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1.
Medicine (Baltimore) ; 99(15): e19794, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282743

RESUMO

RATIONALE: Multiple evanescent white dot syndrome (MEWDS) is a self-limited multifocal chorioretinopathy that typically affects otherwise healthy young females in the second to fourth decades of life. Current understanding of the pathophysiology of MEWDS is still limited. One of the possible underlying causes is an infectious etiology. PATIENT CONCERNS: A 24-year-old female with recurrent episodes of typical MEWDS ocular manifestation was observed over 2 years. Viral-specific antibody serologic tests showed evidence of exposure to the Herpesviridae family during the acute stage of MEWDS in the first and recurrent episodes. DIAGNOSES: MEWDS was diagnosed by the clinical findings and ancillary testing results of fundus photography, optical coherence tomography, fluorescein angiography, indocyanine green angiography and electroretinogram. The laboratory serology data was positive for varicella-zoster virus (VZV) immunoglobulin M (IgM) in the first episode and exhibited high Epstein-Barr virus (EBV) elevated immunoglobulin G (IgG) titer in the recurrent episode. INTERVENTIONS: Due to the self-limited nature of MEWDS, we observed the clinical course without intervention. OUTCOMES: During acute onset of MEWDS, serologic data for VZV IgM antibody was positive in the first episode. Two years later, the patient had recurrent episodes of MEWDS in the contralateral eye. Serologic study showed highly elevated IgG titer (1:160) of Epstein-Barr virus capsid antigen (EB-VCA) in the acute stage. The follow-up paired serum virus serology test showed that the prior EB-VCA IgG titer decreased fourfold to 1:40 in the recovery stage. LESSONS: Recurrence of MEWDS may be associated with acute systemic infection of the Herpesviridae family or virus-induced autoimmune inflammatory reaction.


Assuntos
Infecções por Herpesviridae/complicações , Herpesviridae/imunologia , Doenças Retinianas/virologia , Síndromes do Ponto Branco/virologia , Angiografia/métodos , Antígenos Virais/imunologia , Grupo com Ancestrais do Continente Asiático/etnologia , Proteínas do Capsídeo/imunologia , Eletrorretinografia/métodos , Feminino , Angiofluoresceinografia/métodos , Fundo de Olho , Infecções por Herpesviridae/virologia , Herpesvirus Humano 3/imunologia , Herpesvirus Humano 4/imunologia , Humanos , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Verde de Indocianina/administração & dosagem , Recidiva , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/patologia , Tomografia de Coerência Óptica/métodos , Síndromes do Ponto Branco/diagnóstico por imagem , Síndromes do Ponto Branco/etiologia , Adulto Jovem
2.
Orv Hetil ; 161(16): 632-636, 2020 04 01.
Artigo em Húngaro | MEDLINE | ID: mdl-32323967

RESUMO

Solar retinopathy is the photochemical and thermic injury of the retinal photoreceptors and the pigment epithelium caused by ultraviolet (UV) radiation. As a consequence, the most common symptoms are visual acuity deterioration, blurred vision and positive scotoma. Optical coherence tomography (OCT), microperimetry and fluorescein angiography (FLA) are helpful in determining the diagnosis. Authors present an 18-year-old male having central scotomas affecting both eyes who presented at the Department of Ophtalmology of Semmelweis University. OCT scans revealed a localised defect and hyperreflectivity of certain retinal layers and microperimetry examination detected decreased retinal sensitivity consistent with the lesions. After a follow-up of 6 months, the defect of the right eye became more subtle and the one on the left disappeared completely. Microperimetry results correlated with OCT findings. Subjective symptoms on the right eye decreased significantly and they do not affect his daily life anymore, symptoms on the left eye discontinued. Currently, no specific therapy exists for solar retinopathy. Symptoms and defects in favourable cases normalise in 3­6 months which highlights the importance of public health education and prevention. Orv Hetil. 2020; 161(16): 632­636.


