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1.
Am J Cardiol ; 156: 123-128, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34344514

RESUMO

This study investigated whether optical frequency domain imaging (OFDI) can identify carotid artery vulnerable plaque characteristics, focusing on lipid-rich necrotic core (NC) and intraplaque hemorrhage (IPH). Fourteen patients scheduled for carotid endarterectomy underwent OFDI scan during preoperative angiography. Atherosclerotic plaque specimens obtained from carotid endarterectomy were cut every 3-4 mm into 4-µm transverse cross-sections and stained with standard methods. Each cross-section was matched with OFDI, and histologically classified into either fibrous, calcific, pathological intimal thickening (PIT), and NC. Of 75 histologic cross-sections, 6 were categorized as fibrous (8%), 18 as calcific (24%), 9 as PIT (12%), and 42 as NC (56%). Tissues categorized as NC had significantly higher OFDI signal attenuation rates than the other tissues (p <0.001), followed by PIT, calcific, and fibrous tissues. The receiver operating characteristic analysis indicated that attenuation rates of >0.023 and >0.031 predicted the presence of NC and IPH with high areas under the curve of 0.91 and 0.88, respectively. OFDI provides potential capability for the detection of NCs with IPH of carotid artery plaques by quantitatively analyzing the attenuation rate.


Assuntos
Artérias Carótidas , Estenose das Carótidas/complicações , Hemorragia/diagnóstico , Tomografia de Coerência Óptica/métodos , Idoso , Idoso de 80 Anos ou mais , Angiografia , Estenose das Carótidas/diagnóstico , Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas/métodos , Feminino , Seguimentos , Hemorragia/complicações , Hemorragia/cirurgia , Humanos , Masculino , Imagem Óptica/métodos , Estudos Prospectivos , Estudos Retrospectivos
2.
Clin Ter ; 172(4): 347-357, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34247218

RESUMO

Purpose: To evaluate the diagnostic ability of pachymetric indexes obtained with Spectral Domain Optical Coherence Tomography (SD-OCT) for early detection of keratoconus (Kc). Methods: 64 patients with Kc in at least one eye (95 eyes, 46 men and 18 women, average age 27.84 ±13.50), 59 healthy control subjects (100 eyes, 28 men and 31 women, average age 27.15 ±16.14). All patients underwent detailed clinical examination, topography and anterior segment OCT. 37 subjects (37 eyes, 27 men and 10 women, average age 24.23 ± 14.24) having one eye with manifest Kc and the fellow eye without clinical signs of Kc were identified. We studied two groups of pachymetric indexes: C1-C2, M1-M2, pCLMI, Pmin-P2 (Group 1 indexes) and PPD, PSD, PSSD and PASD (Group 2 indexes). A ROC (Receiver Operating Characteristic) curve was developed to compare the diagnostic accuracy, relative sensitivity and specificity for each index. Results: In manifest keratoconus, C1-C2, M1-M2, and pCLMI are significantly higher compared to the control group (P<0.0001); for suspect keratoconus, all Group 1 indexes are significantly higher compared to healthy subjects (P<0.0001) excluding M1-M2 obtained using a constant area circle (P = 0.02). Furthermore, for manifest and suspect keratoconus, PPD, PSD, PSSD and PASD are significantly higher compared to the control group (P <0.0001). Conclusion: The studied pachymetric indexes in patients with Kc have high diagnostic accuracy and are statistically significant when compared with healthy subjects (p<0.0001) and can provide a useful tool for keratoconus screening.


Assuntos
Córnea/diagnóstico por imagem , Paquimetria Corneana/métodos , Topografia da Córnea/métodos , Ceratocone/diagnóstico , Programas de Rastreamento/métodos , Exame Físico/métodos , Tomografia de Coerência Óptica/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diagnóstico Precoce , Feminino , Voluntários Saudáveis , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e Especificidade , Adulto Jovem
3.
Methods Mol Biol ; 2319: 111-117, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34331249

RESUMO

The retina offers a unique opportunity to directly visualize blood vessels in vivo noninvasively. Over the past few decades, several new imaging techniques have been adapted to study the retinal vasculature in the laboratory in animal models and in the clinic in human subjects. High-contrast, finely detailed fundus images can be acquired by confocal scanning laser ophthalmoscopy (cSLO). With fluorescein angiography (FA), the retinal microcirculation can be visualized. High-resolution spectral-domain optical coherence tomography (SD-OCT) is able to acquire cross-section images resolving the microarchitecture of the retina, similar to histology. The techniques and protocols for acquiring cSLO, FA, and SD-OCT imaging of the retinal vasculature and morphology in the rodent are described.


