scholarly journals Widefield Swept-Source Optical Coherence Tomography Angiography Assessment of Choroidal Changes in Vogt-Koyanagi-Harada Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yujing Qian ◽  
Jingyuan Yang ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  

Purpose: To investigate choroidal changes in patients with Vogt-Koyanagi-Harada disease (VKH) using widefield swept-source optical coherence tomography angiography (SS-OCTA).Methods: In this cross-sectional study, 133 eyes of 69 patients with VKH (52 eyes of 28 active VKH patients and 81 eyes of 41 inactive VKH patients) and 104 eyes of 52 age and sex matched healthy volunteers were imaged using a widefield SS-OCTA instrument. On 12 mm × 12 mm OCTA scans, mean choroidal thickness (MCT), choroidal vascularity index (CVI), choriocapillaris (CC) flow area, and mean retinal thickness (MRT) were separately calculated in the fovea (diameter of 1 mm) and in concentric rings with different radii (1–3, 3–6, 6–9, and 9–12 mm).Results: Eyes with active VKH showed significant increases in MCT, CVI, and MRT, and decreased CC flow area in all central and peripheral regions (0–1, 1–3, 3–6, 6–9, and 9–12 mm) than in the healthy eyes (p ≤ 0.01) and inactive VKH eyes (p < 0.05). Inactive VKH eyes only showed marked decrease in CC flow area in all regions compared with controls (p < 0.05). Flow voids were observed in 51 of 52 (98.1%) active VKH eyes and 50 of 81 (61.7%) inactive VKH eyes on 12 mm × 12 mm OCTA. The MCT of all regions was significantly correlated with age, disease duration, and disease activity, whereas CVI was associated with age and disease activity. The CC flow void was related to visual acuity in all regions (p < 0.05).Conclusion: Widefield SS-OCTA enables a more comprehensive evaluation of chorioretinal changes in patients with VKH disease. Structural and vascular abnormalities are observed in both the central and peripheral choroid and are closely correlated with disease activity.

2021 ◽  
Author(s):  
Mohammad Reza Akhlaghi ◽  
Farzan Kianersi ◽  
Hamed Radmehr ◽  
Alireza Dehghani ◽  
Afsaneh Naderi Beni ◽  
...  

Abstract Background One of the major side effects of hydroxychloroquine is retinopathy. The aim of this study was to evaluate the Optical coherence tomography angiography (OCTA) parameters in a group of patients who have hydroxychloroquine-induced retinopathy based on Multifocal electroretinography (mfERG) with a group who do not have retinopathy.Method This is a Cross-Sectional Study. In this study, patients with RA or SLE who had been taking HCQ for at least 7 years were included. MfERG and OCTA imaging were performed for all patients. Patients were divided into Normal mfERG and Abnormal mfERG groups based on mfERG results. OCTA parameters were studied in these two groups.Result 61 patients (61 eyes) were included. 41 patients had SLE and 20 patients had RA. 40 patients (66.7%) had Abnormal mfERG. The mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). Mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). In RA subgroup, mean VD in SCP layer in PeriFovea region in Abnormal mfERG group was significantly lower than normal group (P-Value <0.05). Mean VD in DCP layer in Whole Image, Superior Hemi, Inferior Hemi, PeriFovea area in Abnormal mfERG group was significantly lower than normal group (P-Value <0.05). This discrepancy was also observed in the RA subgroup but not in the SLE subgroup. The mean of none of the parameters of FAZ (mm2), Flow Area of Outer Retina (mm2) and Flow Area of Choriocapillaris (mm2) were not statistically significant between the groups Abnormal mfERG and Normal mfERG. (p-value>0.05). Conclusion VD in the DCP layer decreased in abnormal mfERG patients compared to patients with normal mfERG. But it seems that VD in SCP layer, FAZ Area and Flow Area are similar in both groups. OCTA may be used as a non-invasive tool in the diagnosis of early stages of HCQ-induced retinopathy, especially in RA patients, but further studies are needed.


Author(s):  
Anna Lentzsch ◽  
Laura Schöllhorn ◽  
Christel Schnorr ◽  
Robert Siggel ◽  
Sandra Liakopoulos

Abstract Purpose To compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV). Methods In this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA. Results Sensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices. Conclusion Both devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.


Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 658
Author(s):  
Federico Corvi ◽  
Federico Zicarelli ◽  
Matteo Airaldi ◽  
Salvatore Parrulli ◽  
Mariano Cozzi ◽  
...  