Assuntos
Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/etiologia , Luz Solar/efeitos adversos , Adolescente , Angiofluoresceinografia , Humanos , Masculino , Imagem Multimodal , Tomografia de Coerência Óptica
3.
Curr Opin Ophthalmol ; 31(3): 199-206, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32168003

RESUMO

PURPOSE OF REVIEW: This article reviews emerging technologies in retinal imaging, including their scientific background, clinical implications and future directions. RECENT FINDINGS: Fluorescence lifetime imaging ophthalmoscopy is a technology that will reveal biochemical and metabolic changes of the retina at the cellular level. Optical coherence tomography is evolving exponentially toward higher resolution, faster speed, increased portability and more cost effective. Adaptive optics scanning laser ophthalmoscopy fluorescein angiography will provide unprecedented detail of the retinal vasculature down to the level of capillaries, enabling earlier and more sensitive detection of retinal vascular diseases. SUMMARY: Continued developments in retinal imaging focus on improved resolution, faster speed and noninvasiveness, while providing new information on the structure-function relationship of the retina inclusive of metabolic activity at the cellular level.


Assuntos
Diagnóstico por Imagem/tendências , Doenças Retinianas/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Angiofluoresceinografia/métodos , Humanos , Oftalmoscopia , Tomografia de Coerência Óptica/métodos
4.
Medicine (Baltimore) ; 99(7): e19007, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049795

RESUMO

Conbercept is a novel anti-vascular endothelial growth factor for the treatment of age-related macular degeneration (AMD). The most optimal injection strategy is unknown. To assess the effectiveness of intravitreal injection of conbercept using the 3 + pro re nata (PRN) and 3 + Q3 M strategies for the treatment of exudative AMD.From January 2015 to January 2018, patients confirmed with exudative AMD at Qilu Hospital of Shandong University were included in this retrospective study. Intravitreal injection of 0.5 mg of conbercept was conducted either with the 3 + PRN or 3 + Q3 M strategy. Best-corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography were conducted at 1 and 2 weeks, then every month. fundus fluorescein angiography examination was conducted every 3 months.There were 106 eyes from 106 patients. The number of follow-ups (3 + Q3 M: 12.4 ±â€Š1.3 vs 3 + PRN: 12.9 ±â€Š1.6, P = .079) and the follow-up time (3 + Q3 M: 12.7 ±â€Š0.6 vs 3 + PRN: 12.5 ±â€Š0.7 months, P = .121) were similar in the 2 groups. The number of injections was less in 3 + PRN than 3 + Q3 M (5.3 ±â€Š1.0 vs 6.0 ±â€Š0.0, P < .001) The BCVA at months 7 and 9 to 12 in the 3 + Q3 M (n = 51) group were lower than for 3 + PRN (n = 55) (all P < .05). The CRT at months 9 to 12 in the 3 + Q3 M group was lower than in the 3 + PRN group (all P < .05). There were no differences between the 2 groups regarding the exudation area during follow-up. No serious treatment-related ocular complications or serious systemic adverse events were found.The 3 + PRN and 3 + Q3 M strategies of intravitreal injection of conbercept are effective in treating exudative AMD. The 3 + Q3 M strategy needs more injection but is more effective in increasing visual acuity and reducing macular CRT than the 3 + PRN strategy.


Assuntos
Degeneração Macular/tratamento farmacológico , Proteínas Recombinantes de Fusão/administração & dosagem , Idoso , Feminino , Angiofluoresceinografia , Humanos , Injeções Intravítreas , Degeneração Macular/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes de Fusão/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
9.
PLoS One ; 15(2): e0226311, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053618

RESUMO

It is not currently possible to reliably visualise and track immune cells in the human central nervous system or eye. Previous work demonstrated that indocyanine green (ICG) dye could label immune cells and be imaged after a delay during disease in the mouse retina. We report a pilot study investigating if ICG can similarly label immune cells within the human retina. Twelve adult participants receiving ICG angiography as part of routine standard of care were recruited. Baseline retinal images were obtained prior to ICG administration then repeated over a period ranging from 2 hours to 9 days. Matched peripheral blood samples were obtained to examine systemic immune cell labelling and activation from ICG by flow cytometry with human macrophage cultures as positive controls. Differences between the delayed near infrared ICG imaging and 488 nm autofluorescence was observed across pathologies, likely arising from the retinal pigment epithelium (RPE). Only one subject demonstrated ICG signal on peripheral blood myeloid cells and only three distinct cell-sized signals appeared over time within the retina of three participants. No significant increase in immune cell activation markers were detected after ICG administration. ICG accumulated in the endosomes of macrophage cultures and was detectable above a minimum concentration, suggesting cell labelling is possible. ICG can label RPE and may be used as an additional biomarker for RPE health across a range of retinal disorders. Standard clinical doses of intravenous ICG do not lead to robust immune cell labelling in human blood or retina and further optimisation in dose and route are required.


