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Qian Q, Wang J. Bibliometric analysis of ophthalmic OCT and OCT angiography research trends over the past 20 years. Int Ophthalmol 2024; 44:374. [PMID: 39251539 DOI: 10.1007/s10792-024-03292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/25/2024] [Indexed: 09/11/2024]
Abstract
PURPOSE Optical coherence tomography (OCT) and OCT angiography (OCTA) are widely used in the diagnosis of ophthalmic diseases. This study aims to provide a comprehensive bibliometric analysis of ophthalmologic OCT and OCT angiography. METHODS We retrieved publications on ophthalmic OCT and OCTA from 2003 to 2022 from the Web of Science Core Collection and used bibliometric tools to analyze and visualize the distribution, trend, and hotspots. RESULTS In total, 20,817 articles written by 48,160 authors from 106 countries were selected. The number of publications has significantly increased. In the last two decades, the USA was the most productive country and received the highest citations. The most productive journal was Investigative Ophthalmology and Visual Science and received the highest number of citations. Moorfields Eye Hospital was the most productive institution. Bandello F published the most papers, while Spaide RF was the highest cited author. SPAIDE RF, 2011, AM J Ophthalmology was the most cited document. "OCT", "glaucoma" and "OCTA" were three hotspots in the last two decades. "Vessel density" and "deep learning" would be research hotspots in the future. CONCLUSION The bibliometric analysis of ophthalmic OCT and OCTA research over the past two decades on keywords, authors, citations, hotspots and trends will provide global researchers with valuable information for future research and cooperation.
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Affiliation(s)
- Qian Qian
- Department of Ophthalmology, Future Vision Clinic, Shanghai, 200032, China
| | - Jing Wang
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Ghoraba H, Hwang J, Karaca I, Khojasteh H, Or C, Regenold J, Zaidi M, Yavari N, Than NTT, Park SW, Yasar C, Akhavanrezayat A, Nguyen QD. Multifocal electroretinographic findings in angiographic macular leakage in the setting of intermediate, posterior, or panuveitis. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:57-63. [PMID: 36442516 PMCID: PMC10863997 DOI: 10.1016/j.jcjo.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/23/2022] [Accepted: 11/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the functional implications of angiographic macular leakage without the presence of intraretinal fluid on optical coherence tomography (OCT) in eyes with intermediate, posterior, or panuveitis. METHODS Retrospective study on patients with a diagnosis of intermediate, posterior, or panuveitis. Patients who had fluorescein angiography, OCT, and multifocal electroretinography (mfERG) within a predetermined time frame were included. Demographic and clinical data including types of ocular inflammation and best-corrected visual acuity (BCVA), in addition to OCT, fluorescein angiography, and mfERG data were collected. The study cohort was divided into 2 groups based on the presence of angiographic macular leakage and macular edema (ME): group 1 (no ME and no macular leakage) and group 2 (presence of macular leakage without ME). RESULTS A total of 29 patients (43 eyes) were included in the study, with 13 patients (17 eyes) in group 1 and 16 patients (26 eyes) in group 2. No statistically significant differences in age, sex, anterior-chamber cells, lens status, vitreous cells, vitreous haze, BCVA, or mean central subfoveal thickness were found between groups 1 and 2. All mfERG values, including N1 and P1 response densities and timings for rings 1-5, did not show any statistically significant difference between group 1 and 2. No correlation was found between either BCVA or central subfoveal thickness and any of mfERG values for rings 1-3. CONCLUSIONS In absence of ME, angiographic macular leakage in eyes with uveitis might not be associated with worse macular function when compared with eyes without angiographic macular leakage.
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Affiliation(s)
- Hashem Ghoraba
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Jaclyn Hwang
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Irmak Karaca
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Hassan Khojasteh
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Christopher Or
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Jonathan Regenold
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Moosa Zaidi
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Negin Yavari
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Ngoc Trong Tuong Than
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Sung Who Park
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Cigdem Yasar
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Amir Akhavanrezayat
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA
| | - Quan Dong Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA..
