scholarly journals The role of OCT- angiography in predicting anatomical and functional recovery after endoscopic endonasal pituitary surgery: A 1-year longitudinal study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260029
Author(s):  
G. Cennamo ◽  
D. Solari ◽  
D. Montorio ◽  
M. R. Scala ◽  
L. D’Andrea ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Secondary Outcome ◽  
Ganglion Cell Complex ◽  
Endoscopic Endonasal ◽  
Capillary Plexus ◽  
Over Time ◽  
Sd Oct

Purpose The purpose of this study was to investigate the changes in structural spectral-domain optical coherence tomography (SD-OCT), OCT Angiography (OCTA) parameters, and visual acuity, 1 year after endoscopic endonasal approach for the removal of an intra-suprasellar pituitary adenoma compressing optic chiasm and compare outcomes with 48 hours postoperative data. Methods Sixteen eyes of eight patients (4 males, 4 females, mean age 52 ± 11 years) were enrolled in this prospective study. The primary outcome was to evaluate the changes over time before and after surgery, analyzing the Best Corrected Visual Acuity (BCVA), Ganglion Cell Complex (GCC), Retinal Nerve Fiber Layer (RNFL) thicknesses, the retinal vessel density (VD) of Superficial Capillary Plexus (SCP), Deep Capillary Plexus (DCP), Radial Peripapillary Capillary (RPC) and the Foveal Avascular Zone (FAZ). The secondary outcome was to identify potential biomarkers that could predict visual acuity changes after 1-year follow-up. Results When comparing SD-OCT and OCTA measurements obtained after 1 year with those observed 48 hours after surgery, GCC and RNFL were significantly improved. After a significant reduction at 48 hours, GCC thickness showed a significant increase at 1 year after surgery (p = 0.007), while a significant restoration of RNFL thickness was found at 1 year (p = 0.005), as well as the VD of SCP, DCP, and RPC values. FAZ area did not change over time. BCVA significantly improved at each time after surgery (p = 0.037, p = 0.013). A statistically significant correlation was found between the preoperative BCVA, VD of SCP, DCP, RPC, and the postoperative BCVA at 1 year (p = 0.017, p = 0.029, p = 0.031, p = 0.023). Conclusion SD-OCT and OCTA provide helpful information to identify the retinal structural and vascular improvements 1 year after surgery. OCTA parameters could serve as potential predictive markers for visual acuity recovery at long-term follow-up.

scholarly journals Retinal Vascular Changes in Radiation Maculopathy after Intravitreal Ranibizumab by Optical Coherence Tomography Angiography

2020 ◽  
Vol 9 (6) ◽  
pp. 1618 ◽  
Author(s):  
Gilda Cennamo ◽  
Daniela Montorio ◽  
Roberta Bernardo ◽  
Antonio Farella ◽  
Raffaele Liuzzi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Melanoma ◽  
Predictive Biomarkers ◽  
Foveal Avascular Zone ◽  
Functional Improvement ◽  
Optical Coherence ◽  
Foveal Thickness ◽  
Capillary Plexus ◽  
Sd Oct

In this prospective study, we investigated the structural and vascular retinal changes at baseline and after Ranibizumab injections at the last follow up to one year in patients affected by Radiation Maculopathy (RM) after plaque brachytheraphy in choroidal melanoma, using Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT Angiography (OCTA). A total of 40 eyes with RM of 40 patients (18 females, 22 males, mean age 51.9 ± 11 years) that underwent ruthenium-106 plaque brachytherapy were included. All patients received one monthly intravitreal injection of Ranibizumab (Pro Re Nata regimen). We analyzed the Foveal Avascular Zone (FAZ) area, the retinal vessel density (VD) of the superficial capillary plexus (SCP) and of the deep capillary plexus (DCP), using OCTA, and we detected the Central Foveal Thickness (CFT) by SD-OCT at baseline and after treatment. At the last follow up, we found a significant improvement of the CFT (p < 0.001) while OCTA parameters revealed no change in VD of the SCP (p = 0.402), DCP (p = 0.282), and FAZ area (p = 0.255), resulting in a stabilization of the visual acuity (p = 0.210) respect to baseline. The absence of functional improvement, despite the anatomical recovery of the macula, could be due to the absence of improvement in FAZ area and in retinal VD after treatment. OCTA parameters could represent predictive biomarkers to anti-vascular endothelial growth factor (anti-VEGF) intravitreal response and to help to better understand the physiopathological mechanisms of the RM.

