OCT, Optical coherence tomography

OCT,光学相干层析成像
  • 文章类型: Journal Article
    经皮冠状动脉介入治疗已成为冠心病患者的标准治疗策略,技术和技术不断进步。特别是人工智能和深度学习的应用目前正在推动介入解决方案的发展,提高诊断和治疗的效率和客观性。不断增长的数据量和计算能力以及尖端算法为将深度学习整合到临床实践中铺平了道路。彻底改变了成像处理中的介入工作流程,解释,和导航。这篇综述讨论了深度学习算法的发展及其相应的评估指标,以及它们的临床应用。先进的深度学习算法为高度自动化的精确诊断和定制治疗创造了新的机会,减少辐射,并加强风险分层。概括,可解释性,和监管问题仍然是需要通过多学科社区的共同努力来解决的挑战。
    Percutaneous coronary intervention has been a standard treatment strategy for patients with coronary artery disease with continuous ebullient progress in technology and techniques. The application of artificial intelligence and deep learning in particular is currently boosting the development of interventional solutions, improving the efficiency and objectivity of diagnosis and treatment. The ever-growing amount of data and computing power together with cutting-edge algorithms pave the way for the integration of deep learning into clinical practice, which has revolutionized the interventional workflow in imaging processing, interpretation, and navigation. This review discusses the development of deep learning algorithms and their corresponding evaluation metrics together with their clinical applications. Advanced deep learning algorithms create new opportunities for precise diagnosis and tailored treatment with a high degree of automation, reduced radiation, and enhanced risk stratification. Generalization, interpretability, and regulatory issues are remaining challenges that need to be addressed through joint efforts from multidisciplinary community.
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  • 文章类型: Journal Article
    UNASSIGNED:研究使用光学相干断层扫描(OCT)作为评估釉质中一般和局部低矿化缺陷的工具。
    未经授权:十颗拔除的恒牙(四颗具有局部低矿化的牙齿,四颗牙齿一般低矿化,和两个健康对照)用于本研究。此外,4例接受OCT检查的参与者作为拔牙的生活对照.
    UNASSIGNED:将OCT结果与临床照片进行比较,数字射线照片,和牙齿切片的偏振显微镜图像(被认为是黄金标准),以确定具有关于釉质干扰程度的最准确信息的方法:1)釉质干扰的可见性(可见是/否);如果是,2)牙釉质的干扰程度;和3)确定潜在牙本质的合理参与。
    UNASSIGNED:OCT比数字X线摄影和视觉评估更准确。OCT可以提供有关牙釉质局部低矿化紊乱程度的信息,该信息与牙齿切片的偏振显微镜相当。
    未经评估:在本试点研究的限制范围内,可以得出结论,OCT适用于调查和评估局部的低矿化障碍;然而,在牙釉质普遍低矿化的情况下,它不太有用。此外,OCT补充了牙釉质的射线照相检查;然而,需要更多的研究来阐明在低矿化的情况下OCT的使用范围.
    UNASSIGNED: To investigate the use of optical coherence tomography (OCT) as a tool to assess general and localised hypomineralisation defects in the enamel.
    UNASSIGNED: Ten extracted permanent teeth (four teeth with localised hypomineralisation, four teeth with general hypomineralisation, and two healthy controls) were used in this study. In addition, four participants who underwent OCT served as living controls for the extracted teeth.
    UNASSIGNED: The OCT results were compared with clinical photographs, digital radiographs, and polarising microscopy images of tooth sections (considered the gold standard) to determine the method with the most accurate information regarding the extent of enamel disturbances: 1) visibility of enamel disturbance (visible yes/no); if yes, 2) extent of the disturbance in the enamel; and 3) determination of the plausible involvement of the underlying dentin.
    UNASSIGNED: OCT was more accurate than digital radiography and visual assessment. OCT could provide information about the extent of localised hypomineralised disturbances in the enamel that was comparable to that with polarisation microscopy of the tooth sections.
    UNASSIGNED: Within the limitations of this pilot study, it can be concluded that OCT is suitable for investigating and evaluating localised hypomineralisation disturbances; however, it is less useful in cases with generalised hypomineralisation of the enamel. In addition, OCT complements radiographic examination of enamel; however, more studies are necessary to elucidate the full extent of the use of OCT in case of hypomineralisation.
