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Ng DSC, Chen LJ, Chan LKY, Tang FY, Teh WM, Zhou L, Chan F, Lin ESS, Yuen KW, Chu WK, Mohamed S, Tsang CW, Zhang X, Yam JC, Pang CP, Lai TYY. Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity. Br J Ophthalmol 2024:bjo-2023-323374. [PMID: 38729765 DOI: 10.1136/bjo-2023-323374] [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: 02/08/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND/AIMS To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity. METHODS Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators. RESULTS 213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01). CONCLUSION SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.
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Affiliation(s)
- Danny Siu-Chun Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Hong Kong Baptist Hospital, Hong Kong, Hong Kong
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Department of Ophthalmology and Visual Science, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Leo Ka Yu Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | - Fang Yao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | - Linbin Zhou
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Fiona Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Eleanor Sui Sum Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ka Wai Yuen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wai Kit Chu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Shaheeda Mohamed
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | - Chi Wai Tsang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | | | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | - Chi-Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Timothy Y Y Lai
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- 2010 Retina & Macula Centre, Hong Kong, Hong Kong
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Abdellah MM, Amer AA, Eldaly ZH, Anber MA. Optical coherence tomography angiography of the macula of high myopia in children and adolescents. Int J Retina Vitreous 2024; 10:17. [PMID: 38317246 PMCID: PMC10845789 DOI: 10.1186/s40942-024-00532-w] [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: 11/30/2023] [Accepted: 01/13/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND High myopia represents a health issue and leads to the development of complications that threaten vision. The study of macular changes in high myopia patients has undergone great advances with updated technology via new spectral optical coherence tomography (OCT) and Optical coherence tomography angiography (OCTA). Most of related studies have focused on the adults and additional studies need to investigate macular changes in children and adolescents. This study aimed to evaluate the changes in the macular structure by OCT and the macular vessel density in high myopia in children and adolescents by OCTA. METHODS A cross-sectional comparative study. The population was divided into two groups: group 1 (4-11 years) and group 2 (12-18 years). The results were comparable to those of control study of the same age group. The two high myopia groups and the control groups were examined by macular OCT and OCTA to evaluate macular thickness and vessel density in the superficial and deep capillary plexuses. RESULTS OCT measurements of patients in group 1 revealed that central macular thickness was significantly lower in high myopia group than in the control group and measured 220.91 ± 27.87 μm and 258.23 ± 17.26 μm, respectively, (P < 0.0001). However, in group 2 the central macular thickness in the high myopia group and control group was 236.32 ± 27.76 μm and 247.09 ± 16.81 μm respectively, and the difference was not statistically significant (P = 0.09). The parafoveal macular thickness and the perifoveal macular quadrants thickness were significantly lower in high myopic children and high myopic adolescents (P < 0.0001) than age matched controls. The parafoveal and perifoveal vessel densities in the superficial and deep capillary plexuses were lower in the high myopia groups than in the age-matched controls in both groups with a few segment exceptions in group 1. The FAZ was significantly wider in group 1 than in the age-matched emmetropes (P = 0.02). The FAZ was wider in group 2 than controls, but the difference was not statistically significant, (P = 0.75). CONCLUSION High myopic children and adolescents have thinner macular thickness than comparable age-matched emmetropes and have less vessel density in superficial and deep capillary plexuses with a wider FAZ.
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Affiliation(s)
- Marwa Mahmoud Abdellah
- Ophthalmology Department, Sohag Faculty of Medicine, Sohag University, Sohag, 82525, Egypt.
| | - Ahmed Ali Amer
- Ophthalmology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Zeiad Hasan Eldaly
- Ophthalmology Department, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
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Zhang J, Zou H. Insights into artificial intelligence in myopia management: from a data perspective. Graefes Arch Clin Exp Ophthalmol 2024; 262:3-17. [PMID: 37231280 PMCID: PMC10212230 DOI: 10.1007/s00417-023-06101-5] [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: 11/26/2022] [Revised: 03/23/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023] Open
Abstract
Given the high incidence and prevalence of myopia, the current healthcare system is struggling to handle the task of myopia management, which is worsened by home quarantine during the ongoing COVID-19 pandemic. The utilization of artificial intelligence (AI) in ophthalmology is thriving, yet not enough in myopia. AI can serve as a solution for the myopia pandemic, with application potential in early identification, risk stratification, progression prediction, and timely intervention. The datasets used for developing AI models are the foundation and determine the upper limit of performance. Data generated from clinical practice in managing myopia can be categorized into clinical data and imaging data, and different AI methods can be used for analysis. In this review, we comprehensively review the current application status of AI in myopia with an emphasis on data modalities used for developing AI models. We propose that establishing large public datasets with high quality, enhancing the model's capability of handling multimodal input, and exploring novel data modalities could be of great significance for the further application of AI for myopia.
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Affiliation(s)
- Juzhao Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haidong Zou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
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4
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ÇITIRIK M, YAVUZER K, BAĞCI F. Assessment of changes in macular structural retinal layers in patients with pathological myopia. Turk J Med Sci 2023; 53:1807-1816. [PMID: 38813500 PMCID: PMC10760540 DOI: 10.55730/1300-0144.5751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/09/2023] [Accepted: 10/25/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim This study aimed to examine changes in the thickness of individual macular retinal layers in eyes with pathological myopia (PM) and to compare the thickness of each retinal layer between the PM and control groups to gain insights into retinal perfusion. Materials and methods The study included 51 eyes in the PM group and 51 eyes in the control group. Optical coherence tomography (OCT) was used to measure the thickness of each retinal layer in the central fovea, parafoveal, and perifoveal regions. Optical coherence tomography angiography (OCT-A) was used to evaluate the retinal capillary density. Results In the PM group, the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL) were thicker than in the control group (p = 0.004, p = 0.027, p = 0.020, and p < 0.001, respectively), whereas the outer nuclear layer (ONL) and photoreceptor layer (PRL) were thinner (p = 0.001 and p = 0.003, respectively). In other regions, the RNFL was thicker in the myopic group, whereas the GCL, IPL, INL, and ONL were thinner. OCT-A did not reveal any significant difference between the groups in terms of radial capillary plexus density (p = 0.381); however, the densities of the other plexuses were lower in the PM group. Conclusions The results showed alterations in the thickness of retinal layers and capillary plexus density in PM. Thus, assessment of the thickness of individual retinal layers may serve as an indicator of vascular diseases that affect the circulation of the retina and choroid.
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Affiliation(s)
- Mehmet ÇITIRIK
- Department of Ophthalmology, University of Health Sciences, Ankara Etlik City Hospital, Ankara,
Turkiye
| | - Kamil YAVUZER
- Department of Ophthalmology, Dünya Göz Hospital, Gaziantep,
Turkiye
| | - Fatma BAĞCI
- Department of Ophthalmology, University of Health Sciences, Ankara Etlik City Hospital, Ankara,
Turkiye
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Urizar MP, Gambra E, de Castro A, de la Peña Á, Cetinkaya O, Marcos S, Curatolo A. Optical beam scanner with reconfigurable non-mechanical control of beam position, angle, and focus for low-cost whole-eye OCT imaging. BIOMEDICAL OPTICS EXPRESS 2023; 14:4468-4484. [PMID: 37791284 PMCID: PMC10545213 DOI: 10.1364/boe.493917] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 10/05/2023]
Abstract
Whole-eye optical coherence tomography (OCT) imaging is a promising tool in ocular biometry for cataract surgery planning, glaucoma diagnostics and myopia progression studies. However, conventional OCT systems are set up to perform either anterior or posterior eye segment scans and cannot easily switch between the two scan configurations without adding or exchanging optical components to account for the refraction of the eye's optics. Even in state-of-the-art whole-eye OCT systems, the scan configurations are pre-selected and cannot be dynamically reconfigured. In this work, we present the design, optimization and experimental validation of a reconfigurable and low-cost optical beam scanner based on three electro-tunable lenses, capable of non-mechanically controlling the beam position, angle and focus. We derive the analytical theory behind its control. We demonstrate its use in performing alternate anterior and posterior segment imaging by seamlessly switching between a telecentric focused beam scan to an angular collimated beam scan. We characterize the corresponding beam profiles and record whole-eye OCT images in a model eye and in an ex vivo rabbit eye, observing features comparable to those obtained with conventional anterior and posterior OCT scanners. The proposed beam scanner reduces the complexity and cost of other whole-eye scanners and is well suited for 2-D ocular biometry. Additionally, with the added versatility of seamless scan reconfiguration, its use can be easily expanded to other ophthalmic applications and beyond.
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Affiliation(s)
- María Pilar Urizar
- 2EyesVision S.L., Madrid, Spain
- Instituto de Óptica “Daza de Valdés”, Consejo Superior de Investigaciones Científicas (IO, CSIC), Spain
| | | | - Alberto de Castro
- Instituto de Óptica “Daza de Valdés”, Consejo Superior de Investigaciones Científicas (IO, CSIC), Spain
| | - Álvaro de la Peña
- Instituto de Óptica “Daza de Valdés”, Consejo Superior de Investigaciones Científicas (IO, CSIC), Spain
| | - Onur Cetinkaya
- International Centre for Translational Eye Research (ICTER), Institute of Physical Chemistry, Polish Academy of Sciences (IPC-PAS), Warsaw, Poland
| | - Susana Marcos
- Instituto de Óptica “Daza de Valdés”, Consejo Superior de Investigaciones Científicas (IO, CSIC), Spain
- The Institute of Optics and Flaum Eye Institute, Center for Visual Sciences, University of Rochester, New York, USA
| | - Andrea Curatolo
- Instituto de Óptica “Daza de Valdés”, Consejo Superior de Investigaciones Científicas (IO, CSIC), Spain
- International Centre for Translational Eye Research (ICTER), Institute of Physical Chemistry, Polish Academy of Sciences (IPC-PAS), Warsaw, Poland
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6
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Huang X, He S, Wang J, Yang S, Wang Y, Ye X. Lesion detection with fine-grained image categorization for myopic traction maculopathy (MTM) using optical coherence tomography. Med Phys 2023; 50:5398-5409. [PMID: 37490302 DOI: 10.1002/mp.16623] [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: 11/14/2022] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Myopic traction maculopathy (MTM) are retinal disorder caused by traction force on the macula, which can lead to varying degrees of vision loss in eyes with high myopia. Optical coherence tomography (OCT) is an effective imaging technique for diagnosing, detecting and classifying retinopathy. MTM has been classified into different patterns by OCT, corresponding to different clinical strategies. PURPOSE We aimed to engineer a deep learning model that can automatically identify MTM in highly myopic (HM) eyes using OCT images. METHODS A five-class classification model was developed using 2837 OCT images from 958 HM patients. We adopted a ResNet-34 architecture to train the model to identify MTM: no MTM (class 0), extra-foveal maculoschisis (class 1), inner lamellar macular hole (class 2), outer foveoschisis (class 3), and discontinuity or detachment of foveal outer hyperreflective layers (class 4). An independent test set of 604 images from 173 HM patients was used to evaluate the model's performance. Classification performance was assessed according to the area under the curve (AUC), accuracy, sensitivity, specificity. RESULTS Our model exhibited a high training performance for classification (F1-score of 0.953; AUCs of 0.961 to 0.998). In test set, it achieved sensitivities (91.67%-97.78 %) and specificities (98.33%-99.17%) as good as, or better than, those of experienced clinicians. Heatmaps were generated to provide visual explanations. CONCLUSIONS We established a deep learning model for MTM classification using OCT images. This model performed equally well or better than retinal specialists and is suitable for large-scale screening and identifying MTM in HM eyes.