Assuntos
Angiofluoresceinografia/métodos , Oftalmoscopia/métodos , Retina/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Animais , Angiofluoresceinografia/instrumentação , Retina/metabolismo , Vasos Retinianos/metabolismo , Tomografia de Coerência Óptica/instrumentação
4.
Nat Biomed Eng ; 5(7): 726-736, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34253888

RESUMO

Clinical systems for optical coherence tomography (OCT) are used routinely to diagnose and monitor patients with a range of ocular diseases. They are large tabletop instruments operated by trained staff, and require mechanical stabilization of the head of the patient for positioning and motion reduction. Here we report the development and performance of a robot-mounted OCT scanner for the autonomous contactless imaging, at safe distances, of the eyes of freestanding individuals without the need for operator intervention or head stabilization. The scanner uses robotic positioning to align itself with the eye to be imaged, as well as optical active scanning to locate the pupil and to attenuate physiological eye motion. We show that the scanner enables the acquisition of OCT volumetric datasets, comparable in quality to those of clinical tabletop systems, that resolve key anatomic structures relevant for the management of common eye conditions. Robotic OCT scanners may enable the diagnosis and monitoring of patients with eye conditions in non-specialist clinics.


Assuntos
Oftalmopatias/diagnóstico , Tomografia de Coerência Óptica/métodos , Olho/anatomia & histologia , Olho/diagnóstico por imagem , Oftalmopatias/diagnóstico por imagem , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Retina/diagnóstico por imagem , Robótica , Tomografia de Coerência Óptica/instrumentação
5.
Front Immunol ; 12: 630022, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34220797

RESUMO

Ocular inflammation imposes a high medical burden on patients and substantial costs on the health-care systems that mange these often chronic and debilitating diseases. Many clinical phenotypes are recognized and classifying the severity of inflammation in an eye with uveitis is an ongoing challenge. With the widespread application of optical coherence tomography in the clinic has come the impetus for more robust methods to compare disease between different patients and different treatment centers. Models can recapitulate many of the features seen in the clinic, but until recently the quality of imaging available has lagged that applied in humans. In the model experimental autoimmune uveitis (EAU), we highlight three linked clinical states that produce retinal vulnerability to inflammation, all different from healthy tissue, but distinct from each other. Deploying longitudinal, multimodal imaging approaches can be coupled to analysis in the tissue of changes in architecture, cell content and function. This can enrich our understanding of pathology, increase the sensitivity with which the impacts of therapeutic interventions are assessed and address questions of tissue regeneration and repair. Modern image processing, including the application of artificial intelligence, in the context of such models of disease can lay a foundation for new approaches to monitoring tissue health.


Assuntos
Doenças Autoimunes/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Uveíte/diagnóstico por imagem , Animais , Humanos , Processamento de Imagem Assistida por Computador , Aprendizado de Máquina , Retina/diagnóstico por imagem
6.
Int J Mol Sci ; 22(10)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064730

RESUMO

Quantifying changes in bacteria cells in the presence of antibacterial treatment is one of the main challenges facing contemporary medicine; it is a challenge that is relevant for tackling issues pertaining to bacterial biofilm formation that substantially decreases susceptibility to biocidal agents. Three-dimensional label-free imaging and quantitative analysis of bacteria-photosensitizer interactions, crucial for antimicrobial photodynamic therapy, is still limited due to the use of conventional imaging techniques. We present a new method for investigating the alterations in living cells and quantitatively analyzing the process of bacteria photodynamic inactivation. Digital holographic tomography (DHT) was used for in situ examination of the response of Escherichia coli and Staphylococcus aureus to the accumulation of the photosensitizers immobilized in the copolymer revealed by the changes in the 3D refractive index distributions of single cells. Obtained results were confirmed by confocal microscopy and statistical analysis. We demonstrated that DHT enables real-time characterization of the subcellular structures, the biophysical processes, and the induced local changes of the intracellular density in a label-free manner and at sub-micrometer spatial resolution.


