WED 014 Oct minimises unnecessary investigation for suspected papilloedema

2018 ◽  
Vol 89 (10) ◽  
pp. A3.1-A3
Author(s):  
Coysh Thomas ◽  
Whiteside David ◽  
Williamson Sarah ◽  
Muhammed Louwai ◽  
Metta Vinod ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Lumbar Puncture ◽  
Optic Disc ◽  
Optical Coherence ◽  
The Impact ◽  
Optic Discs

BackgroundOptical coherence tomography (OCT) is a rapid and painless way to provide a record of the optic disc structure. Though not specific, it can identify swollen optic discs. We determined the impact of OCT prior to referral on the pathway for managing suspected papilloedema.MethodsAudit of adults referred from the Western Eye Hospital to St Mary’s Hospital with suspected papilloedema was performed between 1/1/17 and 16/5/17. A follow-up re-audit was performed from 1/6/17 to 31/8/17 following implementation of OCT prior to referral.ResultsThe initial audit identified 50 patients over 136 days and the re-audit 26 patients over 92 days. In the initial audit 6/50 had OCT and 17/50 (34%) were admitted. 6/50 patients were subsequently found not to have papilloedema on fundoscopy, none of whom had OCT. 4/6 underwent unnecessary neuroimaging and lumbar puncture. 3 were admitted, equating to 18% of all admissions, for an average of 2.3 days. In the re-audit all had OCT, 6/26 (23%) were admitted and none were subsequently found not to have papilloedema.ConclusionUse of OCT prior to referral for suspected papilloedema helps to reduce unnecessary investigations.

Multimodal imaging of optic disc melanocytoma

2021 ◽  
pp. 112067212110106
Author(s):  
Cinzia Mazzini ◽  
Giulio Vicini ◽  
Cristina Nicolosi ◽  
Giulia Pieretti ◽  
Stanislao Rizzo
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Case Series ◽  
Optical Coherence ◽  
Retrospective Case ◽  
Swept Source ◽  
Rule Out

Purpose: To describe the findings of four patients (four eyes) with optic disc melanocytoma (ODM), using multimodal imaging. Methods: Retrospective case series. Results: On ocular ultrasonography ODMs appeared as hyperechogenic lesions with moderate-to-high internal reflectivity. On blue-light fundus autofluorescence, ODMs showed total hypoautofluorescence, while, on infrared reflectance images appeared as bright and well-marginated lesions. MultiColor composite images showed reddish-brown lesions with well-defined margins. Swept-source optical coherence tomography revealed elevated lesions covering the optic disc with an irregular hyperreflective surface, dishomogeneous internal structure with hyperreflective dots, and posterior shadowing. In all cases optical coherence tomography angiography detected intratumoral blood vessels which were not detectable with fluorescein angiography. Conclusion: Multimodal imaging in ODM might be useful both at presentation, increasing the diagnostic accuracy, and at follow-up, providing helpful details, that can help to rule out the possibility of malignant transformation and other ocular complications.

122Mechanism and impact of lesion morphology on the late lumen loss of drug-eluting resorbable magnesium scaffolds: a serial optical coherence tomography study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Ueki ◽  
L Raber ◽  
T Otsuka ◽  
S Losdat ◽  
S Windecker ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Neointimal Hyperplasia ◽  
Clinical Results ◽  
Optical Coherence ◽  
Plaque Type ◽  
Late Lumen Loss ◽  
Significant Difference ◽  
Potential Factors ◽  
The Impact

Abstract Introduction Resorbable Magnesium Scaffolds have demonstrated favourable clinical results with acceptable late lumen loss (LLL). However, the pathomechanisms influencing LLL of resorbable sirolimus-eluting metallic scaffold (Magmaris) have not been analyzed. Purpose Using serial optical coherence tomography (OCT), we investigated potential factors, i.e. the contribution of recoil versus neointimal hyperplasia (NIH). Methods Patients who were enrolled into BIOSOLVE-II, and underwent serial angiography and OCT (baseline and follow-up: 6-month and/or 1-year) were analyzed. Patients were divided into 2 groups based on angiographic in-scaffold LLL <0.5mm or ≥0.5mm. Endpoints were late absolute recoil and NIH area as assessed by OCT. Results A total of 70 patients (LLL <0.5mm: n=41, LLL ≥0.5mm: n=29) were serially analyzed. Patient and lesion characteristics were comparable and there was no significant difference in mean and minimal scaffold area between groups at baseline. Late absolute recoil was significantly smaller among patients with LLL <0.5mm (0.53±0.68 mm2) compared with those with LLL ≥0.5mm (1.48±1.20 mm2, P<0.001) (Figure). A small difference in NIH area at follow-up was observed (LLL <0.5mm: 1.47±0.33 mm2 vs. LLL ≥0.5mm: 1.68±0.34 mm2, P=0.013). In a matched-frame analysis (baseline and follow-up), late absolute recoil varied according to the underlying plaque type (lipid: 0.63±1.23 mm2, calcified: 0.81±1.44 mm2, and fibrous: 1.20±1.52 mm2, P<0.001), while there was no difference with regards to NIH area (P=0.132). Conclusion The main driver of late lumen loss of sirolimus-eluting absorbable metal scaffold was late scaffold recoil, while the contribution of NIH was modest. The degree of late scaffold recoil depended on the underlying plaque type and was highest among fibrotic lesions. Future studies will address the impact of procedural factors such as adequate lesion preparation and post-dilatation. Acknowledgement/Funding Biotronik

