RESUMO

High-quality imaging of the retina is crucial to the diagnosis and monitoring of disease, as well as for evaluating the success of therapeutics in human patients and in preclinical animal models. Here, we describe the basic principles and methods for in vivo retinal imaging in rodents, including fundus imaging, fluorescein angiography, optical coherence tomography, fundus autofluorescence, and infrared imaging. After providing a concise overview of each method and detailing the retinal diseases and conditions that can be visualized through them, we will proceed to discuss the advantages and disadvantages of each approach. These protocols will facilitate the acquisition of optimal images for subsequent quantification and analysis. Additionally, a brief explanation will be given regarding the potential results and the clinical significance of the detected abnormalities.

Assuntos

Modelos Animais de Doenças , Angiofluoresceinografia , Retina , Doenças Retinianas , Tomografia de Coerência Óptica , Animais , Tomografia de Coerência Óptica/métodos , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/patologia , Doenças Retinianas/diagnóstico , Retina/diagnóstico por imagem , Retina/patologia , Angiofluoresceinografia/métodos , Camundongos , Ratos , Roedores , Imagem Óptica/métodos , Humanos , Fundo de Olho

RESUMO

An important abnormality in Optical Coherence Tomography (OCT) images is Hyper-Reflective Foci (HRF). This anomaly can be interpreted as a biomarker of serious retinal diseases such as Age-related Macular Degeneration (AMD) and Diabetic Macular Edema (DME) or the progression of disease from an early stage to a late one. In this paper, a new method is proposed for the identification of HRFs. The new method divides the OCT B-scan into patches and separately verifies each patch to determine whether or not the patch contains an HRF. The procedure of patch verification contains a texture-based framework which assigns appropriate labels according to intensity changes to each column and row. Then, a feature vector is extracted for each patch based on the assigned labels. The feature vectors are utilized in the training step of well-known classifiers like Support Vector Machine (SVM). Then, the classifiers are used to produce the labels for the test OCT images. The new method is evaluated on a public dataset including HRF labels. The experimental results show that the new method is capable of providing outstanding results in terms of speed and accuracy.

Assuntos

Retina , Máquina de Vetores de Suporte , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Humanos , Retina/diagnóstico por imagem , Retina/patologia , Degeneração Macular/diagnóstico por imagem , Degeneração Macular/patologia , Retinopatia Diabética/diagnóstico por imagem , Edema Macular/diagnóstico por imagem , Algoritmos , Processamento de Imagem Assistida por Computador/métodos , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/patologia

RESUMO

Purpose: To investigate if changes in vessel density (VD) and the foveal avascular zone (FAZ) occur in the preclinical phase of Alzheimer's disease (pAD) over time. Methods: Optical coherence tomography angiography (OCTA) was used to image VD and FAZ at baseline and for a follow-up period of 2 years. Positron emission tomography (PET) was used to determine the amyloid beta (Aß) status of participants. Results: The VD and FAZ of 148 participants (54% female) were analyzed at baseline and follow-up (mean time between measurements, 2.24 ± 0.35 years). The mean age of the participants was 68.3 ± 6.0 years at baseline and 70.3 ± 5.9 years at follow-up. Participants were divided into three groups: control group, participants who had negative Aß status at both measurements (Aß-, n = 116); converter group, participants who transitioned from negative to positive between baseline and follow-up (Aß-+, n = 18); and participants who were consistently positive at both visits (Aß++, n = 14). The VD of both Aß+ groups demonstrated non-significant increases over time in both macula and optic nerve head (ONH) regions. The Aß- group was found to be significantly higher in both ONH and macular regions. The VD of the Aß++ group was significantly higher in the macula inner and outer rings compared to the Aß-+ and Aß- groups. No significant change was found in FAZ values over time. Conclusions: Alterations in VD seem to manifest already in pAD, exhibiting distinct variations between the ONH and macula. Further longitudinal studies with a longer follow-up design and known amyloid pathology should be undertaken to validate these observations.

Assuntos

Doença de Alzheimer , Angiofluoresceinografia , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Feminino , Tomografia de Coerência Óptica/métodos , Doença de Alzheimer/diagnóstico , Masculino , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Idoso , Angiofluoresceinografia/métodos , Seguimentos , Pessoa de Meia-Idade , Microvasos/diagnóstico por imagem , Microvasos/patologia , Tomografia por Emissão de Pósitrons , Fóvea Central/irrigação sanguínea , Fóvea Central/diagnóstico por imagem , Fóvea Central/patologia , Peptídeos beta-Amiloides/metabolismo , Progressão da Doença

