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1.
Int Ophthalmol ; 44(1): 374, 2024 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-39251539

RESUMO

PURPOSE: Optical coherence tomography (OCT) and OCT angiography (OCTA) are widely used in the diagnosis of ophthalmic diseases. This study aims to provide a comprehensive bibliometric analysis of ophthalmologic OCT and OCT angiography. METHODS: We retrieved publications on ophthalmic OCT and OCTA from 2003 to 2022 from the Web of Science Core Collection and used bibliometric tools to analyze and visualize the distribution, trend, and hotspots. RESULTS: In total, 20,817 articles written by 48,160 authors from 106 countries were selected. The number of publications has significantly increased. In the last two decades, the USA was the most productive country and received the highest citations. The most productive journal was Investigative Ophthalmology and Visual Science and received the highest number of citations. Moorfields Eye Hospital was the most productive institution. Bandello F published the most papers, while Spaide RF was the highest cited author. SPAIDE RF, 2011, AM J Ophthalmology was the most cited document. "OCT", "glaucoma" and "OCTA" were three hotspots in the last two decades. "Vessel density" and "deep learning" would be research hotspots in the future. CONCLUSION: The bibliometric analysis of ophthalmic OCT and OCTA research over the past two decades on keywords, authors, citations, hotspots and trends will provide global researchers with valuable information for future research and cooperation.


Assuntos
Bibliometria , Pesquisa Biomédica , Angiofluoresceinografia , Oftalmologia , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Tomografia de Coerência Óptica/tendências , Tomografia de Coerência Óptica/estatística & dados numéricos , Oftalmologia/tendências , Pesquisa Biomédica/tendências , Pesquisa Biomédica/estatística & dados numéricos , Angiofluoresceinografia/métodos , Angiofluoresceinografia/tendências , Oftalmopatias/diagnóstico , Oftalmopatias/diagnóstico por imagem
2.
Retina ; 41(11): 2296-2300, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33990115

RESUMO

PURPOSE: To compare posterior vitreous detachment (PVD) identification rate between clinical examination versus spectral domain optical coherence tomography in patients with retinal detachment (RD). METHODS: Data from the Primary Retinal Detachment Outcomes Study were used for this retrospective cross-sectional study of 506 patients. Spectral domain optical coherence tomography scans were reviewed to detect the separation of the posterior hyaloid face from the retina and the optic nerve on all 31 raster cuts of a 30 × 30 scan. Statistical analysis was performed to compare spectral domain optical coherence tomography-identified PVD with PVD identified on slit-lamp biomicroscopy. RESULTS: There was a significant difference in the rate of PVD identification by clinical examination versus spectral domain optical coherence tomography in patients with RD. Clinical examination identified 51.58% of patients with PVD, whereas spectral domain optical coherence tomography identified 78.42% of patients with PVD. In patients with macula-on RD, 61.68% were found to have PVD on clinical examination versus 83.90% by imaging. Spectral domain optical coherence tomography identified larger number of PVD in patients with macula-off RD compared with clinical examination, 46.28% versus 75.43%, respectively. There was low agreement between the two methods (kappa score = 0.137). There was a significant difference in surgical procedure type chosen in those with versus without PVD. CONCLUSION: Knowledge about the posterior hyaloid anatomy is important before undergoing RD repair. Spectral domain optical coherence tomography can better identify PVD than clinical examination in patients with RD.


Assuntos
Macula Lutea/diagnóstico por imagem , Descolamento Retiniano/diagnóstico , Tomografia de Coerência Óptica/estatística & dados numéricos , Corpo Vítreo/diagnóstico por imagem , Descolamento do Vítreo/diagnóstico , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Oftalmoscopia , Descolamento Retiniano/complicações , Estudos Retrospectivos , Descolamento do Vítreo/complicações
3.
Opt Express ; 28(6): 8512-8527, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32225475

RESUMO

Laser scanning based on Micro-Electro-Mechanical Systems (MEMS) scanners has become very attractive for biomedical endoscopic imaging, such as confocal microscopy or Optical Coherence Tomography (OCT). These scanners are required to be fast to achieve real-time image reconstruction while working at low actuation voltage to comply with medical standards. In this context, we report a 2-axis Micro-Electro-Mechanical Systems (MEMS) electrothermal micro-scannercapable of imaging large fields of view at high frame rates, e.g. from 10 to 80 frames per second. For this purpose, Lissajous scan parameters are chosen to provide the optimal image quality within the scanner capabilities and the sampling rate limit, resulting from the limited A-scan rate of typical swept-sources used for OCT. Images of 233 px × 203 px and 53 px × 53 px at 10 fps and 61 fps, respectively, are experimentally obtained and demonstrate the potential of this micro-scannerfor high definition and high frame rate endoscopic Lissajous imaging.


