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Hu M, Wang C, Li Y, Zhang H, Li H, Dai Q, Lian H, Zhao YE, Fu Y. Quantitative Assessment of Lid Margin Vascularity Using Swept-Source Optical Coherence Tomography Angiography. Transl Vis Sci Technol 2024; 13:6. [PMID: 38874976 PMCID: PMC11182367 DOI: 10.1167/tvst.13.6.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024] Open
Abstract
Purpose To evaluate the ability of swept-source optical coherence tomography angiography (SS-OCTA) to assess lid margin vascularity. Methods This prospective, cross-sectional trial enrolled 125 participants, including 15 control subjects and 110 meibomian gland dysfunction (MGD) patients. Lid margin blood flow density (LMBFD) was obtained using SS-OCTA. LMBFD was assessed for repeatability in 54 of 125 participants and for reproducibility in 23 of 125 participants. The efficacy of LMBFD was validated in the 125 participants, who were divided into mild (n = 46), moderate (n = 42), and severe groups (n = 37) according to the lid margin vascularity severity shown in the slit-lamp photographs. Correlations between LMBFD and MG-related parameters, such as ocular surface disease index (OSDI), fluorescein tear break-up time (FTBUT), cornea fluorescein staining (CFS), lid margin score (LMS), and meibomian gland expressibility (ME), were analyzed in all 125 participants. Results Repeatability and reproducibility coefficients were satisfactorily high in the scan mode with a scan area of 6 mm × 6 mm (intraclass correlation coefficient [ICC] repeatability = 0.905; ICC reproducibility = 0.986) and a scan area of 9 mm × 9 mm (ICC repeatability = 0.888; ICC reproducibility = 0.988). The LMBFD gradually increased in the mild, moderate, and severe groups (P < 0.001). LMBFD was significant correlated with OSDI (r = 0.290, P = 0.001), FTBUT (r = -0.195, P = 0.030), CFS (r = 0.352, P < 0.001), ME (r = 0.191, P = 0.033), and LMS (r = 0.370, P < 0.001). Conclusions LMBFD may be a noninvasive, repeatable, reproducible, and efficient index for the quantitative evaluation of eyelid margin vascularity in the future. Translational Relevance We demonstrated that SS-OCTA has the potential to evaluate the eyelid margin vascularity in MGD patients and guide future treatment strategies in clinics.
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Affiliation(s)
- Man Hu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Chenchen Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Ying Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Hongfang Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Hongzhe Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Qi Dai
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Hengli Lian
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Yun-e Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Yana Fu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
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Qu S, Zou Y, Yang L, Wu H. The progress of assessment methods and treatments of neovascular glaucoma secondary to central retinal vein occlusion. Front Med (Lausanne) 2024; 10:1280776. [PMID: 38259837 PMCID: PMC10800625 DOI: 10.3389/fmed.2023.1280776] [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: 08/21/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Neovascular glaucoma is a condition that results from central retinal vein occlusion and often leads to blindness. Accurate evaluation and appropriate treatment are crucial for patients. However, there is currently no uniform and clear standard to differentiate between ischemic and non-ischemic central retinal vein occlusion. Also, the assessment of neovascular glaucoma progression is uncertain. Meanwhile, although pan-retinal photocoagulation is a standard treatment to prevent the onset of neovascular glaucoma, its actual efficacy and the timing of intervention remain highly controversial. It is still challenging to balance the risks of side effects in the visual field against the uncertain effectiveness of the treatment. This paper delves into the pathogenesis of neovascular glaucoma to understand the development of therapeutic approaches. By taking into account various assessment criteria of central retinal vein occlusion and neovascular glaucoma over the years, combining functional tests and morphological tests provides the most accurate and rigorous solution. The age of patients, the extent, location, and duration of retinal ischemia are the primary factors that affect the severity and extent of ischemic central retinal vein occlusion and induce serious complications. From the perspective of prevention and treatment, the ischemic index is closely related to the development of neovascularization. The paper provides essential insights into the mechanism, efficacy, complications, and optimal timing of pan-retinal photocoagulation. Comparing the treatment effects of pan-retinal photocoagulation and intravitreal anti-VEGF injections, we suggest a combination of both treatments to explore effective treatment with fewer side effects in the long term. This article details the debate on the above issues and explores ideas for the clinical diagnosis and preventive treatment of neovascular glaucoma that results from ischemic central retinal vein occlusion.
