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Ayalon A, Sahel JA, Chhablani J. A journey through the world of vitreous. Surv Ophthalmol 2024:S0039-6257(24)00070-5. [PMID: 38885759 DOI: 10.1016/j.survophthal.2024.06.004] [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: 04/04/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
Vitreous, one of the largest components of the human eye, mostly contains water. Despite decades of studying the vitreous structure, numerous unanswered questions still remain, fueling ongoing active research. We attempt to provide a comprehensive overview of the current understanding of the development, morphology, biochemical composition, and function of the vitreous. We emphasize the impact of the vitreous structure and composition on the distribution of drugs. Fast developing imaging technologies, such as modern optical coherence tomography, unlocked multiple new approaches, offering the potential for in vivo study of the vitreous structure. They allowed to analyze in vivo a range of vitreous structures, such as posterior precortical vitreous pockets, Cloquet canal, channels that interconnect them, perivascular vitreous fissures, and cisterns. We provide an overview of such imaging techniques and their principles and of some challenges in visualizing vitreous structures. Finally, it explores the potential of combining the latest technologies and machine learning to enhance our understanding of vitreous structures.
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Affiliation(s)
- Anfisa Ayalon
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Invernizzi A, Zaffalon C, Manni P, Zicarelli F, Chisari D, Adani C, Mastrofilippo V, Bolletta E, Gozzi F, De Simone L, Staurenghi G, Cimino L. Anterior Vitreous Objective Assessment in Uveitis: An Anterior Segment Swept Source Optical Coherence Tomography Study. Ocul Immunol Inflamm 2024:1-9. [PMID: 38648627 DOI: 10.1080/09273948.2024.2339435] [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: 12/18/2023] [Accepted: 03/30/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To assess inflammatory changes in the anterior vitreous (AV) using a swept source anterior segment optical coherence tomography (SS-ASOCT) and to correlate them with uveitis features and clinical grading of intraocular inflammation. METHODS 140 eyes from 96 patients were included in this observational, cross-sectional study: 40 ACTIVE uveitis, 40 INACTIVE uveitis and 60 CONTROLS. All eyes underwent intraocular inflammation clinical grading (anterior chamber (AC) cells counting and vitreous haze evaluation) and AV imaging with SS-ASOCT. Cells seen in the AV on OCT were manually counted using imageJ. Vitreous reflectivity variation was indirectly measured by calculating the vitreous/iris pigment epithelium (VIT/IPE) relative intensity. These OCT-based parameters were compared across the groups and correlated with inflammation clinical grading. RESULTS The mean [SD] number of AV OCT cells was significantly higher (both p < 0.001) in ACTIVE uveitis (12[9.8]) compared to INACTIVE uveitis (4.5[3.5]) and CONTROLS (4[3.1]). In ACTIVE uveitis the number of AV OCT cells was significantly and positively correlated with the AC cells (p = 0.04), the VIT/IPE relative intensity (p = 0.0002), the uveitis anatomical classification (INTERMEDIATE UVEITIS, p = 0.02) and the vitreous haze clinical grading (p < 0.0001). The mean[SD] VIT/IPE relative intensity of the AV increased from CONTROLS (0.12[0.01]) to INACTIVE uveitis (0.15[0.01]) to ACTIVE uveitis (0.17[0.02]), but with no statistically significant differences. CONCLUSIONS We were able to visualize and objectively evaluate changes occurring in the AV in eyes with uveitis by means of a commercially available SS-ASOCT. OCT-cells in the AV could represent an adjunctive tool in the objective evaluation of intraocular inflammation.