Rapid response to dexamethasone intravitreal implant in diabetic macular edema

2017 ◽  
Vol 28 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Giuseppe Lo Giudice ◽  
Antonio Avarello ◽  
Gianluca Campana ◽  
Alessandro Galan
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Secondary Outcome ◽  
Dexamethasone Intravitreal Implant ◽  
Clinical Series ◽  
Intravitreal Implant ◽  
Early Effects ◽  
Sd Oct

Purpose: To evaluate the early effects of dexamethasone (DEX) intravitreal implants in patients with diabetic macular edema (DME). Methods: This was a prospective, single-arm, interventional clinical series. Eighteen patients (18 eyes) with chronic/recalcitrant or naive DME were included. Patients underwent single DEX intravitreal implant. Clinical assessments, including ophthalmologic examination, central retinal thickness (CRT) measurement by spectral-domain optical coherence tomography (SD-OCT) scan, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were carried out at baseline, 1-3 hours, and then 3, 7, and 30 days after treatment. The main outcome was change in CRT on SD-OCT, while secondary outcome measures included visual acuity (VA) and changes in IOP following implant. Results: Mean CRT significantly decreased from 565 ± 171 µm at baseline to 310 ± 89 µm at end of follow-up (p<0.001), with reduction becoming evident 1-3 hours after injection. Mean BCVA also significantly improved 7 days and 30 days after treatment up to 0.14 logMAR (p<0.05). All patients had a controlled IOP after the injection with only 1/18 eyes having a transient increase in IOP during follow-up. Conclusions: This is the first study showing very early effects of DEX implants on CRT reduction and VA improvement in DME.

scholarly journals Associations Between Diabetic Retinal Microvasculopathy and Neuronal Degeneration Assessed by Swept-Source OCT and OCT Angiography

2021 ◽  
Vol 8 ◽  
Author(s):  
Bingjie Qiu ◽  
Lin Zhao ◽  
Xinyuan Zhang ◽  
Yanhong Wang ◽  
Qiyun Wang ◽  
...  
Keyword(s):  
Ganglion Cell ◽  
Neuronal Degeneration ◽  
Normal Subjects ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Swept Source ◽  
Circularity Index ◽  
Capillary Plexus

Purpose: To provide clinical evidence of the associations between retinal neuronal degeneration and microvasculopathy in diabetic retinopathy (DR).Methods: This case-control study included 76 patients (76 eyes) with type 2 diabetes mellitus (DM), and refraction error between −3.0 and +3.0 D. The eyes were assigned into DM (without DR), non-proliferative DR (NPDR), and proliferative DR (PDR) groups. Age-, sex-, and refractive error-matched normal subjects were enrolled as controls. The mean retinal thickness (mRT), the relative mean thickness of the retinal nerve fiber layer (rmtRNFL, mtRNFL/mRT), ganglion cell layer (rmtGCL), ganglion cell complex (rmtGCC) layer, foveal avascular zone area (FAZa), FAZ perimeter (FAZp), FAZ circularity index (FAZ-CI), and vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP) were assessed by swept-source optical coherence tomography (OCT) and OCT angiography (OCTA). Group comparison and Spearman's partial correlation coefficient analysis were applied to evaluate the correlation between these morphological parameters.Results: rmtRNFL, FAZa, and FAZp in SCP and DCP increased with the DR severity (prmtRNFL &lt; 0.001; pFAZa, SCP = 0.001; pFAZa, DCP = 0.005; pFAZp, SCP &lt; 0.001; pFAZp, DCP &lt; 0.001). The rmtGCL, FAZ-CI in SCP and DCP, and VD in DCP decreased with the DR severity (prmtGCL = 0.002, pFAZ−CI, SCP = 0.002; pFAZ−CI, DCP &lt; 0.001, pVD, DCP &lt; 0.001). After controlling age, sex, duration of diabetes, and hypertension, the rmtRNFL, FAZa in SCP and DCP, and FAZp in SCP and DCP were correlated with the severity of DR (p &lt; 0.05), while VD in SCP and DCP, FAZ-CI, and rmtGCL were negatively correlated with the severity of DR (p &lt; 0.05). The rmtGCL was negatively correlated with the FAZa in SCP (r = −0.34, p = 0.002) and DCP (r = −0.23, p = 0.033), and FAZp in SCP (r = −0.37, p = 0.001) and DCP (r = −0.32, p = 0.003), but positively correlated with VD in SCP (r = 0.26, p = 0.016), VD in DCP (r = 0.28, p = 0.012), and FAZ-CI in DCP (r = 0.31, p = 0.006).Conclusions: rmtRNFL, FAZ-CI in SCP and DCP, and FAZp in SCP are strong predictors of the severity of DR. The ganglion cell body loss is highly correlated with increased FAZp and FAZa, decreased FAZ-CI, and reduced VD with the severity of DR.