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Affiliation(s)
- Xingru Huang
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Shucheng He
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jun Wang
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shangchao Yang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yaqi Wang
- College of Media Engineering, Communication University of Zhejiang, Hangzhou, Zhejiang, China
| | - Xin Ye
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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7
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Sarıgül Sezenöz A, Oto S, Akkoyun İ, Akça Bayar S, Yılmaz G, Çolak MY. Macular Imaging Characteristics in Children with Myelinated Retinal Nerve Fiber and High Myopia Syndrome. Turk J Ophthalmol 2023; 53:234-240. [PMID: 37602641 PMCID: PMC10442755 DOI: 10.4274/tjo.galenos.2023.27612] [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: 06/02/2022] [Accepted: 01/05/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives To investigate the macular imaging features in patients with unilateral myelinated retinal nerve fiber (MRNF) and high myopia syndrome. Materials and Methods Six patients with unilateral MRNF and high myopia syndrome and 13 myopic controls were enrolled in this study. Spectral domain (SD) optical coherence tomography (OCT), SD enhanced depth imaging OCT, and OCT angiography (OCTA) imaging results of MRNF-affected eyes were compared with the fellow eyes and myopic controls. Results All patients had abnormal foveal reflex and/or ectopia. No significant difference in retinal thickness parameters were noted between the groups. In OCT scans, posterior vitreous detachment (PVD) was observed in 4 out of the 6 MRNF-affected eyes. Regarding OCTA parameters, only a significant increase in acircularity index was noted in myelinated eyes (p=0.01). Conclusion All patients demonstrated normal foveal contours, macular structure, and OCTA features except for a higher acircularity index. The incidence of PVD was notably increased in the myelinated eyes.
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Affiliation(s)
| | - Sibel Oto
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - İmren Akkoyun
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - Sezin Akça Bayar
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - Gürsel Yılmaz
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | - Meriç Yavuz Çolak
- Başkent University Faculty of Medicine, Department of Biostatistics, Ankara, Türkiye
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8
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Kalaitzidis G, Pellegrini N, Nagy N, Vasileiou E, Ehrhardt H, Reppen A, Murphy OC, Moussa H, Filippatou A, Lambe J, DuVal A, Fioravante N, Kwakyi O, Nguyen J, Davis S, Douglas M, Ramirez A, Ecoff K, Valenzuela A, Reyes-Mantilla M, Hu C, Fitzgerald KC, Sotirchos ES, Saidha S, Calabresi PA. Effects of Myopia on Rates of Change in Optical Coherence Tomography Measured Retinal Layer Thicknesses in People with Multiple Sclerosis and Healthy Controls. Curr Eye Res 2023; 48:312-319. [PMID: 36440535 DOI: 10.1080/02713683.2022.2149806] [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] [Indexed: 11/29/2022]
Abstract
PURPOSE To quantify the associations of myopia with longitudinal changes in retinal layer thicknesses in people with multiple sclerosis (PwMS) and healthy controls (HC). METHODS A cohort of PwMS and HC with recorded refractive error (RE) prospectively scanned on Cirrus HD-OCT at the Johns Hopkins MS Center was assessed for inclusion. Exclusion criteria included OCT follow-up < 6 months, ocular comorbidities, incidental OCT pathologies, and inadequate scan quality. Eyes were classified as having high myopia (HM) (RE≤ -6 diopters), low myopia (LM) (RE> -6 and ≤ -3 diopters), or no myopia (NM) (RE> -3 and ≤ +2.75). Linear mixed-effects regression models were used in analyses. RESULTS A total of 213 PwMS (eyes: 67 HM, 98 LM, 207 NM) and 80 HC (eyes: 26 HM, 37 LM, 93 NM) were included. Baseline average ganglion cell/inner plexiform (GCIPL) and peri-papillary retinal nerve fiber layer (pRNFL) thicknesses were lower in MS HM compared with MS NM (diff: -3.2 µm, 95% CI: -5.5 to -0.8, p = 0.008 and -5.3 µm, 95% CI: -9.0 to -1.7, p = 0.004, respectively), and similarly in HC HM, as compared with HC NM. Baseline superior, inferior, and nasal pRNFL thicknesses were lower in HM compared with NM, while temporal pRNFL thickness was higher, both in MS and HC (MS: 7.1 µm, 95% CI: 2.7-11.6, p = 0.002; HC: 4.7 µm, 95% CI: -0.3 to 9.7, p = 0.07). No longitudinal differences in rates of GCIPL change were noted between HM and LM vs. NM, either in MS or HC. CONCLUSION Cross-sectional differences in average GCIPL and pRNFL thicknesses are commonly seen in people with HM as compared to reference normative values from people with NM and can lead to false attribution of pathology if RE is not taken into account. However, our study suggests that longitudinal changes in average GCIPL thickness in PwMS with myopia are similar in magnitude to PwMS with NM, and therefore are appropriate for monitoring disease-related pathology.
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Affiliation(s)
- Grigorios Kalaitzidis
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicole Pellegrini
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Natalia Nagy
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eleni Vasileiou
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Henrik Ehrhardt
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Abbey Reppen
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Olwen C Murphy
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hussein Moussa
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Angeliki Filippatou
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey Lambe
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anna DuVal
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas Fioravante
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ohemaa Kwakyi
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Nguyen
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Simidele Davis
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Morgan Douglas
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexandra Ramirez
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katie Ecoff
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alyssandra Valenzuela
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maria Reyes-Mantilla
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chen Hu
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathryn C Fitzgerald
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elias S Sotirchos
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shiv Saidha
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter A Calabresi
- Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD,USA
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9
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Živković ML, Lazić L, Zlatanovic M, Zlatanović N, Brzaković M, Jovanović M, Barišić S, Darabus DM. The Influence of Myopia on the Foveal Avascular Zone and Density of Blood Vessels of the Macula—An OCTA Study. Medicina (B Aires) 2023; 59:medicina59030452. [PMID: 36984453 PMCID: PMC10057575 DOI: 10.3390/medicina59030452] [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: 01/29/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Background and Objectives: Myopia is the most common refractive eye anomaly with a prevalence that is constantly increasing. High myopia is associated with numerous complications that can lead to permanent vision loss. It is believed that the basis of these complications lies in changes in the microvasculature of the retina caused by an increase in the longitudinal axis of the eye. Materials and Methods: Optical coherence tomography angiography (OCTA) was used to analyze differences in macular zone vascular and perfusion density and foveal avascular zone (FAZ) parameters in myopic subjects. The following OCTA parameters were analyzed: the vessel and perfusion density of retinal blood vessels in the superficial plexus; the area, perimeter, and index of circularity of the foveal avascular zone (FAZ); and foveal and ganglion cell complex (GCC) thickness. Results: Subjects with low myopia did not show statistically significant differences compared to the control for any of the analyzed parameters. Groups with moderate and high myopia showed a significant decrease in vessel and perfusion density in the parafoveal and the entire 3 × 3 mm analyzed field. Foveal vessel and perfusion densities in the myopic groups were similar to those of the control regardless of the degree of myopia. The area and perimeter of the FAZ, as well as foveal and mean GCC thickness, did not differ significantly no matter the degree of myopia, while the index of circularity was lower in highly myopic subjects. The minimal thickness of the GCC was also lower in the high myopia group. Conclusions: High and moderate myopia led to a loss of blood vessels in the macular region. Perfusion and vascular densities were preserved in the foveal region and were not affected by different degrees of myopia. The FAZ was not significantly larger in myopic subjects, but its circularity was lower in subjects with high myopia.
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Affiliation(s)
- Maja L.J. Živković
- Ophthalmology Clinic, Clinical Center Niš, Bulevar dr Zorana Đinđića 48, 18000 Niš, Serbia
- Department of Ophthalmology, Faculty of Medicine, University of Niš, Bulevar dr Zorana Đinđića 81, 18000 Niš, Serbia
- Correspondence: ; Tel.: +381-18-4570029; Fax: +381-18-4238770
| | - Lazar Lazić
- Department of Ophthalmology, Faculty of Medicine, University of Niš, Bulevar dr Zorana Đinđića 81, 18000 Niš, Serbia
| | - Marko Zlatanovic
- Ophthalmology Clinic, Clinical Center Niš, Bulevar dr Zorana Đinđića 48, 18000 Niš, Serbia
- Department of Ophthalmology, Faculty of Medicine, University of Niš, Bulevar dr Zorana Đinđića 81, 18000 Niš, Serbia
| | - Nevena Zlatanović
- Community Health Center Niš in Niš, Vojvode Tankosića 15, 18000 Niš, Serbia
| | - Mladen Brzaković
- Special Hospital for Ophthalmology “Clinic Maja”, Vizantijski Bulevar 8, 18000 Nis, Serbia
| | - Mihailo Jovanović
- Department of Clinical and Experimental Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, 34000 Kragujevac, Serbia
| | - Sava Barišić
- Eye Clinic, Clinical Center Vojvodina, Hajduk Veljkova 1-9, 21000 Novi Sad, Serbia
| | - Diana-Maria Darabus
- Department of Ophthalmology, University of Medicine and Pharmacy “Victor Babes”, Piata Eftimie Murgu, No. 2, 300041 Timisoara, Romania
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10
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Ng DSC, Chan LKY, Lai TYY. Myopic macular diseases: A review. Clin Exp Ophthalmol 2023; 51:229-242. [PMID: 36594934 DOI: 10.1111/ceo.14200] [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: 10/04/2022] [Revised: 12/05/2022] [Accepted: 12/16/2022] [Indexed: 01/04/2023]
Abstract
Recent evidence has demonstrated that the global public health burden of myopia is rising rapidly. Highly myopic eyes are associated with increased frequency of eye disorders that can lead to irreversible visual impairment. With recent technological advancement in ophthalmic imaging modalities, various macular complications associated with pathologic myopia are being elucidated. The development and progression of myopic chorioretinal atrophy, myopic macular neovascularization, myopic traction maculopathy and dome-shaped macula are vision-threatening myopic macular diseases. In order to overcome the challenges in managing patients with pathologic myopia, it is important to have a complete understanding in the natural course of these myopic macular diseases. Standardising the classification criteria of pathologic myopia is essential for enhancing clinical surveillance. Personalised pharmaceutical therapy and surgical interventions will help to optimise the treatment outcomes in patients suffering from these myopic macular diseases.
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Affiliation(s)
- Danny S C Ng
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Leo K Y Chan
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.,2010 Retina & Macula Centre, Hong Kong, Hong Kong
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11
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Ho S, Ly A, Ohno-Matsui K, Kalloniatis M, Doig GS. Diagnostic accuracy of OCTA and OCT for myopic choroidal neovascularisation: a systematic review and meta-analysis. Eye (Lond) 2023; 37:21-29. [PMID: 36456704 PMCID: PMC9829918 DOI: 10.1038/s41433-022-02227-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/26/2022] [Accepted: 08/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND/OBJECTIVES The purpose of this project was to systematically review and meta-analyse studies assessing the diagnostic accuracy of optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) for myopic choroidal neovascularisation (mCNV). Fluorescein angiography (FA) was accepted as the reference standard. METHODS PUBMED and EMBASE were searched from inception to March 2021 for studies evaluating the test accuracy of OCTA and/or OCT for diagnosing mCNV. The Preferred Reporting Items for Systematic Reviews and Meta-analyses of Diagnostic Test Accuracy Studies guideline was followed, and the Grading of Recommendations, Assessment, Development and Evaluation approach was used to frame clinical recommendations. Pooled estimates of test accuracy were obtained using a bivariate model. RESULTS Of 410 studies assessed for eligibility, 3 studies were identified that compared OCTA to FA and 3 studies were identified that compared spectral domain (SD) OCT to FA. All studies had at least one major methodological flaw leading to an overall high risk of bias. On meta-analysis, the pooled sensitivity of OCTA was 0.89 (95% CI 0.78-0.94) and pooled specificity was 0.93 (95% CI 0.79-0.98). The pooled sensitivity of SD-OCT was 0.99 (95% CI 0.91-1.00). Due to uncertainty in individual studies, the pooled specificity of SD-OCT could not be estimated. CONCLUSIONS OCTA can reliably diagnose mCNV in clinically suspected patients, however, SD-OCT may not reliably establish a positive diagnosis of mCNV. Future large, prospective studies with improvements in conduct and reporting are needed to strengthen these clinical recommendations.
