|
1
|
Küçüködük A, Avcı E. Choroidal vascular alterations in patients with Helicobacter pylori gastritis. Arab J Gastroenterol 2025:S1687-1979(25)00062-0. [PMID: 40360319 DOI: 10.1016/j.ajg.2025.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/18/2025] [Accepted: 04/26/2025] [Indexed: 05/15/2025]
Abstract
BACKGROUND AND STUDY AIMS This study aims to examine the impact of Helicobacter pylori (H. pylori) gastritis, a condition that induces chronic inflammation in the body, on subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) measurements. PATIENTS AND METHODS In this prospective study, data were collected from 76 patients who visited the gastroenterology clinic, had their H. pylori diagnosis confirmed through gastric biopsy, and had not yet received treatment. An additional 76 age- and gender-matched healthy individuals formed the control group. Subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT) (Spectralis, Heidelberg Engineering, Heidelberg, Germany). CVI measurements were obtained by dividing the subfoveal choroidal area in the EDI-OCT images into luminal and stromal areas using the image binarization technique. RESULTS The mean SFCT was 359.14 ± 24.23 µm in the H. pylori-positive group and 353.62 ± 12.78 µm in the control group, with no statistically significant difference between the groups (p = 0.782). Similarly, the choroidal vascular index (CVI) was 0.63 in the H. pylori group and 0.62 in the control group, with no significant difference observed (p = 0.08). CONCLUSION Results indicate that SFCT and CVI measurements do not undergo significant changes during the active phase of H. pylori infection compared to the control group.
Collapse
Affiliation(s)
- Ali Küçüködük
- Department of Ophthalmology, KTO Karatay University Medicana Konya Hospital, Konya, Turkiye.
| | - Enver Avcı
- Department of Gastroenterology, KTO Karatay University Medicana Konya Hospital, Konya, Turkiye
| |
Collapse
|
|
2
|
Sah RP, Patel NB, Queener HM, Narra PK, Ostrin LA. Deep learning-based segmentation of OCT images for choroidal thickness. JOURNAL OF OPTOMETRY 2025; 18:100556. [PMID: 40328135 DOI: 10.1016/j.optom.2025.100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 03/05/2025] [Accepted: 04/15/2025] [Indexed: 05/08/2025]
Abstract
PURPOSE To develop and validate a custom deep learning-based automated segmentation for choroidal thickness of optical coherence tomography (OCT) scans. METHODS An in-house automated algorithm was trained on a Deeplabv3+ network, based on ResNet50, using a training set of 10,798 manually segmented OCT scans (accuracy 99.25% and loss 0.0229). A test set of 130 unique scans was segmented using manual and in-house automated methods. For manual segmentation, the choroid-sclera border was delineated by the user. For in-house automated segmentation, all borders were automatically detected by the program and manually inspected. Bland-Altman analysis, intraclass correlation coefficient (ICC), and Deming regression compared the central 1-mm diameter and 3-mm and 6-mm annuli for the two methods. The in-house method was also compared with an open-source algorithm for the test set of 130 scans. RESULTS Mean choroidal thicknesses obtained with manual and in-house automated methods were not significantly different for the three regions (P > 0.05 for all). The fixed bias between methods ranged from -2.41 to 3.49 µm. Proportional bias ranged from -0.04 to -0.12 (P < 0.05 for all). The two methods demonstrated excellent agreement across regions (ICC: 0.96 to 0.98, P < 0.001 for all). The open-source automated method consistently resulted in thinner choroidal thickness compared to manual and in-house automated methods. CONCLUSIONS Custom in-house deep learning automated choroid segmentation demonstrated excellent agreement and strong positive linear relationship with manual segmentation. The automated approach holds distinct advantages for estimating choroidal thickness, being more objective and efficient than the manual approach.
Collapse
Affiliation(s)
- Raman Prasad Sah
- University of Houston College of Optometry, 4401 MLK Blvd, Houston, TX 77204, USA
| | - Nimesh B Patel
- University of Houston College of Optometry, 4401 MLK Blvd, Houston, TX 77204, USA
| | - Hope M Queener
- University of Houston College of Optometry, 4401 MLK Blvd, Houston, TX 77204, USA
| | - Pavan K Narra
- University of Houston College of Optometry, 4401 MLK Blvd, Houston, TX 77204, USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4401 MLK Blvd, Houston, TX 77204, USA.
| |
Collapse
|
|
3
|
Ganguly A, Babu SS, Ghosh S, Velyutham R, Kapusetti G. Advances and future trends in the detection of beta-amyloid: A comprehensive review. Med Eng Phys 2025; 135:104269. [PMID: 39922648 DOI: 10.1016/j.medengphy.2024.104269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 11/26/2024] [Accepted: 12/01/2024] [Indexed: 02/10/2025]
Abstract
The neurodegenerative condition known as Alzheimer's disease is typified by the build-up of beta-amyloid plaques within the brain. The timely and precise identification of beta-amyloid is essential for understanding disease progression and developing effective therapeutic interventions. This comprehensive review explores the diverse landscape of beta-amyloid detection methods, ranging from traditional immunoassays to cutting-edge technologies. The review critically examines the strengths and limitations of established techniques such as ELISA, PET, and MRI, providing insights into their roles in research and clinical settings. Emerging technologies, including electrochemical methods, nanotechnology, fluorescence techniques, point-of-care devices, and machine learning integration, are thoroughly discussed, emphasizing recent breakthroughs and their potential for revolutionizing beta-amyloid detection. Furthermore, the review delves into the challenges associated with current detection methods, such as sensitivity, specificity, and accessibility. By amalgamating knowledge from multidisciplinary approaches, this review aims to guide researchers, clinicians, and policymakers in navigating the complex landscape of beta-amyloid detection, ultimately contributing to advancements in Alzheimer's disease diagnostics and therapeutics.
Collapse
Affiliation(s)
- Atri Ganguly
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research - Kolkata, -700054, India
| | - Srivalliputtur Sarath Babu
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research - Kolkata, -700054, India
| | - Sumanta Ghosh
- Divison of Applied Oral Science, The University of Hong Kong, SAR, Hong Kong
| | - Ravichandiran Velyutham
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research - Kolkata, -700054, India.
| | - Govinda Kapusetti
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research - Kolkata, -700054, India.
| |
Collapse
|
|
4
|
Xu Y, Sun R, Hu M, Zeng H. A Dual-Modal Fusion Network Using Optical Coherence Tomography and Fundus Images in Detection of Glaucomatous Optic Neuropathy. Curr Eye Res 2024; 49:1253-1259. [PMID: 38979787 DOI: 10.1080/02713683.2024.2375401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 06/27/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE We designed a dual-modal fusion network to detect glaucomatous optic neuropathy, which utilized both retinal nerve fiber layer thickness from optical coherence tomography reports and fundus images. METHODS A total of 327 healthy subjects (410 eyes) and 87 glaucomatous optic neuropathy patients (113 eyes) were included. The retinal nerve fiber layer thickness from optical coherence tomography reports and fundus images were used as predictors in the dual-modal fusion network to diagnose glaucoma. The area under the receiver operation characteristic curve, accuracy, sensitivity, and specificity were measured to compare our method and other approaches. RESULTS The accuracy of our dual-modal fusion network using both retinal nerve fiber layer thickness from optical coherence tomography reports and fundus images was 0.935 and we achieved a significant larger area under the receiver operation characteristic curve of our method with 0.968 (95% confidence interval, 0.937-0.999). For only using retinal nerve fiber layer thickness, we compared the area under the receiver operation characteristic curves between our network and other three approaches: 0.916 (95% confidence interval, 0.855, 0.977) with our optical coherence tomography Net; 0.841 (95% confidence interval, 0.749, 0.933) with Clock sectors division; 0.862 (95% confidence interval, 0.757, 0.968) with inferior, superior, nasal temporal sectors division and 0.886 (95% confidence interval, 0.815, 0.957) with optic disc sectors division. For only using fundus images, we compared the area under the receiver operation characteristic curves between our network and other two approaches: 0.867 (95% confidence interval: 0.781-0.952) with our Image Net; 0.774 (95% confidence interval: 0.670, 0.878) with ResNet50; 0.747 (95% confidence interval: 0.628, 0.866) with VGG16. CONCLUSION Our dual-modal fusion network utilizing both retinal nerve fiber layer thickness from optical coherence tomography reports and fundus images can diagnose glaucoma with a much better performance than the current approaches based on optical coherence tomography only or fundus images only.
Collapse
Affiliation(s)
- Yongli Xu
- College of Mathematics and Physics, Beijing University of Chemical Technology, Beijing, China
- College of Statistics and Data Science, Faculty of Science, Beijing University of Technology, Beijing, China
| | - Run Sun
- College of Mathematics and Physics, Beijing University of Chemical Technology, Beijing, China
| | - Man Hu
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hui Zeng
- College of Mathematics and Physics, Beijing University of Chemical Technology, Beijing, China
| |
Collapse
|
|
5
|
Sulavikova Z, Sustykevicova Z, Kacerik M, Kozak I. Long-term follow-up demonstrates change in conformation shape of the focal choroidal excavation lesions. BMC Ophthalmol 2024; 24:147. [PMID: 38566166 PMCID: PMC10986083 DOI: 10.1186/s12886-024-03415-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE This study aims to present long-term observation of 5 eyes with focal choroidal excavation (FCE), focusing on morphological changes in conformity of the lesion. METHODS A retrospective case series was conducted, including 5 eyes of 5 patients with FCE. The study utilized multimodal imaging including color fundus photography, optical coherence tomography (OCT), enhanced depth imaging OCT (EDI-OCT), fundus fluorescein angiography (FFA), fundus autofluorescence (FAF), red free imaging, and OCT angiography. RESULTS The mean age at diagnosis was 51 ± 10.65 years, with a mean follow-up period 37 ± 13.59 months. All cases were unilateral, with 1 presenting FCE as an isolated lesion, and one patient exhibiting 2 FCEs in one eye. The mean choroidal thickness measured by EDI-OCT was 268.2 ± 63.39 μm in the affected eye. One patient displayed choroidal thickening and pachyvessels. Of the 5 eyes, one had conforming and 4 non-conforming FCE. We observed a conversion in conformity in all patients, with 4 cases transitioning from non-conforming FCE to conforming type (3 spontaneously, 1 treatment-induced). In conforming FCE, a hyporeflective space appeared twice between neuroretina and retinal pigment epithelium with spontaneous regression. CONCLUSION We observed change in shape from the conforming to non-conforming FCE and vice versa in all patients. We consider this small change in the hyporeflective space as non-pathologic and clinically insignificant.