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  • 文章类型: Journal Article
    未经证实:经皮冠状动脉介入治疗(PCI)期间使用血管内超声(IVUS)或光学相干断层扫描(OCT)进行血管内成像可改善预后。但是这些技术以前在现实世界中没有得到充分利用。我们的目的是研究过去十年来美国血管内成像引导PCI使用的变化,并评估心肌梗死(MI)PCI后血管内成像与临床结局之间的关系。
    UNASSIGNED:我们调查了2008年至2019年的全国住院患者样本,以计算IVUS或OCT指导下MI的PCI数量。使用Cochran-Armitage趋势检验或简单线性回归分析分类或连续结果的时间趋势。分别。多变量逻辑回归用于比较有和没有血管内成像的PCI后的结果。
    UNASSIGNED:对MI进行了2,881,746次PCI。IVUS引导的PCI数量增加了309.9%,从2008年的6,180个增加到2019年的25,330个(P趋势<0.001)。PCI中IVUS的使用比例从2008年的3.4%增加到2019年的8.7%(P趋势<0.001)。OCT引导的PCIs数量增加了548.4%,从2011年的246个增加到2019年的1,595个(P趋势<0.001)。所有PCI中OCT引导的百分比从2008年的0.0%增加到2019年的0.6%(P趋势<0.001)。血管内成像引导的PCI与住院死亡率的几率较低相关(校正比值比0.66,95%置信区间0.60-0.72,p<0.001)。
    UNASSIGNED:尽管血管内成像引导的PCI的数量一直在增加,尽管血管内成像与较低的死亡率相关,但仍较差.
    UNASSIGNED: Intravascular imaging with either intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during percutaneous coronary intervention (PCI) is associated with improved outcomes, but these techniques have previously been underutilized in the real world. We aimed to examine the change in utilization of intravascular imaging-guided PCI over the past decade in the United States and assess the association between intravascular imaging and clinical outcomes following PCI for myocardial infarction (MI).
    UNASSIGNED: We surveyed the National Inpatient Sample from 2008 to 2019 to calculate the number of PCIs for MI guided by IVUS or OCT. Temporal trends were analyzed using Cochran-Armitage trend test or simple linear regression for categorical or continuous outcomes, respectively. Multivariable logistic regression was used to compare outcomes following PCI with and without intravascular imaging.
    UNASSIGNED: A total of 2,881,746 PCIs were performed for MI. The number of IVUS-guided PCIs increased by 309.9 % from 6,180 in 2008 to 25,330 in 2019 (P-trend < 0.001). The percentage of IVUS use in PCIs increased from 3.4 % in 2008 to 8.7 % in 2019 (P-trend < 0.001). The number of OCT-guided PCIs increased 548.4 % from 246 in 2011 to 1,595 in 2019 (P-trend < 0.001). The percentage of OCT guidance in all PCIs increased from 0.0 % in 2008 to 0.6 % in 2019 (P-trend < 0.001). Intravascular imaging-guided PCI was associated with lower odds of in-hospital mortality (adjusted odds ratio 0.66, 95 % confidence interval 0.60-0.72, p < 0.001).
    UNASSIGNED: Although the number of intravascular imaging-guided PCIs have been increasing, adoption of intravascular imaging remains poor despite an association with lower mortality.
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  • 文章类型: Journal Article
    已经进行了许多尝试来抑制或抵消隐静脉移植(SVG)失败模式;然而,只有对SVG的外部支持在临床应用中获得了动力。这项研究揭示了植入的可行性,并在12个月的新型生物修复移植物中表现出良好的通畅性,在具有挑战性的绵羊冠状动脉旁路移植术模型中。这一发现可能会引发首次使用这种新型材料代替SVG的试验。我们相信,最终,这种新型生物修复性旁路移植术可能是冠状动脉旁路移植术患者难以收获SVG的选择之一.
    Many attempts have been made to inhibit or counteract saphenous vein graft (SVG) failure modes; however, only external support for SVGs has gained momentum in clinical utility. This study revealed the feasibility of implantation, and showed good patency out to 12 months of the novel biorestorative graft, in a challenging ovine coronary artery bypass graft model. This finding could trigger the first-in-man trial of using the novel material instead of SVG. We believe that, eventually, this novel biorestorative bypass graft can be one of the options for coronary artery bypass graft patients who have difficulty harvesting SVG.
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  • 文章类型: Case Reports
    在以下案例系列中,我们描述了2例具有不同潜在病理生理机制的非阻塞性冠状动脉心肌梗死患者的临床表现。在这两种情况下,心脏磁共振(CMR)成像利用常规参数标测技术和CMR指纹技术提供了全面的组织表征.这些病例证明了CMR在阐明潜在病因和适当治疗策略方面的诊断效用。(难度等级:高级。).