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Affiliation(s)
- Sharon Ho
- Centre for Eye Health, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- School of Optometry and Vision Science, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Angelica Ly
- Centre for Eye Health, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- School of Optometry and Vision Science, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Brien Holden Vision Institute, University of New South Wales, Sydney, NSW, Australia
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michael Kalloniatis
- Centre for Eye Health, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- School of Optometry and Vision Science, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Gordon S Doig
- Centre for Eye Health, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
- School of Optometry and Vision Science, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
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12
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Multi-layer segmentation of retina OCT images via advanced U-net architecture. Neurocomputing 2023. [DOI: 10.1016/j.neucom.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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13
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Yoo TK, Ryu IH, Kim JK, Lee IS. Deep learning for predicting uncorrected refractive error using posterior segment optical coherence tomography images. Eye (Lond) 2022; 36:1959-1965. [PMID: 34611313 PMCID: PMC9500028 DOI: 10.1038/s41433-021-01795-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/10/2021] [Accepted: 09/24/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to evaluate a deep learning model for estimating uncorrected refractive error using posterior segment optical coherence tomography (OCT) images. METHODS In this retrospective study, we assigned healthy subjects to development (N = 688 eyes of 344 subjects) and test (N = 248 eyes of 124 subjects) datasets (prospective validation design). We developed and validated OCT-based deep learning models to estimate refractive error. A regression model based on a pretrained ResNet50 architecture was trained using horizontal OCT images to predict the spherical equivalent (SE). The performance of the deep learning model for detecting high myopia was also evaluated. A saliency map was generated using the Grad-CAM technique to visualize the characteristic features. RESULTS The developed model showed a low mean absolute error for SE prediction (2.66 D) and a significant Pearson correlation coefficient of 0.588 (P < 0.001) in the test dataset validation. To detect high myopia, the model yielded an area under the receiver operating characteristic curve of 0.813 (95% confidence interval [CI], 0.744-0.881) and an accuracy of 71.4% (95% CI, 65.3-76.9%). The inner retinal layers and relatively steepened curvatures were highlighted using a saliency map to detect high myopia. CONCLUSION A deep learning algorithm showed that OCT could potentially be used as an imaging modality to estimate refractive error. This method will facilitate the evaluation of refractive error to prevent clinicians from overlooking the risks associated with refractive error during OCT assessment.
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Affiliation(s)
- Tae Keun Yoo
- B&VIIT Eye Center, Seoul, South Korea.
- Department of Ophthalmology, Aerospace Medical Center, Republic of Korea Air Force, Cheongju, South Korea.
- VISUWORKS, Seoul, South Korea.
| | - Ik Hee Ryu
- B&VIIT Eye Center, Seoul, South Korea
- VISUWORKS, Seoul, South Korea
| | - Jin Kuk Kim
- B&VIIT Eye Center, Seoul, South Korea
- VISUWORKS, Seoul, South Korea
| | - In Sik Lee
- B&VIIT Eye Center, Seoul, South Korea
- VISUWORKS, Seoul, South Korea
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14
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Omodaka K, Kikawa T, Kabakura S, Himori N, Tsuda S, Ninomiya T, Takahashi N, Pak K, Takeda N, Akiba M, Nakazawa T. Clinical characteristics of glaucoma patients with various risk factors. BMC Ophthalmol 2022; 22:373. [PMID: 36123604 PMCID: PMC9484257 DOI: 10.1186/s12886-022-02587-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Abstract
Background Glaucoma is multifactorial, but the interrelationship between risk factors and structural changes remains unclear. Here, we adjusted for confounding factors in glaucoma patients with differing risk factors, and compared differences in structure and susceptible areas in the optic disc and macula. Methods In 458 eyes with glaucoma, we determined confounding factors for intraocular pressure (IOP), central corneal thickness (CCT), axial length (AL), LSFG-measured ocular blood flow (OBF), which was assessed with laser speckle flowgraphy-measured mean blur rate in the tissue area (MT) of the optic nerve head, biological antioxidant potential (BAP), and systemic abnormalities in diastolic blood pressure (dBP). To compensate for measurement bias, we also analyzed corrected IOP (cIOP; corrected for CCT) and corrected MT (cMT; corrected for age, weighted retinal ganglion cell count, and AL). Then, we determined the distribution of these parameters in low-, middle-, and high-value subgroups and compared them with the Kruskal–Wallis test. Pairwise comparisons used the Steel–Dwass test. Results The high-cIOP subgroup had significantly worse mean deviation (MD), temporal, superior, and inferior loss of circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and large cupping. The low-CCT subgroup had temporal cpRNFLT loss; the high-CCT subgroup had low cup volume. The high-AL subgroup had macular ganglion cell complex thickness (GCCT) loss; the low-AL subgroup had temporal cpRNFLT loss. The high-systemic-dBP subgroup had worse MD, total, superior, and inferior cpRNFLT loss and macular GCCT loss. The low-BAP subgroup had more male patients, higher dBP, and cpRNFLT loss in the 10 o’clock area. The high-OBF subgroup had higher total, superior and temporal cpRNFLT and macular GCCT. Conclusions Structural changes and local susceptibility to glaucomatous damage show unique variations in patients with different risk factors, which might suggest that specific risk factors induce specific types of pathogenesis and corresponding glaucoma phenotypes. Our study may open new avenues for the development of precision medicine for glaucoma.
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Affiliation(s)
- Kazuko Omodaka
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | | | - Sayaka Kabakura
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Noriko Himori
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Aging Vision Healthcare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Takahiro Ninomiya
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Naoki Takahashi
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | | | - Masahiro Akiba
- R and D Division, Topcon Corporation, Tokyo, Japan.,Cloud-Based Eye Disease Diagnosis Joint Research Team, Riken, Wako, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan. .,Department of Ophthalmic Imaging and Information Analytics, Tohoku University, Graduate School of Medicine, Sendai, Japan.
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15
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Ibrahim MN, Bashar SB, Rasheed MA, Selvam A, Sant V, Sahel JA, Chhablani J, Vupparaboina KK, Jana S. Volumetric quantification of choroid and Haller's sublayer using OCT scans: An accurate and unified approach based on stratified smoothing. Comput Med Imaging Graph 2022; 99:102086. [PMID: 35717830 DOI: 10.1016/j.compmedimag.2022.102086] [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: 11/15/2021] [Revised: 05/10/2022] [Accepted: 05/31/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE The choroid, a dense vascular structure in the posterior segment of the eye, maintains the health of the retina by supplying oxygen and nutrients, and assumes clinical significance in screening ocular diseases including age-related macular degeneration (AMD) and central serous chorioretinopathy (CSCR). As a technological assist, algorithmic estimation of choroidal biomarkers has been suggested based on sectional (B-scan) optical coherence tomography (OCT) images. However, most such 2D estimation techniques are compute-intensive, yet enjoy limited accuracy and have only been validated on OCT image datasets of healthy eyes. Not surprisingly, fine-scale analyses, including those involving Haller's sublayer, remain relatively rare and unsophisticated. Against this backdrop, we propose an efficient algorithm to quantify desired biomarkers with improved accuracy based on volume OCT scans. Specifically, we attempted an accurate, computationally light volumetric segmentation method involving stratified smoothing to detect choroid and Haller's sublayer. METHODS For detecting the various boundaries of the choroid and the Haller's sublayer, we propose a common volumetric method that performs suitable exponential enhancement and maintains smooth spatial continuity across 2D B-scans. Further, we achieve suitable volumetric smoothing by primarily deploying light-duty linear regression, and sparingly using compute-intensive tensor voting, and hence significantly reduce overall complexity. The proposed methodology is tested on five health and five diseased OCT volumes considering various metrics including volumetric Dice coefficient and corresponding quotient measures to facilitate comparison vis-à-vis intra-observer repeatability. RESULTS On five healthy and five diseased OCT volumes, respectively, the proposed method for choroid segmentation recorded volumetric Dice coefficients of 93.53 % and 93.30 %, which closely approximate the respective reference observer repeatability values of 95.60 % and 95.49 %. In terms of related quotient measures, our method achieved more than 50 % improvement over a recently reported method. In detecting Haller's sublayer as well, our algorithm records statistical performance closely matching that of reference manual method. CONCLUSION Advancing the state-of-the-art, the proposed volumetric segmentation, tested on both healthy and diseased datasets, demonstrated close match with the manual reference. Our method assumes significance in accurate screening of chorioretinal diseases including AMD, CSCR and pachychoroid. Further, it enables generating accurate training data for developing deep learning models for improved detection of choroid and Haller's sublayer.
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Affiliation(s)
- M N Ibrahim
- Dept. of Electrical Engg, Indian Institute of Technology Hyderabad, Telangana, India; Dept. of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - S Bin Bashar
- L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - M A Rasheed
- School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
| | - A Selvam
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - V Sant
- Fox Chapel Area High School, Pittsburgh, PA, USA
| | - J A Sahel
- Dept. of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Chhablani
- Dept. of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - K K Vupparaboina
- Dept. of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - S Jana
- Dept. of Electrical Engg, Indian Institute of Technology Hyderabad, Telangana, India
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16
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Li Y, Zheng F, Foo LL, Wong QY, Ting D, Hoang QV, Chong R, Ang M, Wong CW. Advances in OCT Imaging in Myopia and Pathologic Myopia. Diagnostics (Basel) 2022; 12:diagnostics12061418. [PMID: 35741230 PMCID: PMC9221645 DOI: 10.3390/diagnostics12061418] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Advances in imaging with optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) technology, including the development of swept source OCT/OCTA, widefield or ultra-widefield systems, have greatly improved the understanding, diagnosis, and treatment of myopia and myopia-related complications. Anterior segment OCT is useful for imaging the anterior segment of myopes, providing the basis for implantable collamer lens optimization, or detecting intraocular lens decentration in high myopic patients. OCT has enhanced imaging of vitreous properties, and measurement of choroidal thickness in myopic eyes. Widefield OCT systems have greatly improved the visualization of peripheral retinal lesions and have enabled the evaluation of wide staphyloma and ocular curvature. Based on OCT imaging, a new classification system and guidelines for the management of myopic traction maculopathy have been proposed; different dome-shaped macula morphologies have been described; and myopia-related abnormalities in the optic nerve and peripapillary region have been demonstrated. OCTA can quantitatively evaluate the retinal microvasculature and choriocapillaris, which is useful for the early detection of myopic choroidal neovascularization and the evaluation of anti-vascular endothelial growth factor therapy in these patients. In addition, the application of artificial intelligence in OCT/OCTA imaging in myopia has achieved promising results.
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Affiliation(s)
- Yong Li
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Feihui Zheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
| | - Li Lian Foo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Qiu Ying Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
| | - Daniel Ting
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Quan V. Hoang
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Department of Ophthalmology, Columbia University, New York, NY 10027, USA
| | - Rachel Chong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Marcus Ang
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Chee Wai Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence:
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17
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Tang J, Yuan M, Tian K, Wang Y, Wang D, Yang J, Yang Z, He X, Luo Y, Li Y, Xu J, Li X, Ding D, Ren Y, Chen Y, Sadda SR, Yu W. An Artificial-Intelligence-Based Automated Grading and Lesions Segmentation System for Myopic Maculopathy Based on Color Fundus Photographs. Transl Vis Sci Technol 2022; 11:16. [PMID: 35704327 PMCID: PMC9206390 DOI: 10.1167/tvst.11.6.16] [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: 12/05/2022] Open
Abstract
Purpose To develop deep learning models based on color fundus photographs that can automatically grade myopic maculopathy, diagnose pathologic myopia, and identify and segment myopia-related lesions. Methods Photographs were graded and annotated by four ophthalmologists and were then divided into a high-consistency subgroup or a low-consistency subgroup according to the consistency between the results of the graders. ResNet-50 network was used to develop the classification model, and DeepLabv3+ network was used to develop the segmentation model for lesion identification. The two models were then combined to develop the classification-and-segmentation–based co-decision model. Results This study included 1395 color fundus photographs from 895 patients. The grading accuracy of the co-decision model was 0.9370, and the quadratic-weighted κ coefficient was 0.9651; the co-decision model achieved an area under the receiver operating characteristic curve of 0.9980 in diagnosing pathologic myopia. The photograph-level F1 values of the segmentation model identifying optic disc, peripapillary atrophy, diffuse atrophy, patchy atrophy, and macular atrophy were all >0.95; the pixel-level F1 values for segmenting optic disc and peripapillary atrophy were both >0.9; the pixel-level F1 values for segmenting diffuse atrophy, patchy atrophy, and macular atrophy were all >0.8; and the photograph-level recall/sensitivity for detecting lacquer cracks was 0.9230. Conclusions The models could accurately and automatically grade myopic maculopathy, diagnose pathologic myopia, and identify and monitor progression of the lesions. Translational Relevance The models can potentially help with the diagnosis, screening, and follow-up for pathologic myopic in clinical practice.