Assuntos
Escherichia coli/metabolismo , Holografia/métodos , Interpretação de Imagem Assistida por Computador/métodos , Fármacos Fotossensibilizantes/metabolismo , Staphylococcus aureus/metabolismo , Tomografia de Coerência Óptica/métodos , Escherichia coli/crescimento & desenvolvimento , Processamento de Sinais Assistido por Computador , Staphylococcus aureus/crescimento & desenvolvimento
7.
Medicine (Baltimore) ; 100(24): e26355, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128888

RESUMO

ABSTRACT: Several macular pathologies are associated with choroidal vascular supply and thus require choroidal thickness evaluation. However, there is no standard subfoveal choroidal thickness (SFCT) measurement method. This study investigated a new method of SFCT measurement, using optical coherence tomography.This is a single-center observational study. Eighty-two senior medical students participated as observers and independently measured the SFCT on 5 standard optical coherence tomography images of healthy adults in a tertiary care setting. They used 3 different methods: the observer's own method, the conventional method, perpendicular to the retinal pigment epithelium, and the new method, along a virtual line connecting the umbo with the most elevated point of the ellipsoid. Additionally, the SFCT angle-the angle between the measurement line and the vertical line of the image-was measured and compared between methods. The intraclass correlation coefficient was used to determine interpersonal variability.The intraclass correlation coefficients for SFCT, measured using methods 1, 2, and 3, were 0.853, 0.880, and 0.896, respectively (P < .001 for all). Method 3 was the highest. The intraclass correlation coefficients of the SFCT angles were 0.647, 0.842, and 0.307, respectively (P < .001 for all).The new method showed the lowest interpersonal variability and could therefore be a reliable standard for SFCT measurement, even in foveae with a steep slope on optical coherence tomography.Trial registration: Not applicable.


Assuntos
Corioide/anatomia & histologia , Corioide/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Feminino , Fóvea Central , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Tamanho do Órgão
8.
Curr Opin Ophthalmol ; 32(4): 369-378, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33989235

RESUMO

PURPOSE OF REVIEW: This review will discuss the utility of high-resolution anterior segment optical coherence tomography (HR-OCT), in-vivo confocal microscopy (IVCM) and ultrasound biomicroscopy (UBM) in characterizing and diagnosing various ocular surface tumors, namely ocular surface squamous neoplasia (OSSN), conjunctival lymphoma and conjunctival melanoma. The strengths and limitations of each imaging modality will be discussed along with the characteristics findings of each lesion on each imaging platform. RECENT FINDINGS: HR-OCT can consistently be utilized in the clinic setting to distinguish between epithelial ocular surface tumors such as OSSN as compared with subepithelial tumors such as conjunctival lymphoma and conjunctival melanoma given their distinctive findings. IVCM can be used as an adjunct to HR-OCT to obtain cellular and surface characteristics, whereas UBM can be used to assess tumor depth and thickness for larger and highly pigmented lesions as well as to detect intraocular invasion. SUMMARY: HR-OCT, IVCM and UBM are all helpful imaging modalities to diagnose and characterize various ocular surface tumors and can serve as valuable adjuncts to monitor treatment response and assess for recurrence ocular surface tumors.


Assuntos
Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/diagnóstico , Diagnóstico por Imagem , Humanos , Microscopia Acústica/métodos , Microscopia Confocal/métodos , Tomografia de Coerência Óptica/métodos
9.
Optom Vis Sci ; 98(5): 437-439, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33973909

RESUMO

SIGNIFICANCE: We report the use of anterior segment optical coherence tomography (AS-OCT) as a valuable tool for capsular block syndrome diagnosis and follow-up. PURPOSE: The purposes of this study are to report a case of late-onset capsular block syndrome or lacteocrumenasia and to describe differential diagnosis with other more common phacoemulsification complications such as intraocular lens (IOL) or posterior capsule opacification. CASE REPORT: We report the case of a 56-year-old man with a clinical history of cataract surgery in his left eye. Five years after cataract surgery, he complained of blurred vision and was referred for IOL removal to our hospital. After careful slit-lamp examination, we found that the lens was clear, and opacity belonged to the accumulation of a whitish material in the capsular bag behind the lens. AS-OCT gave the definite diagnosis of capsular block syndrome. Intraocular lens removal had been wrongly indicated, and we treated our patient by YAG laser posterior capsulotomy. AS-OCT confirmed the absence of a further accumulated material, so no other interventions were needed. After treatment, best-corrected visual acuity improved from 0.48 to 0.1 logMAR. CONCLUSIONS: Capsular block syndrome is a rare late-onset complication of cataract surgery causing a deep visual acuity decay. A precise slit-lamp examination and AS-OCT, together, avoid misdiagnosis and unnecessary surgical treatment, which may be needed in case of IOL opacity or fibrotic-like lacteocrumenasia. AS-OCT also helps in determining the treatment outcome. Immediate best-corrected visual acuity improvement is reached after a successful intervention.


