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Holzwarth J, Krohne TU, Lommatzsch A, Priglinger SG, Hattenbach LO. [Epiretinal membrane: diagnostics, indications and surgical treatment]. DIE OPHTHALMOLOGIE 2024; 121:443-451. [PMID: 38831204 DOI: 10.1007/s00347-024-02055-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/05/2024]
Abstract
An epiretinal membrane (ERM) is a frequently occurring disease affecting the macula, which can be associated with visual impairment and metamorphopsia, depending on the severity and location. A distinction is made between an idiopathic form caused by age-related changes of the vitreous body and a secondary form associated with diseases of the posterior segment. The development of fibrocellular epiretinal membranes formed by dedifferentiation of intraretinal and extraretinal cells at the level of the vitreomacular interface plays a major role in the pathogenesis. The diagnostics and indications for surgical treatment of ERM are based on the visual acuity, evidence of metamorphopsia, ophthalmoscopic findings and optical coherence tomography (OCT) of the macula. In addition to the possibility of observation of the course where benign spontaneous courses are not uncommon, pars plana vitrectomy (PPV) with peeling of the ERM and internal limiting membrane (ILM) to prevent recurrences is the treatment of choice in symptomatic patients. The prognosis after surgical treatment is very good. In approximately two thirds of the cases, an improvement in visual acuity and/or a reduction of metamorphopsia can be achieved, with a number of predictive, primarily OCT-based factors enabling a prediction of the functional prognosis. Comprehensive patient education regarding the generally long duration of postoperative rehabilitation and the possibility of persistent symptoms or visual deterioration despite successful membrane removal is essential.
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Affiliation(s)
- Jakob Holzwarth
- Augenklinik, Klinikum Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen am Rhein, Deutschland
| | - Tim U Krohne
- Augenzentrum, St. Franziskus Hospital, Münster, Deutschland
| | - Albrecht Lommatzsch
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland
| | | | - Lars-Olof Hattenbach
- Augenklinik, Klinikum Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen am Rhein, Deutschland.
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Wan Y, Chen T, Li Y, Yang Y, Wang Y, Wang Y, Li X, Yang A, Xiao X. Clinical application of multicolor scanning laser ophthalmology in diagnosis and grading of central retinal artery occlusion. Front Neurosci 2024; 18:1327806. [PMID: 38660228 PMCID: PMC11039857 DOI: 10.3389/fnins.2024.1327806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Purpose To characterize features of central retinal artery occlusion (CRAO) using multicolor (MC) imaging and to assess the differences in CRAO grading between color fundus photography (CFP) and MC image qualitatively and quantitatively. Methods We conducted a prospective, cross-sectional study in the Department of Ophthalmology of Renmin Hospital of Wuhan University. In total, 86 acute CRAO patients were included. Spectral-domain optical coherence tomography (SD-OCT), CFP, and MC examinations were taken at baseline. Based on the findings of these three examinations, CRAO was divided into three grades (incomplete, subtotal, and total). Based on OCT grading criteria, we qualitatively compared the ability of grading CRAO by CFP and MC. CRAO patient's visual acuity (VA) was obtained from the initial visit. The retinal thickness was measured by SD-OCT. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained from optical coherence tomography angiography (OCTA) examinations. Quantitative data were compared across the three acute CRAO subgroups and against three examination findings. Results MC image had significantly higher power of acute CRAO detection than CFP (P = 0.03). In the same group of CRAO patients, there was no significant difference in VA when comparing OCT with the MC grading system or with the CFP grading system (all P > 0.05). Significant differences in VA were found between the three CRAO subgroups only under MC grading (P = 0.016). In incomplete CRAO patients, significant differences were found in central fovea thickness (CFT) when comparing OCT with the CFP grading system (P = 0.019). In the same group of CRAO patients, there was no significant difference in retinal thickness when comparing OCT with the MC grading system (All P > 0.05). Significance differences in CFT (P < 0.001), innermost retinal layer (IMRL; P < 0.01), middle retinal layer (MRL; P < 0.001), and outer retinal layer (ORL; P = 0.021) were found between the three CRAO subgroups by MC grading. Vessel density of SCP showed a statistically increased as the severity of three CRAO subgroups (P = 0.03), whereas DCP did not have significant differences (P = 0.745). Comparisons were made between the OCT grading method and the MC and CFP grading methods; there is no significant difference in vessel density of SCP and DCP (All P > 0.05). Conclusion The images obtained by MC are superior to those obtained by CFP in CRAO grading, retinal thickness, and vessel density measurement. MC imaging may be more capable of CRAO grading than OCT. We recommend MC imaging to determine CRAO severity to guide disease treatment and predict visual prognosis.
