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Retina (Philadelphia, Pa.) May 2024Central serous chorioretinopathy (CSC) is associated with pachychoroid and dysfunctional retinal pigment epithelium. Autofluorescence (AF) is typically altered. The...
BACKGROUND/PURPOSE
Central serous chorioretinopathy (CSC) is associated with pachychoroid and dysfunctional retinal pigment epithelium. Autofluorescence (AF) is typically altered. The authors performed this study to quantify these alterations using quantitative AF (qAF) in patients with CSC and in their fellow eye in comparison with a healthy control group.
METHODS
Patients with CSC and healthy controls were recruited prospectively. All patients received a full clinical examination including best-corrected visual acuity, enhanced depth imaging-optical coherence tomography, and qAF. Quantitative autofluorescence images were taken with a confocal scanning laser ophthalmoscope (Heidelberg Engineering). Quantitative autofluorescence values were assessed in specified regions of the inner eight and the middle ring of the Delori grid.
RESULTS
In total, 141 eyes of 77 patients with CSC were included. Ninety eyes had a manifest CSC (group 1) while 51 fellow eyes (group 2) did not show signs of CSC. There were no significant differences of qAF values between these two groups: mean qAF values were 241.3 (inner eight) and 212.8 (middle ring) in group 1 and 235.9 (inner eight) and 210.0 (middle ring) in group 2 ( P = 1.0 and 1.0). We compared these eyes with healthy controls comprising 39 eyes. Quantitative autofluorescence signals (inner eight: 164.7; middle ring: 148.9) differed significantly compared with both CSC manifest ( P < 0.001) and fellow eyes ( P < 0.001).
CONCLUSION
Our results show that patients with CSC have increased qAF values in both eyes with manifest CSC and asymptomatic, clinically unremarkable fellow eyes in comparison with healthy controls. This finding suggests that qAF alterations are present even before clinical signs can be observed.
Topics: Humans; Central Serous Chorioretinopathy; Male; Female; Tomography, Optical Coherence; Prospective Studies; Middle Aged; Fluorescein Angiography; Adult; Visual Acuity; Retinal Pigment Epithelium; Optical Imaging; Fundus Oculi; Ophthalmoscopy; Aged
PubMed: 38147686
DOI: 10.1097/IAE.0000000000004029 -
Diagnostics (Basel, Switzerland) Dec 2023Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. In late-stage AMD, geographic atrophy (GA) of dry AMD or choroidal neovascularization... (Review)
Review
Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. In late-stage AMD, geographic atrophy (GA) of dry AMD or choroidal neovascularization (CNV) of neovascular AMD eventually results in macular atrophy (MA), leading to significant visual loss. Despite the development of innovative therapies, there are currently no established effective treatments for MA. As a result, early detection of MA is critical in identifying later central macular involvement throughout time. Accurate and early diagnosis is achieved through a combination of clinical examination and imaging techniques. Our review of the literature depicts advances in retinal imaging to identify biomarkers of progression and risk factors for late AMD. Imaging methods like fundus photography; dye-based angiography; fundus autofluorescence (FAF); near-infrared reflectance (NIR); optical coherence tomography (OCT); and optical coherence tomography angiography (OCTA) can be used to detect and monitor the progression of retinal atrophy. These evolving diverse imaging modalities optimize detection of pathologic anatomy and measurement of visual function; they may also contribute to the understanding of underlying mechanistic pathways, particularly the underlying MA changes in late AMD.
PubMed: 38132220
DOI: 10.3390/diagnostics13243635 -
Eye (London, England) Apr 2024This study aimed to compare a new Artificial Intelligence (AI) method to conventional mathematical warping in accurately overlaying peripheral retinal vessels from two...
PURPOSE
This study aimed to compare a new Artificial Intelligence (AI) method to conventional mathematical warping in accurately overlaying peripheral retinal vessels from two different imaging devices: confocal scanning laser ophthalmoscope (cSLO) wide-field images and SLO ultra-wide field images.
METHODS
Images were captured using the Heidelberg Spectralis 55-degree field-of-view and Optos ultra-wide field. The conventional mathematical warping was performed using Random Sample Consensus-Sample and Consensus sets (RANSAC-SC). This was compared to an AI alignment algorithm based on a one-way forward registration procedure consisting of full Convolutional Neural Networks (CNNs) with Outlier Rejection (OR CNN), as well as an iterative 3D camera pose optimization process (OR CNN + Distortion Correction [DC]). Images were provided in a checkerboard pattern, and peripheral vessels were graded in four quadrants based on alignment to the adjacent box.