Assuntos
Corantes/administração & dosagem , Verde de Indocianina/administração & dosagem , Leucócitos Mononucleares/química , Macrófagos/química , Epitélio Pigmentado da Retina/diagnóstico por imagem , Adulto , Idoso , Corantes/química , Endossomos/química , Estudos de Viabilidade , Feminino , Citometria de Fluxo , Angiofluoresceinografia , Humanos , Verde de Indocianina/química , Injeções Intravenosas , Macrófagos/citologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Epitélio Pigmentado da Retina/citologia , Coloração e Rotulagem/métodos , Adulto Jovem
10.
PLoS One ; 15(2): e0229213, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32078656

RESUMO

PURPOSE: Von Hippel-Lindau (VHL) disease is a hereditary disorder that can lead to ophthalmic manifestations, including retinal capillary hemangioma (RCH). The diagnosis of RCH is often guided by wide-field fluorescein angiography. In some cases, optical coherence tomography angiography (OCT-A) serves as a non-invasive alternative to FA. Herein, we used OCT-A to examine the macular microvasculature in patients with VHL disease. SUBJECTS: Subjects were selected from patients with a diagnosis of VHL. The control group included eyes without retinal diagnosis from patients with an episode of unilateral retinal detachment or trauma and age ≤ 50 years old. METHODS: Subjects were scanned on the Optovue RTVue-XR device to acquire 3mm x 3mm OCT-A images of the superficial (SCP) and deep capillary plexus (DCP). SCP and DCP vessel density (VD) were calculated after the images were binarized. Furthermore, for subjects with RCH, each OCT-A image was divided equally into four quadrants. SCP and DCP VD of quadrants with RCH were compared to those without RCH. T-tests were performed for statistical analysis. RESULTS: 67 eyes with a history of VHL disease were included as study subjects, while 16 eyes were included as controls. Significant increases in VD were found in patients with VHL disease for both the SCP (p = 0.0441) and DCP (p = 0.0344). When comparing quadrants with associated RCH development to those without, we found no significant difference in SCP VD (p = 0.160) or DCP VD (p = 0.484). CONCLUSIONS: OCT-A can detect changes in the retinal microvasculature in the macula of patients with VHL disease. OCT-A imaging may be an additional tool for screening and early detection of patients at risk of developing ocular complications of VHL disease. Future studies should explore subtle progression on OCT-A associated with the pathogenesis and development of RCH, particularly with larger scan patterns.


Assuntos
Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Doença de von Hippel-Lindau/complicações , Adulto , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Doenças Retinianas/etiologia , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Acuidade Visual , Doença de von Hippel-Lindau/diagnóstico por imagem
11.
Invest Ophthalmol Vis Sci ; 61(2): 5, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32031577

