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1.
Skeletal Radiol ; 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39264417

RESUMEN

BACKGROUND: Evaluation of glenoid bone loss following recurrent anterior shoulder dislocations is normally performed using cross sectional imaging. OBJECTIVES: To assess how anteroposterior (AP) and Bernageau view radiographs compare to computed tomography (CT), magnetic resonance imaging (MRI) and arthroscopy for evaluating glenoid bone loss in patients with recurrent anterior shoulder dislocation. MATERIALS AND METHODS: A prospective observational study was performed on 32 patients over two years at a tertiary orthopedic center. The loss of sclerotic glenoid rim (LSGL) on AP radiograph and the percentage relative glenoid bone loss on the Bernageau radiograph were assessed. The percentage glenoid bone loss and anterior straight line (ASL) were calculated using a best fit en face circle method using CT and MRI. Percentage glenoid bone loss was also calculated during arthroscopy in multiples of 5%. RESULTS: In our study, 90.6% (29) patients were males, while only 9.4% (3) were females. This can be attributed to the involvement of the males in outdoor activities and sports. Also, the maximum number of patients were found to belong to 21-30 years of age, with the mean age being 28.66 years. Of the 32 patients, loss of sclerotic glenoid line (LSGL) on AP radiographs correlated with glenoid bone loss on cross-sectional imaging in 27 patients. Three patients had equivocal LSGL and 2 patients with glenoid bone loss on CT did not demonstrate LSGL. The difference between the two modalities was not statistically significant (p value = 0.002). The glenoid bone loss on Bernageau view correlated with glenoid bone loss on cross sectional imaging in all but one patient. The bone loss as evaluated by radiograph Bernageau view was found to have strong correlation (correlation coefficient r = 0.948, p value < 0.0001). CONCLUSION: AP and Bernageau radiographic views for anterior shoulder dislocations demonstrate good correlation with glenoid bone loss on cross-sectional imaging. They may also be used as an adjunct to predict overall bone loss on CT and at arthroscopy.

2.
Perm J ; : 1-5, 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39262213

RESUMEN

Pleomorphic dermal sarcoma (PDS) and atypical fibroxanthoma (AFX) are rare mesenchymal tumors that share similar clinical, histological, and immunohistochemical characteristics. Careful histopathological examination of a biopsy specimen that includes subcutaneous fat remains the preferred way to differentiate between these tumors. AFX is limited to dermal invasion, whereas PDS demonstrates deeper invasion. Moreover, PDS may present with tumor necrosis and high-grade histological findings, such as lymphovascular and perineural invasion, features absent in AFX. However, like PDS, AFX is a diagnosis of exclusion, and an exhaustive immunohistochemistry panel is recommended to distinguish these tumors from other spindled cell tumors in the differential diagnosis. The authors present the case of an 86-year-old man with biopsy-suspected AFX who was referred for Mohs micrographic surgery for tumor excision. During Mohs, the tumor was observed to have invaded deeply into the subcutaneous tissue and galeal aponeurosis, aligning more closely with a PDS. The diagnosis of PDS was confirmed using en face processing during Mohs surgery, which captured the intravascular involvement of a solitary vessel. Differentiating between PDS and AFX is important because PDS is a more aggressive tumor, with a higher rate of local recurrence and metastasis, and requires closer monitoring.

