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1.
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
2.
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
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.
PLoS One ; 15(1): e0227175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923188

RESUMO

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is associated with an increased risk of myocardial infarction and stroke but it remains unclear how to identify microvascular changes in this population. OBJECTIVES: We hypothesized that simple non-mydriatic retinal photography is feasible and can be used to assess microvascular damage in COPD. METHODS: Novel Vascular Manifestations of COPD was a prospective study comparing smokers with and without COPD, matched for age. Non-mydriatic, retinal fundus photographs were assessed using semi-automated software. RESULTS: Retinal images from 24 COPD and 22 control participants were compared. Cases were of similar age to controls (65.2 vs. 63.1 years, p = 0.38), had significantly lower Forced Expiratory Volume in one second (FEV1) (53.4 vs 100.1% predicted; p < 0.001) and smoked more than controls (41.7 vs. 29.6 pack years; p = 0.04). COPD participants had wider mean arteriolar (155.6 ±15 uM vs. controls [142.2 ± 12 uM]; p = 0.002) and venular diameters (216.8 ±20.7 uM vs. [201.3± 19.1 uM]; p = 0.012). Differences in retinal vessel caliber were independent of confounders, odds ratios (OR) = 1.08 (95% confidence intervals [CI] = 1.02, 1.13; p = 0.007) and OR = 1.05 (CI = 1.01, 1.09; p = 0.011) per uM increase in arteriolar and venular diameter respectively. FEV1 remained significantly associated with retinal vessel dilatation r = -0.39 (p = 0.02). CONCLUSIONS: Non-mydriatic retinal imaging is easily facilitated. We found significant arteriole and venous dilation in COPD compared to age-matched smokers without COPD associated with lung function independent of standard cardiovascular risk factors. Retinal microvascular changes are known to be strongly associated with future vascular events and retinal photography offers potential to identify this risk. TRIAL REGISTRATION: clinicaltrials.gov NCT02060292.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Microvasos/diagnóstico por imagem , Fotomicrografia/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/etiologia , Vasos Retinianos/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Estudos de Viabilidade , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Vasos Retinianos/patologia , Fumantes , Fumar/efeitos adversos
5.
BMC Med Imaging ; 19(1): 98, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856750

RESUMO

BACKGROUND: Ocular fundus angiography is an indispensable component of the tests utilized for fundus diseases. Dynamic angiography results can provide additional information; however, many difficulties remain. In this study, we introduce a modified method, time-lapse angiography (TLA), to dynamically present imaging results. METHODS: TLA, combining time-lapse photography and fundus angiography (using Heidelberg retina angiography II, Germany), includes pre-photographing and post- photosynthesis and ultimately produces a video that is approximately 15 s in length. RESULTS: Four typical videos in the article showed the characteristics of TLA, including a short and rapid but continuous and integral presentation, highly valid information, high definition, etc. CONCLUSIONS: TLA is beneficial for the diagnosis of diseases and the assessment of progression and is convenient for peer communication, patient interpretation, and student education. The application of time-lapse photography in ocular fundus angiography is a monumental and innovative attempt.


Assuntos
Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico por imagem , Imagem com Lapso de Tempo/métodos , Fundo de Olho , Humanos , Sensibilidade e Especificidade
6.
PLoS One ; 14(12): e0226728, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31869361

RESUMO

BACKGROUND: Optical coherence tomography is commonly used to measure the retinal nerve fibre layer thickness in both normal and diseased eyes; however, variation among normal eyes is common and may limit the usefulness of the results. The aim of this study was to explore the interocular asymmetries in retinal nerve fibre layer thickness in a group of normal eyes and to investigate the influence of blood vessel diameter on local retinal nerve fibre layer thickness. METHODS: In this prospective study, retinal nerve fibre layer thickness and blood vessel diameter across 100 healthy participants were measured using two optical coherence tomography instruments. Individuals were categorised into two groups based on the presence or absence of interocular retinal nerve fibre layer thickness asymmetry beyond the 75th percentile of all participants. RESULTS: The superonasal sectoral retinal nerve fibre layer thickness was significantly greater in the left eye compared to the right, across all three sectors. Mean blood vessel diameter showed a corresponding difference in thickness at one of the superonasal sectors. Linear regression showed a positive and moderate correlation between blood vessel diameter and focal retinal nerve fibre layer thickness. This trend persisted across both arteries and veins, but veins showed larger variability between left and right eye in participants with marked superonasal retinal nerve fibre layer asymmetry. CONCLUSION: Retinal nerve fibre layer thickness and blood vessel diameter vary significantly between eyes even in healthy individuals. These asymmetries in a normal population should be taken into consideration when interpreting the retinal nerve fibre layer thickness measurements from optical coherence tomography to assist in distinguishing normal variations from disease.


