scholarly journals Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Tuğba Aydoğan ◽  
Esra Güney ◽  
Betül İlkay Sezgin Akçay ◽  
Tahir Kansu Bozkurt ◽  
Cihan Ünlü ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Pigment Epithelium ◽  
Outer Nuclear Layer ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Spectral Domain ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Sd Oct

A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

Torpedo Maculopathy Presenting With Fovea Plana in a 21-Year-Old Female

2017 ◽  
Vol 1 (6) ◽  
pp. 424-427 ◽  
Author(s):  
Douglas S. M. Iaboni ◽  
Mark E. Seamone ◽  
Netan Choudhry ◽  
R. Rishi Gupta
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Spectral Domain ◽  
Optical Coherence ◽  
En Face Oct ◽  
En Face ◽  
Torpedo Maculopathy

Purpose: To report a case of torpedo maculopathy presenting with fovea plana in a 21-year-old female patient. Methods: Multimodal imaging including fluorescein angiography, fundus autofluorescence, and spectral domain optical coherence tomography (OCT) was used to characterize pathology. Results: A well-circumscribed ellipsoidal hypopigmented lesion was observed inferotemporal to the fovea OS. Fluorescein angiography and fundus autofluorescence revealed hyperfluorescence and focal hypoautofluorescence, respectively, corresponding to the hypopigmented lesion. Spectral domain optical coherence tomography imaging of the lesion revealed attenuation of the ellipsoid zone and retinal pigment epithelium with a hyporeflective subretinal cleft. En face OCT imaging demonstrated an area of subretinal hyporeflectivity at the subretinal cleft. Spectral domain optical coherence tomography revealed the absence of a foveal pit. Conclusion: We have described a novel case presentation of fovea plana alongside torpedo maculopathy. The significance of this association remains unclear. Further study into these conditions is necessary to help better determine factors responsible for visual symptoms or lack thereof and circumstances that promote their development.

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 B-Scan and “En-Face” Spectral-Domain Optical Coherence Tomography Imaging for the Diagnosis and Followup of Acute Retinal Pigment Epitheliitis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Flore De Bats ◽  
Benjamin Wolff ◽  
Martine Mauget-Faÿsse ◽  
Claire Scemama ◽  
Laurent Kodjikian
Keyword(s):  
Optical Coherence Tomography ◽  
Indocyanine Green ◽  
Structural Damage ◽  
Outer Nuclear Layer ◽  
Retinal Pigment ◽  
Spectral Domain ◽  
Optical Coherence ◽  
En Face Oct ◽  
En Face ◽  
Sd Oct

Purpose. To report B-scan and “En-face” spectral-domain optical coherence tomography (SD-OCT) findings in acute retinal pigment epitheliitis (ARPE).Methods. Two patients (3 eyes) with ARPE were examined. Fluorescein and indocyanine green (ICGA) angiography, B-scan, and “En-face” SD-OCT were performed in each patient at initial and follow-up visits.Results. Both patients presented with acute onset of blurred vision, and one with bilateral involvement. B-can OCT revealed disruption of the macular retinal pigment epithelial (RPE) inner band layer and photoreceptors’ inner and outer segment (IS-OS) junction. Hyperreflective dots were observed in the outer nuclear layer (ONL) above the RPE/IS-OS disruption. Just around these hyperreflective dots, slight thickening of the hyperreflective IS/OS junction was observed. During the late phase, indocyanine green angiography (ICGA) showed a macular cockade-like hyperfluorescent halo. “En-face” OCT showed the same cockade-like appearance with a hyporeflective center and a hyperreflective border matching the pattern observed on ICGA. At followup, as vision improved without treatment, B-scan OCT demonstrated progressive resolution of the hyperreflective and disrupted lesions; “en-face” OCT also showed disappearance of the macular cockade-like halo with a transient discrete hyperreflective macular star at the RPE level in one eye.Conclusion. “En-face” OCT associated with B-scan SD-OCT analysis appears to be very helpful in the diagnosis and followup of ARPE. The pathophysiology of ARPE remains complex and still poorly understood. These techniques help define the location and extent of structural damage occurring in this disease.

scholarly journals Multimodal Imaging of Acquired Vitelliform Lesion Diagnosed at Pseudohypopyon Stage

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Nuno Moreira Gonçalves ◽  
Ângela M. Carneiro ◽  
Elisete Brandão ◽  
Fernando M. Falcão-Reis
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Fundus Autofluorescence ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Macular Lesion ◽  
Multiple Round ◽  
One Year ◽  
Sd Oct

Purpose. To present a case study of a monocular acquired vitelliform lesion, studied with multimodal fundus imaging (spectral-domain-optical coherence tomography, fundus autofluorescence, and fluorescein angiography) with a followup of three years.Case Report. An asymptomatic macular lesion was detected on a 64-year-old man. Fundus exam revealed a macular lesion with an apparent horizontal level associated with multiple round small whitish lesions, suggestive of cuticular drusen. He was studied with autofluorescence of the fundus (FAF), fluorescein angiography (FA), spectral domain-optical coherence tomography (SD-OCT), and electrooculogram. The findings were compatible with the diagnosis of acquired vitelliform lesion, associated with cuticular drusen. After one year, the visual acuity decreased to 20/50, without identifiable alterations of the FAF, FA, or SD-OCT. Three years later, fundoscopy and imaging showed an evolution to a state similar to vitelli disruptive phase of Best disease with an improvement of visual acuity to 20/25. We report the results of FAF, FA, and SD-OCT at this stage.Conclusion. Acquired vitelliform lesions associated with cuticular drusen can present as a pseudohypopyon lesion, and the evolution to the atrophic phase can be associated with an improvement of visual acuity.

