scholarly journals Optical coherence tomography angiography for the detection of macular neovascularization—comparison of en face versus cross-sectional view

Eye ◽  
2022 ◽  
Author(s):  
Robert Siggel ◽  
Christel Spital ◽  
Anna Lentzsch ◽  
Sandra Liakopoulos
Keyword(s):  
Optical Coherence Tomography ◽  
Sensitivity And Specificity ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Face Images ◽  
En Face ◽  
En Face Imaging ◽  
Subretinal Hyperreflective Material

Abstract Purpose To evaluate sensitivity and specificity of swept source-optical coherence tomography angiography (SS-OCTA) en face images versus cross-sectional OCTA versus a combination of both for the detection of macular neovascularization (MNV). Design Prospective cohort study. Participants Consecutive patients with various chorioretinal diseases and subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye. Methods 102 eyes of 63 patients with fluorescein angiography (FA), OCT and SS-OCTA performed on the same day were included. FA images, the outer retina to choriocapillaris (ORCC) OCTA en face slab, a manually modified en face slab (‘custom slab’), cross-sectional OCTA and a combination of OCTA en face and cross-section were evaluated for presence of MNV. Main outcome measures Sensitivity and specificity for MNV detection, as well as the concordance was calculated using FA as the reference. Results OCTA en face imaging alone yielded a sensitivity of 46.3% (automated)/78.1% (custom) and specificity of 93.4% (automated)/88.5% (custom) for MNV detection. Cross-sectional OCTA (combination with en face) resulted in a sensitivity of 85.4% (82.9%) and specificity of 82.0% (85.3%). Concordance to FA was moderate for automated en face OCTA (κ = 0.43), and substantial for custom en face OCTA (κ = 0.67), cross-sectional OCTA (κ = 0.66) and the combination (κ = 0.68). Conclusion Segmentation errors result in decreased sensitivity for MNV detection on automatically generated OCTA en face images. Cross-sectional OCTA allows detection of MNV without manual modification of segmentation lines and should be used for evaluation of MNV on OCTA.

scholarly journals Comparison of swept-source versus spectral-domain optical coherence tomography angiography for detection of macular neovascularization

2021 ◽  
Author(s):  
Anna Lentzsch ◽  
Laura Schöllhorn ◽  
Christel Schnorr ◽  
Robert Siggel ◽  
Sandra Liakopoulos
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
En Face ◽  
Increased Sensitivity ◽  
Sensitivity Specificity ◽  
Subretinal Hyperreflective Material

Abstract Purpose To compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV). Methods In this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA. Results Sensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices. Conclusion Both devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.

scholarly journals Tethered capsule en face optical coherence tomography for imaging Barrett’s oesophagus in unsedated patients

2020 ◽  
Vol 7 (1) ◽  
pp. e000444
Author(s):  
Kaicheng Liang ◽  
Osman O Ahsen ◽  
Annalee Murphy ◽  
Jason Zhang ◽  
Tan H Nguyen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Lower Oesophageal Sphincter ◽  
Barrett’S Oesophagus ◽  
Optical Coherence ◽  
Sampling Errors ◽  
Cross Sectional ◽  
Swept Source ◽  
Barrett's Oesophagus ◽  
Face Images ◽  
En Face

ObjectiveBarrett’s oesophagus (BE) screening outside the endoscopy suite can identify patients for surveillance and reduce mortality. Tethered capsule optical coherence tomography (OCT) can volumetrically image oesophageal mucosa in unsedated patients and detect features of BE. We investigated ultrahigh-speed tethered capsule swept-source OCT (SS-OCT), improved device design, developed procedural techniques and measured capsule contact, longitudinal pullback non-uniformity and patient toleration.DesignOCT was performed in 16 patients prior to endoscopic surveillance/treatment. Unsedated patients swallowed the capsule with sips of water and the tether was pulled back to image the oesophagus. SS-OCT at 1 000 000 A-scans/s enabled imaging 10 cm oesophageal lengths in 10 s with 30 µm transverse and 8 µm axial resolution. Capsule contact, longitudinal image coverage and patient toleration were assessed.ResultsNine patients had non-dysplastic BE, three had ablative treatment-naïve neoplasia and four had prior ablation for dysplasia. Dry swallows facilitated capsule transit through the lower oesophageal sphincter (LES), and waiting 10 s before pullback reduced swallow induced LES relaxation. Slow nasal inhalation facilitated capsule retrieval and minimised gag reflex. The procedure was well tolerated. Ultrahigh-speed SS-OCT generated cross-sectional and subsurface en face images showing BE features, while subsurface en face images were required to assess the gastro-oesophageal junction. Candidate features of dysplasia were also identified which could inform follow-up endoscopy/biopsy. BE features were seen in all patients with histologically confirmed BE. Mean capsule contact over BE was 75%±27% for all patients and better in short segment BE. Mean longitudinal image coverage over BE was 59%±34% and better for long segment BE.ConclusionsUltrahigh-speed tethered capsule SS-OCT can image en face and cross-sectional mucosal features over wide areas. Device and procedure optimisation improved performance. BE features could be identified in all patients, but limited capsule contact and longitudinal coverage could cause sampling errors for focal pathologies.