RESUMO

Purpose: To compare an optical coherence tomography (OCT) real-world reference database (RW-RDB) of "healthy" eyes obtained from optometry practices to a commercial reference database (RDB). Methods: OCT scans from 6804 individuals 18 years and older were sampled from a larger database tested at 10 optometry practices involved in refractive and screening services. Employing a reading center method, OCT scans from both eyes of 4932 (4.9K) individuals were judged to be of acceptable quality with an absence of pathology. The 4.9K RW-RDB was compared to a commercial RDB with 398 eyes (398 RDB). Results: The means and distributions of global circumpapillary retinal nerve fiber layer (G-cpRNFL) and global ganglion cell layer (G-GCL) thickness, as well as five key anatomical parameters affecting cpRNFL thickness, were not significantly different for all but one parameter (fovea-to-disc distance) and one thickness metric (G-cpRNFL). In both cases, the difference amounted to less than 1.5%. By design, the number of 4.9K RW-RDB eyes 70 years and older (724, 14.7%) was greater than for the 398 RDB (40, 10.1%). The error bands on the 5% and 1% quantile regression lines (QRLs) were substantially narrower for the 4.9K RW-RDB. Conclusions: The 398 RDB and 4.9K RW-RDB have similar characteristics and appear to come from a similar population. However, the large size of the 4.9K RW-RDB leads to narrower error bands of the QRLs, which has the potential to increase accuracy. Translational Relevance: The larger RW-RDB offers the opportunity to better characterize healthy eyes for clinical diagnosis and clinical trials by furthering our understanding of the patterns of artifacts, exploring covariates, developing separate RW-RDBs, and/or improving AI models.

Assuntos

Bases de Dados Factuais , Optometria , Tomografia de Coerência Óptica , Humanos , Masculino , Feminino , Tomografia de Coerência Óptica/métodos , Pessoa de Meia-Idade , Adulto , Idoso , Fibras Nervosas , Células Ganglionares da Retina/citologia , Adulto Jovem , Valores de Referência , Adolescente

RESUMO

Purpose: To investigate if split-spectrum amplitude-decorrelation optoretinography (SSADOR) can detect and measure macular cone dysfunction in inherited retinal dystrophies (IRDs). Methods: This study was a case series of participants presenting with various IRD pathologies. Participants were recruited from the Ophthalmic Genetics clinic at the Casey Eye Institute from February to August 2023. Multimodal and SSADOR imaging was obtained in all cases. Results: We recruited nine participants, including four with macular dystrophy, one with fundus flavimaculatus, one with cone dystrophy, and three with retinitis pigmentosa. SSADOR decorrelation maps identified areas of cone functional impairment consistent with disease phenotypes. A correlation between the SSADOR signal and retinal sensitivity measured by microperimetry within the central 20° diameter area was observed. Additionally, SSADOR was able to demonstrate a decreased signal in mild cases when microperimetry measurements were still normal but subtle changes were also apparent on structural OCT. Conclusions: SSADOR is sensitive at detecting functional changes in macular cones, even prior to abnormalities in perimetry testing. We highlight the potential benefits of this innovative technology for the early detection of cone dysfunction and their potential contributions to earlier diagnosis and more accurate monitoring of progression. Translational Relevance: SSADOR is an innovative technology that detects early macular cone function changes, allowing for early diagnosis and precise monitoring of cone dysfunction progression. By serving as a potential clinical trial endpoint, SSADOR facilitates the translation of scientific findings into practical applications, ultimately improving patient care and outcomes.

Assuntos

Células Fotorreceptoras Retinianas Cones , Distrofias Retinianas , Tomografia de Coerência Óptica , Testes de Campo Visual , Humanos , Tomografia de Coerência Óptica/métodos , Feminino , Masculino , Adulto , Células Fotorreceptoras Retinianas Cones/patologia , Pessoa de Meia-Idade , Distrofias Retinianas/diagnóstico , Distrofias Retinianas/fisiopatologia , Distrofias Retinianas/diagnóstico por imagem , Testes de Campo Visual/métodos , Adulto Jovem , Idoso , Retinose Pigmentar/fisiopatologia , Retinose Pigmentar/diagnóstico , Retinose Pigmentar/diagnóstico por imagem , Acuidade Visual/fisiologia , Adolescente

RESUMO

Purpose: The purpose of this study was to investigate the normal range of ophthalmic parameters and the correlations between systematic and ocular parameters and retinal nerve fiber layer (RNFL) thickness among a healthy non-glaucoma cynomolgus monkey colony. Methods: All included monkeys were given detailed ophthalmic examinations, including anterior and posterior segments. Furthermore, univariate and multivariate linear regression models were conducted to estimate the relationship between systemic and ophthalmic parameters and global RNFL thickness. Results: A total of 349 non-glaucoma monkeys (18.69 ± 2.88 years old) were collected. The global RNFL thickness was 94.61 ± 10.13 µm, and sex-specific differences existed in all sectors. The decreasing trend of RNFL is as follows: inferotemporal, superotemporal, inferonasal, superonasal, temporal, and nasal. For lamina cribrosa (LC)-related parameters, cup depth (P < 0.01), LC thickness (P = 0.014), and Bruch's membrane opening (BMO) - minimum rim width 2 (P = 0.002) were greater in the male group. However, LC depth (P = 0.02), anterior laminar insertion depth-1 (P = 0.009), and mean anterior laminar insertion depth (P = 0.029) of female monkeys were greater than those of male monkeys. In multivariate linear regression, only older age was significantly related to reduced global RNFL thickness (P < 0.001). Conclusions: Our findings suggest the differences in RNFL thickness distribution and sex between non-glaucoma cynomolgus monkeys and humans. Therefore, the impact of this difference on outcomes should be fully considered in laboratory animal studies. Our findings are also significant in terms of developing a normative optical coherence tomography (OCT) database in nonhuman primates (NHPs). Translational Relevance: We found that the differences in RNFL thickness distribution and sex between non-glaucoma cynomolgus monkey colonies and humans should be thoroughly taken into account in laboratory animal studies.

