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Chatzimichail E, Chondrozoumakis G, Doroodgar F, Vounotrypidis E, Panos GD, Gatzioufas Z. Emerging Applications of Intraoperative Optical Coherence Tomography in Corneal Surgery: A Narrative Review. J Clin Med 2024; 13:5426. [PMID: 39336914 PMCID: PMC11432062 DOI: 10.3390/jcm13185426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/03/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Intraoperative OCT (iOCT) is an innovative imaging modality that provides ophthalmic surgeons with real-time cross-sectional views of the surgical field. Recent advances in OCT technology, such as higher acquisition scanning rates, enable real-time video visualization. iOCT systems are widely used in both vitreoretinal and anterior segment surgeries. In corneal surgeries, iOCT imaging aims to optimize efficacy and safety by improving depth perception and enhancing visualization in cases of opaque optical media. iOCT is a valuable tool not only for experienced corneal surgeons, but also for training novice surgeons. This review summarizes the emerging applications of iOCT in corneal surgery, particularly in technically demanding lamellar keratoplasty procedures, as well as in various other corneal diseases and complications that require surgical intervention.
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Affiliation(s)
| | | | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran QF86+QC7, Iran
| | | | - Georgios D. Panos
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Division of Ophthalmology & Visual Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Zisis Gatzioufas
- Department of Ophthalmology, University Hospital of Basel, 4031 Basel, Switzerland
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2
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Qian Q, Wang J. Bibliometric analysis of ophthalmic OCT and OCT angiography research trends over the past 20 years. Int Ophthalmol 2024; 44:374. [PMID: 39251539 DOI: 10.1007/s10792-024-03292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/25/2024] [Indexed: 09/11/2024]
Abstract
PURPOSE Optical coherence tomography (OCT) and OCT angiography (OCTA) are widely used in the diagnosis of ophthalmic diseases. This study aims to provide a comprehensive bibliometric analysis of ophthalmologic OCT and OCT angiography. METHODS We retrieved publications on ophthalmic OCT and OCTA from 2003 to 2022 from the Web of Science Core Collection and used bibliometric tools to analyze and visualize the distribution, trend, and hotspots. RESULTS In total, 20,817 articles written by 48,160 authors from 106 countries were selected. The number of publications has significantly increased. In the last two decades, the USA was the most productive country and received the highest citations. The most productive journal was Investigative Ophthalmology and Visual Science and received the highest number of citations. Moorfields Eye Hospital was the most productive institution. Bandello F published the most papers, while Spaide RF was the highest cited author. SPAIDE RF, 2011, AM J Ophthalmology was the most cited document. "OCT", "glaucoma" and "OCTA" were three hotspots in the last two decades. "Vessel density" and "deep learning" would be research hotspots in the future. CONCLUSION The bibliometric analysis of ophthalmic OCT and OCTA research over the past two decades on keywords, authors, citations, hotspots and trends will provide global researchers with valuable information for future research and cooperation.
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Affiliation(s)
- Qian Qian
- Department of Ophthalmology, Future Vision Clinic, Shanghai, 200032, China
| | - Jing Wang
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Vera-Duarte GR, Jimenez-Collado D, Kahuam-López N, Ramirez-Miranda A, Graue-Hernandez EO, Navas A, Rosenblatt MI. Neurotrophic keratopathy: General features and new therapies. Surv Ophthalmol 2024; 69:789-804. [PMID: 38679146 DOI: 10.1016/j.survophthal.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
Neurotrophic keratopathy is an uncommon degenerative corneal disorder characterized by compromised corneal sensory innervation resulting in the formation of epithelial defects and nonhealing corneal ulcers. Various treatment modalities are available to stabilize disease progression, improve patient well-being, and prevent vision loss. For eligible patients, medical and surgical reinnervation have emerged as pioneering therapies, holding promise for better management. We present a comprehensive review of the disorder, providing an update relevant to ophthalmologists on pathogenesis, diagnosis, treatment options, and novel therapies targeting pathophysiological pathways.
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Affiliation(s)
- Guillermo Raul Vera-Duarte
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - David Jimenez-Collado
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Nicolás Kahuam-López
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, University of Illinois-Chicago (UIC), Chicago, IL 60612, USA.
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4
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Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye 2024; 47:102156. [PMID: 38641525 DOI: 10.1016/j.clae.2024.102156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
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Affiliation(s)
- James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | - David Berkow
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ka Yin Chan
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Suraj K Chaurasiya
- Department of Contact Lens and Anterior Segment, CL Gupta Eye Institute, Moradabad, India; Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, India
| | - Daddi Fadel
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Mera Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarib Imane
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, United States
| | - Lyndon Jones
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Amy L Sheppard
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marta Vianya-Estopa
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karen Walsh
- CooperVision Inc., San Ramon, CA, United States
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fabrizio Zeri
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom; University of Milano-Bicocca, Department of Materials Science, Milan, Italy
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
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Sun Y, Maimaiti N, Xu P, Jin P, Cai J, Qian G, Chen P, Xu M, Jia G, Wu Q, Ye J. An AS-OCT image dataset for deep learning-enabled segmentation and 3D reconstruction for keratitis. Sci Data 2024; 11:627. [PMID: 38871784 PMCID: PMC11176413 DOI: 10.1038/s41597-024-03464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024] Open
Abstract
Infectious keratitis is among the major causes of global blindness. Anterior segment optical coherence tomography (AS-OCT) images allow the characterizing of cross-sectional structures in the cornea with keratitis thus revealing the severity of inflammation, and can also provide 360-degree information on anterior chambers. The development of image analysis methods for such cases, particularly deep learning methods, requires a large number of annotated images, but to date, there is no such open-access AS-OCT image repository. For this reason, this work provides a dataset containing a total of 1168 AS-OCT images of patients with keratitis, including 768 full-frame images (6 patients). Each image has associated segmentation labels for lesions and cornea, and also labels of iris for full-frame images. This study provides a great opportunity to advance the field of image analysis on AS-OCT images in both two-dimensional (2D) and three-dimensional (3D) and would aid in the development of artificial intelligence-based keratitis management.
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Affiliation(s)
- Yiming Sun
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Nuliqiman Maimaiti
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Peifang Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China.
| | - Peng Jin
- College of Computer Science, Hangzhou Dianzi University, Hangzhou, China
| | - Jingxuan Cai
- School of Mathematical Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Guiping Qian
- College of Media Engineering, Communication University of Zhejiang, Hangzhou, China
| | - Pengjie Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Mingyu Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Gangyong Jia
- College of Computer Science, Hangzhou Dianzi University, Hangzhou, China
| | - Qing Wu
- College of Computer Science, Hangzhou Dianzi University, Hangzhou, China
| | - Juan Ye
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China.
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Ucakhan OO. Optical Biopsy Using Anterior-Segment Optical Coherence Tomography in Ocular Surface Tumors: The Game Changer. Eye Contact Lens 2024; 50:241-242. [PMID: 38778464 DOI: 10.1097/icl.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Affiliation(s)
- Omur O Ucakhan
- Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
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7
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Mirzayev I, Gündüz AK, Gündüz ÖÖ, Özalp Ateş FS, Okcu Heper A. Anterior segment swept-source optical coherence tomography and ultrasound biomicroscopy in iris and ciliary body lesions. Expert Rev Med Devices 2024; 21:439-446. [PMID: 38803101 DOI: 10.1080/17434440.2024.2344668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/06/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Differentiation of iris and ciliary body lesions as benign or malignant and cystic or solid is important. The aim of this study was to compare anterior segment swept-source optical coherence tomography (AS SS-OCT) and ultrasound biomicroscopy (UBM) findings in iris and ciliary body tumors. RESEARCH DESIGN AND METHODS Forty-two eyes of 38 cases with iris and ciliary body tumors imaged with UBM and AS SS-OCT between September 2018 and September 2023 were evaluated retrospectively. RESULTS Of 42 eyes, 14 had melanoma, 14 iris pigment epithelial (IPE) cysts, 7 nevi, 3 Lisch nodules, 2 iris stromal cysts, 1 pars plana cysts, and 1 iris mammillations. An equivalent (100%) visualization of the anterior tumor margin was obtained with both techniques. Compared to AS SS-OCT, UBM was superior for posterior margin visualization in melanocytic tumors and IPE cysts. Bland-Altman plots demonstrated good agreement between UBM and AS SS-OCT for melanocytic tumors < 2.5 mm in base diameter and < 2 mm in thickness. CONCLUSIONS Although, UBM is the gold standard for ciliary body and iridociliary tumors. AS SS-OCT should be considered as an excellent alternative to UBM, especially in minimally elevated iris lesions.
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Affiliation(s)
- Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
- Halil Şıvgın Çubuk State Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
- Private Eye Clinic, Ankara, Turkey
| | - Ömür Özlenen Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Funda Seher Özalp Ateş
- Department of Biostatistics and Medical Informatics, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Aylin Okcu Heper
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
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8
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Chong YJ, Azzopardi M, Hussain G, Recchioni A, Gandhewar J, Loizou C, Giachos I, Barua A, Ting DSJ. Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review. Diagnostics (Basel) 2024; 14:122. [PMID: 38248000 PMCID: PMC10814678 DOI: 10.3390/diagnostics14020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Since its introduction, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and has now become an indispensable, noninvasive tool in daily practice. Most ophthalmologists are familiar with its use in the assessment and monitoring of retinal and optic nerve diseases. However, it also has important applications in the assessment of anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris, and has the potential to transform the clinical examination of these structures. In this review, we aim to provide a comprehensive overview of the potential clinical utility of anterior segment OCT (AS-OCT) for a wide range of anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. In addition, the clinical applications of AS-OCT (including epithelial mapping) in preoperative planning and postoperative monitoring for corneal and refractive surgeries are discussed.