Assuntos
Sistemas Microeletromecânicos/métodos , Imagem Óptica/métodos , Sistemas Computacionais , Endoscópios , Endoscopia/métodos , Desenho de Equipamento , Humanos , Processamento de Imagem Assistida por Computador , Sistemas Microeletromecânicos/instrumentação , Sistemas Microeletromecânicos/estatística & dados numéricos , Microscopia Confocal/instrumentação , Microscopia Confocal/métodos , Microscopia Confocal/estatística & dados numéricos , Dispositivos Ópticos , Imagem Óptica/instrumentação , Imagem Óptica/estatística & dados numéricos , Fenômenos Ópticos , Tomografia de Coerência Óptica/instrumentação , Tomografia de Coerência Óptica/métodos , Tomografia de Coerência Óptica/estatística & dados numéricos
4.
Opt Lett ; 45(6): 1293-1296, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32163948

RESUMO

Spatiotemporal optical coherence (STOC) imaging is a new technique for suppressing coherent cross talk noise in Fourier-domain full-field optical coherence tomography (FD-FF-OCT). In STOC imaging, the time-varying inhomogeneous phase masks modulate the incident light to alter the interferometric signal. Resulting interference images are then processed as in standard FD-FF-OCT and averaged incoherently or coherently to produce cross-talk-free volumetric optical coherence tomography (OCT) images of the sample. Here, we show that coherent averaging is suitable when phase modulation is performed for both interferometer arms simultaneously. We explain the advantages of coherent over incoherent averaging. Specifically, we show that modulated signal, after coherent averaging, preserves lateral phase stability, enabling computational phase correction to compensate for geometrical aberrations. Ultimately, we employ it to correct for aberrations present in the image of the photoreceptor layer of the human retina that reveals otherwise invisible photoreceptor mosaics.


Assuntos
Tomografia de Coerência Óptica/métodos , Adulto , Análise de Fourier , Humanos , Imageamento Tridimensional/métodos , Imageamento Tridimensional/estatística & dados numéricos , Interferometria/métodos , Interferometria/estatística & dados numéricos , Fenômenos Ópticos , Células Fotorreceptoras de Vertebrados/citologia , Retina/anatomia & histologia , Retina/diagnóstico por imagem , Razão Sinal-Ruído , Análise Espaço-Temporal , Tomografia de Coerência Óptica/estatística & dados numéricos
5.
Skin Res Technol ; 26(3): 398-404, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31799766

RESUMO

BACKGROUND: Line-field confocal optical coherence tomography (LC-OCT) is an imaging technique providing "optical biopsies" of the skin in real time and non-invasively. At a center optical wavelength of 1.3 µm, this innovative technology can be applied to dermo-cosmetic product development due to both high image resolution (~2 µm) and sufficient penetration (~0.5 mm). Nevertheless, the precise dermal area analyzed with LC-OCT has never been identified. In this study, the objective was to compare LC-OCT images with histological sections of the same area, in order to validate a new method for in vivo and non-invasive quantification of superficial dermis thickness. Once validated, this standardized and quantitative method was used to assess age-related changes of the superficial dermis. MATERIALS AND METHODS: Ex vivo LC-OCT acquisitions and hematoxylin-eosin-safran staining were performed on a panel of four healthy Caucasian female volunteers. In vivo LC-OCT study of skin aging was performed on a panel of 37 healthy Caucasian female divided into five different age-groups. RESULTS: Comparison with histological sections revealed that LC-OCT images allow the visualization and the quantification of the superficial portion of papillary dermis. Applied to different age-group of volunteers, LC-OCT images show a constant decrease in this superficial dermis thickness with age. CONCLUSIONS: In conclusion, we have introduced LC-OCT as a novel technique for in vivo and non-invasive evaluation of superficial dermis thickness. This approach could be used in the future to demonstrate visually and quantitatively the capacity of a dermo-cosmetic active ingredient to renormalize the structural properties of the dermis.