Assuntos

Macaca fascicularis , Fibras Nervosas , Disco Óptico , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Animais , Macaca fascicularis/anatomia & histologia , Masculino , Feminino , Tomografia de Coerência Óptica/métodos , Células Ganglionares da Retina/citologia , Disco Óptico/anatomia & histologia , Pressão Intraocular/fisiologia , Valores de Referência

RESUMO

The integration of digital subtraction angiography (DSA) with intravascular optical coherence tomography (IVOCT) offers a comprehensive 3D arterial model, which is invaluable for the analysis of vascular anatomy and biomechanics. However, the process of image fusion is often hindered by the challenge of accurately orienting IVOCT images. This paper introduces a novel, to our knowledge, dual-path 3D reconstruction method that leverages the guidewire and the vessel's centerline to establish cross sectional direction vectors within the IVOCT images and spatial direction vectors along the guidewire's trajectory. This approach minimizes the accumulation of reconstruction errors by ensuring the precise orientation of each vascular cross section. The efficacy of the proposed method is validated through vascular phantom experiments and the reconstruction of patient-specific 3D coronary models.

Assuntos

Vasos Coronários , Imageamento Tridimensional , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Humanos , Imageamento Tridimensional/métodos , Vasos Coronários/diagnóstico por imagem , Imagens de Fantasmas , Angiografia Coronária/métodos

RESUMO

AIMS: To identify baseline characteristics that best correlate to treatment interval for naive neovascular age-related macular degeneration patients treated with faricimab in the first year (Y1) of the TENAYA and LUCERNE phase 3 trials, and to further understand how these characteristics may impact treatment intervals. METHODS: This post-hoc analysis of Y1 data from the TENAYA and LUCERNE trials evaluated ocular baseline characteristics associated with Y1 treatment intervals. Patients were categorised into three subgroups based on their Y1 treatment interval: Q16W, Q12W or Q8W. Baseline characteristics (central subfield thickness (CST), best-corrected visual acuity, presence of subretinal fluid in centre 1 mm, presence of retinal fluid in centre 1 mm, macular neovascularisation (MNV) location and MNV type) were inputted into an R package 'rpart' to create a classification tree model. A data-driven tree model based on CST was fitted, producing CST subgroups of low, middle and high ranges. Within each CST subgroup, the model identified the most impactful variables and associated thresholds. RESULTS: After fitting the data to produce data-driven CST ranges, the model chose MNV location, followed by MNV lesion type as the most impactful baseline characteristics with these factors having a p value <0.05 in a multivariate analysis. CONCLUSIONS: Among the selected ocular baseline characteristics from TENAYA and LUCERNE trial, CST, MNV type and MNV location were seen as the most relevant variables to enable extension of treatment intervals during Y1. While this analysis provides insights for treatment intervals during the first year, further analysis incorporating Y2 data from the TENAYA and LUCERNE studies will be needed to assess factors influencing treatment intervals over a longer period.

Assuntos

Inibidores da Angiogênese , Injeções Intravítreas , Acuidade Visual , Degeneração Macular Exsudativa , Humanos , Masculino , Feminino , Inibidores da Angiogênese/uso terapêutico , Inibidores da Angiogênese/administração & dosagem , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Método Duplo-Cego , Idoso de 80 Anos ou mais , Resultado do Tratamento , Fatores de Tempo

RESUMO

BACKGROUND: To investigate the risk factors and prognosis of clinical pseudophakic cystoid macular edema (PCME) after uneventful phacoemulsification surgery in patients without pre-existing fundus diseases. METHODS: This was a retrospective case-control study. Medical records between August 2020 and August 2023 were reviewed for patients who had no previous fundus diseases and developed clinical PCME. A control group was randomly chosen and the risk factors for PCME was analyzed by binary logistic regression. Structure and visual prognosis of the PCME cohort were observed and compared among subgroups undergoing different treatment measures. RESULTS: Forty-seven eyes of 47 patients with PCME were included. The development of PCME was associated with higher systolic blood pressure (OR, 1.048; 95%CI 1.002, 1.097; P = .042), no posterior vitreous detachment (OR, 0.215; 95%CI: 0.553, 0.887; P = .032) and shorter axial lengths (OR, 0.401; 95%CI 0.161, 0.997; P = .049) compared to controls. During a mean follow-up of 8.26 months, 36 eyes (76.6%) showed visual improvement with decreased macular thickness. Different treatment modalities, including observation, topical NSAIDs, and intervention therapy, have no significant differences on the visual prognosis (P = 1.000). However, the intervention group had a shorter recovery time compared to the observation group (28.6 vs. 45.9 days, P = .037). CONCLUSION: PCME remains an encountered morbidity in patients without pre-existing fundus diseases. Shorter axial lengths, absence of posterior vitreous detachment, and higher systolic blood pressure are risk factors of PCME. Active intervention failed to improve the prognosis of PCME but could shorten the recovery time.

