Hypotony Maculopathy: A Silent Mimicker of Common Macular Diseases With Nonspecific Optical Coherence Tomography Findings

2018 ◽  
Vol 2 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Ramon Lee ◽  
Hossein Ameri
Keyword(s):  
Optical Coherence Tomography ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Diagnostic Challenge ◽  
Hypotony Maculopathy ◽  
Age Related ◽  
Macular Diseases ◽  
Oct Imaging ◽  
Chorioretinal Folds

Purpose: To highlight the diagnostic challenge of eyes with hypotony maculopathy with concurrent macular diseases and to present optical coherence tomography (OCT) imaging findings in hypotony maculopathy. Methods: Retrospective review of 15 eyes of 12 patients with hypotony maculopathy at a single institution. Results: Low intraocular pressure (IOP) was caused by overfiltration from trabeculectomy in 9 eyes (of 15, 60%), overtreatment with topical aqueous suppressants after trabeculectomy in 3 eyes (of 15, 20%), bleb leak in 1 eye (of 15, 7%), and treatment with topical aqueous suppressants alone in 2 eyes (of 15, 13%). On OCT imaging, 7 eyes (of 15, 47%) had chorioretinal folds without intraretinal fluid (IRF) or subretinal fluid (SRF), 5 eyes (of 15, 33%) had either IRF or SRF with chorioretinal folds, and 3 eyes (of 15, 20%) had IRF or SRF without chorioretinal folds. The majority of eyes (11 of 15 eyes, 73%) had additional diagnoses apart from hypotony maculopathy that could have potentially caused IRF or SRF, which included epiretinal membrane, retinal vein occlusion, and age-related macular degeneration. Two eyes (of 15, 13%) were initially erroneously managed for a nonhypotony maculopathy pathology due to the diagnostic challenge in eyes with hypotony maculopathy. Conclusion: Hypotony maculopathy demonstrates nonspecific OCT findings such as IRF and SRF that are commonly seen in other macular diseases. In eyes with these macular diseases, diagnosing hypotony maculopathy may be challenging; thus, attention to past ocular history and IOP must always be part of evaluation.

A Comparison of Radial and Horizontal Macular Optical Coherence Tomography on Detection of Macular Pathology: A Prospective Study at an Academic Institution

2021 ◽  
pp. 247412642199705
Author(s):  
Halward M.J. Blegen ◽  
Samuel D. Hobbs ◽  
Reggie Taylor ◽  
Andrew L. Plaster ◽  
Paul M. Drayna
Keyword(s):  
Optical Coherence Tomography ◽  
Prospective Study ◽  
Macular Degeneration ◽  
Epiretinal Membrane ◽  
Central Serous Chorioretinopathy ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Age Related ◽  
Macular Diseases ◽  
A Prospective Study

Purpose: Optical coherence tomography (OCT) is useful in diagnosing and monitoring retinal pathology such as age-related macular degeneration, diabetic macular edema (DME), central serous chorioretinopathy, and epiretinal membrane, among others. This study compared the ability of horizontal (H) 25-, 13-, and 7-cut macular OCT vs 24-, 12-, and 6-cut radial (R) macular OCT in identifying various macular pathology. Methods: This was a prospective study of 161 established patients evaluated at Wilford Hall Eye Center Retina Clinic between September and October of 2019. Pathology included age-related macular degeneration, central serous chorioretinopathy, DME, and epiretinal membrane, among others. Patients obtained 25-, 13-, and 7-cut H raster OCT as well as 24-, 12-, and 6-cut R OCT. Primary outcomes were sensitivity in detecting macular fluid and each macular abnormality. Results: The 24-cut radial (R24) OCT equally or out-performed the H25 (horizontal 25-cut OCT) in detecting macular fluid across all pathological groups. Generally, a higher number of cuts correlated with better detection of fluid. In detecting any macular abnormalities, H25, R24, and R12 had 100% sensitivity. R6 OCT had near 100% sensitivity across all groups, except for DME (95%). Overall, R OCT had better sensitivity (0.960) than H OCT (0.907) in detecting macular pathology. Conclusions: R outperformed H macular OCT in detecting fluid and other abnormalities. Clinically, both scanning patterns can be used by ophthalmologists in diagnosis and management of commonly encountered macular diseases. Technicians may be able to use a variety of these scans to screen for pathology prior to physician evaluation.