Assuntos
Derme/diagnóstico por imagem , Derme/patologia , Técnicas Histológicas/normas , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Biópsia/instrumentação , Cosméticos , Feminino , Técnicas Histológicas/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Envelhecimento da Pele/patologia , Tomografia de Coerência Óptica/estatística & dados numéricos
6.
Heart Lung Circ ; 29(6): 874-882, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31353214

RESUMO

BACKGROUND: Optical coherence tomography (OCT) can detect detailed plaque features in native coronary arteries. Stent struts cause shadows that partially obscure the vessel wall, but plaque features can still be seen. We investigated the impact of stent artefact on plaque quantification and whether the plaque behind struts is associated with microvascular dysfunction. METHODS: Patients retrospectively recruited from two centres, underwent OCT pre- and post-stenting on the same vessel segment. Lipid (LA) and calcium (CA) were measured as arcs. Macrophages, microchannels and cholesterol crystals were counted. Subsequently, we determined whether stented plaque features were associated with reduced Thrombolysis in Myocardial Infarction (TIMI) flow grade in consecutive patients who underwent OCT post-stenting. RESULTS: In 52 patients the lipid arc was similar pre- vs post-stent: median (55º [13º-93º] vs. 40º [18º-87°]; difference 1º [-7º to 16º], p = NS). Pre- and post-stent lipid were strongly correlated (r = 0.92, p < 0.001). In a further 128 patients those with reduced (TIMI ≤ II) vs normal flow post percutaneous coronary intervention (PCI) showed more plaque behind struts: lipid (89º [50º-139º] vs 62º [29º-88°]; p < 0.001); and calcium (24º [6º-45º] vs 7° [0º-34º]; p = 0.031). Multivariate logistic regression analysis showed that abnormal TIMI flow post-stenting was associated with diabetes (Odds ratio [OR] 2.87, CI 1.01-8.19, p = 0.048), LA (OR 1.29, 95% CI 1.14-1.38, p < 0.001) and CA (OR 1.26, CI 1.07-1.40, p = 0.005). CONCLUSIONS: Plaque behind the struts can be accurately quantified using OCT. Furthermore, OCT plaque features in stented segments are associated with microvascular dysfunction post PCI.


Assuntos
Artefatos , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/diagnóstico por imagem , Intervenção Coronária Percutânea/efeitos adversos , Placa Aterosclerótica/diagnóstico , Stents/efeitos adversos , Tomografia de Coerência Óptica/métodos , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/cirurgia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/etiologia , Falha de Prótese , Estudos Retrospectivos , Tomografia de Coerência Óptica/estatística & dados numéricos
7.
J Interv Cardiol ; 2019: 6515129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31772538

RESUMO

OBJECTIVES: We aimed to compare the results of neointimal modification before drug-coated balloon (DCB) treatment with excimer laser coronary atherectomy (ELCA) plus scoring balloon predilation versus scoring balloon alone in patients presenting with in-stent restenosis (ISR). BACKGROUND: Treatment of ISR with ELCA typically results in superior acute gain by neointima debulking. However, the efficacy of combination therapy of ELCA and DCB remains unknown. METHODS: A total of 42 patients (44 ISR lesions) undergoing DCB treatment with ELCA plus scoring balloon (ELCA group, n = 18) or scoring balloon alone (non-ELCA group, n = 24) were evaluated via serial assessment by optical coherence tomography (OCT) performed before, after intervention, and at 6 months. RESULTS: Although there was significantly greater frequency of diffuse restenosis and percent diameter stenosis (%DS) after intervention in the ELCA group, comparable result was shown in %DS, late lumen loss, and binary angiographic restenosis at follow-up. On OCT analysis, a decreased tendency in the minimum lumen area and a significant decrease in the minimum stent area were observed in the ELCA group between 6-month follow-up and after intervention (-0.89 ± 1.36 mm2 vs. -0.09 ± 1.25 mm2, p = 0.05, -0.49 ± 1.48 mm2 vs. 0.28 ± 0.78 mm2, p = 0.03, respectively). The changes in the neointimal area were similar between the groups, and target lesion revascularization showed comparable rates at 1 year (11.1% vs. 11.4%, p = 0.85). CONCLUSIONS: Despite greater %DS after intervention, ELCA before DCB had possible benefit for late angiographic and clinical outcome.