Assuntos
Opacificação da Cápsula/diagnóstico por imagem , Cápsula Posterior do Cristalino/diagnóstico por imagem , Complicações Pós-Operatórias , Tomografia de Coerência Óptica , Opacificação da Cápsula/etiologia , Opacificação da Cápsula/fisiopatologia , Opacificação da Cápsula/cirurgia , Humanos , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Facoemulsificação , Cápsula Posterior do Cristalino/fisiopatologia , Cápsula Posterior do Cristalino/cirurgia , Capsulotomia Posterior , Tomografia de Coerência Óptica/métodos , Transtornos da Visão/fisiopatologia , Acuidade Visual/fisiologia
10.
Optom Vis Sci ; 98(5): 531-541, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33973913

RESUMO

SIGNIFICANCE: Adaptive-optics scanning-laser-ophthalmoscopy (AOSLO) retinal imaging of the retinal nerve fiber layer (RNFL) helps predict the severity of perimetric damage based on absence of fibers and projection of the defects in en face images of the RNFL from spectral-domain optical coherence tomography (SD-OCT). PURPOSE: En face images of the RNFL reveal reflectance defects in patients with glaucoma and predict locations of perimetric defects. These defects could arise from either loss of retinal nerve fiber bundles or reduced bundle reflectance. This study used AOSLO to assess presence of bundles in areas with RNFL reflectance defects on SD-OCT. METHODS: Adaptive-optics scanning laser ophthalmoscopy was used to image a vertical strip of RNFL measuring approximately 30 × 3° between the optic disc and the fovea. Fifteen patients with glaucoma who had SD-OCT reflectance defects that passed through this region were chosen. Four patients had reflectance defects in both superior and inferior hemifields, so presence of bundles on AOSLO was assessed for 19 hemifields. Where bundles were present, the hemifield was scored for whether bundles seemed unusual (low contrast and/or low density). Perimetric defects were considered deep when sensitivity was below 15 dB. RESULTS: Ten hemifields had a region with no fibers present on AOSLO; all had a corresponding deep perimetric defect. The other nine hemifields had no region in the AOSLO image without fibers: four with normal fibers and five with unusual fibers. The only one of these nine hemifields with a deep perimetric defect was one with low-contrast fibers and overall thin RNFL. CONCLUSIONS: Retinal nerve fiber layer reflectance defects, which were associated with deep perimetric defects, usually had a region with absence of fibers on AOSLO images of RNFL. Ability to predict severity of perimetric damage from en face SD-OCT RNFL reflectance images could benefit from quantification that differentiated between absence of fibers and unusual fibers.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Idoso , Interpretação Estatística de Dados , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Oftalmoscopia/métodos , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual/métodos
11.
Optom Vis Sci ; 98(5): 476-482, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33973919

RESUMO

SIGNIFICANCE: This research found that anterior and posterior biometrics differ in many aspects between fellow eyes of anisometropic children. This might shed light on the mechanisms underlying the onset and progression of anisometropia and myopia. PURPOSE: This study aimed to investigate the ocular biometric parameters, peripheral refraction, and accommodative lag of fellow eyes in anisometropic children. METHODS: Anisometropic children were recruited. Axial length (AL), vitreous chamber depth (VCD), central corneal thickness, anterior chamber depth (ACD), lens thickness (LT), simulated K readings, central and peripheral refractive errors, and accommodative lag were measured in both eyes. The subfoveal choroidal thickness, average choroidal thickness, and choroid vessel density of the 6 × 6-mm macular area were measured by optical coherence tomography. RESULTS: Thirty-two children aged 11.1 ± 1.7 years were enrolled. The average degree of anisometropia was 2.49 ± 0.88 D. The AL, VCD, ACD, and simulated K reading values were significantly larger in the more myopic eyes, whereas the LT value was significantly smaller. Subfoveal choroidal thickness (P = .001) and average choroidal thickness (P = .02) were smaller in the more myopic eyes than in the contralateral eyes, whereas choroid vessel density (P = .03) was larger. The amount of anisometropia had a significant positive correlation with the difference in AL (r = 0.869, P < .001), VCD (r = 0.853, P < .001), and ACD (r = 0.591, P < .001) and a negative correlation with the difference in LT (r = -0.457, P = .009). CONCLUSIONS: Ocular biometrics differ in many aspects between the fellow eyes of anisometropic Chinese children, and the difference is correlated with the degree of anisometropia.


