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Romero-Morales VA, Bousquet E, Abraham N, Santina A, Somisetty S, Peiris T, Lu A, Fogel Levin M, Sarraf D. EVALUATION OF PARAVASCULAR INNER RETINAL DEFECTS USING EN FACE OPTICAL COHERENCE TOMOGRAPHY. Retina 2023; 43:1644-1652. [PMID: 37433217 DOI: 10.1097/iae.0000000000003889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
PURPOSE To evaluate the prevalence and risk factors for development of paravascular inner retinal defects (PIRDs) using en face optical coherence tomography. METHODS This is a retrospective cross-sectional study. En face and cross-sectional optical coherence tomography images were reviewed (9 × 9 mm or 12 × 12 mm). Paravascular inner retinal defects were classified as either Grade 1 (i.e., paravascular inner retinal cysts) when the lesion was confined within the nerve fiber layer without any communication to the vitreous cavity or Grade 2 (i.e., paravascular lamellar hole) when the defects communicated to the vitreous. Paravascular inner retinal defect grading was correlated with presence of high myopia, stage of posterior vitreous detachment, and presence of epiretinal membrane and retinoschisis. RESULTS Of 1,074 patients (2,148 eyes), PIRDs were detected in 261 eyes with a prevalence of 261 per 2,148 eyes (12.2%) and 176 per 1,074 patients (16.4%). A total of 116 eyes (44.4%) displayed Grade 2 PIRDs while 145 eyes (55.6%) were Grade 1. In the multivariate logistic regression model, the presence of partial/complete posterior vitreous detachment, retinoschisis, and epiretinal membrane was significantly correlated with PIRDs (OR = 2.78 [1.7-4.4], P < 0.001; OR = 2.93 [1.7-5], P < 0.001; and OR = 25.9 [2.8-242.5], P < 0.001, respectively). The presence of partial/complete posterior vitreous detachment and epiretinal membrane was also significantly associated with Grade 2 PIRDs versus Grade 1 PIRDs ( P = 0.03 and P < 0.001). CONCLUSION Our results indicate that wide-field en face optical coherence tomography facilitates the identification of PIRDs over a large area of retina with a single capture. The presence of PIRDs was significantly associated with posterior vitreous detachment, epiretinal membrane, and retinoschisis, confirming the role of vitreoretinal traction in the pathogenesis of PIRDs.
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Affiliation(s)
- Veronica A Romero-Morales
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Department of Retina, Instituto Mexicano de Oftalmología, Querétaro, México
| | - Elodie Bousquet
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Department of Ophthalmology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
| | - Neda Abraham
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Ahmad Santina
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Swathi Somisetty
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Timothy Peiris
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Anthony Lu
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Meira Fogel Levin
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel; and
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Greater Los Angeles VA Healthcare Center, Los Angeles, California
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Jiang X, Shen M, Gregori G, Rosenfeld PJ. Swept-Source OCT En Face Imaging of Paravascular Inner Retinal Defects. Ophthalmic Surg Lasers Imaging Retina 2021; 52:407-411. [PMID: 34309428 DOI: 10.3928/23258160-20210628-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Widefield swept-source optical coherence tomography angiography (SS-OCTA) was performed on eyes with paravascular inner retinal defects (PIRDs) and the morphological alterations of PIRDs were described. Patients with PIRDs were imaged using 12 mm × 12 mm SS-OCTA scans. En face structural and angiographic images of the superficial retinal layers were reviewed along with retinal thickness maps. SS-OCTA en face structural images identified dark, scalloped regions along major retinal veins that corresponded to PIRDs on B-scans. The authors concluded that imaging with both structural and angiographic en face OCT was useful for the diagnosis and monitoring of patients with PIRDs. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:407-411.].
