Swept-source optical coherence tomography angiography in serpiginous choroiditis

2017 ◽  
Vol 102 (7) ◽  
pp. 991-995 ◽  
Author(s):  
Daniela Montorio ◽  
Chiara Giuffrè ◽  
Elisabetta Miserocchi ◽  
Giulio Modorati ◽  
Riccardo Sacconi ◽  
...  

Background/AimsTo analyse choroidal vascular density of affected and non-affected areas in active and inactive serpiginouschoroiditis (SC) by means of optical coherence tomography angiography (OCT-A).MethodsIn this cross-sectional and observational study, 22 eyes of 11 patients diagnosed with SC were included. All patients underwent blue-light fundus autofluorescence (spectralis Heidelberg retinalangiography+OCT) and swept-source OCT-A (AngioPlex Elite 9000 SS-OCT, Carl Zeiss Meditech) to analyse qualitative features and choroidal vessel density of areas considered affected, and the inner and the outer border of the lesions. Unaffected areas of otherwise healthy retina have also been studied.ResultsAll inactive inflammatory lesions were characterised by atrophy of choriocapillaris with an impairment of its detectable flow and greater visibility of choroidal vessels. On the other hand, all active inflammatory lesions showed an area of complete absence of decorrelation signal. The pathological border was characterised by a statistically significant lower choroidal vessel density compared with both the outer border and the unaffected area (0.650±0.113 vs 0.698±0.112, (p<0.001)). Although not statistically significant, vessel density of the outer border of inactive lesions was lower than vessel density of unaffected areas (0.650±0.113 vs 0.698±0.112, p=0.441). Active inflammatory lesions showed an area of complete absence of decorrelation signal at the level of the choriocapillaris and whole choroid.ConclusionOCT-A represents a new imaging technique that provides useful information about the leading changes of choroidal vascular network in active and inactive lesions of SC.

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Youxin Chen

The aim of this study was to compare the repeatability of optical coherence tomography angiography (OCT-A) measurements of macular vessel density using four OCT-A systems, including Heidelberg Spectralis HRA, Optovue RTVue XR, Zeiss Cirrus HD-OCT 5000, and Topcon DRI OCT Triton. A cross-sectional design was used for this study. The vascular density and vascular length density of the superficial and deep retinal capillary plexuses were imaged with OCT-A using 3 mm and 6 mm scan patterns and were calculated using ImageJ. Comparisons of intraclass correlation coefficients (ICC) were conducted. We found that the OCT-A systems had various levels of repeatability. Zeiss had better repeatability for vessel density than the other systems (overall ICC = 0.936). Optovue had better repeatability for vessel length density when the 6 mm scan pattern was used (ICC = 0.680 and 0.700 for retinal superficial and deep capillary plexus, respectively). We concluded that repeatability varied when different scan patterns of various OCT-A systems were used for imaging the superficial retinal and deep capillary plexuses. Results should be seen as valid only for a given method. The repeatability of various OCT-A systems should be considered in clinical practice and in clinical trials that use OCT-A metrics as outcome measures.


2020 ◽  
pp. bjophthalmol-2020-316930
Author(s):  
Marcus Ang ◽  
Kavya Devarajan ◽  
Anna CS Tan ◽  
Mengyuan Ke ◽  
Bingyao Tan ◽  
...  

