OCT Measurements Research Articles

Bruch Membrane Opening Minimum Rim Width Changes During Scleral Lens Wear.

The purpose of this study was to evaluate the change in Bruch membrane opening minimum rim width (BMO-MRW) during scleral lens (SL) wear. Twenty young white subjects were enrolled (10 women and 10 men); preliminary evaluation consisted of serial measurements of intraocular pressure (IOP) using a dynamic noncontact tonometer (Corvis, Oculus), which also yielded a corneal biomechanical index and central corneal thickness, and BMO-MRW using optical coherence tomography imaging (OCT) imaging (Spectralis, Heidelberg) through 6 hrs to establish normative diurnal curves. The next day, participants were fitted with a 16-mm SL on one eye, and OCT measurements were repeated over the same time span. Statistical analysis was carried out with a two-way analysis of variance. Multiple linear regressions were used to identify significant associations. The average diurnal variation for BMO-MRW without lenses was -4.65 μm (95% confidence interval [CI], 0.52-8.77) after 6 hours, whereas it decreased by 8 μm (95% CI, 3.87-12.12; P<0.001) after 6 hours of SL wear. The difference between variations after 6 hours was then -3.35 μm (P=0.029). Variation of the BMO-MRW did not significantly correlate with corneal rigidity (CR), central corneal thickness (CCT), and refractive error (r=-0.224, -0.054 and -0.085, respectively). Scleral lens wear induces a statistically significant decrease in BMO-MRW that could potentially be attributed to a change in IOP. The change in BMO-MRW was not affected by CR, CCT, or refractive error. Further studies are needed to better understand the significance of the observed changes at the optic nerve head during scleral lens wear.

Dose-Response Relationship between Intravitreal Injections and Retinal Nerve Fiber Layer Thinning in Age-Related Macular Degeneration

To determine if multiple intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors for unilateral exudative age-related macular degeneration (eAMD) are associated with thinning of the retinal nerve fiber layer (RNFL), we compared RNFL thickness measurements from the injected eye with that of the fellow eye with nonexudative age-related macular degeneration (neAMD). Retrospective, cross-sectional study. Patients undergoing anti-VEGF therapy for unilateral eAMD. Patients receiving anti-VEGF therapy secondary to eAMD in 1 eye with neAMD in their fellow eye were identified. Patients with a known diagnosis of glaucoma were excluded. Spectral domain OCT measurements of the peripapillary RNFL thickness from both eyes were performed and compared. The differences in the RNFL thickness measurements between eyes were correlated with the number of injections and the duration of therapy. Correlation between the number of anti-VEGF injections and peripapillary RNFL thinning. A total of 108 eyes of 54 patients were evaluated in this study. The average peripapillary RNFL thickness measurements of the injected eye and fellow eye were 87.3 ± 9.6 μm and 89.0 ± 7.5 μm, respectively (P= 0.055). The RNFL thickness difference (fellow eye minus injected eye) was significantly correlated with the number of injections (r= 0.40, P= 0.002) and months of injections (r= 0.38, P= 0.005). The relationship between the difference in the RNFL thickness and the number of injections had a nonlinear dose-response relationship that became apparent after approximately 30 injections and 50 months of injections. The difference in RNFL thickness measurements between injected eyes and uninjected fellow eyes was largely within the reported normal limits for interocular differences between healthy eyes. Nevertheless, there was a dose-response relationship between RNFL thinning and number of injections among patients receiving a greater number of injections, suggesting that anti-VEGF injections may have a modest effect on the RNFL thickness after several years of therapy in eyes requiring more anti-VEGF injections; however, we cannot exclude that the RNFL thinning may be secondary to active age-related macular degeneration (AMD) disease progression in both eyes.

