scholarly journals Multimodal imaging in choroidal metastasis

2020 ◽  
Author(s):  
Gilda Cennamo ◽  
Daniela Montorio ◽  
Marianna Carosielli ◽  
Mario R. Romano ◽  
Giovanni Cennamo
Keyword(s):  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Choroidal Metastasis ◽  
Depth Imaging ◽  
Lipofuscin Pigment ◽  
Imaging Optical Coherence Tomography ◽  
Intraocular Tumours

Background: Choroidal metastasis represent the most common malignant intraocular tumours. Objectives: To detect the structural and vascular features of choroidal metastasis by multimodal imaging. Methods: Sixteen eyes of 16 patients with choroidal metastasis were enrolled in this prospective study. The multimodal imaging was performed in all patients: fluorescein angiography, indocyanine green angiography, enhanced depth imaging optical coherence tomography (EDI-OCT), OCT angiography (OCTA) and ultrasonography. Results: The choroidal metastasis were located in the macula region in 9 eyes (57%) and in the extramacular region in 7 eyes (43%). EDI-OCT showed a mean thickness of 950 ± 246 µm, a smooth anterior tumour surface in 5 eyes (31%) and a lumpy bumpy appearance in 11 eyes (69%). The most frequent EDI-OCT features were represented by choriocapillaris thinning (100%), shaggy photoreceptors (82%), subretinal fluid with speckles (69%), subretinal lipofuscin pigment (6%), absence of drusen (100%), optical shadowing (94%), low internal optical reflectivity (75%) and retinal pigment epithelium alterations (43%). OCTA revealed an absence of intratumoral vascular network in all cases.

Delayed-onset unilateral Vogt-Koyanagi-Harada syndrome: a multimodal imaging appraisal

2021 ◽  
Vol 14 (2) ◽  
pp. e238623
Author(s):  
Saurabh Verma ◽  
Himani Thakur ◽  
Shorya Vardhan Azad ◽  
Vinod Kumar
Keyword(s):  
Multimodal Imaging ◽  
Intravitreal Bevacizumab ◽  
Choroidal Neovascularisation ◽  
Enhanced Depth Imaging ◽  
Depth Imaging ◽  
Delayed Onset ◽  
First Case ◽  
Imaging Optical Coherence Tomography ◽  
The Right ◽  
Active Inflammation

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.

scholarly journals Optical Coherence Tomography Characteristics of the Choroid Underlying Congenital Hypertrophy of the Retinal Pigment Epithelium

2020 ◽  
Vol 6 (4) ◽  
pp. 238-243
Author(s):  
Jasmine H. Francis ◽  
Ethan K. Sobol ◽  
Molly Greenberg ◽  
Robert Folberg ◽  
David H. Abramson
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Choroidal Thickness ◽  
Retinal Thickness ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Enhanced Depth Imaging ◽  
Optical Coherence ◽  
Depth Imaging ◽  
Congenital Hypertrophy

Purpose: This study evaluates and characterizes the choroid underlying congenital hypertrophy of the retinal pigment epithelium (CHRPE). Methods: Retrospective observational study of CHRPE at least 2 mm in diameter. Choroidal vascular architecture was qualitatively examined. Choroidal thickness was measured by 2 independent observers using enhanced depth imaging spectral domain optical coherence tomography. Results: Forty-six eyes of 46 patients with CHRPE were included. Thirty-two lesions had imaging sufficient for analysis. Haller’s layer was healthy in 18 (56%), thin in 13 (41%), and absent in 1 (2%). Sattler’s layer was atrophic in 30 (94%), and choriocapillaris was atrophic in 31 (97%). CHRPE with thinned Haller’s layer had significantly larger diameter. The mean sub-CHRPE choroidal thickness was 82.4 ± 7.9 µm, compared to a thickness of 148.4 ± 9.6 µm in the normal adjacent choroid (p < 0.0001). Mean retinal thickness overlying the CHRPE was 77.3 ± 4.3 µm, compared to a retinal thickness of 137.8 ± 2.9 µm overlying the normal adjacent choroid (p < 0.0001). Sub-CHRPE choroidal thickness was a mean of 56.2 ± 3.1% of the adjacent normal choroidal thickness. Conclusion: The underlying choroid CHRPE is thinner than the adjacent normal choroid. All layers of the choroid can be thin with a preference of the inner Sattler’s and choriocapillaris layers.

scholarly journals MACULOPATHY AND CHORIORETINOPATHY IN CHILDREN WITH RETINOBLASTOMA RECEIVING CHEMOTHERAPY: CLINICAL TRIALS AND MORPHOMETRIC ANALYSIS