scholarly journals Bilateral Vitreopapillary Traction Demonstrated by Optical Coherence Tomography Mistaken for Papilledema

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Elizabeth Houle ◽  
Neil R. Miller
Keyword(s):  
Optical Coherence Tomography ◽  
Case Report ◽  
Fluorescein Angiography ◽  
Optic Disc ◽  
Correct Diagnosis ◽  
Optical Coherence ◽  
Vitreous Traction ◽  
Optic Disc Swelling ◽  
Optic Discs

Purpose. The purpose of this study was to report a case of bilateral vitreopapillary traction, previously misdiagnosed as papilledema.Methods. A case report is presented of a 47-year-old woman with a prior diagnosis of papilledema, who is shown to have bilateral vitreopapillary traction rather than true optic disc swelling, confirmed by optical coherence tomography (OCT).Results. OCT showed vitreous traction surrounding the optic discs of both eyes. Fluorescein angiography demonstrated focal leakage of both discs.Conclusion. Bilateral disc elevation caused by vitreous traction can be confused with papilledema. In such cases, OCT can be used to arrive at the correct diagnosis. Although the phenomenon of vitreopapillary traction is well reported, this case indicates that not all ophthalmologists recognize the condition.

scholarly journals Re-evaluating diabetic papillopathy using optical coherence tomography and inner retinal sublayer analysis

Eye ◽  
2021 ◽  
Author(s):  
Josef Huemer ◽  
Hagar Khalid ◽  
Daniel Ferraz ◽  
Livia Faes ◽  
Edward Korot ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optic Disc ◽  
Case Series ◽  
Retinal Nerve Fibre Layer ◽  
Optical Coherence ◽  
Patients With Diabetes ◽  
Optic Disc Swelling ◽  
The Mean

Abstract Background/Objectives To re-evaluate diabetic papillopathy using optical coherence tomography (OCT) for quantitative analysis of the peripapillary retinal nerve fibre layer (pRNFL), macular ganglion cell layer (mGCL) and inner nuclear layer (mINL) thickness. Subjects/Methods In this retrospective observational case series between June 2008 and July 2019 at Moorfields Eye hospital, 24 eyes of 22 patients with diabetes and optic disc swelling with confirmed diagnosis of NAION or diabetic papillopathy by neuro-ophthalmological assessment were included for evaluation of the pRNFL, mGCL and mINL thicknesses after resolution of optic disc swelling. Results The mean age of included patients was 56.5 (standard deviation (SD) ± 14.85) years with a mean follow-up duration of 216 days. Thinning of pRNFL (mean: 66.26, SD ± 31.80 µm) and mGCL (mean volume: 0.27 mm3, SD ± 0.09) were observed in either group during follow-up, the mINL volume showed no thinning with 0.39 ± 0.05 mm3. The mean decrease in visual acuity was 4.13 (SD ± 14.27) ETDRS letters with a strong correlation between mGCL thickness and visual acuity (rho 0.74, p < 0.001). Conclusion After resolution of acute optic disc swelling, atrophy of pRNFL and mGCL became apparent in all cases of diabetic papillopathy and diabetic NAION, with preservation of mINL volumes. Analysis of OCT did not provide a clear diagnostic distinction between both entities. We suggest a diagnostic overlay with the degree of pRNFL and mGCL atrophy of prognostic relevance for poor visual acuity independent of the semantics of terminology.

scholarly journals Comparison of vascular parameters between normal cynomolgus macaques and healthy humans by optical coherence tomography angiography