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Cheng Y, He L, Miao Q, Wang W, Yuan J, Chen C. Clinical application of multicolor imaging in Leber hereditary optic neuropathy. Front Neurol 2022; 13:1003514. [DOI: 10.3389/fneur.2022.1003514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo characterize features of retinal never fiber in Leber Hereditary Optic Neuropathy (LHON) using multicolor (MC) imaging and color fundus photography (CFP).MethodsNinety-two eyes of patients with LHON underwent MC imaging, optic disc spectral domain optical coherence tomography (SD-OCT), and CFP. Two independent observers graded RNFL visibility scores and two other experts determined never fiber bundle defects from four-quadrant readings. CFP, standard MC, infrared reflectance (IR), green reflectance (GR), blue reflectance (BR), and green-blue-enhanced (BG) imaging were compared.ResultsAgreement on never fiber bundle defects was substantial for CFP, standard MC, GR, BR, and BG images relative to IR. It was shown that BR (2.71 ± 0.55) had the best mean RNFL visibility score, BG (2.69 ± 0.52), GR (2.69 ± 0.56), standard MC (2.04 ± 0.79), CFP (1.80 ± 0.82), and IR (0.45 ± 0.59) followed. Agreement on temporal area defects was relatively improved. Youden's indices for CFP (78.21%), standard MC (84.48%), GR (90.92%), BR (89.64%), and BG (90.99%) indicated good detection of defects in the papillomacular bundle (PMB)/ high suspicion of patients with LHON, particularly for BG and GR. According to the proportion of never fiber bundle defects, standard MC, GR, BR, and BG can roughly determine the LHON clinical stage, especially in subacute and chronic stages, and standard MC is superior for patients with LHON of all stages. The stage judged by MC was consistent with the course inferred by pRNFL thickness.ConclusionAs an adjunct to SD-OCT, the MC image, particularly the GR and BG can delineate RNFL more effectively than CFP. The MC image may be a useful adjunct to OCT for detecting or monitoring never fiber bundle defects, providing inexpensive and rapid methods that can quickly identify patients with high suspicion of LHON.
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Venkatesh R, Agrawal R, Reddy NG, Gupta A, Yadav NK, Chhablani J. Intercalary membrane break and detachment causes intrachoroidal cavitation in macular coloboma. Int Ophthalmol 2022; 42:2581-2589. [PMID: 35357639 DOI: 10.1007/s10792-022-02306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the clinical and imaging features in a series of patients diagnosed with macular coloboma (MC) and intrachoroidal cavitation (ICC). METHODS Patients diagnosed with MC based on clinical examination between June 2017 and July 2021 were retrieved from the electronic medical record system and were included in the study. Colour fundus photographs, optical coherence tomography (OCT) and Multicolour® imaging scans of these patients were analysed. RESULTS We identified 16 eyes of 11 patients with MC on fundus examination. Based on OCT imaging features, conforming variant of MC was seen in 9 (56%) eyes and non-conforming variant in 7 (44%) eyes. No eyes with MC in the study showed features of both conforming and non-conforming varieties simultaneously. In the non-conforming variety of MC with presence of intercalary membrane break, ICC was identified in 5 (71%) of these eyes. ICC in MC appeared as flat, dark greenish areas with or without an orange-coloured boundary abutting the margin of the coloboma on Multicolour® imaging. CONCLUSION In 31% eyes, ICC was seen in non-conforming type of MC and was well-identified on Multicolour® imaging. It appears that presence of intercalary membrane break and detachment are prerequisites for developing ICC.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, 560010, India.
| | - Rohit Agrawal
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, 560010, India
| | - Nikitha Gurram Reddy
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, 560010, India
| | - Aditi Gupta
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, 560010, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, 560010, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburgh, PA, 15213, USA
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Multicolor confocal scanning laser ophthalmoscope imaging in posterior uveitis. Retina 2022; 42:1356-1363. [DOI: 10.1097/iae.0000000000003444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kim YH, Ahn J, Kim KE. Multicolor Imaging for Detection of Retinal Nerve Fiber Layer Defect in Myopic Eyes With Glaucoma. Am J Ophthalmol 2022; 234:147-155. [PMID: 34314686 DOI: 10.1016/j.ajo.2021.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To investigate the diagnostic performance of multicolor imaging for detection of retinal nerve fiber layer (RNFL) defects in myopic eyes with glaucoma. DESIGN Comparative diagnostic analysis. METHODS A total of 150 myopic eyes of 138 patients (< -1.00 diopter or axial length >24 mm) underwent multicolor imaging by Spectralis (Heidelberg Engineering GmbH) optical coherence tomography (OCT). Two independent observers graded the RNFL visibility score and determined the location of the RNFL defect on each image. Readings were taken from the superior and inferior areas. The diagnostic performances of multicolor, green-reflectance, and blue-reflectance images for detection of the RNFL defect were compared with those of conventional fundus and red-free RNFL photographs. RESULTS The interobserver agreement on the RNFL visibility score was substantial for fundus and RNFL photographs and multicolor and green-reflectance images and was perfect for blue-reflectance images. The interobserver agreement on the location of the RNFL defect was better when using multicolor imaging than when using conventional photography. The green-reflectance image (2.89 ± 0.31) showed the highest RNFL visibility score, followed by blue-reflectance (2.88 ± 0.32) and multicolor (2.57 ± 0.63) images. The sensitivity of multicolor imaging (94.9%, 93.2%, and 91.5% for green-reflectance, blue-reflectance, and multicolor images, respectively) was significantly higher than that of fundus photography (83.1%) for detection of superotemporal RNFL defects (all P < .05). It was significantly higher for inferotemporal defects than those of fundus and RNFL photographs (all P < .05). CONCLUSIONS Multicolor imaging can visualize the glaucomatous RNFL defects in myopic eyes that are indistinguishable on conventional photography.