2018 ◽  
Vol 13 (4) ◽  
pp. 167-175
Author(s):  
S. V Saakyan ◽  
Elena В. Myakoshina ◽  
V. G Polyakov ◽  
T. L Ushakova ◽  
D. M Ismailova
Keyword(s):  
Optical Coherence Tomography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Enhanced Depth Imaging ◽  
Optical Coherence ◽  
Depth Imaging ◽  
Chemotherapy Group ◽  
Intravitreal Chemotherapy ◽  
Group 3 ◽  
Group 2

Purpose. This research is to evaluate patients with retinoblastoma, who receive chemotherapy, with Spectralis optical coherence tomography with enhanced depth imaging to compare the signs of chorioretinopathy and maculopathy. Material and methods. 74 patients were examined and treated, 125 eyes with retinoblastoma in age at average of 24 ± 1.6 months. Group 1 - 31 patients, 62 eyes after intravenous chemotherapy, 2 - 24 patients, 25 eyes after intravenous and superselective intraarterial or intravitreal chemotherapy. Group 3 (control) - 19 patients (38 eyes) with primary retinoblastoma. The condition of the retina, choroid and macula was assessed using Ret Cam II and Spectralis optical coherence tomography with enhanced depth imaging. All patients had complete tumor resorption after treatment. Results. In group 1, after 3 courses of chemotherapy Spectralis optical coherence tomography with enhanced depth imaging showed a decrease of caliber of retinal vessels; wavelength of photoreceptors, hyperreflective round foci and calcinates in the retinal pigment epithelium; choriocapillary hyperreflexivity, choroid thinning; in the sclera - hyperreflective foci with visualization of the scleral vessels. In the macula - disorganization of retinal pigment epithelium, cystic edema, smoothness of the papillomacular bundle, coracoid form of the fovea, retinal thickening. After 3 courses of systemic chemotherapy and superselective intraarterial chemotherapy (group 2) - peritumoral increase in the caliber of retinal vessels. After systemic superselective intraarterial and intravitreal chemotherapy (group 2) - epiretinal membranes, punctate hyperreflective foci in the inner layers of the retina. In group 3 (control), before treatment, a normal anatomical and topographic state of the macula was observed with extracentral localization of retinoblastoma. Conclusions. Profound morphometric disturbances that come with combined chemotherapy (intravenous, superselective intraarterial and intravitreal chemotherapy treatments) call for a more careful treatment with methods selected in terms of Spectralis optical coherence tomography with enhanced depth imaging findings and specific chemotherapy contraindications.

Choroidal Characteristics of Acute and Chronic Central Serous Chorioretinopathy Using Enhanced Depth Imaging Optical Coherence Tomography

2016 ◽  
Vol 27 (4) ◽  
pp. 476-480 ◽  
Author(s):  
Jorge Ruiz-Medrano ◽  
Marco Pellegrini ◽  
Matteo G. Cereda ◽  
Mario Cigada ◽  
Giovanni Staurenghi
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Retinal Pigment ◽  
University Hospital ◽  
Enhanced Depth Imaging ◽  
Optical Coherence ◽  
Depth Imaging ◽  
Choroidal Vessel ◽  
Imaging Optical Coherence Tomography ◽  
Vessel Walls

Purpose Central serous chorioretinopathy (CSC) is an idiopathic disorder characterized by serous detachments of the neurosensory retina and/or the retinal pigment epithelium affecting the macular area in the majority of cases. The objective of this study was to describe choroidal findings in patients with acute and chronic CSC based on enhanced depth imaging optical coherence tomography analysis. Methods This is a cross-sectional, noninterventional study performed at Luigi Sacco University Hospital of Milan. Inclusion criteria were the presence of diagnosed (acute or chronic) CSC and being 18 years or older. Patients were evaluated with Spectralis spectral-domain optical coherence tomography enhanced depth imaging by 2 operators. The main features analyzed were intrachoroidal hyperreflective spots and hyperreflective choroidal vessel walls, as actual measurements of wall thickness could not be performed. Results Patients with chronic CSC had hyperreflective spots in 83.3% of the cases and hyperreflective choroidal vessel walls in 75%, whereas patients with acute course had the same alterations in 33% and 6.7% of cases, respectively. Conclusions These findings, if proven, may be indicative of chronic forms, thus guiding more accurate treatments and guiding clinicians through more accurate prognosis.