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Affiliation(s)
- Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Modality Ophthalmology, Modality Partnership, Birmingham B19 1BP, UK;
| | - Matthew Azzopardi
- Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK;
| | - Gulmeena Hussain
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK;
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Jaishree Gandhewar
- New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK;
| | | | - Ioannis Giachos
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Ankur Barua
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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9
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Kottaridou E, Hatoum A. Imaging of Anterior Segment Tumours: A Comparison of Ultrasound Biomicroscopy Versus Anterior Segment Optical Coherence Tomography. Cureus 2024; 16:e52578. [PMID: 38249646 PMCID: PMC10798380 DOI: 10.7759/cureus.52578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 01/23/2024] Open
Abstract
Anterior segment tumours of the eye are relatively rare but can pose significant morbidity and mortality. We conducted a literature review to compare the performance of ultrasound biomicroscopy to anterior segment optical coherence tomography in the imaging of these tumours. A total of seven studies were included accounting for a cumulative 1,114 eyes. Ultrasound biomicroscopy has traditionally formed, and remains, the mainstay of tumour imaging due to its ability to penetrate pigmented lesions and delineate the posterior border of tumours, and the current evidence supports this.
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Affiliation(s)
| | - Adam Hatoum
- Accident and Emergency, Barts Health NHS Trust, London, GBR
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10
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Gupta P, Rai N, Verma A, Gautam V. Microscopy based methods for characterization, drug delivery, and understanding the dynamics of nanoparticles. Med Res Rev 2024; 44:138-168. [PMID: 37294298 DOI: 10.1002/med.21981] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/04/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
Nanomedicine is an emerging field that exploits nanotechnology for the development of novel therapeutic and diagnostic modalities. Researches are been focussed in nanoimaging to develop noninvasive, highly sensitive, and reliable tools for diagnosis and visualization in nanomedical field. The application of nanomedicine in healthcare requires in-depth understanding of their structural, physical and morphological properties, internalization inside living system, biodistribution and localization, stability, mode of action and possible toxic health effects. Microscopic techniques including fluorescence-based confocal laser scanning microscopy, super-resolution fluorescence microscopy and multiphoton microscopy; optical-based Raman microscopy, photoacoustic microscopy and optical coherence tomography; photothermal microscopy; electron microscopy (transmission electron microscope and scanning electron microscope); atomic force microscopy; X-ray microscopy and, correlative multimodal imaging are recognized as an indispensable tool in material research and aided in numerous discoveries. Microscopy holds great promise in detecting the fundamental structures of nanoparticles (NPs) that determines their performance and applications. Moreover, the intricate details that allows assessment of chemical composition, surface topology and interfacial properties, molecular, microstructure, and micromechanical properties are also elucidated. With plethora of applications, microscopy-based techniques have been used to characterize novel NPs alongwith their proficient designing and adoption of safe strategies to be exploited in nanomedicine. Consequently, microscopic techniques have been extensively used in the characterization of fabricated NPs, and their biomedical application in diagnostics and therapeutics. The present review provides an overview of the microscopy-based techniques for in vitro and in vivo application in nanomedical investigation alongwith their challenges and advancement to meet the limitations of conventional methods.
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Affiliation(s)
- Priyamvada Gupta
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Nilesh Rai
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashish Verma
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vibhav Gautam
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Farias FM, Salomão RC, Rocha Santos EG, Sousa Caires A, Sampaio GSA, Rosa AAM, Costa MF, Silva Souza G. Sex-related difference in the retinal structure of young adults: a machine learning approach. Front Med (Lausanne) 2023; 10:1275308. [PMID: 38162881 PMCID: PMC10755955 DOI: 10.3389/fmed.2023.1275308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose To compare the accuracy of machine learning (ML) algorithms to classify the sex of the participant from retinal thickness datasets in different retinal layers. Methods This cross-sectional study involved 26 male and 38 female subjects. Data were acquired using HRA + OCT Spectralis, and the thickness and volume of 10 retinal layers were quantified. A total of 10 features were extracted from each retinal layer. The accuracy of various algorithms, including k-nearest-neighbor, support vector classifier, logistic regression, linear discriminant analysis, random forest, decision tree, and Gaussian Naïve Bayes, was quantified. A two-way ANOVA was conducted to assess the ML accuracy, considering both the classifier type and the retinal layer as factors. Results A comparison of the accuracies achieved by various algorithms in classifying participant sex revealed superior results in datasets related to total retinal thickness and the retinal nerve fiber layer. In these instances, no significant differences in algorithm performance were observed (p > 0.05). Conversely, in other layers, a decrease in classification accuracy was noted as the layer moved outward in the retina. Here, the random forest (RF) algorithm demonstrated superior performance compared to the others (p < 0.05). Conclusion The current research highlights the distinctive potential of various retinal layers in sex classification. Different layers and ML algorithms yield distinct accuracies. The RF algorithm's consistent superiority suggests its effectiveness in identifying sex-related features from a range of retinal layers.
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Affiliation(s)
- Flávia Monteiro Farias
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Andrew Sousa Caires
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Marcelo Fernandes Costa
- Departamento de Psicologia, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
| | - Givago Silva Souza
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
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12
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Akyol S, Ocal O, Ilhan HD. Imaging of the lower punctum with anterior segment OCT in patients with dacryocystorhinostomy who underwent bicanalicular silicone tube implantation. Photodiagnosis Photodyn Ther 2023; 44:103850. [PMID: 37858913 DOI: 10.1016/j.pdpdt.2023.103850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
Spectral domain OCT imaging of the lower punctum in cases with silicone tube implantation OBJECTIVE: To record the structural changes in the lower punctum by performing spectral domain anterior segment OCT imaging of dacryocystorhinostomy cases who underwent bicanalicular silicone tube implantation. METHODS Thirty eyes of 30 patients who underwent bicanalicular Crawford silicone tube implantation with dacryocystorhinostomy were included in the study. The mean age of the cases was 53 ± 13.96 (24-72). Of the cases, 19 were female and 11 were male, 18 of them were operated on the right eye and 12 on the left eye. The lower punctum images of the cases were recorded with spectral domain anterior segment OCT preoperatively and at the 1st day, 1st month and 6th month after explantation of the silicone tube. In the lower punctum, external punctal width(EPW) and canaliculi depth (CD) were measured. RESULTS The mean EPW and CD measurements of the cases in the preoperative period, respectively; 544.90±144.11 µm and 451.70±197.45 µm. First day after silicone tube explantation, EPW was 818.00±186.83 µm and CD was 735.35±337.15 µm, at 1st month EPW was 665.95±142.12 µm and CD was 619.30±212.11 µm and at 6th months EPW was 530±150.29 µm and CD was 558.45±254.37 µm, respectively. Mean EPW values were found to be higher on the first day after extubation than before surgery (p = 0.001). There was no significant difference in the mean EPW values at the first and sixth months after extubation compared to pre-implantation (p>0.05). The mean CD values were higher at the 1st day, 1st month and 6th month after tube explantation than preoperative CD values, they were not statistically significant. CONCLUSIONS According to the lower punctum OCT imaging data, silicone tube implantations applied to the canalicular system do not create a structurally significant difference in the lower punctum. The punctal opening gradually decreases after extubation. The decrease in EPW values is more pronounced than the decrease in CD values. Silicone tube implantation was more effective in maintaining canaliculi depth compared to external punctal diameter.
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Affiliation(s)
- Sibel Akyol
- Antalya Training and Research Hospital, Ophthalmology Clinic, Antalya, Turkey
| | - Olgar Ocal
- Suruc Government Hospital, Ophthalmology Clinic, Suruc, Sanliurfa, Turkey.
| | - Hatice Deniz Ilhan
- Akdeniz University Hospital, Ophthalmology Clinic, Konyaaltı, Antalya, Turkey
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Pichi F, Ometto G, Invernizzi A, Hay S, Chaudhry H, Aljneibi S, Montesano G, Zicarelli F, Neri P. Automated quantification of uveitic keratic precipitates by use of anterior segment optical coherence tomography. Clin Exp Ophthalmol 2023; 51:790-798. [PMID: 37717946 DOI: 10.1111/ceo.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/11/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Evaluation of ocular inflammation via common imaging modalities like optical coherence tomography (OCT) has emphasised cell visualisation, but automated detection of uveitic keratic precipitates (KPs) remains unexplored. METHODS Anterior segment (AS)-OCT dense volumes of the corneas of patients with uveitic KPs were collected at three timepoints: with active (T0), clinically improving (T1), and resolved (T2) inflammation. At each visit, visual acuity and clinical grading of the anterior chamber cells were assessed. A bespoke algorithm was used to create an en face rendering of the KPs and to calculate their volume and a ratio of the volume of precipitates over the analysed area. The variation of AS-OCT-derived measurements over time was assessed, and compared with clinical grading. RESULTS Twenty eyes from 20 patients (13 females, mean age 39 years) were studied. At T0, the mean volume of the corneal KPs was 0.1727 mm3 , and it significantly reduced to 0.1111 mm3 (p = 0.03) only at T2. The ratio between the volume of the KPs and the corneal area decreased from T0 (0.007) to T1 (0.006; p = 0.2) and T2 (0.004; p = 0.009). There was a statistically significant correlation between the AC cell count and the AS-OCT volume measurements of the KPs at the three time points. CONCLUSIONS AS-OCT can image uveitic KPs and through a bespoke algorithm we were able to create an en face rendering allowing us to extrapolate their volume. We found that objective quantification of KPs correlated with inflammatory cell counts in the anterior chamber.
