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2.
Sci Rep ; 12(1): 1444, 2022 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-35087071

RESUMO

We analyzed fundus images to identify whether convolutional neural networks (CNNs) can discriminate between right and left fundus images. We gathered 98,038 fundus photographs from the Gyeongsang National University Changwon Hospital, South Korea, and augmented these with the Ocular Disease Intelligent Recognition dataset. We created eight combinations of image sets to train CNNs. Class activation mapping was used to identify the discriminative image regions used by the CNNs. CNNs identified right and left fundus images with high accuracy (more than 99.3% in the Gyeongsang National University Changwon Hospital dataset and 91.1% in the Ocular Disease Intelligent Recognition dataset) regardless of whether the images were flipped horizontally. The depth and complexity of the CNN affected the accuracy (DenseNet121: 99.91%, ResNet50: 99.86%, and VGG19: 99.37%). DenseNet121 did not discriminate images composed of only left eyes (55.1%, p = 0.548). Class activation mapping identified the macula as the discriminative region used by the CNNs. Several previous studies used the flipping method to augment data in fundus photographs. However, such photographs are distinct from non-flipped images. This asymmetry could result in undesired bias in machine learning. Therefore, when developing a CNN with fundus photographs, care should be taken when applying data augmentation with flipping.


Assuntos
Aprendizado Profundo , Fundo de Olho , Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Conjuntos de Dados como Assunto , Técnicas de Diagnóstico Oftalmológico , Humanos , República da Coreia , Estudos Retrospectivos
3.
Medicine (Baltimore) ; 100(37): e27206, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664854

RESUMO

RATIONALE: We report a new scleral buckling technique using a 27-gauge endoilluminator and a wide-field viewing system to overcome the limitations of conventional indirect ophthalmoscope-methods and "chandelier-assisted" surgery. PATIENT CONCERNS: A 26-year-old female patient visited the local clinic for floaters and lower visual field defects in her left eye that had occurred 5 days prior. DIAGNOSES: On fundus examination, upper retinal detachment without macular involvement and an atrophic hole was observed in her left eye. INTERVENTIONS: Under general anesthesia and after perilimbal conjunctival incision, extraocular muscle isolation, and traction with black silk, a 27-gauge trocar-cannula was inserted 90° away from the retinal break, 4 mm away from the limbus. Under wide-field viewing using a contact lens, the fundus was observed through a surgical microscope. Retinal break was evaluated and cryopexy was performed with careful movement of the endoilluminator, paying attention to damage to the lens. The surgeon could accurately and freely control the direction of the illumination tip to obtain a brighter view of the region of interest. OUTCOMES: There were no complications associated with trocar cannula incision or the illuminator. The retina was successfully reattached. LESSONS: Twenty seven gauge endoilluminator-assisted scleral buckling is an easy and safe procedure and provides better control over and free adjustment of the light direction, thus overcoming the limitations of chandelier-assisted surgery.


Assuntos
Recurvamento da Esclera/métodos , Adulto , Feminino , Humanos , Iluminação/instrumentação , Iluminação/normas , Microscopia/instrumentação , Microscopia/métodos , Recurvamento da Esclera/instrumentação , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos
4.
J Clin Med ; 10(18)2021 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-34575366

RESUMO

BACKGROUND: We aimed to study the bilateral choroidal thickness (CT) symmetry and difference in uncomplicated pachychoroid subjects using wide-field swept-source optical coherence tomography (SS-OCT). METHODS: All subjects underwent a wide-field 16-mm one-line scan using SS-OCT. Bilateral CT was measured at, and compared among, the following 12 points: three points at 900-µm intervals from the nasal optic disc margin (nasal peripapillary area), one point at the subfovea, six points at 900-µm intervals from the fovea to the nasal and temporal areas (macular area), and two peripheral points 5400 and 8100 µm from the fovea (peripheral area). RESULTS: There were no statistically significant differences in CT between the right and left eyes in any area (all p > 0.05); they all showed significant positive correlations (all p < 0.01). However, the correlation coefficients (ρ) were smaller for the nasal peripapillary and peripheral areas compared to the macular area. CONCLUSIONS: The CTs in each region were bilaterally symmetrical in subjects with uncomplicated pachychoroid. However, interocular difference in CT increased from the center to the periphery, indicating that the anatomical variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.