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Affiliation(s)
| | | | | | - Hong Wu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
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Xia F, Hua R. The Latest Updates in Swept-Source Optical Coherence Tomography Angiography. Diagnostics (Basel) 2023; 14:47. [PMID: 38201356 PMCID: PMC10795713 DOI: 10.3390/diagnostics14010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Optical coherence tomography (OCT) is a revolutionary imaging technology in the field of ophthalmic medical imaging [...].
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Affiliation(s)
- Fan Xia
- Department of Ophthalmology, The Fourth People’s Hospital of Shenyang, China Medical University, Shenyang 110000, China;
| | - Rui Hua
- Department of Ophthalmology, First Hospital of China Medical University, Shenyang 110001, China
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Wang YJ, Ke M, Yan M. The ocular anterior segment examination of perinatal newborns by wide-field digital imaging system: a cross-sectional study. BMC Ophthalmol 2023; 23:411. [PMID: 37828431 PMCID: PMC10571344 DOI: 10.1186/s12886-023-03139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate and summarize the developmental rules of the ocular anterior segment of neonates by means of wild-field digital imaging system. METHODS We used the wide-field digital imaging system to sequentially capture images of the neonates' eyes within 42 days after delivery, including the ocular surface, anterior segment, and fundus. At the same time, basic information at the time of birth and examination was collected. RESULTS Among 248 newborns, 51.21% were male. Abnormalities of the anterior segment such as visualization of anterior chamber angle vessels (79.03%) and iris vessels (51.21%), iris process (42.34%), persistent pupillary membranes (19.35%), albinism, congenital cataracts, corneal leucoma, and subconjunctival hemorrhage were observed in this study. There were significant differences in the appearance of iris vessels among different sex, gestational age and birth weight, postmenstrual age and weight at the time of examination and iris color groups. The iris vessels were more visualized in males relative to females (OR = 6.313, 95% CI 2.529-15.759). The greater the postmenstrual age at the time of examination, the lower the visualization of iris vessels (OR = 0.377, 95% CI 0.247-0.575). In addition, although visualization of anterior chamber angle vessels differed within the birth gestation age and weight at examination groups, there was no significant correlation by regression analysis. CONCLUSIONS The anterior segment of perinatal neonates can be visualized by the wide-field digital imaging system. The neonatal iris and anterior chamber angle are immature, and the visible vessels at the anterior chamber angle that vanish later than the surface of the iris are characteristic structures.
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Affiliation(s)
- Yu-Jing Wang
- Dept of ophthalmology, Zhongnan Hospital of Wuhan University, 430060, Wuhan, Hubei Province, P. R. China
| | - Min Ke
- Dept of ophthalmology, Zhongnan Hospital of Wuhan University, 430060, Wuhan, Hubei Province, P. R. China
| | - Ming Yan
- Dept of ophthalmology, Zhongnan Hospital of Wuhan University, 430060, Wuhan, Hubei Province, P. R. China.
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Wen Y, Jiang D, Tang K, Chen W. Current clinical applications of anterior segment optical coherence tomography angiography: a review. Graefes Arch Clin Exp Ophthalmol 2023; 261:2729-2741. [PMID: 36862203 DOI: 10.1007/s00417-023-05997-3] [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: 08/16/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 03/03/2023] Open
Abstract
Optical coherence tomography (OCT) is a revolutionary in vivo imaging technology that presents real-time information on ocular structures. Angiography based on OCT, known as optical coherence tomography angiography (OCTA), is a noninvasive and time-saving technique originally utilized for visualizing retinal vasculature. As devices and built-in systems have evolved, high-resolution images with depth-resolved analysis have assisted ophthalmologists in accurately localizing pathology and monitoring disease progression. With the aforementioned advantages, application of OCTA has extended from the posterior to anterior segment. This nascent adaptation showed good delineation of the vasculature in the cornea, conjunctiva, sclera, and iris. Thus, neovascularization of the avascular cornea and hyperemia or ischemic changes involving the conjunctiva, sclera, and iris has become prospective applications for AS-OCTA. Although traditional dye-based angiography is regarded as the gold standard in demonstrating vasculature in the anterior segment, AS-OCTA is expected to be a comparable but more patient-friendly alternative. In its initial stage, AS-OCTA has exhibited great potential in pathology diagnosis, therapeutic evaluation, presurgical planning, and prognosis assessments in anterior segment disorders. In this review of AS-OCTA, we aim to summarize scanning protocols, relevant parameters, and clinical applications as well as limitations and future directions. We are sanguine about its wide application in the future with the development of technology and refinement in built-in systems.