scholarly journals Correlations among age, sex, axial length, and subfoveal choroidal thickness in the choriocapillaris structure analyzed using multiple en face image averaging optical coherence tomography angiography

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259880
Author(s):  
Ai Ichioka ◽  
Sotaro Ooto ◽  
Akihito Uji ◽  
Saki Manabe ◽  
Chieko Shiragami ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Axial Length ◽  
Choroidal Thickness ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Face Images ◽  
En Face ◽  
Flow Void ◽  
The Mean

Purpose To analyze the structure of the choriocapillaris in healthy eyes by using averaged en face images acquired using swept source optical coherence tomography angiography and to examine the changes in the macular profile in relation to age, sex, axial length, and choroidal thickness. Methods This prospective, cross-sectional study included 81 eyes of 81 subjects without ophthalmologic or systemic diseases who underwent a full ophthalmologic examination, including 3 × 3-mm macular optical coherence tomography angiography. Four to nine choriocapillaris en face images were registered and averaged. The averaged images were then binarized and analyzed. Results The averaged choriocapillaris images showed a continuous capillary meshwork, whereas the unaveraged images had a granular appearance. The mean total area and size of flow voids were 0.99 ± 0.20 mm2 and 567.8 ± 201.5 μm2, respectively, and these values correlated positively with age (p = 0.002, R = 0.336 and p = 0.026, R = 0.247, respectively). Age-related gains in the mean total area and flow void size were 4.20 × 10−3 mm2 and 3.07 μm2 per year, respectively. However, the mean total area and flow void size had no significant correlation with axial length, subfoveal choroidal thickness, or sex. Conclusions Multiple averaged en face swept source optical coherence tomography angiography is more effective than a single optical coherence tomography angiography scan for better visualizing the choriocapillaris. The total area and size of flow voids within a 3 × 3-mm macular area positively correlated with age. This technique can be useful for investigating the changes arising in macular diseases.

scholarly journals Choroidal vessel density in unilateral hyperopic amblyopia using en-face optical coherence tomography

2020 ◽  
Author(s):  
Syunsuke Araki ◽  
Atsushi Miki ◽  
Katsutoshi Goto ◽  
Tsutomu Yamashita ◽  
Tsuyoshi Yoneda ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Normal Control ◽  
Structural Changes ◽  
Vascular Density ◽  
Optical Coherence ◽  
Swept Source ◽  
3 Dimensional ◽  
Face Images ◽  
En Face ◽  
Normal Controls

Abstract Background Structural changes of the choroid, such as choroidal thickening, have been indicated in amblyopic eyes with hyperopic anisometropia as compared to fellow or healthy eyes. The purpose of the present study was to investigate choroidal vascular density (CVD) in children with unilateral hyperopic amblyopia.Methods This study included 88 eyes of 44 patients with unilateral amblyopia due to hyperopic anisometropia with or without strabismus and 29 eyes of 29 age-matched normal controls. The CVD of Haller's layer was quantified from en-face images constructed by 3-dimensional swept-source optical coherence tomography images flattened relative to Bruch's membrane. The analysis area was a 3×3-mm square of macula after magnification correction. Relationships between CVD and other parameters [best-corrected visual acuity (BCVA), refractive error and subfoveal choroidal thickness (SFCT)] were investigated, and CVDs were compared between amblyopic, fellow, and normal control eyes.Results Mean CVD was 59.11 ± 0.66% in amblyopic eyes, 59.23 ± 0.81% in fellow eyes, and 59.29 ± 0.74% in normal control eyes. CVD showed a significant positive relationship with SFCT (p=0.004), but no relationships with other parameters. No significant differences in CVD were evident among amblyopic, fellow, and normal control eyes after adjusting for SFCT (p=0.502).Conclusions CVD was unrelated to BCVA, and CVD did not differ significantly among amblyopic, fellow and normal control eyes. These results suggest that the local CVD of Haller's layer is unaffected in unilateral hyperopic amblyopic eyes.

