scholarly journals Artifact Removed Quantitative Analysis Of Choriocapillaris Flow Voids

2021 ◽  
Author(s):  
M. Giray Ersoz ◽  
Mumin Hocaoglu ◽  
Isil Sayman Muslubas ◽  
Serra Arf ◽  
Erdost Yildiz ◽  
...  
Keyword(s):  
Optical Coherence Tomography Angiography ◽  
Autosomal Dominant ◽  
Pigment Epithelium ◽  
Subretinal Fluid ◽  
Outer Retina ◽  
En Face Oct ◽  
En Face ◽  
Capillary Plexus ◽  
Vitreous Opacities ◽  
Superficial Capillary Plexus

Abstract Purpose: To investigate choriocapillaris flow voids (FV) with a new optical coherence tomography angiography (OCTA) image processing strategy to exclude artifacts due to vitreous opacities, subretinal pigment epithelium (sub-RPE) fluid and deposits, and subretinal fluid (SRF) by thresholding the en-face OCT image of the outer retina.Methods: This retrospective study included 15 eyes with drusen and 15 eyes with SRF. Number (FVn), average area (FVav), and maximum area (FVmax) of FV and the percentage of the nonperfused choriocapillaris area (PNPCA) obtained using the proposed strategy were compared with those obtained by removing only artifacts due to superficial capillary plexus (SCP).Results: There were three eyes with autosomal dominant drusen and 12 eyes with drusen secondary to non-exudative AMD in the drusen group. SRF group included 15 eyes with active central serous chorioretinopathy. PNPCA, FVav, FVmax, and FVn obtained using the algorithm were significantly lower than those obtained by removing only SCP in both groups (all p< 0.05). The algorithm was able to remove 94.7% of artifacts secondary to vitreous opacities and all artifacts secondary to serous pigment epithelial detachments. Conclusion: Nonperfusion areas of choriocapillaris may be overestimated in eyes with RPE abnormalities and SRF. These areas can be removed using thresholded images of the outer retina en-face OCT scans.

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.

Does Projection Artifact Removal Improve Visualization of Images in Optical Coherence Tomography Angiography?

2019 ◽  
Vol 3 (5) ◽  
pp. 289-296
Author(s):  
Verena R. Juncal ◽  
Armin Abadeh ◽  
Keyvan Koushan ◽  
Alan R. Berger ◽  
David R. Chow
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Artifact Removal ◽  
3 Dimensional ◽  
Face Images ◽  
En Face ◽  
Before And After ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

Purpose: This study assesses the frequency of projection artifacts in optical coherence tomography angiography (OCTA) en face images and compares images before and after applying a 3-dimensional projection artifact removal (3D-PAR) algorithm. Methods: This is a single-center, retrospective study that included consecutive patients with any underlying diagnosis who had OCTA obtained from January to March 2017. Patients with various retinal diseases and also healthy eyes were included. All participants underwent imaging with a scan area of 3 mm × 3 mm. The 4 default en face slabs were analyzed: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina (OR), and choriocapillaris (CC). Images were qualitatively analyzed before and after 3D-PAR by 2 independent graders. Results: None of the SCP images had projection artifact before or after 3D-PAR. Scans of the DCP presented projection artifact in 96.5% of the cases. After 3D-PAR, 14.7% had a complete improvement of projection artifact, 56.5% had a partial improvement, 14.1% were worse, and 14.7% presented no change. In the OR, 2.9% had projection artifact, with a complete improvement after 3D-PAR in 40%, partial improvement in 20%, and no change in 40%. Projection artifact was initially present in 97.6% of the images in the CC. After 3D-PAR, there was a complete improvement in 72.9%, partial improvement in 26.5%, and no change in 0.6%. Choroidal neovascularization (CNV) was detected in 29 eyes (17.1%), and 3D-PAR improved detection of CNV in 12 cases (41.4%). Conclusions: OCTA with 3D-PAR technology minimizes the appearance of projection artifacts in the DCP and CC slabs.

scholarly journals Morpho-Functional Evaluation of Full-Thickness Macular Holes by the Integration of Optical Coherence Tomography Angiography and Microperimetry

2020 ◽  
Vol 9 (1) ◽  
pp. 229
Author(s):  
Daniela Bacherini ◽  
Maria Cristina Savastano ◽  
Francesco Dragotto ◽  
Lucia Finocchio ◽  
Chiara Lenzetti ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Functional Evaluation ◽  
Retinal Sensitivity ◽  
Optical Coherence ◽  
Full Thickness ◽  
Macular Holes ◽  
En Face Oct ◽  
En Face ◽  
Capillary Plexus