Collapse
Affiliation(s)
- Zuzana Sulavikova
- Department of Ophthalmology, Faculty hospital Trencin, Legionarska 28, 91101, Trencin, Slovakia.
| | - Zuzana Sustykevicova
- Department of Ophthalmology, Faculty hospital Trencin, Legionarska 28, 91101, Trencin, Slovakia
| | - Marek Kacerik
- Department of Ophthalmology, Faculty hospital Trencin, Legionarska 28, 91101, Trencin, Slovakia
| | - Igor Kozak
- Moorfields Eye Hospitals UAE, Abu Dhabi, United Arab Emirates
| |
Collapse
|
|
6
|
Bansal A, Narnaware SH, Bawankule PK, Gupta R, Nagdeve R. Retro-mode: a newer insight into dry age-related macular degeneration (AMD). Lasers Med Sci 2023; 38:178. [PMID: 37552467 DOI: 10.1007/s10103-023-03845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
The purpose of this study is to study the role of retro-mode (RM) in early detection and to compare it with other preexisting available modalities on multimodal imaging system in dry AMD. A prospective observational cross-sectional study was done between November 2020 and October 2021 which included 409 eyes of 207 patients. For study purpose, eyes were divided into 3 groups according to the size and number of the drusen, viz, group 1: No AMD, group 2: early AMD and group 3: intermediate AMD which was further divided into 2 subgroups, viz, subgroup A: eyes with drusen size 63-125 μm and subgroup B: eyes with drusen size 125-250 μm. Patients with active or treated wet AMD, scarred choroidal neovascular membrane (CNVM), other maculopathies, other retinopathies, high myopia, trauma and glaucoma were excluded from the study. In cases of No AMD and early AMD, a number of drusens detected on RM were statistically not significant compared to fundus autofluorescence (FAF) and color photo (CF), but in intermediate AMD cases, it was statistically significant. While the area involved by drusens calculated by RM was statistically significant compared to both other modalities. When all modalities were compared with enhanced depth imaging-optical coherence tomography (EDI-OCT) at the choroid and chorio-capillary (CC) level and vessel density (VD) on optical coherence tomography angiography (OCTA) at the choroid, capillaries, deep retinal and superficial retinal plexus level; it was only RM which was found to be in sync with these proven modalities in terms of pattern and trend. In the present scenario, RM is found to be a better diagnostic modality in detecting early and a greater number of drusens with area of involvement than other existing modalities. Though superior, as found in this study, this mode cannot replace other modalities at present but only acts as a complementary investigation in early detection of this disease.
Collapse
Affiliation(s)
- Anju Bansal
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India.
| | - Shilpi H Narnaware
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Prashant K Bawankule
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Richa Gupta
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| | - Rakesh Nagdeve
- Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur, Maharashtra, 440025, India
| |
Collapse
|
|
7
|
Venkatesh R, Agrawal S, Reddy NG, Sridharan A, Ong J, Yadav NK, Chhablani J. Choroidal and retinal thickness variations in ocular albinism. Indian J Ophthalmol 2022; 70:2506-2510. [PMID: 35791146 PMCID: PMC9426091 DOI: 10.4103/ijo.ijo_2907_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age-matched healthy subjects. Methods This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length-matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single-line horizontal-raster enhanced depth imaging - optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann-Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant. Results The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from -8.5D to +10.5D in the OA group and from -8.0D to +10.0D in the control group. The mean axial length between the two groups (P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 μm; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 μm; P < 0.001) was significantly thinner in the OA group. Conclusion Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism.
Collapse
Affiliation(s)
- Ramesh Venkatesh
- Department of Retina-Vitreous, Narayana Nethralaya, Benguluru, Karnataka, India
| | - Sameeksha Agrawal
- Department of Retina-Vitreous, Narayana Nethralaya, Benguluru, Karnataka, India
| | | | - Akhila Sridharan
- Department of Retina-Vitreous, Narayana Nethralaya, Benguluru, Karnataka, India
| | - Joshua Ong
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA, USA
| | - Naresh Kumar Yadav
- Department of Retina-Vitreous, Narayana Nethralaya, Benguluru, Karnataka, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA, USA
| |
Collapse
|
|
8
|
Zhu L, Li J, Zhu R, Meng X, Rong P, Zhang Y, Jiang Z, Geng M, Qiu B, Rong X, Zhang Y, Gu X, Wang Y, Zhang Z, Wang J, Yang L, Ren Q, Lu Y. Synergistically segmenting choroidal layer and vessel using deep learning for choroid structure analysis. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac5ed7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/17/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Objective. The choroid is the most vascularized structure in the human eye, whose layer structure and vessel distribution are both critical for the physiology of the retina, and disease pathogenesis of the eye. Although some works have used graph-based methods or convolutional neural networks to separate the choroid layer from the outer-choroid structure, few works focused on further distinguishing the inner-choroid structure, such as the choroid vessel and choroid stroma. Approach. Inspired by the multi-task learning strategy, in this paper, we propose a segmentation pipeline for choroid analysis which can separate the choroid layer from other structures and segment the choroid vessel synergistically. The key component of this pipeline is the proposed choroidal U-shape network (CUNet), which catches both correlation features and specific features between the choroid layer and the choroid vessel. Then pixel-wise classification is generated based on these two types of features to obtain choroid layer segmentation and vessel segmentation. Besides, the training process of CUNet is supervised by a proposed adaptive multi-task segmentation loss which adds a regularization term that is used to balance the performance of the two tasks. Main results. Experiments show the high performance (4% higher dice score) and less computational complexity (18.85 M lower size) of our proposed strategy. Significance. The high performance and generalization on both choroid layer and vessel segmentation indicate the clinical potential of our proposed pipeline.
Collapse
|
|
9
|
Venkatesh R, Agrawal S, Reddy NG, Mutalik D, Mishra P, Yadav NK, Chhablani J. Visual function correlates with foveal slope, retinal and choroidal thickness on optical coherence tomography in type 2 Macular Telangiectasia. Semin Ophthalmol 2021; 37:524-530. [PMID: 34965178 DOI: 10.1080/08820538.2021.2022166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To correlate the foveal slope angle (FSA), retinal (RT) and choroidal (CT) thickness measured using optical coherence tomography (OCT) across different stages of type 2 macular telangiectasia (MacTel) with best-corrected visual acuity (BCVA). METHODS A cross-sectional study of 182 gradable quality macular OCT images of 49 patients with type 2 MacTel was carried out. RT was measured on the Spectralis OCT machine from ETDRS (Early Treatment Diabetic Retinopathy Study) retinal thickness map and later used for calculating FSA. RT and CT were measured at 500-µm intervals up to 1500 µm from foveal centre manually. The change in RT, CT and FSA across five stages of type 2 MacTel was assessed. The measurements were correlated with BCVA. RESULTS The FSA, RT and CT were calculated quadrantwise and stagewise. The FSA and RT showed a significant negative correlation with disease stage and BCVA (p < .05) in all four quadrants. No significant correlation was noted between CT and BCVA. Multivariate linear regression analysis identified the temporal FSA to correlate best with BCVA. CONCLUSION BCVA correlates best with temporal FSA. Smaller the temporal FSA, poorer the vision.
Collapse
Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | - Sameeksha Agrawal
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | | | - Deepashri Mutalik
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | - Pranjal Mishra
- Department of Retina and Vitreous Narayana Nethralaya, Bengaluru India
| | | | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, Pittsburg, PA, USA
| |
Collapse
|
|
10
|
Shim KY, Bae JG, Lee JK, Kim YC. Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia. PLoS One 2021; 16:e0251933. [PMID: 34015042 PMCID: PMC8136667 DOI: 10.1371/journal.pone.0251933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/05/2021] [Indexed: 11/18/2022] Open
Abstract
This retrospective study aimed to evaluate the correlation between ophthalmologic factors and proteinuria in patients with pre-eclampsia using swept-source optical coherence tomography (OCT) and OCT angiography. In total, 61 pregnant patients diagnosed with pre-eclampsia were recruited during their hospital stay. The authors investigated the relationship between urine protein–creatinine ratio (PCR) and chorioretinal measurements including choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ), vascular density (VD), ganglion cell layer+ (GCL+) and GCL++. The associations between mean arterial pressure (MAP) and ophthalmologic factors were also evaluated. Central subfield CT of the right eye (p = 0.031) and paracentral CT of both eyes were related to higher PCR (≥1.35 mg/mg). A significant association with PCR after logarithm transformation was noted (r = 0.284, p = 0.026). Retinal measurements (FAZ, VD, GCL+ and GCL++) and CVI were not related with PCR. There was a positive association between MAP and PCR after logarithm transformation (r = 0.296, p = 0.021); however, chorioretinal factors were not related with MAP. In pregnant women with pre-eclampsia, CT using OCT is a novel factor that is correlated with PCR. Ocular structural alteration in patients with pre-eclampsia may be one of systemic vascular changes caused by pre-eclampsia rather than hypertension.
Collapse
Affiliation(s)
- Kyu Young Shim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Gon Bae
- Department of Obstetrics, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Kyoung Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
- * E-mail:
| |
Collapse
|
|
11
|
Hoseini‐yazdi H, Vincent SJ, Collins MJ, Read SA, Alonso‐caneiro D. Impact of image averaging on wide‐field choroidal thickness measurements using enhanced‐depth imaging optical coherence tomography. Clin Exp Optom 2021; 102:320-326. [DOI: 10.1111/cxo.12855] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Hosein Hoseini‐yazdi
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - David Alonso‐caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| |
Collapse
|
|
12
|
Giannopoulos K, Gazouli M, Chatzistefanou K, Bakouli A, Moschos MM. The Genetic Background of Central Serous Chorioretinopathy: A Review on Central Serous Chorioretinopathy Genes. J Genomics 2021; 9:10-19. [PMID: 33456587 PMCID: PMC7806452 DOI: 10.7150/jgen.55545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022] Open
Abstract
Central serous chorioretinopathy is characterized by neurosensory detachment of the central retina secondary to fluid leakage through the retinal pigment epithelium. Though it has an incidence of 9,9 per 100.000 in men and 1,7 per 100.000 in women, it is the fourth most common retinal disorder. Central serous chorioretinopathy patients present with blurred vision, central scotoma, metamorphopsia, micropsia and mild color discrimination. It is usually a self-limited disorder with nearly none or minimal visual impairment but in some patients the disease persists and may cause severe visual impairment. Central serous chorioretinopathy pathophysiology is not well understood. Choroid, retinal pigment epithelium and hormonal pathways seem to play important roles in central serous chorioretinopathy pathophysiology. Also, familial cases of the disease indicate that there is a genetic background. The identification of certain disease genes could lead to the development of better diagnostic and therapeutic approaches for central serous chorioretinopathy patients.