Assuntos

Edema Macular , Facoemulsificação , Acuidade Visual , Humanos , Edema Macular/etiologia , Edema Macular/diagnóstico , Masculino , Estudos Retrospectivos , Feminino , Fatores de Risco , Idoso , Prognóstico , Acuidade Visual/fisiologia , Estudos de Casos e Controles , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias , Tomografia de Coerência Óptica , Fundo de Olho , Seguimentos , Pseudofacia/fisiopatologia , Pseudofacia/complicações , Idoso de 80 Anos ou mais

RESUMO

BACKGROUND: Optical coherence tomography angiography (OCTA) is a relatively new extension of Optical coherence tomography (OCT) that generates non-invasive, depth-resolved images of the retinal microvasculature which allows for the detection of various features of diabetic retinopathy. OBJECTIVES: This study aimed to detect biomarkers that may predict an early anatomical response to the treatment of diabetic macular edema (DME) with intravitreal ranibizumab (IVR) by means of OCTA. PATIENTS AND METHODS: This prospective interventional study was undertaken on 111 eyes of 102 naïve participants who had diabetic macular edema; enrolled patients were evaluated by taking a complete ophthalmologic history, examination and investigations by use of a pre-designed checklist involving Optical Coherence Tomography Angiography. RESULTS: Regarding the best corrected visual acuity (BCVA) the Mean ± SD was 0.704 ± 0.158 preoperatively and 0.305 ± 0.131 postoperatively in good responder patients; and was 0.661 ± 0.164 preoperatively and 0.54 ± 0.178 postoperatively in poor responders. The central macular thickness (CMT) was 436.22 ± 54.66 µm preoperatively and 308.12 ± 33.09 µm postoperatively in good responder patients; and was 387.74 ± 44.05 µm preoperatively and 372.09 ± 52.86 µm postoperatively in poor responders. By comparing the pre injection size of the foveal avascular zone area (FAZ-A) in both groups, it found that the mean ± SD of FAZ-A was 0.297 ± 0.038 mm in good responder patients compared to 0.407 ± 0.05 mm in non-responder patients. The preoperative superficial capillary plexus (SCP) foveal vascular density (VD) was 24.02 ± 3.01% in good responder patients versus 17.89 ± 3.19% um in poor responders. The preoperative SCP parafoveal VD was 43.06 ± 2.67% in good responder patients versus 37.96 ± 1.82% um in poor responders. The preoperative deep capillary plexus (DCP) foveal VD was 30.58 ± 2.89% in good responder patients versus 25.45 ± 3.14% in poor responders. The preoperative DCP parafoveal VD was 45.66 ± 2.21% in good responder patients versus 43.26 ± 2.35% um in poor responders, this was statistically significant. CONCLUSION: OCTA offers an accurate measurement for VD in the macula as well as the FAZ-A which could be used to predict an early anatomical response of anti-VEGF treatment in DME.

Assuntos

Inibidores da Angiogênese , Retinopatia Diabética , Angiofluoresceinografia , Injeções Intravítreas , Edema Macular , Ranibizumab , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Tomografia de Coerência Óptica/métodos , Edema Macular/tratamento farmacológico , Edema Macular/diagnóstico , Edema Macular/diagnóstico por imagem , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/tratamento farmacológico , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Angiofluoresceinografia/métodos , Acuidade Visual/fisiologia , Inibidores da Angiogênese/uso terapêutico , Ranibizumab/uso terapêutico , Ranibizumab/administração & dosagem , Idoso , Valor Preditivo dos Testes , Adulto , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Fundo de Olho , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia

RESUMO

BACKGROUND: The inner segments and outer segments (IS/OS) of the retinal photoreceptors are the areas that receive light signals and are the most initial sites for generating visual impulses, and the integrity of the IS/OS has a direct impact on visual sensitivity. METHODS: We performed OCT on a 6-year-old child with vision loss and found that the cause of his vision loss was a retinal IS/OS fracture, and the child underwent some treatments to improve microcirculation and nourish the retina at a higher-level hospital, but his vision never improved. Our examination of this child revealed that this child not only had decreased visual acuity, but also hypermetropia, but his near stereopsis was normal. The symptoms were similar to those of amblyopia, so we tried to use visual training as a treatment. RESULTS: First, 6 sessions of fine visual stimulation were given, followed by 3 sessions of accommodation training, and we followed the 4 stages of accommodation training: perception of accommodation, amplitude of accommodation, sensitivity of accommodation, and autonomic accommodation. After 9 consecutive visual training sessions, the child's visual acuity was stabilized at 0.6, and then we added eye movement training, and after the child's visual acuity was improved to 0.7, we suppressed the visual acuity of the left eye to 0.6, so as to make the visual acuity of both eyes similar, which would promote the establishment of binocular stereo vision, and then we carried out 9 more visual training sessions, and the patient's visual acuity was stabilized at 0.8 gradually. OCT review showed that the child's retinal IS/OS fracture was basically closed. CONCLUSION SUBSECTIONS: In conclusion, our study found that visual training can restore visual acuity in children with monocular IS/OS fracture and also promote repair of IS/OS fracture, which increases our understanding and knowledge of the treatment of retinal IS/OS fracture, and this case may provide some lessons for the treatment of retinal IS/OS fracture in children. We hope to have more samples of retinal IS/OS fracture in the future to evaluate the efficacy of visual training for retinal IS/OS fracture.