(1) Objective: To use optical coherence tomography angiography (OCTA) and microperimetry (MP) to evaluate the correlation between retinal structure and function in patients with idiopathic, full-thickness macular holes (FTMHs) (2) Methods: This prospective, observational study included 11 eyes of 10 patients with FTMHs evaluated before surgery using OCTA and MP. MP sensitivity maps were superimposed and registered on slabs corresponding to superficial capillary plexus (SCP) and deep capillary plexus (DCP) on OCTA, and on the outer plexiform layer (OPL) and the Henle fiber layer (HFL) complex in en face OCT. On these maps, mean retinal sensitivity was calculated at 2° and 4°, all centered on the FTMH. Cystic cavity extension was assessed on the slab corresponding to the OPL + HFL complex in en face OCT and DCP in OCTA using the Image J software (Version 1.49v; National Institutes of Health, Bethesda, MD, USA); (3) Results: Absolute scotomas were observed corresponding to the FTMH. Additionally, rings of relative scotoma in the perilesional area were detected and correlated to the cystic spaces on en face OCT and OCTA. There was a significant correlation between reduced retinal sensitivity at 2° and 4° diameters around the FTMH and the extension of cystic areas (p < 0.01). There was a significant correlation between the extension of cystic cavities and BCVA (p < 0.01). (4) Conclusions: Morpho-functional analysis of FTMH using OCTA and MP, and the correlation between vascular abnormalities and impaired retinal sensitivity, may provide new, useful information. This integrated evaluation of FTMH may be useful to determine the function–structure correlation before and after vitreoretinal surgery, in order to gain a better understanding of the functional consequences induced by the morphological alterations, assessing outcomes in a more objective way, and potentially adding new surgical prognostic factors.

scholarly journals Inter-relationship between retinal and choroidal vasculatures using optical coherence tomography angiography in normal eyes

2018 ◽  
Vol 30 (1) ◽  
pp. 48-57 ◽  
Author(s):  
Jaeryung Oh ◽  
Daniel Jinhag Baik ◽  
Jaemoon Ahn
Keyword(s):  
Optical Coherence Tomography ◽  
Layer Thickness ◽  
Optical Coherence Tomography Angiography ◽  
Macular Thickness ◽  
Vascular Density ◽  
Inner Plexiform Layer ◽  
Central Macular Thickness ◽  
Optical Coherence ◽  
Outer Retina ◽  
Capillary Plexus

Purpose: To quantify vascular and structural macular variables in healthy eyes and to investigate correlations between these variables and age using optical coherence tomography angiography. Materials and methods: A total of 261 eyes of 261 subjects with normal fundus were included. Central macular thickness, ganglion cell layer to inner plexiform layer thickness, outer retina layer thickness, subfoveal choroidal thickness, and choroidal vascularity index were measured using optical coherence tomography. Foveal avascular zone area, vascular density, and flow void area were measured using optical coherence tomography angiography. Results: Vascular density in the superficial capillary plexus was correlated with central macular thickness, ganglion cell layer to inner plexiform layer thickness, and outer retina layer thickness ( P < 0.001, P = 0.004, and P < 0.001, respectively). Vascular density in the deep capillary plexus was correlated with central macular thickness and outer retina layer thickness ( P = 0.003 and P = 0.001, respectively). Vascular density of choriocapillaris was correlated with vascular density of superficial capillary plexus and deep capillary plexus ( P < 0.001 and P = 0.001, respectively). Conclusion: Vascular density of choriocapillaris varies with retinal vascular density rather than the structure of choroid using optical coherence tomography angiography. In contrast, retinal vascular density changes as the retinal structure. Our results provide more information about the relationship between retina and choroid.

scholarly journals Spectral OCT-Angiography in En Face Mode for Detection of Morphological Changes in the Retinal Pigment Epithelium before and after Selective Micro-Pulse Laser Exposure in Patients with Central Serous Chorioretinopathy

2019 ◽  
Vol 16 (2) ◽  
pp. 192-201
Author(s):  
P. L. Volodin ◽  
E. V. Ivanova ◽  
E. Iu. Polyakova ◽  
A. V. Fomin
Keyword(s):  
Retinal Pigment Epithelium ◽  
Central Serous Chorioretinopathy ◽  
Morphological Changes ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Laser System ◽  
Subretinal Fluid ◽  
Micropulse Laser ◽  
En Face ◽  
Before And After