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Affiliation(s)
- Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Giovanni Ometto
- Optometry and Visual Sciences, City University of London, London, UK
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy
- Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia
| | - Steven Hay
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Hannah Chaudhry
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Shaikha Aljneibi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Giovanni Montesano
- Optometry and Visual Sciences, City University of London, London, UK
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Federico Zicarelli
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Piergiorgio Neri
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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14
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Toth CA. Optical Coherence Tomography and Eye Care. N Engl J Med 2023; 389:1526-1529. [PMID: 37732605 DOI: 10.1056/nejmcibr2307733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- Cynthia A Toth
- From the Department of Ophthalmology, School of Medicine, and the Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC
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15
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Wen Y, Jiang D, Tang K, Chen W. Current clinical applications of anterior segment optical coherence tomography angiography: a review. Graefes Arch Clin Exp Ophthalmol 2023; 261:2729-2741. [PMID: 36862203 DOI: 10.1007/s00417-023-05997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 03/03/2023] Open
Abstract
Optical coherence tomography (OCT) is a revolutionary in vivo imaging technology that presents real-time information on ocular structures. Angiography based on OCT, known as optical coherence tomography angiography (OCTA), is a noninvasive and time-saving technique originally utilized for visualizing retinal vasculature. As devices and built-in systems have evolved, high-resolution images with depth-resolved analysis have assisted ophthalmologists in accurately localizing pathology and monitoring disease progression. With the aforementioned advantages, application of OCTA has extended from the posterior to anterior segment. This nascent adaptation showed good delineation of the vasculature in the cornea, conjunctiva, sclera, and iris. Thus, neovascularization of the avascular cornea and hyperemia or ischemic changes involving the conjunctiva, sclera, and iris has become prospective applications for AS-OCTA. Although traditional dye-based angiography is regarded as the gold standard in demonstrating vasculature in the anterior segment, AS-OCTA is expected to be a comparable but more patient-friendly alternative. In its initial stage, AS-OCTA has exhibited great potential in pathology diagnosis, therapeutic evaluation, presurgical planning, and prognosis assessments in anterior segment disorders. In this review of AS-OCTA, we aim to summarize scanning protocols, relevant parameters, and clinical applications as well as limitations and future directions. We are sanguine about its wide application in the future with the development of technology and refinement in built-in systems.
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Affiliation(s)
- Yajing Wen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan Jiang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kexin Tang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Wei Chen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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16
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Azzopardi M, Chong YJ, Ng B, Recchioni A, Logeswaran A, Ting DSJ. Diagnosis of Acanthamoeba Keratitis: Past, Present and Future. Diagnostics (Basel) 2023; 13:2655. [PMID: 37627913 PMCID: PMC10453105 DOI: 10.3390/diagnostics13162655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Acanthamoeba keratitis (AK) is a painful and sight-threatening parasitic corneal infection. In recent years, the incidence of AK has increased. Timely and accurate diagnosis is crucial during the management of AK, as delayed diagnosis often results in poor clinical outcomes. Currently, AK diagnosis is primarily achieved through a combination of clinical suspicion, microbiological investigations and corneal imaging. Historically, corneal scraping for microbiological culture has been considered to be the gold standard. Despite its technical ease, accessibility and cost-effectiveness, the long diagnostic turnaround time and variably low sensitivity of microbiological culture limit its use as a sole diagnostic test for AK in clinical practice. In this review, we aim to provide a comprehensive overview of the diagnostic modalities that are currently used to diagnose AK, including microscopy with staining, culture, corneal biopsy, in vivo confocal microscopy, polymerase chain reaction and anterior segment optical coherence tomography. We also highlight emerging techniques, such as next-generation sequencing and artificial intelligence-assisted models, which have the potential to transform the diagnostic landscape of AK.
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Affiliation(s)
- Matthew Azzopardi
- Department of Ophthalmology, Royal London Hospital, London E1 1BB, UK;
| | - Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
| | - Benjamin Ng
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | | | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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17
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Xiao X, Zhong D, Liu H, Fan R, Jiang C, Zheng Z, Li Y, Wan L. Role of optical coherence tomography in depression detection: a protocol of systematic review and meta-analysis. BMJ Open 2023; 13:e065549. [PMID: 37423631 DOI: 10.1136/bmjopen-2022-065549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION Optical coherence tomography (OCT) is a non-invasive approach for detecting changes in the retinal layers, which may also reflect changes in brain structure and function. As one of the leading causes of disability worldwide, depression has been associated with alteration of brain neuroplasticity. However, the role of OCT measurements in detecting depression remains unknown. This study aims to employ a systematic review and meta-analysis approach to explore ocular biomarkers measured by OCT for detecting depression. METHODS AND ANALYSIS We will search studies describing the relationship between OCT and depression across seven electronic databases, and retrieve articles published from database inception to date. We will also manually search grey literature and reference lists included in the retrieved studies. Two independent reviewers will screen studies, extract data and assess risk of bias. Target outcomes will include peripapillary retinal nerve fibre layer thickness, macular ganglion cell complex thickness and macular volume, as well as other related indicators. Next, we will conduct subgroup analysis and meta-regression to explore study heterogeneity, then perform sensitivity analysis to investigate the robustness of the synthesised results. Meta-analysis will be performed using Review Manager (V.5.4.1) and STATA (V.12.0), and the certainty of evidence will be graded according to the Grading of Recommendations Assessment, Development and Evaluation system. ETHICS AND DISSEMINATION Ethics approval is not necessary because the data used in this systematic review and meta-analysis will be extracted from published studies. Study results will be disseminated by publishing our findings in a peer-reviewed journal.
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Affiliation(s)
- Xili Xiao
- Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Liu
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Rong Fan
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Chengzhi Jiang
- Department of Rehabilitation Medicine, Sichuan Science City Hospital, Mianyang, China
| | - Zhong Zheng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Wan
- School of sports medicine and health, Chengdu Sport University, Chengdu, China
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18
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Li JD, Viehland C, Dhalla AH, Trout R, Raynor W, Kuo AN, Toth CA, Vajzovic LM, Izatt JA. Visualization of surgical maneuvers using intraoperative real-time volumetric optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:3798-3811. [PMID: 37497507 PMCID: PMC10368043 DOI: 10.1364/boe.488967] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/25/2023] [Accepted: 06/12/2023] [Indexed: 07/28/2023]
Abstract
Ophthalmic microsurgery is traditionally performed using stereomicroscopes and requires visualization and manipulation of sub-millimeter tissue structures with limited contrast. Optical coherence tomography (OCT) is a non-invasive imaging modality that can provide high-resolution, depth-resolved cross sections, and has become a valuable tool in clinical practice in ophthalmology. While there has been substantial progress in both research and commercialization efforts to bring OCT imaging into live surgery, its use is still somewhat limited due to factors such as low imaging speed, limited scan configurations, and suboptimal data visualization. In this paper we describe, to the best of our knowledge, the translation of the fastest swept-source intraoperative OCT system with real-time volumetric imaging with stereoscopic data visualization provided via a heads-up display into the operating room. Results from a sampling of human anterior segment and retinal surgeries chosen from 93 human surgeries using the system are shown and the benefits that this mode of intrasurgical OCT imaging provides are discussed.
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Affiliation(s)
- Jianwei D. Li
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - Al-Hafeez Dhalla
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - Robert Trout
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - William Raynor
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Anthony N. Kuo
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Lejla M. Vajzovic
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
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19
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Trout RM, Viehland C, Li JD, Raynor W, Dhalla AH, Vajzovic L, Kuo AN, Toth CA, Izatt JA. Methods for real-time feature-guided image fusion of intrasurgical volumetric optical coherence tomography with digital microscopy. BIOMEDICAL OPTICS EXPRESS 2023; 14:3308-3326. [PMID: 37497493 PMCID: PMC10368056 DOI: 10.1364/boe.488975] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 07/28/2023]
Abstract
4D-microscope-integrated optical coherence tomography (4D-MIOCT) is an emergent multimodal imaging technology in which live volumetric OCT (4D-OCT) is implemented in tandem with standard stereo color microscopy. 4D-OCT provides ophthalmic surgeons with many useful visual cues not available in standard microscopy; however it is challenging for the surgeon to effectively integrate cues from simultaneous-but-separate imaging in real-time. In this work, we demonstrate progress towards solving this challenge via the fusion of data from each modality guided by segmented 3D features. In this way, a more readily interpretable visualization that combines and registers important cues from both modalities is presented to the surgeon.
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Affiliation(s)
- Robert M Trout
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Jianwei D Li
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - William Raynor
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Al-Hafeez Dhalla
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Anthony N Kuo
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Cynthia A Toth
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Joseph A Izatt
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
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20
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Shan J, Pardeshi A, Jiang X, Richter GM, McKean-Cowdin R, Varma R, Xu BY. Optimal number and orientation of anterior segment OCT images to measure ocular biometric parameters in angle closure eyes: the Chinese American Eye Study. Br J Ophthalmol 2023; 107:795-801. [PMID: 35063932 PMCID: PMC9529245 DOI: 10.1136/bjophthalmol-2021-319275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/31/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess the optimal number and orientation of anterior segment optical coherence tomography (AS-OCT) images for accurately measuring ocular biometric parameters in angle closure eyes. METHODS Subjects with angle closure, defined as >3 quadrants of non-visible pigmented trabecular meshwork on static gonioscopy, were selected from the Chinese American Eye Study. Mean angle opening distance (AOD500) was calculated using four images (0°-180°, 45°-225°, 90°-270° and 135°-315° meridians) from one eye per subject. Ten eyes from each quartile of AOD500 measurements were randomly selected for detailed 32-image analysis of 10 biometric parameters, including AOD500, iris curvature (IC), anterior chamber depth (ACD), lens vault (LV), and anterior chamber area (ACA). Mean and range of measurements from 1, 2, 4, 8 or 16 images were compared with 32-image values for all parameters. RESULTS 40 out of 335 eyes with angle closure were selected for 32-image analysis. Deviation from the 32-image mean was between 0.44% and 19.31% with one image, decreasing to 0.08% to 4.21% with two images for all parameters. Deviation from the 32-image range of measurements was between 54.67% to 88.94% with one image, decreasing to <7.00% with eight images for all parameters except ACD and ACA. Orienting the first image analysed along the 25°-205° meridian better approximated the range of measurements when four or fewer images were analysed. CONCLUSIONS Sectoral anatomical variations in angle closure eyes are easily misrepresented based on current AS-OCT imaging conventions. A revised multi-image approach can better capture the mean and range of biometric measurements.