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Affiliation(s)
- Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Chiara Zaffalon
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Priscilla Manni
- Department of Sense Organs, Ocular Immunovirology Service, Sapienza University of Rome, Rome, Italy
| | - Federico Zicarelli
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Domenico Chisari
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Chantal Adani
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | | | - Elena Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Luca De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Ueno T, Fujita H, Ikeda A, Harada K, Tsukahara-Kawamura T, Ozaki H, Uchio E. Finite Element Analysis of Changes in Deformation of Intraocular Segments by Airbag Impact in Eyes of Various Axial Lengths. Clin Ophthalmol 2024; 18:699-712. [PMID: 38468913 PMCID: PMC10926924 DOI: 10.2147/opth.s445253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024] Open
Abstract
Background We studied the kinetic phenomenon of an airbag impact on eyes with different axial lengths using finite element analysis (FEA) to sequentially determine the physical and mechanical responses of intraocular segments at various airbag deployment velocities. Methods The human eye model we created was used in simulations with the FEA program PAM-GENERISTM. The airbag was set to impact eyes with axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 20, 30, 40, 50 and 60 m/s. The deformation rate was calculated as the ratio of the length of three segments, anterior chamber, lens and vitreous, to that at the baseline from 0.2 ms to 2.0 ms after the airbag impact. Results Deformation rate of the anterior chamber was greater than that of other segments, especially in the early phase, 0.2-0.4 ms after the impact (P < 0.001), and it reached its peak, 80%, at 0.8 ms. A higher deformation rate in the anterior chamber was found in hyperopia compared with other axial length eyes in the first half period, 0.2-0.8 ms, followed by the rate in emmetropia (P < 0.001). The lens deformation rate was low, its peak ranging from 40% to 75%, and exceeded that of the anterior chamber at 1.4 ms and 1.6 ms after the impact (P < 0.01). The vitreous deformation rate was lower throughout the simulation period than that of the other segments and ranged from a negative value (elongation) in the later phase. Conclusion Airbag impact on the eyeball causes evident deformation, especially in the anterior chamber. The results obtained in this study, such as the time lag of the peak deformation between the anterior chamber and lens, suggest a clue to the pathophysiological mechanism of airbag ocular injury.
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Affiliation(s)
- Tomohiro Ueno
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hideaki Fujita
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Aya Ikeda
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Kazuhiro Harada
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | | | - Hiroaki Ozaki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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Gupta A, Ruminski D, Villar AJ, Toledo RD, Gondek G, Pierscionek B, Artal P, Grulkowski I. Age-related changes in geometry and transparency of human crystalline lens revealed by optical signal discontinuity zones in swept-source OCT images. EYE AND VISION (LONDON, ENGLAND) 2023; 10:46. [PMID: 38037146 PMCID: PMC10691129 DOI: 10.1186/s40662-023-00365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND The shape and microstructure of the human crystalline lens alter with ageing, and this has an effect on the optical properties of the eye. The aim of this study was to characterise the age-related differences in the morphology and transparency of the eye lenses of healthy subjects through the optical signal discontinuity (OSD) zones in optical coherence tomography (OCT) images. We also investigated the association of those changes with the optical quality of the eye and visual function. METHODS OCT images of the anterior segment of 49 eyes of subjects (9-78 years) were acquired, and the OSD zones (nucleus, C1-C4 cortical zones) were identified. Central thickness, curvature and optical density were measured. The eye's optical quality was evaluated by the objective scatter index (OSI). Contrast sensitivity and visual acuity tests were performed. The correlation between extracted parameters and age was assessed. RESULTS The increase in lens thickness with age was dominated by the thickening of the cortical zone C3 (0.0146 mm/year). The curvature radii of the anterior lens surface and both anterior and posterior nucleo-cortical interfaces decreased with age (- 0.053 mm/year, - 0.013 mm/year and - 0.006 mm/year, respectively), and no change was observed for the posterior lens radius. OCT-based densitometry revealed significant correlations with age for all zones except for C1β, and the highest increase in density was in the C2-C4 zones (R = 0.45, 0.74, 0.56, respectively, P < 0.001). Increase in OSI was associated with the degradation of visual function. CONCLUSIONS OCT enables the identification of OSD zones of the crystalline lens. The most significant age-related changes occur in the C3 zone as it thickens with age at a faster rate and becomes more opaque than other OSD zones. The changes are associated with optical quality deterioration and reduction of visual performance. These findings contribute to a better understanding of the structure-function relationship of the ageing lens and offer insights into both pathological and aging alterations.
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Affiliation(s)
- Ashish Gupta
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100, Toruń, Poland
| | - Daniel Ruminski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100, Toruń, Poland
| | - Alfonso Jimenez Villar
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100, Toruń, Poland
| | - Raúl Duarte Toledo
- Laboratorio de Óptica, Centro de Investigación en Óptica y Nanofísica, Universidad de Murcia, Edif. CIOyN, N º34, Campus de Espinardo, 30100, Murcia, Spain
| | - Grzegorz Gondek
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100, Toruń, Poland
| | - Barbara Pierscionek
- Faculty of Health, Education, Medicine, and Social Care, Medical Technology Research Center, Chelmsford Campus, Anglia Ruskin University, Bishop Hall Ln, Chelmsford, CM1 1SQ, UK
| | - Pablo Artal
- Laboratorio de Óptica, Centro de Investigación en Óptica y Nanofísica, Universidad de Murcia, Edif. CIOyN, N º34, Campus de Espinardo, 30100, Murcia, Spain
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100, Toruń, Poland.