Collapse
Affiliation(s)
- Konstantinos Giannopoulos
- First Department of Ophthalmology, Gennimatas General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.,Department of Ophthalmology, General Hospital of Sitia, Sitia, Greece
| | - Maria Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Klio Chatzistefanou
- First Department of Ophthalmology, Gennimatas General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Anthi Bakouli
- Department of Ophthalmology, Elpis General Hospital, Athens, Greece
| | - Marilita M Moschos
- First Department of Ophthalmology, Gennimatas General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| |
Collapse
|
|
13
|
Weill Y, Brosh K, Levi Vineberg T, Arieli Y, Caspi A, Potter MJ, Zadok D, Hanhart J. Enhanced depth imaging in swept-source optical coherence tomography: Improving visibility of choroid and sclera, a masked study. Eur J Ophthalmol 2020; 30:1295-1300. [DOI: 10.1177/1120672119863560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To compare enhanced depth imaging in swept-source optical coherence tomography and non–enhanced depth imaging optical coherence tomography in their ability to capture choroidal and scleral details. Methods Averaged foveal B-Scans were obtained from 40 eyes of 20 healthy volunteers by swept-source optical coherence tomography with and without enhanced depth imaging. Visibility and contrast of vascular details within the choroid, choroidoscleral junction, and sclera were evaluated by masked readers using an ordinal scoring scale. Outcomes were analyzed using the Wilcoxon signed rank-sum test. Results Visibility of the choroidal vascular details ( Z = 5.94, p < .001), the choroidoscleral junction ( Z = 5.85, p < .001), and the sclera ( Z = 6.80, p < .001) was significantly higher with enhanced depth imaging than with non–enhanced depth imaging swept-source optical coherence tomography. Similarly, image contrast was significantly higher with enhanced depth imaging than with non–enhanced depth imaging swept-source optical coherence tomography for the choroidal vascular details ( Z = 9.47, p < .001), for the choroidoscleral junction ( Z = 9.28, p < .001), and for the sclera ( Z = 9.42, p < .001). Conclusion Enhanced depth imaging applied to swept-source optical coherence tomography–averaged foveal B-scans enhances visualization of the choroidal details, of the choroidoscleral junction, and of the sclera. This novel modality can easily be implemented in clinics and could improve our understanding of conditions involving the choroid or the sclera.
Collapse
Affiliation(s)
- Yishay Weill
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Koby Brosh
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Tamar Levi Vineberg
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yoel Arieli
- Electro-Optics Department, Jerusalem College of Technology, Jerusalem, Israel
| | - Avi Caspi
- Electro-Optics Department, Jerusalem College of Technology, Jerusalem, Israel
| | - Michael J Potter
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology and Visual Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - David Zadok
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joel Hanhart
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
|
14
|
The Application of Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography in Macular Diseases. J Ophthalmol 2020; 2020:9503795. [PMID: 32908688 PMCID: PMC7463401 DOI: 10.1155/2020/9503795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/22/2020] [Indexed: 11/21/2022] Open
Abstract
The choroid plays an essential role in the pathogenesis of various posterior segment diseases. However, traditional imaging methods still have limited cross-sectional observation of choroid. Enhanced depth imaging in spectral-domain optical coherence tomography (EDI SD-OCT) uses a closer scanning position to the eye to create an inverted SD-OCT image with the advantage of better depth sensitivity, which can observe choroidal structure and measure choroidal thickness (CT) accurately. At present, more and more choroidal thickness measurements have been made in normal and pathologic states, in order to understand the pathogenesis and differential diagnosis and prognosis of various diseases, especially for macular lesions. This paper would review relevant original literatures published from January 1, 2008, to February 1, 2020, to evaluate the relationship between the changes of CT with EDI SD-OCT and macular diseases.
Collapse
|
|
15
|
Verma S, Kumar V, Azad S, Bhayana AA, Surve A, Kumar S, Agarwal P, Chawla R, Venkatesh P. Focal choroidal excavation: review of literature. Br J Ophthalmol 2020; 105:1043-1048. [DOI: 10.1136/bjophthalmol-2020-316992] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/16/2020] [Accepted: 07/03/2020] [Indexed: 11/04/2022]
Abstract
Focal choroidal excavation (FCE) is defined as an area of concavity in choroid detected on optical coherence tomography. These are mostly present in macular region without evidence of accompanying scleral ectasia or posterior staphyloma. Though initially considered to be congenital, increasing number of cases have been identified in association with other choroidal pathologies such as central serous choroidopathy, choroidal neovascularisation, polypoidal choroidal vasculopathy, choroiditis, choroidal tumours. In this review article, we aim to elaborate on the morphology, pathogenesis and differential diagnosis of FCE and specifically discuss the spectrum of diseases with known association along with the impact of their treatment on FCE
Collapse
|
|
16
|
Lee JH, Hong IH, Lee TY, Han JR, Jeon GS. Choroidal Thickness Changes after Orthokeratology Lens Wearing in Young Adults with Myopia. Ophthalmic Res 2020; 64:121-127. [PMID: 32759609 DOI: 10.1159/000510715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/05/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Recently in South Korea, there are increasing number of young adults undergoing orthokeratology treatment for myopia control. They prefer orthokeratology treatment more than wearing spectacles or having a refractive surgery for several reasons. However, there is little research on the effect of orthokeratology treatment on choroids. OBJECTIVE The aim of this study was to analyze the change in choroidal thickness (CT) in the horizontal axis in young myopic adults after orthokeratology treatment. METHODS This was a retrospective research among young myopic patients (-1.0 to -5.0 diopters) aged 19-29 years (n = 36; 23.6 ± 2.5 years). We selected patients who were treated with orthokeratology for 12 months. CT values of the horizontal axis near the fovea before and after orthokeratology treatment were analyzed using optical coherence tomography. The value was measured at the beginning of treatment and at 3, 6, and 12 months after orthokeratology treatment. Three regional areas of choroid on the horizontal plane including fovea were analyzed. RESULT AND CONCLUSIONS In the beginning of orthokeratology treatment, CT of the horizontal axis was 248.9 ± 45.7 μm in the temporal region, 259.9 ± 55.3 μm in the macular region, and 219.2 ± 46.4 μm in the nasal region. Three months after orthokeratology treatment, thickness values of choroids in the 3 divided areas increased significantly (p < 0.05). Mean CT at 6 or 12 months after orthokeratology treatment was greater than before ortho<X00_Del_TrennDivis>--</X00_Del_TrennDivis>keratology treatment. CT increased after 3 months of orthokeratology treatment in each regional area. In young myopic adults, CT in nasal area was thinner than that in foveal or temporal area before treatment. CT recovered to near baseline when it was observed for more than 6 months after orthokeratology treatment.
Collapse
Affiliation(s)
- Jang Hun Lee
- Department of Ophthalmology, Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Republic of Korea
| | - In Hwan Hong
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Gyeonggi-do, Republic of Korea
| | - Tae Yeem Lee
- Galmae Samsung Bright Clinic, Gyeonggi-do, Republic of Korea
| | - Jae Ryong Han
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Gyeonggi-do, Republic of Korea
| | - Gang Seok Jeon
- Department of Ophthalmology, Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Republic of Korea,
| |
Collapse
|
|
17
|
Ebner C, Wernigg C, Schütze C, Weingessel B, Vécsei-Marlovits PV. Retinal pigment epithelial characteristics in eyes with neovascular age-related macular degeneration : Long-term retinal changes under anti-vascular endothelial growth factor treatment. Wien Klin Wochenschr 2020; 133:123-130. [PMID: 32761460 DOI: 10.1007/s00508-020-01718-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 07/08/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to assess retinal pigment epithelial (RPE) and retinal structural changes in eyes with neovascular age-related macular degeneration (AMD) treated with anti-vascular endothelial growth factor (anti-VEGF) during long-term follow-up and to evaluate morphological markers potentially influencing prognosis. METHODS A total of 18 eyes of 18 patients with neovascular AMD were examined subsequent to completion of the Avastin Versus Lucentis in Age Related Macular Degeneration (MANTA) study following a mean period of 84 months (range 69-93 months). After receiving a loading dose of 3 intravitreal anti-VEGF injections subsequent to baseline of the MANTA study, patients were treated as needed (pro re nata, PRN). Functional and morphological changes were assessed, the latter using spectral domain optical coherence tomography (SD-OCT). RESULTS Retinal/RPE atrophy generally increased significantly during follow-up compared to baseline (fibrosis 28% vs. 89%, p = 0.0001, geographic atrophy, GA 0% vs. 67%, p = 0.0002, RPE porosity 61% vs. 100%, p = 0.009) whereas regenerative alterations tendentially increased until 3 months and then subsequently declined until the last visit (RPE thickening 28% vs. 11%, p = 0.22 and intraretinal hyperreflective foci 89% vs. 78%, p = 0.39). CONCLUSION Atrophic alterations of the retina and RPE are progressive and may partly be induced by anti-VEGF. Morphological findings may aid in the identification of prognostic markers in the progression of neovascular AMD. This could lead to a more targeted education of affected patients.
Collapse
Affiliation(s)
- Christian Ebner
- Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstraße 1, Pavillon 2a and 2b, 1130, Vienna, Austria
- Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Clara Wernigg
- Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstraße 1, Pavillon 2a and 2b, 1130, Vienna, Austria
- Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Christopher Schütze
- Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstraße 1, Pavillon 2a and 2b, 1130, Vienna, Austria
- Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Birgit Weingessel
- Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstraße 1, Pavillon 2a and 2b, 1130, Vienna, Austria
- Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Pia-Veronika Vécsei-Marlovits
- Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstraße 1, Pavillon 2a and 2b, 1130, Vienna, Austria.
- Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstraße 1, 1130, Vienna, Austria.
| |
Collapse
|
|
18
|
Brovkina AF, Stoyukhina AS, Nechesnyuk SY, Musatkina IV. [Choroidal melanoma and retinal changes]. Vestn Oftalmol 2020; 135:4-10. [PMID: 32015302 DOI: 10.17116/oftalma20191350614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Literary sources suggest the existence of a new phenotype - retinoinvasive choroidal melanoma (CM). However, the factual evidence of its spreading over the inner retinal surface cannot be dismissed. PURPOSE To study the capabilities of optical coherence tomography (OCT) in terms of finding the ways CM spreads into the retina based on pathomorphological examination of the eyes enucleated due to CM. MATERIAL AND METHODS OCT tomograms of 64 eyes with CM (mean tumor elevation - 2.89±0.19 mm, diameter - 9.58±0.43 mm) were studied. Pathomorphological study was conducted on 18 eyes with CM elevated by up to 7 mm and without previous treatment. RESULTS OCT revealed signs of melanoma invading into the retina in 49 eyes. Among those signs were: presence of retina/CM aggregation (21 eyes), tearing of Bruch's membrane and retinal pigment epithelium, disturbed differentiation of outer retinal layers (15 eyes). Combination of two types of invasion was found in 11 eyes. Pathomorphological study showed low mitotic activity of CM and the presence of a small number of fine-local necroses and hemorrhages. Invasion of CM into the retina was determined in 13 eyes. Retinal invasion began with local destruction of Bruch's membrane (BM) and was often limited by the photoreceptor level, disturbing architectonics of the retina and nuclear layers. Large CMs were accompanied by rough destruction of the Bruch's membrane, tumor cells - in the edematous retina with cystoid dystrophy, in its inner layers, invading into the vitreous body. Infiltration of the retina to inner nuclear layer was accompanied by its transudative detachment and cystoid dystrophy. CONCLUSION Invasion of CM into the retina affecting all of its layers imposes use of OCT to examine the integrity of the retina, even with a tumor of small thickness. Tumoral infiltration of the retina and localization of tumor near the optic disc are two contraindications for local endovitreal resection. Brachytherapy requires consideration of tumor characteristics and thickness of the retina for calculation of apical radiation dose.