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Affiliation(s)
- Jing Shan
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
| | - Anmol Pardeshi
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Xuejuan Jiang
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
| | - Grace M Richter
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
| | - Roberta McKean-Cowdin
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Benjamin Y Xu
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
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21
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Zhang J, Mazlin V, Fei K, Boccara AC, Yuan J, Xiao P. Time-domain full-field optical coherence tomography (TD-FF-OCT) in ophthalmic imaging. Ther Adv Chronic Dis 2023; 14:20406223231170146. [PMID: 37152350 PMCID: PMC10161339 DOI: 10.1177/20406223231170146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Ocular imaging plays an irreplaceable role in the evaluation of eye diseases. Developing cellular-resolution ophthalmic imaging technique for more accurate and effective diagnosis and pathogenesis analysis of ocular diseases is a hot topic in the cross-cutting areas of ophthalmology and imaging. Currently, ocular imaging with traditional optical coherence tomography (OCT) is limited in lateral resolution and thus can hardly resolve cellular structures. Conventional OCT technology obtains ultra-high resolution at the expense of a certain imaging range and cannot achieve full field of view imaging. In the early years, Time-domain full-field OCT (TD-FF-OCT) has been mainly used for ex vivo ophthalmic tissue studies, limited by the low speed and low full-well capacity of existing two-dimensional (2D) cameras. The recent improvements in system design opened new imaging possibilities for in vivo applications thanks to its distinctive optical properties of TD-FF-OCT such as a spatial resolution almost insensitive to aberrations, and the possibility to control the curvature of the optical slice. This review also attempts to look at the future directions of TD-FF-OCT evolution, for example, the potential transfer of the functional-imaging dynamic TD-FF-OCT from the ex vivo into in vivo use and its expected benefit in basic and clinical ophthalmic research. Through non-invasive, wide-field, and cellular-resolution imaging, TD-FF-OCT has great potential to be the next-generation imaging modality to improve our understanding of human eye physiology and pathology.
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Affiliation(s)
- Jinze Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Viacheslav Mazlin
- ESPCI Paris, PSL University, CNRS, Langevin Institute, Paris, France
| | - Keyi Fei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | | | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Jinsui Road 7, Guangzhou 510060, Guangdong, China
| | - Peng Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Jinsui Road 7, Guangzhou 510060, Guangdong, China
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22
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de Castro A, Martínez-Enríquez E, Marcos S. Effect of fixational eye movements in corneal topography measurements with optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:2138-2152. [PMID: 37206127 PMCID: PMC10191639 DOI: 10.1364/boe.486460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 05/21/2023]
Abstract
There is an increasing interest in applying optical coherence tomography (OCT) to quantify the topography of ocular structures. However, in its most usual configuration, OCT data is acquired sequentially while a beam is scanned through the region of interest, and the presence of fixational eye movements can affect the accuracy of the technique. Several scan patterns and motion correction algorithms have been proposed to minimize this effect, but there is no consensus on the ideal parameters to obtain a correct topography. We have acquired corneal OCT images with raster and radial patterns, and modeled the data acquisition in the presence of eye movements. The simulations replicate the experimental variability in shape (radius of curvature and Zernike polynomials), corneal power, astigmatism, and calculated wavefront aberrations. The variability of the Zernike modes is highly dependent on the scan pattern, with higher variability in the direction of the slow scan axis. The model can be a useful tool to design motion correction algorithms and to determine the variability with different scan patterns.
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Affiliation(s)
- Alberto de Castro
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
| | | | - Susana Marcos
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
- Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester, Rochester, NY, USA
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23
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Moramarco A, di Geronimo N, Airaldi M, Gardini L, Semeraro F, Iannetta D, Romano V, Fontana L. Intraoperative OCT for Lamellar Corneal Surgery: A User Guide. J Clin Med 2023; 12:jcm12093048. [PMID: 37176489 PMCID: PMC10179477 DOI: 10.3390/jcm12093048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/07/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
Intraoperative OCT is an innovative and promising technology which allows anterior and posterior segment ocular surgeons to obtain a near-histologic cross-sectional and tomographic image of the tissues. Intraoperative OCT has several applications in ocular surgery which are particularly interesting in the context of corneal transplantation. Indeed, iOCT images provide a direct and meticulous visualization of the anatomy, which could guide surgical decisions. In particular, during both big-bubble and manual DALK, the visualization of the relationship between the corneal layers and instruments allows the surgeon to obtain a more desirable depth of the trephination, thus achieving more type 1 bubbles, better regularity of the plane, and a reduced risk of DM perforation. During EK procedures, iOCT supplies information about proper descemetorhexis, graft orientation, and interface quality in order to optimize the postoperative adhesion and reduce the need for re-bubbling. Finally, mushroom PK, a challenging technique for many surgeons, can be aided through the use of iOCT since it guides the correct apposition of the lamellae and their centration. The technology of iOCT is still evolving: a larger field of view could allow for the visualization of all surgical fields, and automated tracking and iOCT autofocusing guarantee the continued centration of the image.
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Affiliation(s)
- Antonio Moramarco
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Natalie di Geronimo
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Matteo Airaldi
- Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123 Brescia, Italy
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Lorenzo Gardini
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Francesco Semeraro
- Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123 Brescia, Italy
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Danilo Iannetta
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Vito Romano
- Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123 Brescia, Italy
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Luigi Fontana
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
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Wong EN, Foo VHX, Peh GSL, Htoon HM, Ang HP, Tan BYL, Ong HS, Mehta JS. Early Visibility of Cellular Aggregates and Changes in Central Corneal Thickness as Predictors of Successful Corneal Endothelial Cell Injection Therapy. Cells 2023; 12:cells12081167. [PMID: 37190076 DOI: 10.3390/cells12081167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
(1) Background: Cell injection therapy is an emerging treatment for bullous keratopathy (BK). Anterior segment optical coherence tomography (AS-OCT) imaging allows the high-resolution assessment of the anterior chamber. Our study aimed to investigate the predictive value of the visibility of cellular aggregates for corneal deturgescence in an animal model of bullous keratopathy. (2) Methods: Cell injections of corneal endothelial cells were performed in 45 eyes in a rabbit model of BK. AS-OCT imaging and central corneal thickness (CCT) measurement were performed at baseline and on day 1, day 4, day 7 and day 14 following cell injection. A logistic regression was modelled to predict successful corneal deturgescence and its failure with cell aggregate visibility and CCT. Receiver-operating characteristic (ROC) curves were plotted, and areas under the curve (AUC) calculated for each time point in these models. (3) Results: Cellular aggregates were identified on days 1, 4, 7 and 14 in 86.7%, 39.5%, 20.0% and 4.4% of eyes, respectively. The positive predictive value of cellular aggregate visibility for successful corneal deturgescence was 71.8%, 64.7%, 66.7% and 100.0% at each time point, respectively. Using logistic regression modelling, the visibility of cellular aggregates on day 1 appeared to increase the likelihood of successful corneal deturgescence, but this did not reach statistical significance. An increase in pachymetry, however, resulted in a small but statistically significant decreased likelihood of success, with an odds ratio of 0.996 for days 1 (95% CI 0.993-1.000), 2 (95% CI 0.993-0.999) and 14 (95% CI 0.994-0.998) and an odds ratio of 0.994 (95% CI 0.991-0.998) for day 7. The ROC curves were plotted, and the AUC values were 0.72 (95% CI 0.55-0.89), 0.80 (95% CI 0. 62-0.98), 0.86 (95% CI 0.71-1.00) and 0.90 (95% CI 0.80-0.99) for days 1, 4, 7 and 14, respectively. (4) Conclusions: Logistic regression modelling of cell aggregate visibility and CCT was predictive of successful corneal endothelial cell injection therapy.
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Affiliation(s)
- Evan N Wong
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA 6009, Australia
| | - Valencia H X Foo
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore
| | - Gary S L Peh
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore 169857, Singapore
| | - Hla M Htoon
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore 169857, Singapore
| | - Heng-Pei Ang
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore
| | - Belinda Y L Tan
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore
| | - Hon-Shing Ong
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore 169857, Singapore
| | - Jodhbir S Mehta
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore 169857, Singapore
- School of Material Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore
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Gündüz AK, Mirzayev I, Okcu Heper A, Kuzu I, Gahramanli Z, Cansiz Ersöz C, Gündüz ÖÖ, Ataoğlu Ö. Anterior segment optical coherence tomography in ocular surface tumours and simulating lesions. Eye (Lond) 2023; 37:925-937. [PMID: 36513855 PMCID: PMC10050214 DOI: 10.1038/s41433-022-02339-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/26/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
This study aims to systematically review the reported literature on the use of anterior segment optical coherence tomography (AS-OCT) in ocular surface tumours and simulating lesions. A systematic literature search was done using PubMed, Scopus, and Web of Science databases between January 2002 and December 2021. On AS-OCT, ocular surface squamous neoplasia typically demonstrate epithelial thickening, epithelial hyperreflectivity, and an abrupt transition between normal and abnormal epithelium. Conjunctival nevi usually show mildly hyperreflective epithelium of normal thickness, internal hyperreflectivity, and intralesional cysts which is the hallmark of this tumour. Primary acquired melanosis presents with normal thickness epithelium, basal epithelial hyperreflectivity, and absence of cysts. Conjunctival melanoma demonstrates hyperreflective normal/thickened epithelium, hyperreflective basal epithelium, internal hyperreflectivity, and absence of intralesional cysts. Conjunctival lymphoma shows homogenous, low-medium reflective subepithelial lesions with smooth borders, and dot-like infiltrates. Benign reactive lymphoid hyperplasia findings are similar to lymphoma but the infiltrates are more hyperreflective compared to lymphoma. Pterygium shows thickened conjunctival epithelium, epithelial hyperreflectivity, and subepithelial wedge-shaped hyperreflective tissue separated from the overlying epithelium by a cleavage plane. Pinguecula demonstrates mildly thickened epithelium and similar findings with pterygium but does not extend beyond the corneal limbus. This review shows that AS-OCT, as a noninvasive tool, has potential uses in the differential diagnosis of ocular surface tumours and simulating lesions. Major limitations of AS-OCT include limited visualization of the posterior border of thick, keratinized, and pigmented tumours and lack of assessment of large conjunctival tumours in a single cut.
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Affiliation(s)
- Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.