Assuntos
Retina/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Células Ganglionares da Retina/patologia , Vasos Retinianos/diagnóstico por imagem , Adulto , Idoso , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retina/patologia , Doenças Retinianas/patologia , Células Ganglionares da Retina/citologia , Vasos Retinianos/anatomia & histologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Adulto Jovem
7.
Arch. Soc. Esp. Oftalmol ; 94(11): 540-544, nov. 2019. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-187410

RESUMO

El objetivo fue presentar un caso de retinopatía autoinmune (AIR) no paraneoplásica con anticuerpos antirecoverina positivos. Una mujer de 28 años consultó por pérdida de la agudeza visual bilateral de 8 meses de evolución. El fondo de ojo presentó un patrón de coloración moteado desde el centro a la periferia, sin espículas pigmentarias. La angiografía mostró un patrón de áreas puntiformes, sin fuga de contraste. Se observó una reducción de las capas externas de la retina en la tomografía de coherencia óptica, mientras que el electrorretinograma mostró una ausencia de respuesta de los conos y los bastones en el ojo derecho, y una respuesta disminuida de los conos con ausencia de respuesta de los bastones en el ojo izquierdo. Se sospechó AIR, y se empezó tratamiento empírico con corticoides a la espera de los resultados del Western-blot, que posteriormente resultó positivo para recoverina, GAPDH, anti-alfa-enolasa y aldolasa. Mientras pudo ser tratada, la agudeza visual se mantuvo estable. Al retirarse el tratamiento, esta se redujo a amaurosis en el ojo derecho y movimiento de manos en el ojo izquierdo


The case is presented of a non-paraneoplastic autoimmune retinopathy (AIR) with positive anti-recoverin autoantibodies. A 28-year-old woman presented with a rapidly progressive bilateral visual loss of 8 months onset. Funduscopic examination revealed diffuse fine mottled atrophic changes in both eyes. Fluorescein angiographic studies showed a pattern of mottled areas of early hyperfluorescence without leakage of dye. In the ocular coherence tomography it was observed that was a loss of external layers. The electroretinogram showed absence of rod and cone responses in the right eye, and diminished cone response associated to absence of rod response in the left eye. AIR was suspected, and empirical corticosteroid treatment was started while waiting for Western-blot results, which was finally positive for recoverin, GAPDH, anti-alpha-enolase, and aldolase. The patient was able to be treated, and her visual acuity remained stable, but as soon as it was suspended, vision was completely lost in the right eye and reduced to hand movement in the left eye


Assuntos
Humanos , Feminino , Adulto , Anticorpos/análise , Doenças Autoimunes/imunologia , Recoverina/imunologia , Doenças Retinianas/imunologia , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Eletrorretinografia , Fundo de Olho , Glucocorticoides/uso terapêutico , Ácido Micofenólico/uso terapêutico , Prednisona/uso terapêutico , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/tratamento farmacológico , Tomografia de Coerência Óptica , Acuidade Visual , Campos Visuais
9.
Invest Ophthalmol Vis Sci ; 60(12): 3878-3886, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31529082