5.
J Clin Med ; 10(11)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34064150

RESUMO

The Bruch's membrane opening-minimum rim width (BMO-MRW) is a recently introduced parameter of the neuroretinal rim. We analyzed the repeatability of spectral-domain optical coherence tomography (SD-OCT) measurements of BMO-MRW in epiretinal membrane (ERM) patients with peripapillary involvement, since the surface around the optic disc is distorted in such patients. BMO-MRW and retinal nerve fiber layer (RNFL) thickness measurements were performed using SD-OCT in prospectively enrolled ERM patients and age-matched healthy control individuals. After two consecutive measurements with a 5 min interval, repeatability was analyzed using the intraclass correlation coefficient (ICC), repeatability coefficient (RC), and coefficient of variation (CV). Fifty-two eyes of 52 ERM patients and 62 eyes of 62 healthy controls were included in the study. The ICCs of the mean BMO-MRW/RNFL thickness measurements were 0.999/0.985 in ERM eyes and 0.999/0.999 in normal eyes, respectively. The RC values of mean BMO-MRW/RNFL thickness measurements were 9.0/6.25 µm in ERM eyes and 4.61/0.92 µm in normal eyes, respectively. The CV values were 0.91% and 1.45% for BMO-MRW and RNFL thickness in ERM eyes, and 0.63% and 0.33% in normal eyes, respectively. In ERM eyes, the RC, CV of average BMO-MRW were 1.9 and 1.4 times greater than those of normal eyes, but 6.8 and 4.4 times greater for average RNFL thickness. BMO-MRW and RNFL thickness showed good repeatability in the diseased eyes with peripapillary involvement and healthy control eyes. Based on the ICC, RC, and CV values, the repeatability of BMO-MRW measurements in peripapillary membrane patients was better than that of RNFL thickness.

6.
Invest Ophthalmol Vis Sci ; 62(3): 5, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33656554

RESUMO

Purpose: The purpose of this paper was to study the bilateral choroidal thickness (CT) symmetry and differences in healthy individuals using wide-field swept-source optical coherence tomography (SS-OCT). Methods: All participants underwent a wide-field 16-mm 1-line scan using SS-OCT. CTs were measured at the following 12 points: 3 points at 900 µm, 1800 µm, and 2700 µm away from the nasal optic disc margin (nasal peripapillary area), 1 point at the subfovea, 6 points at 900 µm, 1800 µm, and 2700 µm away from the subfovea to the nasal and temporal areas (macular area), and 2 peripheral points at 2700 and 5400 µm from temporal point 3 (peripheral area). Bilateral CTs were measured; their correlations and differences in the corresponding regions were analyzed. Results: There were no statistically significant differences in CTs between the right and left eyes in all corresponding areas (all P > 0.05); they all showed significant positive correlation coefficients (r) (all P < 0.001). However, the nasal peripapillary and peripheral areas had relatively low correlation coefficients, compared to the macular areas. In addition, the bilateral CT differences were 32.60 ± 25.80 µm in the macular area, 40.67 ± 30.58 µm in the nasal peripapillary area, and 56.03 ± 45.73 µm in the peripheral area (all P < 0.001). Conclusions: Overall, the CTs of each region were bilaterally symmetrical. However, the differences in CTs increased from the center to the periphery, which indicated that the anatomic variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.