Intravitreal aflibercept efficacy in neovascular age-related macular degeneration with suboptimal response to anti-vascular endothelial growth factor-A therapy

2019 ◽  
Vol 30 (5) ◽  
pp. 1082-1090
Author(s):  
Jordi Monés ◽  
Marc Biarnés ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Best Corrected Visual Acuity

Importance: To provide new insights into aflibercept effect in non-naive-treated patients with neovascular age-related macular degeneration. Purpose: To assess the efficacy of intravitreal aflibercept in patients with neovascular age-related macular degeneration without optimal response to previous anti-vascular endothelial growth factor A therapy. Design: Single-arm, multi-centre, prospective study. Participants: Patients ⩾50 years with active neovascular age-related macular degeneration, best-corrected visual acuity between 20/32 and 20/320 with suboptimal response to ranibizumab or bevacizumab. Methods: Aflibercept was administered monthly (3-first months), and bimonthly thereafter until month 8. Anatomical and functional outcomes were assessed. Main outcome measure: Percentage of eyes without intra or subretinal fluid on optical coherence tomography after 3-monthly loading doses of aflibercept. Results: A total of 46 patients were included. At week 12, 45.7% (95% confidence interval: 31.5%–60.1%) of eyes showed no fluid on optical coherence tomography. The mean (standard deviation) best-corrected visual acuity increased from 65.1 (8.3) to 69.6 (8.1) letters (+4.5 (5.8) p < 0.0001) and was stabilized at week 40 as compared to baseline. Mean central macular thickness decreased from 430 (119) µm to 323 (100) µm at week 12 (–107 (90) µm, p < 0.0001) and was reduced at week 40 (–46 (111) µm, p = 0.0056). At week 40, 21.7% (95% confidence interval: 9.8%–33.7%) had no fluid. There was a case of presumed noninfectious endophthalmitis that was successfully managed. Conclusion: Almost half of patients presented no fluid on optical coherence tomography at week 12, and there was a clinically significant improvement in best-corrected visual acuity. At week 40, one in five patients did not show intra or subretinal fluid, central macular thickness decreased and best-corrected visual acuity was stabilized compared to baseline.

scholarly journals Need for manual segmentation in optical coherence tomography angiography of neovascular age-related macular degeneration

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244828
Author(s):  
Supriya Dabir ◽  
Vaidehi Bhatt ◽  
Deepak Bhatt ◽  
Mohan Rajan ◽  
Preetam Samant ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Automated Segmentation ◽  
Optical Coherence ◽  
Manual Segmentation ◽  
Outer Retina ◽  
Age Related ◽  
En Face

Purpose To compare the characteristics of eyes that had manual vs. automated segmentation of choroidal neovascular membrane (CNVM) using optical coherence tomography angiography (OCTA). Methods All patients with CNVM underwent OCTA using the Zeiss Angioplex Cirrus 5000. Slabs of the avascular outer retina, outer retina to choriocapillaris (ORCC) region and choriocapillaris were generated. Manual segmentation was done when there were significant segmentation artifacts. Presence of activity of CNVM was adjudged by the presence of subretinal fluid (SRF) on structural OCT and was compared to activity detected on en face OCTA slabs based on well-defined criteria. Results Eighty-one eyes of 81 patients were recruited of which manual segmentation was required in 46 (57%). Eyes with automated segmentation had significantly more CNVM in the ORCC (75%) whereas those with manual segmentation had deeper CNVM (sub-RPE = 22%, intra-PED = 22%) (p<0.001). Twenty eyes (25%) were found to have active CNVM on both the structural OCT and OCTA while an additional 19 eyes were presumed to have active CNVM on OCTA alone. There was only modest concordance between disease activity detected using structural OCT and OCTA (Kappa = 0.47, 95% CI = 0.30 to 0.64). Conclusions Manual segmentation of OCTA is required in more than 50% eyes with CNVM and this progressively increases with increasing depth of CNVM location from the ORCC to below the RPE. There is moderate concordance between OCTA and structural OCT in determining CNVM activity.