RESUMO

Purpose: To test the hypothesis that the capacity for retinal ganglion cells to functionally recover from chronic IOP elevation is dependent on the duration of IOP elevation. Methods: IOP elevation was induced in one eye in anesthetized (isoflurane) adult C57BL6/J mice using a circumlimbal suture. Sutures were left in place for 8 and 16 weeks (n = 30 and 28). In two other groups the suture was cut after 8 and 12 weeks (n = 30 and 28), and ganglion cell function (electroretinography) and retinal structure (optical coherence tomography) were assessed 4 weeks later. Ganglion cell density was quantified by counting RBPMS (RNA-binding protein with multiple splicing)-stained cells. Results: With IOP elevation (∼10 mm Hg above baseline), ganglion cell function declined to 75% ± 8% at 8 weeks and 59% ± 4% at 16 weeks relative to contralateral control eyes. The retinal nerve fiber layer was thinner at 8 (84% ± 4%) and 16 weeks (83% ± 3%), without a significant difference in total retinal thickness. Ganglion cell function recovered with IOP normalization (suture removal) at week 8 (97% ± 7%), but not at week 12 (73% ± 6%). Ganglion cell loss was found in all groups (-8% to -13%). Conclusions: In the mouse circumlimbal suture model, 12 weeks of IOP elevation resulted in irreversible ganglion cell dysfunction, whereas retinal dysfunction was fully reversible after 8 weeks of IOP elevation.


Assuntos
Pressão Intraocular/fisiologia , Hipertensão Ocular/fisiopatologia , Doenças Retinianas/fisiopatologia , Células Ganglionares da Retina/fisiologia , Animais , Contagem de Células , Doença Crônica , Modelos Animais de Doenças , Eletrorretinografia , Camundongos , Camundongos Endogâmicos C57BL , Recuperação de Função Fisiológica/fisiologia , Doenças Retinianas/diagnóstico por imagem , Fatores de Tempo , Tomografia de Coerência Óptica
10.
Comput Methods Programs Biomed ; 178: 181-189, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31416547

RESUMO

BACKGROUND AND OBJECTIVES: Spectral Domain Optical Coherence Tomography (SD-OCT) is a volumetric imaging technique that allows measuring patterns between layers such as small amounts of fluid. Since 2012, automatic medical image analysis performance has steadily increased through the use of deep learning models that automatically learn relevant features for specific tasks, instead of designing visual features manually. Nevertheless, providing insights and interpretation of the predictions made by the model is still a challenge. This paper describes a deep learning model able to detect medically interpretable information in relevant images from a volume to classify diabetes-related retinal diseases. METHODS: This article presents a new deep learning model, OCT-NET, which is a customized convolutional neural network for processing scans extracted from optical coherence tomography volumes. OCT-NET is applied to the classification of three conditions seen in SD-OCT volumes. Additionally, the proposed model includes a feedback stage that highlights the areas of the scans to support the interpretation of the results. This information is potentially useful for a medical specialist while assessing the prediction produced by the model. RESULTS: The proposed model was tested on the public SERI-CUHK and A2A SD-OCT data sets containing healthy, diabetic retinopathy, diabetic macular edema and age-related macular degeneration. The experimental evaluation shows that the proposed method outperforms conventional convolutional deep learning models from the state of the art reported on the SERI+CUHK and A2A SD-OCT data sets with a precision of 93% and an area under the ROC curve (AUC) of 0.99 respectively. CONCLUSIONS: The proposed method is able to classify the three studied retinal diseases with high accuracy. One advantage of the method is its ability to produce interpretable clinical information in the form of highlighting the regions of the image that most contribute to the classifier decision.


Assuntos
Aprendizado Profundo , Retinopatia Diabética/diagnóstico por imagem , Degeneração Macular/diagnóstico por imagem , Edema Macular/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Área Sob a Curva , Humanos , Pessoa de Meia-Idade , Reconhecimento Automatizado de Padrão , Reprodutibilidade dos Testes , Software
11.
Comput Methods Programs Biomed ; 178: 237-246, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31416552

