scholarly journals En face image-based classification of diabetic macular edema using swept source optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Atsushi Fujiwara ◽  
Yuki Kanzaki ◽  
Shuhei Kimura ◽  
Mio Hosokawa ◽  
Yusuke Shiode ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Nuclear Layer ◽  
Subretinal Fluid ◽  
Plexiform Layer ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Swept Source ◽  
En Face

AbstractThis retrospective study was performed to classify diabetic macular edema (DME) based on the localization and area of the fluid and to investigate the relationship of the classification with visual acuity (VA). The fluid was visualized using en face optical coherence tomography (OCT) images constructed using swept-source OCT. A total of 128 eyes with DME were included. The retina was segmented into: Segment 1, mainly comprising the inner nuclear layer and outer plexiform layer, including Henle’s fiber layer; and Segment 2, mainly comprising the outer nuclear layer. DME was classified as: foveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 24), parafoveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 25), parafoveal cystoid space at Segment 1 and diffuse fluid at Segment 2 (n = 16), diffuse fluid at both segments (n = 37), and diffuse fluid at both segments with subretinal fluid (n = 26). Eyes with diffuse fluid at Segment 2 showed significantly poorer VA, higher ellipsoid zone disruption rates, and greater central subfield thickness than did those without fluid at Segment 2 (P < 0.001 for all). These results indicate the importance of the localization and area of the fluid for VA in DME.

The prognostic role of optical coherence tomography in diabetic macular edema patients undergoing early dexamethasone implant shift

2021 ◽  
pp. 112067212110195
Author(s):  
Mehmet Murat Uzel ◽  
Eyyup Karahan ◽  
Melek Koroglu Canli ◽  
Cenap Guler
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Nuclear Layer ◽  
Subretinal Fluid ◽  
Fluid Volume ◽  
Optical Coherence ◽  
Characteristic Analysis ◽  
Intravitreal Ranibizumab ◽  
Visual Gain

Purpose: To determine the prognostic characteristics of optical coherence tomography (OCT) parameters by evaluating diabetic macular edema (DME) patients with early dexamethasone (DEX) shift after three doses of intravitreal ranibizumab (RNB) injection. Methods: Fifty-four eyes of 34 patients who had DEX implant after three doses of RNB were included in this retrospective study. Early DEX shift includes patients who received direct DEX implant replacement after three doses of RNB load. Baseline OCT values and factors affecting best corrected visual acuity (BCVA) and central macular thickness (CMT) response were analyzed with logistic regression analyses. Results: The presence of subretinal fluid and hyperreflective spot (HRS) >20 were found to be a negative predictive factor for anatomical response. ( p = 0.009, p = 0.001, respectively) Low initial BCVA creates a positive effect on visual gain.( p = 0.041) Giant outer nuclear layer cysts, completely disrupted inner segment-outer segment and HRS > 20 have a negative effect on visual gain. ( p = 0.025, p = 0.043, p = 0.023, respectively) According to the receiver operating characteristic analysis, the subretinal fluid volume threshold at which >20% reduction in CMT occurs was determined to be 0.85 mm3. (sensitivity 70%, specificity 84% area under the curve 0.817, p = 0.021). Conclusion: The presence of high number of HRS and high subretinal fluid volume at the baseline negatively affect prognosis even in patient groups with early DEX shift.

scholarly journals Stepwise segmentation error correction in optical coherence tomography angiography images of patients with diabetic macular edema

2020 ◽  
Vol 12 ◽  
pp. 251584142094793
Author(s):  
Khalil Ghasemi Falavarjani ◽  
Reza Mirshahi ◽  
Shahriar Ghasemizadeh ◽  
Mahsa Sardarinia
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Plexiform Layer ◽  
Vessel Density ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Density Measurements ◽  
Segmentation Error

