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1.
Transl Vis Sci Technol ; 13(8): 13, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39115838

RESUMEN

Purpose: Proliferative retinal changes may occur postsurgery for rhegmatogenous retinal detachment (RRD), possibly preceding recurrent detachment. This study aims to establish the groundwork for an imaging system capable of discerning changes in retinal vessel tortuosity after RRD repair, analyzing widefield optical coherence tomography angiography (WF-OCTA) images. Methods: Eighty-eight eyes of 86 patients with RRD who underwent surgical procedures and had repeated imaging with clear widefield optical coherence tomography (WF-OCT) and WF-OCTA on different postoperative days were enrolled in this retrospective study. We compared WF-OCTA images over time to identify alterations in retinal vessel tortuosity and observed regional changes in retinal morphology. Results: After image processing, changes in retinal vessel tortuosity were detected in 66 quadrants. These changes, attributed to retinal traction from proliferative membranes, were observed in 56 quadrants, among which retinal thickness remained unchanged in seven sectors (12.5%) according to the WF-OCT map. In nine quadrants, changes in retinal vessel tortuosity were attributed to changes in subretinal fluid, aligning with observable variations in retinal thickness. Conclusions: Observation of vessel tortuosity changes using WF-OCTA can help detect early postoperative proliferative changes in eyes with RRD. Translational Relevance: Because WF-OCTA can detect minute vessel tortuosity changes, it can offer a noninvasive alternative for the detection of early postoperative proliferative changes.


Asunto(s)
Angiografía con Fluoresceína , Desprendimiento de Retina , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Desprendimiento de Retina/cirugía , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/patología , Tomografía de Coherencia Óptica/métodos , Femenino , Estudios Retrospectivos , Masculino , Persona de Mediana Edad , Anciano , Angiografía con Fluoresceína/métodos , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patología , Adulto , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Vitrectomía/métodos , Agudeza Visual/fisiología , Periodo Posoperatorio , Curvatura de la Esclerótica/métodos
2.
Tokai J Exp Clin Med ; 49(2): 85-88, 2024 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-38904240

RESUMEN

An 84-year-old man presented with decreased right-eye visual acuity. Upon initial examination, the rightand left-eye visual acuities were 0.03 and 1.2, respectively; moreover, the right- and left-eye intraocular pressure was 12 mmHg and 13 mmHg, respectively. Examination revealed a shallow anterior chamber of the right eye, anterior chamber inflammation, vitreous opacity, and marked retinochoroidal detachment. Optical coherence tomography (OCT) revealed retinal detachment (RD) and choroidal folds; moreover, B-scan ultrasonography (B-scan) showed RD as well as thickened sclera with fluid in Tenon's space. Fluorescent fundus angiography revealed hyperfluorescence in the optic disc and vascular hyperpermeability in the right eye. The left eye lacked extra-ocular symptoms or abnormalities. The right ocular axis measured 23.4 mm with no apparent subretinal fluid migration due to positional changes. Accordingly, the patient was diagnosed with panuveitis associated with posterior scleritis and immediately started on 40 mg prednisolone, which improved his symptoms. However, at 3 post-treatment months, choroidal folds were observed and was restarted on 20 mg prednisolone. The choroidal folds subsequently disappeared, with a current visual acuity of 0.3 in the right eye and no recurrence. Our findings indicated the utility of accurate diagnosis of posterior scleritis by B-scan and prompt systemic steroid administration.


