Spectral domain optical coherence tomography (SD-OCT)

  • 文章类型: Journal Article
    通过使用半峰全宽(FWHM)和智能图像识别测量视网膜血管来研究视网膜血管变化与ICA狭窄之间的相关性。
    本研究选取2018年1月至2020年12月衢州市人民医院血管外科收治的患者,为颈动脉支架术(CAS)做准备。参与者分为两组:无ICA狭窄(第0组)和有ICA狭窄(第1组)。共纳入109例病例,1组50例,0组59例。通过谱域光学相干断层扫描(SD-OCT)获得视网膜上颞区B的血管图像。通过FWHM识别视网膜血管的边缘。用FWHM测量所有受试者的每个血管三次,取平均值,得到视网膜小动脉腔直径(RALD),视网膜小动脉外径(RAOD),视网膜静脉腔直径(RVLD),和视网膜静脉外径(RVOD),动脉壁厚(AWT),静脉壁厚(VWT)=(RVOD-RVLD)/2,动静脉比(AVR)=RAOD/RVOD。
    我们发现,与第0组相比,第1组的RALD(P<0.001)和RAOD(P<0.001)较小,和更宽的RVOD(P<0.001),VWT较厚(P<0.001)。与第1组的对侧眼相比,同侧眼表现出更小的RALD,RAOD和AVR(P<0.001,P<0.001,P<0.001)。在CAS之后,RALD,第1组的RAOD和AVR增加(P<0.001,P<0.001,P<0.001),而RVLD和RVOD降低(P<0.05,P<0.001)。我们的研究揭示了视网膜血管变化与内部ICA狭窄之间的显着相关性。
    将SD-OCT与FWHM结合使用,我们实现了非侵入性,智能,稳定,以及对视网膜血管相关数据的精确采集。这些发现强调了视网膜血管结构改变与ICA狭窄的存在之间的显著相关性。正如我们的研究所证明的那样。
    UNASSIGNED: To investigate the correlation between retinal vascular changes and ICA stenosis by measuring retinal vessels using full-width-at-half-maximum (FWHM) and intelligent image recognition.
    UNASSIGNED: This research selected patients who were admitted to the Vascular Surgery Department of Quzhou People\'s Hospital from January 2018 to December 2020 and were preparing for Carotid Artery Stenting (CAS). Participants were divided into two groups: without ICA stenosis (Group 0) and with ICA stenosis (Group 1). A total of 109 cases were included in the study, with 50 cases in Group 1 and 59 cases in Group 0. Vascular images of superior temporal zone B of the retina were obtained by spectral domain optical coherence tomography (SD-OCT). The edges of retinal vessels were identified by FWHM. Each vessel of all subjects was measured three times with the FWHM, and the average value was taken to obtain the retinal arteriolar lumen diameter (RALD), retinal arteriolar outer diameter (RAOD), retinal venular lumen diameter (RVLD), and retinal venular outer diameter (RVOD),Arterial Wall Thickness (AWT),Venular Wall Thickness (VWT)=(RVOD-RVLD)/2,Arteriovenous Ratio (AVR) = RAOD/RVOD.
    UNASSIGNED: We found that compared to Group 0, Group 1 had smaller RALD (P < 0.001) and RAOD (P < 0.001), and wider RVOD (P < 0.001), with thicker VWT (P < 0.001). When compared with the contralateral eye in Group 1, the ipsilateral eye exhibited even smaller RALD,RAOD and AVR (P < 0.001, P < 0.001, P < 0.001). After CAS, the RALD,RAOD and AVR in Group 1 increased (P < 0.001, P < 0.001, P < 0.001),while the RVLD and RVOD decreased (P < 0.05, P < 0.001). Our research reveals a significant correlation between retinal vascular changes and internal ICA stenosis.
    UNASSIGNED: Utilizing SD-OCT in conjunction with the FWHM,we achieved a non-invasive, intelligent, stable, and precise acquisition of data pertaining to retinal vessels. These findings underscore a significant correlation between alterations in retinal vascular structure and the presence of ICA stenosis, as demonstrated by our research.