Assuntos
Corioide/anatomia & histologia , Corioide/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Comprimento Axial do Olho/anatomia & histologia , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Pressão Intraocular/fisiologia , Masculino , Tamanho do Órgão , Reprodutibilidade dos Testes , Estudos Retrospectivos , Acuidade Visual/fisiologia
7.
Sci Rep ; 11(1): 6813, 2021 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-33762673

RESUMO

To identify the effects of prolonged type 2 diabetes (T2DM) on changes in peripapillary retinal nerve fiber layer (pRNFL) thickness in patients without clinical diabetic retinopathy. Subjects were divided into two groups: controls and patients with T2DM (DM group). After the initial visits, the pRNFL thicknesses were measured three more times at 1-year intervals. Subgroup analyses were performed in patients with T2DM duration ≥ 10 years. The mean pRNFL thickness at each visit was 95.8 ± 8.1, 95.4 ± 8.3, 94.9 ± 8.1, and 94.5 ± 8.3 µm in the control group (P = 0.138) (n = 55); and 93.4 ± 9.1, 92.1 ± 9.3, 90.9 ± 9.3, and 89.5 ± 9.2 µm in the DM group (P < 0.001) (n = 85). The estimated rate of reduction in mean pRNFL thickness was - 0.45 µm/year in the control group and - 1.34 µm/year in the DM group, respectively. In the DM group, the BCVA and HbA1c (both P = 0.001) were significant factors associated with pRNFL reduction. In patients with T2DM duration ≥ 10 years, the estimated pRNFL reduction rate was - 1.61 µm/year, and hypertension was a significant factor affecting the pRNFL reduction (P = 0.046). We confirmed rapid pRNFL reduction over time in T2DM, and the reduction rate was higher in patients with T2DM ≥ 10 years. Additionally, BCVA and HbA1c levels were significantly associated with the change in pRNFL thickness in T2DM patients.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Fibras Nervosas/fisiologia , Retina/fisiologia , Idoso , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/etiologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Tomografia de Coerência Óptica , Acuidade Visual
8.
Retina ; 41(11): 2310-2317, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33782364

RESUMO

PURPOSE: To determine the mechanism of infection, clinical features, and risk factors of endophthalmitis after scleral fixation of an intraocular lens. METHODS: We included 15 patients with infectious endophthalmitis after scleral fixation of an intraocular lens between April 2004 and December 2017, as well as four patients found through a literature search. Thus, a total of 19 patients were analyzed. RESULTS: Among 19 eyes, infectious endophthalmitis developed at a mean of 23 months (range: 1 day-10 years) after scleral fixation surgery. Nine eyes (47.4%) had early-onset endophthalmitis (≤6 weeks), and 10 eyes (52.6%) had delayed-onset endophthalmitis (>6 weeks). Eleven eyes (57.9%) had presumed microbial influx due to suture exposure. Those with delayed-onset endophthalmitis showed a higher rate of suture-related infection (80.0% vs. 33.3%) and culture of gram-negative bacteria (70.0% vs. 12.5%) than did those with early-onset endophthalmitis. CONCLUSIONS: Infectious endophthalmitis can develop late after scleral fixation of an intraocular lens, usually related to the exposed sutures, and the visual prognosis is poor. Eyes that have sutured scleral fixation should be monitored regularly, and preventive measures should be performed if an exposed suture is found.


Assuntos
Bactérias/isolamento & purificação , Endoftalmite/etiologia , Infecções Oculares Bacterianas/etiologia , Implante de Lente Intraocular/métodos , Lentes Intraoculares/efeitos adversos , Esclera/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Endoftalmite/diagnóstico , Endoftalmite/epidemiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/epidemiologia , Técnicas de Sutura/efeitos adversos , Suturas/efeitos adversos , Suturas/microbiologia , Acuidade Visual , Adulto Jovem
9.
Eye (Lond) ; 35(11): 3064-3070, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33423044

