Tomography, Optical Coherence

体层摄影术, 光学相干
  • 文章类型: Journal Article
    这项研究的目的是分析生成对抗网络(GAN)的光学相干断层扫描(OCT)图像,以预测长期治疗后的糖尿病性黄斑水肿。
    糖尿病性黄斑水肿(DME)眼(n=327)每4周接受抗血管内皮生长因子(VEGF)治疗,共52周。在第0、4、12和52周,通过中央凹中心的OCTB扫描图像,眼底摄影,收集视网膜厚度(RT)图。训练GAN模型以在治疗后生成可能的OCT图像。每个模型的输入包括单独的基线B扫描或与额外的OCT组合。厚度图,或眼底图像。将生成的OCTB扫描图像与实际的52周图像进行比较。
    对于30个测试图像,CycleGAN生成了28、29、15和30张可分级的OCT图像,UNIT,Pix2PixHD,还有RegGAN,分别。与真实的第52周相比,这些GAN模型显示出阳性预测值(PPV),灵敏度,特异性,残留流体的κ分别为0.500至0.889、0.455至1.000、0.357至0.857和0.537至0.929。对于硬渗出物(HE),它们分别为0.500至1.000、0.545至0.900、0.600至1.000和0.642至0.894。用第4周和12周B扫描作为基线B扫描的额外输入训练的模型显示出改善的性能。
    GAN模型可以预测DME长期抗VEGF治疗后的残余液体和HE。
    该工具的实施可能有助于识别长期治疗后潜在的无反应者,从而促进这些眼睛的管理规划。
    UNASSIGNED: The purpose of this study was to analyze optical coherence tomography (OCT) images of generative adversarial networks (GANs) for the prediction of diabetic macular edema after long-term treatment.
    UNASSIGNED: Diabetic macular edema (DME) eyes (n = 327) underwent anti-vascular endothelial growth factor (VEGF) treatments every 4 weeks for 52 weeks from a randomized controlled trial (CRTH258B2305, KINGFISHER) were included. OCT B-scan images through the foveal center at weeks 0, 4, 12, and 52, fundus photography, and retinal thickness (RT) maps were collected. GAN models were trained to generate probable OCT images after treatment. Input for each model were comprised of either the baseline B-scan alone or combined with additional OCT, thickness map, or fundus images. Generated OCT B-scan images were compared with real week 52 images.
    UNASSIGNED: For 30 test images, 28, 29, 15, and 30 gradable OCT images were generated by CycleGAN, UNIT, Pix2PixHD, and RegGAN, respectively. In comparison with the real week 52, these GAN models showed positive predictive value (PPV), sensitivity, specificity, and kappa for residual fluid ranging from 0.500 to 0.889, 0.455 to 1.000, 0.357 to 0.857, and 0.537 to 0.929, respectively. For hard exudate (HE), they were ranging from 0.500 to 1.000, 0.545 to 0.900, 0.600 to 1.000, and 0.642 to 0.894, respectively. Models trained with week 4 and 12 B-scans as additional inputs to the baseline B-scan showed improved performance.
    UNASSIGNED: GAN models could predict residual fluid and HE after long-term anti-VEGF treatment of DME.
    UNASSIGNED: The implementation of this tool may help identify potential nonresponders after long-term treatment, thereby facilitating management planning for these eyes.