Assuntos

Acuidade Visual , Humanos , Criança , Masculino , Tomografia de Coerência Óptica , Acomodação Ocular/fisiologia , Segmento Externo das Células Fotorreceptoras da Retina

RESUMO

BACKGROUND: Percutaneous coronary intervention (PCI) has become one of the most commonly performed interventional life-saving procedures worldwide. Intravascular Imaging (intravascular ultrasound (IVUS) and optical coherence tomography (OCT)) have initially evolved to guide PCI compared with angiography. However, this technology is not universally employed in all PCI procedures, and there is ongoing controversy regarding its additional benefits to patient outcomes. We aim to estimate the efficacy and safety of imaging modalities during PCI, allowing pre-, per, and post-intervention assessment of coronary vascularization. METHODS: A systematic review and Bayesian network meta-analysis of randomized controlled trials (RCTs), which were retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through September 2023. We used R, version 4.2.0. Effect sizes will be presented as odds ratios with accompanying 95% credible intervals. PROSPERO ID: CRD42024507821. RESULTS: Our study, encompassing 36 RCTs with a total of 17,572 patients, revelead that compared to conventional angiography, IVUS significantly reduced the risk of major adverse cardiovascular events (MACE) (OR: 0.71 [95% CrI: 0.56 to 0.87]) but not OCT (OR: 0.91 [95% CrI: 0.62 to 1.39]), IVUS and OCT significantly reduced the risk of cardiac death (OR: 0.50 [95% CrI: 0.33 to 0.76]) and (OR: 0.55 [95% CrI: 0.31 to 0.98]), respectively, IVUS significantly reduced the risk of target vessel-related revascularization (OR: 0.60 [95% CrI: 0.48 to 0.75]) but not OCT (OR: 0.86 [95% CrI: 0.60 to 1.19]), IVUS and OCT significantly reduced the risk of stent thrombosis (OR: 0.50 [95% CrI: 0.28 to 0.92]) and (OR: 0.48 [95% CrI: 0.22 to 0.98]), respectively, IVUS significantly reduced the risk of re-stenosis (OR: 0.65 [95% CrI: 0.46 to 0.88]) but not OCT (OR: 0.55 [95% CrI: 0.15 to 1.99]), neither IVUS (OR: 0.97 [95% CrI: 0.71 to 1.38]) nor OCT (OR: 0.75 [95% CrI: 0.49 to 1.22]) were associated with statistically significant reductions in all-cause mortality, neither IVUS (OR: 0.70 [95% CrI: 0.45 to 1.32]) nor OCT (OR: 0.81 [95% CrI: 0.47 to 1.59]) were associated with statistically significant reductions in target vessel failure, neither IVUS (OR: 0.88 [95% CrI: 0.43 to 2.44]) nor OCT (OR: 0.81 [95% CrI: 0.37 to 2.04]) were associated with statistically significant reductions in target lesion failure, and neither IVUS (OR: 0.82 [95% CrI: 0.60 to 1.06]) nor OCT (OR: 0.84 [95% CrI: 0.59 to 1.19]) were associated with statistically significant reductions in myocardial infarction. CONCLUSION: Intravascular imaging-guided, including IVUS and OCT, improved the postinterventional outcomes of PCI, notably suggesting their advantage over traditional angiography with no significant difference between IVUS and OCT.

Assuntos

Teorema de Bayes , Angiografia Coronária , Doença da Artéria Coronariana , Metanálise em Rede , Intervenção Coronária Percutânea , Valor Preditivo dos Testes , Ensaios Clínicos Controlados Aleatórios como Assunto , Tomografia de Coerência Óptica , Ultrassonografia de Intervenção , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Intervenção Coronária Percutânea/instrumentação , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/terapia , Doença da Artéria Coronariana/mortalidade , Resultado do Tratamento , Fatores de Risco , Medição de Risco , Feminino , Pessoa de Meia-Idade , Masculino , Idoso , Vasos Coronários/diagnóstico por imagem

RESUMO

The mechanical properties of the sclera play a critical role in supporting the ocular structure and maintaining its shape. However, non-invasive measurements to quantify scleral biomechanics remain challenging. Recently introduced multi-directional optical coherence elastography (OCE) combined with an air-coupled ultrasound transducer for excitation of elastic surface waves was used to estimate phase speed and shear modulus in ex vivo rabbit globes (n = 7). The scleral phase speed (12.1 ± 3.2 m/s) was directional-dependent and higher than for corneal tissue (5.9 ± 1.4 m/s). In the tested locations, the sclera proved to be more anisotropic than the cornea by a factor of 11 in the maximum of modified planar anisotropy coefficient. The scleral shear moduli, estimated using a modified Rayleigh-Lamb wave model, showed significantly higher values in the circumferential direction (65.4 ± 31.9 kPa) than in meridional (22.5 ± 7.2 kPa); and in the anterior zone (27.3 ± 9.3 kPa) than in the posterior zone (17.8 ± 7.4 kPa). The multi-directional scanning approach allowed both quantification and radial mapping of estimated parameters within a single measurement. The results indicate that multi-directional OCE provides a valuable non-invasive assessment of scleral tissue properties that may be useful in the development of improved ocular models, the evaluation of potential myopia treatment strategies, and disease characterization and monitoring.

