Spectral-domain Optical Coherence Tomography Research Articles

Effect of tube debonding on the enamel surface in vitro : Evaluation with optical coherence tomography.

In vitro evaluation of the morphology of the enamel surface before bonding metal tubes and after debonding using spectral domain optical coherence tomography (SD-OCT) and light microscopy. In all, 40 extracted caries-free human molars without defects were selected and cleaned. The tooth surfaces were imaged by light microscopy and SD-OCT prior to the placement of metal tubes (Titanium Orthos; Ormco, Brea, CA, USA). The metal tubes were bonded to the teeth using four adhesive systems: group1) BrackFix Primer SE with BrackFix adhesive, group2) BrackFix Primer with BrackFix adhesive (VOCO, Cuxhaven, Germany), group3) Transbond Plus SE Primer with Transbond XT adhesive, group4) Transbond XT Primer with Transbond XT adhesive (reference, 3M Deutschland, Neuss, Germany). After tube removal, the bonded areas were imaged by light microscopy and/or OCT and evaluated according to the following four criteria: (1) depth of cohesive enamel defect, (2) enamel cracks, (3) adhesive residue after tube removal, and (4) adhesive residues after polishing. None of the groups had enamel defects or enamel cracks. Group1 showed significantly less adhesive residue after tube removal than the other groups (pi ≤ 0.014). There were no significant differences between the groups for adhesive residues after polishing (pi ≥ 0.628). Adhesive residues, if present, were only detectable by OCT and covered less than 1% of the enamel surfaces evaluated. Tube removal did not cause clinically relevant enamel damage such as chipping or cracking.

Optical Coherence Tomography of the Corn Snake (Pantherophis guttatus) Eye: An Exploratory Study

Abstract The aim of this exploratory study was to capture images of the anterior and posterior segments of the corn snake eye using spectral domain optical coherence tomography (OCT). Post-mortem OCT scans were conducted on three euthanized corn snakes (Pantherophis guttatus), followed by a histological examination of their eyes. OCT findings were correlated with histology to identify anterior and posterior ocular structures, and to delineate retinal layers on OCT. Total retinal thickness (RT) was manually measured every 360 μm from the edge of the optic disc over a 3600 μm distance in the dorsal and ventral quadrant of each snake. In the anterior segment of the eye, OCT imaging successfully identified the spectacle, cornea, iris, lens and Schlemm’s canal. The posterior segment scans revealed a vestigious conus papillaris and retinal folds adjacent to the optic nerve head which were confirmed by histology. The membrana vasculosa was distinguishable from the surrounding retina, and despite some limitations in image resolution, retinal layers were discernible. There was a positive correlation between the total RT and the distance from the optic disc (with the retina being thicker farther from the optic disc). Additionally, the total RT in the ventral quadrant was significatively lower than in the dorsal quadrant. OCT imaging effectively identified various anatomical features and retinal layers of the corn snake’s eye. To establish comprehensive OCT references for the posterior segment of the eye, further studies involving healthy, living snakes are needed.

Association between the ARMS2 rs10490924 risk genotype and dry-age related macular degeneration patients with and without reticular pseudodrusen in a Turkish population: findings from a study conducted at a tertiary clinic.

To evaluate the relationship between the presence of reticular pseudodrusen (RPD) and the risk allele of ARMS2 rs10490924 variation in dry-AMD patients by using multimodal imaging. Also, to compare patients with and without RPD and healthy volunteers according to the distribution of the risk allele. In this cross-sectional study, dry-AMD patients with (Group A,n = 50) and without (Group B,n = 50) RPD and healthy volunteers (Group C,n = 50) were enrolled. After detailed ophthalmologic examination, confocal scanning laser ophthalmoscope (Heidelberg, Germany) was used to acquire near infra-red (NIR) imaging for RPD and the diagnosis was confirmed by Spectral Domain-Optical coherence tomography (Heidelberg, Germany). In silent choroidal neovascularization suspicion, optical coherence tomography angiography (Optovue, Fremont, CA) was performed and those were excluded. For genetic assessment, peripheric blood sampling was performed. Using next-generation sequencing technique (NGS), ARMS2 rs10490924 single nucleotide polymorphism was investigated. Groups were compared according to the distribution of the risky allele. 150 eyes of 150 participants were included. In Group A, 42% (21) of patients were heterozygous for the T risk allele, 30% (15) were homozygous, and the risk allele was not detected in 28% (14). In Group B, 44% (22) of patients were heterozygous, 17% (8) were homozygous, and the risk allele was not detected in 39% (20). In Group C, 30% (15) of participants were heterozygous, 4% (2) were homozygous, and variation was not observed in 64% (32). Homozygous participants in Group A were significantly higher than other two groups (Group A-B: OR = 2.67, 95% CI: 0.895, 8.020; Group A-C: OR = 17.14, 95% CI: 3.449, 85.208) while in Group B, homozygous individuals were higher than Group C (respectively, p values 0.0039, 0.0002, 0.013). T risky allele frequencies were 51%, 38%, and 20% in Groups A, B, and C, respectively, which was significantly higher in Group A (p = 0.02). Genetic influence in AMD is inevitable while certain differences according to different ethnicities may apply. Association of genetic variations and imaging findings like RPD is lacking among literature for different populations. By the aspect of this study, the relationship between RPD and ARMS2 rs10490924 polymorphism in dry-AMD patients were highlighted among Turkish population by using multimodal imaging for the first time. What is Known? Pathophysiology of age-related macular degeneration is influenced from multiple factors including single nucleotide polymorphisms. The variations of ARMS2 are suspected well in the current literature. Reticular pseudodrusen is related to advanced stages of age related macular degeneration disease. What is New? The ARMS2 rs10490924 risk genotype is associated with the presence of reticular pseudodrusen in dryage related macular degeneration patients. Homozygous genotype of T risk allele is evaluated significantly higher in dry age related macular degeneration patientswith reticular pseudodrusen.