Asunto(s)
Panuveítis , Prednisolona , Desprendimiento de Retina , Escleritis , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Masculino , Escleritis/etiología , Escleritis/diagnóstico , Escleritis/diagnóstico por imagen , Escleritis/complicaciones , Desprendimiento de Retina/etiología , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/diagnóstico , Anciano de 80 o más Años , Panuveítis/diagnóstico , Panuveítis/etiología , Panuveítis/complicaciones , Prednisolona/administración & dosificación , Resultado del Tratamiento , Angiografía con Fluoresceína/métodos , Coroides/diagnóstico por imagen , Coroides/patología , Enfermedades de la Coroides/etiología , Enfermedades de la Coroides/diagnóstico por imagen , Enfermedades de la Coroides/diagnóstico , Enfermedades de la Coroides/complicaciones
4.
Sci Rep ; 14(1): 12023, 2024 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-38797771

RESUMEN

To study the clinical characteristics of macula off rhegmatogenous retinal detachment (RRD) with peripheral causative breaks and concomitant macular hole (RRD+MH). This is a bi-center study. Consecutive eyes of macula off RRD with or without macular hole (MH) were collected. Eyes in these two groups were compared with best corrected visual acuity in logarithm of minimal angle of resolution (logMAR BCVA), the presence of choroidal detachment (CD), proliferative vitreoretinopathy (PVR) and the extent of RRD. In the group of RRD+MH, regression analysis was used to evaluate the correlation of clinical factors and final logMar BCVA. In addition, optical coherence tomography was performed both pre-and post-operatively if possible. There were 40 eyes in the RRD+MH group and 80 eyes in the control group. Eyes with RRD+MH had worse initial and final logMar BCVA (p < 0.001), higher incidence of CD (p < 0.001), PVR and extensive RRD at baseline (p < 0.001). Among the eyes with RRD+MH, final BCVA was correlated with initial BCVA (p < 0.001, CI 0.637 to 0.837), recurrent RRD (p = 0.004, CI - 0.661 to - 0.126), duration of RRD (p = 0.021, CI - 0.576 to - 0.048) and presence of PVR (p = 0.001, CI - 0.131 to - 0.035). The hole closure rate at final follow up is 87.5%.11 of the 17 eyes had preoperative optical coherence tomography (OCT) obtained had ellipsoid zone lining the bottom of MH. CD, PVR and extensive RRD were more commonly observed in RRD+MH. The morphology of MH may suggest the pathogenesis of MH in RRD+MH include mechanism different from that of idiopathic MH.


Asunto(s)
Desprendimiento de Retina , Perforaciones de la Retina , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Tomografía de Coherencia Óptica/métodos , Perforaciones de la Retina/diagnóstico por imagen , Perforaciones de la Retina/patología , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/patología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos
6.
Pregnancy Hypertens ; 36: 101117, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38428345

RESUMEN

OBJECTIVE: To evaluate the characteristics of serous retinal detachment on spectral-domain optical coherence tomography in preeclampsia. METHODS: In this retrospective case-series study, clinical characteristics of retinal damage were evaluated using spectral-domain optical coherence tomography (SD-OCT) imaging. RESULTS: Thirty affected eyes from 16 pregnant women with preeclampsia were included. The features of serous retinal detachment, observed using SD-OCT, consisted of lesions located in the macular or peripapillary region; the presence of intraretinal or subretinal fluid (intraretinal fluid, IRF; subretinal fluid, SRF); ellipsoid zone integrity (normal/abnormal); intraretinal hyper-reflective dots; and Elschnig spots (retinal pigment epithelium lesions). Of the 30 affected eyes, 25 (83.33%) had lesions located in the macular region, 19 (63.33%) outside the macula (in the peripapillary region), and 14 (46.67%) in both. SD-OCT showed IRF in 2 eyes (6.67%), SRF in 30 eyes (100.00%), and both in 2 eyes (6.67%). The ellipsoid zone was disrupted in 20 eyes (66.67%), intraretinal hyper-reflective dots were observed in 4 eyes (13.33%), and Elschnig spots were observed in 20 eyes (66.67%). CONCLUSION: Spectral-domain optical coherence tomography is a non-invasive, reliable imaging tool for the assessment of retinal pathologies in preeclampsia.


