Quantifying vascular density and morphology using different swept-source optical coherence tomography angiographic scan patterns in diabetic retinopathy

AimsTo evaluate quantitative metrics of the retinal microvasculature in eyes with diabetic retinopathy (DR) using various en face swept-source optical coherence tomography angiography (SS-OCTA) image sizes.MethodsNon-segmented and segmented images were acquired using an SS-OCTA device (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, California, USA). The scanning protocols included the 3×3 mm, 6×6 mm and 12×12 mm fields of view. Quantitative analysis of the perfusion density (PD), vessel length density (VLD) and fractal dimension (FD) was performed. The area under the receiver operating characteristic curve was estimated to assess the ability of each image size to predict DR.ResultsThis prospective, cross-sectional study included 60 eyes, (non-DR, 13 eyes; non-proliferative DR (NPDR), 24 eyes; proliferative DR (PDR), 23 eyes) of 46 patients with diabetes and 21 eyes of 16 healthy individuals. In the 12×12 mm images, the PD of healthy individuals was significantly greater than that of patients with NPDR or PDR for all layers (NPDR, p<0.05; PDR, p<0.001 0.001; FD, p<0.001) or PDR (VLD, p<0.001; FD, p<0.001 for all layers). The results were similar for the 3×3 mm and 6×6 mm images. Overall, PD, VLD and FD progressively decreased with worsening DR severity in segmented and non-segmented layers for all SS-OCTA scan sizes. For detecting DR, 3×3 mm images best predicted DR for all evaluated quantitative parameters.ConclusionsVascular changes in DR can be monitored in detail through quantitative evaluations that combine different SS-OCTA scan sizes and parameters.

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Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age

Journal of Clinical Medicine ◽

10.3390/jcm9030883 ◽

2020 ◽

Vol 9 (3) ◽

pp. 883 ◽

Cited By ~ 2

Author(s):

Seung Hun Park ◽

Heeyoon Cho ◽

Sun Jin Hwang ◽

Beomseo Jeon ◽

Mincheol Seong ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Foveal Avascular Zone ◽

Vascular Density ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Age Related ◽

Retinal Microvasculature ◽

Significant Difference

In this cross-sectional study, we examined age-related changes in the retinal vessels of 100 healthy participants, aged from 5 to 80 years, and divided into four groups (G1, under 20 years of age; G2, from 20 to 39 years of age; G3, from 40 to 59 years of age; G4, age 60 years or older). All subjects underwent swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). The vascular density (VD) of the superficial (SCP) and deep capillary plexus (DCP), and choriocapillaris (CCP) were measured using OCTA. The vascular density of each capillary layer, foveal avascular zone (FAZ) area, ganglion cell-inner plexiform layer (GC-IPL) thickness, retinal thickness (RT), and choroidal thickness (CT) were compared between age groups. Most OCT variables were correlated with OCTA variables. The FAZ area; VD of the SCP, DCP, and CCP; GC-IPL thickness; RT; and CT showed significant difference (p < 0.001) between G1 + G2 and G3 + G4, except for central GC-IPL thickness (p = 0.14) and central RT (p = 0.25). Density of the retinal capillary vasculature reduced and FAZ area increased after age 40, which represents the onset of middle age.

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Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317983 ◽

2020 ◽

pp. bjophthalmol-2020-317983

Author(s):

Edward S Lu ◽

Ying Cui ◽

Rongrong Le ◽

Ying Zhu ◽

Jay C Wang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optic Disc ◽

Proliferative Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Vitreoretinal Interface ◽