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Değirmenci MFK, Yalçındağ FN. Are optical coherence tomography and fluorescein angiography comparable for detection of macular edema in Behçet uveitis? Graefes Arch Clin Exp Ophthalmol 2023; 261:3275-3281. [PMID: 37773289 DOI: 10.1007/s00417-023-06249-0] [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: 04/19/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023] Open
Abstract
PURPOSE To investigate the role and agreement of spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) for macular edema (ME) diagnosis in Behçet uveitis (BU). METHODS Eyes with ME detected by SD-OCT and/or FA were enrolled. Type of ME by SD-OCT and grade of macular leakage (ML) by FA were investigated. Eyes were divided into three groups according to the agreement of tests. Three groups and factors that could affect the compatibility of tests were statistically analyzed. RESULTS Sixty-one eyes of 61 patients were included. Both imaging methods detected ME in 42.6% of eyes (group 1). In 47.5% of eyes, ME was revealed by OCT (group 2). The remaining 9.8% of the eyes had ME, detected only by FA (group 3). Grade 2 ML by FA was more common in group 1 (p = 0.01). The grade of ML by FA was similar in groups 2 and 3. In group 2, most of the eyes showed diffuse ME by OCT (p < 0.001). Epiretinal membrane was detected more frequently in group 3 (p = 0.005). Duration and activity of uveitis were similar between groups. CONCLUSION SD-OCT was able to detect ME in 90% of the eyes with BU. Duration and activity of uveitis were not related to the compatibility of imaging methods.
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Affiliation(s)
| | - F Nilüfer Yalçındağ
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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4
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Choi SW, Hong HK, Jeon J, Choi JY, Kim M, Kim P, Lee BC, Woo SJ. FITC-Labeled RGD Peptides as Novel Contrast Agents for Functional Fluorescent Angiographic Detection of Retinal and Choroidal Neovascularization. Cells 2023; 12:1902. [PMID: 37508566 PMCID: PMC10377818 DOI: 10.3390/cells12141902] [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: 06/29/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The development of choroidal neovascularization (CNV) is a crucial factor in the pathophysiology and prognosis of exudative age-related macular degeneration (AMD). Therefore, the detection of CNV is essential for establishing an appropriate diagnosis and treatment plan. Current ophthalmic imaging techniques, such as fundus fluorescent angiography and optical coherence tomography, have limitations in accurately visualizing CNV lesions and expressing CNV activity, owing to issues such as excessive dye leakage with pooling and the inability to provide functional information. Here, using the arginine-glycine-aspartic acid (RGD) peptide's affinity for integrin αvβ3, which is expressed in the neovascular endothelial cells in ocular tissues, we propose the use of fluorescein isothiocyanate (FITC)-labeled RGD peptide as a novel dye for effective molecular imaging of CNV. FITC-labeled RGD peptides (FITC-RGD2), prepared by bioconjugation of one FITC molecule with two RGD peptides, demonstrated better visualization and precise localization of CNV lesions than conventional fluorescein dyes in laser-induced CNV rodent models, as assessed using various imaging techniques, including a commercially available clinical fundus camera (Optos). These results suggest that FITC-RGD2 can serve as an effective novel dye for the diagnosis of neovascular retinal diseases, including AMD, by enabling early detection and treatment of disease occurrence and recurrence after treatment.