Assuntos
Angioplastia Coronária com Balão , Aterectomia Coronária , Angiografia Coronária/métodos , Reestenose Coronária , Neointima , Tomografia de Coerência Óptica , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Angioplastia Coronária com Balão/métodos , Aterectomia Coronária/efeitos adversos , Aterectomia Coronária/instrumentação , Aterectomia Coronária/métodos , Reestenose Coronária/diagnóstico , Reestenose Coronária/cirurgia , Stents Farmacológicos , Feminino , Humanos , Japão/epidemiologia , Lasers de Excimer/uso terapêutico , Masculino , Neointima/diagnóstico por imagem , Neointima/etiologia , Neointima/cirurgia , Avaliação de Processos e Resultados em Cuidados de Saúde , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica/métodos , Tomografia de Coerência Óptica/estatística & dados numéricos
8.
Retina ; 39(5): 836-843, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29384996

RESUMO

PURPOSE: To determine whether ultra-widefield (UWF) retinal imaging changes the staging or management of sickle cell retinopathy compared with clinical examination. METHODS: Prospective, observational study including patients with sickle cell disease. All patients underwent dilated fundus examination by a fellowship-trained retina specialist, as well as UWF fundus photography (FF) and fluorescein angiography (FA). Sickle retinopathy stage and treatment recommendation per eye were determined after clinical examination, UWF-FF, and UWF-FA, respectively, and differences in retinopathy stage and treatment recommendation were compared. RESULTS: A total of 70 eyes from 35 patients (17 women, 48.6%), mean age 30.4 years, were included. Sickle genotypes included 26 patients with sickle SS (74.3%), 7 SC (20.0%), and 2 ß(+)thalassemia (5.7%). Based on examination, most eyes (42/70; 60.0%) had no visible retinopathy. Based on UWF-FF, about half of the eyes were found to be Goldberg Stage 2 or above (36/70; 51.4%). Based on UWF-FA, nearly all eyes were Goldberg Stage 2 or above (63/70; 90%). However, clinical examination reliably detected neovascularization, and in no case did the addition of UWF imaging change management relative to examination alone. CONCLUSION: Ultra-widefield imaging detects a higher stage of sickle cell retinopathy compared with clinical examination alone, but these differences may not be clinically significant.


Assuntos
Anemia Falciforme/complicações , Gerenciamento Clínico , Angiofluoresceinografia/estatística & dados numéricos , Retina/patologia , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica/estatística & dados numéricos , Adulto , Anemia Falciforme/diagnóstico , Anemia Falciforme/terapia , Feminino , Fundo de Olho , Humanos , Masculino , Estudos Prospectivos , Doenças Retinianas/etiologia , Doenças Retinianas/terapia
9.
Dis Esophagus ; 32(9)2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31037293

RESUMO

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291.


Assuntos
Esôfago de Barrett/diagnóstico por imagem , Padrões de Prática Médica/estatística & dados numéricos , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Esôfago de Barrett/patologia , Esôfago de Barrett/terapia , Biópsia , Tomada de Decisão Clínica , Sistemas Computacionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Tomografia de Coerência Óptica/estatística & dados numéricos , Estados Unidos
10.
Dis Esophagus ; 31(6)2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29701760

RESUMO

Anastomotic leakage is one of the most severe complications after esophageal resection with gastric tube reconstruction. Impaired perfusion of the gastric fundus is seen as the main contributing factor for this complication. Optical modalities show potential in recognizing compromised perfusion in real time, when ischemia is still reversible. This review provides an overview of optical techniques with the aim to evaluate the (1) quantitative measurement of change in perfusion in gastric tube reconstruction and (2) to test which parameters are the most predictive for anastomotic leakage.A Pubmed, MEDLINE, and Embase search was performed and articles on laser Doppler flowmetry (LDF), near-infrared spectroscopy (NIRS), laser speckle contrast imaging (LSCI), fluorescence imaging (FI), sidestream darkfield microscopy (SDF), and optical coherence tomography (OCT) regarding blood flow in gastric tube surgery were reviewed. Two independent reviewers critically appraised articles and extracted the data: Primary outcome was quantitative measure of perfusion change; secondary outcome was successful prediction of necrosis or anastomotic leakage by measured perfusion parameters.Thirty-three articles (including 973 patients and 73 animals) were selected for data extraction, quality assessment, and risk of bias (QUADAS-2). LDF, NIRS, LSCI, and FI were investigated in gastric tube surgery; all had a medium level of evidence. IDEAL stage ranges from 1 to 3. Most articles were found on LDF (n = 12), which is able to measure perfusion in arbitrary perfusion units with a significant lower amount in tissue with necrosis development and on FI (n = 12). With FI blood flow routes could be observed and flow was qualitative evaluated in rapid, slow, or low flow. NIRS uses mucosal oxygen saturation and hemoglobin concentration as perfusion parameters. With LSCI, a decrease of perfusion units is observed toward the gastric fundus intraoperatively. The perfusion units (LDF, LSCI), although arbitrary and not absolute values, and low flow or length of demarcation to the anastomosis (FI) both seem predictive values for necrosis intraoperatively. SDF and OCT are able to measure microvascular flow, intraoperative prediction of necrosis is not yet described.Optical techniques aim to improve perfusion monitoring by real-time, high-resolution, and high-contrast measurements and could therefore be valuable in intraoperative perfusion mapping. LDF and LSCI use perfusion units, and are therefore subjective in interpretation. FI visualizes influx directly, but needs a quantitative parameter for interpretation during surgery.


