Scotopic microperimetric sensitivity and inner choroid flow deficits as predictors of progression to nascent geographic atrophy

2020 ◽  
pp. bjophthalmol-2020-316893
Author(s):  
Giulia Corradetti ◽  
Liran Tiosano ◽  
Marco Nassisi ◽  
Ahmed Roshdy Alagorie ◽  
Federico Corvi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Survival Curve ◽  
Retinal Pigment ◽  
Geographic Atrophy ◽  
Functional Regression ◽  
Optical Coherence ◽  
Swept Source ◽  
Kaplan Meier ◽  
The Mean

Background/AimsTo assess the role of microperimetric retinal sensitivity (MPRS) and inner choroid flow deficits (IC FD) in predicting the development of incomplete retinal pigment epithelial and outer retinal atrophy (iRORA) in intermediate AMD (i-AMD).MethodsThirty eyes with i-AMD evaluated at the Doheny-UCLA Eye Centres were enrolled in this prospective IRB-approved study. Subjects underwent several diagnostic tests: (a) 6×6 mm swept-source optical coherence tomography angiography (SS-OCTA) with the IC slab used to quantify the FDs, (b) 20°×20° spectral-domain optical coherence tomography (SD-OCT) to monitor progression to iRORA and (c) scotopic MPRS within an area of 18° centred on the fovea. All subjects were followed-up for 24 months. The baseline IC FD and MPRS were correlated with the development of iRORA. At 24-month follow-up, the stage of AMD was re-assessed and the eyes were divided into two sub-groups based on the development of iRORA.ResultsTwenty-eight eyes completed the 2-year follow-up. At baseline, the mean MPRS was 13.40±4.66 dB and the mean IC FD was 27.55±8.67%. The morpho-functional regression showed a significant correlation between baseline MPRS and IC FD and the development of iRORA within 24 months (R2=0.744, p<0.05). A Kaplan–Meier survival curve was fit to determine the cumulative incidence of iRORA over the 24 months.ConclusionsA lower MPRS and greater IC FD at baseline were predictors of progression to iRORA in eyes with i-AMD. These parameters may be useful biomarkers for risk stratification and prognostication.

Evolution of retinal changes measured by optical coherence tomography in the assessment of hydroxychloroquine ocular safety in patients with systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (4) ◽  
pp. 555-559 ◽  
Author(s):  
D Martín-Iglesias ◽  
J Artaraz ◽  
A Fonollosa ◽  
A Ugarte ◽  
A Arteagabeitia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Optical Coherence Tomography ◽  
Lupus Erythematosus ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Optical Coherence ◽  
The Mean ◽  
Sd Oct

Objective The objective of this report is to analyse retinal changes over a five-year period, assessed by spectral domain-optical coherence tomography (SD-OCT), in patients from the Lupus-Cruces cohort treated with hydroxychloroquine (HCQ). Methods SD-OCT screening was performed annually between 2012 and 2017. Average macular thickness (AMT), ganglion cell layer thickness (GCLT) and qualitative data of retinal pigment epithelium (RPE) and external retina (ExtR) were collected prospectively. We compared data from 2012 (first) and 2017 (second) SD-OCT. Results We studied 110 patients and 195 eyes. No cases of HCQ toxicity were detected. At the time of the second SD-OCT, 99% patients had taken a daily dose of HCQ ≤5 mg/kg/day. The median time on HCQ was 133 months. The mean AMT and GCLT were significantly lower in both eyes at the second SD-OCT; however, all the differences were clinically insignificant at less than 1%. Qualitative analysis of RPE and ExtR showed no significant changes. Similar results were found among patients with risk factors for retinopathy. The comparison of patients with and without risk factors showed no differences. Conclusions This study shows clinically irrelevant retinal changes in an SLE cohort on HCQ treatment over a five-year follow-up. Our findings support the safety of long-term HCQ at doses ≤5 mg/kg/day.

scholarly journals Geographic mapping of choroidal thickness in myopic eyes using 1050-nm spectral domain optical coherence tomography