scholarly journals Multimodal Imaging Analysis in a Case with Congenital Fovea-Involving Retinal Macrovessel and Excellent Visual Acuity

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Vishal Shah ◽  
M. Ashwin Reddy ◽  
Vasilios P. Papastefanou
Keyword(s):  
Visual Acuity ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Swept Source ◽  
En Face Oct ◽  
En Face ◽  
Avascular Zone ◽  
Capillary Plexus ◽  
Swept Source Oct ◽  
Swept Source Oct Angiography

Purpose. Congenital retinal macrovessels (CRM) represent rare aberrant vasculature of the retinal vessels that can supply or drain the macula. In this report, the optical coherence tomography angiography features of a congenital retinal macrovessel are discussed. Methods. The history and examination findings are presented alongside swept-source OCT angiography with corresponding B scan and en face OCT imaging. Patients. The case is a 12-year-old female patient with excellent best-corrected visual acuity in both eyes. Results. Swept-source OCT angiography demonstrated considerable loss of the foveal avascular zone at the levels of the superficial and deep capillary plexus. Discussion. In this case there was no detrimental effect on vision despite anatomical loss of the foveal avascular zone.

scholarly journals Macular Microvascular Modifications in Progressive Lamellar Macular Holes

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1717
Author(s):  
Fiammetta Catania ◽  
Davide Allegrini ◽  
Alessandra Nembri ◽  
Filippo Confalonieri ◽  
Piero Zollet ◽  
...  
Keyword(s):  
Tissue Loss ◽  
Oct Angiography ◽  
Group 14 ◽  
Macular Holes ◽  
Capillary Plexus ◽  
Perfusion Density ◽  
Linear Correlations ◽  
Functional Deterioration ◽  
Over Time

Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography (OCT) angiography parameters. Methods: OCT B scans of eyes with LMH were analyzed to detect the presence of tissue loss (TL) over time, allowing us to identify a TL group and a stable (ST) group (14 patients each). The best corrected visual acuity (BCVA) at each considered imaging time point was collected. Lastly, patients underwent macular OCT angiography. Results: BCVA at last follow up was significantly reduced in the TL group compared to both the ST group and TL group baseline assessment. SCP foveal vessel density (VD), SCP and deep capillary plexus (DCP) perfusion density (PD) and parafoveal PD were lower in the TL group. Linear correlations between quantitative TL over time and parafoveal PD in SCP and between the speed of TL and BCVA variation during follow up were also detected. Conclusions: TL in LMHs is associated with both OCT angiography modifications and BCVA deterioration over time. We suggest these findings to be a manifestation of foveal Muller cell impairment in progressive LMHs.

scholarly journals Femtosecond laser-assisted anterior lamellar keratoplasty (FSALK) versus microkeratome-assisted anterior lamellar keratoplasty (MALK) for the treatment of anterior corneal dystrophy.

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Radwan Almousa ◽  
Sheraz M Daya
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Visual Outcome ◽  
Corneal Dystrophy ◽  
Lamellar Keratoplasty ◽  
Secondary Outcome ◽  
Clinical Recurrence ◽  
Corneal Scarring ◽  
Anterior Lamellar Keratoplasty

Purpose: To compare the visual outcome of femtosecond laser-assisted anterior keratoplasty (FSALK) and microkeratome-assisted anterior lamellar keratoplasty (MALK) in anterior corneal dystrophy.  Methods: retrospective comparative chart review of 7 eyes that underwent FSALK and 7 eyes that underwent MALK. The primary outcome was the visual outcome of both procedures. The secondary outcome was the recurrence of the corneal dystrophies.Results: Mean follow-up time was 30±14(7-51) months for the FSALK group and 127±28(80-127) months for the MALK group. In the FSALK group the preoperative best spectacle-corrected visual acuity (BSCVA) improved from 20/63 to 20/25 at 36 months. In the MALK group there was 1 eye with documented BSCVA over 36 months follow-up; it improved from 20/160 preoperatively to 20/32 at 36 months. Uncorrected visual acuity (UCVA) at 36 months improved from 20/100 preoperatively to 20/63 in the FSALK group and from 20/200 preoperatively to 20/63 in the MALK group. Five eyes with Reis-Bucklers showed a clinical recurrence at a mean of 142±13(125-152) months. Two eyes with granular dystrophy showed a clinical recurrence at 23 and 80 months of follow-up. One eye in the MALK group had epithelial ingrowth. One eye in the FSALK group with compromised ocular surface due to 2 previous penetrating keratoplasty, suffered bacterial keratitis that ended up with corneal scarring. Conclusion: Both procedures improve visual outcome for anterior corneal dystrophy. FSALK has theoretical advantages over MALK; however, larger prospective studies are needed to prove this.