    In the following case series, we describe the clinical presentation of 2 patients with myocardial infarction with nonobstructive coronary arteries with different underlying pathophysiologic mechanisms. In both scenarios, cardiac magnetic resonance (CMR) imaging provided comprehensive tissue characterization with both conventional parametric mapping techniques and CMR fingerprinting. These cases demonstrate the diagnostic utility for CMR to elucidate the underlying etiology and appropriate therapeutic strategy. (Level of Difficulty: Advanced.).
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  • 文章类型: Case Reports
    未经证实:急性黄斑神经视网膜病变(AMN)可能是深视网膜毛细血管丛(DCP)损伤的结果,但其机制仍然难以捉摸。最近的一项研究描述了同时发作的中央急性中间黄斑病变(PAMM)和AMN,提示相关的致病途径。在这份报告中,我们分析并描述了伴随视网膜中央动脉闭塞(CRAO)和AMN患者的影像学特征,并提出了解释这种关系的机制途径.
    未经证实:共2例CRAO,动脉和非动脉,包含在本报告中。在最初的介绍中,视网膜外层完好无损。在为期两周的随访中,两种情况均显示Henle纤维层超反射率和椭圆体区破坏,与AMN一致。
    UNASSIGNED:CRAO中AMN的二次开发是一个新发现。CRAO继发的DCP缺血可能导致Henle纤维层破坏,导致AMN的特征性发现。
    UNASSIGNED: Acute Macular Neuroretinopathy (AMN) may be the result of deep retinal capillary plexus (DCP) impairment, but its mechanism remains elusive. A recent study has described simultaneous onset of Paracentral Acute Middle Maculopathy (PAMM) and AMN, suggesting a related pathogenic pathway. In this report, we analyze and describe the imaging characteristics of patients with concomitant Central Retinal Artery Occlusion (CRAO) and AMN and suggest a mechanistic pathway to explain this relationship.
    UNASSIGNED: A total of 2 cases of CRAO, arteritic and non arteritic, were included in this report. At initial presentation, outer retinal layers were intact. At the two-week follow-up visit, both cases displayed Henle fiber layer hyperreflectivity and ellipsoid zone disruption consistent with AMN.
    UNASSIGNED: Secondary development of AMN in CRAO is a new finding. DCP ischemia secondary to CRAO may lead to Henle fiber layer disruption, leading to the characteristic findings of AMN.
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  • 文章类型: Case Reports
    UNASSIGNED:近年来,免疫治疗已成为肿瘤治疗计划的重要补充。随着这些疗法的应用越来越广泛,已经报道了许多独特的副作用。在眼科中,最有据可查的免疫检查点抑制剂(ICI)的副作用包括葡萄膜炎,黄斑水肿和干眼症。该手稿描述了在HLA定向疫苗和ICIpembrolizumab的全身性毛细血管渗漏综合征(SCLS)的背景下,双侧脉络膜积液和继发性角度狭窄的罕见病例。用于治疗IV期肺鳞状细胞癌(SCC)。
    UNASSIGNED:一名67岁男性,因功能下降,在肺切除术后,有肺部状态的IV期SCC病史,Anasarca,在接受HLA定向疫苗与pembrolizumab组合后呼吸困难。广泛的检查显示他的症状是SCLS继发的。由于在磁共振成像上看到双侧脉络膜脱离,因此咨询了眼科。B超和超声生物显微镜显示大,睫状体前旋的非并置脉络膜积液。鉴于对口服类固醇治疗的反应很小,Sub-Tenon\'s曲安奈德,阿托品,和降低眼压的滴眼液开始有良好的反应。
    UNASSIGNED:脉络膜积液和继发性闭角可能是ICIs设置中SCLS的罕见并发症。临床医生必须意识到ICI治疗的潜在副作用,随着这些药物的使用越来越普遍。
    UNASSIGNED: Immunotherapy has become an important addition to oncology treatment plans in recent years. As these therapies become more widely employed, many unique side effects have been reported. In ophthalmology the most well-documented side effects of immune checkpoint inhibitors (ICI) include uveitis, macular edema and dry eye syndrome. This manuscript describes a rare case of bilateral choroidal effusions and secondary angle narrowing in the setting of systemic capillary leak syndrome (SCLS) from an HLA-directed vaccine and an ICI, pembrolizumab, for the treatment of stage IV squamous cell carcinoma (SCC) of the lung.