2015 ◽  
Vol 08 (04) ◽  
pp. 1550012 ◽  
Author(s):  
Qinqin Zhang ◽  
Maureen Neitz ◽  
Jay Neitz ◽  
Ruikang K. Wang
Keyword(s):  
Optical Coherence Tomography ◽  
High Myopia ◽  
Choroidal Thickness ◽  
Retinal Pigment ◽  
Reduction Rate ◽  
Radial Distance ◽  
Spectral Domain ◽  
Temporal Region ◽  
Optical Coherence ◽  
The Mean

Purpose: To provide a geographical map of choroidal thickness (CT) around the macular region among subjects with low, moderate and high myopia. Methods: 20 myopic subjects (n = 40 eyes) without other identified pathologies participated in this study: 20 eyes of ≤ 3 diopters (D) (low myopic), 10 eyes between -3 and -6D (moderate myopic), and 10 eyes of ≥ 6D (high myopic). The mean age of subjects was 30.2 years (± 7.6 years; range, 24 to 46 years). A 1050 nm spectral-domain optical coherence tomography (SD-OCT) system, operating at 120 kHz imaging rate, was used in this study to simultaneously capture 3D anatomical images of the choroid and measure intraocular length (IOL) in the subject. The 3D OCT images of the choroid were segmented into superior, inferior, nasal and temporal quadrants, from which the CT was measured, representing radial distance between the outer retinal pigment epithelium (RPE) layer and inner scleral border. Measurements were made within concentric regions centered at fovea centralis, extended to 5 mm away from fovea at 1 mm intervals in the nasal and temporal directions. The measured IOL was the distance from the anterior cornea surface to the RPE in alignment along the optical axis of the eye. Statistical analysis was performed to evaluate CT at each geographic region and observe the relationship between CT and the degree of myopia. Results: For low myopic eyes, the IOL was measured at 24.619 ± 0.016 mm. The CT (273.85 ± 49.01 μm) was greatest under fovea as is in the case of healthy eyes. Peripheral to the fovea, the mean CT decreased rapidly along the nasal direction, reaching a minimum of 180.65 ± 58.25μm at 5 mm away from the fovea. There was less of a change in thickness from the fovea in the temporal direction reaching a minimum of 234.25 ± 42.27 μm. In contrast to the low myopic eyes, for moderate and high myopic eyes, CTs were thickest in temporal region (where CT = 194.94 ± 27.28 and 163 ± 34.89 μm, respectively). Like the low myopic eyes, moderate and high myopic eyes had thinnest CTs in the nasal region (where CT = 100.84 ± 16.75 and 86.64 ± 42.6μm, respectively). High myopic eyes had the longest mean IOL (25.983 ± 0.021mm), while the IOL of moderate myopia was 25.413 ± 0.022 mm (**p < 0.001). The CT reduction rate was calculated at 31.28 μm/D (diopter) from low to moderate myopia, whilst it is 13.49 μm/D from moderate to high myopia. The similar tendency was found for the IOL reduction rate in our study: 0.265 mm/D from low to moderate myopia, and 0.137 mm/D from moderate to high myopia. Conclusion: The CT decreases and the IOL increases gradually with the increase of myopic condition. The current results support the theory that choroidal abnormality may play an important role in the pathogenesis of myopic degeneration.

scholarly journals Early Detection of Incipient Retinal Pigment Epithelium Atrophy Overlying Drusen with Fundus Autofluorescence vs. Spectral Domain Optical Coherence Tomography

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Anabel Rodríguez ◽  
Marc Biarnés ◽  
Rosa M. Coco-Martin ◽  
Anna Sala-Puigdollers ◽  
Jordi Monés
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Median Time ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Geographic Atrophy ◽  
Optical Coherence ◽  
Rpe Atrophy ◽  
Sd Oct