Comparison of aflibercept and ranibizumab in diabetic macular edema associated with subretinal detachment

2019 ◽  
Vol 30 (2) ◽  
pp. 363-369 ◽  
Author(s):  
Abdullah Ozkaya ◽  
Gokhan Demir ◽  
Asli Kirmaci
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Secondary Outcome ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Best Corrected Visual Acuity

Purpose: To compare the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular edema associated with subfoveal retinal detachment. Methods: This is a retrospective, comparative study. The treatment-naïve diabetic macular edema patients who had diabetic macular edema associated with subfoveal retinal detachment and underwent intravitreal aflibercept or intravitreal ranibizumab treatment were included. The patients were treated on a pro re nata treatment regimen after a loading dose of 3-monthly injections and the follow-up time was 12 months. The primary outcome measure of this study was the presence of subfoveal retinal detachment after treatment at different time points. The secondary outcome measures were the change in best corrected visual acuity and central retinal thickness. Results: A total of 46 eyes of 46 patients were included. The aflibercept group consisted of 20 and the ranibizumab group consisted of 26 eyes. During the follow-up period of 12 months, subfoveal retinal detachment was completely resolved in 75% versus 57.7% of the eyes at month 3 (p = 0.2), 90% versus 76.9% at month 6 (p = 0.2), 90% versus 65.4% at month 9 (p = 0.05), and 100% versus 80.8% at month 12 (p = 0.03) in the intravitreal aflibercept versus intravitreal ranibizumab groups. The change in best corrected visual acuity was not statistically different between the groups at months 3, 6, 9, and 12, respectively (p > 0.05 for all). Conclusion: Both intravitreal aflibercept and intravitreal ranibizumab were effective in regards to anatomical and functional outcomes of diabetic macular edema patients associated with subfoveal retinal detachment. Interestingly, intravitreal aflibercept seemed more effective than intravitreal ranibizumab in the resolution of subfoveal retinal detachment at month 12.

scholarly journals OCT Angiography Findings in Macula-ON and Macula-OFF Rhegmatogenous Retinal Detachment: A Prospective Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3982
Author(s):  
Francesco Barca ◽  
Daniela Bacherini ◽  
Francesco Dragotto ◽  
Ruggero Tartaro ◽  
Chiara Lenzetti ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Foveal Avascular Zone ◽  
Vascular Density ◽  
Vein Occlusion ◽  
Repair Materials ◽  
Capillary Plexus ◽  
Group A ◽  
A Prospective Study

Background: The aim of the study was to evaluate pre-operative and post-operative retinal vasculature using optical coherence tomography angiography (OCTA) in patients who underwent rhegmatogenous retinal detachment (RRD) surgery repair. Materials and Methods: A total of 33 eyes were included in this prospective consecutive observational study: 15 affected by macula-ON and 18 by macula-OFF RRD. Superficial (SCP), deep capillary plexus (DCP), and foveal avascular zone (FAZ) area variations were evaluated by OCTA and correlated with visual acuity (VA) during a six-month follow-up. Results: In the macula-ON group, the preoperative vascular density (VD) of the whole SCP (wSCP) on affected eyes was lower than that of the fellow eyes (p < 0.05); this difference disappeared at 6 months after surgery (p = 0.88). The wSCP VD and the parafoveal SCP (pfSCP) VD increased during follow-up (p < 0.05); moreover, the higher the preoperative wSCP and pfSCP VD, the better the baseline VA (p < 0.05). In the macula-OFF group, at the first and sixth months after surgery, the larger the FAZ, the lower the VA (p < 0.05). Conclusions: Macula-ON SCP VD affected preoperative VA, and it was lower than the fellow eye, but recovered over time. In the macula-OFF group, a larger FAZ area was related to a worse VA, as is the case in diabetes and in retinal vein occlusion (RVO).

scholarly journals The Effect of Nutrition Intervention With Oral Nutritional Supplements on Ovarian Cancer Patients Undergoing Chemotherapy