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Affiliation(s)
- Jia Tang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingzhen Yuan
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Kaibin Tian
- AI and Media Computing Lab, School of Information, Renmin University of China, Beijing, China
| | - Yuelin Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Dongyue Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhikun Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
| | - Xixi He
- Vistel AI Lab, Visionary Intelligence, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China
| | - Jie Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Xirong Li
- AI and Media Computing Lab, School of Information, Renmin University of China, Beijing, China.,Key Laboratory of Data Engineering and Knowledge Engineering, Renmin University of China, Beijing, China
| | - Dayong Ding
- Vistel AI Lab, Visionary Intelligence, Beijing, China
| | - Yanhan Ren
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Srinivas R Sadda
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Weihong Yu
- Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
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18
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Clinical effect of rigid gas permeable (RGP) contact lens in improving vision and controlling myopia progression of unilateral high myopic children. Int Ophthalmol 2022; 42:3511-3520. [PMID: 35612690 DOI: 10.1007/s10792-022-02349-8] [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: 11/30/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this study was to explore the clinical effect of the RGP contact lens in improving vision and controlling myopia progression of the unilateral high myopic children. METHODS In this retrospective analysis case series study, we analyzed the clinical data for 23 subjects with unilateral high myopic children under 6 years old, with the spherical equivalent refractive error of the myopic eye from -5.0 D to -12.0 D, who were enrolled from the outpatient clinic at Beijing Tongren Hospital, China. Fourteen subjects could successfully fit the RGP contact lens, and nine subjects used the spectacle lens. Complete ocular examination was performed at the first visit at the clinic and every three months during the follow-up period. RESULTS In the RGP group, the change of axial length (AL) of the high myopic eye was from 25.62 ± 1.31 mm to 25.69 ± 1.31 mm after 12 months. The change of spherical equivalent (SE) was from -8.73 ± 2.54 D to -8.48 ± 2.77 D. The best corrected visual acuity (BCVA) improved from 0.24 ± 0.18 to 0.78 ± 0.26. In the spectacle group, the change of AL was from 24.76 ± 0.56 mm to 24.94 ± 0.71 mm. The change of SE was from -6.16 ± 2.86 D to -9.45 ± 2.06 D. The improvement of BCVA was from 0.52 ± 0.15 to 0.72 ± 0.23. CONCLUSIONS Wearing RGP lens in the children with unilateral high myopia is a safe, convenient and effective method to improve the best corrected vision and controlling myopia progression.
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19
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Xu Y, Yang W, Long T, Shang W, Xu X, Wang J, Yao J, Li K. Analysis of Microcirculation Changes in the Macular Area and Para-Optic Disk Region After Implantable Collamer Lens Implantation in Patients With High Myopia. Front Neurosci 2022; 16:867463. [PMID: 35663554 PMCID: PMC9160968 DOI: 10.3389/fnins.2022.867463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Myopia has become an important public health problem to be solved urgently. Posterior chamber phakic implantable Collamer lens (ICL) implantation is one of the latest and safest products for myopia correction worldwide. This prospective cross-sectional case series aimed to observe changes in the macular retinal thickness, retinal nerve fiber layer (RNFL) thickness of para-optic disk region, and blood flow density after posterior ICL implantation in patients with high myopia using optical coherence tomography angiography (OCTA). A total of 67 eyes of 67 patients with high myopia, who underwent ICL implantation at The Affiliated Eye Hospital of Nanjing Medical University from January 2020 and December 2020, were included. The spherical equivalent (SE) of the operative eyes was >−6.00 D. The changes in vision, intraocular pressure (IOP), SE, and vault were observed pre-operatively, and follow-up were performed 1 week, 1 month, and 3 months. OCTA was used to observe the changes in the CRT, retinal thickness of paracentral fovea, FAZ, superficial and deep retinal blood flow density in the macular area, RNFL thickness of para-optic disk region, and blood flow density before and after ICL implantation. The uncorrected distance visual acuity (UDVA) and best corrected distance visual acuity (CDVA) of the patients post-operation were significantly improved (P < 0.001). The IOP increased in comparison with other time points at 1 week post-operation (P < 0.05). There were no significant changes in CRT post-operation. The retinal thickness in the upper, lower, nasal, and temporal quadrants of the paracentral fovea increased significantly at 1 month and 3 months post-operation (P < 0.05). The FAZ area at all postoperative time points were decreased (P < 0.001). At 3 months post-operation, the blood flow density of the superficial and deep retinal layers in the upper, lower, and nasal macular area were significantly reduced (P < 0.05). At 1 month post-operation, the RNFL thickness in the temporal para-optic disk region and blood flow density were significantly reduced (P = 0.001 and P < 0.05, respectively). ICL implantation for highly myopic eyes led to an increase of the retinal thickness in the upper, lower, nasal, and temporal regions of the paracentral fovea; reduction of RNFL thickness in the temporal area of para-optic disk; decrease in FAZ area; and decrease in the blood flow density of some deep and superficial retinal layers as well as that of the temporal para-optic disk region.
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Affiliation(s)
- Yingnan Xu
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Weihua Yang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Tan Long
- Department of Ophthalmology, Xi’an No. 1 Hospital, Xi’an, China
| | - Weihong Shang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangzhong Xu
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Jinfan Wang
- School of Marxism, Nanjing Medical University, Nanjing, China
- *Correspondence: Jinfan Wang,
| | - Jin Yao
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- Jin Yao,
| | - Keran Li
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- Keran Li,
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20
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Deep Learning Model Based on 3D Optical Coherence Tomography Images for the Automated Detection of Pathologic Myopia. Diagnostics (Basel) 2022; 12:diagnostics12030742. [PMID: 35328292 PMCID: PMC8947335 DOI: 10.3390/diagnostics12030742] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/10/2022] [Accepted: 03/16/2022] [Indexed: 12/20/2022] Open
Abstract
Pathologic myopia causes vision impairment and blindness, and therefore, necessitates a prompt diagnosis. However, there is no standardized definition of pathologic myopia, and its interpretation by 3D optical coherence tomography images is subjective, requiring considerable time and money. Therefore, there is a need for a diagnostic tool that can automatically and quickly diagnose pathologic myopia in patients. This study aimed to develop an algorithm that uses 3D optical coherence tomography volumetric images (C-scan) to automatically diagnose patients with pathologic myopia. The study was conducted using 367 eyes of patients who underwent optical coherence tomography tests at the Ophthalmology Department of Incheon St. Mary’s Hospital and Seoul St. Mary’s Hospital from January 2012 to May 2020. To automatically diagnose pathologic myopia, a deep learning model was developed using 3D optical coherence tomography images. The model was developed using transfer learning based on four pre-trained convolutional neural networks (ResNet18, ResNext50, EfficientNetB0, EfficientNetB4). Grad-CAM was used to visualize features affecting the detection of pathologic myopia. The performance of each model was evaluated and compared based on accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). The model based on EfficientNetB4 showed the best performance (95% accuracy, 93% sensitivity, 96% specificity, and 98% AUROC) in identifying pathologic myopia.
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21
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Hanyuda A, Torii H, Hayashi K, Uchida A, Mori K, Yotsukura E, Ogawa M, Negishi K, Kurihara T, Tsubota K. Relationship of choroidal thickness and axial length with posterior vitreous detachment in patients with high myopia. Sci Rep 2022; 12:4093. [PMID: 35260743 PMCID: PMC8904456 DOI: 10.1038/s41598-022-08101-7] [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: 10/15/2021] [Accepted: 02/28/2022] [Indexed: 11/09/2022] Open
Abstract
Although accumulating evidence suggests a higher prevalence of posterior vitreous detachment (PVD) in highly myopic eyes, the relation between ocular biometric features and PVD stages in such eyes remains unclear. Therefore, we enrolled 170 patients with high myopia (axial length ≥ 26.0 mm) to investigate the status of PVD regarding subfoveal choroidal thickness and axial length. Utilising swept-source optical coherence tomography, we classified the PVD status into five stages. The distribution of PVD grades increased as the choroidal thickness decreased and axial length increased (P < 0.01). On adjusting for age and sex, decreased choroidal thickness and increased axial length were associated with more advanced PVD stages: odds ratios with the highest vs. lowest groups were 0.31 (95% confidence interval [CI] 0.09-1.01; Ptrend = 0.009) for choroidal thickness and 5.16 (95% CI 1.34-19.80; Ptrend = 0.002) for axial length. The inverse association between choroidal thickness and PVD status seemed stronger in women than in men (Pinteraction = 0.05). In conclusion, we firstly observed a significant trend of decreased choroidal thickness, along with increased axial length, with increased grade of PVD, particularly among women with highly myopic eyes, suggesting that advanced morphological myopic changes contribute to PVD in middle-aged adults.
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Affiliation(s)
- Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | | | - Atsuro Uchida
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kiwako Mori
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mamoru Ogawa
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. .,Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. .,Tsubota Laboratory, Inc., Shinjuku-ku, Tokyo, 160-0016, Japan.
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22
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Macular vascular density and visual function after phacoemulsification in cataract patients with non-pathological high myopia: a prospective observational cohort study. Graefes Arch Clin Exp Ophthalmol 2022; 260:2597-2604. [PMID: 35258718 DOI: 10.1007/s00417-022-05606-9] [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: 11/13/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 02/08/2023] Open
Abstract
PURPOSES This study aimed to evaluate changes in macular vascular density and macular function in patients with high myopia cataract (HMC) after phacoemulsification surgery, using optical coherence tomography angiography (OCTA) and multifocal electroretinography (mfERG). METHODS Patients with cataracts scheduled for phacoemulsification surgery were divided into a high myopia group (axial length > 26.5 mm) and a control group (22 mm < axial length ≤ 24.5 mm). OCTA examinations were performed before surgery and at 1 day, 1 week, 1 month, and 3-6 months post-surgery, while mfERG was conducted before surgery and at 3-6 months post-surgery. RESULTS A total of 38 patients were included, of whom 20 were HMC patients and 18 were control patients. The macular vascular density significantly increased after phacoemulsification surgery in both groups, while foveal avascular zone area decreased significantly (HMC group: all p < 0.01; control group: all p < 0.05). Mean changes in macular vascular density were significantly greater in HMC patients than in the control group at 1 day after surgery (all p < 0.05). The amplitude density and latency of P1 wave in all macular rings (Ring1-5) did not differ significantly before or after surgery in either group (all p > 0.1). CONCLUSION Phacoemulsification may not affect HMC patients' macular mfERG responses within 3-6 months post-surgery, but it may influence macular microcirculation. HMC patients should be closely monitored after surgery, as their retinal vascular density may fluctuate substantially in the early postoperative period.
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23
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CHARACTERISTICS AND MANAGEMENT OF MYOPIC TRACTION MACULOPATHY IN MYOPIC EYES WITH AXIAL LENGTH LESS THAN 26.5 mm. Retina 2022; 42:540-547. [PMID: 35188492 PMCID: PMC8852681 DOI: 10.1097/iae.0000000000003351] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To explore the characteristics and underlying mechanisms of myopic traction maculopathy (MTM) with axial length less than 26.5 mm and to assess the effectiveness of macular buckling for the treatment of MTM.