3.
Sci Rep ; 14(1): 17013, 2024 07 23.
Artículo en Inglés | MEDLINE | ID: mdl-39043834

RESUMEN

This study aims to develop a method to quantify choroidal vessels in normal eyes using wide-field optical coherence tomography (OCT) en-face images. The study included participants with normal eyes in whom wide-angle OCT images were acquired to generate planarized choroidal en-face and thickness map images. The images were segmented into central, midperipheral, and peripheral areas, and the midperipheral and peripheral areas were further segmented into supratemporal, infratemporal, supranasal, and infranasal sectors. The mean planarized choroidal-vessel density (p-CVD), planarized choroidal-vessel size (p-CVS), and choroidal thickness (CT) were calculated in each sector. Sex differences were analyzed using the Mann-Whitney U test. The study included 162 participants comprising 84 female (mean age, 43.5 years; axial length, 24.0 mm) and 78 male (mean age, 44.4 years; axial length, 24.2 mm) participants with no significant differences in demographics (P ≥ 0.107). Men had a higher mean p-CVD in all regions (P < 0.001). The mean p-CVS was greater in men in all regions except for the supratemporal sector (P < 0.001). No significant differences in sex in the mean CT were observed in all regions (P ≥ 0.106). The p-CVD and p-CVS in normal eyes differ between sexes. This finding may contribute to the understanding of the pathophysiology of choroidal diseases.


Asunto(s)
Coroides , Caracteres Sexuales , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Coroides/diagnóstico por imagen , Coroides/irrigación sanguínea , Femenino , Masculino , Adulto , Persona de Mediana Edad , Factores Sexuales
4.
J Clin Med ; 13(13)2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38999503

RESUMEN

Background: The aim of this study was to compare en-face optical coherence tomography (OCT) imaging and confocal scanning laser ophthalmoscopy (cSLO) imaging at different wavelengths to identify the internal limiting membrane (ILM) peeling area after primary surgery with vitrectomy and ILM peeling for macular hole (MH). Methods: In total, 50 eyes of 50 consecutive patients who underwent primary surgery with vitrectomy and ILM peeling for MH were studied. The true ILM rhexis based on intraoperative color fundus photography was compared to the presumed ILM rhexis identified by a blinded examiner using en-face OCT imaging and cSLO images at various wavelengths. To calculate the fraction of overlap (FoO), the common intersecting area and the total of both areas were measured. Results: The FoO for the measured areas was 0.93 ± 0.03 for en-face OCT, 0.76 ± 0.06 for blue reflectance (BR; 488 nm), 0.71 ± 0.09 for green reflectance (GR; 514 nm), 0.56 ± 0.07 for infrared reflectance (IR; 815 nm) and 0.73 ± 0.06 for multispectral (MS). The FoO in the en-face OCT group was significantly higher than in all other groups, whereas the FoO in the IR group was significantly lower compared to all other groups. No significant differences were observed in FoO among the MS, BR, and GR groups. In en-face OCT, there was no significant change in the ILM peeled area measured intraoperatively and postoperatively (8.37 ± 3.01 vs. 8.24 ± 2.81 mm2; p = 0.8145). Nasal-inferior foveal displacement was observed in 38 eyes (76%). Conclusions: En-face OCT imaging demonstrates reliable postoperative visualization of the ILM peeled area. Although the size of the ILM peeling remains stable after one month, our findings indicate a notable inferior-nasal shift of the overall ILM peeling area towards the optic disc.

5.
Artículo en Inglés | MEDLINE | ID: mdl-38856954

RESUMEN

PURPOSE: To investigate the incidence and distribution of fingerprint-like microwaves in the Henle fibre layer (HFL) of the eyes with epiretinal membrane (ERM). METHODS: Patients with idiopathic ERM were included. The fingerprint sign was defined using en-face optical coherence tomography images of the HFL, and its extent was classified into three grades. RESULTS: At baseline, fingerprint sign was found in 70 of 83 (84.3%) eyes with ERM and was more frequently observed in eyes with a higher ERM stage (P < 0.001). Its extent increased (P < 0.001) with an increase in ERM stage or the central macular thickness (P < 0.001). Best corrected visual acuity (BCVA) was worse in eyes with a fingerprint sign than in those without (P = 0.024). Metamorphopsia was more common in eyes with a greater extent of fingerprint-like microwaves (P = 0.048). The fingerprint sign persisted over a mean follow-up period of 18.0 ± 23.3 without surgery. In 45 eyes that underwent surgery, the extent of fingerprint-like microwaves decreased at 1.2 months (P = 0.001), and further decreased at 13.7 months postoperatively (P = 0.019). However, the proportion of eyes with a fingerprint sign after surgery was similar to that observed preoperatively (P = 0.912). CONCLUSIONS: Fingerprint-like microwaves were commonly found in eyes with ERM and were associated with ERM severity and BCVA. The microwaves remained long after surgery, although their extent may have decreased after the ERM was resolved. These results suggest that ERM traction may cause long-lasting changes in the HFL.