2019 ◽  
Author(s):  
Jingyi Peng ◽  
Liuxueying Zhong ◽  
Li Ma ◽  
Jiayi Jin ◽  
Yongxin Zheng ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Optical Parameter ◽  
Vessel Density ◽  
Normal Adult ◽  
Optical Coherence ◽  
Healthy Humans ◽  
Cynomolgus Macaques ◽  
Optic Discs

Abstract Background: The metabolic activity of retina is higher than other human tissues and is crucial to the vision. Cynomolgus macaques is widely used in ophthalmic disease research. The evaluation and comparison of macular and optic disc vascular circulation parameters between normal adult cynomolgus macaques and healthy adult humans using OCT-A can promote better use of nonhuman primate models in studies of ophthalmic vascular disease. Methods: 12 normal adult cynomolgus macaques with a mean age of 4.91±0.43 years were studied for data collection. The macula of 28 adult healthy humans (14 males and 14 females), with a mean age of 25.11±6.21 years and the optic discs of 9 adult healthy humans (4 males and 5 females) with a mean age of 28.56±6.78 years were measured. The vessel density (VD) was measured using an RTVue XR with AngioVue. The scan sizes of the macular and optic discs were 3×3 mm and 4.5×4.5 mm, respectively. Results: OCT-A can image the superficial and deep capillary plexuses and radial peripapillary capillary network. In RPC layer of the optic disc, the VD in the nasal quadrant was lower than the VD in the inferior temporal quadrant. Similarities and significant differences in VD between healthy humans and cynomolgus macaques were obtained using OCT-A. Conclusions: This study provides normal vascular parameters for adult cynomolgus macaques using OCT-A to help establish an optical parameter database for cynomolgus macaques and compare VD between healthy humans and cynomolgus macaques to promote choroid-retinopathy research. Trial registration: Current Controlled Trials NCT03692169, retrospectively registered on 26 sept 2018 Keywords: Cynomolgus macaques, Healthy humans, Vascular, Optical coherence tomography angiography (OCT-A), Vessel density (VD)

scholarly journals The Importance of Optical Coherence Tomography and Autofluorescence in the Documentation of Papillary Colobomatous Fossette

2021 ◽  
pp. 19-23
Author(s):  
Thiago Sande Miguel ◽  
Vinicius Sande Miguel ◽  
Tais Cristina Rossett ◽  
Daniel Almeida da Costa ◽  
Maurício Bastos Pereira
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Present Report ◽  
Serous Retinal Detachment ◽  
Male Student ◽  
Lamina Cribrosa ◽  
Optical Coherence ◽  
Topical Medication ◽  
Visual Complaints

Aims: To describe the importance of optical coherence tomography and autofluorescence in the documentation of papillary colobomatous fossette. Presentation of Case: F.D.O. A 14-year-old male student is referred for evaluation of the fundus of the eye due to an alteration in the optic disc noticed by another professional who did not feel safe in the follow-up. The patient was completely asymptomatic at the time of the consultation and did not claim previous visual complaints. She denied systemic and ocular comorbidities and did not use any systemic and topical medication. Discussion: The congenital optic disc pit is a rare and typically unilateral congenital anomaly, consisting of a retinal herniation that extends into the subarachnoid space through a lamina cribrosa defect. 8,13,15,16 Although this condition, in most cases, does not present complications and remains asymptomatic, it can sometimes worsen with a significant decrease in visual acuity. This more serious condition can be characterized by important macular alterations, such as serous retinal detachment, cystic degenerations and degenerative pigmentary alterations. 14,16,17,18 The patient in the present report did not have any visual complaints and did not present severe structural and functional retinal damage, which highlights the importance of early diagnosis. Conclusions: The colobomatous papilla pit is characterized by the presence of isolated cavities in the optic disc head secondary to a developmental disorder of the primitive epithelial papilla. Its incidence is 1:10,000 people without sexual or racial predilection. It presents, in most cases, asymptomatic, unilateral in 85-95% of cases and rarely with more than one pit per disc.