Purpose — to study the morphological changes of the retinal pigment epithelium (RPE) by optical coherence tomography-angiography (OCT-A) in En Face mode before and after selective micropulse laser irradiation in patients with central serous chorioretinopathy (CSC), determine the correspondence between the topographic location of RPE defects and detachment on the OCT-angiogram in En Face mode and points of leakage on the FAG.Patients and methods. There were 20 patients (21 eyes) with CSC before and after laser treatment under the observation. All patients underwent high-resolution FAG and OCT-A using Angio Retina 2×2 or 3×3 mm protocol and Angio Retina HD 6×6 mm. The treatment was carried out in a selective micropulse mode with individual selection of parameters using the Navilas 577s navigation laser system (OD-OS, Germany) or the IQ 577 laser system (IRIDEX, USA).Results were evaluated at 2 weeks and 1 month after treatment. Results. In all cases, the leaking points of the subretinal fluid on FAG corresponded to the topographic location of defects and detachments of RPE detachment on OKT-A En Face. According to OCT-A En Face, the following morphological changes were revealed: in 5 cases — single defects of RPE, in 7 cases — multiple defects of RPE, in 9 cases of slit-like detachment of RPE, in 3 patients a combination of slit-like detachment and defect RPE. The sizes of RPE defects varied in the range from 21 to 159 microns, while their rounded shape prevailed. 1 month after the selective micropulse laser effect on OCT-A in the En Face mode, the defects were closed and the RPE detachments fit in all patients, which resulted in resorption of the subretinal fluid and the neurosensory retina attachment.Findings. OCT-A in En Face mode is a highly informative diagnostic method that allows noninvasive detection of morphological changes in RPE with a clear topographic localization relative to the retinal vascular network, as well as evaluating the effectiveness of selective micropulse laser treatment in patients with CSC. 

Optical coherence tomography angiography in diabetic patients without diabetic retinopathy

2019 ◽  
Vol 30 (6) ◽  
pp. 1418-1423 ◽  
Author(s):  
Claudio Furino ◽  
Grazia Montrone ◽  
Maria Vittoria Cicinelli ◽  
Stefania Balestra ◽  
Maria Oliva Grassi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Foveal Avascular Zone ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Avascular Zone ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

Purpose: To investigate a subset of diabetic patients without diabetic retinopathy with optical coherence tomography angiography, assessing the differences in macular perfusion between diseased eyes and healthy controls. Methods: Monocentric cross-sectional study, including 86 eyes from 43 diabetic patients with no clinical signs of diabetic retinopathy and 78 eyes from 39 controls. Patients underwent 3.0 × 3.0 mm and 4.5 × 4.5 mm swept-source optical coherence tomography angiography. Vessel density (%), foveal avascular zone area (mm2), and avascular density (%) were provided for the superficial capillary plexus and the deep capillary plexus. Results: The foveal avascular zone area at the superficial capillary plexus was larger in the study group compared to controls, irrespective of the area of the slab considered. A meaningful difference was found in the vessel density at the deep capillary plexus of the 3.0 × 3.0 mm slab (p = 0.03). Almost all the variables considered in the study showed a significant within-subject effect. Age significantly correlated with vessel density of superficial capillary plexus on 4.5 × 4.5 mm in both control and diabetic eyes. Conclusion: Diabetic patients with subclinical diabetic retinopathy feature a larger foveal avascular zone at the superficial capillary plexus compared with controls, as well as relative reduction of the vessel density at the deep capillary plexus. These findings might serve as the basis for screening between normal and diabetic subjects.

scholarly journals Early Retinal Flow Changes after Vitreoretinal Surgery in Idiopathic Epiretinal Membrane Using Swept Source Optical Coherence Tomography Angiography

2019 ◽  
Vol 8 (12) ◽  
pp. 2067 ◽  
Author(s):  
Rodolfo Mastropasqua ◽  
Rossella D’Aloisio ◽  
Pasquale Viggiano ◽  
Enrico Borrelli ◽  
Carla Iafigliola ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Epiretinal Membrane ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Vascular Changes ◽  
Ilm Peeling ◽  
Swept Source ◽  
Idiopathic Epiretinal Membrane ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