2021 ◽  
Vol 8 ◽  
Author(s):  
Nan Qin ◽  
Guichun Jiang ◽  
Xu Zhang ◽  
Di Sun ◽  
Meishuo Liu
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Cancer Patients ◽  
Nutrition Education ◽  
Nutritional Risk ◽  
Secondary Outcome ◽  
Control Group ◽  
Oral Nutritional Supplements ◽  
Over Time

Background: Ovarian cancer is the third most common gynecological malignancy in the world and it is under a higher incidence of malnutrition. Chemotherapy is currently a common treatment for ovarian cancer, but the resulting side effects can exacerbate malnutrition. Our aim was to investigate the beneficial effects of oral nutrition supplements (ONS) on ovarian cancer patients undergoing chemotherapy.Methods: Single-blinded randomized controlled trial. Patients with ovarian cancer receiving chemotherapy were randomly assigned either to the ONS or non-ONS groups via a simple randomization. The ONS group was given 250 mL ONS each time (1.06 kcal, 0.0356 g of protein per mL), three times a day, and nutrition education. Control group received nutrition education alone. The primary outcome was the nutritional risk of the patients as assessed by the Patient-Generated Subjective Global Assessment (PG-SGA). The secondary outcome was the results of the participants' biochemical tests at each measurement time point. Data were collected (T0) at baseline, (T1) post intervention at 3 weeks, (T2) 9-week follow-up, (T3) 15-week follow-up. Generalized estimating equation models were used to compare the changes in outcomes over time between groups.Results: 60 participants (30 ONS, 30 controls) completed the trial, and data was analyzed. For baseline comparisons, no significant differences were found between the two groups. A progressive trend toward amelioration in PG-SGA scores over time was found within the ONS group, with scores decreasing from 9.27 ± 1.68 at baseline (T0) to 5.87 ± 2.06 after the intervention (T3). Furthermore, ONS group achieved a significantly greater reduction in PG-SGA score at the T1 (p = 0.03, confidence interval −2.23 to −0.11), T2 (p = 0.001, confidence interval −2.86 to −0.74) and T3 (p &lt; 0.001, confidence interval −3.81 to −1.53), than the control group. In terms of biochemical test results, patients in the ONS group had better leukocytes, lymphocytes, Hemoglobin, Albumin and Total Protein than the control group at different time points, with statistical differences between the two groups (p &lt; 0.05).Conclusions: The present study demonstrated that ONS can significantly reduce the nutritional risk of patients undergoing chemotherapy for ovarian cancer. In addition, we also found that nutritional education seems to have a positive effect on reducing the nutritional risk of patients especially at the beginning of chemotherapy.

Оptical coherence tomography and optical coherence tomography-angiography in determining the progression of glaucoma

2021 ◽  
pp. 26-31
Author(s):  
N.I. Kurysheva ◽  
◽  
A.D. Nikitina ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Functional Assessment ◽  
Oct Angiography ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Complex Dynamic ◽  
Glaucoma Progression ◽  
Primary Glaucoma ◽  
Sd Oct

Purpose. To study the role of optical coherence tomography (OCT) and OCT angiography (OCTA) in the detection of the primary glaucoma progression. Material and methods. The prospective study of 128 patients with primary glaucoma (128 eyes), conducted from 2015 to 2019, included at least 6 standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT) examinations in each patient; OCTA was also used during the last year of observation. To determine the disease progression, the trend and event analysis using the Humphrey Field Analyzer was performed. The fact and rate of thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated. If they had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The values of corneal-compensated IOP were also considered: minimal (IOPmin) and peak (IOPmax). Results. Glaucoma progression was detected in 79 eyes. The isolated use of SAP allows detecting the progression only in 2.3% cases, SD-OCT - in 37.5%, among them the isolated assessment of GCC amounted to 7.8%, and RNFL – to 5.5%. The complex dynamic morphological and functional assessment increased the possibility of progression detection up to 61.7%. Progression was related to the stage of glaucoma damage at the moment of diagnosis: for the perimetry index PSD p=0.025, for the focal loss volume of GCC p=0.024, as well as with the level of minimal IOP (p=0.04). All patients with progression have shown the vessel density decrease in the peripapillary retina and parafovea. Conclusion. SD-OCT plays an important role in detecting the progression of glaucoma. The complex dynamic morphological and functional assessment allows detecting the progression in over half of patients. Progression is associated with the initial stage of glaucoma and an insufficient IOP decrease during treatment, accompanied by retinal microcirculation deterioration. Key words: primary, glaucoma progression, optical coherence tomography, OCT-angiography, IOP.

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