PurposeTo compare anterior segment optical coherence tomography angiography (AS-OCTA) systems in delineating normal iris vessels and iris neovascularisation (NVI) in eyes with pigmented irides.MethodsProspective study from January 2019 to June 2019 of 10 consecutive patients with normal pigmented iris, had AS-OCTA scans with a described illumination technique, before using the same protocol in five eyes with NVI (clinical stages 1–3). All scans were sequentially performed using a spectral-domain OCTA (SD-OCTA), and a swept-source OCTA (SS-OCTA, Plex Elite 9000). Images were graded by two masked observers for visibility, artefacts and NVI characteristics. The main outcome measure was iris vessel density measurements comparing SS-OCTA and SD-OCTA systems.ResultsThe median age of subjects was 28 (20–35) years, and 50% were female. The paired mean difference of iris vessel density measurements was 11.7 (95% CI 14.7 to 8.1; p=0.002), SS-OCTA detecting more vessels than SD-OCTA. The inter-rater reliability for artefact score (κ=0.799, p<0.001) and visibility score (κ=0.722; p<0.001) were substantial. Both AS-OCTA systems were able to detect NVI vessels with a fair agreement (κ=0.588), with clearer NVI characteristics in stage 1/2 compared to stage 3 NVI (mean difference NVI score: 2.7±0.4, p=0.009).ConclusionThe SS-OCTA was better able to delineate iris vessels in normal pigmented irides compared to SD-OCTA. Both AS-OCTA systems identified NVI characteristics based on its atypical configuration or location, but further improvements are needed to allow for more accurate objective, serial quantification for clinical use.


2019 ◽  
Vol 30 (4) ◽  
pp. 756-763 ◽  
Author(s):  
José Ignacio Fernández-Vigo ◽  
Bachar Kudsieh ◽  
Ana Macarro-Merino ◽  
Pedro Arriola-Villalobos ◽  
José María Martínez-de-la-Casa ◽  
...  

Purpose: To assess the reproducibility of swept-source optical coherence tomography angiography (SS-OCTA) for macular and optic nerve head (ONH) vessel density (VD). Methods: Cross-sectional study using the Triton OCTA (Topcon, Tokyo, Japan), for VD (%) measurements in 40 eyes of 40 healthy subjects on two 6 × 6 mm scans of the macula and ONH across five subfields (central, superior, inferior, temporal, and nasal) at different segmentation levels: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris. Reproducibility values were summarized as intraclass correlation coefficients (ICCs) and coefficients of variations (CV). Results: ICCs for the macular VD measurements in the central zone were 0.874, 0.770, 0.575, 0.718 at the levels SCP, DCP, outer retina, and choriocapillaris, respectively, while worse ICCs were obtained for the parafoveal subfields (ICC ⩽ 0.589); CVs were 2.8%–6.7%. The reproducibility of the ONH superficial VD was ICC = 0.941 for the papillary region and was ICC = 0.499–0.853 for the peripapillary zone; CVs ranged from 4.8% to 17%. Peripapillary VD showed an ICC = 0.533–0.770 in the DCP layer, and 0.572–0.828 in the choriocapillaris. Lowest VD were obtained for the macular SCP and DCP (23% and 22%, respectively), in the foveal zone, while greatest VD were recorded in the nasal and temporal peripapillary subfields at the level of the choriocapillaris (both 68%). Conclusions: The new SS-OCTA software served to quantify macular and ONH VD with a reproducibility that was good in the central zones (foveal and papillary, respectively) and moderate in the peripheral zones (parafoveal and peripapillary).


2021 ◽  
pp. bjophthalmol-2021-318847
Author(s):  
Marcus Ang ◽  
Valencia Foo ◽  
Mengyuan Ke ◽  
Bingyao Tan ◽  
Louis Tong ◽  
...  