Collapse
Affiliation(s)
- A F Brovkina
- Russian Medical Academy of Continuous Professional Education, Department of Ophthalmology, 2/1 Barricadnaya St., Moscow, Russian Federation, 125993
| | - A S Stoyukhina
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - S Yu Nechesnyuk
- S.P. Botkin Moscow City Clinical Hospital, Branch No. 1, Ophtalmooncology department, 7 Mamonovskiy Lane, Moscow, Russian Federation, 123001
| | - I V Musatkina
- S.P. Botkin Moscow City Clinical Hospital, Branch No. 1, Ophtalmooncology department, 7 Mamonovskiy Lane, Moscow, Russian Federation, 123001
| |
Collapse
|
|
19
|
Steiner M, Esteban-Ortega MDM, Muñoz-Fernández S. Choroidal and retinal thickness in systemic autoimmune and inflammatory diseases: A review. Surv Ophthalmol 2019; 64:757-769. [PMID: 31034855 DOI: 10.1016/j.survophthal.2019.04.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
Abstract
To identify the risk of relapse and subclinical inflammatory stages of systemic autoimmune diseases, new tools are needed. In the recent years, choroidal thickness and retinal thickness measured with ocular coherence tomography (OCT) have been proposed as an inflammatory marker for different systemic diseases, especially for conditions with a vascular component. Our aim in this article is to review the literature regarding the role of choroidal and retinal thickness as a potential inflammatory marker in systemic autoimmune and inflammatory diseases measured by OCT. Current literature suggests that the choroid of patients thickens in active phases of inflammatory diseases with vascular involvement. This pattern is observed in lupus, systemic sclerosis, Behçet disease, spondylitis, and familial Mediterranean fever. Choroidal thickness may decrease with biological treatments, along with systemic inflammation. Repeated flares and long-term disease, however, may thin the choroid, as a result of prolonged insult to the microvasculature and subsequent atrophy. Less is known about the effect of these diseases on retinal thickness. In summary, choroidal and retinal thickness measured by OCT may be promising markers for inflammation in systemic autoimmune and inflammatory diseases; however, more studies are warranted before generalizing choroidal thickness measurements by OCT as a marker for disease activity. The role of retinal thickness is more unclear due to a lack of studies in this field.
Collapse
Affiliation(s)
- Martina Steiner
- Department of Rheumatology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain.
| | - Maria Del Mar Esteban-Ortega
- Universidad Europea de Madrid, Madrid, Spain; Department of Ophthalmology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain
| | - Santiago Muñoz-Fernández
- Department of Rheumatology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain
| |
Collapse
|
|
20
|
Hoseini-Yazdi H, Vincent SJ, Collins MJ, Read SA, Alonso-Caneiro D. Wide-field choroidal thickness in myopes and emmetropes. Sci Rep 2019; 9:3474. [PMID: 30837507 PMCID: PMC6401121 DOI: 10.1038/s41598-019-39653-w] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 01/23/2019] [Indexed: 12/19/2022] Open
Abstract
There is a paucity of knowledge regarding the normal in-vivo thickness of the choroid beyond the macula (~17°). In this study, the choroidal thickness of 27 healthy young adults was examined across the macular (the central 5 mm including the fovea, parafovea, and perifovea) and extra-macular (a 5-14 mm annulus including the near-periphery and periphery) regions using wide-field optical coherence tomography, and compared between emmetropes (n = 14) and myopes (n = 13). The choroid progressively thinned beyond the parafovea (350 ± 86 µm) towards the periphery (264 ± 44 µm), and was thickest superiorly (355 ± 76 µm) and thinnest nasally (290 ± 79 µm). Choroidal thickness also varied with refractive error; myopes exhibited a thinner choroid than emmetropes in the macular region (311 ± 88 vs. 383 ± 66 µm), however, this difference diminished towards the periphery (251 ± 48 vs. 277 ± 37 µm). Meridional variations in choroidal thickness were not different between myopes and emmetropes. In conclusion, the choroid was thickest within the perifovea; thinned substantially towards the periphery, and exhibited the minimum and maximum peripheral thinning superiorly and nasally across a 55° region respectively. Choroidal thinning associated with myopia was more pronounced in the macular than extra-macular regions.
Collapse
Affiliation(s)
- Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia.
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
|
21
|
Dehghani A, Ghanbari H, Akhlaghi M, Kianersi F, Alemzadeh-Ansari MH. Peripapillary and macular choroidal thickness in both eyes of patients with acute unilateral retrobulbar optic neuritis. Taiwan J Ophthalmol 2019; 10:184-188. [PMID: 33110749 PMCID: PMC7585478 DOI: 10.4103/tjo.tjo_67_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 12/20/2018] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The purpose of this study was to examine macular and peripapillary choroidal thickness (CT) in patients with acute unilateral retrobulbar optic neuritis. MATERIALS AND METHODS In this cross-sectional study, 19 patients with acute unilateral retrobulbar optic neuritis were examined. A control group was matched with patients for sex and age. Enhanced depth imaging optical coherence tomography in macula and peripapillary areas in both eyes was performed for evaluation of CT. The CT was measured in subfoveal and other six points of macula and four points of peripapillary areas with a 3.4-mm scan circle centered on the optic nerve head. RESULTS The mean subfoveal CT was 384.7 ± 101.6 μm, 380.5 ± 109 μm, and 401.2 ± 84.6 μm for affected eye, unaffected fellow eye, and healthy control, respectively. All measurements of macular CT were thinner in the patient group compared with healthy controls. Global peripapillary CT in affected eyes, unaffected fellow eyes, and healthy controls were 202 ± 43.3, 195.1 ± 42.9, and 234 ± 71.2, respectively. The difference between the three groups was statistically significant in the nasal point of peripapillary area (P = 0.023). No correlation was seen between CT and initial visual acuity or duration from symptom onset to medical survey in acute phase of retrobulbar optic neuritis. CONCLUSION Patients with acute retrobulbar optic neuritis showed no significantly thinner macular and peripapillary CT in both eyes compared with healthy controls.
Collapse
Affiliation(s)
- Alireza Dehghani
- Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Farzan Kianersi
- Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad-Hasan Alemzadeh-Ansari
- Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Mohammad-Hasan Alemzadeh-Ansari, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan 81488, Iran. E-mail:
| |
Collapse
|
|
22
|
Chen Z, Mo Y, Ouyang P, Shen H, Li D, Zhao R. Retinal vessel optical coherence tomography images for anemia screening. Med Biol Eng Comput 2018; 57:953-966. [PMID: 30506116 DOI: 10.1007/s11517-018-1927-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 10/31/2018] [Indexed: 11/27/2022]
Abstract
Anemia is a disease that leads to low oxygen carrying capacity in the blood. Early detection of anemia is critical for the diagnosis and treatment of blood diseases. We find that retinal vessel optical coherence tomography (OCT) images of patients with anemia have abnormal performance because the internal material of the vessel absorbs light. In this study, an automatic anemia screening method based on retinal vessel OCT images is proposed. The method consists of seven steps, namely, denoising, region of interest (ROI) extraction, layer segmentation, vessel segmentation, feature extraction, feature dimensionality reduction, and classification. We propose gradient and threshold algorithm for ROI extraction and improve region growing algorithm based on adaptive seed point for vessel segmentation. We also conduct a statistical analysis of the correlation between hemoglobin concentration and intravascular brightness and vascular shadow in OCT images before feature extraction. Eighteen statistical features and 118 texture features are extracted for classification. This study is the first to use retinal vessel OCT images for anemia screening. Experimental results demonstrate the accuracy of the proposed method is 0.8358, which indicates that the method has clinical potential for anemia screening. Graphical abstract.
Collapse
Affiliation(s)
- Zailiang Chen
- School of Information Science and Engineering, Central South University, Changsha, 410083, China
- Joint Laboratory of Mobile Health, Ministry of Education and China Mobile, Changsha, 410083, China
| | - Yufang Mo
- School of Information Science and Engineering, Central South University, Changsha, 410083, China
- Joint Laboratory of Mobile Health, Ministry of Education and China Mobile, Changsha, 410083, China
| | - Pingbo Ouyang
- School of Information Science and Engineering, Central South University, Changsha, 410083, China.
- The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
| | - Hailan Shen
- School of Information Science and Engineering, Central South University, Changsha, 410083, China.
| | - Dabao Li
- School of Information Science and Engineering, Central South University, Changsha, 410083, China
- Joint Laboratory of Mobile Health, Ministry of Education and China Mobile, Changsha, 410083, China
| | - Rongchang Zhao
- School of Information Science and Engineering, Central South University, Changsha, 410083, China
- Joint Laboratory of Mobile Health, Ministry of Education and China Mobile, Changsha, 410083, China
| |
Collapse
|
|
23
|
Abstract
When planning conservation therapy for choroidal melanoma (CM), evaluation of its size and stage is done using various methods of visualization, among which is optical coherence tomography (OCT). A recently introduced modification of OCT - Enhanced Depth Imaging (EDI) allows observation of deep choroid and sclera. PURPOSE To specify clinicomorphologic correlations between OCT signs related to CM and its pathomorphological state as described in literature. MATERIAL AND METHODS The study included 33 patients with predominantly small CM who were examined with EDI-OCT. RESULTS The following surface profiles were revealed: small and medium sized CM with even and uneven surface and with a plateau on the top; medium sized CM with flattened edge. Bruch's membrane (BM) had folds along the tumor edge in medium and big CM. In mushroom-shaped CM, extended defective areas could be observed. Increase of optical density in the inner parts of choroidal complex were seen over time. In CM of 2.9 mm and less, cavities were observed in the middle layers of choroid in the tumor area. In roughly half of the cases, vascular distention was seen in choroid in the tumor periphery. Changes of retinal pigment epithelium (RPE) included its thickening and presence of hyperreflective foci. In CM with prominence of more than 2.17 mm at the top, the changes included the formation of a 'single unitary block' at the level of BM/RPE and neurosensory retinal layers. Intraretinal cysts could be seen on top of the tumor at the level of outer retinal layers in CM with prominence of more than 1.5 mm. CONCLUSION Comparison of OCT images of CM with various biometric parameters with literature data on pathomorphological changes helped specify early pathomorphological symptoms in perifocal choroid (a feature of initial CM) and highly dynamic phasing of secondary changes in the retina.
Collapse
Affiliation(s)
- A S Stoyukhina
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - I V Musatkina
- S.P. Botkin Moscow City Clinical Hospital, Branch No. 1, Ophtalmooncology department, 7 Mamonovskiy Lane, Moscow, Russian Federation, 123001
| |
Collapse
|
|
24
|
Torabi H, Sadraei M, Jadidi K, Alishiri AA. Choroidal thickness changes following cataract surgery in patients with type 2 diabetes mellitus. J Curr Ophthalmol 2018; 31:49-54. [PMID: 30899846 PMCID: PMC6407067 DOI: 10.1016/j.joco.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/15/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the choroidal thickness changes after cataract surgery in type 2 diabetic patients. Methods Three groups of patients were enrolled into this prospective study. Group A included diabetic patients without diabetic retinopathy (DR) or with mild non-proliferative diabetic retinopathy (NPDR) who underwent phacoemulsification, Group B included non-diabetic patients with significant cataract who underwent phacoemulsification, and Group C included diabetic patients without DR or with mild NPDR who followed up without surgical procedure. Choroidal thickness in 5 points (subfoveal and 500 μ temporal, nasal, superior and inferior to the fovea) and central macular thickness were measured before surgery using enhanced depth spectral domain optical coherence tomography. Patients were re-evaluated 1 week, 1 month, and 3 months after operation and compared with the baseline values. Results In total, 63 eyes from 63 patients were enrolled to this study, including 21 eyes in Group A, 22 eyes in Group B, and 20 eyes in Group C. After three months of follow-up of the patients, choroidal thickness in all measured points was decreased significantly, and central macular thickness was increased significantly following cataract surgery in diabetic eyes (Ggroup A); meanwhile, both choroidal thickness and central macular thickness were increased significantly in non-diabetic eyes (Group B). In Group C, choroidal thickness and central macular thickness had no significant changes, after three months. Conclusion Unlike in non-diabetic eyes, choroidal thickness in diabetic patients decreased following cataract surgery.