Asunto(s)
Preeclampsia , Desprendimiento de Retina , Tomografía de Coherencia Óptica , Humanos , Femenino , Preeclampsia/diagnóstico por imagen , Embarazo , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/etiología , Estudios Retrospectivos , Adulto , Líquido Subretiniano/diagnóstico por imagen
8.
Sci Rep ; 13(1): 19513, 2023 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-37945766

RESUMEN

To compare the choroidal neovascular features of individuals with pachychoroid neovasculopathy (PNV) and neovascular age-related macular degeneration (nAMD) with and without shallow irregular pigment epithelial detachment (SIPED). Using optical coherence tomography angiography, the choroidal neovascular complexes of 27 patients with PNV, 34 patients with nAMD and SIPED, and 15 patients with nAMD without SIPED were analyzed with FIJI and AngioTool software. PNV compared to nAMD with SIPED had a greater vessel percentage area (P = 0.034), junction density (P = 0.045), average vessel length (P < 0.001), and fractal dimension (P < 0.001). PNV, compared to nAMD without SIPED, had a greater total vessel length (P = 0.002), total number of junctions (P < 0.001), junction density (P = 0.034), and fractal dimension (P = 0.005). nAMD with SIPED, compared to nAMD without SIPED, had greater vessel area, total number of junctions, total vessel length, and average vessel length (all P values < 0.001). Patients with nAMD plus SIPED and individuals with nAMD without SIPED have similar fractal dimension values (P = 0.703). Biomarkers of choroidal neovascular complexity, such as fractal dimension, can be used to differentiate PNV from nAMD with or without SIPED.


Asunto(s)
Neovascularización Coroidal , Degeneración Macular , Desprendimiento de Retina , Degeneración Macular Húmeda , Humanos , Degeneración Macular/diagnóstico por imagen , Degeneración Macular/tratamiento farmacológico , Desprendimiento de Retina/diagnóstico por imagen , Coroides/irrigación sanguínea , Neovascularización Coroidal/diagnóstico por imagen , Neovascularización Coroidal/tratamiento farmacológico , Angiografía , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Angiografía con Fluoresceína/métodos , Inhibidores de la Angiogénesis/uso terapéutico
9.
Transl Vis Sci Technol ; 12(10): 3, 2023 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-37792693

RESUMEN

Purpose: Machine learning models based on radiomic feature extraction from clinical imaging data provide effective and interpretable means for clinical decision making. This pilot study evaluated whether radiomics features in baseline optical coherence tomography (OCT) images of eyes with pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nAMD) can predict treatment response to as-needed anti-vascular endothelial growth factor (VEGF) therapy. Methods: Thirty-nine eyes of patients with PED undergoing anti-VEGF therapy were included. All eyes underwent a loading dose followed by as-needed therapy. OCT images at baseline, month 3, and month 6 were analyzed. Images were manually separated into non-responding, recurring, and responding eyes based on the presence or absence of subretinal fluid at month 6. PED radiomics features were then extracted from each image and images were classified as responding or recurring using a machine learning classifier applied to the radiomics features. Results: Linear discriminant analysis classification of baseline features as responsive versus recurring resulted in classification performance of 64.0% (95% confidence interval [CI] = 0.63-0.65), area under the curve (AUC = 0.78, 95% CI = 0.72-0.82), sensitivity 0.79 (95% CI = 0.63-0.87), and specificity 0.58 (95% CI = 0.50-0.67). Further analysis of features in recurring eyes identified a significant shift toward non-responding mean feature values over 6 months. Conclusions: Our results demonstrate the use of radiomics features as predictors for treatment response to as-needed anti-VEGF therapy. Our study demonstrates the potential for radiomics feature in clinical decision support for personalizing anti-VEGF therapy. Translational Relevance: The ability to use PED texture features to predict treatment response facilitates personalized clinical decision making.


