Association between choriocapillaris flow deficit and choroidal neovascularization activity in eyes with myopic choroidal neovascularization

Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less associated with CNV activity in myopic eyes, no reports are investigating its size as an indicator of CNV activity. We investigated the relationship between CFD and high myopia-related CNV. In this retrospective, observational study, patients underwent optical coherence tomography angiography (OCTA) with split-spectrum amplitude-decorrelation angiography for diagnosing pathological myopic CNV (mCNV); CFD features around CNV margins were evaluated. Of the 33 eyes (30 patients), 11 (33.3%) had active mCNV, and 22 (66.7%) had inactive CNV. Six eyes (18.2%) were treatment-naïve, while the remainder previously underwent anti-vascular endothelial growth factor therapy. On OCTA, blood flow signals were detected in CNV in the outer retinal layer in 28 (84.8%) eyes, including all active cases (11 cases) and 17 (77.3%) of 22 inactive cases. CNV flow signal size correlated significantly with activity (P < 0.001). CFD around CNV was observed in 24 eyes (72.7%), including all active cases (11 cases) and 13 (59.1%) of 22 inactive cases. CFD size correlated significantly with CNV activity (P < 0.001). The size of both the CFD area around CNV and CNV flow signal area are useful indicators of CNV activity in eyes with mCNV, which may help determine treatment timing.

Quantitative Assessment of Three-Dimensional Choroidal Vascularity and Choriocapillaris Flow Signal Voids in Myopic Patients Using SS-OCTA

Purpose: To compare the choroidal vascularity of large- and middle-sized choroidal vessels and choriocapillaris (CC) perfusion in patients with different degrees of myopia using swept-source optical coherence tomography angiography (SS-OCTA). Methods: One hundred and thirteen people with myopia were enrolled. SS-OCTA was performed to analyze the choroidal vascularity and CC perfusion. Three-dimensional (3D) choroidal vascularity index (CVI) and choroidal luminal volumes (LV) were obtained by artificial intelligence segmentation of the choroidal lumen in Volume OCT images. CC perfusion was assessed by flow signal voids (FSVs). Results: In the macular, multiple linear regression model showed that choroidal thickness (CT), total choroidal volume, LV, and choroidal stromal volume were negatively correlated with axis length (AL), respectively (all p < 0.001). Three dimensional CVI was negatively associated with AL (p < 0.05). FSV% was positively correlated with age only (p < 0.001). Additionally, after adjustment for age and AL, FSV% had a significant negative correlation with CT (p < 0.05). Conclusion: Choroidal vascularity decreases gradually with increasing severity of myopia. The decrease of CC blood perfusion was related to a higher severity of myopia and the thinning of choroid.

Isolated unilateral axillary lymphadenopathy diagnosed in a teenager by ultrasonography after BNT162b2 COVID-19 vaccination

Axillary lymphadenopathy is a local reaction to mRNA COVID-19 vaccination. A 19-year-old healthy woman presented with a mass in the axilla diagnosed by ultrasonography as vaccine-induced hyperreactive lymphadenopathy. After two weeks, ultrasonography revealed that the lymph node had shrunk and that the blood flow signal in the hilum had disappeared.

Total flow intensity, active flow intensity and volume related flow intensity as new quantitative metrics in optical coherence tomography angiography

Optical coherence tomography (OCT) angiography (OCTA) is a non-invasive tool for the in-vivo study of the intraretinal vascular network. It is based on the analysis of motion particles within the retina to reconstruct the paths followed by the erythrocytes, i.e. retinal capillaries. To date, qualitative and quantitative information are based on the morphological features disclosed by retinal capillaries. In the present study, we proposed new quantitative functional metrics, named Total Flow Intensity (TFI), Active Flow Intensity (AFI), and Volume-related Flow Intensity (VFI), based on the processing of the blood flow signal detected by OCTA. We studied these metrics in a cohort of healthy subjects, and we assessed their clinical utility by including a cohort of age-matched patients affected by Stargardt disease. Moreover, we compared TFI, AFI, and VFI to the widely used vessel density (VD) parameter. TFI, AFI, and VFI were able to describe in detail the different properties of the retinal vascular compartment. In particular, TFI was intended as the overall amount of volumetric retinal blood flow. AFI represented a selective measure of voxels disclosing blood flow signal. VFI was developed to put in relationship the volumetric blood flow information with the not vascularized retinal volume. In conclusion, TFI, AFI, and VFI were proposed as feasible functional OCTA biomarkers based on the analysis of retinal blood flow signal.

Association between choriocapillaris flow deficit and choroidal neovascularization activity in eyes with myopic choroidal neovascularization

Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less associated with CNV activity in myopic eyes, there are no reports investigating its size as an indicator of CNV activity. We investigated the relationship between CFD and high myopia-related CNV. In this retrospective, observational study, patients underwent optical coherence tomography angiography (OCTA) with split-spectrum amplitude decorrelation angiography for diagnosing pathological myopic CNV (mCNV); CFD features around CNV margins were evaluated. Of the 33 eyes (30 patients), 11 (33.3%) had active mCNV, and 22 (66.7%) had inactive CNV. Five eyes (15.2%) were treatment-naïve, while the remainder previously underwent anti-vascular endothelial growth factor therapy. On OCTA, blood flow signals were detected in CNV in the outer retinal layer in 28 (84.8%) eyes, including all active cases (11 cases) and 17 (77.3%) of 22 inactive cases. CNV flow signal size correlated significantly with activity (P = 0.002). CFD around CNV was observed in 18 eyes (54.5%), eight of which had active CNV. CFD size correlated significantly with CNV activity (P = 0.014). The size of both the CFD area around CNV and CNV flow signal area are useful indicators of CNV activity in eyes with mCNV, which may help determine treatment timing.

Application of Ultrasound in Diagnosis of Prosthesis Loosening and Infection After Total Hip Arthroplasty

Objective: To explore the diagnostic efficiency of ultrasound for the identification of periprosthetic joint infection (PJI) and aspetic loosening.Methods: 50 patients with joint pain after total hip arthroplasty, who were all clinically diagnosed as aseptic prosthesis loosening or PJI, were examined by ultrasonography combined with C-reactive protein, erythrocyte sedimentation rate, bacterial culture and pathology.Results: Thirty-eight of the 50 cases were PJI (group A) , and twelve cases were aseptic loosening (group B) . Fourteen patients with extra-capsular effusion were diagnosed as PJI, while none appeared extra-capsular effusion effusion in group B. 34 cases PJI obtained joint fluid, which was more than group B (7/11) (P < 0.05). The average depth of joint effusion of group B (19.83 ± 8.9mm), was significantly less than group A (25.97±15.25mm) (P < 0.05). In group A , 21 cases (55.26%) had grade 2-3 synovial blood flow signal,which was higher than group B (8.3%) (P < 0.05). Under the circumstance that PJI was diagnosed: (1) There was a sinus tract or extra-capsular effusion; or (2) Joint fluid depth was ≥ 17.0 mm; or (3) Grade 2-3 synovial blood flow signal was detected,the positive predictive value of ultrasound diagnosis of PJI was 92.1% (35/38)，and the accuracy of aseptic loosening was 83.3% (10/12) (P < 0.05).Conclusions: Ultrasound has significant value in the differential diagnosis of PJI and aspetic loosening.