- Private Eye Clinic, Ankara, Turkey.
| | - Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
- Department of Ophthalmology, Dünyagöz Hospital, Ankara, Turkey
| | - Aylin Okcu Heper
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Işınsu Kuzu
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | | | - Ömür Özlenen Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ömür Ataoğlu
- Private Mikro-Pat Pathology Laboratory, Ankara, Turkey
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Mirzayev I, Gündüz AK, Aydın Ellialtıoğlu P, Gündüz ÖÖ. Clinical applications of anterior segment swept-source optical coherence tomography: A systematic review. Photodiagnosis Photodyn Ther 2023; 42:103334. [PMID: 36764640 DOI: 10.1016/j.pdpdt.2023.103334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/25/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Optical coherence tomography (OCT) is a non-invasive method that provides the opportunity to examine tissues by taking cross-sectional images. OCT is increasingly being used to evaluate anterior segment (AS) pathologies. Swept-source (SS) OCT allows greater penetration and achieves better visualization of the internal configuration of AS tissues due to the longer wavelength employed and high scan speeds. We reviewed the utilization of AS SS-OCT in various conditions including glaucoma, ocular surface pathologies, iris tumors, refractive surgery, cataract surgery, and scleral diseases. A systematic literature search was carried out on PubMed, Scopus, and Web of Science databases between January 1, 2008, and September 1, 2022 using the following keywords: AS SS-OCT; dry eye and SS-OCT; ocular surface and SS-OCT; cornea and SS-OCT; dystrophy and SS-OCT; glaucoma and SS-OCT; ocular surface tumors and SS-OCT; conjunctival tumors and SS-OCT; refractive surgery and SS-OCT; cataract and SS-OCT; biometry and SS-OCT; sclera and SS-OCT; iris and SS-OCT; ciliary body and SS-OCT; artificial intelligence and SS-OCT. A total of 221 studies were included in this review. Review of the existing literature shows that SS-OCT offers several advantages in the diagnosis of AS diseases. Exclusive features of SS-OCT including rapid scanning, deeper tissue penetration, and better image quality help improve our understanding of various AS pathologies.
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Affiliation(s)
- Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Halil Şıvgın Çubuk State Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Private Eye Clinic, Ankara, Turkey.
| | | | - Ömür Özlenen Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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Li JD, Raynor W, Dhalla AH, Viehland C, Trout R, Toth CA, Vajzovic LM, Izatt JA. Quantitative measurements of intraocular structures and microinjection bleb volumes using intraoperative optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:352-366. [PMID: 36698674 PMCID: PMC9842013 DOI: 10.1364/boe.483278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Intraoperative optical coherence tomography (OCT) systems provide high-resolution, real-time visualization and/or guidance of microsurgical procedures. While the use of intraoperative OCT in ophthalmology has significantly improved qualitative visualization of surgical procedures inside the eye, new surgical techniques to deliver therapeutics have highlighted the lack of quantitative information available with current-generation intraoperative systems. Indirect viewing systems used for retinal surgeries introduce distortions into the resulting OCT images, making it particularly challenging to make calibrated quantitative measurements. Using an intraoperative OCT system based in part on the Leica Enfocus surgical microscope interface, we have devised novel measurement procedures, which allowed us to build optical and mathematical models to perform validation of quantitative measurements of intraocular structures for intraoperative OCT. These procedures optimize a complete optical model of the sample arm including the OCT scanner, viewing attachments, and the patient's eye, thus obtaining the voxel pitch throughout an OCT volume and performing quantitative measurements of the dimensions of imaged objects within the operative field. We performed initial validation by measuring objects of known size in a controlled eye phantom as well as ex vivo porcine eyes. The technique was then extended to measure other objects and structures in ex vivo porcine eyes and in vivo human eyes.
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Affiliation(s)
- Jianwei D. Li
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - William Raynor
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Al-Hafeez Dhalla
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Robert Trout
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Lejla M. Vajzovic
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
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Morland I, Zhu F, Dalgarno P, Leach J. Rapid nanometer-precision autocorrelator. OPTICS EXPRESS 2022; 30:46020-46030. [PMID: 36558566 DOI: 10.1364/oe.473540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
The precise measurement of a target depth has applications in biophysics and nanophysics, and non-linear optical methods are sensitive to intensity changes on very small length scales. By exploiting the high sensitivity of an autocorrelator's dependency on path length, we propose a technique that achieves ≈30 nm depth precision for each pixel in 30 seconds. Our method images up-converted pulses from a non-linear crystal using a sCMOS (scientific Complementary Metal-Oxide-Semiconductor) camera and converts the intensity recorded by each pixel to a delay. By utilising statistical estimation theory and using the data from a set of 32×32 pixels, the standard error (SE) of the detected delay falls below 1 nm after 30 seconds of measurement. Numerical simulations show that this result is extremely close to what can be achieved with a shot-noise-limited source and is consistent with the precision that can be achieved with a sCMOS camera.
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Bhargava M, Bhambhani V, Paul RS. Anterior segment optical coherence tomography characteristics and management of a unique spectrum of foreign bodies in the cornea and anterior chamber. Indian J Ophthalmol 2022; 70:4284-4292. [PMID: 36453330 PMCID: PMC9940523 DOI: 10.4103/ijo.ijo_878_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To report anterior-segment optical coherence tomography (ASOCT) characteristics of different types of corneal and anterior chamber (AC) foreign bodies (FBs) and their usefulness in diagnosis and management. Methods This is a retrospective descriptive clinical study involving 11 eyes of 11 patients who presented at the outpatient department of a tertiary ophthalmic care center from January 2017 to January 2022. All patients had a diagnosed or suspected corneal FB. All participants underwent a comprehensive ophthalmological examination, followed by slit-lamp photography and ASOCT. FB removal was done where required by an external, internal, or combined approach. Results The mean age of patients was 28.2 (7-53) years. Ten were male, and one was female. Seven patients had a definitive positive history of injury; in one, there was a history suggestive of trauma, one had the post-operative complication of scleral buckling surgery, and two patients had a history of insect fall in the eyes. Three patients had acute, four had sub-acute, and four had chronic presentations. Descemet's membrane (DM) breach was suspected in three cases of deep FB, which was later confirmed on ASOCT. In two cases, DM was presumed to be intact clinically, but ASOCT showed an AC penetration. The FB was removed in seven patients, one via slit-lamp, one via an external approach, two via an internal approach, and three via a combined approach. Conclusion ASOCT facilitates non-invasive rapid imaging of ocular tissue at various depths, provides an accurate assessment of FB characteristics, and thereby serves as an additional tool in our armamentarium for diagnosis and management of deep corneal and AC FBs.
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Affiliation(s)
- Mona Bhargava
- Department of Cornea and Ocular Surface, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai, India), Kolkata, West Bengal, India,Correspondence to: Dr. Mona Bhargava, Aditya Birla Sankara Nethralaya, 147/1, Mukundapur, E M Bypass Road (A Unit of Medical Research Foundation, Chennai, India), Kolkata, West Bengal, India. E-mail:
| | - Varsha Bhambhani
- Department of Cornea and Ocular Surface, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai, India), Kolkata, West Bengal, India
| | - Raj S Paul
- Department of Cornea and Ocular Surface, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai, India), Kolkata, West Bengal, India
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Valmaggia P, Inglin N, Kaiser P, Scholl HPN, Maloca PM. Iris Color Matters—A Contractility Analysis With Dynamic Volume-Rendered Optical Coherence Tomography Pupillometry. Transl Vis Sci Technol 2022; 11:6. [DOI: 10.1167/tvst.11.11.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Philippe Valmaggia
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Nadja Inglin
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | | | - Hendrik P. N. Scholl
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Peter M. Maloca
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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31
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Shinzawa H, Koga M. Polyamide (PA) 66 molding defect studied with optical coherence tomography (OCT) and near-infrared (NIR) spectroscopy. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2022; 279:121492. [PMID: 35691164 DOI: 10.1016/j.saa.2022.121492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/20/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
An optical coherence tomography (OCT) system combined with near-infrared spectroscopy (NIRS) was developed to carry out simultaneously the cross-sectional observation and spectral measurement of a specific area inside a polymer sample. This OCT-NIRS system consists of a fiber-optic-based spectrometer combined with an OCT system and enables non-invasive imaging up to a depth of several millimeters and the recording of the NIR spectrum in the observed area. A subsequent analysis of the collected data will provide key information revealing the way in which the microscopic structure of the polymer is affected by the chemical composition around it. A structural defect inside a molded polyamide (PA) 66 sample was examined with the OCT-NIRS system to demonstrate how this technique can be utilized to characterize chemical composition as well as the morphological features inside the sample. A specific void was detected by OCT when the PA sample was molded without any drying treatment. The NIR spectrum collected around the void area of the undried PA was then compared with that of vacuum-dried PA by two-trace two-dimensional (2T2D) correlation analysis to identify a subtle but pertinent difference in the spectral features. The appearance of several correlation peaks in the 2T2D asynchronous correlation spectrum revealed that the OH group represented by the NIR band at 1446 nm is found in relative abundance around the void, which clearly reveals that the development of the void in the molded PA results from inadequate sample pretreatment.
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Affiliation(s)
- Hideyuki Shinzawa
- Research Institute for Sustainable Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan.
| | - Maito Koga
- Research Institute for Sustainable Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
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32
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Beckmann L, Cai Z, Margolis M, Fang R, Djalilian A, Zhang HF. Recent advances in optical coherence tomography for anterior segment imaging in small animals and their clinical implications. Ocul Surf 2022; 26:222-233. [PMID: 36195237 PMCID: PMC10040227 DOI: 10.1016/j.jtos.2022.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 12/05/2022]
Abstract
Anterior segment optical coherence tomography (AS-OCT) is a rapidly evolving area of OCT imaging, providing high-resolution and non-invasive volumetric imaging of the anterior segment. This review focuses on recent advances in AS-OCT imaging in small animals, which we categorize into ultrahigh-resolution, spectroscopic, magnetomotive, polarization-sensitive, and angiographic AS-OCTs. We summarize their technical foundations, review their applications to small animal imaging, and briefly discuss their current and future clinical applications.