Asunto(s)
Degeneración Macular , Desprendimiento de Retina , Humanos , Ranibizumab/uso terapéutico , Inhibidores de la Angiogénesis/uso terapéutico , Factor A de Crecimiento Endotelial Vascular/uso terapéutico , Proyectos Piloto , Estudios Retrospectivos , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/tratamiento farmacológico , Desprendimiento de Retina/complicaciones , Degeneración Macular/diagnóstico por imagen , Degeneración Macular/tratamiento farmacológico
10.
Med Eng Phys ; 120: 104048, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37838406

RESUMEN

Nowadays, automated disease diagnosis has become a vital role in the medical field due to the significant population expansion. An automated disease diagnostic approach assists clinicians in the diagnosis of disease by giving exact, consistent, and prompt results, along with minimizing the mortality rate. Retinal detachment has recently emerged as one of the most severe and acute ocular illnesses, spreading worldwide. Therefore, an automated and quickest diagnostic model should be implemented to diagnose retinal detachment at an early stage. This paper introduces a new hybrid approach of best basis stationary wavelet packet transform and modified VGG19-Bidirectional long short-term memory to detect retinal detachment using retinal fundus images automatically. In this paper, the best basis stationary wavelet packet transform is utilized for image analysis, modified VGG19-Bidirectional long short-term memory is employed as the deep feature extractors, and then obtained features are classified through the Adaptive boosting technique. The experimental outcomes demonstrate that our proposed method obtained 99.67% sensitivity, 95.95% specificity, 98.21% accuracy, 97.43% precision, 98.54% F1-score, and 0.9985 AUC. The model obtained the intended results on the presently accessible database, which may be enhanced further when additional RD images become accessible. The proposed approach aids ophthalmologists in identifying and easily treating RD patients.


Asunto(s)
Desprendimiento de Retina , Humanos , Desprendimiento de Retina/diagnóstico por imagen , Fondo de Ojo , Análisis de Ondículas , Procesamiento de Imagen Asistido por Computador
11.
Photodiagnosis Photodyn Ther ; 44: 103763, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37643664

RESUMEN

PURPOSE: To assess the changes of hyperreflective foci (HRF) in rhegmatogenous retinal detachment (RRD) patients after successful reattachment surgery. METHODS: Twenty-nine macula-off RRD eyes with successful reattachment surgery were retrospectively analyzed. Optical coherence tomography (OCT) was used to image macular regions and measure HRF in outer retina and inner retina at 0.5, 1, 3, 6, 12 months after surgery. The relationships between HRF and photoreceptor layer status, visual outcomes were evaluated. RESULTS: After retinal reattachment, HRF mainly distributed at the location where external limiting membrane (ELM) or inner and outer segment (IS/OS) line was disrupted. The HRF numbers in outer and inner retina were greater in eyes with discontinuous IS/OS line than eyes with continuous IS/OS line (all p<0.05). In the outer retina,  HRF increased in the initial three months after retinal reattachment, and then decreased gradually after 3 months (p<0.05). The HRF number in the outer retina at postoperative 0.5 months was associated with favorable visual outcomes at 6 and 12 months (r=-0.487,  p =0.025; r=-0.626,  p=0.005, respectively), nevertheless, the HRF number at 3 months was correlated with poor visual results at 6 and 12 months (r=0.441,  p =0.017; r=0.477,  p=0.019, respectively). CONCLUSION: HRF mainly occurred near the site where ELM or IS/OS line was injured after retinal reattachment. In the outer retina, the number of HRF gradually increased in the first 3 months and then gradually decreased. The early appearance of HRF in the outer retina was associated with a good visual prognosis, while the late appearance may suggest a less favorable visual outcome.


Asunto(s)
Fotoquimioterapia , Desprendimiento de Retina , Humanos , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/cirugía , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes
12.
Comput Biol Med ; 165: 107319, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37611427