Topographic Analysis of Short Posterior Ciliary Arteries Using Wide-Field Swept-Source En-Face Optical Coherence Tomography

2021 ◽  
Author(s):  
Raphael Lejoyeux ◽  
Raphael Atia ◽  
Kiran Vupparaboina ◽  
Mohamed Ibrahim ◽  
Jose-Alain Sahel ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Posterior Pole ◽  
Wide Field ◽  
Temporal Part ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Topographic Analysis ◽  
En Face ◽  
Ciliary Arteries

Abstract Purpose: To study the topographic distribution of the short posterior ciliary arteries (SPCA) entry sites into the choroid in normal eyes using structural en-face swept source optical coherence tomography (SS-OCT). Methods: Retrospective analysis of SS-OCT scans (wide-field structural SS-OCT 12x12mm) of 13 healthy subjects was performed. Cross-sectional swept-source OCT scans derived from a volume scan were represented as en-face image display following the Choroid-Scleral Interface to obtain en-face OCT. SPCAs in their last scleral location before choroidal entrance were identified manually, counted and localized by two masked observers. Correlations between two masked observers were analyzed using inter- and intra- class correlation. Results: Accuracy for the choroidal inner and outer border segmentation was 95-99%. Eighteen eyes from 13 normal subjects were included for SPCA analysis. The mean number of arteries was 13.8±3.5 per eye. Thirty-six percent were in the center of the posterior pole image; however, 21% were in the temporal part of the posterior pole. Median accuracy of the detection is 0.94. The correlation between the two observers was fair (0.54).Conclusion: Our algorithm allows visualization of the SPCA at the posterior pole of the eye using wide-field en-face SS-OCT. It can also help the clinicians to study the SPCAs in numerous ocular diseases, particularly its relationship with focal choroidal diseases.

scholarly journals Swept Source Optical Coherence Tomography Assessment of Bursa Premacularis in Healthy Eyes

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Paolo Carpineto ◽  
Rossella D’Aloisio ◽  
Daniele Guarini ◽  
Carla Iafigliola ◽  
Luca Cerino ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraclass Correlation ◽  
Optical Coherence ◽  
High Definition ◽  
Swept Source ◽  
Visualization Software ◽  
En Face ◽  
Bursa Premacularis ◽  
Youth Population ◽  
En Face Imaging

Purpose. To describe the reliability and the limits of bursa premacularis (BPM) evaluation using a swept source optical coherence tomography (SS-OCT) device with enface and 16 mm-high definition (HD) longitudinal scans. Methods. 60 eyes of 60 subjects were enrolled and imaged with SS-OCT system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). BPM area was measured using enface scans imported to ImageJ. HD horizontal and vertical longitudinal scans centered at the fovea were used to detect width (W) and central thickness (CT) of BPM at baseline (T0) and after 30 minutes (T30) performed by two different observers. An enhanced vitreous visualization software provided by the manufacturer of the device was used to highlight vitreous structures. Results. BPM was identifiable in 100% of eyes using both horizontal and vertical longitudinal scans. On horizontal scan, BPM was not entirely measurable in 21.7% and in 18.3% of cases at T0 and T30, respectively. On vertical scan, BPM was not entirely measurable in 75.0% and in 81.7% at T0 and T30, respectively. No statistically significant differences were found between the two different time measurements with an intraclass correlation coefficient above 70%. Median BPM area was 26.9 (Q1-Q3: 19.5-40.5) mm2. In en face imaging, the most frequent BPM shape was the boat one. Conclusion. SS-OCT is a reliable tool for a detailed quantification and mapping of BPM, and it is able to add useful details about the morphological BPM features in youth population. However, the enhanced visualization of the vitreous structures is still a challenge, also with the most forefront devices.

scholarly journals Comparison of two different optical coherence tomography angiography devices in detecting healthy versus glaucomatous eyes – an observational cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. R. Kee ◽  
V. C. H. Yip ◽  
E. L. T. Tay ◽  
C. W. Lim ◽  
J. Cheng ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diagnostic Accuracy ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Retest Reliability ◽  
Significant Difference ◽  
Test Retest Reliability

Abstract Background To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability. Methods A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated. Results A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761–1.000) compared to Swept Source (0.113–0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source. Conclusions AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.

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