RESULTS
A total of 660 boxes were analysed from 55 eyes. Dice scores were compared between the three methods (RANSAC-SC/OR CNN/OR CNN + DC): 0.3341/0.4665/4784 for fold 1-2 and 0.3315/0.4494/4596 for fold 2-1 in composite images. The images composed using the OR CNN + DC have a median rating of 4 (out of 5) versus 2 using RANSAC-SC. The odds of getting a higher grading level are 4.8 times higher using our OR CNN + DC than RANSAC-SC (p < 0.0001).
CONCLUSION
Peripheral retinal vessel alignment performed better using our AI algorithm than RANSAC-SC. This may help improve co-localizing retinal anatomy and pathology with our algorithm.
Topics: Humans; Artificial Intelligence; Retina; Retinal Vessels; Algorithms; Neural Networks, Computer
PubMed: 38114568
DOI: 10.1038/s41433-023-02868-3 -
Ophthalmic Surgery, Lasers & Imaging... Dec 2023We investigated the additive clinical benefits of a new ultra-widefield (UWF) red-green-blue (RGB) imaging technology. (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVE
We investigated the additive clinical benefits of a new ultra-widefield (UWF) red-green-blue (RGB) imaging technology.
PATIENTS AND METHODS
This was a retrospective, observational, single-center study of 86 consecutive patients (172 eyes). UWF red-green (RG) and RGB images were taken using a new Optos California (Optos Plc). This scanning laser ophthalmoscope uses wavelengths of 635 nm, 532 nm, and 488 nm for the red (R), green (G), and blue laser (B), respectively. The same device can image both in UWF RG and RGB simultaneously.
RESULTS
The new Optos California provides a well-balanced, three-channel color image that is clinically useful in imaging and identifying vitreoretinal, retinal, and chorioretinal pathologies. The combination of the images captured by each laser source produces a final composite image that more accurately reflects the natural colors of the fundus. The addition of blue light provides additional detail to visualize the vitreoretinal interface and superficial retina, both within the posterior pole and in the periphery.
CONCLUSIONS
This new device allows for both RG and RGB imaging of the retina, providing valuable information on the anatomy of the vitreoretinal interface, retina, retinal pigment epithelium, and their abnormalities. Both techniques complement each other and can be useful in daily practice, allowing clinicians to choose the preferred imaging technique depending on specific findings and conditions. .
Topics: Humans; Retina; Retinal Pigment Epithelium; Fundus Oculi; Diagnostic Imaging; Retrospective Studies; Fluorescein Angiography
PubMed: 38113363
DOI: 10.3928/23258160-20231019-03 -
Klinische Monatsblatter Fur... Dec 2023The in vivo characterisation of corneal epithelial tissue morphology is of considerable importance for diagnosis, disease prognosis, and the development of a treatment...
BACKGROUND
The in vivo characterisation of corneal epithelial tissue morphology is of considerable importance for diagnosis, disease prognosis, and the development of a treatment strategy for ocular surface diseases. In contrast to many alternative methods, in vivo corneal confocal microscopy (CCM) not only provides a macroscopic description of the corneal tissue but also allows its visualisation with cellular resolution. However, the translation of CCM from research to clinical practice is significantly limited by the complex and still largely manual operation of available CCM systems. In addition, for cross-sectional images, and analogously to conventional slit lamp microscopy, volume data must be acquired in time-consuming depth scans due to the frontal orientation of the image field in CCM, from which depth slices can subsequently be calculated. The pure acquisition time is already in the range of seconds, and additionally, motion artefacts have to be corrected in a sophisticated way.
MATERIALS AND METHODS
This paper presents the concept and optics simulation of a new imaging technique based on a swept-source laser in combination with special chromatic optics. Here, the laser periodically changes its wavelength and is focused at different depths due to the wavelength-dependent aberration of the chromatic optics.
RESULTS
The optics simulation results promise good optical resolution at a total imaging depth of 145 µm.
CONCLUSION
The long-term goal is cell-resolving in vivo corneal confocal microscopy in real time with differently oriented sectioning directions.