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Mahoun Z, Malaise D, Lumbroso-Le Rouic L, Levy-Gabriel C, Cassoux N, Matet A. Optical Density Ratio of Subretinal Fluid in Choroidal Melanomas Versus Choroidal Naevi Assessed by Optical Coherence Tomography. Invest Ophthalmol Vis Sci 2023; 64:1. [PMID: 37788003 PMCID: PMC10552873 DOI: 10.1167/iovs.64.13.1] [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: 04/04/2023] [Accepted: 09/05/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose The purpose of this study was to determine whether optical density ratio (ODR) of subretinal fluid (SRF) on optical coherence tomography (OCT) differs between choroidal naevi and melanomas. Methods One hundred ninety-nine patients (one eye per patient) presenting choroidal melanoma or choroidal naevus with SRF on OCT, evaluated between February and June 2019, were retrospectively included. Other retinal conditions, opaque media, and low-quality OCT were excluded. Mean pixel intensity of SRF (range = 0-255) was quantified using a semi-automated procedure by a masked observer on standard horizontal OCT sections. Mean vitreous intensity served as the reference for ODR. Results One hundred twenty-eight patients with choroidal melanoma and 71 patients with choroidal naevus were included in this study. ODR (mean ± SD) was higher in melanomas (181 ± 64) than in naevi (78 ± 48, P < 0.0001). ODR was correlated to lesion thickness (P < 0.0001, r = 0.27), largest basal diameter (P = 0.028, r = 0.16) and, among naevi, to the number of risk factors for growth into melanoma (P = 0.032, r = 0.22). Among 110 patients with naevi or melanoma who underwent fluorescein angiography, ODR was 120.7 ± 550.1 in eyes presenting angiographic pinpoints versus 14.19 ± 26.0 in eyes that did not (P = 0.06). Fourteen eyes with naevi that transformed into melanoma over 3 years had a mean baseline ODR of 94.7 ± 243.5 compared to 4.01 ± 9.74 in 28 matched naevi eyes of similar size that did not transform (P = 0.027). Conclusions SRF ODR is higher in choroidal melanoma compared to choroidal naevi. This OCT-derived imaging marker is also higher in choroidal naevi with the potential to transform into melanoma, compared to stationary naevi.
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Affiliation(s)
- Zachary Mahoun
- Department of Ocular Oncology, Institut Curie, Paris, France
| | - Denis Malaise
- Department of Ocular Oncology, Institut Curie, Paris, France
- Laboratoire d'Imagerie Translationnelle en Oncologie, INSERM U1288, Institut Curie, PSL University, Orsay, France
| | | | | | - Nathalie Cassoux
- Department of Ocular Oncology, Institut Curie, Paris, France
- Université Paris Cité, Paris, France
- INSERM UMR1138 “From physiopathology of ocular diseases to clinical developments,” Centre de Recherche des Cordeliers, Paris, France
| | - Alexandre Matet
- Department of Ocular Oncology, Institut Curie, Paris, France
- Université Paris Cité, Paris, France
- INSERM UMR1138 “From physiopathology of ocular diseases to clinical developments,” Centre de Recherche des Cordeliers, Paris, France
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Gozzi F, Bertolini M, Gentile P, Verzellesi L, Trojani V, De Simone L, Bolletta E, Mastrofilippo V, Farnetti E, Nicoli D, Croci S, Belloni L, Zerbini A, Adani C, De Maria M, Kosmarikou A, Vecchi M, Invernizzi A, Ilariucci F, Zanelli M, Iori M, Cimino L. Artificial Intelligence-Assisted Processing of Anterior Segment OCT Images in the Diagnosis of Vitreoretinal Lymphoma. Diagnostics (Basel) 2023; 13:2451. [PMID: 37510195 PMCID: PMC10378347 DOI: 10.3390/diagnostics13142451] [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: 05/24/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Anterior segment optical coherence tomography (AS-OCT) allows the explore not only the anterior chamber but also the front part of the vitreous cavity. Our cross-sectional single-centre study investigated whether AS-OCT can distinguish between vitreous involvement due to vitreoretinal lymphoma (VRL) and vitritis in uveitis. We studied AS-OCT images from 28 patients (11 with biopsy-proven VRL and 17 with differential diagnosis uveitis) using publicly available radiomics software written in MATLAB. Patients were divided into two balanced groups: training and testing. Overall, 3260/3705 (88%) AS-OCT images met our defined quality criteria, making them eligible for analysis. We studied five different sets of grey-level samplings (16, 32, 64, 128, and 256 levels), finding that 128 grey levels performed the best. We selected the five most effective radiomic features ranked by the ability to predict the class (VRL or uveitis). We built a classification model using the xgboost python function; through our model, 87% of eyes were correctly diagnosed as VRL or uveitis, regardless of exam technique or lens status. Areas under the receiver operating characteristic curves (AUC) in the 128 grey-level model were 0.95 [CI 0.94, 0.96] and 0.84 for training and testing datasets, respectively. This preliminary retrospective study highlights how AS-OCT can support ophthalmologists when there is clinical suspicion of VRL.