Collapse
Affiliation(s)
- Hamidreza Torabi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadraei
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Khosrow Jadidi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali-Agha Alishiri
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
25
|
Benfica CZ, Zanella T, Farias LB, Oppermann MLR, Canani LHS, Lavinsky D. Macular choroidal thickness in pregnant women with type 1, type 2 and gestational diabetes mellitus measured by spectral-domain optical coherence tomography. Clin Ophthalmol 2018; 12:1259-1265. [PMID: 30050277 PMCID: PMC6055625 DOI: 10.2147/opth.s166620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Purpose To analyze choroidal thickness (CT) of pregnant women with type 1 diabetes mellitus (DM), type 2 DM and gestational diabetes mellitus (GDM) using spectral-domain optical coherence tomography. Patients and methods This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: 27 non-diabetic pregnant women; 15 pregnant women with GDM; 16 with type 2 DM and 14 with type 1 DM. CT was measured using optical coherence tomography at ten different locations. We also analyzed possible confounding factors, such as gestational age, glycosylated hemoglobin, time from DM diagnosis, hypertension and severity of diabetic retinopathy. Results The comparison between the four groups showed a thinner choroid in patients with type 1 DM in all locations, with statistical significance in subfoveal and temporal measurements. When comparing only patients with type 1 and type 2 DM, adjusting for confounding factors, the choroid of patients with type 1 DM remained thinner at all macular points, also with statistical significance in subfoveal and temporal measurements. Conclusion Pregnant women with type 1 DM had significantly thinner CT measurements on subfoveal and temporal locations. No differences were found in CT between the control group and pregnant women with GDM and type 2 DM.
Collapse
Affiliation(s)
- Camila Zanella Benfica
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
| | - Teresinha Zanella
- Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Brandolt Farias
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
| | - Maria Lúcia Rocha Oppermann
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luis Henrique Santos Canani
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
| |
Collapse
|
|
26
|
Jin WQ, Huang SH, Jiang J, Mao XJ, Shen MX, Lian Y. Short term effect of choroid thickness in the horizontal meridian detected by spectral domain optical coherence tomography in myopic children after orthokeratology. Int J Ophthalmol 2018; 11:991-996. [PMID: 29977813 DOI: 10.18240/ijo.2018.06.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/03/2018] [Indexed: 12/18/2022] Open
Abstract
AIM To investigate choroidal thickness changes in the horizontal meridian after orthokeratology. METHODS This is a prospective cross-sectional observed study. Subjects (n=30; 11.3±1.7y) with low-to-moderate myopia (-1.0 to -6.0 diopters), wore orthokeratology (Ortho-K) lenses for 3mo. Before and after Ortho-K, OCT scans were made through the fovea in the horizontal meridian. Choroid thickness around the fovea was acquired by custom software. The analyzed regions along the horizontal meridian were divided into 7 equal zones. Ocular parameters were measured by Lenstar LS 900 non-contact biometry. RESULTS Only the right eye ocular parameters were analyzed in this study. Before Ortho-K, choroidal thickness along the horizontal meridian was 273.7±31.8 µm in the temporal zone, 253.1±38.6 µm in the macula zone, and 194.8±52.2 µm in the nasal zone. After Ortho-K, the choroid was thicker in each horizontal zone (P<0.05). The increased thickness was greatest in the temporal zone (13.5±22.5 µm) and least in the nasal zone (8.4±14.2 µm). The axial length (AL) increased 0.02 mm (P>0.05). The choroid thickness change in each horizontal zone was negatively correlated with AL (r, -0.3 to -0.4; P<0.05) except one of the nasal zones. CONCLUSION In myopic children, the thickness of the choroid is greatest in the temporal zone and thinnest in the nasal zone. After nightly Ortho-K for 3mo, the thickness increase along the horizontal meridian. The choroid thickness changes are negatively correlated with the change of AL.
Collapse
Affiliation(s)
- Wan-Qing Jin
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Sheng-Hai Huang
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jun Jiang
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xin-Jie Mao
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Mei-Xiao Shen
- Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yan Lian
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| |
Collapse
|
|
27
|
Ulusoy MO, Kal A, Işik-Ulusoy S, Kal Ö. Choroidal thickness in patients with fibromyalgia and correlation with disease severity. Indian J Ophthalmol 2018; 66:428-432. [PMID: 29480257 PMCID: PMC5859601 DOI: 10.4103/ijo.ijo_877_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose: To evaluate and compare choroidal thickness in patients with fibromyalgia (FM) and healthy controls. Methods: In this prospective, cross-sectional study, forty eyes of 40 patients with FM and 40 eyes of 40 age- and sex-matched healthy subjects were enrolled. FM was diagnosed according to the American College of Rheumatology criteria. The choroidal thickness measurements of the subjects were obtained using spectral-domain optical coherence tomography (RTVue-100, Optovue). Widespread pain index (WPI), symptom severity scale (SSS), and fibromyalgia impact questionnaire (FIQ) scores were recorded. The choroidal thickness measurements of the groups were compared, and correlations among the WPI, SSS, and FIQ scores and these measurements were calculated. Results: Choroidal thicknesses at 1500 μm nasally were 198.5 ± 46.7 μm and 306.3 ± 85.4 μm; at 1000 μm nasally were 211.7 ± 50.2 μm and 310.05 ± 87.26 μm; at 500 μm nasally were 216 ± 55.05 μm and 311.5 ± 83.4 μm; at subfoveal region were 230.9 ± 58.4 μm and 332.4 ± 91.3 μm; at 500 μm temporally 227.5 ± 58.1 μm and 318.15 ± 92.3 μm; at 1000 μm temporally 224.5 ± 57.07 μm and 315.1 ± 84.2 μm; at 1500 μm temporally 212.5 ± 56.08 μm and 312.9 ± 87.8 μm in the FM and control groups, respectively (P < 0.001). Choroidal thicknesses were thinner at all measurement location, except temporal 1000 and 1500 in patients with FIQ score ≥50 than in FIQ score <50. Conclusion: The results of this study demonstrated that choroidal thickness decreases in patients with FM and correlated with disease activity. This choroidal changes might be related with the alterations in autonomic nervous system functioning. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and FM.
Collapse
Affiliation(s)
- Mahmut Oguz Ulusoy
- Department of Ophthalmology, School of Medicine, Baskent University, Konya Research Hospital, Konya, Turkey
| | - Ali Kal
- Department of Ophthalmology, School of Medicine, Baskent University, Konya Research Hospital, Konya, Turkey
| | - Selen Işik-Ulusoy
- Department of Psychiatry, School of Medicine, Baskent University, Konya Research Hospital, Konya, Turkey
| | - Öznur Kal
- Department of Internal Medicine, Nephrology, School of Medicine, Baskent University, Konya Research Hospital, Konya, Turkey
| |
Collapse
|
|
28
|
Chen Q, Niu S, Fang W, Shuai Y, Fan W, Yuan S, Liu Q. Automated choroid segmentation of three-dimensional SD-OCT images by incorporating EDI-OCT images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 158:161-171. [PMID: 29544782 DOI: 10.1016/j.cmpb.2017.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/28/2017] [Accepted: 11/03/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE The measurement of choroidal volume is more related with eye diseases than choroidal thickness, because the choroidal volume can reflect the diseases comprehensively. The purpose is to automatically segment choroid for three-dimensional (3D) spectral domain optical coherence tomography (SD-OCT) images. METHODS We present a novel choroid segmentation strategy for SD-OCT images by incorporating the enhanced depth imaging OCT (EDI-OCT) images. The down boundary of the choroid, namely choroid-sclera junction (CSJ), is almost invisible in SD-OCT images, while visible in EDI-OCT images. During the SD-OCT imaging, the EDI-OCT images can be generated for the same eye. Thus, we present an EDI-OCT-driven choroid segmentation method for SD-OCT images, where the choroid segmentation results of the EDI-OCT images are used to estimate the average choroidal thickness and to improve the construction of the CSJ feature space of the SD-OCT images. We also present a whole registration method between EDI-OCT and SD-OCT images based on retinal thickness and Bruch's Membrane (BM) position. The CSJ surface is obtained with a 3D graph search in the CSJ feature space. RESULTS Experimental results with 768 images (6 cubes, 128 B-scan images for each cube) from 2 healthy persons, 2 age-related macular degeneration (AMD) and 2 diabetic retinopathy (DR) patients, and 210 B-scan images from other 8 healthy persons and 21 patients demonstrate that our method can achieve high segmentation accuracy. The mean choroid volume difference and overlap ratio for 6 cubes between our proposed method and outlines drawn by experts were -1.96µm3 and 88.56%, respectively. CONCLUSIONS Our method is effective for the 3D choroid segmentation of SD-OCT images because the segmentation accuracy and stability are compared with the manual segmentation.
Collapse
Affiliation(s)
- Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu, China; Fujian Provincial Key Laboratory of Information Processing and Intelligent Control, Minjiang University, Fuzhou, 350121, China
| | - Sijie Niu
- School of Information Science and Engineering, University of Jinan, Jinan, 250022, China
| | - Wangyi Fang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanlu Shuai
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qinghuai Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
|
29
|
Bernucci MT, Merkle CW, Srinivasan VJ. Investigation of artifacts in retinal and choroidal OCT angiography with a contrast agent. BIOMEDICAL OPTICS EXPRESS 2018; 9:1020-1040. [PMID: 29541501 PMCID: PMC5846511 DOI: 10.1364/boe.9.001020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 05/18/2023]
Abstract
Optical coherence tomography angiography (OCTA) has recently emerged for imaging vasculature in clinical ophthalmology. Yet, OCTA images contain artifacts that remain challenging to interpret. To help explain these artifacts, we perform contrast-enhanced OCTA with a custom-designed wide-field ophthalmoscope in rats in vivo. We choose an intravascular contrast agent (Intralipid) with particles that are more isotropically scattering and more symmetrically shaped than red blood cells (RBCs). Then, by examining how OCTA artifacts change after contrast agent injection, we attribute OCTA artifacts to RBC-specific properties. In this work, we investigate retinal and choroidal OCTA in rats with or without melanosomes, both before and after contrast agent injection, at a wavelength at which scattering dominates the image contrast (1300 nm). First, baseline images suggest that high backscattering of choroidal melanosomes accounts for the relatively dark appearance of choroidal vessel lumens in OCTA. Second, Intralipid injection tends to eliminate the hourglass pattern artifact in OCTA images of vessel lumens and highlights vertical capillaries that were previously faint in OCTA, showing that RBC orientation is important in determining OCTA signal. Third, Intralipid injection increases lumen signal without significantly affecting the tails, suggesting that projection artifacts, or tails, are due to RBC multiple scattering. Fourth, Intralipid injection increases the side-to-top signal ratio less in choroidal vessel lumens of pigmented rats, suggesting that melanosome multiple scattering makes the hourglass artifact less prominent. This study provides the first direct experimental in vivo evidence to explain light scattering-related artifacts in OCTA.