PurposeTo study the role of two anterior segment optical coherence tomography angiography (AS-OCTA) systems in eyes with acute chemical injury.MethodsProspective study in subjects with unilateral chemical injuries. Sequential slit-lamp assessment with spectral domain (SD) (AngioVue, Optovue, USA) and swept source (SS) (Plex Elite, Zeiss, Carl Zeiss Meditec, Dublin, California, USA) AS-OCTA was performed in both eyes within 24–48 hours of injury. Subjects were managed with a standard clinical protocol and followed-up for 3 months. We assessed limbal disruption (loss of normal limbal vessel architecture), limbal vessel density measurements and agreement (kappa coefficient, κ) between masked assessors of limbal disruption based on AS-OCTA scans and slit-lamp assessment.ResultsTen subjects with median age 31 (25–33) years, 20% women, 60% suffered alkali injuries (Roper-Hall grade 1.5±0.7, Dua grade 2.3±1.2) at presentation. Mean limbal vessel density was lower in quadrants of affected eyes compared with controls detected by SD AS-OCTA (9.4%±2.0% vs 15.5%±1.8%, p<0.001) and SS AS-OCTA (8.8%±2.5% vs 13.9%±1.3%, p=0.01). There was substantial agreement when assessing limbal disruption on AS-OCTA (κ=0.7) compared with slit-lamp evaluation (κ=0.4). Overall, we found good agreement between SD and SS AS-OCTA systems in assessing limbal vessel density in eyes with chemical injury at presentation (mean paired difference: −1.08, 95% CI −3.2 to 0.5; p=0.189).ConclusionsIn this pilot study, AS-OCTA provided objective, non-contact, rapid assessment of limbal vasculature involvement in eyes with acute chemical injury. Further studies are required to establish the role of AS-OCTA in determining the prognosis of eyes with chemical injury.


2019 ◽  
Vol 8 (10) ◽  
pp. 1515 ◽  
Author(s):  
Díez-Sotelo ◽  
Díaz ◽  
Abraldes ◽  
Gómez-Ulla ◽  
Penedo ◽  
...  

The assessment of vascular biomarkers and their correlation with visual acuity is one of the most important issues in the diagnosis and follow-up of retinal vein occlusions (RVOs). The high workloads of clinical practice make it necessary to have a fast, objective, and automatic method to analyze image features and correlate them with visual function. The aim of this study is to propose a fully automatic system which is capable of estimating visual acuity (VA) in RVO eyes, based only on information obtained from macular optical coherence tomography angiography (OCTA) images. We also propose an automatic methodology to rapidly measure the foveal avascular zone (FAZ) area and the vascular density (VD) in the superficial and deep capillary plexuses in swept-source OCTA images centered on the fovea. The proposed methodology is validated using a representative sample of 133 visits of 50 RVO patients. Our methodology estimates VA with very high precision and is even more accurate when we integrate depth information, providing a high correlation index of 0.869 with the real VA, which outperforms the correlation index of 0.855 obtained when estimating VA from the data obtained by the semiautomatic existing method. In conclusion, the proposed method is the first computational system able to estimate VA in RVO, with the additional benefits of being automatic, less time-consuming, objective and more accurate. Furthermore, the proposed method is able to integrate depth information, a feature which is lacking in the existing method.


2018 ◽  
Vol 103 (3) ◽  
pp. 410-414 ◽  
Author(s):  
Giuseppe Casalino ◽  
Alessandro Arrigo ◽  
Francesco Romano ◽  
Marion R Munk ◽  
Francesco Bandello ◽  
...  

AimTo describe the optical coherence tomography angiography (OCT-A) features of patients affected by acute macular neuroretinopathy (AMN).Methods This is a prospective, observational, cross-sectional study. Multimodal imaging, including spectral domain OCT (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany) and 6×6 mm swept source OCT-A (ZEISS PLEX Elite 9000; ZEISS, Dublin, California), was performed on all patients. The primary outcome measure was assessment of the vascular alterations of the superficial (SCP) and deep (DCP) capillary plexuses and choriocapillaris (CC). A segmentation of the AMN lesions using enface OCT images of photoreceptors-retinal pigment epithelium complex was used to discriminate intralesional and extralesional regions on the OCT-A enface slabs of the DCP and CC reconstructions. Each OCT-A slab was imported into ImageJ V.1.50 and digitally binarised for quantitative analyses.ResultsOverall, seven patients (mean age 19.4±3.2 years, six women) affected by AMN were included. The mean best-corrected visual acuity was 0.00±0.00 logarithm of the minimum angle of resolution. Twelve healthy age-matched subjects (mean age 22±3.4 years, 10 women) represented the control group. The quantitative analysis of global vessel densities showed that the CC vessel density was significantly lower in patients with AMN (0.495±0.03) compared with the age-matched controls (0.545±0.02) (corrected p=0.0003). The intralesional vessel density of the DCP was 0.349±0.04 in AMN and vs 0.497±0.02 in the controls (corrected p=0.0002).ConclusionsOur study confirmed inner choroidal vascular flow void as a possible pathogenetic mechanism of AMN. We also found a focal impairment of the DCP within the AMN lesions. Future studies are needed to clarify which is the primary location of the vascular insult in this condition.