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Gong R, Han R, Guo J, Liu W, Xu G. Quantitative evaluation of hard exudates in diabetic macular edema by multicolor imaging and their associations with serum lipid levels. Acta Diabetol 2021; 58:1161-1167. [PMID: 33811294 DOI: 10.1007/s00592-021-01697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
AIMS To quantify hard exudates (HEs) by multicolor imaging (MCI) and traditional color fundus photography (CFP) in diabetic macular edema (DME), and study their associations with serum lipid levels. METHODS Observational study. DME patients with HEs were recruited. The HE area and location both by MCI and CFP were measured by ImageJ software. Multivariate regression models were used to analyze the associations of serum lipid levels with the total HE area and HE location. RESULTS Sixty-two patients (74 eyes) were enrolled to quantify HEs in DME. The total HE area by MCI was larger than that by CFP (P = 0.004), and the distance between the fovea and the nearest HE by MCI was shorter than that by CFP (P = 0.003). The percentage of patients with HEs involving the central macula by MCI was significantly higher than that by CFP (P < 0.001). Furthermore, 62 eyes of 62 patients were included to analyze the associations of HE parameters with serum lipid levels. In both MCI and CFP, the HE areas were positively associated with triglyceride level (P = 0.016, P = 0.022, respectively). HEs involving the central macula were positively associated with triglyceride and low-density cholesterol levels in MCI (P = 0.028, P = 0.046, respectively), while no significant association was found between serum lipid levels and HE location in CFP. CONCLUSIONS MCI is superior to traditional CFP for the detection of HEs and the analysis of associations between HEs and serum lipid levels in DME.
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Affiliation(s)
- Ruowen Gong
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China
| | - Ruyi Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China
| | - Jingli Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China
| | - Wei Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China.
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People's Republic of China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China.
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Sakono T, Terasaki H, Sonoda S, Funatsu R, Shiihara H, Uchino E, Yamashita T, Sakamoto T. Comparison of multicolor scanning laser ophthalmoscopy and optical coherence tomography angiography for detection of microaneurysms in diabetic retinopathy. Sci Rep 2021; 11:17017. [PMID: 34426631 PMCID: PMC8382757 DOI: 10.1038/s41598-021-96371-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the usefulness of multicolor (MC) scanning laser ophthalmoscopy (MC-SLO) in detecting microaneurysm (MA) in eyes with diabetic retinopathy (DR). This was a retrospective cross-sectional study. Eyes with DR underwent fluorescein angiography (FA), MC-SLO, optical coherence tomography angiography (OCTA), and color fundus photography (CFP) were analyzed. The foveal region was cut in an 6 × 6 mm image and the number of MA in each image was counted by retina specialists to determine the sensitivity and positive predictive value. FA results were used as the ground standard. MAs were classified as those with early, late, or no dye leakage based on FA images. Fifty-four eyes of 35 patients with an average age of 64.5 ± 1.24 years were included. The sensitivity of MA detection was 37.3%, 15.3%, and 4.12% in MC-SLO, OCTA, and CFP, respectively (P < 0.01 in each pair).The positive predictive value was 66.4%, 46.4%, and 27.6% in MC, OCTA, and CFP, respectively (P < 0.01 in each pair). Sensitivity for MAs with early leakage was 36.4% in MC-SLO, which was significantly higher than 4.02% in OCTA. MC-SLO was more useful in detecting MA in eyes with DR than OCTA.
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Affiliation(s)
- Takato Sakono
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Kagoshima Sonoda Eye and Plastic Surgery Clinic, Kagoshima, Japan
| | - Ryoh Funatsu
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hideki Shiihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Eisuke Uchino
- Kagoshima Sonoda Eye and Plastic Surgery Clinic, Kagoshima, Japan
| | - Toshifumi Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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Pole C, Au A, Navajas E, Freund KB, Sadda S, Sarraf D. En Face Optical Coherence Tomography Imaging of Foveal Dots in Eyes With Posterior Vitreous Detachment or Internal Limiting Membrane Peeling. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 34351357 PMCID: PMC8354030 DOI: 10.1167/iovs.62.10.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To analyze the morphology of foveal hyperreflective dots (HRD) identified with en face optical coherence tomography (OCT) and evaluate the effects of internal limiting membrane (ILM) peeling and posterior vitreous detachment (PVD) on the number of these lesions. Methods Retrospective cross-sectional study of patients with OCT angiography and en face OCT. Using en face OCT, superficial HRD lying on the foveal floor were measured and quantitated in eyes with ILM peel and in the fellow nonsurgical eyes. Eyes with foveal PVD were also compared to fellow eyes without foveal PVD. High-magnification en face OCT was also performed to better understand the morphology of HRD in the fovea. Results Eyes that underwent ILM peel (n = 10) displayed fewer HRD (P = 0.012) compared to control fellow nonoperated eyes. In eyes with foveal PVD, the mean number of HRD was numerically greater, but without statistical significance, compared to the contralateral eye without foveal PVD. High-magnification en face OCT illustrated HRD with irregular shapes and fine cilia-like or dendriform extensions. Average length of HRD was between 15 to 21 µm in all four groups. Conclusions HRD decreased in eyes with ILM peeling by en face OCT compared with fellow nonoperated eyes and exhibited a glial cell-like morphology and size closely resembling the white dot fovea described previously using scanning electron microscopy. HRD may represent processes of activated retinal glia, possibly Muller cells, that traverse defects in the ILM.