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  • 文章类型: Journal Article
    本研究旨在使用扫频源光学相干断层扫描(SS-OCT)和其他眼科参数研究血液透析(HD)对终末期患者视神经乳头(ONH)的筛板(LC)的影响。肾脏疾病(ESKD)。这项前瞻性观察性研究包括29例因ESKD而接受HD的患者。ONH参数包括神经管直径(NCD),乳头周围垂直高度(PVH),和前LC深度(LCD),使用SS-OCT进行评估。统计分析HD前后ONH参数的变化。使用Pearson的相关性分析确定了LCD变化与其他眼部和全身测量之间的相关性。平均前LCD从HD前的441.6±139.8μm降至HD后的413.5±141.7μm(P=0.001)。平均NCD和PVH在HD后没有显示显著变化(分别为P=0.841和P=0.574)。前LCD的变化与平均眼灌注压之间存在显着相关性(r=0.397,P=0.036)。我们观察到HD后前部LCD的显着减少。我们的研究表明,HD可以影响ONH,尤其是在LC。
    This study is aimed to investigate the effect of hemodialysis (HD) on the lamina cribrosa (LC) of the optic nerve head (ONH) using swept-source optical coherence tomography (SS-OCT) and other ophthalmological parameters in patients with end-stage kidney disease (ESKD). This prospective observational study included 29 patients who underwent HD for ESKD. ONH parameters including neural canal diameter (NCD), peripapillary vertical height (PVH), and anterior LC depth (LCD), were assessed using SS-OCT. Changes in the ONH parameters before and after HD were statistically analysed. Correlations between changes in the LCD and other ocular and systemic measurements were identified using Pearson\'s correlation analyses. The mean anterior LCD significantly decreased from 441.6 ± 139.8 μm before HD to 413.5 ± 141.7 μm after HD (P = 0.001). Mean NCD and PVH did not show significant changes after HD (P = 0.841 and P = 0.574, respectively). A significant correlation was found between changes in the anterior LCD and the mean ocular perfusion pressure (r = 0.397, P = 0.036). We observed a significant decrease in anterior LCD after HD. Our study suggests that HD can influence the ONH, especially in the LC.
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  • 文章类型: Journal Article
    目的:回顾局限性脉络膜血管瘤(CCH)的长期结果。
    方法:回顾性分析2008年至2019年诊断的所有CCH病例的医院图。
    结果:所有172例患者均接受任一观察,经瞳孔热疗,氩激光光凝,光动力疗法,斑块近距离放射治疗或立体定向放射外科。最常见的3种管理模式是临床观察(30.2%),经瞳孔热疗(52.9%)和氩激光光凝(8.7%)。中位随访时间为10个月(范围:3、160)。观察组的解剖结果稳定为87.1%,热疗组的改善为60.5%。量化的光学相干断层扫描血管造影结果显示,血管瘤患者的双眼血管密度和灌注密度存在统计学差异。
    结论:脉络膜血管瘤的治疗方法多种多样。在某些情况下,经瞳孔热疗是解剖学上有效的治疗方法。CCH的诊断可能对患者的眼睛有血管影响。
    OBJECTIVE: To review long-term outcomes of circumscribed choroidal hemangioma (CCH).
    METHODS: Hospital charts of all CCH cases diagnosed from 2008 to 2019 were retrospectively reviewed.
    RESULTS: All 172 patients were managed with either observation, transpupillary thermotherapy, argon laser photocoagulation, photodynamic therapy, plaque brachytherapy or stereotactic radiosurgery. The most common 3 modes of management were clinical observation (30.2%), transpupillary thermotherapy (52.9%) and argon laser photocoagulation (8.7%). Median follow-up time was 10 months (range: 3, 160). Anatomical outcomes were stable in 87.1% of observation group and improved in 60.5% of thermotherapy group. Quantified optical coherence tomography angiography findings showed statistical differences in vascular and perfusion densities in fellow eyes of hemangioma patients.
    CONCLUSIONS: Circumscribed choroidal hemangioma can be treated in various ways. Transpupillary thermotherapy is an anatomically effective treatment in selected cases. The diagnosis of CCH may have vascular implications in fellow eyes of the patients.
