Top PDF Renal function and choroidal thickness using swept-source optical coherence tomography in diabetic patients

Renal function and choroidal thickness using swept-source optical coherence tomography in diabetic patients

Renal function and choroidal thickness using swept-source optical coherence tomography in diabetic patients

Abstract ● AIM: To assess the relationship between choroidal thickness and renal function in diabetic patients. ● METHODS: Cross-sectional retrospective clinical study of 42 eyes of 21 ocular treatment-naïve diabetic patients. Demographic data included: age, sex, type and course of diabetes. Ocular data included: severity of diabetic retinopathy; retinal thickness at the central macular region, as well as choroidal thickness at the central and paracentral quadrants, using automatically generated maps by swept-source optical coherence tomography; presence of cystic macular edema; and ocular axial length (AXL). Lab-test parameters included: glycated hemoglobin (HbA1c), albuminuria, albumin/creatinine ratio in urine, and glomerular filtration rate.
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Macular retinal and choroidal thickness in unilateral relentless placoid chorioretinitis analyzed by swept-source optical coherence tomography

Macular retinal and choroidal thickness in unilateral relentless placoid chorioretinitis analyzed by swept-source optical coherence tomography

devices [4,5]. The last generation of these integrates the swept-source (SS) laser technology. The SS-OCT is char- acterized by a light source with a longer wavelength of 1,050 nm. This technical change allows deeper penetration through the ocular tissue, thus obtaining a three- dimensional (3D) high-contrast image of the retina and the choroid [6,7]. This system has a scanning speed of 100,000 A-scans per second and a scan window depth of 2.6 mm with an axial resolution of 8 mm and a transverse resolution of 20 mm in tissue [8]. In the present study, we evaluated the choroidal thickness of the macular area in patients with unilateral RPC and macular involvement.
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In vivo choroidal vascular lesions in diabetes on swept-source optical coherence tomography

In vivo choroidal vascular lesions in diabetes on swept-source optical coherence tomography

remains to be further elucidated[ 3 – 5 ]. Diabetes induces macrovascular and microvascular complications systemically, and a few histologic publications have proposed “diabetic choroi- dopathy ” as another diabetic ocular complication[ 6 – 8 ]. The choroid is comprised of stroma and vasculature which the posterior ciliary arteries feed and vortex veins drain. The choroidal vessels with a larger or smaller diameter are mainly in Haller’s and Sattler’s layers, respectively, and further branch off to the choriocapillaries, which are in contact with Bruch ’s membrane and substantially nourish the outer retinal layers through the retinal pigment epithelium[ 9 ]. Previous histologic publications have reported thickening of the vascular basement membrane, arteriosclerotic changes, or vascular luminal narrowing in the choroid of patients with diabetes[ 6 ]. Capillary dropout and leakage of pro- teinaceous fluid into the stroma also have been reported and may represent ischemia and vas- cular hyperpermeability, as clinically shown in the retinal vasculature in DR[ 7 ]. Recent research has suggested a definite damages in the photoreceptor cells in DR[ 10 , 11 ], although it remains ill-defined how diabetic choroidopathy affects the pathophysiology in the outer retinal layers.
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Study on foveal avascular zone and subfoveal choroidal vasculature in type II diabetic patients using swept source optical coherence tomography

Study on foveal avascular zone and subfoveal choroidal vasculature in type II diabetic patients using swept source optical coherence tomography

the eye in a way that was not possible in any other specialty. The optimal use of this capability was possible only up to the level of anterior vitreous. OCT has now made it possible for us to see not only the retina but also the choroid in cross-sections and that too with a resolution of 10microns. Swept source OCT (DRI-TRITON plus) is particularly suited for this. What is equally exciting is the ability to do angiogram of the retina without using any dye with the help of OCT. Since the vasculature is what is primarily affected in diabetes; studying this by the least invasive method would be ideal. Previously fluorescein dye was required to study the retinal vasculature. The invasive nature of this procedure with attendant systemic complications including death following this procedure limited its use only to very specifically indicated cases. Therefore it was impossible to use this as a screening tool. The big advantage of OCT if it is found useful in the evaluation and management of diabetes is that it is a non invasive tool with a digital output. It can therefore be useful for telemedicine and also be subject to deep machine learning. FA picks up only the superficial capillary network around the fovea but the OCT detects the deep vascular capillary network also. Thus this provides us with an opportunity to study changes in the deep capillary network too. The disadvantage of OCT angiogram (OCTA) is that it does not detect leaks of the capillary because the flow is slow and non-particulate. In addition OCTA is not good for picking up microaneurysms (MA) as the blood flow through them is poor and OCTA depends on change in image over time to detect flow. Eventually OCTA and flourescein angiography will have its own indications in the management of diabetic retinopathy.
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Choroidal thickness measurement by enhanced depth imaging and swept-source optical coherence tomography in central serous chorioretinopathy