OCT analysis and MPOD assessment in patients affected by retinitis pigmentosa

This study aimed to analyze Optical Coherence Tomography (OCT) parameters and Macular Pigment Optical Density (MPOD) changes in patients affected by Retinitis pigmentosa (RP). Eighteen eyes of 18 patients suffering from early-stage RP were enrolled in our observational study. 18 eyes of 18 patients age and gender matched were enrolled as controls. Patients were analyzed at baseline by undergoing complete baseline ophthalmologic examination, Spectral-domain Optical Coherence Tomography (OCT), Electroretinogram (ERG) and Heterochromatic Flicker Photometry (HFP). Main outcome measures were Macular Pigment Optical Density (MPOD), Central macular thickness (CMT), Central Choroidal Thickness (CCT) and Choroidal Vascularity Index (CVI). Lower CCT (p = 0.006), CVI (p < 0.001) and MPOD levels (p = 0.038) were found in affected patients, whereas higher CMT was detected in cases compared to healthy controls. Correlation analysis revealed the presence of a negative correlation between BCVA and Age and CMT and BCVA and a positive correlation between CCT and MPOD and CVI and CCT. Retinal and choroidal variations occur in patients affected by early-stage RP regarding functional and anatomical changes.

Automated Detection of Drusenoid Pigment Epithelial Detachments From Spectral-Domain Optical Coherence Tomography in Patients With AMD.

This study aimed to develop an algorithm for automated detection of drusenoid pigment epithelial detachments (DPEDs) in optical coherence tomography (OCT) volumes of patients with age-related macular degeneration (AMD) and to compare its performance against traditional reading center grading on color-fundus photographs (CFPs). Eyes with a range of AMD severities, excluding neovascular disease, were imaged using spectral-domain OCT (SD-OCT) and paired CFPs and were followed annually for up to 5years. DPEDs were automatically identified by segmenting the retinal pigment epithelium (RPE) and Bruch's membrane (BM) layers from the SD-OCT volumes and imposing both a minimum RPE BM height (>75 µm) and a two-dimensional length requirement (>433 µm). Comparisons in detection rates and contoured areas were made between the algorithmic SD-OCT detections and manually graded and contoured CFPs. Of the 1602 visits for the 323 eyes, the automated OCT algorithm identified 139 visits (8.7%) from 50 eyes with DPED, but a reading center review of paired CFPs identified 23 visits (1.4%) from nine eyes as having DPEDs. Eyes identified with DPEDs on OCT received nine-step AMD severity scores ranging from 6 to 10, and those scores had occurrence ratios of 23/160 (14%), 89/226 (39%), 24/99 (24%), 2/63 (3%), and 1/29 (3%), respectively. On a subset of 25 visits that also underwent manual contouring of DPED lesions in CFP, the Pearson correlation coefficient for DPED areas observed by OCT and CFP was 0.85. Our analysis shows the feasibility of using OCT scans to objectively detect features that historically have been detected qualitatively by expert graders on CFPs. Automated detection and quantitation of high-risk features can facilitate screening patients for clinical-trial enrollment and could serve as an outcome metric [T1 (Translation-to-Humans) and T4 (Translation-to-Population-Health)].