RESUMO

BACKGROUND AND OBJECTIVE: Retinal fundus images are widely used to diagnose retinal diseases and can potentially be used for early diagnosis and prevention of chronic vascular diseases and diabetes. While various automatic retinal vessel segmentation methods using deep learning have been proposed, they are mostly based on common CNN structures developed for other tasks such as classification. METHODS: We present a novel and simple multi-scale convolutional neural network (CNN) structure for retinal vessel segmentation. We first provide a theoretical analysis of existing multi-scale structures based on signal processing. In previous structures, multi-scale representations are achieved through downsampling by subsampling and decimation. By incorporating scale-space theory, we propose a simple yet effective multi-scale structure for CNNs using upsampling, which we term scale-space approximated CNN (SSANet). Based on further analysis of the effects of the SSA structure within a CNN, we also incorporate residual blocks, resulting in a multi-scale CNN that outperforms current state-of-the-art methods. RESULTS: Quantitative evaluations are presented as the area-under-curve (AUC) of the receiver operating characteristic (ROC) curve and the precision-recall curve, as well as accuracy, for four publicly available datasets, namely DRIVE, STARE, CHASE_DB1, and HRF. For the CHASE_DB1 set, the SSANet achieves state-of-the-art AUC value of 0.9916 for the ROC curve. An ablative analysis is presented to analyze the contribution of different components of the SSANet to the performance improvement. CONCLUSIONS: The proposed retinal SSANet achieves state-of-the-art or comparable accuracy across publicly available datasets, especially improving segmentation for thin vessels, vessel junctions, and central vessel reflexes.


Assuntos
Doenças Retinianas/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Algoritmos , Área Sob a Curva , Aprendizado Profundo , Reações Falso-Positivas , Fundo de Olho , Humanos , Processamento de Imagem Assistida por Computador , Distribuição Normal , Curva ROC , Processamento de Sinais Assistido por Computador
12.
Medicine (Baltimore) ; 98(26): e16073, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261518

RESUMO

The present study aims to measure the retinal thickness of the macular region of AIDS patients with normal ocular fundus, HIV-related microvascular retinopathy patients and cytomegalovirus retinitis (CMVR) patients by optical coherence tomography, and generalize the characteristics of retinal thickness of these 3 groups of patients.In this retrospective case series, the study object comprised of 111 AIDS patients who received diagnosis and treatment in the Ophthalmology Department of Beijing Youan Hospital. There are 33 patients in the AIDS normal ocular fundus group, 47 patients in the HIV-related microvascular retinopathy group, and 31 patients in the CMVR group. The retinal thickness of the macular region of these above patients was measured. The main indicators were retinal thickness of 9 macular partitions, best corrected visual acuity, CD4+ T lymphocyte count, and the start of highly active antiretroviral therapy.In the CMVR group, except for the nasal-outer and temporal-outer sectors, the thickness of the affected eye of the rest of the regions was greater than that of healthy eye (P < .05). Furthermore, there was a difference in thickness of the superior-outer and inferior-outer sectors between the AIDS normal ocular fundus group and HIV-related microvascular retinopathy group. The difference in thickness of the superior-inner sector between patients in the AIDS normal ocular fundus group and CMVR group was not statistically significant, while the difference in thickness of the rest of the regions was statistically significant. The difference in thickness of various regions between patients in the HIV-related microvascular retinopathy group and CMVR group was statistically significant.The retinal thickness of patients in the CMVR group generally increased, the retinal thickness of superior-outer and inferior-outer sections of patients in the HIV-related microvascular retinopathy group increased, when compared to the AIDS normal ocular fundus group. These optical coherence tomography (OCT) examination results present its own characteristics in different eye diseases in AIDS patients, and different stages of eye disease.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Síndrome de Imunodeficiência Adquirida/diagnóstico por imagem , Macula Lutea/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/patologia , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/patologia , Adulto , Idoso , Contagem de Linfócito CD4 , Feminino , Fundo de Olho , Humanos , Macula Lutea/patologia , Masculino , Microvasos , Pessoa de Meia-Idade , Tamanho do Órgão , Doenças Retinianas/complicações , Doenças Retinianas/patologia , Vasos Retinianos , Estudos Retrospectivos , Tomografia de Coerência Óptica , Doenças Vasculares/complicações , Doenças Vasculares/patologia , Acuidade Visual , Adulto Jovem
14.
Indian J Ophthalmol ; 67(8): 1368-1371, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31332147