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  • 文章类型: English Abstract
    Objective: To investigate the clinical features of acute macular neuroretinopathy (AMN) following coronavirus disease 2019 (COVID-19). Methods: This retrospective case series study included 15 patients (28 eyes) diagnosed with AMN at the Department of Ophthalmology, Peking University Third Hospital, from November 2022 to January 2023. The AMN group comprised 4 males and 11 females, with a mean age of (31.36±8.08) years. A control group of 15 individuals [5 males, 10 females; mean age (33.20±5.10) years] who had COVID-19 but did not develop AMN was also included. Data collected for all patients included best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fluorescein fundus angiography (FFA), and optical coherence tomography (OCT) results. Serum cytokine levels, including interleukins (ILs), interferons (IFNs), and tumor necrosis factor-alpha (TNF-α), were measured for both groups. Results: Among the 28 eyes, severe vision loss (BCVA≤0.3) was observed in 3 eyes (10.7%), moderate vision loss (BCVA>0.3 and≤0.5) in 2 eyes (13.3%), and mild vision loss (BCVA>0.5 and≤1.0) in 23 eyes (82.1%). OCT findings in all 28 eyes revealed hyperreflectivity of the outer nuclear layer and disruption of outer retinal structure. Additionally, 3 eyes (10.7%) exhibited cotton wool spots in the posterior pole, 2 eyes (7.1%) showed mild cystoid macular edema with intraretinal hyperreflective dots, and 1 eye (3.6%) presented with paracentral acute middle maculopathy. FFA indicated retinal vasculitis in 2 cases (4 eyes, 14.3%). Serum levels of IL-4, IL-5, IFN-α, and IFN-γ were significantly higher in the AMN group compared to the control group: IL-4 [4.49 (3.66, 6.08) vs. 1.40 (0.62, 1.68) pg/ml], IL-5 [7.34 (5.04, 14.06) vs. 0.17 (0.11, 1.86) pg/ml], IFN-α [8.42 (6.31, 14.89) vs. 0.50 (0.30, 0.83) pg/ml], and IFN-γ [17.93 (12.75, 32.44) vs. 7.43 (0.00, 14.74) pg/ml], with all differences being statistically significant (all P<0.05). Conclusion: AMN following COVID-19 can present with wedge-shaped dark red lesions in the macular area, often accompanied by cotton wool spots and retinal vasculitis. Additionally, there is a significant elevation in various inflammatory cytokines in the serum.
    目的: 探讨新型冠状病毒感染后的急性神经视网膜病变(AMN)的临床特征。 方法: 回顾性病例系列研究。收集2022年11月至2023年1月在北京大学第三医院眼科诊断为AMN的15例(28只眼)新型冠状病毒感染者资料作为AMN组,其中男性4例,女性患者11例,年龄为(31.36±8.08)岁。同期选择新型冠状病毒感染后未发生AMN者15名作为对照组,其中男性5例,女性10例,年龄为(33.20±5.10)岁。收集所有患者的最佳矫正视力(BCVA)、裂隙灯检查、散瞳后眼底检查、彩色眼底照相、荧光素眼底血管造影术(FFA)、相干光层析成像术(OCT)检查结果。对两组受试者进行血清细胞因子检测,包括白细胞介素(IL)类、干扰素(IFN)类以及肿瘤坏死因子α的水平。 结果: 28只眼中,严重视力下降(BCVA≤0.3)者3只眼(10.7%),中度视力下降(BCVA>0.3且≤0.5)者2只眼(13.3%),轻度视力下降(BCVA>0.5且≤1.0)者23只眼(82.1%)。所有28只眼在OCT上均表现为外核层高反射及外层视网膜结构的不连续,其中有3只眼同时伴有后极部视网膜1处或多处棉絮斑(10.7%),2只眼伴有轻度黄斑囊样水肿和视网膜内高反射点(7.1%),1只眼同时伴有旁中心性急性黄斑病变(3.6%)。有2例(4只眼,14.3%)FFA检查结果提示伴有视网膜血管炎。AMN组和对照组血清IL-4分别为4.49(3.66,6.08)和1.40(0.62,1.68)pg/ml、IL-5分别为7.34(5.04,14.06)和0.17(0.11,1.86)pg/ml、IFN-α分别为8.42(6.31,14.89)和0.50(0.30,0.83)pg/ml、IFN-γ分别为17.93(12.75,32.44)和7.43(0.00,14.74)pg/ml,两组差异均有统计学意义(均P<0.05)。 结论: 新型冠状病毒感染后AMN除表现为黄斑区楔形暗红色病灶外,还可合并棉絮斑以及视网膜血管炎,同时伴有血清多种炎症因子的升高。.