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Affiliation(s)
- Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Marco Bertolini
- Medical Physics Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Pietro Gentile
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
- Clinical and Experimental Medicine Ph.D. Program, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Laura Verzellesi
- Medical Physics Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Valeria Trojani
- Medical Physics Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Luca De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Elena Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | | | - Enrico Farnetti
- Molecular Pathology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Davide Nicoli
- Molecular Pathology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Lucia Belloni
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Alessandro Zerbini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Chantal Adani
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Michele De Maria
- Ophthalmology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Areti Kosmarikou
- Ophthalmology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Marco Vecchi
- Ophthalmology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Alessandro Invernizzi
- Eye Clinic, Luigi Sacco Hospital, Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
- Faculty of Health and Medicine, Save Sight Institute, University of Sydney, Sydney, NSW 2000, Australia
| | | | - Magda Zanelli
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Mauro Iori
- Medical Physics Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
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Stanga PE, Valentin Bravo FJ, Reinstein UI, Stanga SFE, Marshall J, Archer TJ, Reinstein DZ. New Terminology and Methodology for the Assessment of the Vitreous, Its Floaters and Opacities, and Their Effect on Vision: Standardized and Kinetic Anatomical and Functional Testing of Vitreous Floaters and Opacities (SK VFO Test). Ophthalmic Surg Lasers Imaging Retina 2023; 54:306-315. [PMID: 37184989 DOI: 10.3928/23258160-20230412-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To introduce VFO and SK VFO Test: new, more representative terminology for symptoms of vitreous floaters/opacities (VFO) and new standardized kinetic (SK) anatomical-functional assessment. MATERIALS AND METHODS Eight eyes underwent before-after limited vitrectomy (LV): best-corrected visual acuity, low-luminance visual acuity, Minnesota Low Vision Reading Chart near visual acuity in logMAR, contrast sensitivity function (CV1000E), and straylight measurements (SM) (HDA/LDA/C-Quant). SK infrared confocal scanning laser ophthalmoscopy (SK IRcSLO) and swept-source widefield optical coherence tomography (SS-WF-OCT) identified VFO and posterior vitreous detachment (PVD). SK IRcSLO was performed with gaze directed towards the extreme superior, inferior, and lateral directions. RESULTS Anatomical-functional results after LV improved in 7 eyes (87.5%): objective scatter index (27.34%), disturbance index (47.97%) and C-Quant Log units (2.26%). Pre-LV SK IRcSLO and SS-WFOCT imaging identified dynamic well-defined VFO and PVD status (100%). A residual asymptomatic anterior cortical vitreous-induced shadowing ripple effect was detected post-LV. CONCLUSIONS This is the first objective-standardized test accounting for VFO kinesis and intermittent effect. There is potential for personalizing treatment and establishing best candidates for laser or surgery. [Ophthalmic Surg Lasers Imaging Retina 2023;54:306-315.].