Deep-RPD-Net: A 3D Deep Network for Detection of Reticular Pseudodrusen on Optical Coherence Tomography Scans

To propose Deep-RPD-Net, a 3-dimensional deep learning network with semisupervised learning (SSL) for the detection of reticular pseudodrusen (RPD) on spectral-domain OCT scans, explain its decision-making, and compare it with baseline methods. Deep learning model development. Three hundred fifteen participants from the Age-Related Eye Disease Study 2 Ancillary OCT Study (AREDS2) and 161 participants from the Dark Adaptation in Age-related Macular Degeneration Study (DAAMD). Two datasets comprising of 1304 (826 labeled) and 1479 (1366 labeled) OCT scans were used to develop and evaluate Deep-RPD-Net and baseline models. The AREDS2 RPD labels were transferred from fundus autofluorescence images, which were captured at the same visit for OCT scans, and DAAMD RPD labels were obtained from the Wisconsin reading center. The datasets were divided into 70%, 10%, and 20% at the participant level for training, validation, and test sets, respectively, for the baseline model. Then, SSL was used with the unlabeled OCT scans to improve the trained model. The performance of Deep-RPD-Net was compared to that of 3 retina specialists on a subset of 50 OCT scans for each dataset. En face and B-scan heatmaps of all networks were visualized and graded on 25 OCT scans with positive labels, using a scale of 1 to 4, to explore the models' decision-making. Accuracy and area under the receiver-operating characteristic curve (AUROC). Deep-RPD-Net achieved the highest performance metrics, with accuracy and AUROC of 0.81 (95% confidence interval [CI]: 0.76-0.87) and 0.91 (95% CI: 0.86-0.95) on the AREDS2 dataset and 0.80 (95% CI: 0.75-0.84) and 0.86 (95% CI: 0.79-0.91) on the DAAMD dataset. On the subjective test, it achieved accuracy of 0.84 compared with 0.76 for the most accurate retina specialist on the AREDS2 dataset and 0.82 compared with 0.84 on the DAAMD dataset. It also achieved the highest visualization grades, of 3.26 and 3.32 for en face and B-scan heatmaps, respectively. Deep-RPD-Net was able to detect RPD accurately from OCT scans. The visualizations of Deep-RPD-Net were the most explainable to the retina specialist with the highest accuracy. The code and pretrained models are publicly available at https://github.com/ncbi-nlp/Deep-RPD-Net. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Comparison between spectral-domain optical coherence tomography-based and partial coherence interferometry-based biometry

We compared axial length (AL) measurements using spectral-domain optical coherence tomography (SD-OCT)-based and partial coherence interferometry (PCI)-based biometry in eyes with various chorioretinal diseases. Medical records were retrospectively analyzed in 123 eyes from 73 patients who underwent AL measurements using SD-OCT and PCI. AL values were highly consistent by both measurements (ICC = 0.996 in SD-OCT and 0.995 in PCI-based biometry). The mean difference in AL between the two instruments was − 0.09 ± 0.17 mm, which was significant (P < 0.001). There was a strong correlation between the measurements obtained using the two instruments (r = 0.982, P < 0.001). The 95% limits of agreement were − 0.43 to 0.25 mm, and the agreement of AL in the Bland–Altman analysis showed a difference. The difference in measurements was not associated with the difference in central retinal thickness (r = 0.033, P = 0.720). However, the presence of an epiretinal membrane affected the difference in measurements, unlike in other chorioretinal diseases (P = 0.014). SD-OCT-based biometry showed a good correlation with PCI-based biometry in the measurement of AL; however, the mean AL between the two instruments was significantly different. Therefore, AL measurements made using SD-OCT-based and PCI-based biometry are not interchangeable.

Characterization of the Subclinical Perilesional Zone in the Macula of Early-Stage ABCA4 Disease.

To characterize photoreceptor layer thinning in clinically unremarkable regions adjacent to the atrophic lesion in early-stage ABCA4 disease eyes. 27 patients with confined atrophic lesions (≤ 3.5mm in diameter) were included. Two pathogenic alleles were confirmed by sequencing of the ABCA4 locus. Multimodal imaging included color fundus photography, short wavelength-autofluorescence (SW-AF) and near infrared-autofluorescence (NIR-AF) imaging. Total receptor+ (TREC+) thickness was segmented in spectral domain-optical coherence tomography (SD-OCT) scans in patient eyes (n=27) along with age-matched healthy control eyes (n=20). μ age of the study cohort was 24.1 years and 15/27 (55.6%) patients harbored genotypes consisting of the p.(Gly1961Glu) variant in ABCA4. Atrophic lesions in the central macula ranged from 0.61 to 3.13 mm in diameter (μ = 1.73, σ = 0.70). Six patients had mild RPE mottling adjacent to the lesion on NIR-AF. The atrophic lesion corresponded to a disruption of photoreceptor-attributable bands on SD-OCT while all layers were visibly intact outside the lesion. TREC+ thickness in patient eyes were <0.15 mm or below 4σ of normal control eyes immediately adjacent to the lesion edge and gradually normalized to within ± 2σ at ≈ 1.2 mm eccentricity from the fovea. A uniform subclinical perilesional zone (SPZ) of photoreceptor thinning extends around the perimeter of early-stage atrophic lesions in ABCA4 disease. This region spatially maps to known regions of vision loss and more accurately approximates the extent of photoreceptor abnormality compared to the disease changes visible on standard fundus imaging. Semi-automated segmentation of SD-OCT scans identifies a consistent subclinical biomarker relevant to early photoreceptor degeneration in ABCA4 disease.