Collapse
Affiliation(s)
- Marcel T. Bernucci
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Conrad W. Merkle
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Vivek J. Srinivasan
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
- Department of Ophthalmology and Vision Science, University of California Davis School of Medicine, Sacramento, California, USA
| |
Collapse
|
|
30
|
Hussain MA, Bhuiyan A, Ishikawa H, Theodore Smith R, Schuman JS, Kotagiri R. An automated method for choroidal thickness measurement from Enhanced Depth Imaging Optical Coherence Tomography images. Comput Med Imaging Graph 2018; 63:41-51. [PMID: 29366655 DOI: 10.1016/j.compmedimag.2018.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/01/2018] [Accepted: 01/03/2018] [Indexed: 11/24/2022]
Abstract
The choroid is vascular tissue located underneath the retina and supplies oxygen to the outer retina; any damage to this tissue can be a precursor to retinal diseases. This paper presents an automated method of choroidal segmentation from Enhanced Depth Imaging Optical Coherence Tomography (EDI-OCT) images. The Dijkstra shortest path algorithm is used to segment the choroid-sclera interface (CSI), the outermost border of the choroid. A novel intensity-normalisation technique that is based on the depth of the choroid is used to equalise the intensity of all non-vessel pixels in the choroid region. The outer boundary of choroidal vessel and CSI are determined approximately and incorporated to the edge weight of the CSI segmentation to choose optimal edge weights. This method is tested on 190 B-scans of 10 subjects against choroid thickness (CTh) results produced manually by two graders. For comparison, results obtained by two state-of-the-art automated methods and our proposed method are compared against the manual grading, and our proposed method performed the best. The mean root-mean-square error (RMSE) for finding the CSI boundary by our method is 7.71±6.29 pixels, which is significantly lower than the RMSE for the two other state-of-the-art methods (36.17±11.97 pixels and 44.19±19.51 pixels). The correlation coefficient for our method is 0.76, and 0.51 and 0.66 for the other two state-of-the-art methods. The interclass correlation coefficients are 0.72, 0.43 and 0.56 respectively. Our method is highly accurate, robust, reliable and consistent. This identification can enable to quantify the biomarkers of the choroidin large scale study for assessing, monitoring disease progression as well as early detection of retinal diseases. Identification of the boundary can help to determine the loss or change of choroid, which can be used as features for the automatic determination of the stages of retinal diseases.
Collapse
Affiliation(s)
- Md Akter Hussain
- Department of Computing and Information Systems, The University of Melbourne, Australia.
| | | | | | | | | | - Ramamohanrao Kotagiri
- Department of Computing and Information Systems, The University of Melbourne, Australia
| |
Collapse
|
|
31
|
Koh LHL, Agrawal R, Khandelwal N, Sai Charan L, Chhablani J. Choroidal vascular changes in age-related macular degeneration. Acta Ophthalmol 2017; 95:e597-e601. [PMID: 28391615 DOI: 10.1111/aos.13399] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 12/19/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE To assess the choroidal vascular changes using choroidal vascularity index (CVI) in patients with age-related macular degeneration (AMD) compared to controls. METHODS Enhanced depth imaging (EDI) optical coherence tomography (OCT) scans of 64 patients with unilateral or bilateral AMD were obtained. Images with a poorly demarcated choroidal-scleral interface (CSI) were excluded from the analysis. Foveal scans of 63 AMD eyes and 35 'normal fellow' eyes were analysed. Images of 30 eyes from 18 age-matched healthy subjects were included as controls. Choroidal vascularity index (CVI) was derived from binarization of EDI OCT images, using fiji software. RESULTS The mean age was 56.50 ± 5.50 years for AMD patients and 52.25 ± 6.75 years for controls. All patients were treatment naïve. Subfoveal choroidal thickness (SFCT) in AMD, 'normal fellow' eyes and controls was 314.02 ± 78.80 μm, 300.88 ± 53.85 μm and 278.5 ± 65.31 μm, respectively. Choroidal vascularity index (CVI) in AMD, 'normal fellow' eyes and controls was 64.04 ± 2.43%, 64.66 ± 2.25% and 66.07 ± 1.72%, respectively. Choroidal vascularity index (CVI) of both AMD and 'normal fellow' eyes was significantly lower compared to controls (p < 0.0001 and p = 0.007). The SFCT of AMD eye was not found to be significantly different from 'normal fellow eyes' (p = 0.45). CONCLUSION There was no statistical difference in SFCT, but CVI was significantly lower in patients with AMD. Choroidal vascularity index (CVI) was also lower in 'normal fellow' AMD eyes as compared to controls. This suggests possible reduction in choroidal vascularity in eyes with AMD and also to a certain extent in the 'normal fellow' eyes without phenotypical manifestations and may suggest underlying choroidal morphological change leading to wet AMD.
Collapse
Affiliation(s)
- Lilian Hui Li Koh
- National Healthcare Group Eye Institute; Tan Tock Seng Hospital; Singapore Singapore
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute; Tan Tock Seng Hospital; Singapore Singapore
| | - Neha Khandelwal
- National Healthcare Group Eye Institute; Tan Tock Seng Hospital; Singapore Singapore
| | - Labishetty Sai Charan
- National Healthcare Group Eye Institute; Tan Tock Seng Hospital; Singapore Singapore
| | | |
Collapse
|
|
32
|
Mahendradas P, Madhu S, Kawali A, Roy AS, Vala R, Vinekar A, Shetty R. Enhanced Vitreous Imaging in Uveitis. Ocul Immunol Inflamm 2017; 27:148-154. [DOI: 10.1080/09273948.2017.1360501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
|
33
|
Analysis of choroidal thickness in ocular hypertensive patients using enhanced depth imaging optical coherence tomography. Lasers Med Sci 2017; 33:111-121. [PMID: 29027026 DOI: 10.1007/s10103-017-2349-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 10/01/2017] [Indexed: 12/27/2022]
Abstract
This study aimed to compare choroidal thickness between subjects with ocular hypertension (OHT) and normal individuals and explore factors affecting choroidal thickness. This study included 60 untreated newly diagnosed OHT eyes and 60 normal eyes. Choroidal thickness obtained from Cirrus HD-OCT was measured at different locations in the macular and peripapillary regions and compared between the two groups before and after adjusting for potential confounding variables. Regression analysis was performed to figure out factors influencing choroidal thickness. The macular choroidal thickness did not vary significantly between OHT patients and normal controls regardless of locations (all P > 0.05). The average peripapillary choroidal thickness was 167 ± 53 μm in OHT eyes and 185 ± 63 μm in the normal eyes; no significant differences were identified (P = 0.107). Only one of the locations in the temporal area in the OHT group demonstrated significantly thinner peripapillary choroidal thickness as compared to the normal group (P = 0.033). Age was the only significant factor affecting choroidal thickness on multivariate analysis regardless of locations (all P < 0.001). Choroidal thickness of the macular and peripapillary regions in OHT patients is not decreased significantly except one location in the temporal area of the optic disc when comparing with the normal subjects. Anatomic peripapillary choroidal thickness measurements with SD-OCT might be one more tool to track changes in OHT patients.
Collapse
|
|
34
|
Ishihara M, Shibuya E, Tanaka S, Mizuki N. Diagnostic and therapeutic evaluation of multiple choroidal granulomas in a patient with confirmed sarcoidosis using enhanced depth imaging optical coherence tomography. Int Ophthalmol 2017; 38:2603-2608. [PMID: 28983716 DOI: 10.1007/s10792-017-0720-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/26/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Sarcoidosis is a major cause of granulomatous uveitis but rarely manifests as multiple choroidal granulomas. This report describes the use of enhanced depth imaging optical coherence tomography (EDI-OCT) to visualize changes occurring in multiple choroidal granulomas during treatment. METHODS The patient was a 36-year-old Japanese man with histopathologically confirmed sarcoidosis, who was examined using EDI-OCT and showed multiple yellowish-white subretinal lesions in the peripapillary region and the arcade of the right eye. RESULTS EDI-OCT revealed homogeneous hyporeflective choroidal lesions with choriocapillaris thinning, consistent with a diagnosis of choroidal granulomas. Subretinal fluid adjacent to one of the peripapillary choroidal lesions was also apparent. EDI-OCT during oral prednisolone administration revealed a decrease in lesion size at as early as 3 weeks and complete resolution of the lesions after 6 months of treatment. However, 2 months after prednisolone discontinuation, EDI-OCT revealed recurrence of choroidal granulomas in the peripapillary region and the arcade of the right eye. After injection of triamcinolone acetonide into the posterior sub-Tenon's capsule (sub-Tenon's injection), EDI-OCT demonstrated a reduction in granuloma lesion size within 3 months of the injection. CONCLUSION EDI-OCT allowed detailed morphologic visualization of the choroidal granulomas caused by sarcoidosis. This imaging technique was useful for monitoring changes in granuloma size in response to steroid administration and for early detection of recurrence. Injection of triamcinolone acetonide into the posterior sub-Tenon's capsule was as effective as oral prednisolone for the treatment of choroidal granulomas.
Collapse
Affiliation(s)
- Mami Ishihara
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, 236-0004, Japan.
| | - Etsuko Shibuya
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, 236-0004, Japan
| | - Shin Tanaka
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, 236-0004, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, 236-0004, Japan
| |
Collapse
|
|
35
|
Jaisankar D, Raman R, Sharma HR, Khandelwal N, Bhende M, Agrawal R, Sridharan S, Biswas J. Choroidal and Retinal Anatomical Responses Following Systemic Corticosteroid Therapy in Vogt-Koyanagi-Harada Disease Using Swept-Source Optical Coherence Tomography. Ocul Immunol Inflamm 2017; 27:235-243. [PMID: 28700251 DOI: 10.1080/09273948.2017.1332231] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess structural changes in retina and choroid after systemic corticosteroid therapy in Vogt-Koyanagi-Harada (VKH) disease using swept-source optical coherence tomography (SS-OCT). METHODS SS-OCT was conducted before treatment and during first-month follow-up in 16 eyes treated with systemic corticosteroids for active VKH. Retina was divided into five zones depending on pretreatment choroidal thickness (CT) of <100, >100 to <200, >200 to <300, >300 to <400 and >400μm, and changes in retinal thickness and CT after treatment in these zones were compared with baseline. RESULTS Mean CT significantly improved from 83.1±8.75 to 156.4±62.73μm(p = 0.008) in the zone with pre-CT <100μm and significantly decreased from 336.1 ± 17.28 to 266.28 ± 81.39μm(p = 0.008) in the zone with pre-CT > 300μm. CONCLUSIONS We have shown choroidal remodeling in VKH. SS-OCT can serve as an important noninvasive tool in assessment of treatment response in patients with VKH disease.