The Association between Foveal Floor Measurements and Macular Hole Size

Determining which factors influence idiopathic macular hole (MH) size is important because it is a major prognostic indicator of treatment success. Foveal pit morphologic features are highly symmetrical within individuals and may influence idiopathic MH size. Using a series of patients with unilateral idiopathic MHs, we examined the foveal floor size of the fellow eye to evaluate its relationship with idiopathic MH size and postoperative outcomes. Retrospective observational study. Two hundred forty-one participants with a unilateral idiopathic MH treated with surgery and a fellow eye with no ocular pathologic features. Both eyes underwent spectral-domain (SD) OCT imaging at the time of surgery. Minimum linear diameter (MLD) and base diameter (BD) defined idiopathic MH size. Foveal floor width (FFW) and minimal foveal thickness defined foveal pit morphologic features of the fellow eye. Baseline characteristics, SD OCT measurements, and preoperative variables were compared to determine their relationship with idiopathic MH size and postoperative visual acuity (VA) in logarithm of the minimum angle of resolution units. Foveal floor width was correlated with MLD (r= 0.36; P ≤ 0.001) and BD (r= 0.30; P ≤ 0.001), but not postoperative VA. Minimum linear diameter correlated with preoperative VA (r= 0.49; P ≤ 0.0001) and postoperative VA (r= 0.54; P ≤ 0.0001). A 2-stage regression model was developed to predict postoperative VA (r2= 0.28): preoperative VA (β= 0.36; P= 0.002) explained 13% of variability and MLD (β= 0.29; P= 0.002), and idiopathic MH duration (β= 0.23; P= 0.004) explained a further 16%. Foveal floor width of the fellow eye in patients with a unilateral idiopathic MH was correlated significantly with idiopathic MH size and may explain some of the variability in idiopathic MH size observed between individuals. However, FFW could not predict postoperative vision.

Seven-Year Outcomes of Uveitic Macular Edema: The Multicenter Uveitis Steroid Treatment Trial and Follow-up Study Results

To evaluate the long-term outcomes of uveitic macular edema (ME). Longitudinal follow-up of a cohort of participants in a randomized clinical trial. A total of 248 eyes of 177 participants with uveitic ME enrolled in the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study. OCT measurements, taken at baseline and annually, were graded by reading center graders masked to clinical data. Macular edema was defined as a center macular thickness (CMT) ≥240 μm on time-domain OCT or time-domain OCT equivalent. Resolution of ME was defined as normalization of macular thickness on OCT. Relapse of ME was defined as increase in macular thickness to ≥240 μm in an eye that previously had resolution. Visual acuity was measured at each visit with logarithmic visual acuity charts. Resolution and relapse of ME. Visual acuity. Among 227 eyes with ME followed ≥1 year, the cumulative percent of eyes with ME resolving at any point during 7 years was 94% (95% confidence interval [CI], 89-97). Epiretinal membranes on OCT were associated with a lower likelihood of ME resolution (hazard ratio [HR], 0.74; 95% CI, 0.55-1.01; P= 0.05). Among 177 eyes with resolved ME, the cumulative percent with relapse within 7 years was 43% (95% CI, 32-51). Eyes in which ME resolved gained a mean of 6.24 letters (95% CI, 4.40-8.09; P < 0.001) compared with eyes that remained free from ME during the 1-year follow-up intervals, whereas eyes in which ME did not resolve experienced no gain in vision (mean change-1.30 letters; 95% CI,-2.70 to 0.09; P= 0.065), and eyes that developed ME during the year (incident or relapsed) experienced a mean loss of-8.65 letters (95% CI,-11.5 to-5.84, P<0.001). Given sufficient time and treatment, nearly all uveitic ME resolves, but episodes of relapse were common. Visual acuity results were better among eyes with resolved ME, suggesting that control of inflammation and resolution of ME might be visually relevant treatment targets.

Repeatability and reproducibility of post-mortem central corneal thickness measurements using a portable optical coherence tomography system in humans: a prospective multicenter study

To assess the repeatability and reproducibility of post-mortem central corneal thickness (CCT) measurements made by the portable iVue spectra-domain (SD) optical coherence tomography OCT (Optovue Inc, Fremont, CA) system in humans, and to prospectively establish the time-course of CCT after death. In a prospective multicenter setting, CCT measurements were obtained from 58 human eyes at the following 16 time-points after death: immediately (within 2 h), and at each hour by the next 17 h. The range of CCT values for each subject was determined and longitudinal data were used to illustrate the variation in open and close eye mode. All measurements were made by two independent and well-trained examiners for session. Main outcome measures were intraclass correlation coefficients (ICC), repeatability and reproducibility coefficients, and coefficients of variation of the average central (0–2 mm). Overall, a total of 5,568 OCT measurements were performed by examiners. The repeatability coefficient varied from 0.3 to 1.7% and the reproducibility coefficient varied from 0.3 to 1.6% throughout the entire experimental time frame. Furthermore, the values of the different ICCs were also high during the different postmortem intervals, thus demonstrating the excellent repeatability and reproducibility of the present OCT approach. When CCT measurements were analyzed longitudinally, corneal thickness showed different behavior based on the open or close eye mode. The present study demonstrates that portable OCT imaging can be reliably used for corneal pachymetric measurements in supine subjects and during the post mortem period, i.e. without visual fixation and normal physiology/architecture of examined tissues.