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  • 文章类型: Journal Article
    背景和目的:急性后部多灶性色素上皮病/急性多灶性缺血性脉络膜毛细血管炎(APMPPE/AMIC)是脉络膜毛细血管炎实体组的一部分。本文的目的是报告一系列患者,重点是临床表现和治疗范式。材料和方法:在眼科专业护理中心(COS)进行的回顾性病例系列研究,洛桑,瑞士,2000年至2021年诊断为APMPPE/AMIC的患者。演示时和随访时(可用时)执行的程序包括最佳矫正视力(BCVA),常规眼部检查,激光耀斑测光(LFP)显微视野(如果可用)和视野测试。成像研究包括谱域光学相干断层扫描(SD-OCT)/增强深度成像OCT(EDI-OCT),OCT血管造影(OCT-A)以及荧光素和吲哚菁绿血管造影(FA,ICGA)。注意到是否存在前驱系统性病毒样症状。病灶的定位,无论是中央凹还是外凹,将患者分为2组(中央凹,周围或半凹)。排除标准为诊断为APMPPE/AMIC和阳性QuantiFERON测试和/或VDRL-TPHA测试的患者。结果:1664例新患者(1.14%)中有19例(35眼)被诊断为APMPPE/AMIC,并纳入我们的研究。13(68%)为男性,6(32%)为女性。平均年龄为33.1±9.2岁。16例(84%)患者提到病毒前驱发作或其他全身症状,3例(16%)未提及眼部症状发作前的任何发作.38只眼睛中有15只(39%)的病灶位于中央凹,20例(52.6%)有中央凹或中央凹周围定位,3只眼正常[3例(15%)]。整个组出现时的平均BCVA为0.83±0.24。中央凹病变组为0.58±0.28,末次随访时增加到0.97±0.13(p=0.0028)。对于有眼球外病变的组,平均BCVA在表现为0.94±0.18,在最后一次随访时提高到1.18±0.10(p=0.0039)。13例(68%)患者接受泼尼松治疗,其中2人(10%)接受了至少一种免疫抑制剂,4例(20%)患者未接受治疗,2例患者的信息不可用。中央凹病变组的所有患者都接受了皮质类固醇治疗,除了一名发展为双侧黄斑萎缩的患者。结论:APMPPE/AMIC是一种原发性绒毛膜毛细血管炎。虽然人们认为这种疾病是自我限制的,在大多数情况下,治疗是必要的,特别是当病变位于中央凹。
    Background and objectives: Acute posterior multifocal pigment epitheliopathy/acute multifocal ischaemic choriocapillaritis (APMPPE/AMIC) is part of the group of choriocapillaritis entities. The aim of this article was to report a series of patients with emphasis on the clinical presentation and treatment paradigms. Materials and Methods: Retrospective case series study performed in the Centre for Ophthalmic Specialised care (COS), Lausanne, Switzerland, on patients diagnosed from 2000 to 2021 with APMPPE/AMIC. Procedures performed at presentation and upon follow-up (when available) included best corrected visual acuity (BCVA), routine ocular examination, laser flare photometry (LFP) microperimetry (when available) and visual field testing. Imaging investigations included spectral domain optical coherence tomography (SD-OCT)/enhanced depth imaging OCT (EDI-OCT), OCT angiography (OCT-A) as well as fluorescein and indocyanine green angiography (FA, ICGA). The presence or not of prodromal systemic viral-like symptoms was noted. The localisation of lesions whether foveal or extrafoveal, divided the patients into 2 groups (foveal, peri-or parafoveal). Exclusion criteria were patients diagnosed with APMPPE/AMIC and a positive QuantiFERON test and/or VDRL-TPHA tests. Results: Nineteen (35 eyes) of 1664 new patients (1.14%) were diagnosed with APMPPE/AMIC and included in our study. 13 (68%) were male and 6 (32%) were female. The mean age was 33.1 ± 9.2 years. 16 (84%) patients mentioned a viral prodromal episode or other systemic symptoms, and 3 (16%) did not mention any episode before the onset of ocular symptoms. 15 (39%) out of 38 eyes had foveal localisation of the lesions, 20 (52.6%) had peri- or para-foveal localisations and 3 eyes were normal [3 unilateral cases (15%)]. Mean BCVA at presentation was 0.83 ± 0.24 for the whole group. It was 0.58 ± 0.28 for the group with foveal lesions, increasing to 0.97 ± 0.13 at last follow-up (p = 0.0028). For the group with extrafoveal lesions mean BCVA at presentation was 0.94 ± 0.18, improving to 1.18± 0.10 at last follow-up (p = 0.0039). 13 (68%) patients received prednisone treatment, of whom 2 (10%) received additionally at least one immunosuppressive agent, 4 (20%) patients received no treatment and in 2 patients the information was unavailable. All patients in the foveal lesion group received corticosteroid treatment except one who evolved to bilateral macular atrophy. Conclusions: APMPPE/AMIC is a primary choriocapillaritis. Although it is thought that the disease is self-limited, treatment is necessary in most cases, especially when lesions are located in the fovea.