Assuntos
Acomodação Ocular/fisiologia , Anisometropia/fisiopatologia , Refração Ocular/fisiologia , Adolescente , Segmento Anterior do Olho/patologia , Comprimento Axial do Olho/patologia , Biometria , Criança , Corioide/patologia , Feminino , Humanos , Masculino , Miopia/fisiopatologia , Erros de Refração/fisiopatologia , Tomografia de Coerência Óptica/métodos
12.
Optom Vis Sci ; 98(5): 518-530, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33973920

RESUMO

SIGNIFICANCE: Optical coherence tomography (OCT) summary measures have been suggested as a way to detect progression in eyes with advanced glaucoma. Here, we show that these measures have serious flaws largely due to segmentation errors. However, inspection of the images and thickness maps can be clinically useful. PURPOSE: This study aimed to test the hypothesis that recently suggested global OCT measures for detecting progression in eyes with advanced progression are seriously affected by segmentation mistakes and other errors that limit their clinical utility. METHODS: Forty-five eyes of 38 patients with a 24-2 mean deviation worse than -12 dB had at least two spectral domain OCT sessions (0.8 to 4.4 years apart) with 3.5-mm circle scans of the disc and cube scans centered on the fovea. Average (global) circumpapillary retinal nerve fiber layer thickness, GcRNFL, and ganglion cell plus inner plexiform layer thickness, GGCLP, were obtained from the circle and cube scan, respectively. To evaluate progression, ΔGcRNFL was calculated for each eye as the GcRNFL value at time 2 minus the value at time 1, and ΔGGCLP was calculated in a similar manner. The b-scans of the six eyes with the highest and lowest ΔGcRNFL and ΔGGCLP values were examined for progression as well as segmentation, alignment, and centering errors. RESULTS: Progression was a major factor in only 7 of the 12 eyes with the most negative values of either ΔGcRNFL or ΔGGCLP, whereas segmentation played a role in 8 eyes and was the major factor in all 12 eyes with the largest positive values. In addition, alignment (one eye) and other (three eyes) errors played a secondary role in four of the six eyes with the most negative ΔGcRNFL values. CONCLUSIONS: For detecting the progression of advanced glaucoma, common summary metrics have serious flaws largely due to segmentation errors, which limit their utility in clinical and research settings.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Benchmarking , Progressão da Doença , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Adulto Jovem
13.
Clin Exp Optom ; 104(6): 717-722, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34016010

RESUMO

CLINICAL RELEVANCE: The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina. BACKGROUND: To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT. RESULTS: The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were significantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all). CONCLUSION: In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.


Assuntos
COVID-19/epidemiologia , Glaucoma/diagnóstico , Pandemias , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Idoso , Comorbidade , Estudos Transversais , Feminino , Seguimentos , Glaucoma/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Prospectivos , SARS-CoV-2 , Adulto Jovem
14.
Front Immunol ; 12: 613051, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33968016