6.
Am J Ophthalmol Case Rep ; 35: 102013, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38884112

RESUMEN

Purpose: This report describes the presentation of a 49-year-old woman with a branch retinal artery occlusion of the right eye in the setting of taking phentermine, a commonly used weight loss medication. Observations: A 49-year-old woman presented with acute painless vision loss in her right eye and was found to have a branch retinal artery occlusion after taking prescribed dosages of phentermine for weight loss therapy. Fundus examination revealed retinal whitening in the distribution of the superior temporal branch retinal artery, and spectral domain optical coherence tomography demonstrated macular edema. Systemic evaluation was negative for cardiovascular, infectious, or autoimmune etiologies. Based on the retinal findings, the patient was diagnosed with phentermine associated branch retinal artery occlusion. She was followed for nine years with no further complications and her vision remained stable in the right eye. Conclusions and Importance: This case highlights that phentermine, a commonly used weight loss medication, could be associated with ischemic retinopathies. Thus, clinicians should be aware that retinal vascular occlusions may not only occur in those who use recreational amphetamines but also in patients taking the prescribed dosages of a weight loss medication like phentermine.

7.
Artículo en Inglés | MEDLINE | ID: mdl-38810912

RESUMEN

BACKGROUND: Glenoid bone loss is proposed to be an important risk factor for recurrent anterior shoulder instability. The purpose of the present study was to develop an accurate and reproducible method for quantifying a bone loss in patients with anterior shoulder instability. METHODS: A total of 66 sets of computed tomography images of the glenoid were acquired and en face view was established. Based on the contour of the inferior half and posteroinferior quadrant of the glenoid, the best-fit circle was drawn using the least-squares method with a comparison of the radii. A bone loss was created via a simulated osteotomy, and a method for estimating the bone loss based on the contour of the posteroinferior quadrant was developed. RESULTS: The radii of the best-fit circle were 29.30 ± 1.84 mm and 33.76 ± 2.04 mm, based on the inferior half and posteroinferior quadrant of the glenoid, respectively (P < .01). Bone loss quantification using the contour of the inferior half or posteroinferior quadrant with simulated osteotomy showed a significant difference (P < .01). For a 25% of glenoid bone loss, the estimated value using the traditional method on the contour of the posteroinferior quadrant was 34%. A new method for accurate bone loss quantification was developed based on the contour of the posteroinferior quadrant of the glenoid. CONCLUSION: Estimation of the glenoid bone loss based on the rim of the posteroinferior quadrant may overestimate the glenoid bone loss due to the difference in the radius of the curvature of the inferior half and posteroinferior quadrant. A mathematical method developed to correct this error and may aid in more accurately, measuring the glenoid bone loss using the contour of the posteroinferior quadrant in patients with anterior shoulder instability.

8.
Eur J Ophthalmol ; 34(3): NP97-NP100, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38699790

RESUMEN

INTRODUCTION: We present a single-eyed case with a previous diagnosis of breast cancer who had intraretinal cystoid changes associated with the systemic administration of ixabepilone in her only seeing eye. To our best knowledge, this is the first reported case describing this phenomenon related to the ixabepilone administration. CASE DESCRIPTION: A 54-year-old woman with a history of breast cancer was examined due to visual deterioration in her only good left eye. The patient had undergone cataract surgery and lens implantation in her right eye following a childhood accident, but subsequently had developed a refractory glaucoma and lost her right vision. Six cycles of 40 mg/m2 systemic ixabepilone (3-hly intravenous infusion once every 3 weeks) had been administered within the past six months. Her visual decline started two weeks following the last treatment session. She was offered intravitreal anti-vascular endothelial growth factor injection elsewhere. Fluorescein angiogram showed no dye leakage whereas spectral-domain optical coherence tomography demonstrated parafoveal intraretinal cystoid changes. En-face optical coherence tomography revealed petaloid type roundish hyporeflective areas at the level of superficial and deep vascular plexus. Ixabepilone-associated cystoid maculopathy was suspected as she received only ixabepilone for the chemotherapy in the last six months. We thus recommended her not to continue ixabepilone therapy. Ten weeks after the ixabepilone cessation, intraretinal cystoid changes had resolved completely. CONCLUSION: Angiographically silent intraretinal cystoid changes may develop in association with the use of ixabepilone. Referral to an ophthalmologist should be considered for the patients experiencing visual complaints as ixabepilone cessation may lead to visual improvement and avoid unnecessary treatment.