Comparative study between swept-source and spectral-domain OCTA for imaging of choroidal neovascularization in age-related macular degeneration.

To compare the differences of choroidal neovascularization (CNV) measurements between swept-source and spectral-domain optical coherence tomography angiography (SS-OCTA and SD-OCTA) in neovascular age-related macular degeneration (nAMD) and the imaging reliability of the two devices. Prospective comparative study. SS-OCTA and SD-OCTA were used to scan the same eye with the modes of 3×3 and 6×6 mm2 centered on the neovascularization. Only qualified images were chosen and the border of CNV was manually delineated by two graders independently. The area of CNV (ACNV), vascular perfusion density (PD), and vessel length density (VLD) within the delineation were calculated using Image J. The differences of CNV measurements between the two OCTA devices were compared using Bland-Altman analysis. The agreement between the two graders on the measurements of each device was compared using the intraclass correlation coefficient (ICC). A total of 18 patients (22 eyes) with nAMD were included. The measurements of ACNV, PD, and VLD were 7.247±4.586 and 4.901±3.741 mm2, 43.202±9.636 and 34.904±10.489, 6.339±1.228 and 5.908±1.741 mm-1 for SS-OCTA and SD-OCTA, respectively. The differences between the two devices were 2.346±3.030 mm2 (Z=-3.782, P<0.0001), 8.298±14.160 (Z=-2.419, P=0.016), and 0.431±2.114 mm-1 (Z=-0.828, P=0.408) for ACNV, PD and VLD, respectively. The ICC between two graders were 0.893 (P<0.001), 0.902 (P<0.001), 0.885 (P<0.001) for ACNV, PD, VLD in SS-OCTA, and 0.971 (P<0.001), 0.976 (P<0.001), 0.973 (P<0.001) in SD-OCTA, respectively. Both OCTA devices have high imaging reliability. Compared with SD-OCTA, SS-OCTA has a larger ACNV measurements, but doesn't show better resolution of internal vessels of CNV and well signal strength.

The analysis of foveal microvascular anomalies in retinopathy of prematurity after anti-vascular endothelial growth factor therapy using optical coherence tomography angiography

BackgroundTo investigate the quantitative vascular and structural differences in the foveal region of the eyes in retinopathy of prematurity children with or without anti-vascular endothelial growth factor (VEGF) therapy and healthy children using optical coherence tomography angiography (OCTA).MethodsThis cross-sectional study analyzed 75 eyes from 44 subjects, categorized into four groups: ROP children treated with Conbercept or Ranibizumab, spontaneously regressed ROP, and healthy age-matched children. Using spectral-domain OCT and OCTA, we assessed parameters like central foveal thickness (CFT), foveal avascular zone (FAZ), superficial/deep capillary plexus (SCP/DCP), and choroidal vessel density (VD) at the fovea. Correlations between foveal microvasculature, preterm status and visual acuity were evaluated.ResultsSignificant differences were found in FAZ area, CFT, and VD-SCP (parafoveal) among the groups. The FAZ area was smaller in ROP children (with/without treatment) than in healthy counterparts(p = 0.009). CFT was higher in the Ranibizumab and spontaneously regressed groups compared to healthy ones (p = 0.043, p = 0.037), while Conbercept-treated children showed no significant difference (p = 0.886). Foveal VD trends were higher in groups A, B, and C compared to group D. FAZ area correlated negatively with CFT, VD-SCP (foveal), and VD-DCP (foveal) (p < 0.001, p < 0.001, p = 0.001), and positively with choroidal VD (p = 0.012). CFT showed positive correlations with VD-SCP (foveal) and VD-DCP (foveal) (p = 0.003, p = 0.001).ConclusionROP children exhibit a smaller FAZ area compared to healthy group, with no significant difference noted when comparing the use of different anti-VEGF agents. ROP children have a thicker CFT than healthy children, except for those treated with Conbercept. Furthermore, microvascular irregularities were correlated with central foveal thickness.