Collapse
Affiliation(s)
- Durgasri Jaisankar
- a Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya , Chennai , Tamil Nadu , India
| | - Rajiv Raman
- a Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya , Chennai , Tamil Nadu , India
| | - Hitesh R Sharma
- b Department of Uvea , Sankara Nethralaya , Chennai , Tamil Nadu , India
| | - Neha Khandelwal
- c National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore
| | - Muna Bhende
- a Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya , Chennai , Tamil Nadu , India
| | - Rupesh Agrawal
- c National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore
| | | | - Jyotirmay Biswas
- b Department of Uvea , Sankara Nethralaya , Chennai , Tamil Nadu , India
| |
Collapse
|
|
36
|
Afonso JM, Falcão M, Schlichtenbrede F, Falcão-Reis F, Silva SE, Schneider TM. Spectral Domain-Optical Coherence Tomography As a New Diagnostic Marker for Idiopathic Normal Pressure Hydrocephalus. Front Neurol 2017; 8:172. [PMID: 28507532 PMCID: PMC5410594 DOI: 10.3389/fneur.2017.00172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 04/12/2017] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Characterized by a progressive onset of gait disturbances, dementia, and urinary incontinence, idiopathic normal pressure hydrocephalus (iNPH) is considered a rare, but under-diagnosed disease. Non-invasive diagnostic markers are still insufficient to enable the diagnosis of iNPH with certainty and yet early treatment with ventriculoperitoneal (VP) shunting can reverse symptoms and stop disease progression. Vascular circulation abnormalities in iNPH may be reflected by changes in subfoveal and peripapillary choroidal thickness (PPChT). This study uses spectral domain-optical coherence tomography (SD-OCT)-based measures of retinal and choroidal thickness to test this hypothesis and to assess ophthalmological non-invasive markers for iNPH. METHODS Twelve patients who displayed neurological and neuroradiological characteristics of iNPH were subject to a full ophthalmological examination including enhanced depth imaging (EDI) SD-OCT. Of the 12 included iNPH patients, 6 had undergone VP shunting with beneficial outcome. Parameters studied with EDI SD-OCT were macular retinal thickness (MT), subfoveal choroidal thickness (SFChT), retinal nerve fiber layer thickness (RNFL), and PPChT. Results were compared with 13 healthy, age-matched controls. RESULTS Macular thickness and RNFL and MT values of iNPH patients did not reflect atrophy. Non-shunted iNPH patients showed significantly lowered median PPChT and SFChT values compared to healthy controls. Shunted iNPH patients displayed a significantly higher median PPChT and SFChT compared to non-shunted iNPH patients. SFChT and PPChT values in shunted patients were not significantly different to values in healthy controls. CONCLUSION Although limited by small sample size, SD-OCT measures in this study reveal significant changes of choroidal thickness and support the hypothesis of choroidal susceptibility to hemodynamic alterations in iNPH. Non-shunted iNPH patients in this study show choroidal thinning in combination with normal RNFL and MT values. In addition to neurological and neuroradiological exams, this pattern may aid in the challenging diagnosis of iNPH.
Collapse
Affiliation(s)
- Joana M Afonso
- Department of Ophthalmology, São João University Hospital, Porto, Portugal.,Department of Ophthalmology, University Hospital Mannheim, Mannheim, Germany
| | - Manuel Falcão
- Department of Ophthalmology, São João University Hospital, Porto, Portugal.,Faculty of Medicine, Department of Sense Organs, University of Porto, Porto, Portugal
| | | | - Fernando Falcão-Reis
- Department of Ophthalmology, São João University Hospital, Porto, Portugal.,Faculty of Medicine, Department of Sense Organs, University of Porto, Porto, Portugal
| | | | - Till M Schneider
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
|
37
|
Islam QU, Farooq MA, Mehboob MA. Factors affecting the visual outcome in acute central serous chorioretinopathy. Pak J Med Sci 2017; 33:3-7. [PMID: 28367162 PMCID: PMC5368324 DOI: 10.12669/pjms.331.11664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: To determine the visual outcome in patients with acute Central serous chorioretinopathy (CSCR) and to analyze the association of clinical, angiographic and tomographic factors with final visual outcome in Pakistani population. Methods: This study was conducted at AFIO Rawalpindi and PNS Shifa Naval hospital Karachi from November 2011 to August 2016. Fifty five eyes of 53 patients with acute CSCR were included. All patients underwent a detailed ophthalmic examination including SD OCT imaging at baseline, One month and three month and FFA was performed at baseline. Primary outcome measures were measurement of initial and final BCVA and CFT. SPSS 13.0 was used for the analysis of data. Results: Mean age of study population was 36.66 ± 6.24 years. On OCT mean CFT at baseline was 467.49 ± 144.80 µm in affected eye, whereas mean CFT measurements at final follow up was 244.67 ± 32.99 µm (p <0.01). Presenting mean log MAR BCVA was 0.47 ± 0.25 and final mean log MAR BCVA was 0.18 ± 0.14 (p <0.01). Baseline BCVA showed statistically significant association with final BCVA (p=0.03). Conclusion: Presenting VA of 6/12 or better is associated with favorable visual outcome in patients with acute CSCR.
Collapse
Affiliation(s)
- Qamar Ul Islam
- Dr. Qamar Ul Islam, FCPS (Ophthalmology), FCPS (VRO). Department of Ophthalmology, PNS Shifa Hospital, Karachi
| | | | - Mohammad Asim Mehboob
- Dr. Mohammad Asim Mehboob, MBBS. Department of Ophthalmology, PNS Shifa Hospital, Karachi
| |
Collapse
|
|
38
|
Wang C, Wang YX, Li Y. Automatic Choroidal Layer Segmentation Using Markov Random Field and Level Set Method. IEEE J Biomed Health Inform 2017; 21:1694-1702. [PMID: 28333647 DOI: 10.1109/jbhi.2017.2675382] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The choroid is an important vascular layer that supplies oxygen and nourishment to the retina. The changes in thickness of the choroid have been hypothesized to relate to a number of retinal diseases in the pathophysiology. In this paper, an automatic method is proposed for segmenting the choroidal layer from macular images by using the level set framework. The three-dimensional nonlinear anisotropic diffusion filter is used to remove all the optical coherence tomography (OCT) imaging artifacts including the speckle noise and to enhance the contrast. The distance regularization and edge constraint terms are embedded into the level set method to avoid the irregular and small regions and keep information about the boundary between the choroid and sclera. Besides, the Markov random field method models the region term into the framework by correlating the single-pixel likelihood function with neighborhood information to compensate for the inhomogeneous texture and avoid the leakage due to the shadows cast by the blood vessels during imaging process. The effectiveness of this method is demonstrated by comparing against other segmentation methods on a dataset with manually labeled ground truth. The results show that our method can successfully and accurately estimate the posterior choroidal boundary.
Collapse
|
|
39
|
Grosor coroideo central en sujetos hispanos sanos medido por tomografía de coherencia óptica con imagen de profundidad mejorada. REVISTA MEXICANA DE OFTALMOLOGÍA 2017. [DOI: 10.1016/j.mexoft.2016.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
|
40
|
Huynh E, Chandrasekera E, Bukowska D, McLenachan S, Mackey DA, Chen FK. Past, Present, and Future Concepts of the Choroidal Scleral Interface Morphology on Optical Coherence Tomography. Asia Pac J Ophthalmol (Phila) 2017; 6:94-103. [PMID: 28161920 DOI: 10.22608/apo.201698] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/23/2016] [Indexed: 11/08/2022] Open
Abstract
The choroid is the most vascular tissue in the eye and it has been implicated in the pathophysiology of a variety of ocular diseases. A new era of research in the choroid began with the improved ability to visualize this layer and its inner and outer boundaries using spectral domain optical coherence tomography (OCT) with enhanced depth imaging and swept source OCT. The accuracy and precision of qualitative and quan-titative assessments of the choroidal layer support the potential use of OCT-derived choroidal parameters for diagnosis, monitoring of disease progression, planning surgical access, and evaluating treatment response. Although there is increasing interest in measuring choroidal thickness, there is currently no consensus nomenclature to classify choroidal layers and boundaries. Furthermore, the definition and description of the choroidal scleral interface is inconsistent in the literature, contributing to interstudy variation in choroidal thickness measurements. The purpose of this review is to provide an overview of the literature on the definition of choroidal layers and choroidal scleral boundary, review the discrepan-cies, and harmonize the terminology so that a consensus nomenclature can be proposed.
Collapse
Affiliation(s)
- Emily Huynh
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, Perth, Australia
| | - Erandi Chandrasekera
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Save Sight Institute, University of Sydney, Sydney, Australia
- Sir Charles Gairdner Hospital, Perth, Australia
| | - Danuta Bukowska
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, Perth, Australia
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, Perth, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, Perth, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, Perth, Australia
- Royal Perth Hospital, Perth, Australia
| |
Collapse
|
|
41
|
Chen Q, Niu S, Yuan S, Fan W, Liu Q. Choroidal vasculature characteristics based choroid segmentation for enhanced depth imaging optical coherence tomography images. Med Phys 2016; 43:1649. [PMID: 27036564 DOI: 10.1118/1.4943382] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In clinical research, it is important to measure choroidal thickness when eyes are affected by various diseases. The main purpose is to automatically segment choroid for enhanced depth imaging optical coherence tomography (EDI-OCT) images with five B-scans averaging. METHODS The authors present an automated choroid segmentation method based on choroidal vasculature characteristics for EDI-OCT images with five B-scans averaging. By considering the large vascular of the Haller's layer neighbor with the choroid-sclera junction (CSJ), the authors measured the intensity ascending distance and a maximum intensity image in the axial direction from a smoothed and normalized EDI-OCT image. Then, based on generated choroidal vessel image, the authors constructed the CSJ cost and constrain the CSJ search neighborhood. Finally, graph search with smooth constraints was utilized to obtain the CSJ boundary. RESULTS Experimental results with 49 images from 10 eyes in 8 normal persons and 270 images from 57 eyes in 44 patients with several stages of diabetic retinopathy and age-related macular degeneration demonstrate that the proposed method can accurately segment the choroid of EDI-OCT images with five B-scans averaging. The mean choroid thickness difference and overlap ratio between the authors' proposed method and manual segmentation drawn by experts were -11.43 μm and 86.29%, respectively. CONCLUSIONS Good performance was achieved for normal and pathologic eyes, which proves that the authors' method is effective for the automated choroid segmentation of the EDI-OCT images with five B-scans averaging.
Collapse
Affiliation(s)
- Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Sijie Niu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Qinghuai Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| |
Collapse
|
|
42
|
Lavinsky F, Lavinsky D. Novel perspectives on swept-source optical coherence tomography. Int J Retina Vitreous 2016; 2:25. [PMID: 27847643 PMCID: PMC5088466 DOI: 10.1186/s40942-016-0050-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 10/04/2016] [Indexed: 01/20/2023] Open
Abstract
Technologies for multimodal digital imaging of vitreoretinal diseases have improved the accuracy of diagnosis and the depth of the knowledge of the mechanisms of disease and their response to treatments. Optic coherence tomography (OCT) has become a mandatory tool for the management and for the follow-up of retinal pathologies. OCT technology evolved in the last two decades from time-domain to spectral domain and recently to the swept-source OCTs (SS-OCT). SS-OCT improved the depth of imaging and the scan speed, thus adding novel algorithms and features such as for vitreous and vitreoretinal interface evaluation, choroid segmentation and mapping, OCT angiography and En-face OCT. The multimodal approach using SS-OCT is expected to advance the understanding of retinal pathologies such as age related macular degeneration, diabetic maculopathy, central serous chorioretinopathy, the pachychoroid spectrum and macular telangiectasia. Surgical vitreoretinal diseases such as vitreo-macular traction syndrome, epiretinal membrane, retinal detachment, proliferative vitreoretinal retinopathy and diabetic traction retinal detachment also will be better understood and documented with SS-OCT. This technology also provides great utility for a broad spectrum of ophthalmic pathologies including glaucoma, uveitis, tumors and anterior segment evaluation.