Patterns and Determinants of Choroidal Thickness in a Multiethnic Asian Population: The Singapore Epidemiology of Eye Diseases Study

To describe the distribution and determinants of choroidal thickness (CT) in participants in a population study based on spectral-domain (SD)-OCT measurements. Population-based, cross-sectional study. Ethnic Chinese, Indian, and Malay adults aged more than 50 years without any retinal diseases (e.g., diabetic retinopathy, macular edema, age-related macular degeneration, central serous chorioretinopathy) that might affect the CT were recruited from the Singapore Epidemiology of Eye Diseases Study. Choroidal imaging was performed by SD-OCT (Spectralis, Heidelberg Engineering, Heidelberg, Germany) in enhanced depth imaging (EDI) mode. Subfoveal choroidal thickness (SFCT) was measured on the foveal line scan by 2 retinal experts independently (YS and KT), and the average was used in the analyses. In Chinese and Indian cohorts in whom macular raster scans were captured, the manufacturer-supplied research software (Heyex SP-X version 6.4.8.116; Heidelberg Engineering) was used to obtain automated segmentation yielding mean choroidal thickness in each of the 9 ETDRS grid sectors. Subfoveal choroidal thickness and regional CT in the 9 ETDRS grid sectors. For the SFCT analysis, 2794 eyes of 1619 participants (Chinese, Indian, and Malay ) were included. The mean age was 60.9 years (standard deviation, 7.7), and 797 (49.2%) were male. Mean SFCT was 255.2 μm (standard deviation, 102.6). The normal range of SFCT was 106 to 447 μm (corresponding to 5th and 95th percentile limits of SFCT, respectively). In multivariable models, thinner SFCT was associated with older age, female gender, longer axial length, and Malay (vs. Chinese) ethnicity. In the subset of Chinese and Indian eyes (n = 1842) in whom regional variation was evaluated, the choroid was thickest at the superior and temporal sectors and thinner at the inferior and nasal sectors. Subfoveal choroidal thickness is influenced by age, gender, and ethnicity along with regional differences even within individual eyes. Subfoveal choroidal thickness also shows a wide range in physiologic limits. These data may be used as a reference in future studies.

Improving Visual Field Trend Analysis with OCT and Deeply Regularized Latent-Space Linear Regression

To investigate whether OCT measurements can improve visual field (VF) trend analyses in glaucoma patients using the deeply regularized latent-space linear regression (DLLR) model. Retrospective cohort study. Training and testing datasets included 7984 VF results from 998 eyes of 592 patients and 1184 VF results from 148 eyes of 84 patients with open-angle glaucoma, respectively. Each eye underwent a series of 8 VF tests with the Humphrey Field Analyzer OCT series obtained within the same observation period. Using pointwise linear regression (PLR), the threshold values of a patient's eighth VF results were predicted using values from shorter VF series (first to second VF tests [VF1-2], first to third VF tests, . . . , to first to seventh VF tests [VF1-7]), and the root mean square error (RMSE) was calculated. With DLLR, OCT measurements (macular retinal nerve fiber layer thickness, the thickness of macular ganglion cell layer and inner plexiform layer, and the thickness of the outer segment and retinal pigment epithelium) that were obtained within the period of shorter VF series were incorporated into the model to predict the eighth VF. Prediction accuracy of VF trend analyses. The mean ± standard deviation RMSE resulting from PLR averaged 27.48 ± 16.14 dB for VF1-2 and 3.98 ± 2.25 dB for VF1-7. Significantly (P < 0.001) smaller RMSEs were obtained from DLLR: 4.57 ± 2.71 dB (VF1-2) and 3.65 ± 2.27 dB (VF1-7). It is useful to include OCT measurements when predicting future VF progression in glaucoma patients, especially with short VF series.