Assuntos
Fístula Anastomótica/diagnóstico por imagem , Esofagectomia/efeitos adversos , Fundo Gástrico/diagnóstico por imagem , Imagem de Perfusão/métodos , Estômago/cirurgia , Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica/etiologia , Meios de Contraste , Angiofluoresceinografia/métodos , Angiofluoresceinografia/estatística & dados numéricos , Fundo Gástrico/irrigação sanguínea , Humanos , Fluxometria por Laser-Doppler/métodos , Fluxometria por Laser-Doppler/estatística & dados numéricos , Microcirculação , Microscopia/métodos , Microscopia/estatística & dados numéricos , Imagem de Perfusão/estatística & dados numéricos , Período Pós-Operatório , Valores de Referência , Fluxo Sanguíneo Regional , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Espectroscopia de Luz Próxima ao Infravermelho/estatística & dados numéricos , Tomografia de Coerência Óptica/métodos , Tomografia de Coerência Óptica/estatística & dados numéricos
11.
Opt Express ; 25(21): 25819-25830, 2017 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-29041245

RESUMO

Sparse representation theory is an exciting area of research with recent applications in medical imaging and detection, segmentation, and quantitative analysis of biological processes. We present a variant on the robust-principal component analysis (RPCA) algorithm, called frequency constrained RPCA (FC-RPCA), for selectively segmenting dynamic phenomena that exhibit spectra within a user-defined range of frequencies. The algorithm lacks subjective parameter tuning and demonstrates robust segmentation in datasets containing multiple motion sources and high amplitude noise. When tested on 17 ex-vivo, time lapse optical coherence tomography (OCT) B-scans of human ciliated epithelium, segmentation accuracies ranged between 91-99% and consistently out-performed traditional RPCA.


Assuntos
Algoritmos , Movimento , Análise de Componente Principal , Tomografia de Coerência Óptica/estatística & dados numéricos , Traqueia/diagnóstico por imagem , Cílios/fisiologia , Epitélio/diagnóstico por imagem , Humanos , Fatores de Tempo , Tomografia de Coerência Óptica/métodos , Traqueia/citologia
12.
Curr Opin Ophthalmol ; 28(6): 552-557, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28806189

RESUMO

PURPOSE OF REVIEW: In the last decade, with the advances of optical coherence tomography (OCT) technology, different imaging protocols and analysis algorithms have been introduced to maximize the potential of this diagnostic tool in the evaluation of different eye diseases. This review aims to provide an update on these additional features, with respect to the management of a diverse range of neuro-ophthalmologic conditions. RECENT FINDINGS: Macular ganglion cell complex (mGCC) analysis has been shown to be superior to peripapillary retinal nerve fiber layer (pRNFL) analysis in certain settings, such as differentiating Leber's hereditary optic neuropathy from functional visual loss; monitoring neurodegenerative diseases or multiple sclerosis; and predicting visual loss in nonarteritic ischemic optic neuropathy. mGCC analysis also demonstrates high correlation with perimetry and might serve as an early structural indicator of irreversible neuronal loss. Compared to pRNFL, retinal thickness analysis of the optic nerve head demonstrates better correlation with the severity of papilledema, thus enabling its possible application in detecting raised intracranial pressure, especially in the pediatric group. Upcoming research on emerging OCT technologies including OCT-angiography, enhanced depth imaging, retinal single-layer analysis and portable systems will hopefully further enhance the utility of OCT in the field. SUMMARY: It is crucial for neuro-ophthalmologists to be updated and familiar with these newer OCT imaging protocols and to make appropriate choices for different clinical scenarios, in order to optimize the diagnostic sensitivity and specificity.