Cross Sectional ◽

Swept Source ◽

Detection Rates

AimsTo compare the efficacy of diabetic retinal neovascularisation (NV) detection using the widefield swept-source optical coherence tomography angiography (WF SS-OCTA) vitreoretinal interface (VRI) Angio slab and SS-OCT VRI Structure slab.MethodsA prospective, observational study was performed at Massachusetts Eye and Ear from January 2019 to June 2020. Patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy and patients with diabetes but without diabetic retinopathy were included. All patients were imaged with WF SS-OCTA using the 12×12 mm Angio scan protocol centred on the fovea and optic disc. The en-face SS-OCTA VRI Angio slab and SS-OCT VRI Structure slab were evaluated for the presence or absence of NV. SS-OCTA B-scan was used to classify NV according to cross-sectional morphology (forward, tabletop or flat). All statistical analyses were performed using SPSS V.26.0.ResultsOne hundred and forty-two eyes of 89 participants were included in the study. VRI Angio detected NV at higher rates compared with VRI Structure (p<0.05). Combining VRI Angio and Structure improved detection rates compared with VRI Angio alone (p<0.05). Due to segmentation errors of the internal limiting membrane, NV with flat morphological classification had lower rates of detection on VRI Angio compared with NV with forward and tabletop morphology (p<0.05).ConclusionsWF SS-OCTA 12×12 mm VRI Angio and SS-OCT VRI Structure imaging centred on the fovea and optic disc detected NV with high sensitivity and low false positives. The VRI slab may be useful to diagnose and monitor PDR in clinical practice.

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Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

International Journal of Retina and Vitreous ◽

10.1186/s40942-020-00269-2 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Fariba Ghassemi ◽

Sahar Berijani ◽

Ramak Roohipoor ◽

Masoumeh Mohebbi ◽

Ameneh Babeli ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optic Nerve ◽

Optic Nerve Head ◽

Optical Coherence Tomography Angiography ◽

Blood Perfusion ◽

Cross Sectional Study ◽

Vascular Density ◽

Optical Coherence ◽

Cross Sectional

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.

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Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography

American Journal of Ophthalmology ◽

10.1016/j.ajo.2017.09.030 ◽

2017 ◽

Vol 184 ◽

pp. 75-83 ◽

Cited By ~ 31

Author(s):

Jay C. Wang ◽

Inês Laíns ◽

Joana Providência ◽

Grayson W. Armstrong ◽

Ana R. Santos ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Vascular Density ◽

Optical Coherence ◽

Swept Source ◽

Diabetic Choroidopathy

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

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05229-6 ◽

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.

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Comparison between Widefield Optical Coherence Tomography Devices in Eyes with High Myopia

Diagnostics ◽

10.3390/diagnostics11040658 ◽

2021 ◽

Vol 11 (4) ◽

pp. 658

Author(s):

Federico Corvi ◽

Federico Zicarelli ◽

Matteo Airaldi ◽

Salvatore Parrulli ◽

Mariano Cozzi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

High Myopia ◽

Cross Sectional Study ◽

Horizontal Line ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Image Artifact ◽

Control Subjects ◽

And Control

Background: To compare four different optical coherence tomography (OCT) devices for visualization of retinal and subretinal layers in highly myopic eyes. Methods: In this prospective, observational, cross-sectional study, consecutive patients with high myopia and control subjects were imaged by four OCT devices: Spectralis OCT2, PlexElite 2.0 100 kHz, PlexElite 2.0 200 kHz and the Canon Xephilio OCT-S1. The acquisition protocol for comparison consisted of single vertical and horizontal line scans centered on the fovea. Comparison between the devices in the extent of visible retina, presence of conjugate image or mirror artifacts, visibility of the sclerochoroidal interface and retrobulbar tissue. Results: 30 eyes with high myopia and 30 control subjects were analyzed. The visualized RPE length was significantly different between the OCT devices with Xephilio OCT-S1 imaging the largest extent (p < 0.0001). The proportion of eyes with conjugate image artifact was significantly higher with the Spectralis OCT (p < 0.0001), and lower with the PlexElite 200 kHz (p < 0.0001). No difference in visibility of the sclerochoroidal interface was noted among instruments. The retrobulbar tissue was visible in a higher proportion of eyes using swept-source PlexElite 100 kHz and 200 kHz (p < 0.007) compared to the other devices. Conclusions: In highly myopic eyes, the four OCT devices demonstrated significant differences in the extent of the retina imaged, in the prevalence of conjugate image artifact, and in the visualization of the retrobulbar tissue.