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Affiliation(s)
- Lisa Beckmann
- Department of Biomedical Engineering, Northwestern University, Evanston IL, USA
| | - Zhen Cai
- Department of Biomedical Engineering, Northwestern University, Evanston IL, USA; Currently with Department of Ophthalmology, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, China
| | - Mathew Margolis
- Department of Ophthalmology and Visual Science, University of Illinois at Chicago, Chicago IL, USA
| | - Raymond Fang
- Department of Biomedical Engineering, Northwestern University, Evanston IL, USA
| | - Ali Djalilian
- Department of Ophthalmology and Visual Science, University of Illinois at Chicago, Chicago IL, USA
| | - Hao F Zhang
- Department of Biomedical Engineering, Northwestern University, Evanston IL, USA.
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Fourier analysis on irregular corneal astigmatism using optical coherence tomography in various severity stages of keratoconus. Am J Ophthalmol 2022; 243:55-65. [PMID: 35850250 DOI: 10.1016/j.ajo.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the diagnostic capability of Fourier indices in detecting clinical or subclinical keratoconus (KC). DESIGN Prospective cross-sectional study METHODS: : The study included 126 eyes with clinical KC (50 KC without any corneal scar, 50 KC with anterior corneal scar, and 26 KC with posterior scar having a history of acute corneal hydrops), 50 with topographic KC (without clinical signs), 50 with pre-topographic KC (normal topography without clinical signs), and 50 controls. Corneal tomographic data were obtained using anterior segment optical coherence tomography (OCT). Fourier analysis decomposed dioptric data from both anterior and posterior corneal surface into spherical, regular astigmatism, asymmetry, and higher-order irregularity components. The discriminating ability of the Fourier indices of pre-topographic KC, topographic KC, and clinical KC from controls were assessed after quantitative Fourier analysis of irregular corneal astigmatism. RESULTS Posterior asymmetry and higher-order irregularity components were significantly greater in pre-topographic KC eyes than those in controls (p<0.001 for both), with the highest area under the receiver operating characteristic curve (AUROC) of 0.778 and 0.709, respectively. The same was true for anterior asymmetry, posterior asymmetry, and posterior higher-order irregularity components in topographic KC (AUROC of 0.945, 0.941, and 0.893, respectively), whereas it was >0.948 for all Fourier components in clinical KC. CONCLUSIONS Fourier analysis using OCT can evaluate anterior and posterior corneal irregular astigmatism of various KC stages, from very mild to advanced, including severe cases with corneal scar. Irregular astigmatism indices from the posterior corneal surface showed the highest AUROC values in discriminating early KC stages.
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Binotti WW, Saukkonen D, Seyed-Razavi Y, Jamali A, Hamrah P. Automated Image Threshold Method Comparison for Conjunctival Vessel Quantification on Optical Coherence Tomography Angiography. Transl Vis Sci Technol 2022; 11:15. [PMID: 35857329 PMCID: PMC9315074 DOI: 10.1167/tvst.11.7.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the impact of image binarization and the best thresholding method for conjunctival optical coherence tomography angiography (OCTA). Methods Vessel density (VD) of 14 OCTA conjunctival images (nine nasal and five temporal conjunctivas, and eight right and six left eyes) from normal subjects was analyzed. The binarization of gold-standard images, created by removing pixels that do not represent vessels on ImageJ software, was assessed by three masked graders to determine consistency of VD for images. Various thresholding methods on ImageJ, including manual, 1-, 2- and 3-step processes, were performed on unprocessed images for comparison. Interclass correlation coefficient (ICC) ≥0.750 were classified as good reliability and selected for calculation of the performance of the pixel location in the binarized images of each method. Results Analysis of the gold-standard threshold method achieved an ICC of 0.816 with excellent agreement (R2 = 0.965, P < 0.001). From a total 28 different methods and variations performed, only nine methods performed with good reliability, including two 1-step thresholds, six 2-step thresholds, and one 3-step threshold method. Overall, 2-step threshold methods were more reliable than 3-step threshold methods. The 2-step method of Bandpass filter + Phansalkar local threshold (LT) showed the best performance with mean pixel accuracy of 86.9% ± 6.8%, area under the curve of 0.826, sensitivity of 79.0%, and specificity 86.1%. Conclusions Bandpass filter + Phansalkar LT was the best method for VD measurement in conjunctival OCTA. Most commonly reported threshold methods showed unsatisfactory agreement. There is a need in the OCTA field for a standardized method to allow comparison between different studies. Translational Relevance The proposed threshold method using a widely accessible and commonly used software provides an accurate VD measurement for future OCTA studies.
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Affiliation(s)
- William W Binotti
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA.,Cornea Department, New England Eye Center, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA
| | - Daniel Saukkonen
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA.,Cornea Department, New England Eye Center, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA
| | - Yashar Seyed-Razavi
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA
| | - Arsia Jamali
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA
| | - Pedram Hamrah
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA.,Cornea Department, New England Eye Center, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA
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35
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Garcia Marin YF, Alonso-Caneiro D, Vincent SJ, Collins MJ. Anterior segment optical coherence tomography (AS-OCT) image analysis methods and applications: A systematic review. Comput Biol Med 2022; 146:105471. [DOI: 10.1016/j.compbiomed.2022.105471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/03/2022]
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36
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Alexopoulos P, Madu C, Wollstein G, Schuman JS. The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques. Front Med (Lausanne) 2022; 9:891369. [PMID: 35847772 PMCID: PMC9279625 DOI: 10.3389/fmed.2022.891369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.
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Affiliation(s)
- Palaiologos Alexopoulos
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Chisom Madu
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
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Elfalah M, Mohammad M, Toro MD, Abu-Yaghi N, Rejdak R, Yousef YA. Anterior Ocular Biometrics as Measured by Ultrasound Biomicroscopy. Healthcare (Basel) 2022; 10:healthcare10071188. [PMID: 35885715 PMCID: PMC9318338 DOI: 10.3390/healthcare10071188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: High frequency ultrasonography (ultrasound biomicroscopy; UBM) is an ophthalmic diagnostic tool that can be used to measure the depth of the anterior segment (ASD), the anterior chamber angle (ACA), as well as thicknesses of the iris and the ciliary body (CB). Methods: The anterior segment dimensions and thicknesses were measured by Sonomed 35-MHz. Results: Measurements for 95 eyes from 52 adults were analyzed. The mean and median ASD and ACA were 2.91, 2.92 ± 0.41 mm and 34.1, 34.3 ± 12.1 degrees, respectively. The angle superiorly was wider than inferiorly (p = 0.04). At the root of the iris, the mid of the iris, and the juxtapupillary edge of the iris, the iris thicknesses (median, mean) were 0.40, 0.41 ± 0.1, 0.50, 0.51 ± 0.1, and 0.70, 0.71 ± 0.1 mm, respectively. The thicknesses of CB and CB together with the ciliary processes (median, mean), were 0.70, 0.71 ± 0.15 mm and 1.36, 1.41 ± 0.15 mm, respectively. The upper quadrant of both the iris and the CB was significantly thicker than the lower quadrant (p = 0.04). Conclusions: Our biometric measurements for the anterior segment can be used as normative data for anterior segment depth and angle and iris and ciliary body thickness in normal eyes.
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Affiliation(s)
- Mutasem Elfalah
- School of Medicine, The University of Jordan, Amman 11941, Jordan; (M.E.); (N.A.-Y.)
| | - Mona Mohammad
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman 11941, Jordan;
| | - Mario Damiano Toro
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland;
- Eye Clinic, Public Health Department, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: (M.D.T.); (Y.A.Y.); Tel.: +96-27-8722-8749 (Y.A.Y.)
| | - Nakhleh Abu-Yaghi
- School of Medicine, The University of Jordan, Amman 11941, Jordan; (M.E.); (N.A.-Y.)
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman 11941, Jordan;
- Correspondence: (M.D.T.); (Y.A.Y.); Tel.: +96-27-8722-8749 (Y.A.Y.)
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Anterior chamber angle features in primary congenital glaucoma infants using hand-held anterior segment-oct. Eye (Lond) 2022; 36:1238-1245. [PMID: 34117386 PMCID: PMC9151785 DOI: 10.1038/s41433-021-01583-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/08/2021] [Accepted: 04/27/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To describe anterior chamber angle (ACA) structures and parameters in primary congenital glaucoma (PCG) and normal infant eyes, using Hand-held anterior segment optical coherence tomography (HH AS-OCT), as an in-office, non-contact technique. METHODS Normal and PCG-infants <24 months were examined, using HH AS-OCT (RTVue RT- 100, Optovue Inc., Fremont, CA). Sedation was not required. Corneal pachymetry map, ACA width and iris thickness (IT) were measured. Trabecular meshwork (TM), Schlemm's canal (SC), and scleral spur (SS) identification were assessed in both groups. RESULTS Forty-eight infants; (26 PCG-eyes and 22 normal-eyes) aged 9.12 ± 6.7 months, were included. Nasal and temporal ACA width in PCG infants was found significantly larger (39.3 ± 6.6° vs. 30.4 ± 5.6, and 40.1 ± 5.3° vs. 32.5 ± 6.2 respectively) (p < 0.001). IT was significantly reduced (121.7 ± 43.9 μm in PCG-infants, vs. 160.3 ± 38.6 μm in normal-eyes) (p < 0.01). TM was identified in all normal eyes (100%) and nine (34.6%) PCG- eyes. SC was identified in 16 (72.7%) normal eyes versus four (15.4%) PCG. In PCG-eyes, an abnormal structure occluding the angle was seen in seven (26.9%), and a hyper-reflective membrane in five (19.2%), the iris was anteriorly inserted in all PCG-eyes, and iridotrabeculodysgenesis was clearly identified (with constant iris anterior insertion). The abnormal tissue obscuring the angle was seen in younger PCG-infants and iris thinning appeared to be part of the pathology, not a result of IOP elevation. CONCLUSION Using HH AS-OCT permits tomographic examination of the ACA in PCG infants and may help in the understanding of disease pathology. Hence, may assist in optimizing treatment.