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  • 文章类型: Case Reports
    背景:视网膜动脉阻塞是由视网膜小动脉暂时阻塞引起的血管实体。
    方法:我们介绍了一个57岁女性的案例,该女性由于毛细血管视网膜动脉阻塞导致右眼部分视力丧失。检眼镜显示右眼视神经上方的视网膜白斑区域,而左眼在极限范围内。视网膜成像,特别是光学相干断层扫描血管造影(OCTA),显示毛细血管从浅表毛细血管丛脱落,相应的b扫描显示圆形的低反射灰色点(光学空),对应于视网膜美白区域水平的正面视图上的深灰色点。
    结论:尽管图像不能区分血管痉挛或视网膜栓子,OCTA成像可能有助于识别并捕获导致视网膜损伤的特定区域。此外,在视网膜分支动脉阻塞的情况下,应考虑可能形成小的微腔。使用这种新的成像技术可能有助于评估体内治疗的疗效。
    BACKGROUND: Retinal artery occlusion is a vascular entity caused by the temporary blockage of retinal arterioles.
    METHODS: We present the case of a 57-year-old woman a partial visual loss in the right eye due to a cilioretinal artery occlusion. Ophthalmoscopy revealed a focal area of retinal whitening superior to the optic nerve in the right eye, while the left eye was within the limit. Retinal imaging, in particular optical coherence tomography angiography (OCTA), showed a capillary drop out of the superficial capillary plexus and the corresponding b-scan showed a round hyporeflective grey dot (optical empty) corresponding to the dark grey spot on the enface view at the level of the retinal whitening area.
    CONCLUSIONS: Although the images did not allow the differentiation between vasospasm or retinal emboli, the OCTA imaging might help to identify and to caught in the act the specific region causing the retinal impairment. Also, the possible formation of small microcavity should be considered in case with branch retinal artery occlusion. The use of this new imaging technology might help to evaluate the efficacy of the therapy in vivo.
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  • 文章类型: Journal Article
    Choroidal imaging investigation techniques were very limited until 2-3 decades ago.Fluorescein angiography (FA) was not suited for the analysis of the choroidal compartment and B-scan ultrasonography did not provide enough accuracy. It was on this background that a purely phenomenological approach was attempted to classify these choroiditis diseases by regrouping them under the vague potpourri term of \"white dot syndromes\". With the availability of precise investigational modalities of choroidal inflammation or choroiditis-induced lesions, such as indocyanine green angiography (ICGA), spectral domain optical coherence tomography (SD-OCT) and enhanced depth imaging optical coherence tomography (EDI-OCT) it became possible to better classify these diseases based on clinico-pathological mechanisms rather than on purely phenomenological observation.Recently OCT-angiography has implemented the armamentarium of diagnostic techniques possibly also contributing to the classification of choroidal inflammatory diseases.Based on pioneering pragmatism, the aim of this article was to give a clear classification of non-infectious choroiditis. Thanks to new imaging investigations of the choroid, it is now possible to classify and understand the diverse clinicopathological mechanisms in the group of non-infectious choroiditis entities.
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  • 文章类型: Case Reports
    OBJECTIVE: AZOOR is a rare disease characterized by loss of zones of outer retinal function, first described by J Donald Gass in 1993. Symptoms include acute onset photopsias and subjective visual field losses. The syndrome is characterized by a normal fundus appearance, scotomas and electroretinographic changes pointing towards outer retinal dysfunction. Evolution, response to immunosuppressive treatment and outcome are difficult to predict. The aim of this small case series was to identify the morphological changes and sequence of events in AZOOR thanks to multimodal imaging.