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Affiliation(s)
- Cameron Pole
- Retinal Disorders and Ophthalmic Genetics, Stein Eye Institute, University of California at Los Angeles, Los Angeles, California, United States
| | - Adrian Au
- Retinal Disorders and Ophthalmic Genetics, Stein Eye Institute, University of California at Los Angeles, Los Angeles, California, United States
| | - Eduardo Navajas
- Department of Ophthalmology and Visual Sciences, Eye Care Center, University of British Columbia, British Columbia, Vancouver, Canada
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, United States.,Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
| | - Srinivas Sadda
- Doheny Eye Institute, Los Angeles, California, United States.,University of California at Los Angeles, Los Angeles, California, United States
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics, Stein Eye Institute, University of California at Los Angeles, Los Angeles, California, United States.,Greater Los Angeles VA Healthcare Center, Los Angeles, California, United States
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Sanjay S, Reddy NG, Kawali A, Mahendradas P, Pulipaka RS, Shetty R, Yadav NK, Venkatesh R. Role of multicolour imaging in post-fever retinitis involving posterior pole. Int Ophthalmol 2021; 41:3797-3804. [PMID: 34263386 DOI: 10.1007/s10792-021-01951-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe composite multicolour (MC) imaging features along with the monocoloured fundus reflectance images in active and resolving stages of post-fever retinitis (PFR). METHODS Retrospective image analysis of cases of PFR who underwent dilated retinal clinical examination followed by optical coherence tomography and MC imaging. RESULTS Twenty-five eyes of 18 patients diagnosed with PFR were included. There were 11 males and 7 females. Mean age of patients was 30.63 years. The retinitis lesion appeared bright white on MC image and white mainly on blue and green reflectance images during the active stages of PFR. The lesion appeared dull-grey to greyish white during the resolving stages and as dull-green in resolved cases. The active stages showed the presence of intraretinal/subretinal fluid which appeared as green colour on MC images and less green to normal during resolving stages. Hard exudates were seen as bright yellow- or orange-coloured spots on MC image during the resolving stages of the disease. CONCLUSION The different stages of PFR show different colour on multicolour image and different reflectance patterns on individual colour reflectance channels. Hence, multimodal fundus imaging with different wavelength can be helpful for differentiation of activity in PFR.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Nikitha Gurram Reddy
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India.,Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | - Ram Snehith Pulipaka
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India.,Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Rohit Shetty
- Department of Cornea-Refractive Services, Narayana Nethralaya, Bangalore, India
| | - Naresh Kumar Yadav
- Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Ramesh Venkatesh
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India. .,Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India.
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MORE EFFECTIVE SCREENING FOR EPIRETINAL MEMBRANES WITH MULTICOLOR SCANNING LASER OPHTHALMOSCOPE THAN WITH COLOR FUNDUS PHOTOGRAPHS. Retina 2021; 40:1412-1418. [PMID: 31180985 DOI: 10.1097/iae.0000000000002595] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the ability of the multicolor scanning laser ophthalmoscope (MC-SLO) to screen for epiretinal membranes (ERMs). METHODS A retrospective cross-sectional study of 35 eyes of 32 patients with an ERM detected by optical coherence tomography and 46 eyes of 23 healthy volunteers. The detection of the ERM was graded into three visibility scores-1, not visible, 2, barely visible, and 3, clearly visible-by retina specialists or by ophthalmology residents. The sensitivity and specificity of the detection with the merged image of the MC-SLO or color fundus photographs (CFPs) were calculated. RESULTS The sensitivity for ERM detection in the MC-SLO and CFP were 91.4% and 65.7% by specialists and 97.1% and 60.0% by residents. The specificity for both devices was 100% by specialists and residents. The visibility score for the MC-SLO images were significantly higher than that for the CFP by both specialists and residents. In addition, the visibility score for the MC-SLO determined by residents was significantly higher than that for the CFP by specialists. CONCLUSION The detection of an ERM is better with the MC-SLO images than with CFP. Furthermore, the ERM detection in the MC-SLO images by residents was comparable to that by specialists.
