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American Journal of Ophthalmology Apr 2021To study the effects of age, sex, intraocular pressure (IOP), corneal thickness, axial length (AXL), disc area, and the signal strength of the scan on optical coherence...
PURPOSE
To study the effects of age, sex, intraocular pressure (IOP), corneal thickness, axial length (AXL), disc area, and the signal strength of the scan on optical coherence tomography (OCT) parameters of normal subjects in the L V Prasad Eye Institute-Glaucoma Epidemiological and Molecular Genetic Study (LVPEI-GLEAMS), a population-based study.
DESIGN
Cross-sectional study.
METHODS
A total of 1,100 eyes (1,100 subjects) of normal adults aged between 40 and 80 years from LVPEI-GLEAMS underwent macular and optic nerve head imaging with spectral-domain OCT (SDOCT). Effect of age, sex, IOP, central corneal thickness (CCT) and AXL, disc area, and signal strength of the OCT scan on retinal nerve fiber layer (RNFL) thickness, rim area, and ganglion cell-inner plexiform layer (GC-IPL) thickness measurements were evaluated using univariate and multivariate regression models.
RESULTS
Mean rim area, RNFL, and GC-IPL thickness were 1.31 mm (standard deviation [SD] = 0.22), 93.7 μm (SD = 9.3) and 79.6 μm (SD = 8.7), respectively. Age had a negative association with RNFL thickness (coefficient: -0.18, P < .001) and GC-IPL thickness (-0.18, P < .001). GC-IPL thickness was significantly less in women than in men (-1.05, P < .001). AXL had a negative association with rim area (-0.05, P < .001). Disc area was positively associated with RNFL thickness (4.90, P < .001) and rim area (0.15, P < .001). Signal strength of OCT scan was positively associated with RNFL thickness (1.6, P < .001) and negatively associated with rim area (-0.02, P < .001).
CONCLUSION
Age, sex, AXL, disc area, and signal strength of the scan were significantly associated with OCT measurements. These factors may need to be considered while interpreting the OCT parameters in pathologic conditions such as glaucoma.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Axial Length, Eye; Cornea; Cross-Sectional Studies; Female; Healthy Volunteers; Humans; Intraocular Pressure; Male; Middle Aged; Nerve Fibers; Optic Disk; Retinal Ganglion Cells; Sex Factors; Tomography, Optical Coherence
PubMed: 33307000
DOI: 10.1016/j.ajo.2020.11.015 -
Scientific Reports Jun 2022We present a compact multi-modal and multi-scale retinal imaging instrument with an angiographic functional extension for clinical use. The system integrates scanning...
We present a compact multi-modal and multi-scale retinal imaging instrument with an angiographic functional extension for clinical use. The system integrates scanning laser ophthalmoscopy (SLO), optical coherence tomography (OCT) and OCT angiography (OCTA) imaging modalities and provides multi-scale fields of view. For high resolution, and high lateral resolution in particular, cellular imaging correction of aberrations by adaptive optics (AO) is employed. The entire instrument has a compact design and the scanning head is mounted on motorized translation stages that enable 3D self-alignment with respect to the subject's eye by tracking the pupil position. Retinal tracking, based on the information provided by SLO, is incorporated in the instrument to compensate for retinal motion during OCT imaging. The imaging capabilities of the multi-modal and multi-scale instrument were tested by imaging healthy volunteers and patients.
Topics: Humans; Ophthalmoscopy; Optics and Photonics; Pupil; Retina; Tomography, Optical Coherence
PubMed: 35688890
DOI: 10.1038/s41598-022-13631-1 -
International Ophthalmology Jul 2022Methamphetamine and crystal methamphetamine abusers were compared with healthy subjects using optical coherence tomography to assess their retinal nerve fiber layer,...
PURPOSE
Methamphetamine and crystal methamphetamine abusers were compared with healthy subjects using optical coherence tomography to assess their retinal nerve fiber layer, macula, and optic disk characteristics.