Assuntos
Fibras Nervosas/patologia , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Doenças Retinianas/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/estatística & dados numéricos , Humanos , Oftalmologia , Sensibilidade e Especificidade , Tomografia de Coerência Óptica/métodos
13.
Graefes Arch Clin Exp Ophthalmol ; 255(9): 1727-1735, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28601911

RESUMO

PURPOSE: To analyze the repeatability of thickness measurements of the central macula, ganglion cell-inner plexiform layer (GC-IPL), and retinal nerve fiber layer (RNFL) using spectral-domain optical coherence tomography (SD-OCT) before and after treatment of macular edema in branch retinal vein occlusion (BRVO). METHODS: We analyzed patients with BRVO who visited our retinal clinic. The repeatability of the thickness measurements were compared using the intraclass correlation coefficient (ICC) and coefficient of variation (COV) of affected versus normal fellow eyes. RESULTS: The average thicknesses of the central macula, RNFL, and GC-IPL were 371.28 µm, 105.60 µm, and 61.88 µm, respectively, in affected eyes with macular edema before treatment, and the ICCs were 0.978, 0.919, and 0.705, respectively. The average thicknesses were 244.98 µm, 96.70 µm, and 82.70 µm, respectively, in affected eyes without macular edema after treatment, and the ICCs were 0.999, 0.975, and 0.928, respectively. After resolution of macular edema, the average thickness of the GC-IPL increased, whereas that of the central macula and RNFL significantly decreased (P < 0.05); all of the ICCs increased compared to pretreatment values. In normal fellow eyes, the average thicknesses were 250.98 µm, 93.50 µm, and 83.84 µm, respectively, and the ICCs were 0.996, 0.995, and 0.994, respectively. CONCLUSIONS: After treatment of macular edema, the repeatability and thickness of the GC-IPL increased, along with reduction in the central macular thickness. This resulted from auto-segmentation errors following macular contour changes and unstable gazes of the patients due to decreased visual acuities in BRVO with macular edema.


Assuntos
Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Oclusão da Veia Retiniana/diagnóstico , Tomografia de Coerência Óptica/estatística & dados numéricos , Adulto , Idoso , Progressão da Doença , Feminino , Seguimentos , Humanos , Macula Lutea/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
14.
Graefes Arch Clin Exp Ophthalmol ; 255(12): 2317-2324, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28891028

RESUMO

PURPOSE: The study objective was to compare dye angiography and optical coherence tomography angiography (OCTA) in detecting choroidal neovascuarization (CNV) in patients presenting with pachychoroid features and flat irregular pigment epithelial detachment (PED). METHODS: Nineteen eyes of 17 patients, presenting with flat PED and pachychoroid features, and without age-related macular degeneration or any other degenerative change, were analyzed. Fuorescein angiography (FA)/Indocyanine green angiography (ICGA) and OCTA were performed during the same visit. Subfoveal choroidal thickness was measured by enhanced depth imaging using spectral domain optical coherence tomography. RESULTS: The mean age of the patients was 59.1 years. Mean subfoveal choroidal thickness was 388 µm. FA revealed non-patognomic features including RPE alterations, window defects, leaking points and leakage from an undetermined source. ICGA revealed choroidal vascular plaque in eight eyes (42%) and suspicious plaque in five eyes (26%). Nonneovascular features, such as hyperpermeability or dilated choroidal vessels, were observed in six eyes (32%). OCTA showed choroidal neovascularization in 14 (74%). For all of the eyes, which ICGA was positive for presence of CNV, OCTA also showed CNV, and in one case it also revealed polypoidal characteristics of the neovascular network. OCTA was also able to detect CNV in all of the eyes with suspicious plaque, and in one eye without CNV appearance using ICGA. CONCLUSIONS: OCTA demonstrated greater sensitivity in detecting type 1 CNV than conventional dye angiography in cases with pachychoroid spectrum disease.


Assuntos
Doenças da Coroide/diagnóstico , Corioide/irrigação sanguínea , Angiofluoresceinografia/estatística & dados numéricos , Verde de Indocianina/farmacologia , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/estatística & dados numéricos , Idoso , Corioide/patologia , Corantes/farmacologia , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
15.
Dis Esophagus ; 30(11): 1-8, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-28881898

RESUMO

Optical coherence tomography (OCT) can generate high-resolution images of the esophagus that allows cross-sectional visualization of esophageal wall layers. We conducted a systematic review to assess the utility of OCT for diagnosing of esophageal intestinal metaplasia (IM; Barrett's esophagus BE)), dysplasia, cancer and staging of early esophageal cancer. English language human observational studies and clinical trials published in PubMed and Embase were included if they assessed any of the following: (i) in-vivo features and accuracy of OCT at diagnosing esophageal IM, sub-squamous intestinal metaplasia (SSIM), dysplasia, or cancer, and (ii) accuracy of OCT in staging esophageal cancer. Twenty-one of the 2,068 retrieved citations met inclusion criteria. In the two prospective studies that assessed accuracy of OCT at identifying IM, sensitivity was 81%-97%, and specificity was 57%-92%. In the two prospective studies that assessed accuracy of OCT at identifying dysplasia and early cancer, sensitivity was 68%-83%, and specificity was 75%-82%. Observational studies described significant variability in the ability of OCT to accurately identify SSIM. Two prospective studies that compared the accuracy of OCT at staging early squamous cell carcinoma to histologic resection specimens reported accuracy of >90%. Risk of bias and applicability concerns was rated as low among the prospective studies using the QUADAS-2 questionnaire. OCT may identify intestinal metaplasia and dysplasia, but its accuracy may not meet recommended thresholds to replace 4-quadrant biopsies in clinical practice. OCT may be more accurate than EUS at staging early esophageal cancer, but randomized trials and cost-effective analyses are lacking.