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24
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Ng DSC, Lai TYY. Insights Into the Global Epidemic of High Myopia and Its Implications. JAMA Ophthalmol 2021; 140:123-124. [PMID: 34913960 DOI: 10.1001/jamaophthalmol.2021.5347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Danny S C Ng
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong.,Hong Kong Eye Hospital, Hong Kong
| | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong.,2010 Retina & Macula Centre, Hong Kong
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25
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Meng LH, Yuan MZ, Zhao XY, Yu WH, Chen YX. Wide-field swept source optical coherence tomography evaluation of posterior segment changes in highly myopic eyes. Eur J Ophthalmol 2021; 32:2777-2788. [PMID: 34841931 DOI: 10.1177/11206721211062362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To investigate the features in the posterior pole of highly myopic (HM) eyes using a wide-field high-resolution swept source optical coherence tomography (SS OCT). METHODS This observational cross-sectional study involved 262 eyes of 139 patients, who were diagnosed as HM and had consecutively been examined by SS OCT in the Ophthalmology Department of the Peking Union Medical College Hospital between March 2019 and December 2019. The characteristics of OCT images were documented and analyzed. RESULTS In our study, SS OCT could demonstrate the entire layer of the choroid and detect the sclera in all eyes. The mean subfoveal retinal/choroidal/scleral thickness were 204.84 ± 119.86 μm, 92.80 ± 75.78 μm and 394.734 ± 123.09 μm, respectively. 138 eyes (52.67%) had posterior precortical vitreous pocket. Myopic foveoschisis was detected in 110 eyes (41.98%), and significantly associated with the presence of posterior staphyloma. 36 eyes (13.74%) had DSM in our study, of which 8 eyes (22.22%) showed a round dome, 16 (44.44%) were horizontal oval-shaped, 9 (25%) were vertical oval-shaped and 3 (8.34%) were oblique oval-shaped. Both SFCT and SFST were inversely and significantly associated with age and refractive errors. Macular neovascularization was significantly correlated with intrascleral vessels. Different deformation of the sclera and posterior staphyloma were vividly identified on SS OCT images. CONCLUSIONS This study provided a relatively comprehensive picture of posterior pole in HM eyes. Such good visualization of ocular fundus provided by wide-field SS OCT could be useful for the therapy option, disease condition monitoring and pathogenesis investigation.
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Affiliation(s)
- Li-Hui Meng
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ming-Zhen Yuan
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Xin-Yu Zhao
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei-Hong Yu
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - You-Xin Chen
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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26
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Shin YK, Kang SW, Kim SJ, Lee GW, Choi KJ. Assessment of Scleral Contour Changes in High Myopia by Optical Coherence Tomography. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 36:97-107. [PMID: 34823344 PMCID: PMC9013557 DOI: 10.3341/kjo.2021.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to establish and validate optical coherence tomography (OCT) based diagnostic criteria of high myopia. Methods This was a cross-sectional study including 100 eyes of high myopia with axial length larger than 26.5 mm and 100 control eyes, which were examined by spectral-domain OCT. Vertical and horizontal OCT of 9 mm scanning across fovea were analyzed. OCT characteristics including mirror artifact, scleral sink due to steep inclination of posterior sclera, scleral visibility, abnormality of outer retinal layer, foveoschisis, and dome-shaped macula were assessed in each group. Results The mean axial length was 28.65 ± 2.07 mm (range, 26.51–34.59 mm) in high myopia group and 23.79 ± 0.99 mm (range, 21.26–25.94 mm) in control group. Among the OCT characteristics noted at high frequency in the eyes with high myopia, three criteria achieving high sensitivity and specificity were determined: scleral sink over 500 μm, scleral visibility over 100 μm, and dome-shaped macula. Under conditions of presence of any of three criteria in either horizontal or vertical OCT scanning, the diagnostic sensitivity, specificity, positive predictive value, and negative predictive value for high myopia were found to be 95.0%, 98.0%, 98.0%, and 95.1%, respectively. In a new set of OCT images from 50 eyes with high myopia and 50 eyes of nonhigh myopia cases, the OCT-based criteria also proved similar level of diagnostic validity. Conclusions The OCT-based criteria, which directly addressed posterior scleral contour changes, may lead to an intuitive and accurate diagnosis of high myopia. Also, the criteria may contribute to early detection and monitoring of eyes that cannot be defined as high myopia but can progress. OCT may be useful for monitoring high myopia patients as OCT can detect myopia-associated retinal pathologies as well as scleral contour changes.
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Affiliation(s)
- Yong Kyun Shin
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geun Woo Lee
- Department of Ophthalmology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Kyung Jun Choi
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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27
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Wen X, Li Z, Xiao J, Liu X, Zhang Y, Lan Y. Association of Myopia With Microvascular Alterations in Patients With Type 2 Diabetes: An Optical Coherence Tomography Angiography Study. Front Med (Lausanne) 2021; 8:715074. [PMID: 34660628 PMCID: PMC8517071 DOI: 10.3389/fmed.2021.715074] [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: 05/26/2021] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: To determine the association of myopia with peripapillary and macular microvasculature in eyes with type 2 diabetes using optical coherence tomography angiography (OCTA). Methods: Diabetic patients with and without diabetic retinopathy (DR) were recruited and grouped according to myopic status in this cross-sectional study. Axial length, refractive error, and OCTA parameters were measured. OCTA parameters were analyzed with adjustment of confounding factors and further Bonferroni analysis was performed to determine the differences in multiple group comparisons. Results: Compared with the diabetic eyes without myopia, those with myopia had lower rate of DR (21.82 vs. 35.90%, χ2 = 6.190, P = 0.013), longer axial lengths (24.94 ± 0.75 vs. 23.16 ± 0.64, F = 311.055, P < 0.001) and reduced whole vessel density (VD) of optic nerve head (ONH) (45.89 ± 5.76 vs. 49.14 ± 4.33, F = 19.052, P < 0.001), peripapillary VD (48.75 ± 6.56 vs. 50.76 ± 4.51, F = 7.600, P = 0.006), and reduced thickness of the retinal nerve fiber layer (RNFL) (95.50 ± 12.35 vs. 100.67 ± 13.68, F = 5.020, P = 0.026). In eyes without myopia, the superficial vessel density (SVD) (46.58 ± 4.90 vs. 43.01 ± 4.25; 95% CI, 1.80-4.61; P < 0.001), deep vessel density (DVD) (45.64 ± 6.34 vs. 42.15 ± 6.31; 95% CI, 1.07-5.00; P < 0.001), and FD300 area density (50.31 ± 5.74 vs. 44.95 ± 6.96; 95% CI, 2.88-7.27; P < 0.001) were significant reduced in eyes with DR(DR eyes) comparing to those without DR (NoDR eyes). In eyes with myopia, only SVD were significantly reduced in DR eyes comparing to NoDR eyes (41.68 ± 3.34 vs. 45.99 ± 4.17; 95% CI, 1.10-7.22; P = 0.002). In NoDR eyes, both whole VD of ONH and Peripapillary VD demonstrated a significant decrease in eyes with myopia comparing to those without myopia (49.91 ± 4.36 vs. 45.61 ± 6.32; 95% CI, 1.95-6.27; P < 0.001 and 51.36 ± 4.24 vs. 48.52 ± 6.99; 95% CI, 0.56-5.11; P = 0.006, respectively). Conclusions: In diabetic patients, myopic eyes exhibited lower prevalence of DR and thinner thickness of RNFL. The refractive status could possibly impact the retinal microvascular changes from NoDR to DR stage.
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Mendez-Martinez S, Martínez-Rincón T, Subias M, Pablo LE, García-Herranz D, Feijoo JG, Bravo-Osuna I, Herrero-Vanrell R, Garcia-Martin E, Rodrigo MJ. Influence of Chronic Ocular Hypertension on Emmetropia: Refractive, Structural and Functional Study in Two Rat Models. J Clin Med 2021; 10:jcm10163697. [PMID: 34441992 PMCID: PMC8397123 DOI: 10.3390/jcm10163697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/29/2022] Open
Abstract
Chronic ocular hypertension (OHT) influences on refraction in youth and causes glaucoma in adulthood. However, the origin of the responsible mechanism is unclear. This study analyzes the effect of mild-moderate chronic OHT on refraction and neuroretina (structure and function) in young-adult Long-Evans rats using optical coherence tomography and electroretinography over 24 weeks. Data from 260 eyes were retrospectively analyzed in two cohorts: an ocular normotension (ONT) cohort (<20 mmHg) and an OHT cohort (>20 mmHg), in which OHT was induced either by sclerosing the episcleral veins (ES group) or by injecting microspheres into the anterior chamber. A trend toward emmetropia was found in both cohorts over time, though it was more pronounced in the OHT cohort (p < 0.001), especially in the ES group (p = 0.001) and males. IOP and refraction were negatively correlated at week 24 (p = 0.010). The OHT cohort showed early thickening in outer retinal sectors (p < 0.050) and the retinal nerve fiber layer, which later thinned. Electroretinography demonstrated early supranormal amplitudes and faster latencies that later declined. Chronic OHT accelerates emmetropia in Long–Evans rat eyes towards slowly progressive myopia, with an initial increase in structure and function that reversed over time.
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Affiliation(s)
- Silvia Mendez-Martinez
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- Correspondence: ; Tel.: +34-9-7676-5558
| | - Teresa Martínez-Rincón
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Manuel Subias
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Luis E. Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
| | - David García-Herranz
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415 Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
- Health Research Institute, San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
- University Institute for Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Julian García Feijoo
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
- Department of Ophthalmology, San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain
| | - Irene Bravo-Osuna
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415 Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
- Health Research Institute, San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
| | - Rocío Herrero-Vanrell
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415 Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
- Health Research Institute, San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
| | - María J. Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
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29
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Jia X, Wei Y, Song H. Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes. Int Ophthalmol 2021; 41:4175-4185. [PMID: 34350527 DOI: 10.1007/s10792-021-01987-8] [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: 02/07/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To quantitatively evaluate the possible effects of phacoemulsification cataract surgery on macular hemodynamics using optical coherence tomography angiography (OCTA). METHODS This was a prospective observational study. Superficial and deep macular vascular densities, as well as parameters of foveal avascular zone (FAZ), were measured preoperatively (baseline) and at 1 day, 1 week, and 4 weeks postoperatively in normal eyes (≥ 22 mm and ≤ 24 mm) of patients scheduled for phacoemulsification cataract surgery with intraocular lens implantation. The correlations between the rate of change of pre- and postoperative vascular densities and surgical parameters were analyzed. RESULTS A total of 107 eyes of 107 patients were included in this study. Compared to the baseline measurements, no statistically significant variation was found in macular vascular densities at 1 day after the surgery (P > 0.05). Both superficial and deep macular vascular densities were significantly increased postoperatively at weeks 1 and week 4 (P < 0.05; P < 0.05); however, no statistically significant differences were detected in any of the FAZ parameters between the baseline measurements and the entire follow-up period (P > 0.05 for all). Also, no statistically significant correlations were established between main surgical parameters and macular vascular densities changes. CONCLUSIONS In normal eyes, macular blood perfusion gradually increased after phacoemulsification cataract surgery and was stabilized in one week. The foveal avascular zone was stabilized before and after the surgery. The main parameters and intraoperative perfusion of phacoemulsification surgery may not be the key factors affecting macular hemodynamics.