METHODS
Forty-one methamphetamine and crystal methamphetamine abusers and 42 healthy subjects (mean ± SD of age: 35.82 ± 8.6 and 37.76 ± 9.1 years, respectively) were incorporated in this cross-sectional study. The drug abusers had a history of at least five years of substance use through smoking. Fourier-domain optical coherence tomography was used to image and assess the characteristics of retinal nerve fiber layer, macular thickness, and optic disk in the study groups.
RESULTS
The retinal nerve fiber layer thickness was significantly lower in the superior and temporal retinal quadrants of drug abusers than healthy subjects (P = 0.008 and P = 0.028, respectively). This study did not find a significant difference between drug abusers and healthy controls regarding optic to disk ratio, rim area, and disk area (P > 0.05). The comparison between the study groups showed that the reductions in perifovea and the superior quadrant of parafoveal thickness were statistically significant (P < 0.001 and P = 0.029, respectively).
CONCLUSION
Fourier-domain optical coherence tomography measurements showed that the retinal nerve fiber layer and macular thickness were different between methamphetamine and crystal methamphetamine abusers and healthy subjects, which should be considered in clinical practice. It seems that these drug abuses can cause alterations in retinal morphology.
Topics: Adult; Cross-Sectional Studies; Humans; Macula Lutea; Methamphetamine; Nerve Fibers; Optic Disk; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 35188605
DOI: 10.1007/s10792-021-02200-6 -
Vestnik Oftalmologii 2020To assess the thickness of the retinal nerve fiber layer and its morphometric parameters using optical coherent tomography in Alzheimer's disease (AD).
PURPOSE
To assess the thickness of the retinal nerve fiber layer and its morphometric parameters using optical coherent tomography in Alzheimer's disease (AD).
MATERIAL AND METHODS
The study included 105 patients, among which 45 were with AD and 60 patients without AD (control group). Visual acuity of each eye was measured using Snellen chart, intraocular pressure according to Goldman, and cognitive state on the MMSE scale. All patients underwent optical coherence tomography.
RESULTS
The average thickness of the nerve fibers of the retina in patients with AD was lower by 27.0%, in the temporal, upper and lower quadrants - by 24.0, 17.9 and 24.9%, respectively. The thickness in the nasal quadrant with AD was reduced by 15.4%. Excavation to diameter ratio, as well as vertical and horizontal excavation to diameter ratios on average exceeded the benchmark by 12.5%, 23.4% and 30.8% (<0.05), respectively. There was a decrease in the size of the area of the neuroretinal belt and the area of the disk by an average of 28.5% (<0.05) and 8.8%, respectively. The average thickness, the thickness in the upper and lower segments of the ganglion cell complex is reduced, the indices of focal and global loss of the volume of retinal ganglion cells complex are increased respectively by 1.7 (<0.05) and 2.8 times (<0.01).
CONCLUSION
In patients with moderate AD, the thickness of retinal nerve fibers (RNFL) in the temporal, upper, and lower segments decreases significantly (<0.001); a statistically significant (<0.05) increase in the excavation to diameter ratio of the optic nerve head and a decrease in the area of the neuroretinal belt is observed; the increase in the indices of focal and global loss of the volume of ganglion cells complex is statistically significant (<0.01).
Topics: Alzheimer Disease; Humans; Nerve Fibers; Optic Disk; Retina; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 32504480
DOI: 10.17116/oftalma202013603174 -
Ophthalmology Oct 2020To review the published literature on the accuracy of ophthalmic imaging methods to differentiate between papilledema and pseudopapilledema in children. (Review)
Review
PURPOSE
To review the published literature on the accuracy of ophthalmic imaging methods to differentiate between papilledema and pseudopapilledema in children.
METHODS
Literature searches were conducted in January 2020 in the PubMed database for English-language studies with no date restrictions and in the Cochrane Library database without any restrictions. The combined searches yielded 354 abstracts, of which 17 were reviewed in full text. Six of these were considered appropriate for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist. All 6 included studies were rated as level III evidence.