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Affiliation(s)
- Seung Woo Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Hye Kyoung Hong
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Jehwi Jeon
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
- KAIST Institute for Health Science and Technology (KIHST), Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Ji Young Choi
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
- Bio-Max Institute, Seoul National University, Seoul 08826, Republic of Korea
| | - Minah Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Pilhan Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
- KAIST Institute for Health Science and Technology (KIHST), Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Byung Chul Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
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Anastasopoulos E, Koronis S, Matsou A, Dermenoudi M, Ziakas N, Tzamalis A. Safety and Efficacy of Prostaglandin Analogues in the Immediate Postoperative Period after Uneventful Phacoemulsification. Vision (Basel) 2023; 7:45. [PMID: 37368818 DOI: 10.3390/vision7020045] [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: 04/04/2023] [Revised: 06/04/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Prostaglandin analogues (PGAs) have been associated with the development of pseudophakic macular edema (PME) in complicated cataract cases, but evidence on their effects in uncomplicated phacoemulsification remains controversial. This two-arm, prospective, randomised study included patients with glaucoma or ocular hypertension under PGA monotherapy who were scheduled for cataract surgery. The first group continued PGA use (PGA-on), while the second discontinued PGAs for the first postoperative month and reinitiated use afterwards (PGA-off). Topical non-steroidal anti-inflammatory drugs (NSAIDs) were routinely administered to all patients during the first postoperative month. The patients were followed up for three months and the primary outcome was PME development. Secondary outcomes were corrected distance visual acuity (CDVA), central and average macular thickness (CMT and AMT), and intraocular pressure (IOP). The analysis included 22 eyes in the PGA-on group and 33 eyes in the PGA-off group. No patient developed PME. CDVA was not significantly different between the two groups (p = 0.83). CMT and AMT showed a small but statistically significant increase until the end of follow-up (p < 0.001). Mean IOP values had no significant differences between the groups at each visit (p > 0.05). At the end of follow-up, the IOP values were significantly lower than baseline in both groups (p < 0.001). In conclusion, PGA administration with concomitant topical NSAIDs appears to be a safe practice in the early postoperative period of uncomplicated phacoemulsification.
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Affiliation(s)
| | - Spyridon Koronis
- Department of Ophthalmology, General Hospital Papageorgiou, 56429 Thessaloniki, Greece
| | - Artemis Matsou
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead RH19 3DZ, UK
| | - Maria Dermenoudi
- Department of Ophthalmology, General Hospital Papageorgiou, 56429 Thessaloniki, Greece
| | - Nikolaos Ziakas
- Department of Ophthalmology, General Hospital Papageorgiou, 56429 Thessaloniki, Greece
| | - Argyrios Tzamalis
- Department of Ophthalmology, General Hospital Papageorgiou, 56429 Thessaloniki, Greece
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Ali SM, Kozak I. Fundus fluorescein angiography via percutaneous endoscopic gastrostomy: Description of technique. Am J Ophthalmol Case Rep 2023; 30:101832. [PMID: 37064252 PMCID: PMC10101993 DOI: 10.1016/j.ajoc.2023.101832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Purpose To report an alternative technique of fundus fluorescein angiography using percutaneous endoscopic gastrostomy (PEG). Methods A case series from a single center. Results Two bed-bound children on tracheostomy received 10% fluorescein sodium via PEG to diagnose their retinal condition. The dye appeared at 5 min after administration and stayed in the retinal circulation past 30 min. Good quality fluorescein angiograms were obtained in all cases. There were no safety issues in these two children. Conclusions and Importance Retinal angiography with fluorescein dye administered via percutaneous endoscopic gastrostomy may represent a suitable alternative to currently used intravenous and oral fluorescein angiography.
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Oral Fluorescein Angiography for the Diagnosis of Papilledema Versus Pseudopapilledema in Children. Am J Ophthalmol 2023; 245:8-13. [PMID: 36084685 DOI: 10.1016/j.ajo.2022.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the accuracy and safety of oral fluorescein angiography (OFA) in differentiating papilledema from pseudopapilledema in pediatric patients. DESIGN Retrospective evaluation of a diagnostic test. METHODS We retrospectively reviewed medical records of all children ≤18 years of age who presented to the Arkansas Children's Hospital between May 2018 and August 2021 with suspected optic disc (OD) swelling that had OFA and images >30 minutes after oral ingestion. Two masked specialists interpreted the images as either OD leakage, no leakage, or borderline leakage. Optic disc swelling was graded clinically according to the Frisen grading scale (0-5). We compared OFA images to the final clinical diagnosis and calculated the accuracy of the test as follows: (number of eyes correctly identified as papilledema [true positive] + number of eyes correctly identified as pseudopapilledema [true negative]) / (total number of eyes) × 100%. RESULTS Forty-five patients (90 eyes) were included, 11 patients with papilledema and 34 with pseudopapilledema. The mean age was 14.1 ± 3.5 years; 66.7% were female. The accuracy of OFA was 62% for reviewer 1 and 69% for reviewer 2. No ocular or systemic side effects after OFA were observed. There was substantial agreement (k = 0.779) between both reviewers in grading the OFA images. CONCLUSION OFA cannot definitively distinguish papilledema from pseudopapilledema in children and should be interpreted in conjunction with other clinical findings.