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COMPARISON OF MULTICOLOR IMAGING AND COLOR FUNDUS PHOTOGRAPHY IN THE DETECTION OF PATHOLOGICAL FINDINGS IN EYES WITH POLYPOIDAL CHOROIDAL VASCULOPATHY. Retina 2021; 40:1512-1519. [PMID: 31464882 DOI: 10.1097/iae.0000000000002638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the appearance and frequency of detection of common features in eyes with polypoidal choroidal vasculopathy using multicolor imaging (MC) or color fundus photography (CFP). METHODS Thirty-eight eyes with indocyanine green angiography-proven polypoidal choroidal vasculopathy, imaged with both MC and CFP, were graded by three independent retinal specialists. The presence of five prespecified pathological features (blood, exudation, polypoidal lesions, pigment epithelial detachments, and atrophy) was graded on each modality independently. Multimodal imaging including optical coherence tomography, fluorescein, and indocyanine green angiography was used as the gold standard. RESULTS Overall, there was no statistically significant difference in the ability of MC imaging compared with CFP in detecting the pathological features. Polypoidal lesions appear as small, dark green, round lesions which have higher contrast on MC compared with a nodular orange appearance seen on CFP. Polypoidal lesions can be identified noninvasively using both MC and CFP in about half of the cases. CONCLUSION There are differences in the appearance of polypoidal choroidal vasculopathy-associated features on MC compared with CFP. Both modalities are comparable for the detection of pathological features in eyes with polypoidal choroidal vasculopathy. MC imaging may be considered as an alternative to CFP.
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[Statement of the Professional Association of German Ophthalmologists (BVA), the German Ophthalmological Society (DOG) and the Retinological Society (RG) on the development, diagnostics and treatment of epiretinal gliosis : Status October 2020]. Ophthalmologe 2021; 118:121-138. [PMID: 33346894 DOI: 10.1007/s00347-020-01291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Philippakis E, Thouvenin R, Gattoussi S, Couturier A, Tadayoni R. Preoperative imaging optimized for epiretinal membrane surgery. Int J Retina Vitreous 2021; 7:32. [PMID: 33849642 PMCID: PMC8045200 DOI: 10.1186/s40942-021-00304-w] [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: 11/19/2020] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background To compare imaging modalities for visualizing primary epiretinal membrane (ERM) with each other and with intraoperative digital images (IDI) after blue staining. Methods The records of consecutive patients operated for primary ERM over a 12-month period were retrospectively reviewed. Preoperative imaging included color fundus photography (CFP), En Face spectral-domain optical coherence tomography (OCT), 45° infrared- (IR) and blue-reflectance (BR) scanning laser ophthalmoscopy. All images were qualitatively analyzed and scored from 0–4 according to the ability to visualize ERM details (0 = no visible ERM or vessel contraction, 1 = vessel contraction, 2 = retinal folds, 3 = ERM limits, 4 = elevated ERM edge). The preoperative ERM morphology was then compared to that seen on the IDI acquired after 1-min blue dye staining when available. Results Seventy eyes were included. The highest score for ERM visualization was obtained on BR and En Face OCT. A score of 3 or 4 was obtained in 68.5%, 62.1%, 17.9% and 13.6% of cases on En Face OCT, BR, CFP and IR images, respectively. IDI were available for 20 eyes, and showed a similar ERM morphology compared to preoperative images in most cases: a negative staining pattern corresponded to a plaque on En face OCT in 91% of eyes. However, IDI failed to show the ERM edges in 37.5% of cases. Conclusion ERM morphology was better visualized preoperatively by BR and En Face OCT, in a similar way to the IDI after staining. Future intraoperative visualization systems could integrate both imaging modalities overlaid with the IDI for guiding ERM removal instead of staining.
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Affiliation(s)
- Elise Philippakis
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, 75010, Paris, France.
| | - Raphaël Thouvenin
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, 75010, Paris, France
| | - Sarra Gattoussi
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, 75010, Paris, France
| | - Aude Couturier
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, 75010, Paris, France
| | - Ramin Tadayoni
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, 75010, Paris, France
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Abstract
Advances in imaging techniques of the retina have substantially enhanced our current understanding of the pathogenesis, morphology and prognosis of vitreomacular retinal diseases. Optical coherence tomography-based criteria and classification systems were recently proposed for uniform diagnoses and treatment recommendations for patients with vitreomacular traction, epiretinal gliosis and the various forms of macular holes. This article provides an overview of the different retinal imaging modalities as well as the currently recommended classification for vitreomacular traction pathologies.
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Thomseth VM, Engelsvold DH, Ushakova A, Forsaa VA. EN FACE IMAGING OF OUTER RETINAL PATHOLOGY AFTER RETINAL DETACHMENT. Retina 2021; 41:324-330. [PMID: 32282661 DOI: 10.1097/iae.0000000000002814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore the potentials of multicolor (MC) confocal scanning laser ophthalmoscopy (cSLO) to detect structural retinal pathology after macula-off rhegmatogenous retinal detachment (RRD) and to describe their appearances. METHODS Thirty MC cSLO images of 30 eyes after RRD repair were prospectively studied for the presence of RRD-related pathology. All MC cSLO findings were verified using swept source optical coherence tomography. Positive percent agreements were calculated using swept source optical coherence tomography as reference. RESULTS Eight RRD-related structural pathologies were identified and characterized: ellipsoid zone (EZ) disruption, foveal EZ rosette, outer retinal fold, retinal detachment line, subretinal fluid blebs, subretinal fluid layer, retinal striae, and intraretinal cysts. Multicolor cSLO positive percent agreements were as follows: EZ disruption: 79%, foveal EZ rosette: 73%, outer retinal fold: 67%, retinal detachment line: 84%, subretinal fluid blebs: 0.70%, subretinal fluid layer: 50%, intraretinal cysts: 60%, and retinal striae: 100%. CONCLUSION En face MC cSLO imaging detected and delineated RRD-related structural pathology in high agreement with cross-sectional swept source optical coherence tomography and can supplement optical coherence tomography in the documentation and monitoring of outer retinal remodeling processes after macula-off RRD. Foveal EZ rosette is a new finding of the foveal EZ.