Asunto(s)
Neoplasias de la Mama , Epotilonas , Angiografía con Fluoresceína , Edema Macular , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Femenino , Persona de Mediana Edad , Edema Macular/tratamiento farmacológico , Edema Macular/diagnóstico , Epotilonas/efectos adversos , Epotilonas/administración & dosificación , Agudeza Visual/fisiología , Neoplasias de la Mama/tratamiento farmacológico , Fondo de Ojo
9.
Arch. Soc. Esp. Oftalmol ; 99(4): 165-168, abr. 2024. ilus
Artículo en Español | IBECS | ID: ibc-232137

RESUMEN

La cavitación intracoroidea es un hallazgo identificado con OCT descrito inicialmente en pacientes miopes, pero también aparece en pacientes no miopes. Puede presentarse tanto en el área peripapilar como en el polo posterior. El coloboma macular es un defecto del desarrollo embrionario del polo posterior, y en la OCT estructural es imprescindible la ausencia del epitelio pigmentario de la retina y de los vasos coroideos para su diagnóstico. Este caso presenta la cavitación intracoroidea circunscribiendo el coloboma macular, en ausencia de membrana intercalar. La imagen en face permite valorar la relación entre ambas estructuras, así como la magnitud de las mismas. (AU)


Intrachoroidal cavitation is a finding identified with OCT initially described in myopic patients, it also appears in non-myopic patients. It can occur in both the peripapillary area and the posterior pole. Macular coloboma is a defect of embryonic development of the posterior pole, in structural OCT the absence of the retinal pigment epithelium and choroidal vessels is essential. In this case, intrachoroidal cavitation circumscribes the macular coloboma, in the absence of an intercalary membrane. The face image allows us to assess the relationship between the two structures as well as their magnitude. (AU)


Asunto(s)
Humanos , Coloboma , Tomografía , Miopía Degenerativa , Cavitación , Oftalmología
10.
Clin Exp Optom ; : 1-6, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38412525

RESUMEN

CLINICAL RELEVANCE: Clinical assessment of age-related macular degeneration (AMD) relies on biomarkers that do not necessarily reflect the contributions of vascular dysfunction. Validation of clinically accessible methods of measuring retinal vascular integrity could provide a more holistic understanding of AMD-related changes to facilitate appropriate care. BACKGROUND: There is conflicting evidence if retinal vessel calibre is significantly altered in the early stages of AMD. This study examined the outer and inner diameters of first order retinal vessels in intermediate AMD eyes using en face optical coherence tomography (OCT). METHODS: Retinal en face (6 × 6 mm) OCT images were examined in a single eye of participants with intermediate AMD (n = 46) versus normal macula (n = 43) for arterioles (all identifiable) and venules (40/46 and 39/43 identifiable). All participants were aged ≥50 years without diabetes mellitus, hypertension, or other systemic vascular disease. RESULTS: Intra- and inter-grader agreement was good-to-excellent for all en face OCT measurements of arteriole and venule diameters (intraclass correlation coefficient = 0.87 to 0.99). Arteriolar outer diameters (82.3 ± 19.8 µm vs 73.8 ± 16.1 µm; p < 0.05) and inner diameters (35.1 ± 8.4 µm vs 31.5 ± 8.1 µm; p < 0.05) were significantly greater in AMD eyes compared to normal eyes. Venular inner diameter was significantly greater (43.1 ± 9.5 µm vs 39.2 ± 10.1 µm; p < 0.05), but outer diameter remained unchanged (p = 0.17) in AMD eyes compared to normal eyes. CONCLUSION: Arteriolar dilation and altered venular inner diameter were observed in intermediate AMD eyes. These results support further investigation of vascular contributions to AMD in the early stages of disease, possibly using the en face OCT imaging modality.