Collapse
Affiliation(s)
- Fabio Lavinsky
- Department of Ophthalmology, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Ophthalmology, Instituto de Oftalmologia Lavinsky, Rua Quintino Bocaiuva 673, Porto Alegre, RS 90410-140 Brazil
| | - Daniel Lavinsky
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
|
43
|
Legocki AT, Adhi M, Weber ML, Duker JS. Choroidal Morphology and Vascular Analysis in Eyes With Neovascular Age-Related Macular Degeneration Using Spectral-Domain Optical Coherence Tomography. Ophthalmic Surg Lasers Imaging Retina 2016; 47:618-25. [DOI: 10.3928/23258160-20160707-02] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/22/2016] [Indexed: 01/15/2023]
|
|
44
|
Kume A, Ohshiro T, Sakurada Y, Kikushima W, Yoneyama S, Kashiwagi K. Treatment Patterns and Health Care Costs for Age-Related Macular Degeneration in Japan. Ophthalmology 2016; 123:1263-8. [DOI: 10.1016/j.ophtha.2016.01.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/21/2016] [Accepted: 01/27/2016] [Indexed: 11/28/2022] Open
|
|
45
|
Peripapillary Choroidal Thickness and Open-Angle Glaucoma: A Meta-Analysis. J Ophthalmol 2016; 2016:5484568. [PMID: 27298732 PMCID: PMC4889846 DOI: 10.1155/2016/5484568] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 04/21/2016] [Indexed: 01/11/2023] Open
Abstract
Purpose. To investigate the potential relationship between open-angle glaucoma (OAG) and peripapillary choroidal thickness (PPCT). Materials and Methods. Relevant publications were searched systematically through various databases from inception to January 2016. Studies comparing PPCT in OAG patients and healthy controls were retrieved. All qualified articles were analyzed using Stata 14.0 and Revman 5.3 software. Results. A total of 13 studies were identified for inclusion. There was a significant reduction of average PPCT in OAG patients compared to control participants (WMD = −24.07, 95% CI: −34.29, −13.85). Reduction of PPCT was significant in the superior (WMD = −28.87, 95% CI: −44.96, −12.78) and nasal (WMD = −21.75, 95% CI: −41.52, −1.98) sectors, but there was no significant reduction of PPCT in the inferior (WMD = −9.57, 95% CI: −36.55, 17.40) and temporal (WMD = −13.85, 95% CI: −35.40, 7.70) sectors. No obvious publication bias was detected. Conclusions. This meta-analysis suggests that open-angle glaucoma patients have significantly decreased peripapillary choroidal thickness compared to healthy individuals. Peripapillary choroidal thickness measured by optical coherence tomography may be an important parameter to consider in open-angle glaucoma.
Collapse
|
|
46
|
Coban-Karatas M, Altan-Yaycioglu R, Ulas B, Sizmaz S, Canan H, Sariturk C. Choroidal thickness measurements with optical coherence tomography in branch retinal vein occlusion. Int J Ophthalmol 2016; 9:725-9. [PMID: 27275430 DOI: 10.18240/ijo.2016.05.16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 08/20/2015] [Indexed: 01/07/2023] Open
Abstract
AIM To evaluate central macular thickness (CMT) and mean choroidal thickness (MCT) in eyes with branch retinal vein occlusion (BRVO), before and after ranibizumab treatment using spectral domain-optical coherence tomography (SD-OCT). METHODS Forty-two patients with unilateral BRVO and macular edema were included in this study. There were 25 men and 17 women. Using SD-OCT, choroidal thickness was measured at 500 µm intervals up to 1500 µm temporal and nasal to the fovea. MCT was calculated based on the average of the 7 locations. All the eyes with BRVO were treated with intravitreal ranibizumab (0.5 mg/0.05 mL). Comparisons between the BRVO and fellow eyes were analyzed using Mann-Whitney U test. Pre-injection and post-injection measurements were analyzed using Wilcoxon test and repeated measure analysis. RESULTS At baseline, there was a significant difference between the BRVO and fellow eyes in MCT [BRVO eyes 245 (165-330) µm, fellow eyes 229 (157-327) µm] and CMT [BRVO eyes 463 (266-899) µm, fellow eyes 235 (148-378) µm (P=0.041, 0.0001, respectively)]. Following treatment, CMT [295 (141-558) µm] and MCT [229 (157-329) µm] decreased significantly compared to the baseline measurements (P=0.001, 0.006, respectively). Also BCVA (logMAR) improved significantly (P=0.0001) in the BRVO eyes following treatment. After treatment CMT [BRVO eyes 295 (141-558) µm, fellow eyes 234 (157-351) µm] and MCT [BRVO eyes 229 (157-329) µm, fellow eyes 233 (162-286) µm] values did not reveal any significant difference in BRVO eyes and fellow eyes (P=0.051, 0.824, respectively). CONCLUSION In eyes with BRVO, CMT and MCT values are greater than the fellow eyes, and decrease significantly following ranibizumab injection.
Collapse
Affiliation(s)
- Muge Coban-Karatas
- Department of Ophthalmology, Baskent University School of Medicine, Adana 01250, Turkey
| | - Rana Altan-Yaycioglu
- Department of Ophthalmology, Baskent University School of Medicine, Adana 01250, Turkey
| | - Burak Ulas
- Department of Ophthalmology, Baskent University School of Medicine, Adana 01250, Turkey
| | - Selcuk Sizmaz
- Department of Ophthalmology, Cukurova University School of Medicine, Adana 01330, Turkey
| | - Handan Canan
- Department of Ophthalmology, Baskent University School of Medicine, Adana 01250, Turkey
| | - Cagla Sariturk
- Division of Biostatistics, Baskent University Adana Clinic and Research Center, Adana 01250, Turkey
| |
Collapse
|
|
47
|
Jaki Mekjavic P, Lenassi E, Eiken O, Mekjavic IB. Effect of acute hypercapnia during 10-day hypoxic bed rest on posterior eye structures. J Appl Physiol (1985) 2016; 120:1241-8. [DOI: 10.1152/japplphysiol.00930.2015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/22/2016] [Indexed: 01/31/2023] Open
Abstract
To gain insights into microgravity-induced ophthalmic changes (microgravity ocular syndrome), and as part of a project investigating effects of future planetary habitats, we investigated the effect of acute hypercapnia following 10-day bed rest and hypoxia on posterior eye structures. Female subjects ( N = 7) completed three 10-day experimental interventions: 1) normoxic bed rest [NBR; partial pressure of inspired O2 (PiO2) = 132.9 ± 0.3 Torr]; 2) hypoxic ambulatory confinement (HAMB; PiO2 = 90.4 ± 0.3 Torr); and 3) hypoxic bed rest (HBR; n = 12; PiO2 = 90.4 ± 0.3 Torr). Before and on the last day of each intervention, optical coherence tomography (OCT) of the optic disk was performed, and the thicknesses of the retinal nerve fiber layer (RNFL), retina, and choroid were measured. OCT examinations were conducted with the subjects breathing the prevailing normocapnic breathing mixture (either normoxic or hypoxic) and then following a 10-min period of breathing the same gas mixture, but with the addition of 1% CO2. Choroidal thickness was greater during both bed-rest conditions (NBR and HBR) compared with the ambulatory (HAMB) condition (ANOVA, P < 0.001). Increases in RNFL thickness compared with baseline were observed in the hypoxic trials (HBR, P < 0.001; and HAMB, P = 0.021), but not the normoxic trial (NBR). A further increase in RNFL thickness ( P = 0.019) was observed after the 10-min hypercapnic trial in the NBR condition only. The fact that choroidal thickness was not affected by Po2 or Pco2, but increased by bed rest, suggests a hydrostatic rather than a vasoactive effect. The increments in RNFL thickness were most likely associated with local hypoxia and hypercapnia-induced dilatation of the retinal blood vessels.
Collapse
Affiliation(s)
| | - Eva Lenassi
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ola Eiken
- Department of Environmental Physiology, Swedish Aerospace Physiology Centre, Royal Institute of Technology, Stockholm, Sweden; and
| | - Igor B. Mekjavic
- Department of Automation, Biocybernetics and Robotics, Ljubljana, Slovenia
| |
Collapse
|
|
48
|
Novais EA, Badaró E, Allemann N, Morales MSÁ, Rodrigues EB, de Souza Lima R, Regatieri CVS, Belfort R. Correlation Between Choroidal Thickness and Ciliary Artery Blood Flow Velocity in Normal Subjects. Ophthalmic Surg Lasers Imaging Retina 2016; 46:920-4. [PMID: 26469231 DOI: 10.3928/23258160-20151008-04] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 08/13/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To study the correlation between the choroidal thickness (CT) measured by spectral-domain optical coherence tomography (SD-OCT) and retrobulbar blood flow measured by color Doppler flowmetry (CD) in normal subjects. PATIENTS AND METHODS Healthy subjects underwent enhanced-depth imaging SD-OCT and CD using a linear 6 MHz to 18 MHz transducer. The maximal peak systolic velocity and resistance index (RI) were obtained for the ophthalmic artery (OA), short posterior ciliary artery (SPCA), and central retinal artery (CRA) and correlated with the subfoveal CT measured by SD-OCT. RESULTS Twenty-seven eyes of 27 healthy patients were enrolled (mean age: 40.6 ± 12.4 years; range: 27-68 years). An inverse proportional relationship (P = .0496) was identified between the RI of the SPCA (mean, 0.6117 ± 0.07911) and the subfoveal CT (319.9 µm ± 83.79 µm) but not between the RI and the OA (mean: 0.7019 µm ± 0.07317 µm) or the CRA (mean: 0.68843 µm ± 0.08994 µm). CONCLUSION The results of this study suggested there is an inverse proportional relationship between the RI of the SPCA and the subfoveal CT. The data also suggested a correlation between a decrease in the CT and increased RI in the retrobulbar arteries. Therefore, lower choroidal blood flow may explain the thinner CT in normal subjects.
Collapse
|
|
49
|
Diabetic retinal pigment epitheliopathy: fundus autofluorescence and spectral-domain optical coherence tomography findings. Graefes Arch Clin Exp Ophthalmol 2016; 254:1931-1940. [DOI: 10.1007/s00417-016-3336-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/19/2016] [Accepted: 03/28/2016] [Indexed: 11/26/2022] Open
|
|
50
|
The Relationship Between Choroidal Expansion and Intraocular Pressure Rise During the Water Drinking Test in Healthy Subjects and Patients With Exfoliation Syndrome. J Glaucoma 2016; 25:e324-8. [PMID: 26035419 DOI: 10.1097/ijg.0000000000000283] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|