Topics: Humans; Slit Lamp; Cornea; Bowman Membrane; Epithelium, Corneal; Microscopy, Confocal; Lasers
PubMed: 38092004
DOI: 10.1055/a-2184-9382 -
Eye (London, England) Dec 2023
PubMed: 38081937
DOI: 10.1038/s41433-023-02858-5 -
Discovery Medicine Dec 2023This study evaluates the clinical effectiveness of employing direct retinal pigment epithelium (RPE) laser photocoagulation as a technique for achieving chorioretinal...
BACKGROUND
This study evaluates the clinical effectiveness of employing direct retinal pigment epithelium (RPE) laser photocoagulation as a technique for achieving chorioretinal adhesion to effectively seal retinal breaks.
METHODS
A total of 20 eyes from 20 patients were enrolled in the study; all selected eyes exhibited either rhegmatogenous or combined rhegmatogenous-tractional retinal detachment. During vitrectomy, direct RPE laser photocoagulation was executed, employing a power range of 100-150 mW and a duration of 120-200 ms, targeting the peripheries where the edges of each retinal break were anticipated to settle post-reattachment. This treated area's neuroretina thickness was compared to measurements obtained after conventional transretinal laser photocoagulation.
RESULTS
Patients were followed for an average duration of 24 months, with a range of 11-46 months. A visible pigmentary reaction in the ophthalmoscopic examination was evident in the treated regions for all but one eye, where the retinal break was situated amidst myelinated nerve fibers. The study encountered no severe complications, and successful retinal reattachment was achieved in all 20 eyes. The mean best-corrected visual acuity (BCVA) at the final follow-up showed a statistically significant improvement compared to preoperative levels ( < 0.0001). A noteworthy difference in neuroretinal thickness was observed one-month post-surgery between areas treated with direct RPE and those treated with transretinal photocoagulation, measuring 217 μm and 104 μm, respectively.
CONCLUSIONS
Our findings suggest that direct RPE laser photocoagulation is an effective therapeutic intervention for sealing retinal breaks.
Topics: Humans; Retinal Detachment; Retinal Perforations; Retinal Pigment Epithelium; Vitrectomy; Visual Acuity; Laser Coagulation; Lasers; Retrospective Studies
PubMed: 38058064
DOI: 10.24976/Discov.Med.202335179.95 -
BMJ Open Ophthalmology Dec 2023Colour scanning laser ophthalmoscope (cSLO) offers several advantages, including improved image quality and better visualisation of the retinal structures compared with...
OBJECTIVE
Colour scanning laser ophthalmoscope (cSLO) offers several advantages, including improved image quality and better visualisation of the retinal structures compared with colour fundus photograph (CFP). This study aimed to identify whether cSLO could be used to predict systemic arterial stiffness.
METHODS AND ANALYSIS
We retrospectively analysed the data of 54 patients with 103 eyes. In addition to blood pressure and blood data, all patients had cardio-ankle vascular index (CAVI) measurements, as well as images of the fundus acquired using cSLO and CFP. We determined the retinal artery sclerosis (RAS) index from the colour of the retinal artery in cSLO images, the ratio of arterial to venous diameter (A/V ratio), and Scheie's classification in CFP images. The correlation between each parameter and CAVI was examined using Spearman's rank correlation coefficient, and the correlation between Scheie's classification and CAVI was examined using Steel-Dowass tests.
RESULTS
CAVI showed a significant positive correlation with the RAS index (r=0.679, p<0.001) but not with the A/V ratio or Scheie's classification. Multiple regression analysis showed that the RAS index was significantly and independently correlated with CAVI.
CONCLUSION
cSLO is a non-invasive imaging modality that has the potential to accurately and instantaneously detect early systemic arterial stiffness.
Topics: Humans; Arterioles; Retrospective Studies; Vascular Stiffness; Color; Ophthalmoscopes; Lasers
PubMed: 38057107
DOI: 10.1136/bmjophth-2023-001456 -
Frontiers in Medicine 2023Congenital X-linked retinoschisis (XLRS) presents as macular retinoschisis/degeneration in almost all patients and as peripheral retinoschisis in half the patients....
