Prepapillary vascular loop-a new classification

The RETA Benchmark for Retinal Vascular Tree Analysis

Topological and geometrical analysis of retinal blood vessels could be a cost-effective way to detect various common diseases. Automated vessel segmentation and vascular tree analysis models require powerful generalization capability in clinical applications. In this work, we constructed a novel benchmark RETA with 81 labelled vessel masks aiming to facilitate retinal vessel analysis. A semi-automated coarse-to-fine workflow was proposed for vessel annotation task. During database construction, we strived to control inter-annotator and intra-annotator variability by means of multi-stage annotation and label disambiguation on self-developed dedicated software. In addition to binary vessel masks, we obtained other types of annotations including artery/vein masks, vascular skeletons, bifurcations, trees and abnormalities. Subjective and objective quality validations of the annotated vessel masks demonstrated significantly improved quality over the existing open datasets. Our annotation software is also made publicly available serving the purpose of pixel-level vessel visualization. Researchers could develop vessel segmentation algorithms and evaluate segmentation performance using RETA. Moreover, it might promote the study of cross-modality tubular structure segmentation and analysis.

The prevalance of congenital optic disc anomalies in Turkey: a hospital-based study

PURPOSE

The aim of this study was to investigate the prevalence of congenital optic disc anomalies in Turkey.

METHODS

The 11,123 eyes of 5570 patients were screened for optic disc anomalies. All patients were underwent a complete ophthalmic examination including best corrected visual acuity, refraction, spherical equivalent, slit lamp biomicroscopy, intraocular pressure measurements, dilated stereoscopic fundus examination. Data analyses were performed by using SPSS for Windows, version 22.0 (SPSS Inc., Chicago, IL, United States).

RESULTS

11,123 eyes of 5570 participants were screened. Of the 5570 participants who underwent optic disc examination, 246 eyes of 174 patients (3.12%, 95% CIs 2.66-3.58%) had optic disc anormalies. 92 (52.9%) were female, 82 (47.1%) were male and the mean of age was 44.25 ± 15.67 years. 72 (41.4%) patients were bilateral, 102 (58.6%) patients were unilateral involvement. The tilted disc was the most common anomaly and was found at least one eye in 46 patients (75 eyes) and 0.83% of all screened patients. Peripapillary myelinated nerve fibers was the second common anomaly and was found at least one eye in 31 subjects (35 eyes) and 0.56% of all screened subjects. Peripapillary atrophy was the third common anomaly, and was found in at least one eye in 24 patients (37 eyes) and 0.43% of all screened subjects.

CONCLUSION

To our knowledge, this is the first study that the prevalences of all congenital optic disc anomalies from Turkey. The prevalence of congenital optic disc anomalies is higher than in other countries.

Ocular ischaemia: signs, symptoms, and clinical considerations for primary eye care practitioners

Ischaemic stroke is a major disease burden as well as a leading cause of death. Early signs of ischaemic stroke can manifest in the eye, placing primary eyecare practitioners in an important position to identify patients at risk of ischaemic stroke and initiate suitable referral pathways. The vascular supply to the brain is reviewed with reference to vision including the various retinal signs and ocular symptoms associated with transient ischaemic attacks and ischaemic stroke. Using a range of clinical cases, the diverse clinical presentations of retinal embolic events, as well as other forms of vascular occlusion, are highlighted and the underlying pathophysiology is discussed. A succinct scheme for the assessment and management of ischaemic events for primary eye care practitioners is provided.

Pre- and juxtapapillary arterial loops in eyes with tilted disc syndrome and inferior staphyloma

Purpose

To report and discuss the association between pre- or juxtapapillary arterial loops and tilted disc syndrome (TDS).

Observations

Three patients, aged 43–59 years, with both conditions were examined in a tertiary referral center, and underwent fluorescein angiography, optical coherence tomography (OCT) and/or OCT-angiography. They all presented with a typical inferior staphyloma associated with TDS and anomalies of insertion of retinal vessels. The vascular malformation consisted in one acquired arterial loop or cilioretinal collateral circulation occurring after central artery occlusion, and two more complex pre- and juxtapapillary arterial loops. In all cases, the vascular loops extended inferiorly, in the area of the staphyloma.

Conclusion and importance

We hypothesized that the local anatomical changes in the peripapillary area, observed in eyes with TDS and inferior staphyloma, could have promoted the occurrence and/or extent of the arterial loops.

Prepapillary Arterial Loop Associated with Central Retinal Artery Occlusion: A Case Report

Purpose:

To report a case of central retinal artery (CRA) occlusion secondary to prepapillary loop in a 13-year-old girl.

Methods:

A 13-year-old girl presented with a history of sudden visual loss in her left eye.

Results:

Fundus examination confirmed thrombosis in a prepapillary arterial loop causing CRA occlusion and extensive retinal ischemia. Macular region was watered by an anomalous macular branch, which explained her 20/20 vision central vision.

Conclusion:

Congenital prepapillary vascular loops are rare and usually asymptomatic. We report a case of central artery occlusion confirmed by multimodal imaging.