Retinal Arteriovenous Malformation Assessment Using Swept-Source OCT Angiography.

Swept-source optical coherence tomography angiography (SS-OCTA) is a promising new imaging modality for assessing retinal and choroidal vasculature. Faster scanning speed, large number of A-scan acquisition, and enhanced depth penetration has enhanced the detailed analysis of retinal layers. The authors discuss SS-OCTA features of a rare case of retinal arteriovenous malformation. Image analysis revealed the anomalous large-caliber vessels occupying up to the entire retinal thickness with associated echolucent changes in the inner retinal layers surrounding the retinal vessels, along with disruption of the outer retinal layers, including the inner/outer segments of photoreceptors beneath the large tortuous vessels outside the foveola in absence of any capillary nonperfusion areas or lack of significant macular edema. At the fovea, the outer retinal layers were intact due to a smaller caliber and less-deep extension of the anomalous vessels. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:216-219.].

Rotation of retinal vascular arcades and comparison with disc-fovea angle in the assessment of cycloposition.

BACKGROUND/AIMS: To assess the agreement between disc-fovea angle (DFA) and the retinal vascular arcades rotation to measure cycloposition. Device repeatability and reproducibility between observers were also evaluated. METHODS: Cycloplegic retinography was taken in 321 eyes of 165 normal patients and repeated in 18 eyes at least 24 h later. Two independent observers used software to determine DFA, vein-related angle (VRA) and artery-related angle (ARA) in every retinography. Mean value of related angle (MRA) (mean value of VRA and ARA) was calculated. RESULTS: Camera repeatability was good (Intra-class Correlation Coefficient, ICC 0.89). In Bland-Altman analysis, mean VRA, ARA and MRA were 4° to 5° different from DFA (p<0.01). There was poor correlation between DFA and other methods (ICC): DFA versus VRA 0.3, versus ARA 0.4, versus MRA 0.5. Reliability between observers was good in all methods. The multivariate analysis showed no interaction between each method and eye side, sex or observer (p>0.05). CONCLUSIONS: The rotation of retinal vascular arcades using a first-order approximation technique is no substitute to DFA when assessing torsion in fundus photographs. Of the methods tested, MRA correlated most closely, but DFA remains the gold standard for cycloposition. The rotation of vascular arcades provides a qualitative assessment, particularly in uncertain macular location.

VAMPIRE: Vessel assessment and measurement platform for images of the REtina.

We present VAMPIRE, a software application for efficient, semi-automatic quantification of retinal vessel properties with large collections of fundus camera images. VAMPIRE is also an international collaborative project of four image processing groups and five clinical centres. The system provides automatic detection of retinal landmarks (optic disc, vasculature), and quantifies key parameters used frequently in investigative studies: vessel width, vessel branching coefficients, and tortuosity. The ultimate vision is to make VAMPIRE available as a public tool, to support quantification and analysis of large collections of fundus camera images.

Computer-assisted assessment of plus disease in retinopathy of prematurity using video indirect ophthalmoscopy images.

PURPOSE: "ROPtool" is a computer program that measures retinal blood vessel tortuosity. Our aim was to determine the feasibility and accuracy of analyzing images with ROPtool, which were obtained using video indirect ophthalmoscopy. METHODS: Forty-five posterior pole still images captured from indirect ophthalmoscopy video clips were selected; 20 were selected for high quality and 25 were randomly selected. One of the authors (S.A.) used ROPtool to measure tortuosity for each quadrant of each image. Two of the authors (D.K.W. and S.F.F.) independently judged tortuosity on a 10-point scale, and their averaged grades were used as the reference standard. RESULTS: Among randomly selected images, ROPtool was able to trace at least two major vessels in 43 of 100 quadrants (43%). Lighter fundus pigment color was associated with ROPtool's ability to analyze images (P = 0.004). When considering analyzable images only, ROPtool's sensitivity in detecting tortuosity sufficient for plus disease was 83% (5/6) and specificity was 90% (18/20). ROPtool's sensitivity for pre-plus tortuosity was 100% (9/9) and specificity was 71% (12/17). CONCLUSION: ROPtool is useful for analyzing video indirect ophthalmoscopy images only when applied to those with high quality. When analyzing these images, ROPtool has very good accuracy compared to consensus of experienced examiners.