Background: To compare four different optical coherence tomography (OCT) devices for visualization of retinal and subretinal layers in highly myopic eyes. Methods: In this prospective, observational, cross-sectional study, consecutive patients with high myopia and control subjects were imaged by four OCT devices: Spectralis OCT2, PlexElite 2.0 100 kHz, PlexElite 2.0 200 kHz and the Canon Xephilio OCT-S1. The acquisition protocol for comparison consisted of single vertical and horizontal line scans centered on the fovea. Comparison between the devices in the extent of visible retina, presence of conjugate image or mirror artifacts, visibility of the sclerochoroidal interface and retrobulbar tissue. Results: 30 eyes with high myopia and 30 control subjects were analyzed. The visualized RPE length was significantly different between the OCT devices with Xephilio OCT-S1 imaging the largest extent (p < 0.0001). The proportion of eyes with conjugate image artifact was significantly higher with the Spectralis OCT (p < 0.0001), and lower with the PlexElite 200 kHz (p < 0.0001). No difference in visibility of the sclerochoroidal interface was noted among instruments. The retrobulbar tissue was visible in a higher proportion of eyes using swept-source PlexElite 100 kHz and 200 kHz (p < 0.007) compared to the other devices. Conclusions: In highly myopic eyes, the four OCT devices demonstrated significant differences in the extent of the retina imaged, in the prevalence of conjugate image artifact, and in the visualization of the retrobulbar tissue.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. R. Kee ◽  
V. C. H. Yip ◽  
E. L. T. Tay ◽  
C. W. Lim ◽  
J. Cheng ◽  
...  

Abstract Background To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability. Methods A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated. Results A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761–1.000) compared to Swept Source (0.113–0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source. Conclusions AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.


2017 ◽  
Vol 102 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Jayasree P Venugopal ◽  
Harsha L Rao ◽  
Robert N Weinreb ◽  
Zia S Pradhan ◽  
Srilakshmi Dasari ◽  
...  

AimsTo compare the intrasession repeatability of peripapillary and macular vessel density measurements of optical coherence tomography angiography (OCTA) in normal and glaucoma eyes, and to evaluate the effect of signal strength of OCTA scans on the repeatability.MethodsIn a cross-sectional study, three optic nerve head scans each of 65 eyes (30 normal, 35 glaucoma eyes) and three macular scans each of 69 eyes (35 normal, 34 glaucoma eyes) acquired in the same session with OCTA were analysed. Repeatability was assessed using within-subject coefficient of repeatability (CRw) and variation (CVw). Effect of signal strength index (SSI) on repeatability was evaluated with repeated-measures mixed-effects models.ResultsCRw (%) and CVw (%) of peripapillary measurements in normal eyes ranged between 3.3 and 7.0, and 2.5 and 4.4 respectively, and that in glaucoma eyes between 3.5 and 7.1, and 2.6 and 6.6. For the macular, these measurements ranged between 4.1 and 6.0, and 3.3 and 4.7 in normal eyes and 4.3 and 6.9, and 3.7 and 5.6 in glaucoma eyes. Repeatability estimates of most measurements were similar in normal and glaucoma eyes. Vessel densities of both peripapillary and macular regions significantly increased with increase in SSI of repeat scans (coefficients ranging from 0.15 to 0.38, p<0.01 for all associations).ConclusionsRepeatability estimates of OCTA measured peripapillary and macular vessel densities were similar in normal eyes and eyes with glaucoma. SSI values of the scans had a significant effect on the repeatability of OCTA with the vessel density values increasing in scans with higher SSI values.


Retina ◽  
2019 ◽  
Vol 39 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Karen B. Schaal ◽  
Marion R. Munk ◽  
Iris Wyssmueller ◽  
Lieselotte E. Berger ◽  
Martin S. Zinkernagel ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Chun Yan ◽  
Fan Li ◽  
Min Hou ◽  
Xiaoyuan Ye ◽  
Lishi Su ◽  
...  

Purpose: To investigate the involvement of peripapillary zone vascular abnormalities in Behcet's uveitis (BU) and associated visual dysfunction. We evaluated the retinal and choroidal microvascular features in both macular and peripapillary areas of BU patients to identify vascular abnormalities contributing to reduced best-corrected visual acuity (BCVA) using optical coherence tomography angiography (OCTA).Methods: A prospective, observational study was conducted in 24 eyes of 13 patients with BU and 24 eyes of 15 healthy participants as controls. They received a standard eye examination and were recorded by OCTA measurements of macular and peripapillary areas. The vascular densities of superficial capillary plexus (SCP) and deep capillary plexus (DCP), choroidal flow area, radial peripapillary capillary network (RPCN) density, foveal avascular zone (FAZ) area and perimeter, full retinal thickness (FRT), and peripapillary retinal nerve fiber layer thickness (pRNFLT) were measured.Correlations among microvascular, structural, and functional changes were assessed.Results: Our findings uncovered that the vascular density was significantly reduced in the peripapillary zone of BU eyes compared to healthy eyes, especially in the inferior subfield of the RPCN. The vascular densities of SCP and DCP quadrants within the macular zone had no significant difference between BU and control groups except for DCP density of the nasal parafoveal quadrant. Both FAZ area and perimeter were greater but without statistical significance in the BU group. Compared to healthy eyes, the choriocapillaris flow area was smaller while the FRT and pRNFLT were greater in the BU group. Notably, there was a significant correlation between the reduction in RPCN vascular density and decreased BCVA in BU patients.Conclusion: Based on OCTA, vascular changes associated with BU are more prominent in the peripapillary zone than those in the macular zone. The vascular density of the RPCN could serve as a sensitive indicator to monitoring BU pathogenic progression and treatment response using a non-invasively method of OCTA.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xin Wen ◽  
Zijing Li ◽  
Jianhui Xiao ◽  
Xuane Liu ◽  
Yichi Zhang ◽  
...  