11.
Arch Soc Esp Oftalmol (Engl Ed) ; 99(4): 165-168, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38309662

RESUMEN

Intrachoroidal cavitation is a finding identified with OCT initially described in myopic patients, it also appears in non-myopic patients. It can occur in both the peripapillary area and the posterior pole. Macular coloboma is a defect of embryonic development of the posterior pole, in structural OCT the absence of the retinal pigment epithelium and choroidal vessels is essential. In this case, intrachoroidal cavitation circumscribes the macular coloboma, in the absence of an intercalary membrane. The en face image allows us to assess the relationship between the two structures as well as their magnitude.


Asunto(s)
Enfermedades de la Coroides , Coloboma , Mácula Lútea/anomalías , Miopía , Humanos , Coroides/diagnóstico por imagen , Coloboma/diagnóstico por imagen , Enfermedades de la Coroides/diagnóstico por imagen
12.
Ophthalmic Physiol Opt ; 44(3): 613-625, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38404167

RESUMEN

PURPOSE: To develop criteria to predict visual hemifields with deep perimetric defects based on retinal nerve fibre layer (RNFL) reflectance, in a transparent process whose components can be assessed by independent laboratories analysing data from their own small groups. METHODS: The analysis was carried out in four stages, using three independent groups of patients-30, 33 and 62 participants-with glaucoma and age-similar controls. The first stage used Group 1 to develop a criterion for RNFL reflectance images at 24, 36 or 48 µm below the inner limiting membrane (ILM). The second stage evaluated the criterion using Group 2. The third stage developed a second criterion to improve performance for Groups 1 and 2 combined. The fourth stage evaluated the second criterion with Group 3. Confidence intervals for sensitivity and specificity were then computed by combining results from all three groups. RESULTS: The first criterion identified all hemifields with deep defects and no hemifields from controls, using a within-eye reference for healthy RNFL. For Group 2, specificity remained high but sensitivity was reduced. The second criterion improved sensitivity by using location-specific reference values. For Group 3, sensitivity remained high but reduced specificity was found. Confidence intervals showed substantial overlap for the two criteria. CONCLUSIONS: We developed two criteria to identify patients with deep perimetric defects with high specificity and sensitivity. Several improvements are warranted: automated identification of the fovea-disc angle and optic disc locations, evaluation of normal variation in patterns of RNFL thickness, improved segmentation of ILM and major vasculature, reduction of within-eye variability in RNFL reflectance of healthy eyes, assessment of effects of image quality, assessment of effects of comorbidity and effectiveness of other devices.


Asunto(s)
Presión Intraocular , Campos Visuales , Humanos , Células Ganglionares de la Retina , Tomografía de Coherencia Óptica/métodos , Fibras Nerviosas
13.
Am J Ophthalmol Case Rep ; 33: 101998, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38333032