RESUMO

PURPOSE: To compare visual improvements between initial intravitreal t-PA with gas injection before anti-vascular endothelial growth factor (VEGF) and anti-VEGF injection monotherapy for submacular haemorrhage (SMH) associated with age-related macular degeneration (AMD). METHODS: We retrospectively reviewed medical records of naive patients treated with intravitreal t-PA with gas injection before anti-VEGF (Group 1) or only with intravitreal anti-VEGF injection (Group 2) for SMH [disc area (DA) ≥ 2] associated with AMD from two institutions. Both groups received 3 monthly loads of anti-VEGF injections followed by injections as needed for AMD treatment. Changes in best-corrected visual acuity (BCVA, logMAR) between the initial visit and after 6 months of treatment were compared between two groups. RESULTS: A total of 82 patients were enroled. Of these, 32 patients and 50 patients were grouped in Groups 1 and 2, respectively. The mean change in BCVA over 6 months for Group 1 was -0.52 ± 0.88, which was significantly larger (p = 0.044) than the mean change for Group 2 (-0.15 ± 0.58). We compared visual improvements between the two groups based on the following SMH size categories: ≤5, >5, and ≤15, and >15 DA. When the SMH size was ≤5, or >5 and ≤15 DA, the mean change in BCVA was larger for Group 1 than for Group 2, but this difference was not significant. When SMH size was >15 DA, Group 1 patients exhibited a mean visual improvement of -0.79 ± 0.80, which was significantly greater (p = 0.029) than that of Group 2 (-0.06 ± 0.67). CONCLUSIONS: Patients that were primarily treated for SMH associated with AMD using t-PA and gas injection (followed by anti-VEGF injection) exhibited better visual improvement than those treated with anti-VEGF monotherapy, especially in patients exhibiting larger SMH sizes (>15 DA) at the initial visit.


Assuntos
Degeneração Macular , Ativador de Plasminogênio Tecidual , Fibrinolíticos/uso terapêutico , Angiofluoresceinografia , Humanos , Degeneração Macular/complicações , Degeneração Macular/tratamento farmacológico , Hemorragia Retiniana/tratamento farmacológico , Hemorragia Retiniana/etiologia , Estudos Retrospectivos , Acuidade Visual
10.
PLoS One ; 15(12): e0243201, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33270725

RESUMO

PURPOSE: We investigated risk factors for breakthrough vitreous hemorrhage (VH) after an intravitreal tissue plasminogen activator (tPA) and gas injection in patients with submacular hemorrhage (SMH) associated with age-related macular degeneration (AMD). METHODS: The medical records of patients diagnosed with SMH associated with AMD who received an intravitreal tPA (50 µg/0.05 mL) and perfluoropropane gas (0.3 mL) injection were reviewed retrospectively. We analyzed the associations of breakthrough VH with age, sex, best-corrected visual acuity, intraocular pressure, AMD subtype, accompanying sub-retinal pigment epithelium (RPE) hemorrhage, history of cataract surgery, history of hypertension and diabetes mellitus, history of drinking and smoking, and history of antiplatelet or anticoagulant medication. We also examined the relationships between various parameters, including the area ratio of the SMH to the optic disc (AHD) and the height of the SMH obtained from optical coherence tomography. RESULTS: In total, 52 eyes from 52 patients were enrolled in this study; 16 eyes (30%) showed breakthrough VH. The proportions of patients with a current smoking history were 75.0% in the VH group and 22.2% in the non-VH group (p = 0.010). Other factors did not differ significantly between the two groups. The proportion of cases with accompanying sub-RPE hemorrhage was 50.0% and 58.3% in the VH and non-VH groups, respectively (p = 0.763). The AHD (p = 0.001) and SMH height (p < 0.001) were significantly greater in the VH group. In a receiver operating characteristic curve analysis, the cut-off values of AHD and SMH height were 20.1 and 1208 µm, respectively. According to logistic regression analysis, when the AHD and SMH height were greater than the individual cut-off values, the odds ratio of VH increased by 10.286 fold (95% confidence interval [CI], 2.452-43.148; p = 0.001) and 75.400 fold (95% CI, 7.991-711.441; p < 0.001), respectively, with respect to their respective reference groups (less than the cut-off value). Among the significant factors associated with VH occurrence, including current smoking, AHD, and SMH height, only current smoking and SMH height were found to be significant in multiple regression analysis (p = 0.040, 0.016). CONCLUSIONS: The incidence of breakthrough VH was significantly higher in those with current smoking status and for SMH with a larger AHD and greater height. The height of the SMH was more predictable of the possibility of VH than AHD.