A cross-sectional study of fundus lesion characteristics in patients with acute visual impairment caused by COVID-19 infection

To investigate the characteristics of acute visual dysfunction and fundus lesions in patients with COVID-19 pneumonia. A retrospective case series study was conducted. Data from 48 patients (96 eyes) with COVID-19 infection who presented to our ophthalmology department with acute onset visual disturbance between December 5, 2022, and February 28, 2023 were collected. Asymptomatic patients and those who had already recovered were excluded. Data collected included patient demographics, ophthalmic examinations, multicolor imaging (MCI), infrared autofluorescence (IR), spectral-domain optical coherence tomography (OCT), fundus fluorescein angiography (FFA). Of the 48 patients, 15 were male and 33 were female, with a mean age of 32 years. All patients had bilateral involvement. OCT showed hyperreflective signals in the outer plexiform layer and outer nuclear layer of the macular region in all 96 eyes of 48 patients (100%). Additionally, 66 eyes of 33 patients (68.8%) of eyes demonstrated abnormal reflectivity in the ellipsoid and interdigitation zones. MCI revealed petaloid or wedge-shaped hyperreflective areas in the macula in 46 (47.9%) of eyes, corresponding to hyporeflective areas on IR. Cotton-wool spots were observed in the peripapillary or posterior pole area in 54 (56.3%) of eyes. COVID-19 infection can lead to acute, bilateral, symmetric, and widespread retinal damage. Characteristic findings can be observed in ophthalmological examinations such as OCT, MCI, and IR.

Dysfunction and Morphological Involvement of Inner Macular Layers in Glaucoma.

Objectives: This study aimed to study the inner retina functional and morphological impairment of retinal ganglion cells (RGCs) from specific macular rings and sectors to identify whether selective macular regions were more vulnerable than others within the 20 central degrees in patients with open-angle glaucoma (OAG). Methods: In total, 21 OAG patients [mean age 50.19 ± 7.86 years, Humphrey Field Analyzer (HFA) 24-2 mean deviation (MD) between -5.02 and -22.38 dB, HFA 10-2 MD between -3.07 and -17.38 dB], providing 21 eyes, were enrolled in this retrospective case-control study. And 20 age-similar healthy subjects, providing 20 eyes, served as controls. The multifocal photopic negative response (mfPhNR) response amplitude density (RAD) from concentric rings and macular sectors and ganglion cell layer thickness (GCL-T) assessed by Spectral Domain-Optical Coherence Tomography (SD-OCT) was measured. Mean RAD and GCL-T values were compared between OAG and control ones by ANOVA. In OAG eyes, the relationship between mfPhNR and SD-OCT data was examined by linear regression analysis, and Pearson's correlation coefficients were computed. Results: In considering all rings and sectors, compared to the controls, the OAG group showed a significant (p < 0.01) reduction in mean mfPhNR RAD and in GCL-T values with the greatest reduction in the central area. In OAG eyes, a significant (p < 0.01) correlation between all mfPhNR RAD and GCL-T values, with significant (p < 0.01) correlation coefficients, were found. Conclusions: In OAG eyes, RGC dysfunction was detectable by abnormal mfPhNR responses in localized macular areas, mainly in the central one. Localized macular RGC dysfunction was linearly correlated with the GCL morphological changes.

Correlation of retinal fluid and photoreceptor and RPE loss in neovascular AMD by automated quantification, a real-world FRB! analysis.

To quantify ellipsoid zone (EZ) loss during anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) and correlate these findings with nAMD disease activity using artificial intelligence-based algorithms. Spectral domain optical coherence tomography (Spectralis, Heidelberg Engineering) images from nAMD treatment-naïve patients from the Fight Retinal Blindness! (FRB!) Registry from Zürich, Switzerland were processed at baseline and over 3 years of follow-up. An approved deep learning algorithm (Fluid Monitor, RetInSight) was used to automatically quantify intraretinal fluid (IRF), subretinal fluid (SRF) and pigment epithelial detachment (PED). An ensemble U-net deep learning algorithm was used to automated quantify EZ integrity based on EZ layer thickness. The impact of fluid volumes on EZ thickness and late-stages outcomes were calculated using Wilcoxon rank-sum tests, a linear mixed model and a longitudinal panel regression model. Two hundred and eleven eyes from 158 patients were included. The mean ± SD EZ loss area in the central 6 mm was 1.81 ± 2.68 mm2 at baseline and reached 6.21 ± 6.15 mm2 at month 36. Higher fluid volumes (top 25%) of IRF and PED in the central 1 and 6 mm of the macula were significantly associated with more advanced EZ thinning and loss compared to the low fluid volume subgroup. The high SRF subgroup in the linear regression model showed no statistically significant association with EZ integrity in the central macula; however, the longitudinal analysis revealed an increased EZ thickness with no additional loss. Intraretinal fluid and PED volumes and their resolution pattern have an impact on alteration of the underlying EZ layer. AI-supported quantifications are helpful in quantifying early signs of macular atrophy and providing individual risk profiles as a basis for tailored therapies for optimized visual outcomes.