    METHODS: Charts of AZOOR patients seen in the Centre for Ophthalmic Specialized care (COS, Lausanne, Switzerland) were analyzed by multimodal imaging including fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), blue light fundus autofluorescence (BL-FAF) and spectral domain optical coherence tomography (SD-OCT) in addition to a complete ophthalmological examination including visual field testing and microperimetry, as well as OCT angiography (OCT-A) and ganglion-cell complex analysis when available. Cases and Results: Three AZOOR patients with a mean follow-up of 47 ± 25.5 months were included following the clinical definitions laid down by J Donald Gass. The primary damage was identified at the level of the photoreceptor outer segments with an intact choriocapillaris and retinal pigment epithelium (RPE) layer, these structures being only secondarily involved with progression of the disease.
    CONCLUSIONS: Although AZOOR has often been included within white dot syndromes, some of which are now known to be choriocapillaris diseases (choriocapillaritis entities), our findings clearly commend to differentiate AZOOR from entities such as MEWDS (Multiple evanescent white dot syndrome), APMPPE (Acute Posterior Multifocal Placoid Pigment Epitheliopathy), MFC (Multifocal Choroiditis) and others, as the damage to photoreceptors is primary in AZOOR (a retinopathy) and secondary in choriocapillaritis (a choriocapillaropathy).
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  • 文章类型: Case Reports
    目的:介绍一例星状非遗传性特发性黄斑视网膜裂孔(SNIFR)消退与玻璃体黄斑粘连(VMA)释放相关的病例,并提出SNIFR与玻璃体黄斑相互作用之间的潜在关联。
    方法:对一名67岁女性患者进行诊断,并在第3、6、16和22个月的就诊和随后的就诊时用光谱域光学相干断层扫描(SD-OCT)扫描进行ODSNIFR随访。在随访的前6个月中,在SD-OCT上VMA和黄斑视网膜裂孔保持不变。在16个月的随访中,SD-OCT显示VMA释放和黄斑裂开的重要改善。在22个月的随访中,在没有任何辅助治疗的情况下,SNIFR腔在与黄斑区的后部玻璃样分离的情况下完全解决。在这种情况下,除了VMA释放外,作者无法确定任何其他可能的原因来证明SNIFR的解决。患者在初次就诊后3个月除超声乳化外没有接受任何OD治疗。
    结论:本案例说明了SD-OCT扫描在SNIFR分辨率和VMA释放之间可能存在关联,突出显示内部限制膜上的后玻璃体的潜在牵引成分,以及随之而来的神经胶质细胞随着分裂形成而伸展。
    OBJECTIVE: To present a case of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) resolution associated with vitreomacular adherence (VMA) release and propose a potential contributing association between SNIFR and vitreomacular interactions.
    METHODS: A 67-year-old female patient was diagnosed and followed for SNIFR in OD with spectral-domain optical coherence tomography (SD-OCT) scans at presentation and subsequent visits at 3, 6, 16 and 22 months. VMA and foveomacular retinoschisis remained unchanged on SD-OCT during the first 6 months of the follow-up. At 16-month follow-up visit, SD-OCT revealed VMA release and an important improvement of the macular schisis. At 22 months of follow-up, SNIFR cavities completely resolved in the presence of posterior hyaloid separation from the macular area without any adjunct treatment. The authors could not identify any other possible cause to justify the resolution of SNIFR other than VMA release in this case. Patient did not undergo any treatment for OD other than phacoemulsification 3 months after initial visit.
    CONCLUSIONS: The present case illustrates with SD-OCT scans a possible association between SNIFR resolution and VMA release, highlighting a potential tractional component of the posterior vitreous on the internal limiting membrane and consequent glial cells stretching with schisis formation.