Assuntos
Fluorcarbonetos/uso terapêutico , Degeneração Macular/terapia , Ativador de Plasminogênio Tecidual/uso terapêutico , Hemorragia Vítrea/etiologia , Idoso , Feminino , Fluorcarbonetos/administração & dosagem , Humanos , Injeções Intravítreas , Degeneração Macular/complicações , Degeneração Macular/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Ativador de Plasminogênio Tecidual/administração & dosagem , Hemorragia Vítrea/patologia
11.
Mol Med Rep ; 22(4): 2733-2740, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32945388

RESUMO

Neovascularization in the retina can cause loss of vision. Vascular endothelial growth factor (VEGF) serves an important role in the pathogenesis of retinal vascular diseases. Hypoxia is a notable cause of VEGF release and both STAT3 and ERBB2 are known to be associated with VEGF. In addition, STAT3 and ERBB2 interact with each other. In the present study, it was hypothesized that signal transducer and activator of transcription 3 (STAT3) and erbB­2 receptor tyrosine kinase 2 (ERBB2) may be involved in the regulation of hypoxia­induced VEGF in the retina. Cells of the retinal pigment epithelium (RPE) are an important source of VEGF. Therefore, the RPE­derived human cell line ARPE­19 was exposed to hypoxia. Hypoxia­induced phosphorylation of STAT3 and ERBB2 in ARPE­19 cells was decreased by AG490, an inhibitor of Janus kinase 2, as were hypoxia­induced VEGF release and tube formation in human umbilical vein endothelial cells. Thus, phosphorylation of ERBB2 and STAT3 regulates hypoxia­induced VEGF release in ARPE­19 cells. The results of the present study suggested that inhibition of ERBB2 and STAT3­mediated pathways under hypoxia may represent a new strategy for treating retinal vascular disease.


Assuntos
Receptor ErbB-2/metabolismo , Epitélio Pigmentado da Retina/citologia , Fator de Transcrição STAT3/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Hipóxia Celular/efeitos dos fármacos , Linhagem Celular , Regulação da Expressão Gênica/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana , Humanos , Fosforilação/efeitos dos fármacos , Epitélio Pigmentado da Retina/efeitos dos fármacos , Epitélio Pigmentado da Retina/metabolismo , Tirfostinas/farmacologia
12.
Medicine (Baltimore) ; 99(36): e21835, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899012

RESUMO

RATIONALE: Macular hole (MH) formation after vitrectomy is rare and it may be due to several mechanisms associated with change of foveolar anatomy by vitrectomy. If a MH develops after vitrectomy, surgical treatments including internal limiting membrane peeling and intravitreal gas injection are usually needed for repair of hole. Spontaneous closure of MH is much rarer. PATIENT CONCERNS: A 66-year-old patient had a vitrectomy for rhegmatogenous retinal detachment not involving the macula of the right eye. Eight months after the vitrectomy, the visual acuity decreased and full-thickness defect of macula, epiretinal membrane progression, intraretinal cysts, and flame shape hemorrhage along with superior temporal vascular arcade were observed on fundus examination and optical coherence tomography. DIAGNOSES: MH and branch retinal vein occlusion (BRVO) accompanying cystoid macular edema (CME) were both present on her right eye. Thus, we planned a surgery for MH repair. INTERVENTIONS: The status of MH was observed while waiting the surgery schedule. At 2 weeks after detection of the MH, optical coherence tomography showed that intraretinal cysts had decreased in extent and the inner wall of the MH had contracted; 4 weeks later, the MH was closed with a subtle subretinal space. OUTCOMES: The fovea was well-maintained with a complete closure for 9 months. LESSONS: MH formation and spontaneous closure occurred in association with BRVO accompanying CME in a patient who had a vitrectomy. In vitrectomized eyes, physicians should consider the possibility of MH development in association with BRVO, and possible spontaneous closure of the MH in accordance with CME resolution.