Assuntos
Esôfago de Barrett/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Esôfago/patologia , Intestinos/patologia , Tomografia de Coerência Óptica/estatística & dados numéricos , Adulto , Idoso , Esôfago de Barrett/patologia , Biópsia , Ensaios Clínicos como Assunto , Neoplasias Esofágicas/patologia , Esôfago/diagnóstico por imagem , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Intestinos/diagnóstico por imagem , Masculino , Metaplasia/diagnóstico por imagem , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Observacionais como Assunto , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade
16.
Hong Kong Med J ; 23(4): 356-64, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28684650

RESUMO

INTRODUCTION: A large proportion of patients diagnosed with diabetic maculopathy using fundus photography and hence referred to specialist clinics following the current screening guidelines adopted in Hong Kong and United Kingdom are found to be false-positive, implying that they did not have macular oedema. This study aimed to evaluate the false-positive rate of diabetic maculopathy screening using the objective optical coherence tomography scan. METHODS: This was a cross-sectional observational study. Consecutive diabetic patients from the Hong Kong West Cluster Diabetic Retinopathy Screening Programme with fundus photographs graded R1M1 were recruited between October 2011 and June 2013. Spectral-domain optical coherence tomography imaging was performed. Central macular thickness of ≥300 µm and/or the presence of optical coherence tomography signs of diabetic macular oedema were used to define the presence of diabetic macular oedema. Patients with conditions other than diabetes that might affect macular thickness were excluded. The mean central macular thickness in various subgroups of R1M1 patients was calculated and the proportion of subjects with central macular thickness of ≥300 µm was used to assess the false-positive rate of this screening strategy. RESULTS: A total of 491 patients were recruited during the study period. Of the 352 who were eligible for analysis, 44.0%, 17.0%, and 38.9% were graded as M1 due to the presence of foveal 'haemorrhages', 'exudates', or 'haemorrhages and exudates', respectively. The mean (±standard deviation) central macular thickness was 265.1±55.4 µm. Only 13.4% (95% confidence interval, 9.8%-17.0%) of eyes had a central macular thickness of ≥300 µm, and 42.9% (95% confidence interval, 37.7%-48.1%) of eyes had at least one optical coherence tomography sign of diabetic macular oedema. For patients with retinal haemorrhages only, 9.0% (95% confidence interval, 4.5%-13.5%) had a central macular thickness of ≥300 µm; 23.2% (95% confidence interval, 16.6%-29.9%) had at least one optical coherence tomography sign of diabetic macular oedema. The false-positive rate of the current screening strategy for diabetic macular oedema was 86.6%. CONCLUSION: The high false-positive rate of the current diabetic macular oedema screening adopted by the United Kingdom and Hong Kong may lead to unnecessary psychological stress for patients and place a financial burden on the health care system. A better way of screening is urgently needed. Performing additional spectral-domain optical coherence tomography scans on selected patients fulfils this need.


Assuntos
Retinopatia Diabética/diagnóstico por imagem , Angiofluoresceinografia/estatística & dados numéricos , Edema Macular/diagnóstico por imagem , Programas de Rastreamento/estatística & dados numéricos , Tomografia de Coerência Óptica/estatística & dados numéricos , Idoso , Estudos Transversais , Reações Falso-Positivas , Feminino , Hong Kong , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade
17.
J Drugs Dermatol ; 15(6): 713-4, 2016 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-27272077

RESUMO

Cherry hemangiomas are common vascular proliferative lesions that can be concerning from a cosmetic perspective. Laser therapy is often used to eradicate cherry hemangiomas, but some lesions require multiple treatments or do not resolve at all. The suboptimal response to laser treatment may be due to limitations in penetration depth by vascular lasers such as the pulsed dye laser. Optical coherence tomography is a low-energy, light-based imaging device that can evaluate the depth and extent of vascular lesions such as cherry hemangiomas by allowing visualization of tissue structure and blood vessel architecture, which cannot be appreciated by clinical or dermatoscopic examination alone. We present optical coherence tomography images of a cherry hemangioma to demonstrate the precision and resolution of this imaging modality. Optical coherence tomography provides valuable information that has the potential to predict response to laser therapy without unnecessary attempts. Future prospective studies will determine its value for this purpose.