    UNASSIGNED: A 67-year-old male with a history of stage IV SCC of the lung status-post pneumonectomy presented to the emergency department due to functional decline, anasarca, and dyspnea after receiving an HLA-directed vaccine in combination with pembrolizumab. Extensive workup revealed that his symptoms were secondary to SCLS. Ophthalmology was consulted due bilateral choroidal detachments seen on magnetic resonance imaging. B-scan ultrasound and ultrasound biomicroscopy revealed large, non-appositional choroidal effusions with anterior rotation of the ciliary body. Given minimal response to oral steroid therapy, sub-Tenon\'s triamcinolone acetonide, atropine, and intraocular pressure-lowering eyedrops were initiated with a good response.
    UNASSIGNED: Choroidal effusions and secondary angle closure can be rare complications of SCLS in the setting of ICIs. Clinicians must be aware of the potentials side effects of ICI therapy, as these medications become more commonly used.
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  • 文章类型: Case Reports
    未经授权:报告在2022年爆发期间在美国发生的一例涉及猴痘的眼部感染病例,并回顾迄今为止已知的有关其临床表现和管理的文献。
    UNASHSIGNED:一名36岁艾滋病毒控制良好的男子因肛门疼痛被送往急诊科,弥漫性皮疹,右眼疼痛,一周前他的猴痘检测呈阳性后,右眼发红。眼部检查显示双侧眶周囊泡病变,右眼结膜注射,他的右内侧球结膜上有一个白色斑块。黄斑,囊泡,和他全身的脓疱病变,包括生殖器和肛周区域,也注意到了。他的眼部和全身症状完全解决后,10天疗程的1%三氟尿苷和莫西沙星滴入双眼治疗,以及两周的口服tecovirimat。
    UNASSIGNED:和重要性:2022年7月,猴痘病毒被世界卫生组织宣布为全球卫生紧急情况;然而,目前尚无猴痘治疗的标准指南。关于其临床表现和病程的数据,特别是关于眼部表现,是有限的。我们强调了识别猴痘病毒的眼科表现以及可能的治疗方法以帮助指导这些患者的管理的重要性。
    UNASSIGNED: To report a case of ocular involving monkeypox infection in the United States during the 2022 outbreak, and to review the literature regarding its clinical manifestations and management known to date.
    UNASSIGNED: A 36-year-old man with well controlled HIV presented to the emergency department with anal pain, diffuse rash, right eye pain, and right eye redness after he tested positive for monkeypox one week prior. Ocular examination showed bilateral periorbital vesicular lesions, right eye conjunctival injection, and a single white plaque on his right medial bulbar conjunctiva. Macular, vesicular, and pustular lesions were noted throughout his body, including the genital and perianal region. His ocular and systemic symptoms completely resolved after treatment with a ten-day course of 1% trifluridine and moxifloxacin drops in both eyes, as well as two weeks of oral tecovirimat.
    UNASSIGNED: In July of 2022, monkeypox virus was declared a global health emergency by the World Health Organization; however, there are no standard guidelines for monkeypox treatment. Data on its clinical presentation and course, especially pertaining to ocular manifestations, is limited. We highlight the importance of recognizing ophthalmic manifestations of monkeypox virus and a possible therapeutic approach to help guide the management of these patients.
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  • 文章类型: Journal Article
    青光眼是全世界失明的主要原因(仅次于白内障);因此,一般医师应熟悉受影响患者的诊断和管理.青光眼通常根据前房角的解剖结构分类(开放与狭窄/封闭),发病速度(急性与慢性),和主要病因(原发性与继发性)。大多数青光眼是主要的(即,没有共病);然而,几种并存的眼科疾病可能是继发性青光眼的潜在病因。慢性青光眼最常见;因此,应定期对有风险的患者进行眼科检查,以防止在诊断前可能出现的隐性视力丧失。青光眼损害视神经和视网膜神经纤维层,导致周边和中央视野缺陷。高眼压(IOP),疾病进展的关键决定因素,仍然是唯一可修改的风险因素;因此,所有当前的治疗方法(药物,激光,和操作)旨在降低IOP。药物治疗是通常的一线治疗,但是不遵守规定,不良副作用,和成本限制的有效性。激光和手术治疗可以在长时间内显著降低IOP,并且可能比药物治疗更具成本效益。但是他们受到更大的程序风险和频繁的治疗失败的困扰。传统的切口手术最近被几种新颖的手术所取代,微创青光眼手术具有改善的安全性,并且疗效仅有最小的下降。微创青光眼手术已极大地改变了青光眼的手术管理;然而,大,需要随机试验来评估其长期疗效.