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  • 文章类型: English Abstract
    Fundus imaging plays a pivotal role in diagnosing retinal and choroidal diseases. Optical coherence tomography angiography (OCTA), by capturing signals to reconstruct vascular structures, offers a clear depiction of retinal vasculature with notable advantages such as rapid scanning and non-invasiveness. Although OCTA, due to its underlying principles, cannot dynamically assess vascular function, exploring its future applications and potential to eventually replace traditional fundus angiography remains a key focus in the medical community. OCTA provides multiple parameters that conventional fundus angiography cannot obtain. With the expanding coverage area of OCTA scans and improvements in artifact elimination, the detection rate of various retinal and choroidal diseases has significantly increased, making the widespread clinical application of OCTA an inevitable trend. Although ultra-widefield OCTA cannot yet fully replace angiography in clinical practice, with continued clinical practice, expanded clinical research, and ongoing technological innovation, OCTA is expected to gradually replace fundus angiography in the future.
    眼底影像学在视网膜和脉络膜疾病的诊断中发挥着关键作用。相干光层析血管成像术(OCTA)通过采集信号重建血管结构,能够清晰地展示视网膜血管情况,具备扫描速度快和无创性等显著优势。尽管由于检测原理限制,OCTA无法动态评估血管功能,但探讨OCTA未来应用的发展趋势及其是否能最终替代眼底血管造影术,仍是当前医学界关注的焦点。OCTA因其能够提供传统眼底血管造影术无法获取的多种参数,且随着OCTA检查结果眼底覆盖面积的扩大及伪影消除能力的提升,其在多种视网膜和脉络膜疾病的识别率已显著提高,OCTA在临床上的广泛应用已是大势所趋。尽管目前超广角OCTA在临床应用中还不能全面替代血管造影术,但随着临床实践的深入、临床研究的扩展以及技术的持续创新,OCTA在未来有望逐步替代眼底血管造影术。.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    探讨光学相干断层扫描(OCT)分析的视盘参数与有症状的玻璃体后脱离(PVD)患者周边视网膜撕裂的发生之间的关联。
    这项横断面研究纳入了75例急性PVD症状患者,根据是否发生周边视网膜撕裂将患者分为两组。
    当比较视网膜撕裂和对照组之间的平均视网膜神经纤维层(RNFL)厚度(μm)时,研究表明,患有视网膜撕裂的患者有明显更高的(87.18[95%置信区间(CI),84.47至89.9]vs81.14[95%CI,77.81至84.46],P=0.005)平均RNFL厚度。此外,我们观察到泪液组和对照组之间的杯体积(mm3)大小存在显着差异(0.13,0.06至0.22vs0.07,0.04至0.1,P=0.036,Mann-WhitneyU检验),分别。线性回归显示平均RNFL厚度随着年龄的增加而显著降低(P=0.029)。但两组之间没有显着差异。泪液组与对照组在边缘面积方面无统计学差异,光盘面积,和平均杯盘比。
    具有较高的平均RNFL厚度和通过OCT测量的较大杯体积的患者更容易发生周边视网膜撕裂。由于创伤和随后的炎症,乳头周围平均RNFL厚度增加,可能与视网膜上更粘附的后透明膜有关,也可能表明视网膜撕裂发生的周边视网膜区域的粘连增强。视神经乳头的OCT分析可用于日常临床实践中,作为有症状的PVD患者周围视网膜撕裂发展的预测因子。
    UNASSIGNED: To investigate association between optic disc parameters analyzed by optical coherence tomography (OCT) and occurrence of peripheral retinal tears in patients with symptomatic posterior vitreous detachment (PVD).
    UNASSIGNED: This cross-sectional study enrolled 75 patients with symptoms of acute PVD, who were allocated into two groups based on whether a peripheral retinal tear occurred or not.