RESUMO

Optical coherence tomography (OCT) allows us to identify, into retinal layers, new morphological entities, which can be considered clinical biomarkers of retinal diseases. According to the literature, solitary, small (<30 µm), medium level hyperreflective (similar to retinal fiber layer) retinal foci (HRF) may represent aggregates of activated microglial cells and an in vivo biomarker of retinal inflammation. The identification and quantification of this imaging biomarker allows for estimating the level and possibly the amount of intraretinal inflammation in major degenerative retinal disorders, whose inflammatory component has already been demonstrated (diabetic retinopathy, age-related macular degeneration, radiation retinopathy). Currently, diabetic retinopathy (DR) probably represents the best clinical model to apply this analysis in the definition of this clinical biomarker. However, the main limitation to the clinical use of HRF is related to the technical difficulty of counting them: a time-consuming methodology, which also needs trained examiners. To contribute to solve this limitation, we developed and validated a new method for the semi-automatic detection of HRF in OCT scans. OCT scans of patients affected by DR, were analyzed. HRF were manually counted in High Resolution spectral domain OCT images. Then, the same OCT scans underwent semi-automatic HRF counting, using an ImageJ software with four different settings profiles. Statistical analysis showed an excellent intraclass correlation coefficient (ICC) between the manual count and each of the four semi-automated methods. The use of the second setting profile allows to obtain at the Bland-Altman graph a bias of -0.2 foci and a limit of agreement of ±16.3 foci. This validation approach opens the way not only to the reliable and daily clinical applicable quantification of HRF, but also to a better knowledge of the inflammatory component-including its progression and regression changes-of diabetic retinopathy.


Assuntos
Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/patologia , Retina/diagnóstico por imagem , Retina/patologia , Tomografia de Coerência Óptica , Idoso , Automação , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
15.
Brain ; 144(3): 848-862, 2021 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-33829250

RESUMO

Optical coherence tomography (OCT) is gaining increasing relevance in the assessment of patients with multiple sclerosis. Converging evidence point to the view that neuro-retinal changes, in eyes without acute optic neuritis, reflect inflammatory and neurodegenerative processes taking place throughout the CNS. The present study aims at exploring the usefulness of OCT as a marker of inflammation and disease burden in the earliest phases of the disease. Thus, a cohort of 150 consecutive patients underwent clinical, neurophysiological and brain MRI assessment as well as lumbar puncture as part of their diagnostic workup for a neurological episode suggestive of inflammatory CNS disorder; among those 32 patients had another previous misdiagnosed episode. For the present study, patients also received a visual pathway assessment (OCT, visual evoked potentials, visual acuity), measurement of CSF inflammatory markers (17 cytokines-chemokines, extracellular vesicles of myeloid origin), and dosage of plasma neurofilaments. Subclinical optic nerve involvement is frequently found in clinically isolated syndromes by visual evoked potentials (19.2%). OCT reveals ganglion cell layer asymmetries in 6.8% of patients; retinal fibre layer asymmetries, despite being more frequent (17.8%), display poor specificity. The presence of subclinical involvement is associated with a greater disease burden. Second, ganglion cell layer thinning reflects the severity of disease involvement even beyond the anterior optic pathway. In fact, the ganglion cell layer in eyes without evidence of subclinical optic involvement is correlated with Expanded Disability Status Scale, low contrast visual acuity, disease duration, brain lesion load, presence of gadolinium enhancing lesions, abnormalities along motor and somatosensory evoked potentials, and frequency of CSF-specific oligoclonal bands. Third, the inner nuclear layer thickens in a post-acute (1.1-3.7 months) phase after a relapse, and this phenomenon is counteracted by steroid treatment. Likewise, a longitudinal analysis on 65 patients shows that this swelling is transient and returns to normal values after 1 year follow-up. Notwithstanding, the clinical, MRI, serological and CSF markers of disease activity considered in the study are strictly associated with one another, but none of them are associated with the inner nuclear layer. Our findings challenge the current hypothesis that the inner nuclear layer is an acute phase marker of inflammatory activity. The present study suggests that instrumental evidence of subclinical optic nerve involvement is associated with a greater disease burden in clinically isolated syndrome. Neuro-retinal changes are present since the earliest phases of the disease and yield important information regarding the neurodegenerative and inflammatory processes occurring in the CNS.