Assuntos

Técnicas de Imagem por Elasticidade , Esclera , Tomografia de Coerência Óptica , Animais , Coelhos , Esclera/diagnóstico por imagem , Esclera/fisiologia , Técnicas de Imagem por Elasticidade/métodos , Tomografia de Coerência Óptica/métodos , Fenômenos Biomecânicos , Córnea/diagnóstico por imagem , Córnea/fisiologia , Módulo de Elasticidade

RESUMO

BACKGROUND: We aimed to evaluate microaneurysms (MAs) after treatment with anti-vascular endothelial growth factor (anti-VEGF) therapy to understand causes of chronic edema and anti-VEGF resistance. METHODS: Patients with non-proliferative diabetic retinopathy, with or without macular edema were recruited. Optical coherence tomography angiography (OCTA) MAs-related parameters were observed, including the maximum diameter of overall dimensions, material presence, and flow signal within the lumen. OCTA parameters also included central macular thickness (CMT), foveal avascular zone, superficial and deep capillary plexuses, and non-flow area measurements on the superficial retinal slab. RESULTS: Overall, 48 eyes from 43 patients were evaluated. CMT differed significantly between the diabetic macular edema (DME ) and non-DME (NDME) groups at 1st, 2nd, 3rd, and 6th months of follow-up (P < 0.001; <0.001; 0.003; <0.001, respectively). A total of 55 and 59 MAs were observed in the DME (mean = 99.40 ± 3.18 µm) and NDME (mean maximum diameter = 74.70 ± 2.86 µm) groups at baseline, respectively (significant between-group difference: P < 0.001). Blood flow signal was measurable for 46 (83.6%) and 34 (59.3%) eyes in the DME and NDME groups, respectively (significant between-group difference: P < 0.001). CONCLUSIONS: Compared to the NDME group, the DME group had larger MAs and a higher blood-flow signal ratio. Following anti-VEGF therapy, changes in the diameter of MAs were observed before changes in CMT thickness.

Assuntos

Inibidores da Angiogênese , Retinopatia Diabética , Angiofluoresceinografia , Injeções Intravítreas , Edema Macular , Microaneurisma , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular , Acuidade Visual , Humanos , Tomografia de Coerência Óptica/métodos , Retinopatia Diabética/tratamento farmacológico , Retinopatia Diabética/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/etiologia , Edema Macular/diagnóstico por imagem , Edema Macular/diagnóstico , Masculino , Microaneurisma/diagnóstico , Feminino , Pessoa de Meia-Idade , Inibidores da Angiogênese/uso terapêutico , Angiofluoresceinografia/métodos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Idoso , Ranibizumab/uso terapêutico , Ranibizumab/administração & dosagem , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Fundo de Olho , Seguimentos

RESUMO

OBJECTIVE: To analyze primary angle closure suspect (PACS) patients' anatomical characteristics of anterior chamber configuration, and to establish artificial intelligence (AI)-aided diagnostic system for PACS screening. METHODS: A total of 1668 scans of 839 patients were included in this cross-sectional study. The subjects were divided into two groups: PACS group and normal group. With anterior segment optical coherence tomography scans, the anatomical diversity between two groups was compared, and anterior segment structure features of PACS were extracted. Then, AI-aided diagnostic system was constructed, which based different algorithms such as classification and regression tree (CART), random forest (RF), logistic regression (LR), VGG-16 and Alexnet. Then the diagnostic efficiencies of different algorithms were evaluated, and compared with junior physicians and experienced ophthalmologists. RESULTS: RF [sensitivity (Se) = 0.84; specificity (Sp) = 0.92; positive predict value (PPV) = 0.82; negative predict value (NPV) = 0.95; area under the curve (AUC) = 0.90] and CART (Se = 0.76, Sp = 0.93, PPV = 0.85, NPV = 0.92, AUC = 0.90) showed better performance than LR (Se = 0.68, Sp = 0.91, PPV = 0.79, NPV = 0.90, AUC = 0.86). In convolutional neural networks (CNN), Alexnet (Se = 0.83, Sp = 0.95, PPV = 0.92, NPV = 0.87, AUC = 0.85) was better than VGG-16 (Se = 0.84, Sp = 0.90, PPV = 0.85, NPV = 0.90, AUC = 0.79). The performance of 2 CNN algorithms was better than 5 junior physicians, and the mean value of diagnostic indicators of 2 CNN algorithm was similar to experienced ophthalmologists. CONCLUSION: PACS patients have distinct anatomical characteristics compared with health controls. AI models for PACS screening are reliable and powerful, equivalent to experienced ophthalmologists.