Purpose. This study aims to find out which tool, fundus autofluorescence (FAF) or spectral domain optical coherence tomography (SD-OCT), is more sensitive in detecting retinal pigment epithelium (RPE) demise overlying drusen and can, therefore, help predict geographic atrophy (GA) appearance in Age-Related Macular Degeneration (AMD). Methods. A single-site, retrospective, observational, longitudinal study was conducted. Patients with intermediate AMD (iAMD) (large (>125 μm) or intermediate (63–125 μm) drusen with hyper/hypopigmentation) with a minimum follow-up of 18 months were included. Drusen with overlying incipient RPE atrophy were identified on SD-OCT defined as choroidal hypertransmission or nascent geographic atrophy (nGA). These selected drusen were, then, traced backwards in time to determine if incipient RPE atrophy overlying drusen was observed on FAF (well-demarcated region of absence of autofluorescence) before, simultaneously, or after having detected the first signs of incipient RPE atrophy on SD-OCT. The number of drusen in which signs of incipient RPE atrophy was detected earlier using FAF or SD-OCT was compared. The time elapsed from the identification with the more sensitive method to the other was recorded and analyzed. Results. One hundred and thirty-three drusen in 22 eyes of 22 patients were included. Of these, 112 (84.2%) drusen showed choroidal hypertransmission and 21(15.8%) nGA. Early signs of atrophy overlying drusen were found simultaneously on SD-OCT and FAF in 52 cases (39.1%, 95% CI 30.8–47.9%), earliest on FAF in 51 (38.3%, 95% CI 30.0–47.2%) and first on SD-OCT in 30 (22.6%, 95% CI 15.8–30.6%; p<0.05). Statistically significant differences were found between both techniques (p=0.005), with FAF detecting it earlier than SD-OCT. When RPE atrophy was found first on FAF, the median time to diagnosis with SD-OCT was 6.6 months (95% CI 5.5 to 8.6), while if detection occurred earlier on SD-OCT, the median time until identification with FAF was 12.6 months (95% CI 6.0 to 23.4; p=0.0003). Conclusions. In iAMD cases in which early atrophy overlying drusen is not detected simultaneously in FAF and SD-OCT, FAF was significantly more sensitive. Nevertheless, a multimodal approach is recommended and required to evaluate these patients.

scholarly journals In vivo optical biopsy of choroidal osteoma: a swept source optical coherence tomography–based tumor characterization

2020 ◽  
Vol 12 ◽  
pp. 251584142092274 ◽  
Author(s):  
Shorya Vardhan Azad ◽  
Vinod Kumar ◽  
Rohan Chawla ◽  
Bibhuti Kashyap ◽  
Shreyas Temkar ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Pigment Epithelium ◽  
Signal Transmission ◽  
Retinal Pigment ◽  
Optical Coherence ◽  
Choroidal Neovascular Membrane ◽  
Swept Source ◽  
Retinal Layers ◽  
Choroidal Osteoma

Objective: To study tumor characteristics of choroidal osteoma by swept source optical coherence tomography. Methods: A retrospective case series done at tertiary referral center in northern India. All patients diagnosed with choroidal osteoma examined on swept source optical coherence tomography were included. Swept source optical coherence tomography images were analyzed for integrity of retinal layers—intraretinal layers, outer retinal layers (photoreceptor), retinal pigment epithelium, and contour abnormalities. Choroidal changes assessed were tumor attributes such as shape, depth of choroidal involvement, tumor mass reflectivity pattern, tumor vascularity, and evolutionary structural abnormalities such as deossification, focal depressions, or choroidal neovascular membrane. Results: A total of 15 eyes of 11 patients were analyzed. Seven of 11 patients were females. Mean age of presentation was approximately 26 years. Tumor was large in nine cases (>7.5 mm). Deossification was seen in 12 eyes. Inner and outer retinal integrity was maintained in 7 and 2 eyes, respectively. Most common internal tumor reflectivity pattern seen was a lamellar appearance (12/15). Increased signal transmission to choroid and focal area of deep excavation was present in 11 and 4 eyes, respectively. Osteoclastic activity was noted in 12 eyes. Choroidal neovascular membrane was seen in 6 eyes. Small lesions showed lamellar pattern of tumor reflectivity with preservation of retinal pigment epithelium and overlying retina. Larger tumors were deossified with 6 irregular tumor contour, disorganization of the outer retina, increased signal transmission to choroid, and areas of osteoclastic activity. Conclusion: Swept source optical coherence tomography was helpful in assessing tumor attributes and predicting the different timelines in tumor evolution.