RESUMO

A 48-year-old female presented with complaints of recent onset diminution of vision of the left eye (OS) for the past 2 months. She was highly myopic and was using glasses for the past 30 years. Ocular examination revealed presence of a myopic fundus with high axial lengths in both the eyes. Fundus examination of the OS revealed a myopic tessellated fundus with prominent choroidal vessels and a blunted foveal reflex. There was a small pale whitish lesion just superior to the foveal center. Optical coherence tomography (OCT) scans (both horizontal and vertical) confirmed presence of dome-shaped maculopathy. There was subretinal fluid in the OS. A vertical OCT scan also revealed a subretinal hyperreflective material, which was confirmed to be due to a small mixed type 1 and type 2 choroidal neovascularization (CNV) on swept-source (SS) OCT angiography in the OS. The patient was given intravitreal injection of ranibizumab (0.5 mg/0.05 mL) in the OS. At 1-month follow-up, the subretinal fluid completely resolved. The CNV lesion regressed significantly on SS-OCT angiography. The best-corrected visual acuity improved from 20/80 to 20/20 in the OS, which was maintained at 3 months of follow-up.


Assuntos
Neovascularização de Coroide/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Inibidores da Angiogênese/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Corantes/administração & dosagem , Feminino , Angiofluoresceinografia/métodos , Humanos , Verde de Indocianina/administração & dosagem , Injeções Intravítreas , Pessoa de Meia-Idade , Ranibizumab/uso terapêutico , Doenças Retinianas/tratamento farmacológico , Líquido Sub-Retiniano , Tomografia de Coerência Óptica/métodos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Transtornos da Visão/diagnóstico , Acuidade Visual
15.
BMC Ophthalmol ; 19(1): 154, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31324167

RESUMO

BACKGROUND: Torpedo maculopathy is a rare, benign, and congenital macular lesion that typically appears in a 'torpedo-shape' and is located at the temporal macula region. This study aimed to describe in detail regarding torpedo maculopathy in a Chinese woman using multimodal imaging. CASE PRESENTATION: A 30-year-old Chinese woman with occasional yellowish-white macular lesions in her right eye during a routine examination was presented to our hospital. She had no other symptoms, and the best-corrected visual acuity of both eyes was 6/6. Funduscopic examination revealed a torpedo-shaped and mild hypopigmented lesion in the temporal macular area of her right eye. Infrared fundal (IR) images showed visible lesion contour, transverse elliptical, and with a tip pointing towards the central fovea of the macula. Microperimetry visual field appeared normal. The spectral-domain optical coherence tomography (SD-OCT) showed a normal inner retina, with mild thinner outer retina and retinal pigment epithelium in the temporal macular area, and correspondingly increased choroidal reflectivity. Other OCT findings included outer retinal loss/attenuation with significant atrophy of an intact ellipsoid zone. OCT angiography (OCTA) of choroid capillary layer revealed increased density of choroidal vasculature in corresponding to the area of the lesion, while the superficial and deep layers revealed normal vasculature. Fundus autofluorescence (FAF) revealed normal signal with slight hyperautofluorescence at the nasal lesion margin. Fundus fluorescence angiography (FFA) of the lesion showed variegated fluorescence and no leakage and change in the morphology during the whole imaging process. CONCLUSIONS: This is the first report to include a thorough and detailed description of torpedo maculopathy by using fundal photograph, IR, microperimetry visual field, OCT, OCTA, FAF, and FFA. Multimodal imaging provides precious and detailed information to further clarify the characteristics and development of this rare disease.


Assuntos
Angiofluoresceinografia , Macula Lutea/patologia , Imagem Multimodal , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Feminino , Angiofluoresceinografia/métodos , Humanos , Doenças Retinianas/patologia , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos
16.
BMC Ophthalmol ; 19(1): 126, 2019 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-31176357