RESULTS
Fluorescein angiography, a combination of 2 OCT protocols, and multicolor confocal scanning laser ophthalmoscopy (Spectralis SD-OCT; Heidelberg Engineering, Heidelberg, Germany) demonstrated the highest positive percent agreement (92%-100%; 95% confidence interval [CI], 69%-100%) and negative percent agreement (92%-100%; 95% CI, 70%-100%) with a clinical diagnosis of papilledema in children. However, results must be interpreted with caution owing to methodologic limitations, including a small sample size leading to wide CIs and an overall lack of data (there was only 1 study each for the above methods and protocols). Ultrasonographic measures showed either a high positive percent agreement (up to 95%) with low negative percent agreement (as low as 58%) or vice versa. Autofluorescence and fundus photography showed a lower positive (40%-60%) and negative (57%) percent agreement.
CONCLUSIONS
Although several imaging methods demonstrated high positive and negative percent agreement with clinical diagnosis, no ophthalmic imaging method conclusively differentiated papilledema from pseudopapilledema in children because of the lack of high-quality evidence. Clinicians must continue to conduct thorough history-taking and examination and make judicious use of ancillary testing to determine which children warrant further workup for papilledema.
Topics: Academies and Institutes; Child; Diagnosis, Differential; Eye Diseases, Hereditary; Fluorescein Angiography; Fundus Oculi; Humans; Nerve Fibers; Ophthalmology; Optic Disk; Optic Nerve Diseases; Papilledema; Retinal Ganglion Cells; Tomography, Optical Coherence; United States
PubMed: 32386809
DOI: 10.1016/j.ophtha.2020.03.027 -
Acta Ophthalmologica Sep 2022To map the morphology of the retina and optic disc in adolescents with surgically treated hydrocephalus (HC) in infancy and to compare the results with healthy controls.
PURPOSE
To map the morphology of the retina and optic disc in adolescents with surgically treated hydrocephalus (HC) in infancy and to compare the results with healthy controls.
METHODS
The study comprised 26 adolescents (16 male, mean age 15 years) with HC and 31 sex- and aged-matched controls. The following optical coherence tomography (OCT) parameters were obtained: macular retinal thickness (MRT) and volume (MRV), thickness of the macular and peripapillary retinal nerve fibre layer (ppRNFL), and area of the optic disc, cup and rim.
RESULTS
The MRT was thinner amongst those with HC compared with controls (right eye (RE) 262.2 ± 15.3 and 275.8 ± 15.1 μm; p = 0.0051), and the MRV was smaller (RE 7.37 ± 0.36 and 7.83 ± 0.35 mm ; p = 0.0002). The HC group showed a thinner ppRNFL (RE 88.3 ± 14.9 and 103.5 ± 8.1 μm; p = 0.0002) but a thicker central macular RNFL (RE 11.6 ± 10.4 and 2.07 ± 3.00 μm; p = <0.0001) and foveal minimum (RE 211.1 ± 32.0 and 186.3 ± 15.9 μm; p = 0.0013). Optic disc variables showed no difference between groups. Correlations were found in the HC group between best corrected visual acuity (expressed in logMAR) and ppRNFL (RE r = -0.56, p = 0.018), and disc area (RE r = -0.52, p = 0.033).
CONCLUSION
Thinner ppRNFL and MRT and smaller MRV were found in adolescents with surgically treated HC in infancy compared with controls. In contrast, the central macular RNFL and foveal minimum were thicker. Further studies are required to evaluate the diagnostic value of OCT to indicate increased intracranial pressure timely and follow-up in individuals with surgically treated HC.