Visual acuity in the context of retinal neuroaxonal loss in people with epilepsy

Recent studies reported a significant retinal neuroaxonal loss in people with epilepsy (PWE). However, the impact of these structural alterations on visual function, i.e., visual acuity is yet unknown. In this prospective cohort study, 70 PWE and 76 healthy controls (HC), all aged 18-55 years, underwent an assessment of visual acuity with 100 % high contrast (HCVA) and 2.5 % low contrast (LCVA) Sloan letter charts. Thickness of the global peripapillary retinal nerve fiber layer (G-pRNFL) and volume of the ganglion cell inner plexiform layer (GCIP) were assessed with spectral-domain optical coherence tomography (OCT). For the statistical analyses, the epilepsy group was subdivided into PWE with sodium channel blocking (SCB)-drug intake (n = 52) and PWE without SCB-drug intake (n = 18), since an effect of SCB-drugs on visual perception has been reported previously. The overall PWE cohort presented significantly lower structural retinal measures, i.e., G-pRNFL thickness (97.57 ± 9.06 µm) and GCIP volume (1.99 ± 0.13 mm3) than HC (101.31 ± 8.28 µm, p = .01; 2.10 ± 0.15 mm3, p < .001). Subgroup analyses revealed that PWE who were treated with SCB-drugs had a significantly reduced G-pRNFL thickness (96.61 ± 9.70 µm, p = .01) and GCIP volume (1.98 ± 0.14mm3, p < .001) compared to HC, while PWE without SCB-drugs (100.36 ± 6.32 µm, 2.01 ± 0.13 mm3) did not differ from HC or PWE with SCB-drugs. In visual acuity tests (HCVA and LCVA), the overall PWE cohort (52.28 ± 8.56; 31.71 ± 8.49) scored significantly lower than HC (56.57 ± 4.74, p = .001; 35.13 ± 5.50, p = .04). In subgroup analyses only PWE with SCB-drugs presented significantly lower HCVA (51.25 ± 9.35, p = .003) and LCVA (30.04 ± 8.93, p = .03) scores compared to HC, while visual acuity scores did not differ between PWE without SCB-drugs (55.25 ± 4.75, 36.53 ± 4.50) and HC. PWE with SCB-drugs had significantly lower LCVA scores than PWE without SCB-drugs (p = .03). Importantly, no association was found between visual acuity scores and structural parameters, neither in the overall sample, nor in any of the subgroups. Retinal neuroaxonal loss in PWE was not associated with reduced visual acuity under high and low contrast. Instead, our findings reinforce SCB-drug intake as an important factor for reduced visual acuity under high and low contrast.

Evaluation of the macula, retinal nerve fiber layer and choroid thickness in premature ovarian failure using spectral-domain optical coherence tomography.

The aim of our study is to describe the basal findings at the first diagnosis of the disease in patients with premature ovarian failure (POF) and to draw attention to the early changes in the macula, optic nerve head and choroid. In a prospective case-control study, 90 patients with POF and 90 control patients were evaluated. All participants underwent the same ophthalmic examination, including visual acuity, intraocular preasure measurement, anterior and posterior segment evaluation, macular and coroidal thickening, and retinal nerve fiber layer (RNFL) measurements with the same device (Spectral Domain OCT, software version 5.6.3.0, Heidelberg, Germany). The median age was 30.00 (28.00-31.00) in the control group and 29.00 (27.00-31.00) in the POF group (p = 0.249). The median thickness of the temporal outer macular region was statistically significantly thinner in the POF group (295.00 (289.00-303.25)) compared to the control group (306.00 (290.75-328.00)) (p < 0.001). There was a statistically significant decrease in all choroidal regions (p < 0.001), including the central, nasal 500, nasal 1500, temporal 500, and temporal 1500 regions in the POF group according to the control group. An increase in intraocular pressure in the postmenopausal period has been reported, suggesting a link between the postmenopausal decline in sex hormones and glaucoma. Our study is the first to monitor changes in choroidal, retinal thickness and RNFL in POF images showing early menopausal symptoms.