Assuntos
Perfurações Retinianas/etiologia , Vitrectomia/efeitos adversos , Idoso , Feminino , Humanos , Complicações Pós-Operatórias/etiologia , Remissão Espontânea
13.
Emerg Microbes Infect ; 9(1): 1892-1899, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32811346

RESUMO

Postoperative endophthalmitis (PE) is the devastating complication that frequently results in vision loss. Recently, enterococcus have emerged as a major cause of PE in several countries and resulted in poor visual outcome. However, the reason remains elusive. We investigate whether selection pressure of fluoroquinolone exerts effects on microorganism profiles isolated from PE. Medical records of patients who were diagnosed with PE at eight resident training institutions between January 2004 and December 2015 were reviewed. The most common isolate was Enterococcus faecalis (28.0%), followed by Staphylococcus epidermidis (18.6%) and other coagulase negative Staphylococci (7.6%). However, the rates of E. faecalis isolated from conjunctival microbes were 6.2% (16/257) and their resistance to fluoroquinolones was higher than those of S. epidermidis. In vitro and in vivo co-culture models of E. faecalis and S. epidermidis were established for survival assays after administration of fourth-generation fluoroquinolone. In in vitro co-culture model, the survival assay of E. faecalis and S. epidermidis against the treatment of moxifloxacin showed that E. faecalis survived significantly better than S. epidermidis in the presence of moxifloxacin 1 µg/mL and more. In in vivo co-culture model, E. faecalis survived significantly better than S. epidermidis after topical treatment of moxifloxacin (5 mg/mL). E. faecalis has been the most common causative strain of PE in Korea. We suggest that the increase of E. faecalis in PE could be associated with the selection pressure of fourth-generation fluoroquinolone. Summary: Enterococcus spp. have emerged as a leading causative strain of postoperative endophthalmitis in 11-year clinical data. We suggest that the increase of Enterococcus spp. is associated with the selection pressure of fourth-generation fluoroquinolone.


Assuntos
Endoftalmite/microbiologia , Enterococcus/crescimento & desenvolvimento , Fluoroquinolonas/farmacologia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Complicações Pós-Operatórias/microbiologia , Administração Tópica , Animais , Técnicas de Cocultura , Farmacorresistência Bacteriana Múltipla , Endoftalmite/etiologia , Enterococcus/classificação , Enterococcus/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Coelhos , Seleção Genética
14.
Sci Rep ; 10(1): 6541, 2020 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-32300160

RESUMO

The purpose of this study was to investigate changes in peripapillary microvasculature using optical coherence tomography angiography (OCTA) in systemic hypertension (HTN) patients. This was a cross-sectional study. Based on the duration of HTN, seventy-eight HTN patients were divided into two groups. (HTN group 1: <10 years, 38 eyes; HTN group 2: ≥10 years, 40 eyes) and 90 control subjects. All subjects underwent 6 × 6 mm OCTA scan centered on the optic nerve head. We analyzed peripapillary vessel density (VD) and perfusion density (PD) in superficial capillary plexus among three groups. The average ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) thicknesses of HTN group 2 were thinner than those of the control group (p = 0.016, and 0.035, respectively). HTN group 2 showed lower peripapillary VD and PD than the control group. However, there were no differences between HTN group 1 and the control group in OCT and peripapillary OCTA parameters. In HTN patients, the peripapillary VD, PD and GC-IPL, RNFL thicknesses correlated significantly. OCTA showed that the peripapillary VD and PD were lower in HTN patients with a duration ≥10 years compared with those of normal controls. Peripapillary microvasculature was correlated with the RNFL and GC-IPL thicknesses. HTN duration should therefore be considered when evaluating peripapillary microvasculature using OCTA.