Assuntos

Aprendizado Profundo , Glaucoma de Ângulo Fechado , Humanos , Glaucoma de Ângulo Fechado/diagnóstico por imagem , Glaucoma de Ângulo Fechado/diagnóstico , Estudos Transversais , Feminino , Pessoa de Meia-Idade , Masculino , Tomografia de Coerência Óptica , Idoso , Segmento Anterior do Olho/diagnóstico por imagem , Algoritmos

RESUMO

Intravascular ultrasound and optical coherence tomography are used with increasing frequency for the care of coronary patients and in research studies. These imaging tools can identify culprit lesions in acute coronary syndromes, assess coronary stenosis severity, guide percutaneous coronary intervention (PCI), and detect vulnerable plaques and patients. However, they have significant limitations that have stimulated the development of multimodality intracoronary imaging catheters, which provide improvements in assessing vessel wall pathology and guiding PCI. Prototypes combining 2 or even 3 imaging probes with complementary attributes have been developed, and several multimodality systems have already been used in patients, with near-infrared spectroscopy intravascular ultrasound-based studies showing promising results for the identification of high-risk plaques. Moreover, postmortem histology studies have documented that hybrid imaging catheters can enable more accurate characterization of plaque morphology than standalone imaging. This review describes the evolution in the field of hybrid intracoronary imaging; presents the available multimodality catheters; and discusses their potential role in PCI guidance, vulnerable plaque detection, and the assessment of endovascular devices and emerging pharmacotherapies targeting atherosclerosis.

Assuntos

Doença da Artéria Coronariana , Vasos Coronários , Imagem Multimodal , Intervenção Coronária Percutânea , Placa Aterosclerótica , Valor Preditivo dos Testes , Tomografia de Coerência Óptica , Ultrassonografia de Intervenção , Humanos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/terapia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Intervenção Coronária Percutânea/instrumentação , Desenho de Equipamento , Cateteres Cardíacos , Difusão de Inovações , Cateterismo Cardíaco/instrumentação , Espectroscopia de Luz Próxima ao Infravermelho , Animais

RESUMO

PURPOSE: To evaluate the lamina cribrosa, retinal nerve fiber layer (RNFL), and macula in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG) and healthy individuals using enhanced depth imaging (EDI) of spectral-domain optical coherence tomography (SD-OCT). METHODS: A total of 158 eyes were included in the study, comprising 58 eyes of 29 patients with POAG, 50 eyes of 25 patients with PEXG, and 50 eyes of 25 healthy individuals. The lamina cribrosa thickness (LCT) (at three locations), lamina cribrosa depth (LCD), RNFL thickness, and the macular thickness were measured using the EDI mode of the SD-OCT. The results were compared among the three groups. RESULTS: In both POAG and PEXG groups, the LCT was significantly thinner in the center, mid-superior, and mid-inferior areas in both eyes than in the control group (p < 0.001). However, no statistically significant difference was observed between the POAG and PEXG groups in terms of LCT at all three measurement locations in both eyes (p > 0.05). The LCD was significantly lower in the control group compared to the POAG and PEXG groups (p < 0.05), but there was no significant difference between the POAG and PEXG groups (p > 0.05). The RNFL thickness was significantly lower in both the POAG and PEXG groups compared to the control group in both eyes (p < 0.05). CONCLUSION: The LCT and LCD of patients with POAG and PEXG were thinner than those of healthy individuals, but there was no significant difference between the patients with POAG and PEXG.

Assuntos

Síndrome de Exfoliação , Glaucoma de Ângulo Aberto , Pressão Intraocular , Macula Lutea , Fibras Nervosas , Disco Óptico , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/fisiopatologia , Síndrome de Exfoliação/diagnóstico , Masculino , Feminino , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Pessoa de Meia-Idade , Idoso , Disco Óptico/patologia , Disco Óptico/diagnóstico por imagem , Macula Lutea/patologia , Macula Lutea/diagnóstico por imagem , Pressão Intraocular/fisiologia , Campos Visuais/fisiologia , Estudos Transversais

RESUMO

BACKGROUND AND OBJECTIVES: The 2022 International Consortium for Optic Neuritis diagnostic criteria for optic neuritis (ON) include optical coherence tomography (OCT). The diagnostic value of intereye difference (IED) metrics is high for ON in patients with multiple sclerosis and aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders, but unknown in myelin oligodendrocyte glycoprotein antibody-associated ON (MOG-ON). METHODS: A multicenter validation study was conducted on the published IED cutoff values (>4% or >4 µm in the macular ganglion cell and inner plexiform layer [mGCIP] or >5% or >5 µm in the peripapillary retinal nerve fiber layer [pRNFL]) in individuals with MOG-ON and age-matched and sex-matched healthy controls (HCs). Structural data were acquired with Spectralis spectral-domain OCT >6 months after ON. We calculated sensitivity, specificity, and receiver operating characteristics for both intereye percentage (IEPD) and absolute difference (IEAD). RESULTS: A total of 66 individuals were included (MOG-ON N = 33; HCs N = 33). ON was unilateral in 20 and bilateral in 13 subjects. In the pooled analysis, the mGCIP IEPD was most sensitive (92%), followed by the mGCIP IEAD (88%) and pRNFL (84%). The same pattern was found for the specificity (mGCIP IEPD 82%, IEAD 82%; pRNFL IEPD 82%, IEAD 79%).In subgroup analyses, the diagnostic sensitivity was higher in subjects with unilateral ON (>99% for all metrics) compared with bilateral ON (61%-78%). DISCUSSION: In individuals with MOG-ON, the diagnostic accuracy of OCT-based IED metrics for ON was high, especially of mGCIP IEPD. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that the intereye difference on OCT can distinguish between those with MOG and normal controls.