RESUMEN

As a leading cause of blindness worldwide, macular edema (ME) is mainly determined by sub-retinal fluid (SRF), intraretinal fluid (IRF), and pigment epithelial detachment (PED) accumulation, and therefore, the characterization of SRF, IRF, and PED, which is also known as ME segmentation, has become a crucial issue in ophthalmology. Due to the subjective and time-consuming nature of ME segmentation in retinal optical coherence tomography (OCT) images, automatic computer-aided systems are highly desired in clinical practice. This paper proposes a novel loss-balanced parallel decoding network, namely PadNet, for ME segmentation. Specifically, PadNet mainly consists of an encoder and three parallel decoder modules, which serve as segmentation, contour, and diffusion branches, and they are employed to extract the ME's characteristics, the contour area features, and to expand the ME area from the center to edge, respectively. A new loss-balanced joint-loss function with three components corresponding to each of the three parallel decoding branches is also devised for training. Experiments are conducted with three public datasets to verify the effectiveness of PadNet, and the performances of PadNet are compared with those of five state-of-the-art methods. Results show that PadNet improves ME segmentation accuracy by 8.1%, 11.1%, 0.6%, 1.4% and 8.3%, as compared with UNet, sASPP, MsTGANet, YNet, RetiFluidNet, respectively, which convincingly demonstrates that the proposed PadNet is robust and effective in ME segmentation in different cases.


Asunto(s)
Edema Macular , Desprendimiento de Retina , Humanos , Tomografía de Coherencia Óptica/métodos , Retina/diagnóstico por imagen , Edema Macular/diagnóstico por imagen , Desprendimiento de Retina/diagnóstico por imagen
13.
Stud Health Technol Inform ; 305: 636-639, 2023 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-37387112

RESUMEN

The current state of machine learning (ML) and deep learning (DL) algorithms used to detect, classify and predict the onset of retinal detachment (RD) were examined in this scoping review. This severe eye condition can cause vision loss if left untreated. By analyzing the medical imaging modalities such as fundus photography, AI could help to detect peripheral detachment at an earlier stage. We have searched five databases: PubMed, Google Scholar, ScienceDirect, Scopus, and IEEE. Two reviewers independently carried out the selection of the studies and their data extractions. 32 studies fulfilled our eligibility criteria from the 666 references collected. In particular, based on the performance metrics employed in these studies, this scoping review provides a general overview of emerging trends and practices concerning using ML and DL algorithms for detecting, classifying, and predicting RD.


Asunto(s)
Desprendimiento de Retina , Humanos , Algoritmos , Benchmarking , Determinación de la Elegibilidad , Aprendizaje Automático , Desprendimiento de Retina/diagnóstico por imagen
14.
West J Emerg Med ; 24(3): 622-628, 2023 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-37278794

RESUMEN

INTRODUCTION: Point-of-care ultrasound (POCUS) plays a pivotal role in evaluating ocular complaints in the emergency department (ED). The rapid and non-invasive nature of ocular POCUS makes it a safe and informative imaging modality. Previous studies have investigated using ocular POCUS to diagnose posterior vitreous detachment (PVD), vitreous hemorrhage (VH), and retinal detachment (RD); however, there are few studies that assess image optimization techniques and how they impact the overall accuracy of ocular POCUS. METHODS: We performed a retrospective review of ED patients who received ocular POCUS examinations and ophthalmology consultations as part of their evaluation for eye complaints at our urban, Level I trauma center ED from November 2017-January 2021. Of 706 exams, 383 qualified for the study. In this study we primarily investigated how stratified gain levels impact the accuracy of ocular POCUS for detection of any posterior chamber pathology and, secondarily, whether stratified gain levels impact the accuracy of detecting RD, VH, and PVD specifically. RESULTS: The images were found to have an overall sensitivity of 81% (76-86%), specificity of 82% (76-88%), positive predictive value (PPV) of 86% (81-91%), and negative predictive value (NPV) of 77% (70-83%). Images acquired with a gain of (25, 50] had a sensitivity of 71% (61-80%), specificity of 95% (85-99%), PPV of 96% (88-99%), and NPV of 68% (56-78%). Images acquired with a gain of (50, 75] had a sensitivity of 85% (73-93%), specificity of 85% (72-93%), PPV of 86% (75-94%), and NPV of 83% (70-92%). Images acquired with a high gain (75, 100] had a sensitivity of 91% (82-97%), specificity of 67% (53-79%), PPV of 78% (68-86%), and NPV of 86% (72-95%). CONCLUSION: In the ED setting, high (75, 100] gain on ocular POCUS scanning has a higher degree of sensitivity for detecting any posterior chamber abnormality, as compared to low (25, 50] gain levels. Thus, incorporating the use of high gain for ocular POCUS exams produces a more effective tool for ocular pathologies in acute care settings and may be particularly valuable in resource-limited settings.