RESUMEN

Purpose: To describe the development of cystoid macular edema (CME) as a complication of central retinal artery occlusion (CRAO) in 2 cases. Observations: The first patient was a 51-year-old female who presented with acute loss of vision in the left eye. Multimodal retinal imaging revealed a CRAO with a perfused cilioretinal artery. CME acutely developed one week after presentation. Cystoid spaces predominantly involved the outer nuclear layer (ONL) on optical coherence tomography (OCT) and completely resolved in two weeks. The second case was a 50-year-old man who presented with acute vision loss in the right eye for 3 weeks. Multimodal retinal imaging illustrated an acute CRAO of the right eye. Four weeks later, visual acuity spontaneously improved to 20/20 and was maintained at 20/20 for more than 2 years. After 28 months, the patient returned with a recurrent drop of vision in the right eye. Cross sectional and en face OCT revealed CME in the right eye without leakage on FA. Cystoid spaces predominantly involved the inner nuclear layer (INL) and resolved with intravitreal anti-VEGF injection combined with carbonic anhydrase inhibitor (CAI) and steroid topical drop therapy. Conclusions and Importance: CME can rarely complicate both the acute and chronic phase of CRAO. In the acute phase, cystoid spaces were transient and confined to the ONL on OCT. While in the chronic phase, cystoid spaces were confined to the INL on OCT and angiographically silent on FA. Further studies are needed to identify the incidence, underlying pathophysiology and visual prognosis of CME in cases of CRAO.

14.
Am J Ophthalmol Case Rep ; 33: 101963, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38162804

RESUMEN

Objective: To describe the multimodal imaging features, including en face optical coherence tomography (OCT), of Bietti's crystalline dystrophy (BCD). Methods: Wide field fundus photography, autofluorescence (FAF) imaging, and cross sectional and en face OCT were performed in a case of BCD. The level of the crystals in the retina were analyzed. Results: A 42-year-old patient was referred for retinal evaluation with nyctalopia, photophobia and metamorphopsia. Retinal examination and wide field color fundus photography were remarkable for bilateral crystalline deposits in the posterior pole and midperipheral retina. Wide field FAF showed extensive nummular atrophy of the retinal pigment epithelium (RPE) in the macula and periphery. Spectral-domain (SD) OCT illustrated bilateral chorioretinal atrophy in the macula. En face SD OCT captured the hyperreflective crystals in various retinal layers, depending on the selected segmentation. The patient was diagnosed with BCD and genetic testing confirmed the diagnosis (CYP4V positive for two variants). Conclusion: In this case report, we describe the multimodal imaging features of Bietti's Crystalline Dystrophy. Wide field FAF illustrated diffuse nummular RPE atrophy in the posterior pole and periphery and en face OCT captured the hyperreflective crystals in different layers of the retina.

15.
Graefes Arch Clin Exp Ophthalmol ; 262(2): 469-476, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37864637

RESUMEN

PURPOSE: To assess epiretinal membrane (ERM) formation, severity, and the associated risk factors after scleral buckling using en face optical coherence tomography (OCT) images. METHODS: Medical records of 61 consecutive patients (66 eyes) with rhegmatogenous retinal detachment who underwent scleral buckling were retrospectively reviewed. Posterior vitreous detachment (PVD) was determined based on B-scan OCT images. En face OCT images were used to visualize the ERM and retinal folds. ERM formation was identified by comparing en face images pre- and post-surgery. The maximum depth of the retinal folds (MDRF) was measured using en face imaging to objectively assess traction strength. RESULTS: ERM formation occurred in 15 (22.7%) eyes at the final visit; the foveal pit was preserved in all cases. Parafoveal retinal folds were present in 5 (7.6%) eyes, with a mean MDRF of 21.8 ± 12.6 µm. No significant difference was observed in best-corrected visual acuity (logarithm of the minimal angle of resolution) between the ERM formation (-0.019 ± 0.128) and non-ERM formation (-0.001 ± 0.213) groups at the final visit (P = 0.593; Mann-Whitney U test). Multivariate logistic regression analysis revealed that older age and the presence of PVD were significant risk factors for ERM formation (odds ratio 1.07, 95% confidence interval 1.01-1.14, P = 0.032; odds ratio 5.26, 95% confidence interval 1.06-26.10, P = 0.042; respectively). CONCLUSION: ERM occurred in 22.7% of cases but was mild and did not affect visual acuity. Older age and the presence of PVD are risk factors for ERM formation.