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Oral Fluorescein Angiography with Ultra-Wide-Field Scanning Laser Ophthalmoscopy in Pediatric Patients Precis: Oral Fluorescein Angiography in Children. J Clin Med 2022; 11:jcm11185421. [PMID: 36143067 PMCID: PMC9500735 DOI: 10.3390/jcm11185421] [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: 07/25/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Aims: To investigate the success rate of oral fluorescein angiography (oral FA) in children with ultrawide scanning laser ophthalmoscopy (SLO) system and whether it can provide images of sufficient quality compared with intravenous FA (IVFA). Methods: In this comparative case series study, a series of 40 consecutive pediatric patients of the age of 3−18 with retinal vascular diseases, in whom FA was needed for the diagnosis or treatment, were enrolled in this study. IVFA and oral FA were performed within one week and images were obtained with the SLO system. The image quality was scored blindly and compared based on: (I) visualization of the branch retinal vessel, (II) the foveal avascular zone (FAZ), and (III) clinically important findings, such as the presence of microaneurysms, neovascularization, leakage, or significant nonperfusion. All these were scored using a three-point scale. Results: In preschoolers (three to six years), all 19 children complete oral FA (100%), while only 7 (36.84%) complete IVFA (p < 0.0001). With the SLO system, the branch retinal vessels were well visualized both in oral and IV FA (all images were two scores). The visualization of FAZ was similar between oral and IV FA (p = 0.8972). The clinically important findings were well visualized in both groups (p > 0.9999). The overall image quality was similar between the two groups (p = 0.2500). Conclusion: Oral FA is more acceptable to preschoolers than IVFA owing to the needle-free procedure. With the SLO system, oral FA provided high-quality angiograms similar to IVFA. Oral FA is an effective alternative to IVFA and may be considered the first option for FA in pediatric patients, especially in preschoolers.
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Comparison between Oral and Intravenous Ultrawide-Field Fluorescein Angiography in the Clinical Follow-up of Children with a History of Retinopathy of Prematurity or Prematurity. Retina 2022; 42:1330-1337. [PMID: 35723921 DOI: 10.1097/iae.0000000000003451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare between oral and intravenous (IV) ultrawide-field fluorescein angiography in pediatric patients with a history of prematurity of retinopathy or prematurity. METHODS Pediatric patients (<18 year old; n = 107 patients) who underwent ultrawide-field fluorescein angiography for retinopathy of prematurity were categorized into oral and IV fluorescein angiography (FA) groups. Quality of FA images was graded on the order of retinal vessels visible. Reported outcomes were proportions of graded FA images, peak fluorescein intensity, and the time to first dye appearance and to reach peak fluorescence. RESULTS Image quality analysis revealed that 91.5% of IV FA images had excellent image quality compared with only 55.6% of oral FA images (P < 0.01). There were still 83.3% of oral-contrast images with good or excellent image quality. The average time required for first dye appearance and peak fluorescence were significantly shorter in the IV FA group than in the oral FA group (P < 0.01). Peak intensity was greater in the IV group (141.41 ± 29.09) than in the oral group (111.25 ± 45.68; P < 0.01). Adverse reaction rates were similar between the two groups (P = 0.22). CONCLUSION Ultrawide-field fluorescein angiography provides excellent-quality imaging of the retina in the pediatric population. Overall, oral FA is still an effective and useful alternative to IV FA in children with prematurity history.