Assuntos
Doenças Desmielinizantes/patologia , Esclerose Múltipla/patologia , Nervo Óptico/patologia , Adolescente , Adulto , Doenças Desmielinizantes/diagnóstico por imagem , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico por imagem , Nervo Óptico/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Vias Visuais/diagnóstico por imagem , Vias Visuais/patologia , Adulto Jovem
16.
Acta Neurol Scand ; 144(2): 149-154, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33881171

RESUMO

OBJECTIVES: Wilson disease (WD) is an autosomal recessive disorder that leads to copper accumulation and deposition in different organs, frequently affecting visual pathways. Recent studies have detected morphological changes of the retina in patients with WD using optical coherence tomography (OCT). Measuring the thickness of the retinal nerve fibre layer (RNFL) with OCT provides an objective assessment of integrity and morphological abnormalities of the retina. The aim of this study was to evaluate the relationship between OCT parameters and form of the disease, therapy and symptoms duration, as well as severity of neurological impairment. METHODS: The study comprised of 52 patients with WD and 52 healthy controls (HC). All the patients were on a regular and stable chelation therapy and/or zinc salts. Patients were divided into two groups, with neurological (NWD) or hepatic form of the disease (HWD). OCT was performed to assess the RNFL thickness. RESULTS: The WD patients had significantly lower intraocular pressure in both eyes and lower RNFL thickness than the HC. There were no differences between NWD and HWD in any of the ophthalmologically tested parameters. No significant correlations were found between clinical features and retinal thickness parameters. Stratification of the cohort according to the disease duration showed that disease duration did not influence the RNFL thickness. CONCLUSION: We found that involvement of the retina represented a subclinical finding in neurologically intact patients in the HWD group. Nevertheless, the value of OCT as a biomarker for the assessment of the clinical course and progression of WD still remains uncertain.


Assuntos
Degeneração Hepatolenticular/complicações , Retina/diagnóstico por imagem , Retina/patologia , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/etiologia , Adulto Jovem
17.
Int J Mol Sci ; 22(5)2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33806565

RESUMO

Congenital fibrosis of the extraocular muscles (CFEOM) is a congenital cranial dysinnervation disorder caused by developmental abnormalities affecting cranial nerves/nuclei innervating the extraocular muscles. Autosomal dominant CFEOM arises from heterozygous missense mutations of KIF21A or TUBB3. Although spatiotemporal expression studies have shown KIF21A and TUBB3 expression in developing retinal ganglion cells, it is unclear whether dysinnervation extends beyond the oculomotor system. We aimed to investigate whether dysinnervation extends to the visual system by performing high-resolution optical coherence tomography (OCT) scans characterizing retinal ganglion cells within the optic nerve head and retina. Sixteen patients with CFEOM were screened for mutations in KIF21A, TUBB3, and TUBB2B. Six patients had apparent optic nerve hypoplasia. OCT showed neuro-retinal rim loss. Disc diameter, rim width, rim area, and peripapillary nerve fiber layer thickness were significantly reduced in CFEOM patients compared to controls (p < 0.005). Situs inversus of retinal vessels was seen in five patients. Our study provides evidence of structural optic nerve and retinal changes in CFEOM. We show for the first time that there are widespread retinal changes beyond the retinal ganglion cells in patients with CFEOM. This study shows that the phenotype in CFEOM extends beyond the motor nerves.


Assuntos
Fibrose/patologia , Músculos Oculomotores/patologia , Oftalmoplegia/patologia , Nervo Óptico/patologia , Retina/patologia , Adulto , Nervos Cranianos/patologia , Feminino , Fibrose/genética , Humanos , Masculino , Mutação de Sentido Incorreto/genética , Oftalmoplegia/genética , Disco Óptico/patologia , Fenótipo , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Adulto Jovem
18.
Expert Rev Cardiovasc Ther ; 19(5): 379-386, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33823735

RESUMO

Introduction: Coronary angiography (CAG) is the standard modality for assessing coronary stenosis; however, it has limitations in assessing coronary plaque morphology. Optical coherence tomography (OCT) is a high-resolution (10-20 µm) light-based intravascular imaging technique that can identify more detailed coronary plaque morphology compared to other intravascular imaging modalities. OCT is remarkable for characterizing fibrous, fibrocalcific, and lipid-rich plaques. The capabilities of OCT are well suited for discriminating three types of unstable plaque morphologies underlying coronary thrombosis, such as plaque rupture, erosion, and calcified nodules. The high resolution of OCT makes it possible to identify important features of vulnerable plaques, such as thin-cap (<65 µm thick) fibroatheroma, macrophages, vasa vasorum, and cholesterol crystals.Areas covered: This review summarizes the clinical impact of OCT and its efficacy in identifying plaque components and morphological features associated with plaque vulnerability.Expertopinion: The unique properties of OCT as a tool for investigating high-risk lesions have greatly contributed to a better understanding of plaque vulnerability. Consequently, OCT has led to significant changes in medical treatment and percutaneous coronary intervention strategies for acute coronary syndrome. Further development and investigation of OCT are necessary to better predict and manage acute coronary events in the future.