Asunto(s)
Membrana Epirretinal , Desprendimiento de Retina , Desprendimiento del Vítreo , Humanos , Curvatura de la Esclerótica , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/etiología , Desprendimiento de Retina/cirugía , Membrana Epirretinal/diagnóstico , Membrana Epirretinal/etiología , Membrana Epirretinal/cirugía , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Desprendimiento del Vítreo/cirugía , Vitrectomía/efectos adversos
16.
Ophthalmol Sci ; 4(2): 100382, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37868804

RESUMEN

Purpose: To assess whether the combination of en face OCT and OCT angiography (OCTA) can capture observable, but subtle, structural changes that precede clinically evident retinal neovascularization (RNV) in eyes with diabetic retinopathy (DR). Design: Retrospective, longitudinal study. Participants: Patients with DR that had at least 2 visits. Methods: We obtained wide-field OCTA scans of 1 eye from each participant and generated en face OCT, en face OCTA, and cross-sectional OCTA. We identified eyes with RNV sprouts, defined as epiretinal hyperreflective materials on en face OCT with flow signals breaching the internal limiting membrane on the cross-sectional OCTA without recognizable RNV on en face OCTA and RNV fronds, defined as recognizable abnormal vascular structures on the en face OCTA. We examined the corresponding location from follow-up or previous visits for the presence or progression of the RNV. Main Outcome Measures: The characteristics and longitudinal observation of early signs of RNV. Results: From 71 eyes, we identified RNV in 20 eyes with the combination of OCT and OCTA, of which 13 (65%) were photographically graded as proliferative DR, 6 (30%) severe nonproliferative DR, and 1 (5%) moderate nonproliferative diabetic retinopathy. From these eyes, we identified 38 RNV sprouts and 26 RNV fronds at the baseline. Thirty-four RNVs (53%) originated from veins, 24 (38%) were from intraretinal microabnormalities, and 6 (9%) were from a nondilated capillary bed. At the final visit, 53 RNV sprouts and 30 RNV fronds were detected. Ten eyes (50%) showed progression, defined as having a new RNV lesion or the development of an RNV frond from an RNV sprout. Four (11%) RNV sprouts developed into RNV fronds with a mean interval of 7.0 months. Nineteen new RNV sprouts developed during the follow-up, whereas no new RNV frond was observed outside an identified RNV sprout. The eyes with progression were of younger age (P = 0.014) and tended to be treatment naive (P = 0.07) compared with eyes without progression. Conclusions: Longitudinal observation demonstrated that a combination of en face OCT and cross-sectional OCTA can identify an earlier form of RNV before it can be recognized on en face OCTA. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

17.
Case Rep Ophthalmol ; 14(1): 591-595, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37915517

RESUMEN

Paracentral acute middle maculopathy (PAMM) has recently been described following episodes of migraine. In this report, we present a case of PAMM and describe the role of en face optical coherence tomography (OCT). A 75-year-old woman presented with subjective vision loss over a 2-week period in the right eye. She was known for migraines with aura that presented with progressive spreading of positive and negative visual phenomena which usually resolved in under an hour. Her recent migraine episode was "atypical," as it lasted 3 days. She also experienced a monocular central scotoma with "black spots and jagged, zig-zag edges." The positive auras resolved spontaneously, whereas the central scotoma persisted. Spectral domain OCT showed an area of perifoveal hyperreflectivity from the inner plexiform to the outer plexiform layers consistent with PAMM. The mid-retina en face OCT and OCT angiography demonstrated an ovoid focal patch of hyperreflectivity with flow interruption, characteristic of globular PAMM. We diagnosed her with migraines with aura and presumed retinal vasospasm, complicated by retinal ischemia in the form of globular PAMM. Acute retinal ischemia, which may require urgent neurovascular workup and giant cell arteritis evaluation, must be considered in patients with migraines alongside persistent visual changes. Diagnosing PAMM requires a high level of suspicion since it can present without significant changes in visual acuity, visual fields, and fundus photographs. With the inclusion of en face OCT in the clinicians' diagnostic armamentarium, the slightest signs of retinal ischemic changes, such as PAMM, become evident.