Topics: Adolescent; Aged; Humans; Hydrocephalus; Male; Nerve Fibers; Optic Disk; Retina; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 35507694
DOI: 10.1111/aos.15162 -
Eye (London, England) Sep 2020This study aimed to investigate morphologic features of optic disc drusen (ODD) and peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children, using... (Observational Study)
Observational Study
AIMS
This study aimed to investigate morphologic features of optic disc drusen (ODD) and peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children, using enhanced depth imaging optical coherence tomography (EDI-OCT). It also assessed if the presence of these features were associated with decreased peripapillary retinal nerve fibre layer (RNFL) thickness.
METHODS
Retrospective observational study of children with ODD. All subjects underwent complete ophthalmic examination and multimodal imaging. ODD were identified on EDI-OCT as circumscribed hyporeflective spheroidal elements located in front of lamina cribrosa, fully or partially surrounded by a hyperreflective border. PHOMS were identified as hyperreflective ovoid structures located in the peripapillary circumference. Both associations between ODD and RNFL loss and PHOMS and RNFL loss were tested using chi-squared test.
RESULTS
In total, 38 eyes of 20 children were analysed. PHOMS were present in 90% of patients. ODD and PHOMS were predominantly found in the nasal, superonasal and inferonasal sectors. A significant positive association was found between ODD and decreased RNFL thickness in the nasal (p = 0.02), superonasal (p = 0.05) and inferotemporal (p = 0.04) sectors. There was no significant association found with the presence of PHOMS.
CONCLUSION
EDI-OCT allowed morphological analysis of ODD and PHOMS in children. Drusen were found to be distinct from PHOMS both in their appearance and impact on the RNFL. ODD are hyporeflective and appear on the ONH above the lamina cribrosa and were associated with decreased thickness of the RNFL. On the contrary, PHOMS are hyperreflective structures located around the ONH and were not associated with RNFL loss.
Topics: Child; Humans; Nerve Fibers; Optic Disk; Optic Disk Drusen; Retinal Ganglion Cells; Tomography, Optical Coherence; Visual Fields
PubMed: 31745329
DOI: 10.1038/s41433-019-0694-6 -
Indian Journal of Ophthalmology Feb 2021The objective of this study was to identify the diagnostic features of optic nerve head melanocytoma (ONH-MCT) on spectral domain optical coherence tomography (SD OCT)...
PURPOSE
The objective of this study was to identify the diagnostic features of optic nerve head melanocytoma (ONH-MCT) on spectral domain optical coherence tomography (SD OCT) and OCT angiography (OCT-A).
METHODS
Retrospective study of 11 patients for their demographic, clinical features and imaging including SD OCT (tumour location, extent and interface) and OCT-A (surface and intrinsic vascularity) were reviewed. Flow rate percentage (FR %) was calculated over the lesion and compared to fellow eye and similar pigmented lesions.
RESULTS
The average age was 52.8 ± 10.9 years. ONH-MCT tumors occupied 3-tissue spaces- optic disc (n = 2), retinal layer (n = 5) and retina-choroidal layers (n = 4). SD OCT (11 eyes) showed elevated hyper reflective disorganized retinal layers with posterior shadowing (9 eyes) and hyper reflective dots within the tumor (all eyes). Microvascular features on OCT-A (8 eyes) in radial peripapillary capillary slab showed surface vascularization (7 eyes) and intrinsic vascularity in choroidal slab (8 eyes) with surrounding hypo reflective boundary. The mean FR % was higher at 65.1 ± 3.77% (CI: 61.9-68.2) compared to mean FR at 60.4 ± 1.06% (CI: 59.5-61.2) in the fellow eye (p = 0.01). Comparison with nevus and melanoma SD OCT showed a high reflective choroidal layer with normal or irregular outer retinal layers respectively; OCT-A showed hypo reflective area at the center with hyper reflective boundary and iso reflective area at center with hyper reflective boundary respectively.
CONCLUSION
SD OCT and OCT-A features may help to differentiate ONH-MCT from clinically similar looking pigmented lesions like nevus and melanoma.