Assuntos
Aterosclerose/diagnóstico por imagem , Placa Aterosclerótica/patologia , Tomografia de Coerência Óptica/métodos , Síndrome Coronariana Aguda/terapia , Angiografia Coronária , Doença da Artéria Coronariana/terapia , Estenose Coronária/patologia , Vasos Coronários/patologia , Humanos , Intervenção Coronária Percutânea
19.
Medicine (Baltimore) ; 100(16): e25638, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879743

RESUMO

ABSTRACT: We retrospectively compared the central corneal thickness (CCT) obtained by ultrasound pachymetry (USP; SP-3000, Tomey Corp., Nagoya, Japan), non-contact tonopachy (TP) (NT-530P, Nidek Co., Ltd., Gamagori, Japan), Pentacam HR (OCULUS Inc., Wetzlar, Germany), and RTVue optical coherence tomography (OCT) (Optovue Inc., Fremont, CA, USA) in 78 eyes of 78 healthy subjects with myopia. Agreement between the measurement methods was evaluated using 95% confidence intervals for the limits of agreement (LoA). The mean CCT values were 546.9 ± 34.7, 548.1 ±â€Š33.5, 559.2 ±â€Š34.0, and 547.2 ±â€Š34.8 µm for USP, non-contact TP, Pentacam, and RTVue, respectively. The thickest and the thinnest mean CCT values corresponded to those obtained by Pentacam HR and USP, respectively. Plots of the differences against the means showed the best agreement between USP and RTVue (LoA, 10.14-10.70 µm), while the largest discrepancy was observed between RTVue and Pentacam systems (LoA, -25.47-1.44 µm). Our data showed that CCT measurements using these 4 instruments were well correlated. However, the results from Pentacam differed significantly from those of the other instruments.


Assuntos
Córnea/diagnóstico por imagem , Paquimetria Corneana/estatística & dados numéricos , Miopia/diagnóstico por imagem , Tomografia de Coerência Óptica/estatística & dados numéricos , Tonometria Ocular/estatística & dados numéricos , Adolescente , Adulto , Córnea/patologia , Paquimetria Corneana/métodos , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Tonometria Ocular/métodos , Ultrassonografia , Adulto Jovem
20.
Optom Vis Sci ; 98(4): 326-333, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33828044

RESUMO

SIGNIFICANCE: Choroidal vascularity index measured by image binarization method from peripapillary optical coherence tomography sections has been found significantly lower in papilledema patients than healthy controls. PURPOSE: The purpose of this study was to compare peripapillary choroidal parameters in papilledema patients with control subjects. METHODS: Peripapillary spectral domain optical coherence tomography scans of 34 patients with papilledema and 34 healthy controls are acquired for the study. Images are binarized with the ImageJ software (National Institutes of Health, Bethesda, MD) to calculate total choroidal area, stromal area, luminal area, and choroidal vascularity index. RESULTS: Total choroidal area, luminal area, and choroidal vascularity were significantly lower in papilledema patients compared with healthy controls on right (1.343 ± 0.286 vs. 1.694 ± 0.344, P < .001; 0.880 ± 0.209 vs. 1.167 ± 0.255, P < .001; 65.28 ± 2.99% vs. 68.68 ± 2.81%, P < .001, respectively) and left eyes (1.376 ± 0.308 vs. 1.647 ± 0.339, P < .001; 0.899 ± 0.231 vs. 1.134 ± 0.237, P < .001; 64.92 ± 3.44 vs. 68.84 ± 3.23, P < .001, respectively). No difference was found between active and remitted stages of papilledema in terms of choroidal parameters. CONCLUSIONS: Peripapillary total choroidal area, luminal area, and choroidal vascularity index are significantly reduced in patients with papilledema. These parameters might be beneficial tools for evaluating choroidal vascularity in papilledema quantitatively and differential diagnosis for optic disc edema.


Assuntos
Corioide/irrigação sanguínea , Papiledema/fisiopatologia , Pseudotumor Cerebral/fisiopatologia , Adulto , Corioide/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papiledema/diagnóstico por imagem , Pseudotumor Cerebral/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
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