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Affiliation(s)
- Vilde M Thomseth
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway ; and
| | - David H Engelsvold
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway ; and
| | - Anastasia Ushakova
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Vegard A Forsaa
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway ; and
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dell'Omo R, Filippelli M, De Turris S, Govetto A, Napolitano P, Ermanno dell'Omo, Costagliola C. Multimodal Imaging of Lamellar Macular Holes. J Ophthalmol 2021; 2021:8820444. [PMID: 33604083 PMCID: PMC7868145 DOI: 10.1155/2021/8820444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/01/2020] [Accepted: 01/11/2021] [Indexed: 01/01/2023] Open
Abstract
Evolution of imaging techniques has renewed interest in the diagnosis of lamellar macular hole (LMH) and greatly implemented the possibilities of gaining more detailed insights into its pathogenesis. Among noninvasive techniques, optical coherence tomography (OCT) is considered the primary examination modality to study LMHs, given its ability to image foveal structure and its widespread availability. OCT also allows to resolve the epiretinal materials associated with LMH, i.e., tractional epiretinal membranes (ERMs) and epiretinal proliferation (EP). En face OCT reconstructions are useful to confirm the foveal abnormalities shown by the eyes with LMH, whereas OCT angiography may reveal alterations of the size and shape of the foveal avascular zone and alterations of the density of the superficial and deep vascular plexuses. On slit-lamp biomicroscopy or fundus camera examination, LMH appears as a round or oval, reddish lesion at the center of the macula, slightly darker than the surrounding retina. The associated tractional ERM, causing wrinkling and glistening of the retinal surface, is usually readily appreciable, whereas EP is hardly apparent on biomicroscopy or fundus photography since the retina surface appears smooth. When imaged with blue fundus autofluorescence (B-FAF) imaging, LMHs are characterized by an increased autofluorescent signal, the intensity of which does not correlate with the thickness of the residual outer retinal tissue. Green reflectance and blue reflectance (BR) images clearly show the increased reflection and wrinkling of the retinal surface caused by tractional ERM associated with LMH. BR and multicolor imaging enable the visualization of EP associated with LMH in the form of a sharply demarcated dark area and in the form of a yellowish area surrounding the hole, respectively. Scarce data regarding invasive imaging techniques, such as fluorescein angiography, for the study of LMH are available in the literature. The aim of this review is to evaluate the contribution that each imaging modality can provide to study the morphologic characteristics of LMH.
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Affiliation(s)
- Roberto dell'Omo
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Francesco De Sanctis 1, Campobasso 86100, Italy
| | - Mariaelena Filippelli
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Francesco De Sanctis 1, Campobasso 86100, Italy
| | - Serena De Turris
- Eye Clinic, Polytechnic University of Marche, Via Conca 71, Ancona 60121, Italy
| | - Andrea Govetto
- Vitreoretinal Division, Bristol Eye Hospital, Lower Maudlin St., BS1 2LX, Bristol, UK
| | - Pasquale Napolitano
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Francesco De Sanctis 1, Campobasso 86100, Italy
| | - Ermanno dell'Omo
- Eye Clinic, Casa di Cura “Villa Maria”, Viale Principe di Piemonte 4, Campobasso 86100, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Francesco De Sanctis 1, Campobasso 86100, Italy
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Morphological Changes and Prognostic Factors before and after Photodynamic Therapy for Central Serous Chorioretinopathy. Pharmaceuticals (Basel) 2021; 14:ph14010053. [PMID: 33440827 PMCID: PMC7827861 DOI: 10.3390/ph14010053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 11/17/2022] Open
Abstract
Central serous chorioretinopathy (CSC) is a disease of unknown etiology, but half-dose photodynamic therapy (hPDT) is well known to be effective for CSC. Infrared reflectance (IR) has been shown to be effective for detecting retinal pigmented epithelial and choroidal lesions, but no reports have focused on chorioretinal changes using IR images after as compared to before hPDT. This study aimed to clarify the features of IR images as well as retinal and choroidal morphological changes before and after treatment with verteporfin hPDT for CSC. We also examined prognostic factors associated with CSC treatment. This was a retrospective study that included 140 eyes of 140 patients (male/female ratio 122:18, mean age 53.4 ± 10.8 years) diagnosed with CSC who underwent hPDT in our hospital during the period from April 2015 to December 2018. We determined changes in visual acuity, therapeutic efficacy, central retinal thickness (CRT), central choroidal thickness (CCT), and IR images at one and three months after hPDT as compared to before treatment. Dry macula was defined as a complete resolution of serous retinal detachment after hPDT. History of smoking, disease duration, presence of drusen, presence of retinal pigment epithelium abnormalities, type of fluorescein angiographic leakage, and presence of choroidal vascular hyperpermeability were investigated as prognostic factors associated with treatment efficacy. CRT and CCT were measured using optical coherence tomography (Spectralis HRA-2; Heidelberg Engineering), and IR images after versus before treatment were compared using ImageJ software (version 1.52) to calculate the mean luminance for a 3 × 3 mm area in the macula. Compared with the values before treatment, CCT, CRT, and visual acuity showed significant improvements at one and three months after treatment, and the mean luminance of IR images was also significantly increased. Furthermore, the luminance on IR images tended to rise, though the values at one month and three months after treatment did not differ significantly. Disease duration was significantly associated with dry macula one month after treatment, and visual acuity and CRT before hPDT were both significantly related to dry macula three months after treatment. IR images tended to improve over time, from before treatment through one and three months after hPDT.