Association of Antihypertensive Medication with Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness

To evaluate the association between different classes of antihypertensive medication with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in a nonglaucomatous multiethnic Asian population. Population-based, cross-sectional study. A total of 9144 eyes for RNFL analysis (2668 Malays, 3554 Indians, and 2922 Chinese) and 8549 eyes for GC-IPL analysis (2460 Malays, 3230 Indians, and 2859 Chinese) aged 44 to 86 years. Participants underwent standardized systemic and ocular examinations and interviewer-administered questionnaires for collection of data on medication and other variables. Intraocular pressure (IOP) readings were obtained by Goldmann applanation tonometry before pupil dilation for fundoscopy and OCT imaging. Blood pressure (BP) was measured with an automatic BP monitor. Mean arterial pressure (MAP) was defined as diastolic BP plus 1/3 (systolic BP - diastolic BP). Regression models were used to investigate the association of antihypertensive medication with OCT measurements of RNFL and GC-IPL. Average and sectoral RNFL and GC-IPL thickness. After adjusting for age, gender, ethnicity, MAP, IOP, body mass index (BMI), and presence of diabetes, we found that participants taking any type of antihypertensive medication (β=-0.83; 95% confidence interval [CI],-1.46 to-0.02; P= 0.01), specifically angiotensin-converting enzyme inhibitors (ACEIs) (β=-1.66; 95% CI,-2.57 to-0.75; P < 0.001) or diuretics (β=-1.38; 95% CI,-2.59 to-0.17; P < 0.05), had thinner average RNFL in comparison with participants who were not receiving antihypertensive treatment. Use of a greater number of antihypertensive medications was significantly associated with thinner average RNFL (P for trend= 0.001). This association was most evident in the inferior RNFL quadrant in participants using ACEIs (β=-2.44; 95% CI,-3.99 to-0.89; P= 0.002) or diuretics (β=-2.76; 95% CI,-4.76 to-0.76; P= 0.007). A similar trend was noted in our analysis of macular GC-IPL thickness. Use of 2 or more antihypertensive medications, ACEI, and diuretics were associated with a loss of structural markers of retinal ganglion cell health in a multiethnic Asian population.

Detection of Progressive Glaucomatous Optic Nerve Damage on Fundus Photographs with Deep Learning

PurposeTo investigate whether predictions of retinal nerve fiber layer (RNFL) thickness obtained from a deep learning model applied to fundus photographs can detect progressive glaucomatous changes over time.DesignRetrospective cohort study.ParticipantsEighty-six thousand one hundred twenty-three pairs of color fundus photographs and spectral-domain (SD) OCT images collected during 21 232 visits from 8831 eyes of 5529 patients with glaucoma or glaucoma suspects.MethodsA deep learning convolutional neural network was trained to assess fundus photographs and to predict SD OCT global RNFL thickness measurements. The model then was tested on an independent sample of eyes that had longitudinal follow-up with both fundus photography and SD OCT. The ability to detect eyes that had statistically significant slopes of SD OCT change was assessed by receiver operating characteristic (ROC) curves. The repeatability of RNFL thickness predictions was investigated by measurements obtained from multiple photographs that had been acquired during the same day.Main Outcome MeasuresThe relationship between change in predicted RNFL thickness from photographs and change in SD OCT RNFL thickness over time.ResultsThe test sample consisted of 33 466 pairs of fundus photographs and SD OCT images collected during 7125 visits from 1147 eyes of 717 patients. Eyes in the test sample were followed up for an average of 5.3 ± 3.3 years, with an average of 6.2 ± 3.8 visits. A significant correlation was found between change over time in predicted and observed RNFL thickness (r = 0.76; 95% confidence interval [CI], 0.70–0.80; P < 0.001). Retinal nerve fiber layer predictions showed an ROC curve area of 0.86 (95% CI, 0.83–0.88) to discriminate progressors from nonprogressors. For detecting fast progressors (slope faster than 2 μm/year), the ROC curve area was 0.96 (95% CI, 0.94–0.98), with a sensitivity of 97% for 80% specificity and 85% for 90% specificity. For photographs obtained at the same visit, the intraclass correlation coefficient was 0.946 (95% CI, 0.940–0.952), with a coefficient of variation of 3.2% (95% CI, 3.1%–3.3%).ConclusionsA deep learning model was able to obtain objective and quantitative estimates of RNFL thickness that correlated well with SD OCT measurements and potentially could be used to monitor for glaucomatous changes over time.