Topics: Adult; Choroid; Humans; Middle Aged; Optic Disk; Retrospective Studies; Skin Neoplasms; Tomography, Optical Coherence
PubMed: 33463586
DOI: 10.4103/ijo.IJO_710_20 -
Journal of Neuro-ophthalmology : the... Sep 2021Optical coherence tomography (OCT) devices for imaging of the eye are broadly available. The test is noninvasive, rapid, and well-tolerated by patients. This creates a... (Review)
Review
BACKGROUND
Optical coherence tomography (OCT) devices for imaging of the eye are broadly available. The test is noninvasive, rapid, and well-tolerated by patients. This creates a large number of OCT images and patient referrals. Interpretation of OCT findings at the interface between neurological and ophthalmologic conditions has become a key skill in the neuro-ophthalmology service. Similar to the interpretation of visual fields, recogntion of the vertical and horizontal medians are helpful. A third "red line" is added, which will be reviewed here.
EVIDENCE
Levels 1a to 5 evidence.
ACQUISITION
Literature research.
RESULTS
There is level 1a evidence that neurodegeneration of the brain is associated with inner retinal layer atrophy. Predominantly, this is driven by retrograde (trans-synaptic) axonal degeneration from the brain to the eye. This process typically stops at the level of the inner nuclear layer (INL). Anterograde (Wallerian) axonal degeneration from the eye to the brain can trespass the INL. The geography of atrophy and swelling of individual macular retinal layers distinguishes prechiasmal from postchiasmal pathology. The emerging patterns are a front-back "red line" at the INL; a vertical "red line" through the macula for chiasmal/postchiasmal pathology; and a horizontal "red line" through the macular for pathology pointing to the optic disc. This is summarized by illustrative case vignettes.
CONCLUSIONS
The interpretation of patterns of individual retinal layer atrophy (3 "red lines") needs to be combined with recognition of localized layer thickening (edema, structural) at the macula. Certain macular patterns point to pathology at the level of the optic disc. This requires revision of the optic disc OCT and will guide need for further investigations. The 3 "red lines" proposed here may be found useful in clinical practice and the related mnemonics ("half moon," "sunset," "rainbow") for teaching.
Topics: Diagnosis, Differential; Humans; Optic Disk; Pattern Recognition, Visual; Retinal Degeneration; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 34415273
DOI: 10.1097/WNO.0000000000001173 -
Proceedings of the National Academy of... Nov 2021Retinitis pigmentosa (RP) is the most common group of inherited retinal degenerative diseases, whose most debilitating phase is cone photoreceptor death. Perimetric and...
Retinitis pigmentosa (RP) is the most common group of inherited retinal degenerative diseases, whose most debilitating phase is cone photoreceptor death. Perimetric and electroretinographic methods are the gold standards for diagnosing and monitoring RP and assessing cone function. However, these methods lack the spatial resolution and sensitivity to assess disease progression at the level of individual photoreceptor cells, where the disease originates and whose degradation causes vision loss. High-resolution retinal imaging methods permit visualization of human cone cells in vivo but have only recently achieved sufficient sensitivity to observe their function as manifested in the cone optoretinogram. By imaging with phase-sensitive adaptive optics optical coherence tomography, we identify a biomarker in the cone optoretinogram that characterizes individual cone dysfunction by stimulating cone cells with flashes of light and measuring nanometer-scale changes in their outer segments. We find that cone optoretinographic responses decrease with increasing RP severity and that even in areas where cone density appears normal, cones can respond differently than those in controls. Unexpectedly, in the most severely diseased patches examined, we find isolated cones that respond normally. Short-wavelength-sensitive cones are found to be more vulnerable to RP than medium- and long-wavelength-sensitive cones. We find that decreases in cone response and cone outer-segment length arise earlier in RP than changes in cone density but that decreases in response and length are not necessarily correlated within single cones.
Topics: Electroretinography; Eye Proteins; Humans; Ophthalmoscopy; Retina; Retinal Cone Photoreceptor Cells; Retinitis Pigmentosa
PubMed: 34795055
DOI: 10.1073/pnas.2107444118