2021 ◽  
Vol 13 (1) ◽  
pp. 165-170
Author(s):  
Punita Kumari Sodhi ◽  
Anu Sharma ◽  
Nasiq Hasan

Introduction: The retinal changes following scleral buckling surgery (SBS) for rhegmatogenous retinal detachment (RRD) have been rarely evaluated with optical coherence tomography angiography (OCTA). Methods: A 40 years old male presented with subtotal RD involving the macula and had best corrected visual acuity of logmar 2.3 in the affected right eye. Five months after applying 120 degree scleral buckle, swept source optical coherence tomography (SSOCT) and swept source optical coherence tomography angiography (SS-OCTA) were done.   Result: At five months post-surgery, despite a settled retina in the operated eye, the patient had  vision of logmar 1 and thin retinal nerve fibre layer (115 micrometer). The SSOCT showed  inner segment-outer segment (IS-OS) junction disruption, thinned retinal pigment epithelium, central macular thickness of 275 micrometer and subfoveal choroidal thickness of 222 micrometer. A 3x3 mm macular OCTA scan showed a normal foveal avascular zone along with higher values for vascular density in superficial capillary plexus in all quadrants except temporal quadrant in operated eye as compared to fellow eye.  Conclusion: The SBS with 120 degree buckle did not lead to a reduced vascular density in superficial capillary plexus in the operated eye with respect to fellow eye. 


2020 ◽  
Vol 63 (6) ◽  
pp. 572-579
Author(s):  
Nina Teresa Aicher ◽  
Katsuya Nagahori ◽  
Makoto Inoue ◽  
Yuji Itoh ◽  
Akito Hirakata

<b><i>Objective:</i></b> To determine the vascular density of the anterior segment (AS) of the eye from optical coherence tomography angiography (OCTA) images and slit-lamp photographs. <b><i>Methods:</i></b> A swept-source OCTA (Plex Elite 9000; Carl Zeiss) device modified with a +10-diopter lens was used to record the vasculature of the AS. Twenty eyes, including 4 eyes of 4 healthy subjects and 16 eyes of 12 patients scheduled for cataract surgery or combined vitrectomy and cataract surgery, were studied. The slit-lamp photographs of the AS were acquired concurrently with the AS-OCTA images. The vascular density was measured preoperatively and postoperatively in the nasal, temporal, superior, and inferior quadrants after binarization with ImageJ software. <b><i>Results:</i></b> Acceptable AS-OCTA images were obtained of 65% (superior), 80% (nasal), 70% (inferior), and 80% (temporal) of the eyes. The percentage of acceptable images was significantly lower in the superior quadrant among the AS-OCTA images than among the AS photographs (100%; <i>p</i> = 0.004). The vascular density determined by AS-OCTA was higher than that determined in the AS photographs in all quadrants (<i>p</i> = 0.011 to &#x3c;0.001). The AS-OCTA B-mode images showed that vascular flow was identified mainly between the conjunctiva and sclera but not in the ciliary body. The vascular density increased significantly after cataract surgery in the superior quadrant, which was significantly correlated with the location of the surgical incision (<i>p</i> = 0.03). <b><i>Conclusion:</i></b> AS-OCTA can obtain images with higher vascular density of the conjunctiva and sclera than slit-lamp photographs, and AS-OCTA images can show a postoperative increase in vascular density.


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