Reproducibilidad de la medición manual del grosor coroideo utilizando la tomografía de coherencia óptica

PurposeSpectral-domain optical coherence tomography (SD-OCT) is the most useful tool to measure choroidal thickness (CT). CT may be increased in ocular and systemic diseases. However, there are concerns relating reproducibility and external validity of OCT.The aim of this study was to assess the inter-observer and intra-observer variability of manual OCT measurements. MethodsCT was manually measured in the central choroid of 40 eyes from 21 subjects (11 healthy and 10 with ankylosing spondylitis) using RTVue-100 OCT (Optovue Inc., Fremont, CA, EE.UU.). Measurements were performed by 9 independent ophthalmologists from 6 different centers. To assess the inter-observer variability, the intra-class correlation coefficient (ICC) method was calculated. Also, intra-observer variability was assessed in 2 of the ophthalmologists. ResultsThe mean subfoveal CT was 364.9±85.1μm (range, 170 to 572). The inter-observer ICC was 0.823 (CI 95%, 0.749 to 0.888, p<0.001). The intra-observer ICCs were 0.885 (CI 95%, 0.783 to 0.939, p<0.001) and 0.925 (CI 95%, 0.859 to 0.960. p<0.001). ConclusionsIn this study, manual measurements of CT with OCT showed a good concordance. These results suggest that manual OCT is a valid tool for multicenter studies.

Macular Thickness in Cameroonians Sickle Cell Patients

Introduction: Sickle cell disease is the most common genetic disease in the world. It is particularly prevalent in Africa south of the Sahara. In Cameroon. Several authors have described morphological changes from the macula to Optical Coherence Tomography-Spectral Domain (SD OCT) including the thinning of the predominant inner layers in the temporal area. Methodology: This is a prospective analytic study. It was conducted mainly at the specialized ophthalmology department of the Army Military Application and Reference Hospital of Yaounde (HMARAY) in Cameroon. Clinical ophthalmologic exam was done and biological parameters (rate of hemoglobin, electrophoretic quantification of S hemoglobin) registered from October 2016 to June 2017.We included: Any AS patient or Cameroonian SS patient who is 20 years of age or older; sickle cell patients AS or SS without intercurrent retinal pathology (strong myopia, diabetic retinopathy, vitreoretinal interface pathology). Results: In our study the average age is 31 years. There is a predominance of female versus male sex ratio H/F=0.56. 84% of eyes had retinal lesions suggestive of non-proliferative retinopathy in the retina. The solar black spots were the most found retinal lesions (66.66%). Lesions were more localized temporally. In the OCT measurement, 60% of the eyes showed a decreased retinal thickness SD with 53% concerning the temporal retina. An hemoglobin level between 7 and 10 g/dl was found in 40% of our patients, 24% has severe anemia (hemoglobin<7 g/dl). All our patients had a percentage of hemoglobin S greater than 80%. No decrease in visual acuity in our patients who had a decrease in retinal thickness at OCT SD. Conclusion: There is a thinning of the retinal layers in SS Cameroonian sickle cell patients in the temporal region of the macula. Patients with retinal thinning are asymptomatic with preserved visual acuity.

Macular Ganglion Cell Layer Thickness after Macula-Off Rhegmatogenous Retinal Detachment Repair: Scleral Buckling versus Pars Plana Vitrectomy