Assuntos
Angiofluoresceinografia , Hipertensão/diagnóstico por imagem , Hipertensão/patologia , Microvasos/diagnóstico por imagem , Microvasos/patologia , Disco Óptico/irrigação sanguínea , Disco Óptico/diagnóstico por imagem , Tomografia de Coerência Óptica , Feminino , Humanos , Macula Lutea , Masculino , Pessoa de Meia-Idade , Disco Óptico/patologia , Células Ganglionares da Retina/patologia
15.
Sci Rep ; 10(1): 4791, 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32161280

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

16.
Acta Ophthalmol ; 98(1): e36-e42, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31509329

RESUMO

PURPOSE: To determine the long-term repeatability of optical coherence tomography angiography (OCTA) parameters in normal eyes. METHODS: We prospectively enrolled 104 normal eyes. Participants were divided into three groups based on differences in the signal strength (SS) of OCTA scans obtained at two visits at least 6 months apart: group 1, SS difference = 2; group 2, 1; group 3, 0. We measured a foveal centred scan area of 3 × 3 mm pattern. All measurements were performed twice at 5-min intervals at the initial visit. The second measurements were performed at least 6 months later. RESULTS: In short-term vessel density (VD) repeatability, the coefficient of variation (CV) ranged from 3.89% to 8.10% and the intraclass correlation coefficient (ICC) ranged from 0.785 to 0.941. In terms of long-term repeatability, the CV was 5.39-12.62% and the ICC was 0.598-0.867. In group 1, the ICCs of the inner and full VDs were 0.194 and 0.221, respectively. In groups 2 and 3, the ICCs of the inner and full VDs were 0.611 and 0.603, and 0.763 and 0.765, respectively. The central VDs of all groups had high CV besides high ICC. CONCLUSIONS: Optical coherence tomography angiography parameters showed good short-term and reasonable long-term repeatability in normal individuals. The differences in SSs between measurements affected such repeatability, so physicians should query the reliability of OCTA parameters when the differences in SS are 2 or more even when the SS is high.


Assuntos
Angiofluoresceinografia/métodos , Fóvea Central/diagnóstico por imagem , Disco Óptico/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Estudos Transversais , Feminino , Seguimentos , Fundo de Olho , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Tempo
17.
Br J Ophthalmol ; 104(5): 604-609, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31401557

RESUMO

AIM: To determine longitudinal changes of the ganglion cell-inner plexiform layer (GC-IPL) thickness in patients with high myopia. METHODS: The subjects were divided into two groups: a high myopia group (axial length ≥26.0 mm) and a normal control group. Both groups were divided into subgroups based on age (decade): 20s, 30s, 40s and 50s. Twenty eyes were included in each subgroup. After the initial visit, GC-IPL thicknesses were measured three more times with at least a 1-year interval between examinations using spectral domain optical coherence tomography. The average GC-IPL thickness was fitted with linear mixed models. RESULTS: The average GC-IPL thickness at the first visit was 78.50 ± 8.79 µm and 84.29 ± 6.12 µm in the high myopia and control groups, respectively. In both groups, the average GC-IPL thickness showed a significant change over time. The rate of GC-IPL reduction in individuals aged in their 50s, 40s, 30s and 20s with high myopia were -0.81 µm/year,-0.51 µm/year, -0.28 µm/year and -0.12 µm/year, respectively, and in controls in their 50s, 40s, 30s and 20s, they were -0.31 µm/year,-0.25 µm/year, -0.12 µm/year and -0.02 µm/year, respectively. Additionally, individuals aged in their 50s showed a statistically significant interaction between group and duration (p<0.001). CONCLUSIONS: Highly myopic eyes had thinner GC-IPL and a significantly greater reduction in GC-IPL over 3 years when compared with normal eyes. Additionally, the reduction rate of the GC-IPL thickness was greater in older patients in both groups, which was more prominent in the high myopia group.


Assuntos
Miopia/diagnóstico , Fibras Nervosas/patologia , Refração Ocular/fisiologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Miopia/fisiopatologia , Estudos Prospectivos
18.
Sci Rep ; 9(1): 16291, 2019 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-31704998