Asunto(s)
Desprendimiento de Retina , Desprendimiento del Vítreo , Humanos , Sistemas de Atención de Punto , Sensibilidad y Especificidad , Ultrasonografía/métodos , Ojo/diagnóstico por imagen , Desprendimiento de Retina/diagnóstico por imagen , Servicio de Urgencia en Hospital
15.
Rev. cuba. oftalmol ; 36(2)jun. 2023.
Artículo en Español | LILACS, CUMED | ID: biblio-1550925

RESUMEN

El desprendimiento de la capa bacilar de la retina es la separación de los segmentos internos de los fotorreceptores del resto de la retina neurosensorial, o separación entre la zona miode y elipsoide de la retina, que en un hallazgo reciente se puede identificar mediante la tomografía de coherencia óptica de dominio espectral. El objetivo es actualizar los conocimientos sobre el desprendimiento de la capa bacilar de la retina y el uso de la tomografía de coherencia óptica de dominio espectral en las enfermedades oculares que están asociadas con este signo. Se consultaron las fuentes bibliográficas como Google académico, SciELO LAC, Medline y MEDICARIBE. Se limitaron los resultados al idioma español e inglés y a los últimos cinco años. Se recuperaron 54 documentos, de ellos 18 resultaron relevantes a esta investigación. Los autores más mencionados fueron Ramtohul, Metha y Cicinelli. Ellos trabajaron el signo clínico en cuestión y reportaron la experiencia en la atención a los pacientes aquejados con esta enfermedad ocular. El desprendimiento de la capa bacilar de la retina es un signo presente en varias enfermedades asociadas a inflamación del segmento posterior ocular. La tomografía de coherencia óptica de dominio espectral es una técnica efectiva para determinarlo, aunque estos planteamientos aún son escasos en la literatura, lo cual reafirma la importancia científica de continuar los estudios a partir de hipótesis iniciales desde el punto de vista histológico y tomográfico(AU)


Retinal bacillary layer detachment is the separation of the inner segments of the photoreceptors from the rest of the neurosensory retina, or separation between the myode and ellipsoid zone of the retina, which in a recent finding can be identified by spectral-domain optical coherence tomography. The objective is to update the knowledge about the detachment of the bacillary layer of the retina and the use of spectral-domain optical coherence tomography in ocular diseases that are associated with this sign. Bibliographic sources such as academic Google, SciELO LAC, MEDLINE and MEDICARIBE were consulted. Fifty-four documents were retrieved, of which 18 were relevant to this research. The results were limited to the Spanish and English language and to the last five years. The most mentioned authors were Ramtohul, Metha and Cicinelli. They worked on the clinical sign in question and reported the experience in caring for patients afflicted with this ocular disease. Detachment of the bacillary layer of the retina is a sign present in several diseases associated with ocular posterior segment inflammation. Spectral-domain optical coherence tomography is an effective technique to determine it, although it is still scarce in the literature, which reaffirms the scientific validity of continuing studies from initial hypotheses from the histological and tomographic point of view(AU)


Asunto(s)
Humanos , Desprendimiento de Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Degeneración Macular/etiología , Literatura de Revisión como Asunto , Bases de Datos Bibliográficas
16.
Rev. cuba. oftalmol ; 36(2)jun. 2023.
Artículo en Español | LILACS, CUMED | ID: biblio-1550922