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Affiliation(s)
- Xinyu Jia
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Road, 300020, Heping, Tianjin, China.,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yinjuan Wei
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Road, 300020, Heping, Tianjin, China.,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Hui Song
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Road, 300020, Heping, Tianjin, China. .,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
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Comparison of choroidal thickness measurements between spectral domain optical coherence tomography and swept source optical coherence tomography in children. Sci Rep 2021; 11:13749. [PMID: 34215790 PMCID: PMC8253773 DOI: 10.1038/s41598-021-92980-9] [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: 01/18/2021] [Accepted: 05/28/2021] [Indexed: 11/09/2022] Open
Abstract
Choroidal thickness is associated with many ocular conditions, interchangeability among different generations of optical coherence tomography is therefore important for both research purpose and clinical application. Hence, we compared choroidal thickness measurements between spectral-domain optical coherence tomography (SD-OCT) and swept-source optical coherence tomography (SS-OCT) in healthy paediatric eyes. A total of 114 children from the population-based Hong Kong Children Eye Study with mean age of 7.38 ± 0.82 years were included. Choroidal thickness of the right eye was measured by both devices. The central foveal choroidal thickness (CFCT) measured by SD-OCT and SS-OCT was 273.24 ± 54.29 μm and 251.84 ± 47.12 μm respectively. Inter-device correlation coefficient was 0.840 (95% CI 0.616–0.918). However, choroidal thickness obtained by SD-OCT was significantly thicker than that measured by SS-OCT with a mean difference of 21.40 ± 33.13 μm (P < 0.001). Bland–Altman limit of agreement on the relative difference scale for SD-OCT/SS-OCT was 86.33 μm. Validated conversion equation for translating SD-OCT CFCT measurement into SS-OCT was SS-OCT = 35.261 + 0.810 × SD-OCT. In conclusion, intra-class correlation coefficient (ICC) shows an acceptable agreement between SD-OCT and SS-OCT, however, there was a significant inter-device difference of choroidal thickness measurements in normal children eyes. Therefore, the measurements are not interchangeable.
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Min CH, Al-Qattan HM, Lee JY, Kim JG, Yoon YH, Kim YJ. Macular Microvasculature in High Myopia without Pathologic Changes: An Optical Coherence Tomography Angiography Study. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 34:106-112. [PMID: 32233143 PMCID: PMC7105786 DOI: 10.3341/kjo.2019.0113] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/16/2019] [Accepted: 12/25/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose To investigate macular microvasculature changes using optical coherence tomography angiography (OCTA) and analyze their correlation with the structural parameters in highly myopic eyes. Methods We measured the area of the foveal avascular zone (FAZ) and the parafoveal vessel density in the superficial and deep retinal plexuses using OCTA. The magnification effect of the FAZ area was corrected using Bennett's formula. Retinal thickness measured at each corresponding area of the OCTA parameters, subfoveal choroidal thickness, and ocular characteristics were reviewed, and the relationships between the microvasculature measurements and the ocular structural characteristics were explored. Results Fifty-two eyes with high myopia and 52 normal sex- and age-matched controls were included in the analysis. The FAZ area was significantly larger in the myopic eyes (p = 0.023). The superficial parafoveal vascular density was significantly decreased (p = 0.007) in the myopic eyes compared with the normal eyes, whereas there was no significant difference in the deep parafoveal vascular density (p = 0.226). Regarding the retinal thickness, only the parafoveal inner retinal thickness was significantly smaller in the myopic eyes than in the normal eyes (p = 0.023). The FAZ and subfoveal choroidal thickness were significantly correlated with the axial length, and the parafoveal inner retinal thickness was significantly correlated with the superficial parafoveal vascular density (all p < 0.05). Conclusions The FAZ was enlarged and the parafoveal vascular density was reduced in the highly myopic eyes. The decrease was prominent in the superficial capillary plexuses and well-correlated with the retinal thickness profiles. The macular microvascular network alteration may be attributed to the ocular axial elongation that occurs with myopia.
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Affiliation(s)
- Chan Hong Min
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Joo Yong Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - June Gone Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hee Yoon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoon Jeon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Jain M, Gopal L, Padhi TR. Dome-shaped maculopathy: a review. Eye (Lond) 2021; 35:2458-2467. [PMID: 33875828 DOI: 10.1038/s41433-021-01518-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/25/2021] [Accepted: 03/25/2021] [Indexed: 01/11/2023] Open
Abstract
First described by Gaucher and associates in 2008 in eyes with high myopia, dome-shaped maculopathy (DSM) is an anterior convex protrusion of the macula towards the vitreous cavity observable on OCT. This seems to be related to a localized scleral thickness, which might be the result of regional variation in the scleral bio-mechanical properties and the process of emmetropization causing asymmetric scleral growth. The presence of DSM can be associated with an increased risk of complications. The clinical spectrum ranges from being asymptomatic to metamorphopsia and mild-to-moderate gradual visual loss over years. Visual impairment in DSM results from retinal pigment epithelial changes, sub-foveal serous detachment, retinoschisis and myopic choroidal neovascularization. In this review, we compile and review the available information on the pathophysiology, nomenclature, classification, clinical features including imaging, differential diagnosis, complications associated with DSM and the gaps in our understanding of this entity thus far.
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Affiliation(s)
- Mukesh Jain
- Department of Vitreo-Retinal Services, L.V. Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India.
| | - Lingam Gopal
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Tapas Ranjan Padhi
- Department of Vitreo-Retinal Services, L.V. Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India
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Bontzos G, Xirou T, Gkiala A, Smoustopoulos G, Gkizis I, Kontou E, Kabanarou SA, Tsilimbaris M. Long-term progression of myopic maculopathy in degenerative myopia as imaged by SD-OCT and IR imaging. Clin Exp Optom 2021; 105:26-31. [PMID: 33689624 DOI: 10.1080/08164622.2021.1878820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
CLINICAL RELEVANCE Clinicians can benefit from developing an understanding of the natural disease progression of myopic maculopathy in degenerative myopia using optical coherence tomography (OCT). BACKGROUND The prevalence of high myopia is constantly increasing. In this work, infrared imaging and OCT is used to study the natural course of the disease. METHODS This is a retrospective longitudinal study. Medical records of 72 patients with high myopia (< 6.00 D) and a minimum five-year follow-up period were analysed. Collected data on all enrolled patients included demographic characteristics and medical history, as well as recordings on best-corrected visual acuity, slitlamp examination, OCT, and fluorescein angiography in cases of suspected myopic choroidal neovascularisation. Images were independently marked by two graders. RESULTS The mean age of patients was 54.6 ± 14.4 years (59.72% female) with baseline logMAR best-corrected visual acuity of 0.22 ± 0.28. At baseline examination, 70.83% of the study group showed signs of maculopathy and 62.5% diffuse or patchy atrophy. During follow-up, 22.2% of patients with any type of atrophy showed enlarged affected areas. Two patients with baseline lacquer cracks developed new lesions. There was a weak correlation between patient age and maculopathy progression (r = 0.233; p = 0.03). While central retinal thickness was not associated with maculopathy progression (p = 0.203), a moderate correlation was found between choroidal thickness and maculopathy progression (r = -0.516; p < 0.001). CONCLUSION Lesion characteristics in myopic degeneration have been elucidated, taking advantage of the ongoing technological advances in retinal imaging. The understanding of disease patterns and progression is essential for appropriate management of patients, while discovering biomarkers which lead to choroidal neovascularisation development is of urgent importance to establish international diagnostic criteria and treatment protocols.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, Korgialenio-Benakio General Hospital, Athens, Greece.,Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
| | - Tina Xirou
- Department of Ophthalmology, Korgialenio-Benakio General Hospital, Athens, Greece
| | - Anastasia Gkiala
- Department of Ophthalmology, Korgialenio-Benakio General Hospital, Athens, Greece
| | | | - Ilias Gkizis
- Department of Ophthalmology, Korgialenio-Benakio General Hospital, Athens, Greece
| | - Evgenia Kontou
- Department of Ophthalmology, Korgialenio-Benakio General Hospital, Athens, Greece
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Li T, Guadie A, Feng L, Fan J, Jiang Z, Liu F. Influence of cataract surgery on macular vascular density in patients with myopia using optical coherence tomography angiography. Exp Ther Med 2020; 20:258. [PMID: 33199984 DOI: 10.3892/etm.2020.9388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/01/2020] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to evaluate macular vascular density (MVD) variation after uneventful cataract surgery using optical coherence tomography angiography (OCTA) in patients with high myopia. Patients with cataracts scheduled for cataract surgery were divided into a high-myopia group [spherical equivalent (SE)≤-6.0 diopter (D) and axial length (AL)≥25 mm] and a low-myopia group (SE>-6.0 D and AL<25 mm). All patients were examined for MVD and retinal thickness (RT) with OCTA pre-operatively and post-operatively (1 day, 1 week, and 1 and 3 months after surgery). A total of 55 eyes from 44 patients were included. MVD and RT both changed after cataract surgery. The mean change in superficial vascular density (SVD) in patients with high myopia was significantly lower than that in the low-myopia group at the four post-operative time-points (all P<0.05). In addition, the RT of eyes with high myopia exhibited a different variation compared with that of the low-myopia group. Significant correlations were identified between AL, RT, intraocular pressure and SVD after surgery. In conclusion, superficial retinal perfusion in patients with high myopia was significantly lower than that in low myopia patients, which may lead to complications caused by poor perfusion.
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Affiliation(s)
- Tingting Li
- Department of Ophthalmology, 10th People's Hospital Affiliated to Tongji University, Shanghai 200072, P.R. China
| | - Awoke Guadie
- Department of Biology, College of Natural Sciences, Arba Minch University, 21 Arba Minch, Ethiopia
| | - Le Feng
- Department of Ophthalmology, 10th People's Hospital Affiliated to Tongji University, Shanghai 200072, P.R. China
| | - Jianwu Fan
- Department of Ophthalmology, 10th People's Hospital Affiliated to Tongji University, Shanghai 200072, P.R. China
| | - Ziyuan Jiang
- Department of Ophthalmology, Clinical Medical College of Shanghai 10th People's Hospital of Nanjing Medical University, Shanghai 200072, P.R. China
| | - Fang Liu
- Department of Ophthalmology, 10th People's Hospital Affiliated to Tongji University, Shanghai 200072, P.R. China
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AlTaisan A, Magliyah M, Abouammoh MA, Taskintuna I, Alzahrani Y, Chang E, Alsulaiman SM. Posterior Segment Characterization in Children With Pierson Syndrome. Ophthalmic Surg Lasers Imaging Retina 2020; 51:618-627. [DOI: 10.3928/23258160-20201104-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/10/2020] [Indexed: 01/25/2023]
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Cheng Y, Yan L, Hu L, Wu H, Huang X, Tian Y, Wu X. Differences in network centrality between high and low myopia: a voxel-level degree centrality study. Acta Radiol 2020; 61:1388-1397. [PMID: 32098475 DOI: 10.1177/0284185120902385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous studies have linked high myopia (HM) to brain activity, and the difference between HM and low myopia (LM) can be assessed. PURPOSE To study the differences in functional networks of brain activity between HM and LM by the voxel-level degree centrality (DC) method. MATERIAL AND METHODS Twenty-eight patients with HM (10 men, 18 women), 18 patients with LM (4 men, 14 women), and 59 healthy controls (27 men, 32 women) were enrolled in this study. The voxel-level DC method was used to assess spontaneous brain activity. Correlation analysis was used to explore the change of average DC value in different brain regions, in order to analyze differences in brain activity between HM and LM. RESULTS DC values of the right cerebellum anterior lobe/brainstem, right parahippocampal gyrus, and left caudate in HM patients were significantly higher than those in LM patients (P < 0.05). In contrast, DC values of the left medial frontal gyrus, right inferior frontal gyrus, left middle frontal gyrus, and left inferior parietal lobule were significantly lower in patients with HM (P < 0.05). However, there was no correlation between behavior and average DC values in different brain regions (P < 0.05). CONCLUSION Different changes in brain regions between HM and LM may indicate differences in neural mechanisms between HM and LM. DC values could be useful as biomarkers for differences in brain activity between patients with HM and LM. This study provides a new method to assess differences in functional networks of brain activity between patients with HM and LM.