(1) Background: We evaluated macular ganglion cell layer–inner plexiform layer (GCL-IPL) thickness in patients with primary macula-off rhegmatogenous retinal detachment (RRD) treated with scleral buckling (SB) or pars plana vitrectomy (PPV) using spectral domain optical coherence tomography (SD-OCT). (2) Methods: In this retrospective, observational study, we reviewed the medical records of patients undergoing SB or PPV surgery for macula-off RRD. SD-OCT was performed at three and 12 months after surgery. The central and parafoveal GCL-IPL thicknesses in treated eyes were compared with those of healthy fellow eyes. OCT measurements between the SB and PPV group were also compared using the analysis of covariance. (3) Results: Seventy-one eyes of 71 patients with a mean age of 61.2 ± 11.7 years were included. The parafoveal GCL-IPL thickness of the PPV group was significantly reduced, with respect to fellow eyes, at three and 12 months (p < 0.01). After adjusting for age, axial length, spherical equivalent, RD extent, preoperative intraretinal cysts, duration of symptoms and postoperative IOP, the parafoveal GCL-IPL thickness in the PPV group was significantly reduced with respect to the SB group, both at three and 12 months (F = 11.45, p = 0.001 and F = 12.37, p = 0.001, respectively). (4) Conclusions: In conclusion, the GCL-IPL is reduced in thickness in eyes with macula-off RRD treated with vitrectomy and is significantly thinner compared to eyes undergoing scleral buckling surgery.

Comparing efficacy of reduced-fluence and standard-fluence photodynamic therapy in the treatment of polypoidal choroidal vasculopathy

BackgroundThe EVEREST II study reported superior polyp closure rates and visual outcomes using combination standard photodynamic therapy (PDT) with intravitreal ranibizumab in the treatment of polypoidal choroidal vasculopathy (PCV). The optimal PDT protocol remains controversial and it is postulated that less intensive PDT strategies may reduce complications. We aimed to compare the efficacy of reduced and standard-fluence PDT.MethodsCase-control review of 38 consecutive PDT-naïve macular PCV patients who underwent verteporfin PDT using one of two PDT regimens at a tertiary referral centre in an Asian population. Comparison of outcomes between standard-fluence PDT (light dose, 50 J/cm2; dose rate, 600 mW/cm2; wavelength, 689 nm PDT applied to the treatment eye for 83 s) and reduced-fluence PDT (light dose, 25 J/cm2; dose rate, 600 mW/cm2; wavelength, 689 nm PDT applied to the treatment eye for 42 s). Primary outcome measure was best corrected LogMAR visual acuity (VA). Secondary outcome measures included OCT measurements such as central retinal thickness (CRT), height of subfoveal sub-retinal fluid (SRF), central choroid thickness (CCT), mean number of PDT treatments needed, mean number of anti-VEGF injections needed, polyp closure and recurrence rates.ResultsOf these 38 eyes of 38 patients, an equal number of eyes (19 in each arm) were treated with standard-fluence and reduced-fluence PDT. Mean letter gain at 12 months for the standard-fluence group was 6.0 compared to 4.3 letters for the reduced-fluence group (p = 0.61). Similar results were observed at all time points. There was no statistically significant difference between the retinal and choroidal anatomical OCT outcomes, rates of polyp closure and recurrences between the two PDT regimens.ConclusionsReduced-fluence PDT was comparable to standard-fluence PDT in the treatment of PCV in terms of visual gains, clinical and anatomical OCT outcomes.

Comparison of the effects of 1/10,000 and 1/100,000 concentrations of intracameral epinephrine on corneal endothelium and macular thickness after uncomplicated phacoemulsification.

To evaluate the changes in the corneal endothelial cell parameters and macular thickness after intraocular application of epinephrine [Formula: see text] and epinephrine[Formula: see text]. In this study, 210 eyes from 210 patients with age-related cataracts who underwent uncomplicated surgery were included. For all patients, specular microscopy of the corneal endothelium and macular OCT were performed before surgery and 3 months after the surgery. Patients were divided randomly into three groups: without drug (control group), epinephrine [Formula: see text], and epinephrine[Formula: see text]. Three months after the surgery, specular microscopy of the cornea and macular OCT measurements were performed. Measurements were compared between the three groups. Postoperative measurements were also compared with those measurements obtained before surgery. All the three groups showed a statistically significant decrease in the endothelial cell density after surgery; the reduction in endothelial cell density in the epinephrine [Formula: see text] group was significantly more than those of the other two groups (P value < 0.001). Hexagonality of endothelial cells was significantly reduced in the three groups after the surgery, the epinephrine [Formula: see text] group had more reduction compared with both other groups (P values < 0.001). All the three groups showed a statistically significant increase in the macular thickness after the surgery (P values < 0.001). The mean increase in the macular thickness in the epinephrine [Formula: see text] group was significantly more than those of the other two groups (P values < 0.05). Toxicity of the drug to many endothelial cell parameters and macula was reduced with decreasing concentration of epinephrine to [Formula: see text].