RESUMEN

El síndrome de Vogt-Koyanagi-Harada es una enfermedad autoinmune multisistémica crónica, caracterizada por panuveítis difusa granulomatosa bilateral con desprendimiento exudativo de retina y papilitis. Compromete el sistema nervioso central (meninges, disacusia neurosensorial) así como piel y mucosas. A pesar de ser una enfermedad compleja y poco frecuente, se hace necesario comprender la importancia del diagnóstico rápido y el tratamiento oportuno con seguimiento especializado. Es por ello que se decidió realizar una revisión de la literatura con el objetivo de actualizar los conocimientos existentes sobre este tema. La búsqueda se realizó en diferentes publicaciones y textos básicos de la especialidad. Las fuentes consultadas fueron las bases de datos PubMed y Google Scholar. El diagnóstico de la enfermedad es esencialmente clínico y son los oftalmólogos quienes más lo sospechan por ser los síntomas oculares los más frecuentes y dramáticos. El pronóstico visual de los pacientes es generalmente bueno si el diagnóstico es precoz y se indica un tratamiento adecuado. Los corticosteroides sistémicos a altas dosis asociados a inmunosupresores y agentes biológicos tienen gran impacto en la evolución de la enfermedad, sobre todo estos últimos a nivel mundial, previniendo complicaciones y permitiendo resultados visuales satisfactorios para una mejor calidad de vida del paciente(AU)


Vogt-Koyanagi-Harada syndrome is a chronic multisystem autoimmune disease characterized by bilateral diffuse granulomatous panuveitis with exudative retinal detachment and papillitis. It involves the central nervous system (meninges, sensorineural dysacusis) as well as skin and mucous membranes. In spite of being a complex and infrequent disease, it is necessary to understand the importance of rapid diagnosis and timely treatment with specialized follow-up. For this reason, it was decided to carry out a review of the literature with the aim of updating the existing knowledge on this subject. The search was carried out in different publications and basic texts of the specialty. The sources consulted were the PubMed and Google Scholar databases. The diagnosis of the disease is essentially clinical and it is the ophthalmologists who suspect it the most because the ocular symptoms are the most frequent and dramatic. The visual prognosis of patients is generally good if the diagnosis is early and adequate treatment is indicated. Systemic corticosteroids at high doses associated with immunosuppressants and biological agents have a great impact on the evolution of the disease, especially the latter worldwide, preventing complications and allowing satisfactory visual results for a better quality of life of the patient(AU)


Asunto(s)
Humanos , Enfermedades Autoinmunes/etiología , Desprendimiento de Retina/diagnóstico por imagen , Panuveítis/diagnóstico , Corticoesteroides/uso terapéutico , Literatura de Revisión como Asunto
18.
Sci Rep ; 13(1): 7184, 2023 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-37137948

RESUMEN

The purpose of this study is to evaluate choroidal hyperreflective foci (HRF) changes in central serous chorioretinopathy (CSC) on en-face optical coherence tomography (OCT). Retrospective analysis of 42 patients with unilateral CSC (84 eyes, including fellow eyes for controls) and 42 age- and sex-matched controls. With 4.5 × 4.5 mm macular scans, structural en-face OCT choriocapillaris (CC) slabs were used to calculate the density and number of HRF in acute CSC eyes with serous retinal detachment (SRD), resolved CSC eyes without SRD, unaffected fellow eyes, control eyes, and 1-year follow-up eyes. Based on the 2-disc diameter (3000 µm), the en-face OCT scan was divided into foveal and perifoveal lesion and analyzed to consider the impact of SRF in HRF measurement. Regression analyses were performed on the several factors with HRF number and density in the acute and resolved CSC eyes. The perifoveal density and number of CC HRF was significantly lower in the resolved CSC eyes when compared to the acute CSC eyes (P = 0.002, both), fellow eyes (P = 0.042/density, 0.028/number), and controls (P = 0.021/density, P = 0.003/number). There was no significant difference between the acute CSC eyes, fellow eyes, controls, and 1-year follow-up eyes. As subfoveal choroidal thickness decreased and choroidal vascularity (CVI) increased, the perifoveal density and number of HRF was measured higher with a significant correlation in univariate regression analysis of the acute and resolved CSC eyes (all, P < 0.05). The authors hypothesized that stromal edema induced by choroidal congestion and hyperpermeability has the greatest influence on HRF measurement, possibly affected by inflammatory cells and materials extravasation.