RESUMO

Various factors can affect repeatability of optical coherence tomography angiography (OCTA) measurements, and they have not been studied sufficiently. We aimed to investigate the factors associated with the repeatability of automated superficial retinal vessel density (VD) and foveal avascular zone (FAZ) metrics acquired from OCTA. A total of 141 normal eyes from 141 healthy subjects were included, and two consecutive macular 6 × 6-mm angiography scans were performed. VD, perfusion density (PD), and FAZ of the superficial capillary plexus were calculated automatically. Reproducibility was assessed based on intraclass correlations (ICCs) and coefficients of variation (CVs). VD (ICC: 0.824, CV: 3.898) and PD (ICC: 0.845, CV: 4.042) over the entire 6-mm scan area showed better repeatability than VD (ICC: 0.752, CV: 17.470) and PD (ICC: 0.752, CV: 18.552) in the 1-mm scan, and with respect to the obtained FAZ metrics (ICC < 0.75, CV > 10.0%). Regression analyses showed that two factors, signal strength (p = 0.004) and average VD over the total 6-mm scan area (p < 0.001), were significantly correlated with the CV of the VD. Signal strength was associated with the repeatability of OCTA measurements and should be considered in the analysis of retinal VD and FAZ.

19.
Sci Rep ; 9(1): 16299, 2019 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-31705032

RESUMO

The quality of the scan image is important in peripapillary circulation analysis using optical coherence tomography angiography (OCTA). We aimed to investigate the effects of signal strength (SS) on the peripapillary microvascular density acquired from OCTA. A total of 259 eyes from 259 young healthy subjects were included. Peripapillary OCTA images using 3 × 3 mm angiography scan were acquired from all participants. Subjects were divided into four groups according to the SS: SS 7, SS 8, SS 9, and SS 10. Vessel density (VD) and perfusion density (PD) of the superficial capillary plexus were calculated. VD and PD were compared among the four groups, and linear regression analyses were performed to identify and evaluate the clinical factors associated with average VD. As the SS increased from 7 to 10, the average VD and PD increased; these increases were statistically significant (all, p < 0.001). Regression analyses showed that four factors were significantly correlated with average VD: age (partial r = 0.133), average retinal nerve fiber layer thickness (partial r = 0.169), cup/disc ratio (partial r =-0.481), and SS (partial r = 0.413). SS is a significant factor affecting peripapillary microvascular density, and its influence is similar to well-known structural parameters associated with glaucoma.


Assuntos
Angiofluoresceinografia , Disco Óptico/irrigação sanguínea , Disco Óptico/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Feminino , Angiofluoresceinografia/métodos , Humanos , Masculino , Tomografia de Coerência Óptica/métodos , Adulto Jovem
20.
Sci Rep ; 9(1): 15814, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31676848

RESUMO

To evaluate changes in peripapillary microvascular parameters in diabetes mellitus (DM) patients using optical coherence tomography angiography (OCTA). Seventy-one diabetic patients (40 in the no diabetic retinopathy [DR] group and 31 in the non-proliferative DR [NPDR] group) and 50 control subjects. OCTA (Zeiss HD-OCT 5000 with AngioPlex) 6 × 6 mm scans centered on the optic disc were analyzed. Peripapillary vessel density (VD), perfusion density (PD) in superficial capillary plexus (SCP) were automatically calculated. The average macular ganglion cell-inner plexiform layer (mGC-IPL) and peripapillary retinal nerve fiber layer (pRNFL) thicknesses of the no DR and NPDR groups were significantly thinner than those of the control group. The no DR and NPDR groups showed lower peripapillary VD and PD in SCP compared with the control group. Using univariate regression analyses, the average mGC-IPL thickness, the pRNFL thickness, the no DR group and NPDR group were significant factors that affected the peripapillary VD and PD in SCP. Multivariate regression analyses showed that the grade of DR was a significant factor affecting the peripapillary VD and PD in SCP. OCTA revealed that peripapillary microvascular parameters in the no DR and NPDR groups were lower than those of normal controls. The peripapillary VD and PD in SCP were correlated with the mGC-IPL thickness, the pRNFL thickness, and the no DR and NPDR groups. Changes in peripapillary OCTA parameters may help with understanding the pathophysiology of DM and evaluating a potentially valuable biomarker for patients with subclinical DR.


Assuntos
Retinopatia Diabética/fisiopatologia , Microvasos/fisiopatologia , Tomografia de Coerência Óptica/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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