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NOVEL USE OF FLUORESCEIN DYE IN DETECTION OF ORAL DYSPLASIA AND ORAL CANCER. Photodiagnosis Photodyn Ther 2020; 31:101824. [PMID: 32450303 DOI: 10.1016/j.pdpdt.2020.101824] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/08/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND India is now regarded as the country with one of the highest incidence of oral cancer in the world. Considering poor survival in cases with late diagnosis, early detection can reduce morbidity and mortality of cancer patients and may impede malignant transformation in cases of oral potentially malignant disorders (OPMD). Most of the diagnostic aids are expensive and not available for mass screenings in developing countries. There is a need to develop a sensitive and affordable technique for screening of oral cancer, which can be accurate even in hands of health care workers with limited experience. Fluorescein dye has been used for tumour detection in colon, stomach, breast and brain. However, its utility in the diagnosis of oral cancer and OPMD has not yet been explored. METHODS This is the first study to report the role of fluorescein in the detection of oral cancer and OPMD. The present cross sectional study was conducted at a tertiary care dental centre. It included 100 individuals presenting with 42 OPMDs, 40 oral squamous cell carcinoma (OSCC) and 18 controls. RESULTS The sensitivity and specificity for the fluorescein detection method for OPMDs and OSCC was found to be 96.6% and 52.4% respectively. The positive predictive value was 73.7% and the negative predictive value was 91.7% for the fluorescein method. The likelihood ratios stood at 2.03 for a positive test and 0.066 for a negative test. CONCLUSION We conclude that fluorescein staining along with blue light is likely to improve detection of early oral cancers and dysplasia and can play a vital role in mass screening programmes of oral cancer.
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Littlewood R, Mollan SP, Pepper IM, Hickman SJ. The Utility of Fundus Fluorescein Angiography in Neuro-Ophthalmology. Neuroophthalmology 2019; 43:217-234. [PMID: 31528186 DOI: 10.1080/01658107.2019.1604764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 10/26/2022] Open
Abstract
While its use is still widespread within the medical retina field, fundus fluorescein angiography (FFA) is increasingly falling out of favour in the investigation of neuro-ophthalmological disease, with the introduction of new technologies, particularly optical coherence tomography. FFA does, however, provide useful diagnostic and prognostic information in many neuro-ophthalmological diseases including papilloedema, pseudo-papilloedema, optic neuropathies and central retinal artery occlusion to name a few. We aim to summarise the main FFA findings in each of these conditions and highlight where FFA is of most use in providing complementary information to other modes of investigation.
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Affiliation(s)
| | - Susan P Mollan
- Department of Ophthalmology, Queen Elizabeth Hospital, Birmingham, UK
| | - Irene M Pepper
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK
| | - Simon J Hickman
- Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK
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Amador-Patarroyo MJ, Lin T, Meshi A, Dans KC, Chen K, Borooah S, Molano-Gonzalez N, Díaz-Rojas JA, Freeman WR. Identifying the factors for improving quality of oral fluorescein angiography. Br J Ophthalmol 2019; 104:504-508. [PMID: 31272951 DOI: 10.1136/bjophthalmol-2019-314187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/30/2019] [Accepted: 06/21/2019] [Indexed: 11/04/2022]
Abstract
AIM To evaluate the quality of oral fluorescein angiography (FA) in relation to food intake. METHODS This is an observational, case-crossover study. We collected information from patients undergoing routine oral FA for retinal disease at the Shiley Eye Institute. Eighty patients (160 eyes) were analysed. Fasting and non-fasting images of the same patient were recorded, compared and analysed for different image quality parameters and clinical relevance by experienced retina specialists. RESULTS When analysing the images, intergrader agreement was moderate to good with a Kappa averaging 0.60 (0.5-0.85). When patients were fasting pre-imaging, better angiography quality scores were achieved when compared with images taken when patients were non-fasting (mean 0.84 vs 0.72, p<0.001). Multivariate analysis showed that non-fasting patients with higher body mass index had the worst scores. Other clinical parameters, such as staining of drusen, staining of disciform scars or central and peripapillary atrophy, were also significantly better during the pre-fasting exam (p<0.001). Oral FA was approximately 22% faster (time to fluorescein dye appearance) under fasting conditions than non-fasting (mean±SD, minutes, 18.7±6.9 vs 25.14±8.1, p<0.001). CONCLUSION Fasting oral FA provided significantly better quality images as well as faster optimal imaging times when compared with non-fasting oral FA. By improving its overall quality, oral FA could be a useful adjunctive examination to optical coherence tomography (OCT) and OCT angiography in patients who require FA studies but who have difficult access or refuse an invasive procedure.