Reflux after intravitreal injection: an anterior segment optical coherence tomography study

Purpose: To investigate the intraocular pressure and conjunctival thickness changes following the intravitreal injection Methods: Sixty eyes of 60 patients having intravitreal injection for age-related macular degeneration, macular edema associated with diabetes, central retinal vein occlusion, and branch retinal vein occlusion were enrolled. Intraocular pressure (IOP) was measured by Tonopen-Avia (Reichert Inc., NY, USA) in sitting position and five superior-temporal conjunctival images were obtained using the Anterior Segment 5 Line Raster scanning protocol of Cirrus HD-OCT 4000 (Carl Zeiss Meditec, Dublin, CA, USA) just before the intravitreal injection. 0.05 ml bevacizumab with 27-gauge needle, 0.05 ml ranibizumab with 30-gauge needle, or dexamethasone implant with 23-gauge needle was injected into the vitreous cavity. The second IOP measurements and OCT measurements were taken within 5 mins of injection. Results: The ranibizumab group included 25 subjects, the bevacizumab group included 23 subjects, and the dexamethasone group included 12 subjects. IOP increases following intravitreal injection were significantly higher in ranibizumab and bevacizumab groups compared with Dexamethasone implant group (p&lt;0.001 and p=0.007, respectively). Although, the increase of conjunctival thickness following the intravitreal injection was highest in Dexamethasone implant group, the differences between the groups did not reach statistically significance (p=0.153). Conclusion: A higher IOP elevation is observed if a small-gauge needle is used for intravitreal injection. The conjunctival thickness changes following the intravitreal injection did not differ between the groups

This issue of Acta

This issue of Acta

Correlatıon of neutrophyle/lymphocyte ratio and pulmonary parameters with optic coherence tomography findings in stable chronic obstructive pulmonary disease.

To examine the correlation of pulmonary functions and neutrophyle/lymphocyte ratio (NLR) with optic coherence tomography findings in stable chronic obstructive pulmonary disease (COPD). Fifty-five COPD (110 eyes) and 48 control cases (96 eyes) were enrolled. COPD patients were grouped as Group 1 (mild-moderate) and Group 2 (severe) according to GOLD classification. Subfoveal choroidal thickness (SFCT), ganglion cell-inner plexiform layer (GCIP) and retinal nerve fiber layer (RNFL) analysis by SD-OCT were performed in follow up. NLR was calculated by blood cell count. Inferior RNFL and average GCIP of COPD were lower than control during the initial and sixth month examination (P=.002, P<.001, respectively). Average RNFL and SFCT were lower in COPD patients in sixth month examination (P=.020, P=.015, respectively). Average, temporal, inferior, nasal RNFL and SFCT in sixth month examination were significantly lower in severe COPD (P<.05 for all), but average GCIP were similar (P=.015). Disease duration, Modified Medical Research Council (mMRC) and attacks/year showed significant negative correlations, whereas forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) showed significant positive correlations with OCT values. NLR was significantly higher in COPD cases compared to control (P<.001) and had a negative correlation with GCIP values. Chronic obstructive pulmonary disease severity is shown to have a negative effect on OCT measurements. SD-OCT can reflect severity of inflammation, and suggested to be used in follow up of COPD cases. NLR may have a role to predict the ganglion cell damage in COPD patients.

Optical coherence tomography of the retina in schizophrenia: Inter-device agreement and relations with perceptual function