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Jagadeesh D, Philip K, Fedtke C, Jong M, Ly A, Sankaridurg P. Posterior segment conditions associated with myopia and high myopia. Clin Exp Optom 2020; 103:756-765. [PMID: 32227385 DOI: 10.1111/cxo.13060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/29/2022] Open
Abstract
Myopia, and especially high myopia, is associated with a number of posterior segment changes that are considered to be mostly a consequence of the increased axial elongation. This can result in mechanical strain, attendant vascular changes, stretching and thinning of tissues, and atrophy/deformation of tissues in later or more advanced stages. Such myopia-related changes are observed as changes and/or abnormalities in the vitreous, choroid, retina and peripheral retina, sclera and/or optic disc. Although many of these changes are benign, at times they may be associated with significant vision impairment that either requires active intervention or may suggest future progression of the disease. This review systematically addresses the posterior segment conditions seen in myopic eyes, describes the features associated with the condition and details management pathways.
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Affiliation(s)
- Divya Jagadeesh
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Krupa Philip
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia
| | - Cathleen Fedtke
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Monica Jong
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
| | - Angelica Ly
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.,Centre for Eye Health, Sydney, Australia
| | - Padmaja Sankaridurg
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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Willerslev A, Larsen M, Rothenbuehler SP, Sørensen TL, Hammer T, Paques M, Munch IC. Spectral-domain optical coherence tomography of retinal vessels in Waldenström's macroglobulinemia. Acta Ophthalmol 2020; 98:153-157. [PMID: 31423759 DOI: 10.1111/aos.14211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 07/10/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To image retinal blood vessels in patients with Waldenström's macroglobulinemia using optical coherence tomography (OCT). METHODS Retrospective case series examining fundus photographs and OCT scans of 16 eyes in eight patients with Waldenström's macroglobulinemia. Analyses included intravascular OCT reflectivity profiles and vessel diameters, and their relation to total immunoglobulin M (IgM) levels. RESULTS In six out of eight patients, cross-sectional OCT scans of larger retinal vessels (diameter > 100 μm) showed normal intravascular reflectivity and retrovascular shadowing. In two patients with the highest total IgM > 60 g/l, altered intravascular reflectivity, distinct anterior and posterior vessel wall reflexes, and retrovascular hyposhadowing were seen. Normalization of the OCT reflectivity in these patients occurred after reduction of total IgM to < 17 g/l and was accompanied by decreasing venous tortuosity and disappearance of retinal haemorrhages and cotton wool spots. CONCLUSION This study found that Waldenström's macroglobulinemia and total IgM > 60 g/l were associated with abnormal intravascular reflectivity and retrovascular shadowing on OCT. Awareness of these signs of hyperviscosity could potentially enable earlier detection of critical conditions in patients with Waldenström's macroglobulinemia and improve the assessment of severity and treatment effect.
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Affiliation(s)
- Anne Willerslev
- Department of Ophthalmology Rigshospitalet Copenhagen Denmark
- Health and Medical Science University of Copenhagen Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology Rigshospitalet Copenhagen Denmark
- Health and Medical Science University of Copenhagen Copenhagen Denmark
| | - Simon P. Rothenbuehler
- Department of Ophthalmology Rigshospitalet Copenhagen Denmark
- Department of Ophthalmology University Hospital Basel Basel Switzerland
| | - Torben L. Sørensen
- Health and Medical Science University of Copenhagen Copenhagen Denmark
- Department of Ophthalmology Zealand University Hospital Roskilde Denmark
| | - Troels Hammer
- Department of Hematology Zealand University Hospital Roskilde Denmark
| | - Michel Paques
- Centre National d'Ophtalmologie des Quinze‐Vingts Sorbonne Universités Paris France
| | - Inger Christine Munch
- Health and Medical Science University of Copenhagen Copenhagen Denmark
- Department of Ophthalmology Zealand University Hospital Roskilde Denmark