Multimodal imaging in retinal pigment epithelium rip with exudative bullous retinal detachment

2020 ◽  
Vol 13 (9) ◽  
pp. e235731
Author(s):  
Padmaja Kumari Rani ◽  
Aniruddh Soni
Keyword(s):  
Retinal Pigment Epithelium ◽  
Retinal Detachment ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Exudative Retinal Detachment ◽  
Bullous Retinal Detachment ◽  
Subretinal Fluid Drainage

A middle-aged man presented with exudative retinal detachment in the left eye. He was previously diagnosed as a case of large pigment epithelial detachment in the same eye, for which he was asked to follow-up closely, citing the risk of an retinal pigment epithelium (RPE) rip. Multimodal imaging confirmed the presence of a large RPE rip with exudative retinal detachment. He is a known retrovirus patient on anti-retroviral therapy with stable CD4 counts. He was diagnosed as a possible case of bullous variant of central serous chorioretinopathy and underwent external subretinal fluid drainage. We highlight the multimodal imaging findings of RPE rip with exudative retinal detachment and its impact on the patients visual acuity.

scholarly journals Segmentation of Choroidal Boundary in Enhanced Depth Imaging OCTs Using a Multiresolution Texture Based Modeling in Graph Cuts

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Hajar Danesh ◽  
Raheleh Kafieh ◽  
Hossein Rabbani ◽  
Fedra Hajizadeh
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Automatic Segmentation ◽  
Gaussian Mixture ◽  
Graph Cut ◽  
Enhanced Depth Imaging ◽  
Cross Sectional ◽  
Depth Imaging ◽  
Cross Sectional Imaging

The introduction of enhanced depth imaging optical coherence tomography (EDI-OCT) has provided the advantage of in vivo cross-sectional imaging of the choroid, similar to the retina, with standard commercially available spectral domain (SD) OCT machines. A texture-based algorithm is introduced in this paper for fully automatic segmentation of choroidal images obtained from an EDI system of Heidelberg 3D OCT Spectralis. Dynamic programming is utilized to determine the location of the retinal pigment epithelium (RPE). Bruch’s membrane (BM) (the blood-retina barrier which separates the RPE cells of the retina from the choroid) can be segmented by searching for the pixels with the biggest gradient value below the RPE. Furthermore, a novel method is proposed to segment the choroid-sclera interface (CSI), which employs the wavelet based features to construct a Gaussian mixture model (GMM). The model is then used in a graph cut for segmentation of the choroidal boundary. The proposed algorithm is tested on 100 EDI OCTs and is compared with manual segmentation. The results showed an unsigned error of 2.48 ± 0.32 pixels for BM extraction and 9.79 ± 3.29 pixels for choroid detection. It implies significant improvement of the proposed method over other approaches likek-means and graph cut methods.

scholarly journals The morphology of choroidal neovascularization in chronic central serous chorioretinopathy presenting with flat, irregular pigment epithelium detachment

2021 ◽  
Author(s):  
Claudio Azzolini ◽  
Jennifer Cattaneo ◽  
Laura Premoli ◽  
Cristian Metrangolo ◽  
Maurizio Chiaravalli ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Morphological Characteristics ◽  
Subretinal Fluid ◽  
Chronic Central Serous Chorioretinopathy ◽  
Cross Sectional ◽  
Pigment Epithelium Detachment

Abstract Purpose To evaluate morphological characteristics of choroidal neovascularization in chronic central serous chorioretinopathy (CSC) presenting with flat and irregular pigment epithelium detachment (FIPED) by means of innovative multimodal imaging. Methods In this observational cross-sectional study, we examined 10 consecutive patients affected by chronic CSC and FIPED using fluorescein angiography (FA), indocyanine-green angiography (ICGA) and optical coherence tomography angiography (OCTA). A qualitative analysis of the nature and characteristics of neovascular membrane was performed, combining available multimodal imaging and literature data. Results Multiple areas of retinal pigment epithelium alterations, macular hypo- and hyperpigmentation and atrophic areas were identified. Spectral domain OCT (SD-OCT) showed subretinal fluid in 80% of eyes and the ‘double layer sign’ in all patients. Late FA phases showed staining areas without leakage in all eyes; ICGA showed a hyperfluorescent plaque with surrounding hypofluorescence in 80% of patients. OCTA detected characteristic neovascular networks in the outer retina within the FIPEDs, classified as filamentous vessels with a pruned tree-like pattern in five eyes and a tangled pattern in three eyes. The choriocapillaris network showed dark areas in 80% of eyes and diffuse dark spots in all eyes. Conclusion Multimodal imaging completes clinical characterization of FIPEDs in chronic CSC. This study using OCTA technology describes the phenotype of hidden neovascular lesions in shape and morphology.

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