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Affiliation(s)
- Yi Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Li Yan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Liqun Hu
- Department of Ophthalmology, Ganzhou People's Hospital of Jiangxi Province, PR China
| | - Hongyun Wu
- Department of Ophthalmology, Ganzhou People's Hospital of Jiangxi Province, PR China
| | - Xin Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Yu Tian
- Department of Ophthalmology, Ganzhou People's Hospital of Jiangxi Province, PR China
| | - Xiaorong Wu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
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Hayashi K, Manabe SI, Hirata A, Yoshimura K. Posterior Vitreous Detachment in Highly Myopic Patients. Invest Ophthalmol Vis Sci 2020; 61:33. [PMID: 32334432 PMCID: PMC7401972 DOI: 10.1167/iovs.61.4.33] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose We compared the change in the state of posterior vitreous detachment (PVD) between highly myopic eyes and non-highly myopic eyes using age- and sex-matched patients. Methods Six hundred eyes of 600 patients with high myopia (axial length > 26.0 mm) or without high myopia were enrolled into each of six age categories with 50 eyes each: (1) 20 to 29 years, (2) 30 to 39 years, (3) 40 to 49 years, (4) 50 to 59 years, (5) 60 to 69 years, and (6) 70 to 79 years. The PVD status was evaluated using swept-source optical coherence tomography and classified into five stages: 0 (no PVD), 1 (paramacular PVD), 2 (perifoveal PVD), 3 (peripapillary PVD), and 4 (complete PVD). Results In the high myopia and non-high myopia groups, the mean PVD stage increased significantly with the age category (P < 0.0001). The PVD stage was significantly greater in the high myopia group than in the non-high myopia group in all age categories (P ≤ 0.0395). In the age groups of patients 50 to 59 years old and 60 to 69 years old, complete PVD was detected in 54.0% and 73.9% of eyes, respectively, in the high myopia group and in 14.0% and 44.0% of eyes, respectively, in the non-high myopia group. Abnormal PVD characteristics of pathologic myopia were detected in 1.7% of eyes in the high myopia group. Conclusions We precisely revealed, using age- and sex-matched patients, that partial PVD, including paramacular, perifoveal, and peripapillary PVD, and complete PVD develop at a significantly younger age in highly myopic eyes compared with non-highly myopic eyes, suggesting that PVD-related retinal pathologies occur younger in highly myopic patients.
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Matsumura S, Sabanayagam C, Wong CW, Tan CS, Kuo A, Wong YL, Ohno-Matsui K, Wong TY, Cheng CY, Hoang QV, Saw SM. Characteristics of myopic traction maculopathy in myopic Singaporean adults. Br J Ophthalmol 2020; 105:531-537. [PMID: 32447325 DOI: 10.1136/bjophthalmol-2020-316182] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/17/2020] [Accepted: 05/04/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To investigate the characteristics, risk factors and visual impact of myopic traction maculopathy (MTM) among adults with myopia in Singapore. METHODS We analysed 3316 myopic eyes of adults aged over 40 years who participated in the Singapore Epidemiology of Eye Diseases-2 study. Detailed questionnaires and ophthalmic examinations were conducted. A total of 2913 myopic eyes of 1639 subjects were graded for MTM by spectral-domain optical coherence tomography. MTM is defined as the presence of retinoschisis, lamellar or full-thickness macula hole and foveal retinal detachment. Fundus photographs were graded for myopic macular degeneration (MMD). RESULTS Of these 2913 myopic eyes, the mean and SD of age was 60.1±8.0 years; the spherical equivalent (SE) was -2.5±2.3 D; and the axial length (AL) was 24.6±1.3 mm. MTM was found in 0.9% of myopic eyes and 7.3% of highly myopic eyes. In the multivariate analysis, myopic SE (p<0.001), longer AL (p<0.001), MMD (p=0.01) and epiretinal traction (p<0.001) were independent risk factors for MTM. MTM was not associated with age (p=0.38). MTM was significantly associated with poorer best-corrected visual acuity (BCVA) (p<0.01). CONCLUSIONS Our population-based study revealed that MTM was present in 0.9% of myopic eyes and 7.3% of highly myopic eyes. While greater myopic SE, longer AL, MMD and epiretinal traction are risk factors of MTM, age was not related to MTM. MTM has a negative effect on BCVA.
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Affiliation(s)
- Saiko Matsumura
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Chee Wai Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Anthony Kuo
- Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA.,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Yee Ling Wong
- R&D Vision Sciences, AMERA, Essilor International, Singapore
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,National University of Singapore, Singapore
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Harkness Eye Research Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Seang Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore .,Duke-NUS Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Agarwal A, Aggarwal K, Gupta V. Swept-source optical coherence tomography angiography of choroidal neovascularization in vertically oriented oval dome-shaped maculopathy. Indian J Ophthalmol 2019; 67:1368-1371. [PMID: 31332147 PMCID: PMC6677086 DOI: 10.4103/ijo.ijo_2077_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 48-year-old female presented with complaints of recent onset diminution of vision of the left eye (OS) for the past 2 months. She was highly myopic and was using glasses for the past 30 years. Ocular examination revealed presence of a myopic fundus with high axial lengths in both the eyes. Fundus examination of the OS revealed a myopic tessellated fundus with prominent choroidal vessels and a blunted foveal reflex. There was a small pale whitish lesion just superior to the foveal center. Optical coherence tomography (OCT) scans (both horizontal and vertical) confirmed presence of dome-shaped maculopathy. There was subretinal fluid in the OS. A vertical OCT scan also revealed a subretinal hyperreflective material, which was confirmed to be due to a small mixed type 1 and type 2 choroidal neovascularization (CNV) on swept-source (SS) OCT angiography in the OS. The patient was given intravitreal injection of ranibizumab (0.5 mg/0.05 mL) in the OS. At 1-month follow-up, the subretinal fluid completely resolved. The CNV lesion regressed significantly on SS-OCT angiography. The best-corrected visual acuity improved from 20/80 to 20/20 in the OS, which was maintained at 3 months of follow-up.
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Affiliation(s)
- Aniruddha Agarwal
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kanika Aggarwal
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vishali Gupta
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Minami S, Shinoda H, Shigeno Y, Nagai N, Kurihara T, Watanabe K, Sonobe H, Takagi H, Tsubota K, Ozawa Y. Effect of axial length and age on the visual outcome of patients with idiopathic epiretinal membrane after pars plana vitrectomy. Sci Rep 2019; 9:19056. [PMID: 31836768 PMCID: PMC6911110 DOI: 10.1038/s41598-019-55544-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/30/2019] [Indexed: 11/12/2022] Open
Abstract
We evaluated predictive factors for visual outcomes in patients with idiopathic epiretinal membrane (iERM) after pars plana vitrectomy (PPV). Clinical records for 114 eyes (114 patients, mean age: 70.6 years) with iERM treated by PPV between March 2012 and March 2018 were retrospectively reviewed. Overall, the mean postoperative best-corrected visual acuity (BCVA) and central retinal thickness measured by optical coherence tomography improved as early as 1 month after surgery, and further improved until 3 months (P < 0.01). Multiple linear regression analyses adjusted for the preoperative BCVA showed that older age (B, 0.010; 95% confidence interval, 0.003 to 0.016; P = 0.003) and a shorter axial length (AL; B, −0.059; 95% confidence interval, −0.099 to −0.019; P = 0.005) predicted worse postoperative BCVA. The Mann-Whitney U test showed that the postoperative BCVA was worse in eyes with AL < 23.6 mm than in eyes with AL ≥ 23.6 mm (P = 0.037), and in patients aged ≥69 years than in patients aged <69 years (P = 0.024). The findings may help in evaluating surgical indications for each patient to obtain satisfactory outcomes, irrespective of the preoperative BCVA.
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Affiliation(s)
- Sakiko Minami
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Inagi Municipal Hospital, Tokyo, Japan.,Department of Ophthalmology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hajime Shinoda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yuta Shigeno
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Norihiro Nagai
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Laboratory of Retinal Cell Biology, Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Watanabe
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Sonobe
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Hitoshi Takagi
- Department of Ophthalmology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yoko Ozawa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. .,Laboratory of Retinal Cell Biology, Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
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Ma IH, Hsieh YT, Yeh PT, Yang CH, Yang CM. Long-term results and risk factors influencing outcome of gas tamponade for myopic foveoschisis with foveal detachment. Eye (Lond) 2019; 34:392-399. [PMID: 31406352 DOI: 10.1038/s41433-019-0555-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/07/2019] [Accepted: 07/05/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To evaluate the long-term results of gas tamponade without vitrectomy in patients with myopic foveoschisis (FS) and foveal detachment (FD). METHODS Twenty eyes of 20 patients with myopic foveoschisis and foveal detachment were analysed retrospectively. All patients received an intravitreal injection of 0.2-0.3 mL C3F8 as an initial treatment. The patients were followed up for at least 18 months after the procedure. The refractive status, best-corrected visual acuity (BCVA), and anatomical abnormalities in macular area before and after the treatment were assessed and recorded. RESULTS After initial gas tamponade, FD resolved completely (defined as responders) in 14 eyes, resolved partially in 2 eyes (defined as partial responders), and worsened in 4 eyes (non-responders) at the 3-month follow-up visit. Vitrectomy was performed in four eyes that showed increased detachment (two cases) or developed macular hole (two cases). Repeated gas injection was performed in two recurrent cases after initial success at the 3-month follow-up, and the foveal detachment once again resolved. Overall, 70% of our cases demonstrated resolution of FD at the 3-month follow-up and the long-term responders to gas injection was 65%. The risk factors for treatment failure were: (1) The presence of optical coherence tomography (OCT)-evident premacular membranes (p = 0.03) and (2) the height of FS measured >588 µm (p = 0.009). CONCLUSION Our data supported that gas tamponade may be effective as an alternative treatment for selected cases of myopic FS with FD. The procedure may be especially beneficial in patients without OCT-evident premacular membranes and have low height of FS.
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Affiliation(s)
- I-Hsin Ma
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhongzheng District, Taipei, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhongzheng District, Taipei, Taiwan
| | - Po-Ting Yeh
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhongzheng District, Taipei, Taiwan
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhongzheng District, Taipei, Taiwan.,College of Medicine, National Taiwan University, No. 1, Section 1, Ren-Ai Road, Zhongzheng District, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Zhongzheng District, Taipei, Taiwan. .,College of Medicine, National Taiwan University, No. 1, Section 1, Ren-Ai Road, Zhongzheng District, Taipei, Taiwan.
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Yang H, Luo H, Gardiner SK, Hardin C, Sharpe GP, Caprioli J, Demirel S, Girkin CA, Liebmann JM, Mardin CY, Quigley HA, Scheuerle AF, Fortune B, Chauhan BC, Burgoyne CF. Factors Influencing Optical Coherence Tomography Peripapillary Choroidal Thickness: A Multicenter Study. Invest Ophthalmol Vis Sci 2019; 60:795-806. [PMID: 30811523 PMCID: PMC6392476 DOI: 10.1167/iovs.18-25407] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To quantify peripapillary choroidal thickness (PCT) and the factors that influence it in healthy participants who represent the racial and ethnic composition of the U.S. population. Methods A total of 362 healthy participants underwent optical coherence tomography (OCT) enhanced depth imaging of the optic nerve head with a 24 radial B-scan pattern aligned to the fovea to Bruch's membrane opening axis. Bruch's membrane, anterior scleral canal opening (ASCO), and the anterior scleral surface were manually segmented. PCT was measured at 100, 300, 500, 700, 900, and 1100 μm from the ASCO globally and within 12 clock-hour sectors. The effects of age, axial length, intraocular pressure, ethnicity, sex, sector, and ASCO area on PCT were assessed by ANOVA and univariable and multivariable regressions. Results Globally, PCT was thicker further from the ASCO border and thinner with older age, longer axial length, larger ASCO area, European descent, and female sex. Among these effectors, age and axial length explained the greatest proportion of variance. The rate of age-related decline increased further from the ASCO border. Sectorally, the inferior-temporal sectors were thinnest (10.7%-20.0% thinner than the thickest sector) and demonstrated a higher rate of age-related loss (from 15.6% to 20.7% faster) at each ASCO distance. Conclusions In healthy eyes, PCT was thinnest in the inferior temporal sectors and thinner PCT was associated with older age, European descent, longer axial length, larger ASCO area, and female sex. Among these associations, age had the strongest influence, and its effect was greatest within the inferior temporal sectors.