    Glaucoma is the leading cause of blindness throughout the world (after cataracts); therefore, general physicians should be familiar with the diagnosis and management of affected patients. Glaucomas are usually categorized by the anatomy of the anterior chamber angle (open vs narrow/closed), rapidity of onset (acute vs chronic), and major etiology (primary vs secondary). Most glaucomas are primary (ie, without a contributing comorbidity); however, several coexisting ophthalmic conditions may serve as the underlying etiologies of secondary glaucomas. Chronic glaucoma occurs most commonly; thus, regular eye examinations should be performed in at-risk patients to prevent the insidious loss of vision that can develop before diagnosis. Glaucoma damages the optic nerve and retinal nerve fiber layer, leading to peripheral and central visual field defects. Elevated intraocular pressure (IOP), a crucial determinant of disease progression, remains the only modifiable risk factor; thus, all current treatments (medications, lasers, and operations) aim to reduce the IOP. Pharmacotherapy is the usual first-line therapy, but noncompliance, undesirable adverse effects, and cost limit effectiveness. Laser and surgical treatments may lower IOP significantly over long periods and may be more cost effective than pharmacotherapy, but they are plagued by greater procedural risks and frequent treatment failures. Traditional incisional procedures have recently been replaced by several novel, minimally invasive glaucoma surgeries with improved safety profiles and only minimal decreases in efficacy. Minimally invasive glaucoma surgeries have dramatically transformed the surgical management of glaucoma; nevertheless, large, randomized trials are required to assess their long-term efficacy.
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  • 文章类型: Case Reports
    UNASSIGNED:本报告的目的是描述一例微球体(MSP)患者,该患者在视网膜脱离(RD)修复术中出现巩膜破裂,采用原发性巩膜带扣和冷冻视网膜固定术。
    UNASSIGNED:一名患有MSP的48岁女性表现为六天的视力和光的扩大丧失。检查发现上视网膜脱离涉及黄斑,并伴有两个上视网膜撕裂。患者成功放置了节段性扣环。在冷冻视网膜固定术治疗眼泪,发生4毫米全厚度巩膜破裂。巩膜立即用中断的8-0尼龙缝合线闭合,并用经处理的心包膜同种异体移植物加固。随后的联合超声乳化白内障吸出术与囊袋切除术,大带切除术,带扣放置后9天进行了平坦部玻璃体切除术,并进行了视网膜复位。
    未经评估:此病例说明MSP患者,甚至在没有遗传综合征或家族疾病的情况下观察到,RD修复期间巩膜破裂的风险可能会增加。尽管将来有必要进行调查以确认这种关联,外科医生应采取保守的方法,因为临床高度怀疑MSP患者的巩膜完整性受损,并在可能造成巩膜破裂风险的手术中谨慎行事。心包膜同种异体移植可能是巩膜破裂修复的有效辅助手段。
    UNASSIGNED: The purpose of this report is to describe a case of a patient with microspherophakia (MSP) who had a scleral rupture during a retinal detachment (RD) repair with primary scleral buckle and cryoretinopexy.
    UNASSIGNED: A 48-year-old woman with MSP presented with six days of expanding loss of vision and photopsias. Examination revealed a superior retinal detachment involving the macula associated with two superior retinal tears. The patient underwent successful placement of a segmental buckle. During cryoretinopexy treatment of the tears, a 4 mm full-thickness scleral rupture occurred. The sclera was immediately closed with interrupted 8-0 nylon sutures and reinforced with a processed pericardium allograft. Subsequent combined phacoemulsification with capsulectomy, zonulectomy, and pars plana vitrectomy with retinal reattachment was performed nine days post buckle placement.
    UNASSIGNED: This case illustrates that a patient with MSP, even observed in the absence of a genetic syndrome or familial condition, may be at increased risk of scleral rupture during RD repair. Though future investigations are necessary to confirm this association, surgeons should take a conservative approach by having a high clinical suspicion for compromised scleral integrity in patients with MSP and proceeding with caution in procedures that may pose a risk of scleral rupture. A pericardium allograft can be an effective adjunct for scleral rupture repair.
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