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Musial G, Kohlfaerber T, Ahrens M, Schulz-Hildebrandt H, Steven P, Hüttmann G. Dynamic Contrast Microscopic Optical Coherence Tomography As a Novel Method for Assessing Corneal Epithelium During Exposure to Benzalkonium Chloride. Transl Vis Sci Technol 2022; 11:28. [PMID: 35622381 PMCID: PMC9145126 DOI: 10.1167/tvst.11.5.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Microscopic optical coherence tomography (mOCT) has an imaging resolution of 1 µm in all voxel dimensions, but individual epithelial cells are difficult to resolve due to lack of scattering contrast. Adding dynamic contrast processing to mOCT (dmOCT) results in color images that enable visualization of individual cells and possibly give information on cellular function via the calculation of a motility coefficient. We propose this technique as a novel method of evaluating the ocular surface after exposure to a toxic chemical, benzalkonium chloride (BAK). Methods Ex vivo cross-section images were acquired with a custom-built, frequency-domain mOCT system. Eyes were explanted from healthy adult C57BL/6 mice and imaged every 30 minutes with five sets of dmOCT scans at each imaging time. Total epithelium and stroma thicknesses were measured from a single mOCT B-scan, and measures of color changes (hue) and the motility coefficient were acquired from dmOCT scans. Results After 30-minute exposures to 0.005% BAK, local motility decreased and total epithelium thickness increased compared to controls. For basal epithelium cells, local motility decreased after 60-minute exposures, and the hue shifted red after 90-minute exposures. Stroma thickness did not significantly swell until 150-minute exposures to BAK. Conclusions dmOCT allows us to view the behavior of the cornea epithelium under toxic stress due to BAK, revealing parallel swelling of the extracellular matrix and changes in local subcellular motion. Translational Relevance The evaluation of the cornea epithelium using dmOCT is helpful to our understanding of the toxic effects of BAK.
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Affiliation(s)
- Gwen Musial
- University Hospital Cologne, Cologne, Germany
| | | | - Martin Ahrens
- Institute of Biomedial Optics, University of Lübeck, Lübeck, Germany
| | | | | | - Gereon Hüttmann
- Institute of Biomedial Optics, University of Lübeck, Lübeck, Germany.,Airway Research Center North Member of the German Center for Lung Research, DZL, 22927 Großhansdorf, Germany.,Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
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Imaging of iris vasculature: current limitations and future perspective. Eye (Lond) 2022; 36:930-940. [PMID: 34650219 PMCID: PMC9046297 DOI: 10.1038/s41433-021-01809-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/22/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022] Open
Abstract
Fluorescein and indocyanine green angiography have been the traditional ways to image the vasculature of the iris in the last few decades. Because of the invasive nature of these procedures, they are performed in rare situations, and thus, our understanding about iris vasculature is very limited. Optical coherence tomography angiography (OCTA) is a noninvasive imaging method that enables the detailed visualization of the retinal and choroidal vascular networks. More recently, it has been also used for the examination of the iris vasculature in healthy and disease eyes. However, there is a lack of uniformity in the image acquisition protocols and interpretations in both healthy and pathological conditions. Artifacts of iris OCTA include shadowing, motion, segmentations errors, mirror effects. OCTA devices have an eye-tracking system designed for the posterior segment and the applications of these systems on the anterior segment can determine motion lines, vessel duplication, and vessel discontinuity. OCTA of the iris should always be performed under ambient room lighting to create miosis and reduce iris vasculature changes during the examination. In the near future, eye-tracking systems specifically designed for the iris vessels could permit the follow-up function, and the development of new OCTA metrics could reveal interesting applications of this new imaging technique.
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Khalil HEMA, Abd-Elhafiz KAE, Ibrahim AK. Pentacam versus anterior segment OCT in measuring intended versus achieved ablation depth post-myopic LASIK correction. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022. [DOI: 10.1186/s43088-022-00235-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Accurate quantitative measurements of central corneal thickness (CCT) provide valuable, clinical information for preoperative assessment, surgical planning, and follow-up in myopic patients who have undergone LASIK correction. Typically, an ultrasound is used to measure such parameters. However, noncontact devices such as the Visante anterior segment optical coherence tomographer [AS-optical coherence tomography (OCT)] and Pentacam are becoming more popular to measure ocular parameters. It is important to assess the level of similarity between these two optical devices to compare between the intended and achieved ablation depth after LASIK procedures in cases of myopia and myopic astigmatism.
Methods
This cross-sectional, prospective study included 80 eyes of 40 patients attending Beni-Suef University Hospital between November 2018 and November 2019. All patients underwent LASIK surgery for the correction of myopia with or without myopic astigmatism with spherical equivalent ranging from − 1.5 to − 12 diopters.
Results
No statistically significant difference was observed between the intended ablation depth and the clinically measured ablation depth calculated by Pentacam and AS-OCT 3 months after surgery (P > 0.05).
Conclusion
When planning corneal refraction surgery, ablation depth readouts calculated by the computer software of the excimer laser used in this study are reliable. Both Pentacam and AS-OCT are accurate, sensitive, and specific in measuring the CCT and calculating ablation depth. Pentacam provides slightly higher accuracy and sensitivity compared with AS-OCT. LASIK is a safe, predictable, and effective procedure in the treatment of simple myopia and myopic astigmatism.
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An Overview of Intraoperative OCT-Assisted Lamellar Corneal Transplants: A Game Changer? Diagnostics (Basel) 2022; 12:diagnostics12030727. [PMID: 35328280 PMCID: PMC8947300 DOI: 10.3390/diagnostics12030727] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 02/01/2023] Open
Abstract
Intraoperative optical coherence tomography (iOCT) is a noninvasive imaging technique that gives real-time dynamic feedback on surgical procedures. iOCT was first employed in vitreoretinal surgery, but successively served as a guidance in several anterior segment surgical approaches: keratoplasty, implantable Collamer lens (ICL) implantation, and cataract surgery. Among all of those approaches, the unbeatable features of iOCT are fully exploited in anterior and posterior lamellar keratoplasty, and the purpose of this review is to focus on the advantages and shortfalls of iOCT in these techniques, in order to assess whether this technology could be a real step forward. In deep anterior lamellar keratoplasty (DALK), iOCT is useful to evaluate the needle depth into the corneal stroma, the big bubble dissection plane, and residual stromal bed, thus aiding the standardization of the technique and the reduction of failures. In Descemet stripping automated endothelial keratoplasty (DSAEK), iOCT allowed for clear visibility of fluid at the graft/host interface, allowing for immediate rescue maneuvers and granting the best graft apposition. In Descemet membrane endothelial keratoplasty (DMEK), iOCT can track the lenticule unfolding in real time and assess graft orientation even in severe hazy corneas, thus optimizing surgical times, as well as avoiding the use of potentially hazardous exterior markers (such as the “S” stamp) and preventing unnecessary manipulation of the graft. Overall, the role of iOCT appeared crucial in several complicated cases, overcoming the difficulties of poor visualization in a fast, non-invasive way, thus raising this approach as possible gold standard for challenging conditions. Further improvements in the technology may enable autonomous centering and tracking, overcoming the current constraint of instrument-induced shadowing.
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Applications of Optical Coherence Tomography in the Ocular Diagnosis: From the Tear Film to the Sclera. Diagnostics (Basel) 2022; 12:diagnostics12030673. [PMID: 35328226 PMCID: PMC8947680 DOI: 10.3390/diagnostics12030673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
The latest technological developments have radically impacted the daily practice of ophthalmologists, thanks to the advent of novel diagnostic tools that facilitate an early diagnosis and allow a better management of ocular disorders [...]
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Asroui L, Dupps WJ, Randleman JB. Determining the Utility of Epithelial Thickness Mapping in Refractive Surgery Evaluations. Am J Ophthalmol 2022; 240:125-134. [PMID: 35247335 DOI: 10.1016/j.ajo.2022.02.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the impact of corneal epithelial thickness maps on screening for refractive surgery candidacy in a single refractive surgical practice. DESIGN Comparison of screening methods. METHODS A total of 100 consecutive patients who presented for refractive surgery screening were evaluated. For each patient, screening based on Scheimpflug tomography, clinical data, and patient history was performed and a decision on eligibility for laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE)was independently made by 2 masked examiners. Examiners were then shown patients' epithelial thickness maps derived from optical coherence tomography (OCT). The percentage of screenings that changed after evaluating the epithelial thickness maps, with regard to candidacy for surgery, and ranking of surgical procedures from most to least favorable was determined. RESULTS Candidacy for corneal refractive surgery changed in 16% of patients after evaluation of the epithelial thickness maps, with 10% of patients screened in and 6% screened out. Surgery of choice changed for 16% of patients, and the ranking of surgical procedures from most to least favorable changed for 25% of patients. A total of 11% of patients gained eligibility for LASIK, whereas 8% lost eligibility for LASIK. No significant difference was found between the evaluations of the 2 examiners. CONCLUSIONS Epithelial thickness mapping derived from optical coherence tomography imaging of the cornea altered candidacy for corneal refractive surgery, as well as choice of surgery, in a substantial percentage of patients in our practice, and was thus a valuable tool for screening evaluations. Overall, the use of epithelial thickness maps resulted in screening in a slightly larger percentage of patients for corneal refractive surgery.
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Affiliation(s)
- Lara Asroui
- From the Cole Eye Institute (L.A., W.J.D., J.B.R.), Department of Biomedical Engineering, Lerner Research Institute (W.J.D.), Cleveland Clinic, Department of Biomedical Engineering, Case Western Reserve University (W.J.D.), and the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (W.J.D, J.B.R) Cleveland, Ohio, USA
| | - William J Dupps
- From the Cole Eye Institute (L.A., W.J.D., J.B.R.), Department of Biomedical Engineering, Lerner Research Institute (W.J.D.), Cleveland Clinic, Department of Biomedical Engineering, Case Western Reserve University (W.J.D.), and the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (W.J.D, J.B.R) Cleveland, Ohio, USA
| | - J Bradley Randleman
- From the Cole Eye Institute (L.A., W.J.D., J.B.R.), Department of Biomedical Engineering, Lerner Research Institute (W.J.D.), Cleveland Clinic, Department of Biomedical Engineering, Case Western Reserve University (W.J.D.), and the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (W.J.D, J.B.R) Cleveland, Ohio, USA.