J Drugs Dermatol. 2016;15(6):713-714.


Assuntos
Hemangioma/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Tomografia de Coerência Óptica/estatística & dados numéricos , Adulto , Feminino , Hemangioma/radioterapia , Humanos , Lasers de Corante/estatística & dados numéricos , Neoplasias Cutâneas/radioterapia
18.
Folia Med (Plovdiv) ; 57(3-4): 207-15, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-27180347

RESUMO

AIM: To compare spectral-domain optical coherence tomography (SD-OCT) with fluorescein angiography (FA) in detecting macular edema in patients with uveitis and analyse discrepancies in the findings obtained by the two methods. METHODS: The study included 133 eyes from 117 patients with uveitis that had SD-OCT (RTVue-100/ Optovue) and FA (Topcon TRC 50DX) scans performed to detect or rule out macular edema. RESULTS: Macular edema was found in 57 (42.9%) of the 133 surveyed eyes. In 37 eyes (27.8%) macular edema was confirmed by both imaging methods. In 17 eyes (12.8%) macular edema was detected on SD-OCT but not on FA;in 15 eyes of these the edema was diffuse, and in 2 eyes - serous retinal detachment was verified in the macular area. Focal macular edema was detected on FA in three eyes (2.3%) in which SD-OCT showed normal finding. In 76 eyes (57.1%) no pathological changes in the macula were observed on both SD-OCT and FA. Kappa coefficient was 0.675 at p < 0.001. The agreement rate between the two methods calculated using Kendall's tau-b was 0.693 at p < 0.001. CONCLUSION: Fluorescein angiography and spectral domain optical coherence tomography are highly sensitive methods used in detecting macular edema in patients with uveitis, but they might fail to be efficient in this if used independently. Optical coherence tomography is a more informative method, especially in diagnosing diffuse macular edema.


Assuntos
Angiofluoresceinografia/estatística & dados numéricos , Edema Macular/diagnóstico , Tomografia de Coerência Óptica/estatística & dados numéricos , Uveíte/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Adulto Jovem
19.
Opt Lett ; 39(12): 3472-5, 2014 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-24978514

RESUMO

The speckle pattern of an optical coherence tomography (OCT) image carries potentially useful sample information that may assist in tissue characterization. Recent biomedical results in vivo indicate that the distribution of signal intensities within an OCT tissue image is well described by a log-normal-like (Gamma) function. To fully understand and exploit this finding, an OCT Monte Carlo model that accounts for speckle effects was developed. The resultant Monte Carlo speckle statistics predictions agree well with experimental OCT results from a series of control phantoms with variable scattering properties; the Gamma distribution provides a good fit to the theoretical and experimental results. The ability to quantify subresolution tissue features via OCT speckle analysis may prove useful in diagnostic photomedicine.


Assuntos
Tomografia de Coerência Óptica/métodos , Simulação por Computador , Humanos , Microesferas , Método de Monte Carlo , Fenômenos Ópticos , Imagens de Fantasmas , Tomografia de Coerência Óptica/estatística & dados numéricos
20.
J Neural Transm (Vienna) ; 121(11): 1367-76, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24748549

RESUMO

Spectral-domain Optical coherence tomography (OCT) has shown remarkable utility in the study of retinal disease and has helped to characterize the fovea in Parkinson disease (PD) patients. We developed a detailed mathematical model based on raw OCT data to allow differentiation of foveae of PD patients from healthy controls. Of the various models we tested, a difference of a Gaussian and a polynomial was found to have "the best fit". Decision was based on mathematical evaluation of the fit of the model to the data of 45 control eyes versus 50 PD eyes. We compared the model parameters in the two groups using receiver-operating characteristics (ROC). A single parameter discriminated 70 % of PD eyes from controls, while using seven of the eight parameters of the model allowed 76 % to be discriminated. The future clinical utility of mathematical modeling in study of diffuse neurodegenerative conditions that also affect the fovea is discussed.


Assuntos
Fóvea Central/patologia , Modelos Teóricos , Doença de Parkinson/patologia , Retina/patologia , Tomografia de Coerência Óptica/métodos , Tomografia de Coerência Óptica/estatística & dados numéricos , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC
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