    UNASSIGNED: When comparing the average retinal nerve fiber layer (RNFL) thickness (μm) between retinal tear and control groups, it was shown that patients with a retinal tear have a significantly higher (87.18 [95% confidence interval (CI), 84.47 to 89.9] vs 81.14 [95% CI, 77.81 to 84.46], P = 0.005) average RNFL thickness. Furthermore, we observed a significant difference (0.13, 0.06 to 0.22 vs 0.07, 0.04 to 0.1, P = 0.036, Mann-Whitney U-test) in the size of cup volume (mm3) between the tear and control groups, respectively. Linear regression showed a significant decrease (P = 0.029) in average RNFL thickness with increasing age, but without a significant difference between the two groups. There was no statistically significant difference between the tear and control groups in terms of rim area, disc area, and average cup-to-disc ratio.
    UNASSIGNED: Patients with a higher average RNFL thickness and larger cup volume measured by OCT were more prone to develop a peripheral retinal tear. Increased peripapillary average RNFL thickness due to trauma and subsequent inflammation, possibly related to the more adherent posterior hyaloid membrane to the retina, may also indicate strengthened adhesions in the areas of the peripheral retina where retinal tears occur. OCT analysis of the optic nerve head may be used in everyday clinical practice as a predictor of the development of peripheral retinal tears in patients with symptomatic PVD.
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  • 文章类型: Journal Article
    背景:消费品,例如电动剃须刀,以压力和剪切的形式在皮肤上施加动态载荷的组合。这种机械刺激可能导致不适和皮肤组织反应,其特征为“皮肤敏感性”。为了将剃须后的不适降至最低,需要使用光学相干断层扫描(OCT)等先进工具建立特定的刺激-反应关系.
    目的:探讨电剃刮刺激后皮肤形态和微血管功能的时空变化。
    方法:招募10名健康男性志愿者。这项研究包括对前臂进行60秒的电剃刺激,脸颊和脖子。在基线时记录皮肤参数,刺激后20分钟和刺激后24小时。使用OCT估计结构和动态皮肤参数,同时记录了经皮水分流失(TEWL),以提供皮肤屏障功能的参考值。
    结果:在基线时,八个参数中的六个显示了前臂和面部部位之间的统计学差异,而颊部和颈部之间仅表面粗糙度(Rq)和反射率有统计学差异(p<0.05)。剃须后20分钟,TEWL值显着增加,伴随着血液灌注的增加,变化幅度取决于解剖部位。刺激后24小时观察到恢复特征,大多数参数恢复到基础值,强调刺激的短暂影响。
    结论:OCT参数显示皮肤组织对电剃的反应在空间和时间上存在差异。这种方法可以告知剃须刀设计并防止皮肤敏感。
    BACKGROUND: Consumer products such as electrical shavers exert a combination of dynamic loading in the form of pressure and shear on the skin. This mechanical stimulus can lead to discomfort and skin tissue responses characterised as \"Skin Sensitivity\". To minimise discomfort following shaving, there is a need to establish specific stimulus-response relationships using advanced tools such as optical coherence tomography (OCT).
    OBJECTIVE: To explore the spatial and temporal changes in skin morphology and microvascular function following an electrical shaving stimulus.
    METHODS: Ten healthy male volunteers were recruited. The study included a 60-s electrical shaving stimulus on the forearm, cheek and neck. Skin parameters were recorded at baseline, 20 min post stimulus and 24 h post stimulus. Structural and dynamic skin parameters were estimated using OCT, while transepidermal water loss (TEWL) was recorded to provide reference values for skin barrier function.
    RESULTS: At baseline, six of the eight parameters revealed statistically significant differences between the forearm and the facial sites, while only surface roughness (Rq) and reflectivity were statistically different (p < 0.05) between the cheek and neck. At 20 min post shaving, there was a significant increase in the TEWL values accompanied by increased blood perfusion, with varying magnitude of change dependent on the anatomical site. Recovery characteristics were observed 24 h post stimulus with most parameters returning to basal values, highlighting the transient influence of the stimulus.
    CONCLUSIONS: OCT parameters revealed spatial and temporal differences in the skin tissue response to electrical shaving. This approach could inform shaver design and prevent skin sensitivity.
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  • 文章类型: Editorial
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