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Visualization and Grading of Vitreous Floaters Using Dynamic Ultra-Widefield Infrared Confocal Scanning Laser Ophthalmoscopy: A Pilot Study. J Clin Med 2022; 11:jcm11195502. [PMID: 36233369 PMCID: PMC9571201 DOI: 10.3390/jcm11195502] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: To describe the appearance of vitreous opacities using dynamic ultra-widefield infrared confocal scanning laser ophthalmoscopy (IRcSLO). Design: Retrospective case series. Methods: Eyes of patients complaining of myodesopsia were analyzed using dynamic ultra-widefield IRcSLO imaging (Nidek Mirante, Nidek Co., Ltd., Gamagori, Japan), and classified according to a vitreous opacity severity scale. Results: Thirty eyes of 21 patients were included in this study. The average age was 56 years. Symptom duration ranged from 1 to more than 365 days. The most common cause of vitreous floaters was posterior vitreous detachment (63.3%), followed by vitreous syneresis (23.3%), asteroid hyalosis (10%) and vitreous hemorrhage (3.3%). Opacities were classified as Grade 1 in three eyes (10%), Grade 2 in 10 eyes (33.3%), Grade 3 in 11 eyes (36.6%), Grade 4 in two eyes (6.6%) and Grade 5 in four eyes (13.3%). Patients with Grade 1 opacities were younger than patients with opacities Grade 2 or greater. A visible Weiss ring could be identified in 0% of eyes with Grade 1 opacities, 40% of eyes with Grade 2 opacities, 100% of eyes with Grade 3 opacities, and 100% of eyes with Grade 4 opacities. In patients with Grade 5 opacities, a Weiss ring could not be identified. Conclusion: Dynamic ultra-widefield IRcSLO imaging is a useful tool to evaluate patients with vitreous floaters. It allows for accurate visualization of the number, density, and behavior of the shadows that vitreous opacities project over a very wide area of the retina, which has a positive correlation with patient perception of floaters.
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Incidence and Risk Factors for Berger's Space Development after Uneventful Cataract Surgery: Evidence from Swept-Source Optical Coherence Tomography. J Clin Med 2022; 11:jcm11133580. [PMID: 35806863 PMCID: PMC9267354 DOI: 10.3390/jcm11133580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: This study investigates the incidence and risk factors for the development of Berger’s space (BS) after uneventful phacoemulsification based on swept-source optical coherence tomography (SS-OCT). Methods: Cataractous eyes captured using qualified SS-OCT images before and after uneventful phacoemulsification cataract surgery were included. Six high-resolution cross-sectional anterior segment SS-OCT images at 30° intervals were used for BS data measurements. BS width was measured at three points on each scanned meridian line: the central point line aligned with the cornea vertex and two point lines at the pupil’s margins. Results: A total of 223 eyes that underwent uneventful cataract surgery were evaluated. Preoperatively, only two eyes (2/223, 0.9%) were observed to have consistent BS in all six scanning directions. BS was observed postoperatively in 44 eyes (44/223, 19.7%). A total of 13 eyes (13/223, 5.8%) with insufficient image quality, pupil dilation, or lack of preoperative image data were excluded from the study. A total of 31 postoperative eyes with BS and 31 matched eyes without BS were included in the final data analysis. The smallest postoperative BS width was in the upper quadrant of the vertical meridian line (90°), with a mean value of 280 μm. The largest BS width was observed in the opposite area of the main clear corneal incision, with a mean value >500 μm. Conclusions: Uneven-width BS is observable after uneventful phacoemulsification. Locations with a much wider BS (indirect manifestation of Wieger zonular detachment) are predominantly located in the opposite direction to the main corneal incisions.
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Evaluating posterior vitreous detachment by widefield 23-mm swept-source optical coherence tomography imaging in healthy subjects. Sci Rep 2021; 11:19754. [PMID: 34611277 PMCID: PMC8492648 DOI: 10.1038/s41598-021-99372-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022] Open
Abstract
Posterior vitreous detachment (PVD) is a separation between the posterior vitreous cortex and internal limiting membrane. Although PVD was historically considered an acute event, recent studies using spectral-domain optical coherence tomography (SD-OCT) revealed a gradual progression of PVD in healthy subjects. Although SD-OCT improved PVD studies, the narrow imaging angle and long examination time were problematic to allow wide angle capture. The Xephilio OCT-S1 (Canon), a swept-source OCT (SS-OCT) device, can obtain up to 23-mm of widefield B-scan images in a single acquisition. We used this widefield SS-OCT to quantitatively evaluate the PVD stage in 214 healthy subjects aged 4–89 years and determine whether PVD stages differ between the bilateral eyes of each patient. Age was significantly positively correlated with the overall PVD stage (ρ = 0.7520, P < 0.001). Interestingly, partial PVD occurred in children as young as 5 years, indicating that initial PVD onset may occur much earlier than previously reported. Furthermore, PVD stages of the bilateral eyes were highly consistent in 183 subjects (85.5%). Widefield 23-mm SS-OCT thus revealed that PVD started earlier than anticipated, and age was correlated with the symmetry of PVD stage. Widefield 23-mm SS-OCT may also be clinically useful for the evaluation of diseased eyes.
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