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Lindenberg S, Mahmoudi A, Oncel D, Corradetti G, Oncel D, Emamverdi M, Almidani L, Farahani A, Wakatsuki Y, He Y, Saju S, Lee WK, Wykoff CC, Sarraf D, Freund KB, Sadda SR. Acquired Vitelliform Lesions in Intermediate Age-Related Macular Degeneration: A Cross-Sectional Study. Ophthalmol Retina 2024:S2468-6530(24)00183-0. [PMID: 38631656 DOI: 10.1016/j.oret.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE This study aims to define the characteristics of acquired vitelliform lesions (AVLs) in patients with intermediate age-related macular degeneration (iAMD). DESIGN Retrospective, observational, cross-sectional study SUBJECTS: This study included 217 eyes with AVLs associated with iAMD, and an equivalent number of control patients. METHODS Optical coherence tomography (OCT) scans were evaluated for qualitative and quantitative parameters at both the eye and lesion level. Eye-level parameters included the presence of: hyporeflective core drusen, intraretinal hyperreflective foci (IHRF), subretinal drusenoid deposits, macular pachyvessels, central retinal thickness, and central choroidal thickness (CCT). Lesion-level qualitative parameters included the presence of ellipsoid zone (EZ) and external limiting membrane disruption overlying the AVL, IHRF overlying the AVL, AVL overlying drusen, pachyvessels under the AVL, a solid core within AVL, and AVL location. Lesion-level quantitative characteristics included AVL height and width, AVL distance from the fovea, and sub-AVL choroidal thickness. MAIN OUTCOME MEASURES The primary outcomes assessed included the frequency of iHRF, the presence of macular pachyvessels, CCT, and the dimensions (both height and width) of AVLs. RESULTS Comparing the AVL and control groups, the frequency of IHRF (AVL: 49.3% vs. control: 26.3%) and macular pachyvessels (37.3% vs. 6.9%) was significantly higher in the AVL case group, and the CCT (256.8 ± 88 μm vs. 207.1± 45 μm) was thicker in the AVL group. AVL lesions located over drusen, with overlying IHRF, or situated subfoveally, and AVL lesions with EZ disruption were found to have a greater lesion height and width compared to AVL lesions lacking these characteristics (P-value < 0.001 for all). Additionally, a significant negative correlation was observed between the distance from the fovea and AVL height (Spearman's rho: -0.19, P = 0.002) and width (Spearman's rho: -0.30, P = 0.001). CONCLUSIONS This study represents the largest reported cohort of AVL lesions associated with iAMD. Novel findings include the higher frequency of pachyvessels in addition to the presence of a thicker choroid in these eyes, as well as the greater height and width of AVL closer to the foveal center. These findings may offer insights into pathophysiologic mechanisms underlying the development of AVL.
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Affiliation(s)
| | - Alireza Mahmoudi
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States
| | - Deniz Oncel
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States
| | - Giulia Corradetti
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States
| | - Damla Oncel
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States
| | - Mehdi Emamverdi
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States
| | - Louay Almidani
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States
| | - Alireza Farahani
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States
| | - Yu Wakatsuki
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States
| | - Ye He
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States
| | - Stanley Saju
- Retina Consultants of Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States
| | - Won Ki Lee
- Nune Eye hospital, Seoul, Republic of South Korea
| | - Charles C Wykoff
- Retina Consultants of Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States
| | - David Sarraf
- Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, United States; Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, United States
| | - Srinivas R Sadda
- DIRRL, Doheny Eye Institute, Pasadena, CA, United States; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States.
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Sharma DS, Sharma SD, Sanu KK, Saju S, Deshpande DD, Kannan S. Performance evaluation of a dedicated computed tomography scanner used for virtual simulation using in-house fabricated CT phantoms. J Med Phys 2006; 31:28-35. [PMID: 21206637 PMCID: PMC3003891 DOI: 10.4103/0971-6203.25667] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Accepted: 03/24/2006] [Indexed: 11/04/2022] Open
Abstract
Comprehensive tests on single slice CT scanner was carried out using in-house fabricated phantoms/test tools following AAPM recommended methods to independently validate the auto-performance test (APT) results. Test results of all the electromechanical parameters were found within the specified limits. Radiation and sensitivity profile widths were within ± 0.05 cm of the set slice thickness. Effective energy corresponding to nominal kVp of 80, 110 and 130 were 49.99, 55.08 and 59.48 keV, respectively. Percentage noise obtained by APT was 1.32% while the independently measured value was 0.38%. Observed contrast resolutions by independent method at 0.78% and 12% contrast difference were 4 mm and 1.25 mm (= 4 lp/cm) respectively. However, high contrast resolution (limiting spatial resolution) by APT at 50, 10 and 2% MTF levels were 9, 12.5 and 14.1 lp/cm respectively. Difference in calculated and measured CT numbers of water, air, teflon, acrylic, polystyrene and polypropylene were in the range of 0 to 24 HU, while this difference was 46 and 94 HU in case of nylon and bakelite respectively. The contrast scale determined using CT linearity phantom was 1.998×10−4 cm−1/CT number. CT dose index (CTDI) and weighted CTDI (CTDIw) measured at different kVp for standard head and body phantoms were smaller than manufacturer-specified and system-calculated values and were found within the manufacturer-specified limit of ± 20%. Measured CTDIs on surface (head: 3.6 cGy and body: 2.6 cGy) and at the center (3.3 cGy, head; and 1.2 cGy, body) were comparable to reported values of other similar CT scanners and were also within the industry-quoted CTDI range. Comprehensive QA and independent validation of APT results are necessary to obtain baseline data for CT virtual simulation.
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Affiliation(s)
- D S Sharma
- Department of Medical Physics, Tata Memorial Hospital, Parel, Mumbai, India
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