Assuntos

Autoanticorpos , Glicoproteína Mielina-Oligodendrócito , Neurite Óptica , Tomografia de Coerência Óptica , Humanos , Glicoproteína Mielina-Oligodendrócito/imunologia , Neurite Óptica/imunologia , Neurite Óptica/diagnóstico , Neurite Óptica/diagnóstico por imagem , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Autoanticorpos/sangue , Sensibilidade e Especificidade , Adulto Jovem

RESUMO

PURPOSE: To evaluate the findings and the correlation of optical coherence tomography angiography and pattern and flash electroretinography in diabetes mellitus without retinopathy. METHODS: Seventy-six eyes of 38 diabetic patients and age- and gender-matched control subjects were included in the study. The foveal avascular zone (FAZ), whole, foveal, parafoveal and perifoveal vascular densities of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillary plexus (CCP) layers were analyzed using optical coherence tomography angiography (OCTA). The amplitudes and implicit times of P50 and N95 waves of the pattern ERG (pERG) and the amplitudes and implicit times of the scotopic and photopic b-waves and oscillatory potentials (OP) of the flash ERG (fERG) tests were evaluated using the Metrovision brand monpack model device. RESULTS: The mean age of the patients was 59.7 ± 7.9 [range 43-79] years. Eighteen (47%) of the patients were female and 20 (53%) were male. The mean duration of diabetes was 7.45 ± 6.2 [range 1-20] years. No significant difference in FAZ area was found between study subjects and controls. Vascular density (VD) values of the superficial capillary plexus (SCP) layer were significantly lower (whole VD, 44.7 ± 3.3 vs. 46.6 ± 3.2%, p = 0.01, foveal VD 16.8 ± 6.4 vs. 24.9 ± 6.1%, p < 0.01, parafoveal VD 45.6 ± 4.5 vs. 47.1 ± 4.4%, p = 0.27 and perifoveal VD 45.5 ± 3.3 vs. 47.3 ± 3.1%, p = 0.01, respectively) in the diabetic group except the parafoveal area. VD measurements in deep and choriocapillary plexuses did not significantly differ between the groups (p > 0.05). ERG tests revealed significantly lower scotopic b-wave amplitudes (130.2 ± 39.3 µV vs.163.3 ± 47.8 µV, p < 0.01) and photopic b-wave amplitudes (83.2 ± 20.7 µV vs. 99.6 ± 29.4 µV, p < 0.01) in the diabetic patients. The implicit time of the photopic responses was significantly prolonged (28.9 ± 1.3 ms vs. 27.8 ± 2.1 ms, p = 0.01) in the patients. Oscillatory potentials in all components consisting of O1 to O4 and the sum of the OP potentials were lower in the diabetic group than the control subjects (p < 0.001). The P50 and N95 amplitudes and implicit times were comparable between the groups (p > 0.05). Correlation analysis showed a positive correlation between N95 amplitudes in pERG and the superficial vessel densities in OCTA (r = 0.26, p = 0.04). A negative correlation was found between photopic implicit times in fERG and the choriocapillary vessel densities (r=-0.27, p = 0.03). CONCLUSION: OCTA revealed decreased superficial vascular densities with the onset of the metabolic process of diabetes mellitus. As a result of these structural changes, lower scotopic and photopic amplitudes, decreased OP amplitudes, and prolonged implicit times in flash ERG were obtained.

Assuntos

Eletrorretinografia , Tomografia de Coerência Óptica , Humanos , Eletrorretinografia/métodos , Masculino , Tomografia de Coerência Óptica/métodos , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Angiofluoresceinografia/métodos , Retinopatia Diabética/fisiopatologia , Retinopatia Diabética/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/fisiopatologia , Estudos de Casos e Controles , Fóvea Central/diagnóstico por imagem , Fóvea Central/irrigação sanguínea , Fóvea Central/fisiopatologia , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus/diagnóstico por imagem , Retina/diagnóstico por imagem , Retina/fisiopatologia

RESUMO

Purpose: To develop a Vision Transformer (ViT) model based on the mixed attention feature enhancement mechanism, ChoroidSeg-ViT, for choroid layer segmentation in optical coherence tomography (OCT) images. Methods: This study included a dataset of 100 OCT B-scans images. Ground truths were carefully labeled by experienced ophthalmologists. An end-to-end local-enhanced Transformer model, ChoroidSeg-ViT, was designed to segment the choroid layer by integrating the local enhanced feature extraction and semantic feature fusion paths. Standard segmentation metrics were selected to evaluate ChoroidSeg-ViT. Results: Experimental results demonstrate that ChoroidSeg-ViT exhibited superior segmentation performance (mDice: 98.31, mIoU: 96.62, mAcc: 98.29) compared to other deep learning approaches, thus indicating the effectiveness and superiority of this proposed model for the choroid layer segmentation task. Furthermore, ablation and generalization experiments validated the reasonableness of the module design. Conclusions: We developed a novel Transformer model to precisely and automatically segment the choroid layer and achieved the state-of-the-art performance. Translational Relevance: ChoroidSeg-ViT could segment precise and smooth choroid layers and form the basis of an automatic choroid analysis system that would facilitate future choroidal research in ophthalmology.

Assuntos

Corioide , Tomografia de Coerência Óptica , Corioide/diagnóstico por imagem , Humanos , Tomografia de Coerência Óptica/métodos , Aprendizado Profundo , Algoritmos , Processamento de Imagem Assistida por Computador/métodos