Influence of treatment modality and neointimal characteristics on optical coherence tomography on clinical outcomes of in-stent restenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Xhepa ◽  
J Bresha ◽  
M Joner ◽  
F Rivero ◽  
N Nano ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Clinical Outcomes ◽  
Treatment Modality ◽  
Significant Interaction ◽  
Drug Eluting Stent ◽  
Optical Coherence ◽  
Stent Restenosis ◽  
The Impact ◽  
In Stent Restenosis

Abstract Background In-stent restenosis (ISR) represents the more frequent modality of stent failure. The currently recommended treatment strategies are represented by repeat drug-eluting stent (DES) implantation or drug-coated balloon (DCB) angioplasty. Optical coherence tomography can display important information regarding mechanisms of stent failure as well as neointimal characterization. Purpose Aim of the present study was to determine the impact of treatment modality (DES vs. DCB) as well as neointimal characteristics (homogeneous vs. non-homogeneous) as determined by intravascular OCT, on clinical outcomes and explore whether there is an interaction between neointimal pattern of ISR and treatment modality. Methods Patients presenting with ischemic symptoms and/or evidence of myocardial ischemia in three European centers and undergoing intravascular OCT prior to percutaneous coronary intervention (PCI) for ISR, were retrospectively included in this study. Characterization of neointimal tissue was performed at the frame displaying the maximal %AS as well as the 5 preceding and following analyzed frames. Each frame was subdivided in 4 quadrants (90°) and the neointimal characteristics separately characterized for each of them. Based on its optical characteristics, neointimal tissue was categorized as homogeneous, heterogeneous, layered or neoatherosclerosis. Based on the dominant neointimal type, the study population was divided in two groups, (predominantly homogeneous and non-homogeneous). Primary endpoints of the study were represented by major adverse cardiac events (MACE) and its idividual components (death, cardiac death, myocardial infarction and target lesion revascularization (TLR)) at 2 years follow-up. Results A total of 197 patients undergoing OCT prior to PCI for ISR were included in this study. 100 patients were classified as having predominantly homogeneous and 97 as having predominantly non-homogeneous neointima. No association was found between predominant OCT pattern (homogenous vs. non-homogenous) and MACE at 2 years follow-up (HR=1.01, 95% CI: 0.59–1.75; p=0.94), or the individual MACE components. Analogously, no significant differences in terms of MACE at 2 years were found between predominantly homogeneous vs. non-homogeneous neointima in the patient subgroup receiving a DES (p=0.10) and in that undergoing DCB treatment (p=0.11). However, a significant interaction was found between neointimal tissue pattern and treatment modality in terms of MACE (p=0.02) aa well as death or MI (p=0.016). Predominantly non-homogeneous neointima in patients treated with DCB was associated with a higher incidence of MACE. Conclusions Our results indicate that there is a significant interaction between treatment modality of ISR (DES vs. DCB) and neointimal pattern as determined by intravascular OCT. These results land initial support to an OCT-guided treatment of ISR and should be confirmed by larger trials. Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of vascular parameters between normal cynomolgus macaques and healthy humans by optical coherence tomography angiography

2019 ◽  
Author(s):  
Jingyi Peng ◽  
Liuxueying Zhong ◽  
Li Ma ◽  
Jiayi Jin ◽  
Yongxin Zheng ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Optical Parameter ◽  
Vessel Density ◽  
Normal Adult ◽  
Optical Coherence ◽  
Healthy Humans ◽  
Cynomolgus Macaques ◽  
Optic Discs

Abstract Background: The metabolic activity of retina is higher than other human tissues and is crucial to the vision. Cynomolgus macaques is widely used in ophthalmic disease research. The evaluation and comparison of macular and optic disc vascular circulation parameters between normal adult cynomolgus macaques and healthy adult humans using OCT-A can promote better use of nonhuman primate models in studies of ophthalmic vascular disease. Methods: 12 normal adult cynomolgus macaques with a mean age of 4.91±0.43 years were studied for data collection. The macula of 28 adult healthy humans (14 males and 14 females), with a mean age of 25.11±6.21 years and the optic discs of 9 adult healthy humans (4 males and 5 females) with a mean age of 28.56±6.78 years were measured. The vessel density (VD) was measured using an RTVue XR with AngioVue. The scan sizes of the macular and optic discs were 3×3 mm and 4.5×4.5 mm, respectively. Results: OCT-A can image the superficial and deep capillary plexuses and radial peripapillary capillary network. In RPC layer of the optic disc, the VD in the nasal quadrant was lower than the VD in the inferior temporal quadrant. Similarities and significant differences in VD between healthy humans and cynomolgus macaques were obtained using OCT-A. Conclusions: This study provides normal vascular parameters for adult cynomolgus macaques using OCT-A to help establish an optical parameter database for cynomolgus macaques and compare VD between healthy humans and cynomolgus macaques to promote choroid-retinopathy research. Trial registration: Current Controlled Trials NCT03692169, retrospectively registered on 26 sept 2018 Keywords: Cynomolgus macaques, Healthy humans, Vascular, Optical coherence tomography angiography (OCT-A), Vessel density (VD)

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