mimicking papilledema, such as optic disc drusen (ODD), can be difficult in clinical practice....
BACKGROUND AND OBJECTIVES
The distinction of papilledema from other optic nerve head (ONH) lesions mimicking papilledema, such as optic disc drusen (ODD), can be difficult in clinical practice. We aimed the following: (1) to develop a deep learning algorithm to automatically identify major structures of the ONH in 3-dimensional (3D) optical coherence tomography (OCT) scans and (2) to exploit such information to robustly differentiate among ODD, papilledema, and healthy ONHs.
METHODS
This was a cross-sectional comparative study of patients from 3 sites (Singapore, Denmark, and Australia) with confirmed ODD, those with papilledema due to raised intracranial pressure, and healthy controls. Raster scans of the ONH were acquired using OCT imaging and then processed to improve deep-tissue visibility. First, a deep learning algorithm was developed to identify major ONH tissues and ODD regions. The performance of our algorithm was assessed using the Dice coefficient. Second, a classification algorithm (random forest) was designed to perform 3-class classifications (1: ODD, 2: papilledema, and 3: healthy ONHs) strictly from their drusen and prelamina swelling scores (calculated from the segmentations). To assess performance, we reported the area under the receiver operating characteristic curve for each class.
RESULTS
A total of 241 patients (256 imaged ONHs, including 105 ODD, 51 papilledema, and 100 healthy ONHs) were retrospectively included in this study. Using OCT images of the ONH, our segmentation algorithm was able to isolate neural and connective tissues and ODD regions/conglomerates whenever present. This was confirmed by an averaged Dice coefficient of 0.93 ± 0.03 on the test set, corresponding to good segmentation performance. Classification was achieved with high AUCs, that is, 0.99 ± 0.001 for the detection of ODD, 0.99 ± 0.005 for the detection of papilledema, and 0.98 ± 0.01 for the detection of healthy ONHs.
DISCUSSION
Our artificial intelligence approach can discriminate ODD from papilledema, strictly using a single OCT scan of the ONH. Our classification performance was very good in the studied population, with the caveat that validation in a much larger population is warranted. Our approach may have the potential to establish OCT imaging as one of the mainstays of diagnostic imaging for ONH disorders in neuro-ophthalmology, in addition to fundus photography.
Topics: Humans; Optic Disk; Papilledema; Optic Disk Drusen; Artificial Intelligence; Retrospective Studies; Cross-Sectional Studies; Tomography, Optical Coherence
PubMed: 36175153
DOI: 10.1212/WNL.0000000000201350 -
Survey of Ophthalmology 2021Optical coherence tomography angiography (OCTA) is a noninvasive, depth-resolved imaging tool for the appraisement of retinal vascular changes. Since its introduction,... (Review)
Review
Optical coherence tomography angiography (OCTA) is a noninvasive, depth-resolved imaging tool for the appraisement of retinal vascular changes. Since its introduction, the understanding of diabetic retinopathy, age-related macular degeneration, central serous retinopathy, and other diseases has been enriched on many fronts. Its dyeless imaging property maps retinal as well as deeper choroidal vasculature in quick succession with good reproducibility. Hence, it can play an important role in the diagnosis and management of optic nerve-related diseases as well. A detailed literature review for its role in nonarteritic anterior ischemic optic neuropathy, papilledema, optic disc drusen, papillitis, hereditary optic neuropathies, central nervous system diseases, and others highlights its role. The whole spectrum of neuro-ophthalmological diseases shows consistent peripapillary and macular capillary changes with structural and functional correlation. The superficial and deeper retinal and choroidal vasculatures are affected depending on the nature of the disease process. Hence, OCTA positions itself as a useful, noninvasive tool in the armamentarium of a neuro-ophthalmologist in future; however, there are several limitations of the OCTA with respect to its technical abilities in challenging neuro-ophthalmic cases. Therefore, future research should be directed to enhance the technical capabilities of OCTA and to determine the more precise role of it in the prognosis of neuro-ophthalmic diseases.
Topics: Angiography; Fluorescein Angiography; Humans; Ophthalmology; Optic Disk; Reproducibility of Results; Tomography, Optical Coherence
PubMed: 33157113
DOI: 10.1016/j.survophthal.2020.10.009