RESUMO

Purpose: To investigate characteristics of the foveal pit and the foveal avascular zone (FAZ) in patients with Alport syndrome (AS), a rare monogenetic disease due to mutations in genes encoding for collagen type IV. Methods: Twenty-eight eyes of nine patients with AS, and five autosomal-recessive carriers and 15 eyes from 15 age-similar healthy control subjects were examined using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Foveal configuration and FAZ measures including the FAZ area, circularity, and vessel density in the central 1° and 3° were correlated. Results: Foveal hypoplasia was found in 10 eyes from seven patients with either genotype. In contrast, a staircase foveopathy was found in seven eyes of four X-linked AS patients. The average FAZ area did not differ significantly between AS patients and control subjects (mean ± SD 0.24 ± 0.24 mm2 vs. 0.21 ± 0.09 mm2; P = 0.64). Five eyes showed absence or severe anomalies of the FAZ with crossing macular capillaries that was linked to the degree of foveal hypoplasia on OCT images leading to a significant inverse correlation of FAZ area and foveal thickness (r = -0.88; P < 0.001). In contrary, female patients with X-linked mutations exhibited a significantly greater FAZ area (0.48 ± 0.30 mm2 vs. 0.21 ± 0.09 mm2; P = 0.007), in line with OCT findings of a staircase foveopathy. Conclusions: The foveal phenotypic spectrum in AS ranges from foveal hypoplasia and absence of a FAZ to staircase foveopathy with an enlarged FAZ. Because the development of the FAZ and foveal pit are closely related, these findings suggest an important role for collagen type IV in foveal development and maturation.


Assuntos
Fóvea Central/anormalidades , Nefrite Hereditária/patologia , Doenças Retinianas/patologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Colágeno Tipo IV/genética , Estudos Transversais , Feminino , Angiofluoresceinografia , Fóvea Central/crescimento & desenvolvimento , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Nefrite Hereditária/genética , Nefrite Hereditária/fisiopatologia , Fenótipo , Estudos Prospectivos , Doenças Retinianas/genética , Doenças Retinianas/fisiopatologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica , Acuidade Visual , Adulto Jovem
12.
Invest Ophthalmol Vis Sci ; 61(2): 8, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32031580

RESUMO

Purpose: Examine associations between the vasculature at arteriovenous (AV) crossings and the onset of branch retinal vein occlusion (BRVO). Methods: We included 78 patients with major BRVO, 35 patients with macular BRVO, and 110 controls without BRVO and determined the vessel positions at AV crossings, where the first- or second-order branches of the retinal veins associate, using a viewing angle of 12 × 12 mm2 in optical coherence tomography angiography (OCTA). Results: We reviewed 1349 and 1276 AV crossings in BRVO patients and control subjects, respectively. The proportions of venous overcrossing were 26.5%, 28.6%, and 26.8% at non-causative crossings in BRVO eyes, non-BRVO fellow eyes, and unaffected control eyes, respectively; however, the rate of venous overcrossings at the causative crossings was 45.1%. In OCTA analyses, we divided the branches into macular- or non-macular veins. The rate of venous overcrossing was 52.5% at causative crossings in major BRVO but was 28.6% in macular BRVO. Odds ratios for whether venous overcrossing was a risk factor for BRVO were 3.09 (95% confidence interval [CI], 1.96-4.88) and 0.94 (95% CI, 0.44-2.00) for non-macular veins and macular veins, respectively. The patients with major BRVO caused by venous overcrossing were younger than patients for whom the cause was arterial overcrossing (P < 0.001). The onset of macular BRVO did not differ between crossing patterns at causative crossings (P = 0.60). Conclusions: In eyes with BRVO, venous overcrossing was a common angiographic feature at causative crossings and might be a risk factor for major BRVO onset.


Assuntos
Oclusão da Veia Retiniana/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Veia Retiniana/diagnóstico por imagem , Veia Retiniana/patologia , Oclusão da Veia Retiniana/patologia , Fatores de Risco , Tomografia de Coerência Óptica
13.
Invest Ophthalmol Vis Sci ; 61(2): 36, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32084265