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Affiliation(s)
- Yajing Wen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan Jiang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kexin Tang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Wei Chen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Zheng F, Deng X, Zhang Q, He J, Ye P, Liu S, Li P, Zhou J, Fang X. Advances in swept-source optical coherence tomography and optical coherence tomography angiography. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:67-79. [PMID: 37846376 PMCID: PMC10577875 DOI: 10.1016/j.aopr.2022.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 10/18/2023]
Abstract
Background The fast development of swept-source optical coherence tomography (SS-OCT) and swept-source optical coherence tomography angiography (SS-OCTA) enables both anterior and posterior imaging of the eye. These techniques have evolved from a research tool to an essential clinical imaging modality. Main text The longer wavelength and faster speed of SS-OCT and SS-OCTA facilitate better visualization of structure and vasculature below pigmented tissue with a larger field of view of the posterior segment and 360-degree visualization of the anterior segment. In the past 10 years, algorithms dealing with OCT and OCTA data also vastly improved the image quality and enabled the automated quantification of OCT- and OCTA-derived metrics. This technology has enriched our current understanding of healthy and diseased eyes. Even though the high cost of the systems currently limited the widespread use of SS-OCT and SS-OCTA at the first beginning, the gap between research and clinic practice got obviously shortened in the past few years. Conclusions SS-OCT and SS-OCTA will continue to evolve rapidly, contributing to a paradigm shift toward more widespread adoption of new imaging technology in clinical practice.
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Affiliation(s)
- Fang Zheng
- Eye Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaofeng Deng
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, China
| | - Qi Zhang
- Eye Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Jingliang He
- Eye Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Panpan Ye
- Eye Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Shan Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peng Li
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, China
| | - Jian Zhou
- TowardPi (Beijing) Medical Technology Ltd, Shanghai, China
| | - Xiaoyun Fang
- Eye Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
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Confalonieri F, Ngo HB, Petersen HH, Eide NA, Petrovski G. Iris Racemose Hemangioma Assessment with Swept Source Optical Coherence Tomography Angiography: A Feasibility Study and Stand-Alone Comparison. J Clin Med 2022; 11:jcm11216575. [PMID: 36362803 PMCID: PMC9654924 DOI: 10.3390/jcm11216575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose: To evaluate arteriovenous malformations (AVM) with swept-source (SS) optical coherence tomography (OCT) angiography (OCTA) in iris racemose hemangioma and compare it with traditional intravenous iris fluorescein angiography (IVFA). Methods: A cross-sectional observational clinical study was conducted on patients with iris racemose hemangioma with the ZEISS PLEX Elite 9000 SS OCT & OCTA. Results: Three eyes of three patients were imaged. Iris racemose hemangiomas demonstrated a tortuous, well-defined, and continuous course of the AVM. The ZEISS PLEX Elite 9000 SS OCT & OCTA allowed for a detailed visualization of the ARM and was superior to IVFA in depicting small caliber, fine vessels. Conclusions: SS-OCTA may provide a dye-free, no-injection, cost-effective method comparable to spectral domain OCTA and IVFA for diagnosing and monitoring iris racemose hemangiomas for growth and vascularity.