A Level Set Method with Region-Scalable Fitting Energy for Retinal Layer Segmentation in Spectral-Domain Optical Coherence Tomography Images

2020 ◽  
Vol 10 (2) ◽  
pp. 326-335
Author(s):  
Liming Liang ◽  
Xiaoqi Sheng ◽  
Bowen Liu ◽  
Zhimin Lan
Keyword(s):  
Optical Coherence Tomography ◽  
Level Set ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Spectral Domain ◽  
Retinal Layer ◽  
Optical Coherence ◽  
Retinal Layers ◽  
Layer Segmentation ◽  
Sd Oct

Retinal layer segmentation of spectral-domain optical coherence tomography images plays an important role during diagnosis and analysis of ophthalmic diseases. In this paper, a novel variational level set framework with region-scalable fitting energy is proposed for automated retinal layer segmentation in SD-OCT. To the best of our knowledge, it is the first time that level set based method succeeds in ten retinal layers segmentation. The proposed framework consists of three steps. First, an anisotropic nonlinear diffusion filter is applied for speckle noise reduction and ROI contrast enhancement. Second, Canny edge detectors are used to extract initial layers: nerve fiber layer, connecting cilia and retinal pigment epithelium. Finally, the rest retinal layers are segmented by means of level set model combined with prior knowledge of retinal thickness and morphology, for which the energy function consists of region-scalable fitting energy data term, area constraint term, regularization term and length penalty term. The proposed method was tested on 50 retinal SD-OCT B-scans from 50 normal subjects. The overall unsigned border position error is 5.92 ± 4.72 μm. The result showed that data terms with border weight terms can keep layer segmentation results in strong border while retaining its fitting capability in weak border. The proposed method achieves better segmentation result than other active contour models.

scholarly journals Topographic correlation between multifocal electroretinography, microperimetry, and spectral-domain optical coherence tomography of the macula in patients with birdshot chorioretinopathy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Rubbia Afridi ◽  
Aniruddha Agarwal ◽  
Nam V. Nguyen ◽  
Muhammad Hassan ◽  
Mohammad Ali Sadiq ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Structural Changes ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Multifocal Electroretinogram ◽  
Spectral Domain ◽  
Implicit Time ◽  
Optical Coherence ◽  
Birdshot Chorioretinopathy ◽  
Sd Oct

Abstract Purpose To correlate the findings of retinal function with multifocal electroretinogram (mfERG), microperimetry (MP), and structural assessments with spectral-domain optical coherence tomography (SD-OCT) in topographically corresponding areas of the macula of patients with birdshot chorioretinopathy (BSCR). Methods Patients diagnosed with BSCR by clinical and imaging findings were included in the study. The mfERG was performed using 61 hexagon stimulus patterns grouped into 5 rings (Diagnosys Inc., USA). Individual responses [N1-P1 amplitudes in nanovolt (NV)/degree2 and P1 implicit time in milliseconds (msec)] for each hexagon in the central 3 rings (R1, 0°–2.3°; R2,2.3°–7.7°; and R3, 7.7°–12°) were obtained (19 hexagons). MP examination consisted of Polar 3–12° test with 28 points in 3 concentric rings with diameters of approximately 2.3°, 6.6°, and 11.1° from the foveal center. SD-OCT was performed using macular scans of 20° × 20°. The retinal sensitivity values on MP and thickness values of retinal layers were correlated with the responses on the mfERG for each topographically correlated hexagon. Results Sixteen eyes of eight patients were included in the study (mean age, 59.87 ± 10.01 years; range, 41–73 years). The amplitudes and the implicit times on mfERG and retinal sensitivities on MP were decreased for each of the 19 hexagons. Considering retinotopically matched points, there was correlation between the retinal sensitivities and mfERG implicit times and response amplitudes in all three rings. The thickness of the retinal pigment epithelium showed modest correlation with the mfERG parameters (ρ = 0.29; p = 0.04). The structural changes on SD-OCT, such as IS-OS disruption, were associated with changes in the mfERG trace arrays. Conclusions The structural and functional assessments in retinae of eyes with BSCR suggest that each imaging tool may be capturing unique aspects of retinal dysfunction. Multimodal imaging may allow detailed analyses of retinal damage at various corresponding loci. These findings are important when considering the use of these techniques in BSCR.

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.

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