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  • 文章类型: Journal Article
    背景:冠状病毒病(COVID-19)大流行可引起多种眼部表现。我们报告了一例单侧多灶性中心性浆液性视网膜病变,一名亚裔印度女性感染COVID-19后。
    方法:一位42岁的女性出现单侧模糊,在右眼(OD),COVID-19感染后12天。她发烧了,发冷,呼吸急促和咳嗽伴疲倦,COVID-RTPCR阳性。她接受了静脉和口服抗生素注射肝素/雷米西韦,她在医院呆了7天。她还在使用类固醇吸入器。她没有系统性的记录史。在眼部评估中,她的矫正视力OD为20/40,左眼(OS)为20/20。前段正常。前玻璃体清晰。OD的眼底检查显示中心性浆液性视网膜病变(CSCR),OS正常。
    结论:CSCR可在COVID-19后发生,这是由于类固醇给药,给药的医生应该意识到这一点,并尽早将患者转诊给眼科医生。
    BACKGROUND: Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female.
    METHODS: A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal.
    CONCLUSIONS: CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.
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  • 文章类型: Journal Article
    The aim of the study is to assess choroidal thickness (CT) and choroidal volume (CV) in 90 type 1 diabetes mellitus (DM1) patients with no diabetic retinopathy (DR) and 60 control eyes using spectral domain optical coherence tomography (SD-OCT) and swept source (SS)-OCT in the areas of the Early Treatment Diabetic Retinopathy Study (ETDRS). Mean ages were 42.93 ± 13.62 and 41.52 ± 13.05 years in the diabetic and control groups, respectively. Significant differences were obtained between both groups with Spectralis SD-OCT in all ETDRS areas and in the total CV, excluding the temporal perifoveal one. With Triton SS-OCT, statistically significant differences were obtained in the subfoveal CT and in the vertical areas. CT showed the same tendency with both OCTs, with greater CT and CV in the DM1 group than the mean values of the control group. To assess the influence of DM1 evolution in the CT modifications, DM1 patients were divided into Group 1, with less than 24 years of diagnosis, and Group 2, with ≥24 years of DM1 evolution. Using both OCTs, seven of the nine ETDRS areas and the CV had lower values in Group 2. CT and CV measured by OCT were higher in DM1 without DR. There is a choroidal thinning related to disease evolution in DM1. In patients with DM evolution greater than 24 years, the CT is statistically lower than in patients with less evolution of the disease.
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  • 文章类型: Journal Article
    To study the correlation between disorganization of inner retinal layer (DRIL) and macular thickness parameters, ellipsoid zone (EZ) disruption and retinal nerve fiber layer (RNFL) thickness on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR), for the first time.
    A tertiary care center-based cross-sectional study was undertaken. One hundred and four consecutive study subjects of type 2 diabetes mellitus were included: diabetes mellitus with no retinopathy (No DR) (n = 26); non-proliferative DR (NPDR) (n = 26); proliferative DR (PDR) (n = 26) and healthy controls (n = 26). Best Corrected Visual Acuity (BCVA) was measured on the logarithm of the minimum angle of resolution (logMAR) scale. Clinician-friendly, SD-OCT based, grading systems were created for DRIL and EZ disruption, within the macular cube. DRIL was graded as: grade 0, DRIL absent; and grade 1, DRIL present. EZ disruption was graded as; Grade 0: Intact EZ; Grade 1: Focal disruption and Grade 2: Global disruption. Every study subject underwent RNFL thickness analysis.
    DRIL was significantly associated with increase in severity of DR.Pearson correlation analysis showed significant positive correlation between DRIL and CST CAT and grades of EZ disruption . However, a significant negative correlation was found between DRIL and RNFL thickness .
    Presence of DRIL correlates with severity of DR, EZ disruption and RNFL thinning.
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  • 文章类型: Journal Article
    OBJECTIVE: To relate the concept of the retinal neurovascular unit and its alterations in diabetes to the pathophysiology of diabetic retinopathy.
    METHODS: Case illustrations and conceptual frameworks are presented that illustrate adaptive and maladaptive \"dis-integration\" of the retinal neurovascular unit with the progression of diabetes.
    RESULTS: Retinopathy treatment should address pathophysiologic processes rather than pathologic lesions as is current practice.
    CONCLUSIONS: Future improvements in the treatment of diabetic retinopathy requires deeper understanding of the cellular and molecular changes induced by diabetes, coupled with the use of quantitative phenotyping methods that assess the pathophysiologic processes.
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