Bacillary layer detachment on optical coherence tomography in exudative age-related macular degeneration

2021 ◽  
pp. 112067212110640
Author(s):  
Ramesh Venkatesh ◽  
Nikitha G Reddy ◽  
Sameeksha Agrawal ◽  
Arpitha Pereira ◽  
Naresh Kumar Yadav ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Multimodal Imaging ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Optical Coherence ◽  
Photoreceptor Layer ◽  
Age Related ◽  
Subretinal Hyperreflective Material

Purpose To report the bacillary layer detachment on optical coherence tomography in exudative age-related macular degeneration. Methods Retrospective, observational cases Case descriptions Two cases of exudative age-related macular degeneration, one diagnosed as polypoidal choroidal vasculopathy following exudative age-related macular degeneration and other as wet age-related macular degeneration with choroidal neovascular membrane showed separation of myoid and ellipsoid zones of photoreceptor layer on optical coherence tomography. This is termed as BALAD. Other associated features noted were the presence of subretinal hyperreflective material, submacular hemorrhage and subretinal fluid. Both cases were treated with monthly intravitreal injections of Inj. Ranibizumab (0.5 mg/0.05 ml). Following 3 intravitreal injections at monthly intervals, reattachment of the bacillary layer detachment were noted in case 1 while the bacillary layer detachment persisted in case 2. Conclusion Multimodal imaging using optical coherence tomography in these cases revealed the separation of the bacillary layer following exudative age-related macular degeneration; a finding which is not routinely described in literature.

scholarly journals The Presence of Intra- or Subretinal Fluid during the Loading Phase in the Treatment of Exudative Age-Related Macular Degeneration with Intravitreal Ranibizumab Assessed by Optical Coherence Tomography

2015 ◽  
Vol 234 (2) ◽  
pp. 61-66
Author(s):  
Andreas Ebneter ◽  
Boris Gekkiev ◽  
Bhuvan Chanana ◽  
Sebastian Wolf ◽  
Martin S. Zinkernagel
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Visual Improvement ◽  
Age Related ◽  
Treatment Naïve

Purpose: To assess intra- and subretinal fluid during the loading phase with intravitreal ranibizumab in exudative age-related macular degeneration and to quantify the accuracy of crosshair scan spectral-domain optical coherence tomography with regard to retinal fluid. Methods: This is a retrospective study of 31 treatment-naive patients who received 3 monthly intravitreal ranibizumab injections. Visual acuity and the presence of retinal fluid were assessed at each visit using volume and crosshair scan protocols. Results: Visual acuity improved and central retinal thickness decreased significantly during the loading phase. However, retinal fluid persisted in two thirds of the patients. The accuracy of the crosshair scan to detect fluid was 93%. Conclusions: A substantial proportion of eyes had persistent fluid after 3 months of ranibizumab injections. However, visual improvement was independent of residual fluid. Message: Crosshair scans detect relevant collections of retinal fluid accurately and may be sufficient in daily clinical practice.

scholarly journals Spatio-temporal alterations in retinal and choroidal layers in the progression of age-related macular degeneration (AMD) in optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wolf-Dieter Vogl ◽  
Hrvoje Bogunović ◽  
Sebastian M. Waldstein ◽  
Sophie Riedl ◽  
Ursula Schmidt-Erfurth
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Reference Frame ◽  
Age Related Macular Degeneration ◽  
Disease Stage ◽  
Optical Coherence ◽  
Common Reference ◽  
Age Related ◽  
Oct Imaging ◽  
Spatio Temporal

AbstractAge-related macular degeneration (AMD) is the predominant cause of vision loss in the elderly with a major impact on ageing societies and healthcare systems. A major challenge in AMD management is the difficulty to determine the disease stage, the highly variable progression speed and the risk of conversion to advanced AMD, where irreversible functional loss occurs. In this study we developed an optical coherence tomography (OCT) imaging based spatio-temporal reference frame to characterize the morphologic progression of intermediate age-related macular degeneration (AMD) and to identify distinctive patterns of conversion to the advanced stages macular neovascularization (MNV) and macular atrophy (MA). We included 10,040 OCT volumes of 518 eyes with intermediate AMD acquired according to a standardized protocol in monthly intervals over two years. Two independent masked retina specialists determined the time of conversion to MNV or MA. All scans were aligned to a common reference frame by intra-patient and inter-patient registration. Automated segmentations of retinal layers and the choroid were computed and en-face maps were transformed into the common reference frame. Population maps were constructed in the subgroups converting to MNV (n=135), MA (n=50) and in non-progressors (n=333). Topographically resolved maps of changes were computed and tested for statistical significant differences. The development over time was analysed by a joint model accounting for longitudinal and right-censoring aspect. Significantly enhanced thinning of the outer nuclear layer (ONL) and retinal pigment epithelium (RPE)–photoreceptorinner segment/outer segment (PR-IS/OS) layers within the central 3 mm and a faster thinning speed preceding conversion was documented for MA progressors. Converters to MNV presented an accelerated thinning of the choroid and appearance changes in the choroid prior to MNV onset. The large-scale automated image analysis allowed us to distinctly assess the progression of morphologic changes in intermediate AMD based on conventional OCT imaging. Distinct topographic and temporal patterns allow to prospectively determine eyes with risk of progression and thereby greatly improving early detection, prevention and development of novel therapeutic strategies.