(1) Background: The aim of this observational cross-sectional work was to investigate early retinal vascular changes in patients undergoing idiopathic epiretinal membrane (iERM) surgery using swept source optical coherence tomography angiography (SS-OCTA); (2) Methods: 24 eyes of 24 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling were evaluated pre- and postoperatively using SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 6x6-mm OCTA volume scans were acquired by two observers independently. The en face images of superficial capillary plexus (SCP) were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. Perfusion density (PD), vessel length density (VLD), vessel diameter index (VDI) and vessel tortuosity (VT) of SCP were evaluated in both the parafoveal (2.5 mm diameter) and perifoveal areas (5.5 mm diameter); (3) Results: At OCTA analysis statistically significant differences were found between controls and diseased eyes for all parameters in parafoveal and perifoveal regions (p < 0.001; p < 0.05) except for perifoveal VLD. During 6-month follow up, both anatomical/perfusion and functional parameters showed a statistically significant improvement if compared to preoperative values. In detail, at one-month post vitrectomy, VLD and VT significantly changed in parafoveal region (p = 0.043; p = 0.045), while PD and VDI showed a trend of increase in both parafoveal and perifoveal region. At 6 months after surgery, PD, VLD and VT of parafoveal region significantly improved (p = 0.021, p = 0.018, p = 0.047 respectively). (4) Conclusions: SS-OCTA provides a quantitative and qualitative analysis of the superficial capillary plexus allowing for early vascular changes assessment after vitrectomy with iERM and ILM peeling.

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.

Optical Coherence Tomography Angiography of Polypoidal Neovascularization Associated with Choroidal Nevus

2016 ◽  
Vol 27 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Maria Vittoria Cicinelli ◽  
Lorenzo Iuliano ◽  
Alessandro Rabiolo ◽  
Alessandro Marchese ◽  
Giuseppe Querques ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Vascular Endothelial ◽  
Optical Coherence ◽  
Spectral Domain Oct ◽  
En Face Oct ◽  
En Face ◽  
Choroidal Nevus ◽  
Endothelial Growth Factor ◽  
Different Levels

Purpose To report a case of juxtapapillary polypoidal choroidal neovascularization (PCNV) associated with choroidal nevus investigated by means of optical coherence tomography angiography (OCT-A). Methods Case report. Results A 72-year-old woman presented with visual loss and metamorphopsia in her left eye for 5 days secondary to PCNV that developed on the border of a juxtapapillary choroidal nevus. Fluorescein angiography, indocyanine green angiography, and spectral-domain OCT confirmed the diagnosis. En face OCT-A disclosed a large tangled hyperreflective PCNV spreading from the optic disc at different levels of the choriocapillaris; the polyp lumina appeared hyporeflective. The patient was treated with 3 intravitreal injections of anti-vascular endothelial growth factor with partial functional recovery. Conclusions Our case showed the application of OCT-A in the diagnosis of a case of active PCNV complicating a benign intraocular tumor.

scholarly journals Fluorescein Leakage and Optical Coherence Tomography Angiography Features of Microaneurysms in Diabetic Retinopathy

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Ruoyu Chen ◽  
Anyi Liang ◽  
Jie Yao ◽  
Zicheng Wang ◽  
Yesheng Chen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Detection Rate ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Face Images ◽  
Potential Biomarker ◽  
En Face Oct ◽  
En Face

Background and Objective. To correlate optical coherence tomography angiography (OCTA) characteristics of diabetic microaneurysms (MAs) with leakage status on fluorescein angiography (FA). Patients and Methods. 167 MAs from 39 diabetic eyes were analyzed using OCTA and FA simultaneously. The characteristics of MAs on OCTA en face, OCT en face, and OCT B-scan with flow overlay were evaluated and correlated with fluorescein leakage status. Results. Thirty-six, fifty-two, and seventy-nine MAs showed no, mild, and severe leakage on FA, respectively. Most MAs (61.7%) were centered in the inner nuclear layer. Cystoid spaces were observed adjacent to 60 (35.9%) MAs. MAs with severe leakage had a statistically higher flow proportion compared to MAs with no or mild leakage (both P < 0.001 ). Only 112 MAs (67.1%) were visualized in the OCTA en face images, while 165 MAs (98.8%) could be visualized in the OCT en face images. The location of MAs did not associate significantly with FA leakage status. The presence of nearby cystoid spaces and higher flow proportion by OCT B-scan with flow overlay correlated significantly with FA leakage status. Conclusion. The flow proportion of MAs observed on OCT B-scans with flow overlay might be a potential biomarker to identify leaking MAs. A combination of OCT B-scan, OCT en face, and OCTA en face images increased the detection rate of diabetic MAs in a noninvasive way.

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