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Mavrommatis MA, De Cuir N, Reynaud J, De Moraes CG, Xin D, Rajshekhar R, Liebmann JM, Ritch R, Fortune B, Hood DC. An Examination of the Frequency of Paravascular Defects and Epiretinal Membranes in Eyes With Early Glaucoma Using En-face Slab OCT Images. J Glaucoma 2019; 28:265-269. [PMID: 30817498 PMCID: PMC6400318 DOI: 10.1097/ijg.0000000000001188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the frequency of paravascular defects (PDs) and macular epiretinal membranes (ERMs) in eyes categorized as having mild glaucoma or glaucoma suspect using en-face slab analysis of optical coherence tomography (OCT) scans. MATERIALS AND METHODS Fifty-seven glaucomatous eyes, 44 low-risk suspect eyes, and 101 healthy control eyes were included in the study. The 101 glaucomatous and suspect eyes had a mean deviation better than -6 dB on the 24-2 visual field, and a spherical refractive error between±6 D or axial length <26.5 mm. Two OCT-graders masked to eye classification identified ERMs and PDs on en-face slab images of the macula and peripapillary retina using horizontal B-scans and derived vertical B-scans. RESULTS Glaucomatous eyes had a significantly higher number of PDs and ERMs than healthy controls (PD, P<0.001; ERM, P=0.046) and low-risk glaucoma suspects (PD, P=0.004; ERM, P=0.043). PDs and/or ERMs were present in 16 of 57 (28.1%) glaucomatous eyes, 2 of 44 (4.5%) suspect eyes, and 3 of 101 (3.0%) control eyes. Further, PDs were present in 11 of the 57 (19.3%) glaucomatous eyes, 1 of the 44 (2.3%) suspect eyes and 0 of the 101 (0%) control eyes, ERMs were seen in 7 of the 57 (12.3%) glaucomatous eyes, 1 of the 44 (2.3%) suspects, and 3 of the 101 (3.0%) control eyes. CONCLUSIONS Eyes with early glaucoma have a higher frequency of PDs and ERMs than suspects or controls and exhibit PDs even in the absence of ERMs or high myopia.
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Affiliation(s)
| | - Nicole De Cuir
- Dept. of Psychology, Columbia University, New York, NY, USA
| | - Juan Reynaud
- Discoveries in Sight Research Lab, Legacy Devers Eye Institute, Portland, OR, USA
| | | | - Daiyan Xin
- Dept. of Psychology, Columbia University, New York, NY, USA
| | | | | | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye, and Ear Infirmary, New York, NY, USA
| | - Brad Fortune
- Discoveries in Sight Research Lab, Legacy Devers Eye Institute, Portland, OR, USA
| | - Donald C. Hood
- Dept. of Psychology, Columbia University, New York, NY, USA
- Dept. of Ophthalmology, Columbia University, New York, NY, USA
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Long-term follow-up of retinal nerve fiber layer cleavages in glaucoma patients and suspects. Graefes Arch Clin Exp Ophthalmol 2018; 256:1945-1952. [PMID: 29959507 DOI: 10.1007/s00417-018-4043-4] [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: 02/04/2018] [Revised: 05/18/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To investigate the structural and functional characteristics and change of the retinal nerve fiber layer cleavages (RNFLCs) in glaucoma patients and suspects in long-term follow-up. METHODS This is a retrospective longitudinal study. Within 43 eyes of 30 subjects, 62 RNFLC locations were detected on color fundus photography. Basic ophthalmic examinations, color fundus photography, optical coherence tomography (OCT), and visual field (VF) test were performed in 6-month intervals. Clinical characteristics and the structural and functional changes of the cleaved areas were analyzed. RESULTS RNFLC and localized vitreoretinal traction occurred most commonly along the superotemporal retinal vessel arcade. Nine locations had corresponding defects on OCT deviation map, while 31 locations were associated with defects on OCT deviation map. Three locations had corresponding VF defects. More of the non-highly myopic eyes had lamellar hole than the highly myopes (p = 0.038). The RNFLC lesions in glaucomatous eyes were more frequently associated with OCT defects on deviation map (p = 0.021). There was no difference in the presence of lamellar hole or the number of RNFLCs between the glaucomatous and non-glaucomatous eyes. During a 66.8 ± 37.8-month follow-up, there was no structural or functional progression of the RNFLCs as determined by color fundus photography, VF test, and GPA of OCT interpreted by three ophthalmologists. There was no statistically significant change of RNFLC area (p = 0.268). CONCLUSIONS RNFLC did not show detectable functional or structural change in early glaucoma patients and suspects after long-term follow-up.
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