scholarly journals Quantitative analysis of optical coherence tomography in age related macular degeneration

2021 ◽  
Vol 7 (2) ◽  
pp. 372-375
Author(s):  
D Sukanya ◽  
R Sudha ◽  
K Sushma ◽  
V Sreya
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Tertiary Care ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Tertiary Care Centre ◽  
Age Related ◽  
Macular Diseases ◽  
Significant Difference ◽  
Degenerative Disorder

Age related macular degeneration (ARMD) is a common degenerative disorder of macula in people above 50 years. The dry and wet/neovascular forms can lead to loss of vision. Optical coherence tomography is a popular tool in the diagnosis of AMRD. Aim of the study is to assess the Optical Coherence Tomography to diagnose the Age Related Macular Degeneration in a tertiary care centre. This prospective hospital based study was conducted on 50 patients presenting with age related macular degeneration clinically (100 eyes). Inclusion criteria was patients newly diagnosed clinically as ARMD and on no treatment. Exclusion criteria was Patients already diagnosed ARMD and on treatment, Patients with other retinal and macular diseases, and previous laser treatment. There were 42(84%) of patients are of 50-70 years age. Males were 21, and females were 29 without significant difference (p=0.7). Out of 100 eyes, 32% diagnosed as wet ARMD and 60% eyes had dry ARMD Dry ARMD is common in females (34%) and wet ARMD common in males (26%). In dry ARMD cases, 77.04% eyes had drusen by OCT, and 72.72% eyes had classic Choroidal neovascular membranes (CNVM). OCT showed sub-foveal CNVM as the common type of classic CNVM. 16 men were smokers, and 36 patients have hypertension. Smoking was significantly associated with ARMD (P &#60; 0.05). Increased prevalence of wet ARMD in males due to smoking, which leads to risk for CNVM. Smoking was significantly associated with ARMD (P &#60; 0.01) in our study. The prevalence was increased with increasing age. Dry ARMD was much more common than Wet ARMD, and both types increased in frequency with increasing age. ARMD is more common in females. OCT is highly specific in detecting the early sub-retinal neo vascular membrane and to assess the activity of neovascular membranes in early wet ARMD.

scholarly journals Automated Detection of Macular Diseases by Optical Coherence Tomography and Artificial Intelligence Machine Learning of Optical Coherence Tomography Images

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Soichiro Kuwayama ◽  
Yuji Ayatsuka ◽  
Daisuke Yanagisono ◽  
Takaki Uta ◽  
Hideaki Usui ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Deep Learning ◽  
Automated Detection ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Epiretinal Membranes ◽  
Model Image ◽  
Age Related ◽  
Macular Diseases ◽  
Wet Amd

Purpose. Although optical coherence tomography (OCT) is essential for ophthalmologists, reading of findings requires expertise. The purpose of this study is to test deep learning with image augmentation for automated detection of chorioretinal diseases. Methods. A retina specialist diagnosed 1,200 OCT images. The diagnoses involved normal eyes (n=570) and those with wet age-related macular degeneration (AMD) (n=136), diabetic retinopathy (DR) (n=104), epiretinal membranes (ERMs) (n=90), and another 19 diseases. Among them, 1,100 images were used for deep learning training, augmented to 59,400 by horizontal flipping, rotation, and translation. The remaining 100 images were used to evaluate the trained convolutional neural network (CNN) model. Results. Automated disease detection showed that the first candidate disease corresponded to the doctor’s decision in 83 (83%) images and the second candidate disease in seven (7%) images. The precision and recall of the CNN model were 0.85 and 0.97 for normal eyes, 1.00 and 0.77 for wet AMD, 0.78 and 1.00 for DR, and 0.75 and 0.75 for ERMs, respectively. Some of rare diseases such as Vogt–Koyanagi–Harada disease were correctly detected by image augmentation in the CNN training. Conclusion. Automated detection of macular diseases from OCT images might be feasible using the CNN model. Image augmentation might be effective to compensate for a small image number for training.