Factors Associated With Ocular Perfusion Measurements as Obtained With Laser Speckle Contrast Imaging.

To study the ocular and systemic factors affecting optic nerve head (ONH) perfusion data as obtained using a commercially available laser speckle flowgraphy (LSFG) device in a cohort of Caucasian subjects without ocular diseases. Also, to assess the intrasession repeatability and intersession reproducibility of ONH, macular, retinal, and choroidal perfusion. Seventy-five healthy eyes of 75 Caucasian participants underwent LSFG and spectral-domain optical coherence tomography (SD-OCT) on the same visit. Perfusion of the ONH was assessed with LSFG, and SD-OCT was used to measure peripapillary retinal nerve fiber layer thickness (RNFLT) and macular ganglion cell plus inner plexiform layer thickness (GCIPLT). The intrasession repeatability and intersession reproducibility of ONH and macular perfusion and retinal and choroidal relative flow volume (RFV) were evaluated in 20 participants measured on three different days over a 6-month period. Intrasession and intersession intraclass correlation coefficients of LSFG parameters ranged from 0.787 to 0.967 and from 0.776 to 0.935, respectively. Intersession 95% prediction intervals for the ratio of two measurements were wider for RFV indices than for ONH and macular perfusion parameters. The multiple regression analysis indicated that higher ONH perfusion was associated with younger age, female sex, smaller optic disc area, and higher RNFLT. RNFLT was an independent predictor of ONH perfusion, whereas GCIPLT was not. Each 1-µm increase in RNFLT was associated with a 0.272 arbitrary unit increase in ONH perfusion. LSFG measurements of optic disc perfusion are influenced by sex, age, and anatomical variations in optic disc area and RNFLT. Better evaluation of ocular blood flow will result in better diagnosis and treatment of various ocular diseases.

Visual Acuity, Full-field Stimulus Thresholds, and Electroretinography for 4 Years in the USH2A-associated Retinal Degeneration RUSH2A Study

To describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the USH2A-related Retinal Degeneration study and to assess their suitability as clinical trial endpoints. Prospective natural history study. Participants (n=105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included. BCVA, FST, fundus-guided microperimetry, static perimetry, and spectral domain OCT were performed annually and ERG at baseline and 4 years only. Mixed effects models were used to estimate annual rates of change with 95% confidence intervals. Associations of change from baseline to 4 years between BCVA, FST, ERG, and other metrics were assessed with Spearman correlation coefficients (rs). Best-corrected visual acuity, FST, and ERG. The annual rate of decline in BCVA was 0.83 (95% confidence interval: 0.65-1.02) letters/year. For FST, the change was 0.09 (0.07-0.11) log cd.s/m2/year for white threshold, 0.10 (0.08-0.12) log cd.s/m2/year for blue threshold, and 0.05 (0.04-0.06) log cd.s/m2/year for red threshold. Changes were 22.6 (17.4-28.2)%/year for white threshold, 26.0 (20.3-32.1)%/year for blue threshold, and 12.3 (8.7-16.0)%/year for red threshold. The high percentage of eyes with undetectable ERGs at baseline limited assessment of change. Best-corrected visual acuity was not a sensitive measure of progression over 4 years. Full-field stimulus threshold was a more sensitive measure; however, additional information on the clinical relevance of changes in FST is needed before this test can be adopted as an endpoint for clinical trials. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Structural effects of intraretinal cysts on outer retinal layers in eyes with diabetic macular edema