INTRODUCTION
Congenital X-linked retinoschisis (XLRS) presents as macular retinoschisis/degeneration in almost all patients and as peripheral retinoschisis in half the patients. Although the optical coherence tomography (OCT) findings of macular retinoschisis have been well investigated, those of peripheral retinoschisis have rarely been reported. This study aimed to report the ultra-widefield OCT findings of the peripheral retina in patients with XLRS.
METHODS
Medical records of 10 Japanese patients (19 eyes) with clinically and/or genetically diagnosed XLRS were retrospectively reviewed. Funduscopic, electroretinographic, and OCT findings were reviewed and evaluated. Some were also genetically evaluated for the gene.
RESULTS
OCT of the macula revealed schises and/or cystoid changes in the inner nuclear layer (INL) and outer nuclear layer. In contrast, OCT of the peripheral retina revealed schises and/or cystoid changes in the INL in eight eyes (44%), and/or splitting in the ganglion cell layer (GCL) in 10 (56%) of the 18 eyes with clear OCT images. No schisis or cystoid changes were found in the peripheral OCT images of eight eyes (44%). A 16-year-old boy presented with retinal splitting of the GCL and INL of the inferior retina, although he had no ophthalmoscopic peripheral retinoschisis. Genetic examinations were performed on three patients, all of whom had reported missense mutations in the gene.
CONCLUSION
In XLRS, peripheral bullous retinoschisis results from GCL splitting in the retina. One of the 10 patients with XLRS showed intraretinal retinoschisis in the GCL in the inferior periphery, which was unremarkable on ophthalmoscopy (). Although both peripheral bullous retinoschisis and occult retinoschisis showed splitting/cystic changes in the GCL, further studies are needed to determine whether occult retinoschisis progresses to bullous retinoschisis.
PubMed: 38034549
DOI: 10.3389/fmed.2023.1280564 -
BMC Ophthalmology Nov 2023Retinopathy of prematurity (ROP) is a leading cause of blindness in children and an ROP epidemic is predicted this decade in sub-Saharan Africa. With the increasing...
BACKGROUND
Retinopathy of prematurity (ROP) is a leading cause of blindness in children and an ROP epidemic is predicted this decade in sub-Saharan Africa. With the increasing survival rate of preterm babies in Uganda, and no data on ROP prevalence, there is a need to assess the burden of ROP to inform preventive strategies and targeted screening.
METHODS
We conducted a two-center cross-sectional study of preterm (< 37 weeks gestational age) infants from the neonatal units of Kawempe National Referral Hospital (KNRH) and Mulago Specialised Women and Neonatal Hospital (MSWNH) from August 2022 to October 2022. An ophthalmologist examined all participants using an indirect ophthalmoscope with a + 20D convex lens and captured digital images using a Volk iNview™ Fundus Camera. The collected data were entered into Epidata 4.2 and exported to Stata 14.0 for analysis.
RESULTS
331 preterm infants enrolled in this study. The oxygen received was unblended. The mean gestational age was 30.4 ± 2.7 weeks, and the mean birth weight was 1597 ± 509 g. 18/101 (17.8%) were found to have any ROP amongst the preterm infants recruited from MSWNH, 1/230 (0.4%) from KNRH [95% CI] had any stage of ROP (i.e. stage 5). Of these, 8 (42.1%) had stage 2 ROP. Infants with a birth weight below 1500 g were 10 times more likely to have ROP than those among infants with a birth weight more than 1500 g [AOR: 10.07 (2.71-37.44)]. Infants who were not fed exclusively on breast milk had higher odds of having ROP than those exclusively fed on breast milk [AOR: 7.82(1.92-31.82)].
CONCLUSION
6% of preterm infants born in two tertiary hospitals in Uganda were found to have ROP. Lack of exclusive feeding on breast milk and birth weight of less than 1500 g were strong predictors of ROP. The higher prevalence of ROP in MSWNH calls for cautious use of oxygen among preterms. We recommend targeted ROP screening for those at risk.
Topics: Infant; Child; Infant, Newborn; Humans; Female; Infant, Premature; Birth Weight; Retinopathy of Prematurity; Cross-Sectional Studies; Prevalence; Uganda; Gestational Age; Oxygen; Tertiary Care Centers; Referral and Consultation; Risk Factors; Infant, Very Low Birth Weight
PubMed: 37993817
DOI: 10.1186/s12886-023-03195-7