RESUMO

Purpose: The purpose of this study was to characterize the microstructure of the nonjuxtapapillary microvasculature dropout (MvD) in healthy myopic eyes. Methods: This cross-sectional study included 50 eyes (25 eyes with a nonjuxtapapillary MvD and 25 age-matched eyes without any MvD) from a cohort of 126 nonglaucomatous healthy myopic eyes having parapapillary atrophy (PPA) γ-zone. The parapapillary deep-layer microvasculature was evaluated in en-face images obtained using swept-source optical coherence tomography (OCT) angiography (OCTA). A nonjuxtapapillary MvD was defined as an area with focal absence of vascular signals in the distal portion of PPA confined to the nonjuxtapapillary area. Enhanced depth-imaging OCT scanning was performed to assess the parapapillary microstructure. Results: Nonjuxtapapillary MvD was found in 25 eyes (19.8%). The parapapillary microstructure at the nonjuxtapapillary MvD in 18 eyes was characterized by the misalignment of Bruch's membrane (BM)-retinal pigment epithelium (RPE) complex, which was identified by the absence of BM-RPE complex and the presence of the inner retina and sclera. In seven eyes with a nonjuxtapapillary MvD but without such misaligned BM-RPE complex, RPE atrophy was observed at the location of the nonjuxtapapillary MvD. Eyes with a nonjuxtapapillary MvD had a longer axial length (AXL; P = 0.013) and a wider γ-zone (P < 0.001) than age-matched control eyes without any MvD. Conclusions: The microstructure at the nonjuxtapapillary MvD in healthy myopic eyes was characterized in approximately 70% of eyes by temporally misaligned BM-RPE complex. Although the clinical importance of the nonjuxtapapillary MvD remains to be determined, it should be differentiated from the parapapillary choroidal MvD observed in glaucoma.


Assuntos
Corioide/irrigação sanguínea , Microvasos/fisiopatologia , Miopia/fisiopatologia , Fibras Nervosas/patologia , Esclera/irrigação sanguínea , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Feminino , Angiofluoresceinografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia de Coerência Óptica/métodos
14.
Invest Ophthalmol Vis Sci ; 61(2): 34, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32084269

RESUMO

Purpose: We aimed to observe longitudinal changes in retinal blood flow (RBF) and structural transformations in capillaries using Doppler optical coherence tomography (DOCT) and optical coherence tomography angiography (OCTA) in a feline retinal blood occlusion (RVO) model. Methods: RVO was induced by argon green laser photocoagulation (PC) in six eyes of six cats. RBF was measured at a first-order retinal artery and vein by a DOCT flowmeter, and structural changes in the capillaries around the occluded vessels (12 × 12 and 3 × 3 mm) were assessed by OCTA before (at baseline); immediately after PC; and on days 1, 4, 7, and 14 thereafter. Systemic and ocular parameters were monitored during the observation period. Results: There were no significant differences in any systemic or ocular parameters before and after PC. Arterial RBF increased significantly on day 1 (160.6 ± 8.6% vs. baseline, P < 0.001) and decreased below baseline after day 1 through 14. Venous RBF decreased immediately after PC (17.4 ± 9.6% vs. baseline, P = 0.001) and then gradually increased afterwards, but did not return to baseline. OCTA showed dilatation of retinal venules immediately after PC to day 1. Collateral vessels began to form on day 4, had matured by day 7, and were pruned on day 14, which formed as mature as normal retinal venule diameters. Conclusions: With increasing arterial RBF within 1 day after inducing RVO, venules gradually expanded to form collateral vessels, suggesting that collateral vessels originate from existing capillary networks, not neovascularization.


Assuntos
Fluxo Sanguíneo Regional/fisiologia , Oclusão da Veia Retiniana/fisiopatologia , Vasos Retinianos , Animais , Capilares/patologia , Gatos , Angiofluoresceinografia/métodos , Retina/fisiopatologia , Oclusão da Veia Retiniana/patologia , Vasos Retinianos/patologia , Vasos Retinianos/fisiopatologia , Tomografia de Coerência Óptica/métodos
15.
Invest Ophthalmol Vis Sci ; 61(2): 32, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32084273

RESUMO

Purpose: To characterize the evolution and structure of soft drusen in aged rhesus macaques using in vivo multimodal retinal imaging and ex vivo histologic and ultrastructural analyses as a nonhuman primate model of early age-related macular degeneration (AMD). Methods: Multimodal imaging including fundus photography, spectral domain optical coherence tomography (SD-OCT), and fundus autofluorescence (FAF) were used to characterize and track individual drusen lesions in 20 aged rhesus macaques (mean age 23.3 ± 2.7 years) with drusenoid lesions over 2 years, followed by semithin histologic analysis and transmission electron microscopy (TEM). Results: Although most drusen gradually increased in size, a portion spontaneously regressed or collapsed over 2 years. Histologic analyses showed that soft drusen exhibit hypertrophy and dysmorphia of overlying retinal pigment epithelium (RPE), as seen in early and intermediate AMD, but do not exhibit RPE atrophy, RPE migration, or photoreceptor degeneration characteristic of advanced AMD. Ultrastructure of soft drusen showed abundant lipid particles within Bruch's membrane and AMD-related basal linear deposits (BlinD) resembling those in human drusen. Conclusions: The dynamic remodeling, histologic findings, and ultrastructural features of soft drusen in aged rhesus macaques support nonhuman primates as an animal model of early AMD and reveal important insights into drusen biogenesis and AMD development.