Study of Role of Optical Coherence Tomography in the Interpretation of Common Macular Disorders at a Tertiary Eye Care Centre in Rural Maharashtra

2021 ◽  
Vol 8 (27) ◽  
pp. 2428-2433
Author(s):  
Uttam Haribhau Nisale ◽  
Varsha Ramesh Dhakne ◽  
Sourabh Hanumant Karad ◽  
Samarth Babasaheb Waghambare ◽  
Hanumant Tulshiram Karad ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Macular Hole ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Age Related ◽  
Macular Diseases ◽  
Myopic Maculopathy

BACKGROUND Optical Coherence Tomography (OCT) is a commonly used non invasive imaging instrument useful for the diagnosis and follow up of macular disorders, but it has its own share of drawbacks in the presence of media opacities like corneal oedema, dense cataract and vitreous haemorrhage. We wanted to study and interpret the various patterns of common macular diseases on optical coherence tomography. METHODS 100 patients having macular diseases with no other ocular pathology were selected by simple random sampling. The patients were studied and followed up from day 1 of OPD during the period from January 2019 to December 2019 in rural hospital at Latur. All patients suspected of any macular disorder by slit lamp bio-microscopy with 78D or 90D examination were subjected to OCT evaluation. RESULTS On observation, out of 100 cases of macular pathology, 44 % (44 patients) with age related macular degeneration(ARMD), diabetic macular oedema ( DME) 36 % (36 patients), central serous retinopathy (CSR) 10 % (10 patients), myopic maculopathy (MM) 7 % (7 patients), macular hole (MH) 3 % (3 patients) were found in our study. In ARMD patients our OCT findings were hard drusens in retinal pigment epithelium (RPE), detachment of neurosensory retina and retinal pigment epithelium whereas in patients of DME our OCT findings were cyst like hyporeflective spaces within the retina, with retinal thinning and loss of foveal depression. In patients of CSR our findings were separation of sensory retina from RP, in myopic maculopathy our OCT findings were presence of macular retinoschisis and in patients of MH our findings were showing attachment of the posterior hyaloids to the fovea, separation of a small portion of the sensory retina from RPE in the foveolar region and intraretinal cystic changes. CONCLUSIONS OCT plays a crucial role when added along with the clinical examination in the diagnosis and interpretation of common macular disorders. KEYWORDS Optical Coherence Tomography, Age Related Macular Degeneration, Macular Hole, Myopic Maculopathy

Outer retinal tubulations in central serous chorioretinopathy associated with choroidal neovascularisation

2020 ◽  
pp. 112067212092136
Author(s):  
Spoorti Krishna Reddy Mandadi ◽  
Claudio Iovino ◽  
Riccardo Sacconi ◽  
Giuseppe Querques ◽  
Enrico Peiretti ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Case Series ◽  
Subretinal Fluid ◽  
Choroidal Neovascularisation ◽  
Age Related Macular Degeneration ◽  
Inactive Disease ◽  
Optical Coherence ◽  
Chronic Central Serous Chorioretinopathy ◽  
Age Related

Aim To report the prevalence and characteristics of outer retinal tubulations in eyes with choroidal neovascularisation associated with chronic central serous chorioretinopathy. Methods Retrospective case series which included evaluation of optical coherence tomography B-scans and enface optical coherence tomography scans of eyes with choroidal neovascularisation associated with chronic central serous chorioretinopathy. The characteristics of outer retinal tubulations such as number, shape and distribution were noted. The location of the outer retinal tubulations was correlated with autofluorescence. Results Outer retinal tubulations were detected in 9.1% of the eyes (9 out of 87 eyes). The average number of outer retinal tubulations in each eye was 4.7 ± 4.6. Spheroidal outer retinal tubulations were more common than the branching tubules. Although presence of outer retinal tubulations was mostly associated with inactive disease, two eyes had coexistent subretinal fluid. Conclusion Outer retinal tubulations associated with choroidal neovascularisation in chronic central serous chorioretinopathy, though less frequent, when present are more numerous, mostly extrafoveal and more spheroidal in shape compared to outer retinal tubulations associated with age-related macular degeneration and other degenerative conditions.

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