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

10.21203/rs.3.rs-53300/v3 ◽

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.

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

10.21203/rs.3.rs-151008/v1 ◽

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.

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Wide-field optical coherence tomography deviation map for early glaucoma detection

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-319509 ◽

2021 ◽

pp. bjophthalmol-2021-319509

Author(s):

Hyungjun Kim ◽

Hae Min Park ◽

Hyo Chan Jeong ◽

So Yeon Moon ◽

Hyunsoo Cho ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Characteristic Curve ◽

Wide Field ◽

Optical Coherence ◽

Diagnostic Ability ◽

Swept Source ◽

Early Glaucoma ◽

Field Database ◽

The Individual ◽

Healthy Eyes

Background/aimsThis study aimed to establish a wide-field optical coherence tomography (OCT) deviation map obtained from swept-source OCT (SS-OCT) scans. Moreover, it also aimed to compare the diagnostic ability of this wide-field deviation map with that of the peripapillary and macular deviation maps currently being used for the detection of early glaucoma (EG).MethodsFour hundred eyes, including 200 healthy eyes and 200 eyes with EG were enrolled in this retrospective observational study. Patients underwent a comprehensive ocular examination, including wide-field SS-OCT (DRI-OCT Triton; Topcon, Tokyo, Japan). The individual wide-field scan was converted into a uniform template using the fovea and optic disc centres as fixed landmarks. Subsequently, the wide-field deviation map was obtained via the comparison between individual wide-field data and a normative wide-field database that had been created by combining images of healthy eyes into a uniform template in a previous study. The ability of the new wide-field deviation map to distinguish between EG and healthy eyes was assessed by comparing it with conventional deviation maps based on the area under the receiver operating characteristic curve (AUC).ResultsThe wide-field deviation map obtained using the normative wide-field database showed the highest diagnostic ability for the diagnosis of EG (AUC=0.980 and 961 for colour-coded pixels presenting <5% and <1%, respectively) among various deviation maps. Its AUC was significantly superior to that of most conventional deviation maps (p<0.05). The wide-field deviation map demonstrated early structural glaucomatous damage well over a wider area.ConclusionThe wide-field SS-OCT deviation map exhibited good performance for distinguishing between eyes with EG and healthy eyes. The visualisation of the wider damaged area on the wide-field deviation map could be useful for the diagnosis of EG in clinical settings.

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3D imaging of proximal caries in posterior teeth using optical coherence tomography

Scientific Reports ◽

10.1038/s41598-020-72838-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Yasushi Shimada ◽

Michael F. Burrow ◽

Kazuyuki Araki ◽

Yuan Zhou ◽

Keiichi Hosaka ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diagnostic Accuracy ◽

3D Imaging ◽

Characteristic Curve ◽

Weighted Kappa ◽

Optical Coherence ◽

Cross Sectional ◽

Posterior Teeth ◽

Proximal Caries ◽

X Ray

Abstract Optical coherence tomography (OCT) can create cross-sectional images of tooth without X-ray exposure. This study aimed to investigate the diagnostic accuracy of 3D imaging of OCT for proximal caries in posterior teeth. Thirty-six human molar teeth with 51 proximal surfaces visibly 6 intact, 16 slightly demineralized, and 29 distinct carious changes were mounted to take digital radiographs and 3D OCT images. The sensitivity, specificity and area under the receiver operating characteristic curve (AUC) for the diagnosis of enamel caries and dentin caries were calculated to quantify the diagnostic ability of 3D OCT in comparison with digital radiography. Diagnostic accuracy was evaluated by the agreement with histology using weighted Kappa. OCT showed significantly higher sensitivity, AUC and Kappa values than radiography. OCT can be a safer option for the diagnosis of proximal caries in posterior teeth that can be applied to the patients without X-ray exposure.

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