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Affiliation(s)
- Manuel J Amador-Patarroyo
- Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, USA.,Ophthalmology, Escuela Superior de Oftalmologia, Instituto Barraquer de America, Bogota, Colombia
| | - Tiezhu Lin
- Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA.,Ophthalmology, He Eye Hospital, He University, Shenyang, Shenyang, China
| | - Amit Meshi
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Kunny C Dans
- Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, USA
| | - Kevin Chen
- Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - Shyamanga Borooah
- Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, USA.,Department of Ophthalmology, Center for Clinical Brain Sciences, School of Clinical Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Jorge A Díaz-Rojas
- Department of Pharmacology, Science Faculty, Universidad Nacional de Colombia, Bogota, Colombia
| | - William R Freeman
- Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
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13
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Ly A, Nivison-Smith L, Zangerl B, Assaad N, Kalloniatis M. Advanced imaging for the diagnosis of age-related macular degeneration: a case vignettes study. Clin Exp Optom 2017; 101:243-254. [PMID: 28994139 PMCID: PMC5873408 DOI: 10.1111/cxo.12607] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 01/21/2023] Open
Abstract
Background The aim of this study is to evaluate the diagnosis, staging, imaging and management preferences, and the effect of advanced imaging among practising optometrists in age‐related macular degeneration (AMD). Methods Up to 20 case vignettes (computer‐based case simulations) were completed online in a computer laboratory in random order by 81 practising optometrists of Australia. Each case presented findings from a randomly selected patient seen previously at the Centre for Eye Health for a macular assessment in the following order: case history, preliminary tests and colour fundus photography. Participants were prompted to provide their diagnosis, management and imaging preference. One additional imaging result (either modified fundus photographs and infrared images, fundus autofluorescence, or optical coherence tomography [OCT]) was then provided and the questions repeated. Finally, all imaging results were provided and the questions repeated a third time. Results A total of 1,436 responses were analysed. The presence of macular pathology in AMD was accurately detected in 94 per cent of instances. The overall diagnostic accuracy of AMD was 61 per cent using colour fundus photography. This improved by one per cent using one additional imaging modality and a further four per cent using all imaging. Across all responses, a greater improvement in the diagnostic accuracy of AMD occurred following the presentation of OCT findings (versus other modalities). OCT was the most preferred imaging modality for AMD, while multimodal imaging was of greatest benefit in cases more often misdiagnosed using colour fundus photography alone. Overall, the cohort also displayed a tendency to underestimate disease severity. Conclusion Despite reports that imaging technologies improve the stratification of AMD, our findings suggest that this effect may be small when applied among practising optometrists without additional or specific training.
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Affiliation(s)
- Angelica Ly
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Nivison-Smith
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Barbara Zangerl
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Nagi Assaad
- Centre for Eye Health, Sydney, New South Wales, Australia.,Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
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Shoughy SS, Kozak I. Selective and complementary use of Optical Coherence Tomography and Fluorescein Angiography in retinal practice. EYE AND VISION 2016; 3:26. [PMID: 27833927 PMCID: PMC5066300 DOI: 10.1186/s40662-016-0058-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/27/2016] [Indexed: 01/15/2023]
Abstract
The current field of posterior pole and retinal imaging of the human eye has expanded into detailed analyses of the macula, retinal periphery, individual retinal layers, vitreoretinal interface, imaging of the choroid and the optic nerve head. The challenge in retinal imaging is the enduring pursuit of deeper penetration into tissues, increased resolution to the cellular level, and interpretation of observations. How much deeper can we go and with what resolution and reproducibility? These are fundamental questions for experts in search of novel imaging modalities. New discoveries may resolve existing controversies, but inevitably stimulate new questions. Emerging technologies in retinal imaging include adaptive optics retinal imaging and optical coherence tomography-based retinal angiography. In this review, the focus of our discussion will be the discrepancy between the findings (interpretation) of one imaging technology that do not agree or are not even found with a complementary technology. If a clearly seen abnormality is present with one technology but absent in another, what are the possible explanations? Following is a summary of key concepts of retinal and optic nerve imaging modalities and current controversies regarding their interpretation and/or limitations.
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Affiliation(s)
- Samir S Shoughy
- The Eye Center and The Eye Foundation for Research in Ophthalmology, PO Box 55307, Riyadh, 11534 Saudi Arabia
| | - Igor Kozak
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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