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Zhang Z, Li M, Sun Y, Wei Y, Zhang S. Multicolor Scanning Laser Ophthalmoscopy Strengthens Surgeons' Preoperative Decision-Making and Intraoperative Performance on Epiretinal Membrane. Transl Vis Sci Technol 2020; 9:36. [PMID: 33384890 PMCID: PMC7757626 DOI: 10.1167/tvst.9.13.36] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 11/01/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine whether multicolor scanning laser ophthalmoscopy (MC-SLO) was better than color fundus photography (CFP) to enhance residents and specialists’ preoperative decision-making and intraoperative performance on the epiretinal membrane (ERM). Methods Consecutive patients with idiopathic ERM were recruited prospectively. All the patients underwent MC-SLO and CFP imagings and were randomized into MC-SLO (n = 20) and CFP (n = 20) groups. Preoperatively, residents and specialists were required to have ERM delineation and select an optimal location for initial ERM peeling independently, based on the MC-SLO (MC-SLO group) or CFP (CFP group) images. Intraoperative optical coherence tomography (iOCT) was introduced to evaluate the accuracy. Results Preoperatively, residents and specialists acted more effectively in ERM delineation and selection of initial grasping location in the MC-SLO group (both P < 0.001). In the MC-SLO group, higher resident–specialist agreements were achieved in ERM delineation (P = 0.002) and selection of initial grasping location (P = 0.035). The iOCT revealed greater interobserver (iOCT–resident and iOCT–specialist) agreements of ERM delineation in MC-SLO group (P < 0.001 and = 0.027, respectively). Surgeons acted more effectively on completely peeling the ERM in the MC-SLO group (P < 0.001). Conclusions MC-SLO provided a better visual reference for residents and specialists in ERM delineation and the selection of an initial grasping location for the surgery, compared with CFP. Translational Relevance MC-SLO is able to help surgeons achieve better intraoperative performance and shorten the learning process for residents.
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Affiliation(s)
- Zhaotian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University
| | - Miaoling Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University
| | - Yimeng Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University
| | - Yantao Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University
| | - Shaochong Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University
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20
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Agarwal A, Invernizzi A, Markan A, Testi I, Keane PA, Agrawal R, Nguyen QD, Pavesio C, Gupta V. Imaging in Tubercular Choroiditis: Current Concepts. Ocul Immunol Inflamm 2020; 28:1223-1238. [PMID: 32976732 DOI: 10.1080/09273948.2020.1817500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Ocular tuberculosis has protean clinical manifestations. Because of its varied clinical presentation, multimodal imaging is very important to characterize the disease activity, presence of inflammation, determining therapeutic response, and detection of complications. METHODS Narrative review. RESULTS In this review, various imaging modalities employed in the management of ocular tuberculosis including fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) have been reviewed. Not only do these imaging tools complement each other in providing a comprehensive assessment of the pathology, they also help in gaining valuable insights regarding the evolution of the disease. CONCLUSIONS Fundus imaging plays a vital role in the diagnosis and management of patients with posterior uveitis due to tuberculosis. Fundus imaging may have a useful role in defining clinical endpoints for ocular tuberculosis in the future.