BackgroundOptical coherence tomography (OCT) studies have demonstrated differences between people with schizophrenia and controls. Many questions remain including the agreement between scanners. The current study seeks to determine inter-device agreement of OCT data in schizophrenia compared to controls and to explore the relations between OCT and visual function measures. MethodsParticipants in this pilot study were 12 individuals with schizophrenia spectrum disorders and 12 age- and sex-matched controls. Spectralis and Cirrus OCT machines were used to obtain retinal nerve fiber layer (RNFL) thickness and macular volume. Cirrus was used to obtain ganglion cell layer + inner plexiform layer (GCL + IPL) thickness. Visual function was assessed with low-contrast visual acuity and the King-Devick test of rapid number naming. ResultsThere was excellent relative agreement in OCT measurements between the two machines, but poor absolute agreement, for both patients and controls. On both machines, people with schizophrenia showed decreased macular volume but no difference in RNFL thickness compared to controls. No between-group difference in GCL + IPL thickness was found on Cirrus. Controls showed significant associations between King-Devick performance and RNFL thickness and macular volume, and between low-contrast visual acuity and GCL + IPL thickness. Patients did not show significant associations between OCT measurements and visual function. ConclusionsGood relative agreement suggests that the offset between machines remains constant and should not affect comparisons between groups. Decreased macular volume in individuals with schizophrenia on both machines supports findings of prior studies and provides further evidence that similar results may be found irrespective of OCT device.

Improving the Structure–Function Relationship in Glaucomatous Visual Fields by Using a Deep Learning–Based Noise Reduction Approach

To investigate whether processing visual field (VF) measurements using a variational autoencoder (VAE) improves the structure-function relationship in glaucoma. Cross-sectional study. The training data consisted of 82 433 VF measurements from 16 836 eyes. The testing dataset consisted of 117 eyes of 75 patients with open-angle glaucoma. A VAE model to reconstruct the threshold of VF was developed using the training dataset. OCT and VF (Humphrey Field Analyzer 24-2, Swedish interactive threshold algorithm standard) measurements were carried out for all eyes in the testing dataset. Visual fields in the testing dataset then were reconstructed using the trained VAE. The structure-function relationship between the circumpapillary retinal nerve fiber layer (cpRNFL) thickness and VF sensitivity was investigated in each of twelve 30° segments of the optic disc (3 nasal sectors were merged). Similarly, the structure-function relationship was investigated using the VAE-reconstructed VF. Structure-function relationship. The corrected Akaike information criterion values with threshold were found to be smaller than the threshold reconstructed with the VAE (thresholdVAE) in 9 of 10 sectors. A significant relationship was found between threshold and cpRNFL thickness in 6 of 10 sectors, whereas it was significant in 9 of 10 sectors with thresholdVAE. Applying VAE to VF data results in an improved structure-function relationship.

Evaluation of Papillomacular Nerve Fiber Bundle Thickness in Glaucoma Patients with Visual Acuity Disturbance

ABSTRACT Purpose Assessing the papillomacular nerve fiber bundle (PMB) can identify glaucoma patients with decreased visual acuity. In this study, we explore efficient methods for evaluating PMB thickness in glaucoma patients, based on swept source-optical coherence tomography (SS-OCT). Methods This study included 347 eyes of 205 open-angle glaucoma (OAG) patients. Patients were excluded if they had best-corrected decimal visual acuity < 0.3, axial length >28 mm, non-glaucoma ocular disease, or systemic disease affecting the visual field. We obtained vertical 12.0 × 9.0 mm 3D volume scans covering both the macular and optic disc regions with SS-OCT (DRI OCT Triton, Topcon), and measured the thickness of the PMB, as well as average macular retinal nerve fiber layer thickness (mRNFLT) and macular ganglion cell complex thickness (mGCCT) in the macular map and temporal-quadrant circumpapillary RNFL thickness (tcpRNFLT). We also measured central-strip RNFLT (csRNFLT) and GCC (csGCCT) in a 1.5 × 6.6 mm area of the scan centered between the fovea and optic nerve head. CsRNFLT and csGCCT were divided lengthwise into three 1.5 × 2.2 mm sections. We then calculated Spearman’s rank correlation coefficient between these OCT measurements and visual acuity. Logistic regression analysis was used to find the cutoff value for the OCT measurements to predict logMAR < 0. Results The correlation coefficients with logMAR were 0.38 for mRNFLT, 0.44 for mGCCT, 0.37 for middle csRNFLT, 0.50 for middle csGCCT, and 0.33 for tcpRNFLT (all P < .0001). For middle csGCCT, the area under the curve indicating decreased visual acuity was 0.80, with a cutoff value of 88.6 μm (P < .001). Conclusions We found strong associations between OCT parameters in the PMB, especially middle csGCCT, and visual acuity in patients with OAG. The thickness of the PMB may therefore be valuable information for glaucoma care and may help prevent visual acuity disturbance.