RESUMO

BACKGROUND: To delineate the characteristics of complicated familial exudative vitreoretinopathy (FEVR) patients diagnosed before surgery or intra-/post-operatively and to analyze the risk factors for the diagnostic timing. METHODS: Forty-eight patients who underwent surgery and were diagnosed as FEVR in our department were retrospectively reviewed. Data were collected including the demographic and clinical characteristics of these patients. FEVR patients were divided into 2 groups according to the diagnostic timing: FEVR diagnosed pre-operatively (23 patients), FEVR diagnosed intra-/post-operatively (25 patients). Multivariable analysis was applied for analyzing the risk factors for diagnostic timing. RESULTS: The clinical characteristics of the FEVR patients were of great variability, including retinal detachment (RD), disappear of anterior chamber, retrolental membrane, epiretinal membrane (ERM), vitreous hemorrhage (VH), myopic foveoschisis (MF), lamellar macular hole (LMH), high myopia (HM). And the referral diagnosis or pre-operative diagnosis were always non-specific. The majority of the referral or preoperative diagnosis were unilateral RD (52.1%), bilateral RD (8.3%), unilateral persistent fetal vasculature (PFV) (8.3%), bilateral PFV (4.2%). There are two risk factors for the complicated FEVR cases diagnosed as FEVR preoperatively: pre-operative ocular manifestations with RD only (OR, 0.104; p-value, 0.022), positive parent's fluorescein angiography (FA) (OR, 0.105; p-value, 0.035). CONCLUSIONS: The phenotypes of FEVR were greatly variable, they can mimic many non-specific vitreoretinal disorders. The most non-specific referral diagnosis/pre-operative diagnosis was unilateral RD, bilateral RD, unilateral PFV, bilateral PFV. A positive family history or a simple ocular presentation with RD only could contribute to diagnose FEVR preoperatively.


Assuntos
Diagnóstico Precoce , Oftalmopatias Hereditárias/diagnóstico por imagem , Angiofluoresceinografia/métodos , Oftalmoscopia/métodos , Retina/patologia , Doenças Retinianas/diagnóstico por imagem , Cirurgia Vitreorretiniana/métodos , Corpo Vítreo/patologia , Adolescente , Adulto , Criança , Pré-Escolar , Diagnóstico Diferencial , Oftalmopatias Hereditárias/cirurgia , Feminino , Seguimentos , Fundo de Olho , Humanos , Lactente , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Período Pré-Operatório , Doenças Retinianas/cirurgia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
17.
Semin Ophthalmol ; 34(4): 312-316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31240975

RESUMO

Intraoperative OCT (iOCT) is an emerging modality capable of displaying real-time OCT images to the surgeon during surgery. The use of iOCT during vitreoretinal surgery improves our understanding of the tissue alterations that occur during surgical manipulations, which may impact surgical decision-making. We review the current iOCT modalities and clinical applications of iOCT.


Assuntos
Cirurgia Assistida por Computador/métodos , Tomografia de Coerência Óptica/métodos , Cirurgia Vitreorretiniana/métodos , Humanos , Imageamento Tridimensional/métodos , Período Intraoperatório , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/instrumentação
18.
Invest Ophthalmol Vis Sci ; 60(7): 2726-2732, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31247113

RESUMO

Purpose: To evaluate retinal vascular status during pregnancy by using optical coherence tomography angiography (OCTA). Methods: Women in their third trimester of pregnancy and nonpregnant age-matched women were recruited for this prospective, case-control study. Subjects were imaged with OCTA. Main outcome measures were foveal avascular zone parameters, perfusion density (PD) percentage in the superficial retinal capillary plexus (SCP), PD percentage in the deep retinal capillary plexus (DCP), SCP vessel length density (VLD), DCP-VLD, and choriocapillaris (CC) flow voids (i.e., flow deficits in the CC). Results: Nineteen eyes of 10 pregnant subjects and 44 eyes of 27 nonpregnant control women were included. Mean ages were 36 ± 7 and 35 ± 8 years (SD), respectively (P value = 0.78). Mean gestational age of pregnant women was 33 weeks (range = 29-39, SD = 3). There was a significant reduction in the SCP-PD in the entire scan and in the nasal Early Treatment Diabetic Retinopathy Study subfield (47.9 vs. 49.7, P = 0.04 and 49.3 vs. 51.6, P = 0.03, respectively) in the pregnant cohort versus controls. There was a significant increase in the DCP-PD in the parafoveal region and in the temporal and inferior Early Treatment Diabetic Retinopathy Study subfields (58.0 vs. 55.9, P = 0.03; 57.9 vs. 55.5, P = 0.02; 58.0 vs. 55.9, P = 0.05, respectively) in the pregnant cohort. There was no significant difference in foveal avascular zone parameters, SCP-VLD, DCP-VLD, or CC flow voids between the two populations. Conclusions: This study detected retinal vasculature changes in the third trimester of pregnancy. Mean SCP-PD was significantly decreased and mean DCP-PD was significantly increased without a difference in VLD.