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Affiliation(s)
- Aniruddha Agarwal
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research , Chandigarh, India
| | - Alessandro Invernizzi
- Department of Biomedical and Clinical Science "Luigi Sacco," Eye Clinic, University of Milan , Milan, Italy
| | - Ashish Markan
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research , Chandigarh, India
| | - Ilaria Testi
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust , London, UK
| | - Pearse A Keane
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust , London, UK
| | - Rupesh Agrawal
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust , London, UK.,Department of Ophthalmology, Singapore Eye Research Institute, Singapore , Singapore.,Department of Ophthalmology, Tan Tock Seng Hospital, Singapore , Singapore
| | - Quan Dong Nguyen
- Byers Eye Institute, Department of Ophthalmology, Stanford University , Palo Alto, CA, USA
| | - Carlos Pavesio
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust , London, UK
| | - Vishali Gupta
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research , Chandigarh, India
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Venkatesh R, Jain K, Pereira A, Jain SD, Aseem A, Mahendradas P, Yadav NK. Retinal cafe-au-lait macules: A rare retinal finding in a patient with neurofibromatosis type 1. Indian J Ophthalmol 2020; 67:2101-2103. [PMID: 31755475 PMCID: PMC6896559 DOI: 10.4103/ijo.ijo_925_19] [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] [Indexed: 11/23/2022] Open
Abstract
We report the retinal and choroidal manifestations using multimodal imaging in a patient with Neurofibromatosis type 1 (NF-1). In this report, we describe the occurrence of a new retinal finding which we label as retinal café-au-lait macules. Also, we describe the superiority of multicolour imaging in comparison to colour fundus photography for identifying the retinal manifestations in NF-1.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina-Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Kushagra Jain
- Department of Retina-Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Arpitha Pereira
- Department of Retina-Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Shreya Dass Jain
- Department of Retina and Vitreous, Narayana Nethralaya, All Skin Clinic, Indore, Madhya Pradesh, India
| | - Aditya Aseem
- Department of Retina-Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | | | - Naresh Kumar Yadav
- Department of Retina-Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
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22
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Venkatesh R, Pereira A, Sangai S, Jain K, Gupta I, Aseem A, Singh V, Yadav NK. Variability in Imaging Findings in Choroidal Nevus Using Multicolor Imaging Vis-à-vis Color Fundus Photography. J Curr Ophthalmol 2020; 32:285-289. [PMID: 32775805 PMCID: PMC7382523 DOI: 10.4103/joco.joco_15_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/26/2020] [Accepted: 01/29/2020] [Indexed: 02/03/2023] Open
Abstract
Purpose To describe the multicolor imaging (MCI) features in a series of patients diagnosed with a choroidal nevus and compare it vis-à-vis color fundus photography (CFP) in identifying the lesion. Methods In this retrospective, descriptive case series at a tertiary referral center in South India, all patients diagnosed with the choroidal nevus underwent CFP, optical coherence tomography, MCI, and infrared reflectance (IR) imaging. Results In this study, we found that on MCI, the choroidal nevus could be identified in only six of the 12 eyes. The lesions were seen as an area of hyperreflectance on IR image and orange-colored lesion on multicolor image. In one eye, there was a mixed pattern of hyper and hyporeflectance on IR imaging. The remaining five eyes with choroidal nevus lesions were not identified on MCI. Conclusion The variable features of the choroidal nevus on MCI are most likely due to the variable melanin content within the nevus cells. Further studies are needed to validate these findings.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Arpitha Pereira
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Sajjan Sangai
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Kushagra Jain
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ishank Gupta
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Aditya Aseem
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Vivek Singh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
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Van Tassel SH, Asrani SG. Possible Undiagnosed Glaucoma Detected by MultiColor Imaging of Retinal Diseases. ACTA ACUST UNITED AC 2019; 2:22-27. [DOI: 10.1016/j.ogla.2018.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 11/24/2022]
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Venkatesh R, Bavaharan B, Yadav NK, Saurabh K, Srinivasan P, Mahendradas P, Prabhu V, Roy R. Multicolor imaging in choroidal osteomas. Int J Retina Vitreous 2018; 4:46. [PMID: 30564461 PMCID: PMC6292007 DOI: 10.1186/s40942-018-0150-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background To describe the multicolour (MC) imaging characteristics associated with choroidal osteomas (CO) and their secondary complications. Methods Retrospective descriptive case series of eleven eyes of ten patients with CO. Findings of multicolour imaging were correlated with visual acuity, clinical features, lesion characteristics and findings from other imaging modalities. Results Infrared reflectance (IR) images showed calcified CO lesions as hyporeflectance (dark) areas while decalcified lesions were seen as iso reflectance (normal) areas. Overlying RPE atrophy on IR were seen as white areas. MC images showed color variations depending upon the reflectivity of the tumour material tumour and retinal pigment epithelial (RPE) atrophy. Green color was noted in calcified CO tumour while decalcified CO tumour showed no color change. RPE atrophy were seen as bright orange areas. Green and blue reflectance images were not able to pick the choroidal osteoma lesion. Other changes secondary to CO like presence of choroidal neovascular membrane, hemorrhage and/or fluid in the retinal layers were identified on green and blue reflectance images. Conclusion MC imaging is a useful tool in our arsenal of existing imaging modalities in the assessment of CO and its secondary changes. Change in reflectance of the IR and MC images can be used as an indicator to assess the extent of tumour decalcification and its secondary changes and therefore, can aid in prognostication in the same. It has the potential to replace color fundus photography in documentation and follow up of patients with CO.
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Affiliation(s)
- Ramesh Venkatesh
- 1Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka 560010 India
| | - Bharathi Bavaharan
- 1Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka 560010 India
| | - Naresh Kumar Yadav
- 1Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka 560010 India
| | - Kumar Saurabh
- Department of Retina and Vitreous, Aditya Birla Sankara Nethralaya, No. 147, Mukundapur EM By Pass, Near Purva Jadavpur Thana, Kolkata, West Bengal 700099 India
| | - Priya Srinivasan
- 1Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka 560010 India
| | - Padmalini Mahendradas
- 1Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka 560010 India
| | - Vishma Prabhu
- 1Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka 560010 India
| | - Rupak Roy
- Department of Retina and Vitreous, Aditya Birla Sankara Nethralaya, No. 147, Mukundapur EM By Pass, Near Purva Jadavpur Thana, Kolkata, West Bengal 700099 India
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