Asunto(s)
Coriorretinopatía Serosa Central , Desprendimiento de Retina , Humanos , Coriorretinopatía Serosa Central/diagnóstico por imagen , Coriorretinopatía Serosa Central/patología , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Angiografía con Fluoresceína/métodos , Coroides/diagnóstico por imagen , Coroides/patología , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/patología
19.
Phys Med Biol ; 68(11)2023 05 30.
Artículo en Inglés | MEDLINE | ID: mdl-37137316

RESUMEN

Retinal detachment (RD) and retinoschisis (RS) are the main complications leading to vision loss in high myopia. Accurate segmentation of RD and RS, including its subcategories (outer, middle, and inner retinoschisis) in optical coherence tomography images is of great clinical significance in the diagnosis and management of high myopia. For this multi-class segmentation task, we propose a novel framework named complementary multi-class segmentation networks. Based on domain knowledge, a three-class segmentation path (TSP) and a five-class segmentation path (FSP) are designed, and their outputs are integrated through additional decision fusion layers to achieve improved segmentation in a complementary manner. In TSP, a cross-fusion global feature module is adopted to achieve global receptive field. In FSP, a novel three-dimensional contextual information perception module is proposed to capture long-range contexts, and a classification branch is designed to provide useful features for segmentation. A new category loss is also proposed in FSP to help better identify the lesion categories. Experiment results show that the proposed method achieves superior performance for joint segmentation of RD and the three subcategories of RS, with an average Dice coefficient of 84.83%.


Asunto(s)
Miopía , Desprendimiento de Retina , Retinosquisis , Humanos , Retinosquisis/diagnóstico por imagen , Retinosquisis/complicaciones , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/complicaciones , Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Miopía/complicaciones , Miopía/patología , Procesamiento de Imagen Asistido por Computador
20.
Eye (Lond) ; 37(14): 3020-3025, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-36879162

RESUMEN

PURPOSE: To compare 10-MHz and 15-MHz B-scan probes regarding the detection and localization of retinal detachment (RD) in silicone-oil-filled eyes. METHODS: This cross-sectional observational study included 100 eyes (98 patients) -having media opacity precluding fundus examination- scheduled for silicone-oil removal. Patients were examined in the sitting-position using both frequencies one week preoperatively. Longitudinal and transverse scans were taken in primary-gaze, inferior, inferonasal, and inferotemporal positions to detect the presence/absence and extent of RD. Patients were sub-grouped according to axial lengths (AXLs), state of silicone emulsification, and globe filling. Agreement between sonographic and intraoperative observations was compared. RESULTS: No statistically significant differences were found between 15-MHz and intra-operative findings regarding RD detection (P = 0.752) and accurate localization of inferior, inferonasal, and inferotemporal RD (P = 0.279, 0.606, and 0.599). There were statistically significant differences between 10-MHz and intra-operative findings regarding RD detection and localization (P < 0.001). The 15-MHz probe was superior to 10-MHz probe regarding the accuracy of RD detection and localization (94% and 47%, respectively). The accuracy of 15-MHz probe was 88%, 83%, and 85% in detecting and localizing inferior, inferonasal, and inferotemporal RD compared to 45%, 60%, and 62% with 10-MHz probe. The 15-MHz probe showed better sensitivity while 10-MHz probe showed better accuracy in eyes with short AXLs. The 10-MHz probe showed better sensitivity in patients with sonographic emulsification while15-MHz probe had better sensitivity in detecting vitreoretinal-interface disorders. CONCLUSION: The 15-MHz B-scan probe is more accurate in detecting and localizing recurrent RD in silicone-oil-filled globes with higher sensitivity in detecting vitreoretinal-interface disorders.


Asunto(s)
Desprendimiento de Retina , Aceites de Silicona , Humanos , Estudios Transversales , Retina , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/cirugía , Curvatura de la Esclerótica , Vitrectomía
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