18.
Front Physiol ; 14: 1214427, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38028808

RESUMEN

Purpose: To compare the morphological characteristics of Schlemm's canal (SC) in patients with primary open-angle glaucoma (POAG) and healthy controls, using swept-source optical coherence tomography (SS-OCT) with en face reconstruction. Methods: In this Prospective comparative study, we included 100 eyes from 50 patients diagnosed with POAG and 50 healthy controls. Three-dimensional cube and line scans of the temporal and nasal quadrants of the anterior segment of the limbus were acquired using SS-OCT. SC was identified using en face and cross-sectional images. The diameter and area of SC in cross-sectional images and the visible percentage and area of SC in en face images were measured using ImageJ. Results: SC was observed in 84% of en face images and 81% of cross-sectional images in eyes with POAG but in 92% of en face images and 86% of cross-sectional images in control eyes. Significant differences between the POAG and normal control eyes were found in the en face area (0.35 ± 0.14 mm2 vs. 0.56 ± 0.22 mm2 in the temporal quadrant and 0.36 ± 0.14 mm2 vs. 0.58 ± 0.23 mm2 in the nasal quadrant; both p < 0.001) and visible percentage of SC (85.71% vs. 94.91% and 87.10% vs. 95.52% in the temporal and nasal quadrant respectively, both p < 0.001) in en face images as well as the cross-sectional area (2790.9 ± 942.2 µm2 vs. 4138.6 ± 2027.8 µm2 in the temporal quadrant and 2805.7 ± 947.2 µm2 vs. 4224.0 ± 2002.2 µm2 in the nasal quadrant, both p < 0.001) and diameter of SC (123.1 ± 25.4 µm vs. 149.5 ± 34.7 µm in the temporal quadrant and 126.3 ± 28.9 µm vs. 155.3 ± 36.0 µm in the nasal quadrant, both p < 0.001) in cross-section images. In addition, the mean intraocular pressure (IOP) significantly correlated with the en face area, visible percentage of SC, and cross-sectional area in the temporal and nasal quadrants. Conclusion: SS-OCT can obtain high-quality en face images of SC without post-acquisition processing. Eyes with POAG had a decreased en face SC area compared with normal eyes. A correlation between SC area, visible percentage of en face images, and IOP was also observed.

19.
Cureus ; 15(9): e45983, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37900525

RESUMEN

Angioid streaks are mainly characterized by radially striated lesions around the optical disc and result in severe vision loss when choroidal neovascularization (CNV) develops at the macula. The prediction of visual prognosis in cases with angioid streaks remains an unsolved problem. In this study, we report the usefulness of en-face optical coherence tomography (OCT) to assess the bilateral striated lesions in angioid streaks. A 59-year-old female who was previously diagnosed with angioid streaks complained of decreased visual acuity in her left eye. However, on en-face OCT, the striated lesions in the right eye with better vision were shown as thicker continuous lesions than those in the left eye. Twenty-four months after the initial visit, her right visual acuity was worse than her left. En-face OCT showed fine-striated lesions extending from those thicker lesions to the macular area in the right eye. The thicker striated lesions observed at the initial visit may be a risk factor for future CNV development and vision loss. The evaluation of lesion size using en-face OCT may be useful for predicting the visual prognosis in angioid streaks.

20.
Methods Mol Biol ; 2710: 1-18, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37688720

RESUMEN

Olfactory cilia are the obligate transducers of the odorant signal, and thus their study has been a focus of investigation in the olfactory field. Various methodologies have been established to visualize the cilia of olfactory sensory neurons; however, these approaches are limited to static imaging and often lack the ability to resolve individual cilia projecting from solitary neurons in the postnatal mouse. Here we detail a procedure of the visualization of olfactory cilia by ectopic expression of fluorescently tagged proteins. The procedure can be used for the observation and manipulation of the olfactory cilia and ciliary proteins in both static and dynamic conditions.


Asunto(s)
Cilios , Neuronas Receptoras Olfatorias , Animales , Ratones , Olfato , Odorantes , Imagen de Difusión por Resonancia Magnética
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