Aim: To determine the minimum number of optical coherence tomography B-scan corrections required to provide acceptable vessel density measurements on optical coherence tomography angiography images in eyes with diabetic macular edema. Methods: In this prospective, noninterventional case series, the optical coherence tomography angiography images of eyes with center-involving diabetic macular edema were assessed. Optical coherence tomography angiography imaging was performed using RTVue Avanti spectral-domain optical coherence tomography system with the AngioVue software (V.2017.1.0.151; Optovue, Fremont, CA, USA). Segmentation error was recorded and manually corrected in the inner retinal layers in the central foveal, 100th and 200th optical coherence tomography B-scans. The segmentation error correction was then continued until all optical coherence tomography B-scans in whole en face image were corrected. At each step, the manual correction of each optical coherence tomography B-scan was propagated to whole image. The vessel density and retinal thickness were recorded at baseline and after each optical coherence tomography B-scan correction. Results: A total of 36 eyes of 26 patients were included. To achieve full segmentation error correction in whole en face image, an average of 1.72 ± 1.81 and 5.57 ± 3.87 B-scans was corrected in inner plexiform layer and outer plexiform layer, respectively. The change in the vessel density measurements after complete segmentation error correction was statistically significant after inner plexiform layer correction. However, no statistically significant change in vessel density was found after manual correction of the outer plexiform layer. The vessel density measurements were statistically significantly different after single central foveal B-scan correction of inner plexiform layer compared with the baseline measurements ( p = 0.03); however, it remained unchanged after further segmentation corrections of inner plexiform layer. Conclusion: Multiple optical coherence tomography B-scans should be manually corrected to address segmentation error in whole images of en face optical coherence tomography angiography in eyes with diabetic macular edema. Correction of central foveal B-scan provides the most significant change in vessel density measurements in eyes with diabetic macular edema.

scholarly journals A Swept source optical coherence tomography angiography study: Imaging artifacts and comparison of non-perfusion areas with fluorescein angiography in diabetic macular edema

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249918
Author(s):  
Dominika Podkowinski ◽  
Sophie Beka ◽  
Anna-Sophie Mursch-Edlmayr ◽  
Rupert W. Strauss ◽  
Lukas Fischer ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Mean Size ◽  
The Mean ◽  
Imaging Artifacts

Purpose Swept Source Optical coherence tomography angiography (SS-OCTA) is a novel technique to visualize perfusion and vascular changes like ischemia in patients with diabetic retinopathy. The aim of this study was to compare non-perfusion areas on conventional fluorescein angiography (FA) with those on SS-OCTA using detailed manual annotation in patients with diabetic macular edema (DME) and to evaluate possible artifacts caused by DME on SS-OCTA. Methods 27 eyes of 21 patients with DME were analyzed in this prospective, cross-sectional study; on all, standard ophthalmological examination, SS-OCTA and FA imaging were performed. Early-phase FA and SS-OCTA images were analyzed for capillary dropout and foveal avascular zone (FAZ) was measured on both modalities. Artifacts in SS-OCTA imaging caused by DME were marked and analyzed. Results The mean age of the patients was 62.6 ± 11.5 years. On FA the mean size of the annotated non-perfusion areas was 0.14 ± 0.31 mm2 whereas the mean size in SS-OCTA was 0.04 ± 0.13 mm2; areas marked on FA were statistically significantly larger than on SS-OCTA (p<0.01). Mean size of FAZs was similar between FA and OCTA images. (p = 0.91). Seven eyes (25.9 percent) showed imaging artifacts due to DME in SS-OCTA. Conclusion SS-OCTA is a valid tool to analyze capillary perfusion status of patients with DME, although areas of non-perfusion were measured smaller than in conventional FA. More non-perfusion areas were found on SS-OCTA images. FAZ measurements were similar using the two modalities. However, SS-OCTA is prone to artifacts and therefore requires reviewing of imaging results: up to 25 percent of the analyzed eyes showed artifacts on OCTA, which occurred in the areas of diabetic macular edema and did not correspond to capillary drop out.

scholarly journals Changes in entropy on polarized-sensitive optical coherence tomography images after therapeutic subthreshold micropulse laser for diabetic macular edema: A pilot study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257000
Author(s):  
Koji Ueda ◽  
Tomoyasu Shiraya ◽  
Fumiyuki Araki ◽  
Yohei Hashimoto ◽  
Motoshi Yamamoto ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Unit Area ◽  
Retinal Pigment ◽  
Healing Process ◽  
Optical Coherence ◽  
Micropulse Laser ◽  
En Face ◽  
Subthreshold Micropulse Laser