Assuntos
Complicações na Gravidez , Doenças Retinianas/diagnóstico por imagem , Vasos Retinianos/patologia , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Fluxo Sanguíneo Regional/fisiologia , Doenças Retinianas/fisiopatologia , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos
19.
Ophthalmic Surg Lasers Imaging Retina ; 50(6): 344-353, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31233151

RESUMO

BACKGROUND AND OBJECTIVE: To investigate the variability in optical coherence tomography angiography (OCTA) image interpretation in a cohort of retina specialists. PATIENTS AND METHODS: A survey consisting of a study set of images from 12 eyes examined by OCTA was created. Eight multiple-choice answers were provided as response options for each case. The survey was sent to 100 retina specialists, with instructions to complete the survey only if they had facility with the interpretation of OCTA images. Thirty-eight physicians completed the survey. Data generated were subsequently analyzed and interpreted. RESULTS: Krippendorff's alpha coefficients of agreement and their associated 95% confidence intervals (CIs) were utilized for statistical analyses. For the overall data, the estimated alpha coefficient was 0.366 (95% CI, 0.31-0.47). Although the estimated alpha coefficient is significant, the level of significance is considered low, as it is far from unity (0.366). Therefore, although statistically significant, the overall data did not demonstrate either high reliability or agreement in interpretation. Additional analyses evaluating the influence of years and location of practice, and frequency of OCTA use did not demonstrate a significant effect on reliability measures. CONCLUSIONS: Significant variability exists in the interpretation of OCTA images in this cohort of retina specialists. The overall data did not demonstrate high reliability or agreement in interpretation of images, suggesting the need for additional study of this nascent technology. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:344-353.].


Assuntos
Competência Clínica/estatística & dados numéricos , Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes
20.
Invest Ophthalmol Vis Sci ; 60(7): 2667-2675, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31242288

RESUMO

Purpose: Fabry disease (FD) is a multiorgan X-linked condition characterized by a deficiency of the lysosomal enzyme alpha-galactosidase A, resulting in a progressive intralysosomal deposit of globotriaosylceramide. The aim of this study was to evaluate the macular ultrastructure of the vascular network using optical coherence tomography angiography (OCTA) and to evaluate macular function using focal electroretinography (fERG) in Fabry patients (FPs). Methods: A total of 20 FPs (38 eyes, mean age 57 ± 2.12 SD, range of 27-80 years) and 17 healthy controls (27 eyes, mean age 45 years ± 20.50 SD, range of 24-65 years) were enrolled in the study. Color fundus photography, swept-source optical coherence tomography (SS-OCT), OCTA and fERG were performed in all subjects. The OCTA foveal avascular zone (FAZ), vasculature structure, superficial and deep retinal plexus densities (images of 4.5 × 4.5 mm) and fERG amplitudes were measured. Group differences were statistically assessed by Student's t-test and ANOVA. Results: In the FP group, the FAZ areas of the superficial and deep plexuses were enlarged (P = 0.036, t = 2.138; P < 0.001, t = -3.889, respectively), the vessel density was increased in the superficial plexus, and the fERG amplitude was reduced (P < 0.001, t = -10.647) compared with those in healthy controls. No significant correlations were found between the structural and functional data. Conclusions: OCTA vascular abnormalities and reduced fERG amplitudes indicate subclinical signs of microangiopathy with early retinal dysfunction in FPs. This study highlights the relevance of OCTA imaging analysis in the identification of abnormal macular vasculature as an ocular hallmark of FD.


Assuntos
Doença de Fabry/fisiopatologia , Macula Lutea/irrigação sanguínea , Doenças Retinianas/fisiopatologia , Vasos Retinianos/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Eletrorretinografia , Doença de Fabry/diagnóstico por imagem , Feminino , Angiofluoresceinografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Acuidade Visual
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