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Evolution of optical coherence tomography: from the laboratory to the operating room. J Cataract Refract Surg 2022; 48:259-260. [PMID: 35191865 DOI: 10.1097/j.jcrs.0000000000000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Changes of Lacrimal Puncta by Anterior Segment Optical Coherence Tomography after Topical Combined Antibiotic and Steroid Treatment in Cases of Inflammatory Punctual Stenosis. J Ophthalmol 2022; 2022:7988091. [PMID: 35111339 PMCID: PMC8803470 DOI: 10.1155/2022/7988091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/11/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the role of medical treatment and assessing its effect on resolving epiphora and improving punctum size by high resolution AS-OCT imaging comparing punctal parameters in patients before and after treatment with topical combined antibiotic and steroid treatment in cases of inflammatory punctual stenosis. Patients and Methods. Double-blinded controlled randomized study which was conducted on two groups of patients who had acquired punctal stenosis and epiphora presented to Ophthalmology Clinics of Sohag University Hospitals in the period between Jan 2021 and April 2021. The study included 44 eyes of 50 subjects complaining of epiphora. They were divided into two groups, the epiphora group one (EG1) received eye drops containing combination of antibiotics and steroids (orchadexoline eye drops, each ml contains 5 mg chloramphenicol, 1 mg dexamethasone sodium phosphate, 0.25 mg tetryzoline hydrochloride, 2 mg hydroxypropyl methyl cellulose, 10 mg α-tocopherol acetate (vitamin E), and 8 mg macrogol 400), 5 times daily for the first week, three times daily for the next two weeks, and one time daily for another one week. The second epiphora group (EG2) received preservative-free artificial tears (sodium hyaluronate-, polyethylene-, and propylene glycol-based), three times daily for four weeks. The patients were examined before treatment, one week, one month, and one and half months later. Results Both groups were comparable regarding mean age (49 ± 13 vs 53 ± 11 years, P value = 0.2) and sex (males were 38.6% vs 31.8%, female were 61.4% vs 68.2%, P value = 0.6), respectively, with no statistically significant difference between both groups. Both groups were comparable regarding outer punctual diameter and length between the puncti before treatment. Outer punctal diameters were (EG1 228 ± 113 um, EG2 241 ± 115 um, P value = 0.5). Length between the puncti were (EG1 129 ± 73 um, EG2 137 ± 72 um, P value = 0.6). There was marked improvement of the outer punctual diameter (EG1 373 um ± 92 um, EG2 240 ± 109 um, (P value < 0.0001) and length between the puncti (EG1 217 ± 109 um, 136 ± 71 um (P value < 0.0002)) during the follow-up period. EG1 showed more improvement than EG2 when compared during the follow-up period. Conclusions Topical combined antibiotic and steroid treatment was an effective method in treating cases of inflammatory punctual stenosis as found by monitoring of punctal parameter changes by AS-OCT. AS-OCT was found to be a useful method for evaluation of the lacrimal punctal parameters especially with different treatment modalities in epiphora cases.
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Yousef YA, Mohammad M, AlNawaiseh I, AlJabari R, Toro MD, Gharaibeh A, Rejdak R, Nowomiejska K, Zweifel S, Avitabile T, Rejdak M, Nazzal R. Ultrasound Biomicroscopy Measurements of the Normal Thickness for the Ciliary Body and the Iris in a Middle East Population. Clin Ophthalmol 2022; 16:101-109. [PMID: 35046635 PMCID: PMC8760099 DOI: 10.2147/opth.s297977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Ciliary body (CB) and iris thicknesses may change with certain eye diseases as well as between different populations. Here, we report Ultrasound Biomicroscopy Measurements (UBM) of the normal thickness for the CB and the iris from a homogenous population in the Middle East. Patients and Methods Sonomed 35-MHz (SONOMED, INC. New York, USA) images were obtained at 4 radial meridians, and the thickness was measured at 3 locations along the radial length of the iris and at the thickest part of the CB. Parameters included mean thickness, median thickness, range, and standard deviation. Results Of 46 adult patients, 83 normal eyes were included in this analysis. The overall mean, median iris thicknesses at the iris root, midway along the radial length of the iris, and at the juxtapupillary margin in mm were 0.42, 0.41 ± 0.08, 0.52, 0.51± 0.08, and 0.72, 0.71± 0.1, respectively. The overall mean, median thicknesses of the CB and CB + ciliary processes in mm were 0.72, 0.71 ± 0.1, and 1.42, 1.37 ± 0.2 respectively. Gender, age, side, and height had no impact on iris and/or CB thickness (p>0.05). However, the iris thickness was significantly thicker in the superior quadrant than inferiorly, and in the nasal quadrant than the temporal quadrant (p=0.04), and the CB thickness and the CB + ciliary processes thickness were significantly thicker in the superior quadrant than inferiorly (P = 0.04 and 0.02 consecutively). Conclusion We measured in this study the normal thickness of the CB and the iris in normal eyes from homogenous population in the Middle East using ultrasound biomicroscopy. Our findings are essential for the ophthalmic community worldwide and in the Middle East region and can be used as a normative thickness data for the iris and CB in healthy eyes.
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Affiliation(s)
- Yacoub A Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan
| | - Mona Mohammad
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan
| | - Ibrahim AlNawaiseh
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan
| | - Reem AlJabari
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan
| | - Mario Damiano Toro
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland.,Department of Ophthalmology, University of Zürich, Zürich, Switzerland
| | | | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | - Sandrine Zweifel
- Department of Ophthalmology, University of Zürich, Zürich, Switzerland
| | | | - Magdalena Rejdak
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Rashed Nazzal
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
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High speed, long range, deep penetration swept source OCT for structural and angiographic imaging of the anterior eye. Sci Rep 2022; 12:992. [PMID: 35046423 PMCID: PMC8770693 DOI: 10.1038/s41598-022-04784-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
This study reports the development of prototype swept-source optical coherence tomography (SS-OCT) technology for imaging the anterior eye. Advances in vertical-cavity surface-emitting laser (VCSEL) light sources, signal processing, optics and mechanical designs, enable a unique combination of high speed, long range, and deep penetration that addresses the challenges of anterior eye imaging. We demonstrate SS-OCT with a 325 kHz A-scan rate, 12.2 µm axial resolution (in air), and 15.5 mm depth range (in air) at 1310 nm wavelength. The ultrahigh 325 kHz A-scan rate not only facilitates biometry measurements by minimizing acquisition time and thus reducing motion, but also enables volumetric OCT for comprehensive structural analysis and OCT angiography (OCTA) for visualizing vasculature. The 15.5 mm (~ 11.6 mm in tissue) depth range spans all optical surfaces from the anterior cornea to the posterior lens capsule. The 1310 nm wavelength range enables structural OCT and OCTA deep in the sclera and through the iris. Achieving high speed and long range requires linearizing the VCSEL wavenumber sweep to efficiently utilize analog-to-digital conversion bandwidth. Dual channel recording of the OCT and calibration interferometer fringe signals, as well as sweep to sweep wavenumber compensation, is used to achieve invariant 12.2 µm (~ 9.1 µm in tissue) axial resolution and optimum point spread function throughout the depth range. Dynamic focusing using a tunable liquid lens extends the effective depth of field while preserving the lateral resolution. Improved optical and mechanical design, including parallax “split view” iris cameras and stable, ergonomic patient interface, facilitates accurate instrument positioning, reduces patient motion, and leads to improved imaging data yield and measurement accuracy. We present structural and angiographic OCT images of the anterior eye, demonstrating the unique imaging capabilities using representative scanning protocols which may be relevant to future research and clinical applications.
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Factors Associated with Changes in Peripapillary Retinal Nerve Fibre Layer Thickness in Healthy Myopic Eyes. J Ophthalmol 2022; 2021:3462004. [PMID: 34987866 PMCID: PMC8723879 DOI: 10.1155/2021/3462004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/06/2021] [Indexed: 12/23/2022] Open
Abstract
Myopic people face an elevated risk of primary open angle glaucoma. Changes in the fundus in people with high myopia often lead to misdiagnosis of glaucoma, as this condition has many clinical signs in common with myopia, making the diagnosis of glaucoma more challenging. Compared to reduction of the visual field, a decrease in retinal nerve fibre layer (RNFL) thickness occurs earlier in glaucoma, which is widely considered useful for distinguishing between these conditions. With the development of optical coherence tomography (OCT), RNFL thickness can be measured with good reproducibility. According to previous studies, this variable is not only affected by axial length but also related to the patient's age, gender, ethnicity, optic disc area, and retinal blood flow in myopia. Herein, we intend to summarize the factors relevant to the RNFL in myopia to reduce the false-positive rate of glaucoma diagnosis and facilitate early prevention of myopia.
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50
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Atkova EL, Surnina ZV, Maydanova AA, Krakhovetskiy NN. [Optical coherence tomography in the diagnosis of pathologies of the horizontal portion of the lacrimal drainage system]. Vestn Oftalmol 2022; 138:279-284. [PMID: 36287168 DOI: 10.17116/oftalma2022138052279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This article reviews literature on the use of optical coherence tomography in studying the anatomical structure of the proximal lacrimal drainage system, as well as in diagnosing its pathological changes. Determining the reference values of the parameters of the lacrimal punctum and the lacrimal canaliculus remains an important issue. The review describes the advantages and disadvantages of this method, as well as the prospects for its application in clinical practice.
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Affiliation(s)
- E L Atkova
- Research Institute of Eye Diseases, Moscow, Russia
| | - Z V Surnina
- Research Institute of Eye Diseases, Moscow, Russia
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