Assuntos
Atrofia Geográfica/patologia , Drusas Retinianas/patologia , Animais , Lâmina Basilar da Corioide/patologia , Modelos Animais de Doenças , Angiofluoresceinografia , Macaca mulatta , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos
16.
Optom Vis Sci ; 97(2): 110-120, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32011584

RESUMO

SIGNIFICANCE: Foveal hypoplasia is described clinically by the absence of a foveal pit and subsequent reduction in visual acuity. Optical coherence tomography angiography provides precise segmentation of the retinal vascular supply demonstrating the vascular perfusion in affected patients. Preservation of perfusion is linked to visual acuity and function. PURPOSE: This case report describes a patient with foveal hypoplasia and preservation of visual acuity with preserved retinal capillary density of the superficial and deep capillary plexuses on optical coherence tomography angiography. In addition, the diagnostic findings of foveal hypoplasia as seen on optical coherence tomography angiography will be described. CASE REPORT: A 25-year-old Caucasian female with history of foveal hypoplasia presented to the clinic for evaluation. She had no other visual, ocular, or systemic complaints. Her ocular history included Duane syndrome, accommodative insufficiency, and traumatic brain injury. Her medical history included cardiac ablation secondary to supraventricular tachycardia, gall bladder removal, maxillary sinus cyst, and a history of migraines. Best-corrected visual acuity was 20/15 in the right and left eyes. Funduscopic examination was unremarkable. Spectral domain optical coherence tomography revealed absence of the anatomical foveal pit with normal inner retinal morphology. Optical coherence tomography angiography confirmed a decreased foveal avascular zone; however, a vascular density analysis showed normal perfusion to the inner retinal plexuses. CONCLUSIONS: Optical coherence tomography angiography is a rapid, noninvasive imaging modality that provides excellent insight into the microvasculature supply to the retina and choroid. As such, it allows for an in-depth analysis into the pathophysiology behind certain conditions such as foveal hypoplasia.


Assuntos
Anormalidades do Olho/diagnóstico por imagem , Fóvea Central/anormalidades , Acuidade Visual/fisiologia , Adulto , Capilares/diagnóstico por imagem , Capilares/patologia , Feminino , Angiofluoresceinografia/métodos , Humanos , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Transtornos da Visão/fisiopatologia
17.
Eur J Ophthalmol ; 30(3): 411-416, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31928211

RESUMO

Diabetic retinopathy is a common diabetes complication representing a heavy burden in terms of visual impairment and heath expenditure. Optical coherence tomography angiography is a relatively new imaging method and has proven to be a powerful tool in the analysis of diabetic retinopathy common features, including microaneurysms, intraretinal microvascular abnormalities, or neovascularization, as well as in research field, challenging the gold standard of fluorescein angiography. Many studies underlined the vascular impairment observed through optical coherence tomography angiography and its typical parameters such as vessel length density, foveal avascular zone, and fractal dimension. Choriocapillaris involvement in the pathogenesis of diabetic retinopathy is an interesting point, derived from the analysis of this plexus using optical coherence tomography angiography. In conclusion, optical coherence tomography angiography, which is not free of limitations, such as motion artifacts or segmentation errors, has become an indispensable technique in adding more information to our understanding of diabetic retinopathy.