BackgroundDiabetic macular edema (DME) is the main cause of visual loss in individuals with diabetic retinopathy (DR). This study aims to investigate the effects of central macular intraretinal cysts on the underlying outer retinal layer (ORL) in patients with diabetic macular edema (DME).MethodsIn this retrospective and cross-sectional study, diabetic patients with or without DR were categorized into three groups: without DME (group 1), with DME but without any cyst featuring a plateau in the lower region (group 2), and patients with cyst featuring an inferior cyst plateau (group 3), defined as a flat conformation at its posterior aspect. Variables such as central macular intraretinal cyst height, inferior cyst plateau, and ORL thickness were measured, and ellipsoid zone (EZ) disruption was assessed via Spectral-domain optical coherence tomography (SD-OCT) and compared between groups. Correlations between OCT-measured variables and best-corrected visual acuity (BCVA) were investigated.ResultsA total of 164 eyes were included: 48 in group 1, 47 in group 2 and 69 in group 3. Compared with Groups 1 and 2, Group 3 presented a greater intraretinal cyst height (p < 0.001), a thinner mean ORL beneath the cysts (p < 0.0001) and more frequent EZ disruption (p < 0.0001), which was associated with lower BCVA values. Cyst height, cyst plateau and ORL thickness were significantly correlated with BCVA (p < 0.0001). EZ disruption was associated with the cyst height, the cyst plateau and the underlying ORL thickness. Correlations were observed between cyst height and ORL thickness (r = − 0.32, p < 0.001), between cyst height and cyst plateau (r = 0.60, p < 0.001), and between cyst plateau and ORL thickness (r = − 0.56, p < 0.001). Every increase of 10 μm in plateau width and in cyst height results in reductions of 0.16 μm and 0.29 μm in ORL thickness, respectively, independent of the other parameters. The optimal cutoff point for cyst height that best discriminates plateau formation was determined to be 130.5 μm, with a sensitivity of 89.9% and specificity of 83%.ConclusionsIn patients with DME, large central intraretinal cysts may assume a flat configuration in their lower region, termed a plateau, and are associated with photoreceptor damage due to compression, which can result in visual impairment. These findings can be understood based on modified Hertz’s mechanical contact theory.

Clinical analysis of supraciliary effusion development following gonioscopy-assisted transluminal trabeculotomy surgery for pseudoexfoliation glaucoma.

To investigate clinical characteristics of postoperative supraciliary effusion (SCE) development following gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with pseudoexfoliation glaucoma (PEXG). In this prospective and observational study, 64 eyes (64 patients) with PEXG were examined with spectral-domain optical coherence tomography (SD-OCT) after GATT over a 12-month follow-up. Outcomes were surgical success, intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of antiglaucoma medications (AGM) and complications of the SCE (+) group with those of SCE (-) group. SCE was observed in 39 eyes (60.9%) within the first postoperative week. Probability of complete success was significantly higher in the SCE (+) group than in the SCE (-) group (25.6% vs. 16.0%, p = 0.009). IOP was significantly lower at postoperative first day in the SCE (+) group than in the SCE (-) group (p = 0.04), but it was similar thereafter during follow-up (p > 0.05). Postoperative BCVA did not show significant difference at the end of the follow-up (p > 0.05). Postoperative number of AGM was found to be significantly lower in the SCE (+) group compared to the SCE (-) group (p < 0.05). A significant IOP rise was observed after SCE resolution (p = 0.002). Presence of SCE accompanied with significantly lower IOP during the early postoperative period after GATT surgery for PEXG. SCE might have a favourable impact on postoperative AGM use. SCE can easily be examined by SD-OCT, and be used as a prognostic indicator.

Longitudinal Assessment of Structural and Functional Changes in Rod-cone Dystrophy: A 10-year Follow-up Study

Emerging clinical trials for inherited retinal disease (IRD) require an understanding of long-term progression. This longitudinal study investigated the genetic diagnosis and change in retinal structure and function over 10 years in rod-cone dystrophies (RCDs). Longitudinal observational follow-up study. Individuals initially diagnosed with retinitis pigmentosa who underwent baseline assessment between 2010 and2013. Baseline and follow-up assessments included best-corrected visual acuity (VA), Goldmann visual field (GVF) perimetry, spectral-domain OCT imaging, electroretinogram, and panel-based genetic testing. Linear mixed models were used to investigate disease progression and interaction between progression rate and baseline measurement. Interocular symmetry in disease progression was assessed using intraclass correlation coefficients (ICCs). Change in VA, GVF area, and ellipsoid zone (EZ) width over 10 years in RCD. A total of 23 participants attended follow-up (mean age 63±15 years at follow-up; 48% female), with 20 classified as having RCD and 3 reclassified as having cone-rod dystrophy based on genetic diagnosis. At 10-year follow-up, only 60% of RCD participants showed progression of ≥15 letters in either or both eyes, and 40% did not meet the criteria in either eye. Between the eye with poorer versus better VA at baseline, high symmetry in disease progression was observed for GVF area (ICC=0.87; 95% confidence interval [CI]: 0.68-0.95), and moderate interocular symmetry in disease progression was observed for VA (ICC=0.50 [95%CI: 0.07-0.77]) and EZ width (ICC=0.64 [95% CI: 0.25-0.85]). Baseline values influenced progression for VA and percentage change in GVF area, whereas total percentage change in EZ width did not differ across baseline values. Many individuals with RCD did not have a significant 15-letter decline in VA over a 10-year follow-up, highlighting the challenges of relying on VA as a measure of disease progression. Symmetry between eyes varies, emphasizing a key consideration for selection of outcome measures in IRD clinical trials. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.