Purpose To investigate the dynamics of the healing process after therapeutic subthreshold micropulse laser (SMPL) for diabetic macular edema (DME) using polarization-sensitive optical coherence tomography (PS-OCT). Methods Patients with treatment-native or previously-treated DME were prospectively imaged using PS-OCT at baseline, 1, 2, 3, and 6 months. The following outcomes were evaluated: changes in the entropy value per unit area (pixel2) in the retinal pigment epithelium (RPE) on the B-scan image; changes in the entropy value in each stratified layer (retina, RPE, choroid) based on the ETDRS grid circle overlaid with en face entropy mapping, not only the whole ETDRS grid area but also a sector irradiated by the SMPL; and the relationship between edema reduction and entropy changes. Results A total of 11 eyes of 11 consecutive DME patients were enrolled. No visible signs of SMPL treatment were detected on PS-OCT images. The entropy value per unit area (pixel2) in the RPE tended to decrease at 3 and 6 months from baseline (35.8 ± 17.0 vs 26.1 ± 9.8, P = 0.14; vs 28.2 ± 18.3, P = 0.14). Based on the en face entropy mapping, the overall entropy value did not change in each layer in the whole ETDRS grid; however, decrease of entropy in the RPE was observed at 2, 3, and 6 months post-treatment within the SMPL-irradiated sectors (P < 0.01, each). There was a positive correlation between the change rate of retinal thickness and that of entropy in the RPE within the SMPL-irradiated sector at 6 months (r2 = 0.19, P = 0.039). Conclusion Entropy measured using PS-OCT may be a new parameter that facilitates objective monitoring of SMPL-induced functional changes in the RPE that could not previously be assessed directly. This may contribute to a more promising therapeutic evaluation of DME. Clinical trial This clinical study was registered in UMIN-CTR (ID: UMIN000042420).

COMPARISON OF GANGLION CELL INNER PLEXIFORM LAYER THICKNESS BY CIRRUS AND SPECTRALIS OPTICAL COHERENCE TOMOGRAPHY IN DIABETIC MACULAR EDEMA

Retina ◽  
2018 ◽  
Vol 38 (4) ◽  
pp. 820-827 ◽  
Author(s):  
Julia Hafner ◽  
Sonja Prager ◽  
Jan Lammer ◽  
Katharina Kriechbaum ◽  
Christoph Scholda ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Ganglion Cell ◽  
Macular Edema ◽  
Layer Thickness ◽  
Diabetic Macular Edema ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Optical Coherence

scholarly journals COVID-19: More than a Respiratory Virus, An Optical Coherence Tomography Study

2021 ◽  
Author(s):  
ESRA DAG SEKER ◽  
Elif Inci ERBAHCECI TIMUR
Keyword(s):  
Optical Coherence Tomography ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Control Group ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Ocular Pain ◽  
Fiber Layer ◽  
Retinal Layers ◽  
Sd Oct

Abstract Purpose: The purpose of this study is to investigate anatomic and morphologic features of inner and outer retinal layers in patients recovered from COVID-19 with Spectral Domain Optical Coherence Tomography (SD-OCT), whwther correlate with any symptoms during disease process.Methods: 32 patients recovered from COVID-19; age and gender matched 36 healthy controls were included in this cross-sectional study. Ganglion cell-inner plexiform layer, macular and periapiller retinal nerve fiber layer (RNFL), inner nuclear layer (INL), outer nuclear layer (ONL), outer plexiform layer (OPL) and the outer retinal hyperreflective bands including external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) were examined with SD-OCT. The differences of each retinal layers thickness among subgroup analysis of ocular pain and headache were also compared. Results: Macular RNFL of inner and outer nasal and outer inferior quadrants were thinner in COVID-19 patients compared to healthy control group. (p=0.046, p=0.014 and p=0.016, respectively). Thinning in outer superior quadrant of GCIPL and INL quadrants were detected in patients with headache (p=0.026 and p=0.01). Superonasal and inferotemporal sectors of pRNFL were thinner in patients with ocular pain compared to patients without ocular pain (p=0.024 an p=0.015). Integrity of EZ, ELM and IZ were evaluated as continious line and protected on each OCT scans. Conclusion: The study demostrated convincing evidence that SARS-CoV-2 can affect the inner and outer retinal layers, with subclinical localized alterations particularly in patients with headache and ocular pain symptoms during COVID-19 period.

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