Assuntos
Retinopatia Diabética/diagnóstico , Angiofluoresceinografia , Tomografia de Coerência Óptica , Corioide/irrigação sanguínea , Retinopatia Diabética/fisiopatologia , Humanos , Macula Lutea/fisiopatologia , Disco Óptico/irrigação sanguínea , Vasos Retinianos/patologia
18.
Am J Ophthalmol ; 212: 169-174, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31945331

RESUMO

PURPOSE: To compare measurements of area of geographic atrophy (GA) in dry age-related macular degeneration (AMD) obtained by fundus autofluorescence (FAF) to those obtained by near-infrared reflectance (NIR). DESIGN: Interrater reliability analysis. METHODS: Ninety-seven confocal NIR images (Heidelberg HRA + Spectralis) and FAF images from 97 patients/eyes with GA with dry AMD were collected retrospectively from existing anonymized Doheny Image Reading Center datasets. Two masked reading center graders (N.S., J.S.) independently and blindly performed manual segmentation of the GA lesions on each NIR and FAF image using GNU Image Manipulation Program software (version 2.8.22). GA on NIR/FAF images was defined in accordance to recently published Classification of Atrophy Meeting criteria as sharply demarcated hyperreflective regions ≥250 µm in diameter. The difference and point-to-point correspondence between gradings in GA area measurements between NIR and FAF were assessed by mean difference, overlap ratio, and Dice similarity coefficient. RESULTS: Among the 97 eyes with dry AMD, the mean GA area was 7.62 ± 7.77 mm2 from FAF images and 7.65 ± 7.83 mm2 from NIR, with a mean nonsignificant difference of 0.31 ± 0.55 mm2 (2-tailed t test, P = .65). The overlap ratio in the segmented GA lesion between modalities was 0.84 ± 0.28 with a Dice similarity coefficient of 0.87 ± 0.27. Intermodal reliability was high (intraclass correlation coefficient = 0.998, P < .01). Of note, in 5 cases (5.2%), the GA lesion could be identified on the FAF image but not on the NIR image, translating into a sensitivity of 94.8%. CONCLUSIONS: GA lesions in dry AMD can be identified and quantified reliably using NIR images in many cases, though eyes with a thin choroid resulting in isoreflective GA lesions may be challenging. NIR imaging is comfortable for patients and is commonly obtained along with OCT, and therefore NIR-based GA assessment may be a useful surrogate in clinical settings.


Assuntos
Atrofia Geográfica/patologia , Estudos de Viabilidade , Angiofluoresceinografia , Atrofia Geográfica/diagnóstico por imagem , Humanos , Variações Dependentes do Observador , Imagem Óptica , Padrões de Referência , Estudos Retrospectivos , Espectroscopia de Luz Próxima ao Infravermelho
19.
PLoS One ; 15(1): e0227292, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31910232

RESUMO

PURPOSE: We sought to evaluate the incidence and characteristics of dome-shaped macula (DSM) in children and adolescents with myopia. METHODS: A retrospective review of medical records was performed to identify subjects who were younger than 19 years with myopia of -3.0 diopters or greater. The results of optical coherence tomography images were analyzed to identify DSM. The height and diameter of the dome were measured. Age, best-corrected visual acuity (BCVA), and refractive error of study participants who exhibited DSM were compared with those of patients who did not. RESULTS: Among the 1,042 eyes of 615 patients, eight eyes (0.77%) of seven patients had DSM. Six of these eight eyes were not highly myopic (i.e., less than -6.0 diopters of spherical equivalents). Additionally, the mean height and diameter of the identified domes were 146.50 ± 42.33 µm and 4779.75 ± 699.38 µm, respectively. Patients with DSM were significantly older (mean age: 15.88 ± 2.36 years) than patients without it (11.51 ± 4.60 years; p = 0.007). The youngest affected patient was 11 years old. There was no significant difference in refractive errors (p = 0.629) or BCVA (p = 0.314) between the two groups. CONCLUSIONS: Although the incidence in this study was very low, DSM was found even in children and adolescents. In addition, 75% of affected individuals were not highly myopic. These results suggest that inherent traits may be involved in development of DSM.


Assuntos
Macula Lutea/anormalidades , Miopia/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Progressão da Doença , Feminino , Angiofluoresceinografia , Humanos , Macula Lutea/diagnóstico por imagem , Masculino , Miopia/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
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