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Affiliation(s)
- Hongli Yang
- Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
| | - Haomin Luo
- Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States.,Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China
| | - Stuart K Gardiner
- Devers Eye Institute, Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
| | - Christy Hardin
- Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
| | - Glen P Sharpe
- Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joseph Caprioli
- Jules Stein Eye Institute, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California, United States
| | - Shaban Demirel
- Devers Eye Institute, Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
| | - Christopher A Girkin
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Jeffrey M Liebmann
- Einhorn Clinical Research Center, Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of Mount Sinai Health System, New York, United States
| | | | - Harry A Quigley
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | | | - Brad Fortune
- Devers Eye Institute, Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, United States
| | - Balwantray C Chauhan
- Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claude F Burgoyne
- Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, United States
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Chua J, Schwarzhans F, Nguyen DQ, Tham YC, Sia JT, Lim C, Mathijia S, Cheung C, Tin A, Fischer G, Cheng CY, Vass C, Schmetterer L. Compensation of retinal nerve fibre layer thickness as assessed using optical coherence tomography based on anatomical confounders. Br J Ophthalmol 2019; 104:282-290. [PMID: 31118184 PMCID: PMC7025730 DOI: 10.1136/bjophthalmol-2019-314086] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/04/2019] [Accepted: 04/27/2019] [Indexed: 01/07/2023]
Abstract
Background/Aims To compensate the retinal nerve fibre layer (RNFL) thickness assessed by spectral-domain optical coherence tomography (SD-OCT) for anatomical confounders. Methods The Singapore Epidemiology of Eye Diseases is a population-based study, where 2698 eyes (1076 Chinese, 704 Malays and 918 Indians) with high-quality SD-OCT images from individuals without eye diseases were identified. Optic disc and macular cube scans were registered to determine the distance between fovea and optic disc centres (fovea distance) and their respective angle (fovea angle). Retinal vessels were segmented in the projection images and used to calculate the circumpapillary retinal vessel density profile. Compensated RNFL thickness was generated based on optic disc (ratio, orientation and area), fovea (distance and angle), retinal vessel density, refractive error and age. Linear regression models were used to investigate the effects of clinical factors on RNFL thickness. Results Retinal vessel density reduced significantly with increasing age (1487±214 µm in 40–49, 1458±208 µm in 50–59, 1429±223 µm in 60–69 and 1415±233 µm in ≥70). Compensation reduced the variability of RNFL thickness, where the effect was greatest for Chinese (10.9%; p<0.001), followed by Malays (6.6%; p=0.075) and then Indians (4.3%; p=0.192). Compensation reduced the age-related RNFL decline by 55% in all participants (β=−3.32 µm vs β=−1.50 µm/10 years; p<0.001). Nearly 62% of the individuals who were initially classified as having abnormally thin RNFL (outside the 99% normal limits) were later reclassified as having normal RNFL. Conclusions RNFL thickness compensated for anatomical parameters reduced the variability of measurements and may improve glaucoma detection, which needs to be confirmed in future studies.
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Affiliation(s)
- Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Florian Schwarzhans
- Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Duc Quang Nguyen
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Josh Tjunrong Sia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Claire Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Shivani Mathijia
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Carol Cheung
- Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Aung Tin
- Singapore National Eye Centre, Singapore, Singapore
| | - Georg Fischer
- Section for Medical Information Management and Imaging, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Ching-Yu Cheng
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Clemens Vass
- Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Kuo AN, McNabb RP, Izatt JA. Advances in Whole-Eye Optical Coherence Tomography Imaging. Asia Pac J Ophthalmol (Phila) 2019; 8:99-104. [PMID: 30907077 PMCID: PMC6955390 DOI: 10.22608/apo.201901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Contemporary anterior segment and retinal optical coherence tomography (OCT) systems only image their particular designated region of the eye and cannot image both areas of the eye at the same time. This separation is due to the differences in optical system design needed to properly image the front or back of the eye and also due to limitations in the imaging depth of current commercial OCT systems. More recently, research and commercial OCT systems capable of "whole-eye" imaging have been described. These whole-eye OCT systems enable applications such as ocular biometry for cataract surgery, ocular shape analysis for myopia, and others. Further, these whole-eye OCT systems allow us to image the eye as an integrated whole rather than as separate, independent divisions.
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Affiliation(s)
- Anthony N. Kuo
- Ophthalmology, Duke University School of Medicine, Durham, NC USA
- Biomedical Engineering, Duke University, Durham, NC USA
| | - Ryan P. McNabb
- Ophthalmology, Duke University School of Medicine, Durham, NC USA
| | - Joseph A. Izatt
- Ophthalmology, Duke University School of Medicine, Durham, NC USA
- Biomedical Engineering, Duke University, Durham, NC USA
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FACTORS ASSOCIATED WITH SEROUS RETINAL DETACHMENT IN HIGHLY MYOPIC EYES WITH VERTICAL OVAL-SHAPED DOME. Retina 2019; 39:587-593. [DOI: 10.1097/iae.0000000000001970] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
Since its introduction by Charles L. Schepens, macular buckle (MB) surgery has evolved over the past 60 years. Optical coherence tomography (OCT) has given a paradigm shift to the understanding of myopic macula, thereby helping in objective evaluation of the various manifestation of traction maculopathy. Staphyloma evaluation by ultrasound, wide-field fundus photography, and MRI scans along with OCT has led to the resurgence of MB surgery in the treatment of myopic traction maculopathy (MTM). Various surgical techniques with different buckle materials are being performed with encouraging anatomical and functional success rates. This article reviews the literature to explain the current concept of MB surgery based on its evolution, different kinds of buckle materials, rationale for planning MB surgery, and different surgical techniques for the management of MTM.
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Affiliation(s)
- Pradeep Susvar
- Department of Vitreoretina, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Gitanjli Sood
- Department of Vitreoretina, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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47
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Ang M, Wong CW, Hoang QV, Cheung GCM, Lee SY, Chia A, Saw SM, Ohno-Matsui K, Schmetterer L. Imaging in myopia: potential biomarkers, current challenges and future developments. Br J Ophthalmol 2019; 103:855-862. [DOI: 10.1136/bjophthalmol-2018-312866] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/20/2018] [Accepted: 12/22/2018] [Indexed: 12/21/2022]
Abstract
Myopia is rapidly increasing in Asia and around the world, while it is recognised that complications from high myopia may cause significant visual impairment. Thus, imaging the myopic eye is important for the diagnosis of sight-threatening complications, monitoring of disease progression and evaluation of treatments. For example, recent advances in high-resolution imaging using optical coherence tomography may delineate early myopic macula pathology, optical coherence tomography angiography may aid early choroidal neovascularisation detection, while multimodal imaging is important for monitoring treatment response. However, imaging the eye with high myopia accurately has its challenges and limitations, which are important for clinicians to understand in order to choose the best imaging modality and interpret the images accurately. In this review, we present the current imaging modalities available from the anterior to posterior segment of the myopic eye, including the optic nerve. We summarise the clinical indications, image interpretation and future developments that may overcome current technological limitations. We also discuss potential biomarkers for myopic progression or development of complications, including basement membrane defects, and choroidal atrophy or choroidal thickness measurements. Finally, we present future developments in the field of myopia imaging, such as photoacoustic imaging and corneal or scleral biomechanics, which may lead to innovative treatment modalities for myopia.
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48
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Qu D, Lin Y, Jiang H, Shao Y, Shi Y, Airen S, Gregori G, Wang J. Retinal nerve fiber layer (RNFL) integrity and its relations to retinal microvasculature and microcirculation in myopic eyes. EYE AND VISION 2018; 5:25. [PMID: 30349842 PMCID: PMC6190551 DOI: 10.1186/s40662-018-0120-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/26/2018] [Indexed: 11/10/2022]
Abstract
Background The aim was to determine retinal nerve fiber layer function and its relations to retinal microvasculature and microcirculation in patients with myopia. Method Polarization-sensitive optical coherence tomography (PS-OCT) was used to measure phase retardation per unit depth (PR/UD, proportional to the birefringence) of the retinal nerve fiber layer (RNFL). Optical coherence tomography angiography (OCTA) was used to measure macular vessel density analyzed using fractal analysis. In addition, a retinal function imager (RFI) was used to measure macular blood flow velocities in arterioles and venules. Twenty-two patients with moderate myopia (MM, refraction > 3 and < 6 diopters), seventeen patients with high myopia (HM, ≥ 6 D) and 29 healthy control subjects (HC, ≤ 3.00 D) were recruited. One eye of each patient was imaged. Results Although the average PR/UD of the RNFL in the HM group did not reach a significant level, the birefringence of the inferior quadrant was significantly lower (P < 0.05) in the HM group compared to the HC group. Significant thinning of the average RNFL and focal thinning of RFNL in temporal, superior and inferior quadrants in the HM group were found, compared to the HC group (P < 0.05). There were no significant differences of retinal blood flow velocities in arterioles and venules among groups (P > 0.05). The macular vessel density in both superficial and deep vascular plexuses was significantly lower in the HM group than in the other two groups (P < 0.05) as well as in the MM group than in the HC group (P < 0.05). The average PR/UD and PR/UD in the inferior quadrant were not related to refraction, axial length, blood flow velocities and macular vessel densities (r ranged from − 0.09 to 0.19, P > 0.05). Conclusions The impairment of the retinal nerve fiber birefringence in the HM group may be one of the independent features in high myopic eyes, which appeared not to relate to macular microvascular density and blood flow velocity.
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Affiliation(s)
- Dongyi Qu
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Ying Lin
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA.,2State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Hong Jiang
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA.,3Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Yi Shao
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Yingying Shi
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Shriya Airen
- 4College of Arts and Sciences, University of Miami, Miami, FL USA
| | - Giovanni Gregori
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Jianhua Wang
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA.,5Department of Ophthalmology Bascom Palmer Eye Institute, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
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Bhende M, Shetty S, Parthasarathy MK, Ramya S. Optical coherence tomography: A guide to interpretation of common macular diseases. Indian J Ophthalmol 2018; 66:20-35. [PMID: 29283118 PMCID: PMC5778576 DOI: 10.4103/ijo.ijo_902_17] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Optical coherence tomography is a quick, non invasive and reproducible imaging tool for macular lesions and has become an essential part of retina practice. This review address the common protocols for imaging the macula, basics of image interpretation, features of common macular disorders with clues to differentiate mimickers and an introduction to choroidal imaging. It includes case examples and also a practical algorithm for interpretation.
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Affiliation(s)
- Muna Bhende
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Sharan Shetty
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Mohana Kuppuswamy Parthasarathy
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India; School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - S Ramya
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
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50
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Qiu K, Wang G, Zhang R, Lu X, Zhang M, Jansonius NM. Influence of optic disc-fovea distance on macular thickness measurements with OCT in healthy myopic eyes. Sci Rep 2018; 8:5233. [PMID: 29588514 PMCID: PMC5869586 DOI: 10.1038/s41598-018-23479-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 01/29/2018] [Indexed: 02/07/2023] Open
Abstract
Assessment of macular thickness is important in the evaluation of various eye diseases. This study aimed to determine the influence of the optic disc-fovea distance (DFD) on macular thickness in myopic eyes. We determined the DFD and the macular thickness in 138 eyes from 138 healthy myopic subjects using the Cirrus HD-OCT. Correlation analysis and multiple linear regression were performed to determine the influence of DFD, axial length, disc area, and β-PPA on macular thickness. To further remove the confounding effect of ocular magnification on the DFD and OCT scan area, a subgroup analysis was performed in eyes with a limited axial length range (24-25 mm). DFD was significantly correlated with both regional (central, inner, and outer ETDRS subfields) and overall average macular thickness at a Bonferroni corrected P value of 0.004 (r ranging from -0.27 to -0.47), except for the temporal outer (r = -0.15, P = 0.089) and inferior outer (r = -0.22, P = 0.011) macular thickness. In the multivariable analysis, DFD was significantly associated with the average inner and outer macular thickness, the central subfield thickness, and the overall macular thickness (all P < 0.001), independent of ocular magnification and other covariates. Our findings indicate that eyes with a greater DFD have a lower macular thickness.
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Affiliation(s)
- Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, The People's Republic of China.,Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Geng Wang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, The People's Republic of China
| | - Riping Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, The People's Republic of China
| | - Xuehui Lu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, The People's Republic of China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong Province, The People's Republic of China.
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
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