Purpose: To determine the association of myopia with peripapillary and macular microvasculature in eyes with type 2 diabetes using optical coherence tomography angiography (OCTA).Methods: Diabetic patients with and without diabetic retinopathy (DR) were recruited and grouped according to myopic status in this cross-sectional study. Axial length, refractive error, and OCTA parameters were measured. OCTA parameters were analyzed with adjustment of confounding factors and further Bonferroni analysis was performed to determine the differences in multiple group comparisons.Results: Compared with the diabetic eyes without myopia, those with myopia had lower rate of DR (21.82 vs. 35.90%, χ2 = 6.190, P = 0.013), longer axial lengths (24.94 ± 0.75 vs. 23.16 ± 0.64, F = 311.055, P &lt; 0.001) and reduced whole vessel density (VD) of optic nerve head (ONH) (45.89 ± 5.76 vs. 49.14 ± 4.33, F = 19.052, P &lt; 0.001), peripapillary VD (48.75 ± 6.56 vs. 50.76 ± 4.51, F = 7.600, P = 0.006), and reduced thickness of the retinal nerve fiber layer (RNFL) (95.50 ± 12.35 vs. 100.67 ± 13.68, F = 5.020, P = 0.026). In eyes without myopia, the superficial vessel density (SVD) (46.58 ± 4.90 vs. 43.01 ± 4.25; 95% CI, 1.80–4.61; P &lt; 0.001), deep vessel density (DVD) (45.64 ± 6.34 vs. 42.15 ± 6.31; 95% CI, 1.07–5.00; P &lt; 0.001), and FD300 area density (50.31 ± 5.74 vs. 44.95 ± 6.96; 95% CI, 2.88–7.27; P &lt; 0.001) were significant reduced in eyes with DR(DR eyes) comparing to those without DR (NoDR eyes). In eyes with myopia, only SVD were significantly reduced in DR eyes comparing to NoDR eyes (41.68 ± 3.34 vs. 45.99 ± 4.17; 95% CI, 1.10–7.22; P = 0.002). In NoDR eyes, both whole VD of ONH and Peripapillary VD demonstrated a significant decrease in eyes with myopia comparing to those without myopia (49.91 ± 4.36 vs. 45.61 ± 6.32; 95% CI, 1.95–6.27; P &lt; 0.001 and 51.36 ± 4.24 vs. 48.52 ± 6.99; 95% CI, 0.56–5.11; P = 0.006, respectively).Conclusions: In diabetic patients, myopic eyes exhibited lower prevalence of DR and thinner thickness of RNFL. The refractive status could possibly impact the retinal microvascular changes from NoDR to DR stage.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Qin Zhu ◽  
Chunwen Chen ◽  
Jingyan Yao

Purpose. To evaluate and quantify blood perfusion and retinal thickness (RT) from the perspective of quadrants by optical coherence tomography angiography (OCTA) in adolescents with myopia and explore the relationship between axial elongation and related indexes of OCTA. Methods. A total of 88 subjects (149 eyes) with different degrees of myopia were included in this cross-sectional study. Vessel density (VD) and RT of quadrants in macular and peripheral regions were measured through OCTA. Results. The superficial VD (SVD) of the parainferior region was significantly correlated with axial length (AL) between the emmetropia (EM) group and high myopia (HI) group ( P = 0.012 ). There were significant differences in deep VD (DVD) in all quadrants, except for the foveal, perifoveal, and peri-inferior regions ( P > 0.05 ). However, there were significant alterations in the whole, parainferior, and perinasal regions ( P = 0.030 , 0.023, and 0.035) in the low-to-moderate myopia (L–M) group compared with those in the HI group. There were significant differences in the RT in all quadrants, except for the foveal, paratemporal, and paranasal regions ( P > 0.05 ) between the EM and L–M groups and the foveal region ( P > 0.05 ) between the EM and HI groups. Nevertheless, only RT in the peri-inferior region of the L–M and HI groups showed significant differences. AL was negatively correlated with SVD in the perifoveal and parainferior regions (r = −0.179, P = 0.029 ; r = −0.227, P = 0.005 ) and inversely correlated with DVD and RT in almost all quadrants, except for the foveal region (r = −0.020, P = 0.811 ; r = 0.135, P = 1.000 ). Conclusion. DVD and RT were closely associated with the severity of myopia and might be new indexes in assessing and detecting myopia development via OCTA.


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