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Affiliation(s)
- Filippo Confalonieri
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Correspondence: (F.C.); (G.P.)
| | - Huy Bao Ngo
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
| | | | - Nils Andreas Eide
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
| | - Goran Petrovski
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, 21000 Split, Croatia
- Correspondence: (F.C.); (G.P.)
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Imaging of iris vasculature: current limitations and future perspective. Eye (Lond) 2022; 36:930-940. [PMID: 34650219 PMCID: PMC9046297 DOI: 10.1038/s41433-021-01809-2] [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: 05/09/2021] [Revised: 08/22/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022] Open
Abstract
Fluorescein and indocyanine green angiography have been the traditional ways to image the vasculature of the iris in the last few decades. Because of the invasive nature of these procedures, they are performed in rare situations, and thus, our understanding about iris vasculature is very limited. Optical coherence tomography angiography (OCTA) is a noninvasive imaging method that enables the detailed visualization of the retinal and choroidal vascular networks. More recently, it has been also used for the examination of the iris vasculature in healthy and disease eyes. However, there is a lack of uniformity in the image acquisition protocols and interpretations in both healthy and pathological conditions. Artifacts of iris OCTA include shadowing, motion, segmentations errors, mirror effects. OCTA devices have an eye-tracking system designed for the posterior segment and the applications of these systems on the anterior segment can determine motion lines, vessel duplication, and vessel discontinuity. OCTA of the iris should always be performed under ambient room lighting to create miosis and reduce iris vasculature changes during the examination. In the near future, eye-tracking systems specifically designed for the iris vessels could permit the follow-up function, and the development of new OCTA metrics could reveal interesting applications of this new imaging technique.
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Gan J, Sng CCA, Ke M, Chieh CS, Tan B, Schmetterer L, Ang M. Anterior Segment Optical Coherence Tomography Angiography Following Trabecular Bypass Minimally Invasive Glaucoma Surgery. Front Med (Lausanne) 2022; 9:830678. [PMID: 35321475 PMCID: PMC8936187 DOI: 10.3389/fmed.2022.830678] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo assess anterior segment optical coherence tomography angiography (AS-OCTA) imaging of the episcleral vessels before and after trabecular bypass minimally invasive glaucoma surgery (MIGS).DesignA prospective, clinical, single-centre, single-arm pilot feasibility study conducted at National University Hospital, Singapore.SubjectsPatients with primary glaucomatous optic neuropathy undergoing Hydrus Microstent (Ivantis Inc., Irvine, CA, USA) implantation, who require at least one intra-ocular pressure-lowering medication. One or two eyes per patient may be enrolled.MethodsWe performed AS-OCTA (Nidek RS-3000 Advance 2, Gamagori, Japan) pre- and up to 6 months post-MIGS implantation using a standard protocol in all cornealimbal quadrants, to derive episcleral vessel densities (VD) using a previously described technique.Main Outcome MeasuresEpiscleral VD pre- and post-surgery, in sectors with and without the implant.ResultsWe obtained serial AS-OCTA images in 25 eyes undergoing MIGS implantation (23 subjects, mean age 70.3 ± 1.5, 61% female) with mean preoperative intraocular pressure (IOP) of 15.5 mmHg ± 4.0. We observed reductions in postoperative episcleral VD compared to preoperative VD at month 1 (mean difference −3.2, p = 0.001), month 3 (mean difference −2.94, p = 0.004) and month 6 (mean difference −2.19, p = 0.039) in sectors with implants (overall 6 month follow-up, p = 0.011). No significant changes were detected in episcleral VD in the sectors without implants (p = 0.910).ConclusionIn our pilot study, AS-OCTA was able to detect changes in the episcleral VD following trabecular bypass MIGS, which may be a useful modality to evaluate surgical outcomes if validated in future studies.