scholarly journals Type 1 Choroidal Neovascularization Evolution by Optical Coherence Tomography Angiography: Long-Term Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Marco Rispoli ◽  
Maria Cristina Savastano ◽  
Bruno Lumbroso ◽  
Lisa Toto ◽  
Luca Di Antonio
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Structural Changes ◽  
Imaging Techniques ◽  
Optical Coherence ◽  
Anti Vegf ◽  
The Mean

Purpose. To evaluate structural changes in response to antivascular endothelial growth factor (anti-VEGF) treatment in patients with long-term type 1 choroidal neovascularization (CNV) by optical coherence tomography (OCT) and OCT angiography (OCTA). Method. This is a longitudinal study that involved a total of 51 eyes with type 1 CNV (35 female and 16 male eyes). Structural OCT and OCTA were performed on all the subjects. AngioVue OCTA (XR Avanti, Optovue, Inc., Fremont, CA) was used to obtain qualitative and quantitative information. All eyes were treated with an anti-VEGF ProReNata (PRN) approach and were followed for a mean of 38.9 months (SD±7.22). Best-corrected visual acuity (BCVA) was assessed at each follow-up timepoint. Results. We observed two kinds of possible evolution of type 1 CNV: “positive evolution,” including stabilization in 20% of patients and chronicity in 35%, and “negative evolution,” in which fibrosis was shown in 18% of patients, chorioretinal atrophy in 25%, and hemorrhage or RPE tears in 2%. The mean BCVA at baseline was 33.67±15.85 ETDRS letters; after 1 and 2 years, it was 31.61±18.04 and 31.18±18.58 ETDRS letters, respectively. The mean BCVA at the end of follow-up was 25.27±20 ETDRS letters. The difference between the values at baseline and at the end of follow-up was not statistically significant (P=0.06, r2=0.10). Conclusions. This study describes an in vivo structural long-term evolution of type 1 CNV by OCT and OCTA. Different possible CNV outcomes were observed. This study suggests that new retinal imaging techniques could be useful tools for assessing the potential retinal changes in the evolution of type 1 CNV to develop personalized medicine. Further studies using OCTA in the long term are needed to better understand why similarly treated type 1 CNV cases evolve differently and produce different results.

scholarly journals Quantitative assessment of choriocapillaris flow deficits in diabetic retinopathy: A swept-source optical coherence tomography angiography study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243830
Author(s):  
Yining Dai ◽  
Hao Zhou ◽  
Qinqin Zhang ◽  
Zhongdi Chu ◽  
Lisa C. Olmos de Koo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Significant Difference ◽  
En Face ◽  
The Mean

Purpose To quantitatively assess choriocapillaris (CC) flow deficits in eyes with diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA). Methods Diabetic subjects with different stages of DR and age-matched healthy subjects were recruited and imaged with SS-OCTA. The en face CC blood flow images were generated using previously published and validated algorithms. The percentage of CC flow deficits (FD%) and the mean CC flow deficit size were calculated in a 5-mm-diameter circle centered on the fovea from the 6×6-mm scans. Results Forty-five diabetic subjects and 27 control subjects were included in the study. The CC FD% in diabetic eyes was on average 1.4-fold greater than in control eyes (12.34±4.14% vs 8.82±2.61%, P < 0.001). The mean CC FD size in diabetic eyes was on average 1.4-fold larger than in control eyes (2151.3± 650.8μm2 vs 1574.4±255.0 μm2, P < 0.001). No significant difference in CC FD% or mean CC FD size was observed between eyes with nonproliferative DR and eyes with proliferative DR (P = 1.000 and P = 1.000, respectively). Conclusions CC perfusion in DR can be objectively and quantitatively assessed with FD% and FD size. In the macular region, both CC FD% and CC FD size are increased in eyes with DR. SS-OCTA provides new insights for the investigations of CC perfusion status in diabetes in vivo.

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