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Affiliation(s)
- Jinyuan Gan
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Chelvin C. A. Sng
- Singapore National Eye Centre, Singhealth, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Mengyuan Ke
- Singapore National Eye Centre, Singhealth, Singapore Eye Research Institute, Singapore, Singapore
| | - Chew Shi Chieh
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Bingyao Tan
- Singapore National Eye Centre, Singhealth, Singapore Eye Research Institute, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
| | - Leopold Schmetterer
- Duke-NUS Graduate Medical School, Singapore, Singapore
- Singapore National Eye Centre, Singhealth, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Marcus Ang
- Duke-NUS Graduate Medical School, Singapore, Singapore
- Singapore National Eye Centre, Singhealth, Singapore Eye Research Institute, Singapore, Singapore
- *Correspondence: Marcus Ang
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Role of Anterior Segment-Optical Coherence Tomography Angiography in Acute Ocular Burns. Diagnostics (Basel) 2022; 12:diagnostics12030607. [PMID: 35328160 PMCID: PMC8947509 DOI: 10.3390/diagnostics12030607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/09/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
Acute ocular burns have varied manifestations which require prompt diagnosis and management to prevent chronic sequelae. Of these, the detection of limbal ischemia poses a challenge because of the subjective nature of its clinical signs. Anterior segment optical coherence tomography angiography (AS-OCTA) offers an objective method of assessing ischemia in these eyes. This review provides an overview of the technology of AS-OCTA and its applications in acute burns. AS-OCTA generates images by isolating the movement of erythrocytes within blood vessels from sequentially obtained b-scans. Limbal ischemia manifests in these scans as absent vasculature and the extent of ischemia can be quantified using different vessel-related parameters. Of these, the density of vessels is most commonly used and correlates with the severity of the injury. Incorporation of the degree of ischemia in the classification of acute burns has been attempted in animal studies and its extension to human trials may provide an added dimension in determining the final prognosis of these eyes. Thus, AS-OCTA is a promising device that can objectively evaluate limbal ischemia. This will facilitate the identification of patients who will benefit from revascularization therapies and stem cell transplants in acute and chronic ocular burns, respectively.
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Lucentini S, Ikesugi K, Bonsignore F, Acuti Martellucci C, Sugimoto M, Matsubara H, Matsui Y, Luccarelli SV, Nucci P, Kondo M. Optical coherence tomography angiography application to pigmented iris: Could a new index quantify blood flow? Eur J Ophthalmol 2021; 32:1772-1781. [PMID: 34269093 DOI: 10.1177/11206721211033485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the blood flow and vascular visibility of irises in relation to pigmentation and pupil size, using an anterior segment optical coherence tomography angiography (OCTA). MATERIALS AND METHODS This is a cross-sectional study. OCTA images were acquired in the nasal and temporal quadrants from a cohort of 30 healthy subjects in photopic (miosis) and scotopic (mydriasis) conditions. Patients were divided according to iris color (less pigmented: group L vs more pigmented: group D). Vascular parameters (vessel density (VD), vessel length density (VLD), fractal dimension (FD)) were applied and compared among groups L and D, location and different pupil status. A novel vascular index called Luminance Index (LI) was developed and applied in order to quantify vascular flow and evaluate its variation in photopic and scotopic conditions. Multivariable analyses were performed to evaluate possible predictors of VD and LI. RESULTS No differences were found for all vascular measurements (VD, VDL, FD, LI) between nasal and temporal quadrants. All vascular measurements were higher in group L than in group D (p < 0.05), except for LI and FD in photopic condition. In group L, all vascular parameters increased (p < 0.001) after dark adaptation. In group D, only LI increased after dark adaptation (p < 0.001). Pigmentation and iris thickness were significantly associated with VD in scotopic and photopic conditions, and with LI only in scotopic condition. CONCLUSIONS Pigmentation still remains a major issue for vascular visibility. Quantitative and qualitative vascular changes follow pupil size variation. LI could be a new surrogate to quantify blood flow.
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Affiliation(s)
- Stefano Lucentini
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic San Giuseppe Hospital, Milan, Italy.,Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kengo Ikesugi
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Francesco Bonsignore
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic San Giuseppe Hospital, Milan, Italy
| | - Cecilia Acuti Martellucci
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Masahiko Sugimoto
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hisashi Matsubara
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshitsugu Matsui
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Saverio Vincenzo Luccarelli
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic San Giuseppe Hospital, Milan, Italy
| | - Paolo Nucci
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic San Giuseppe Hospital, Milan, Italy
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
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