Choroidal thickness measurement by enhanced depth imaging and swept-source optical coherence tomography in central serous chorioretinopathy

Between November 2012 and September 2013, we studied 56 eyes of 48 CSC patients (41 men, 49 eyes; 7 women, 7 eyes) at Surugadai Nihon University Hospital, Tokyo, Japan. This study was approved by the institutional review board of Surugadai Nihon University Hospital and written informed concent was obtained from all patients. All subjects underwent a comprehensive ophthalmic exami- nation, that included a thorough ocular examination using an indirect ophthalmoscope and slit-lamp biomicroscope with a contact lens, including an autorefractometer, best- corrected visual acuity (BCVA) measurement with the Landolt C eye chart, color fundus photography (TRC, 50IX/Imagenet, Topcon, Tokyo, Japan), intraocular pres- sure measurement, slit-lamp examination, dilated fundus- copy, fluorescein angiography (FA), indocyanine green angiography, EDI-OCT and SS-OCT. CSC was objectively diagnosed based on the angiographic findings. If both eyes
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Variability of choroidal and retinal thicknesses in healthy eyes using swept-source optical coherence tomography – implications for designing clinical trials

Variability of choroidal and retinal thicknesses in healthy eyes using swept-source optical coherence tomography – implications for designing clinical trials

Axial length was measured using Zeiss IOLMaster 500 (Carl Zeiss Meditec AG, Jena, Germany). Retinal and chor- oidal thicknesses were measured using swept-source optical coherence tomography (DRI OCT-1; TopCon Corporation, Tokyo, Japan). Using this device, a retinal–choroidal map was produced. The Early Treatment Diabetic Retinopathy Study (ETDRS) grid was centered manually at the fovea. The following retinal layers were delineated automatically: RETINA, total retinal thickness from internal limiting membrane to Bruch’s membrane; RNFL, retinal nerve fiber layer; GCLIPL, Ganglion cell layer and inner plexiform layer; RNFLGCLIPL, sum of retinal nerve fiber layer to inner plexiform layer; and CSI, choroid scleral interface. The thicknesses analyzed were the mean of all thickness within the ETDRS grid (Figure 1).
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Effect of amblyopia treatment on choroidal thickness in hypermetropic anisometropic amblyopia using swept-source optical coherence tomography

Effect of amblyopia treatment on choroidal thickness in hypermetropic anisometropic amblyopia using swept-source optical coherence tomography

It has been previously reported that an increased macular choroidal thickness correlates with hypermetro- pia, so in consequence it correlates with a short AL [17, 18]. However, other studies, including our study, show that CT of hypermetropic anisometropic amblyopic eyes is thick, even when the difference in the AL or refractive error between amblyopic and fellow eyes is taken into account in the statistical analysis [10, 12, 19]. Further- more, other investigations have reported changes in the profile of CT [20], in the choroidal structure [21], and in the choroidal blood flow [13] exist in hypermetropic an- isometropic amblyopic eyes. Based on these findings, we assume that there are some structural changes that do occur in the choroid of hypermetropic anisometropic amblyopic eyes. In normal human eyes, it has been Table 1 Demographic and clinical data of the patients before and after treatment
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Noninvasive detection of microaneurysms in diabetic retinopathy by swept-source optical coherence tomography

Noninvasive detection of microaneurysms in diabetic retinopathy by swept-source optical coherence tomography

Our study is limited by its small sample size, lack of masking, and lack of multiple masked graders for the images. However, we hope that it will set the stage for larger masked studies analyzing the potential role of SS-OCT in noninva- sive diagnosis of NPDR. In future studies, we also plan to explore the correlation between SS-OCT, SD-OCT, and FA for the diagnosis of NPDR through visualization of MAs on a large sample size. As OCT imaging technology achieves ever-evolving resolution and noise reduction, we also plan to examine individual MAs and their relative detection on SD-OCT, SS-OCT, FA, and color fundus images. With the further improvement of higher speed point sampling (more slabs within a given thickness), it may also be possible to apply SS-OCT imaging as a biomarker for population-based diabetic retinopathy screening initiatives. We hope that with further research, SS-OCT may someday be used independent of FA as a noninvasive diabetic retinopathy screening tool incorporated into yearly diabetic retinopathy screens. Patients in whom MAs are detected can then be followed closer
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Choroidal thickness in patients with diabetic retinopathy

Choroidal thickness in patients with diabetic retinopathy

A healthy choroid is essential for retinal function. Until recently, the choroid could only be evaluated by indocyanine green angiography, laser flowmetry, and ultrasonography. However, these techniques are only able to show us choroidal vessel abnormalities and blood flow changes; they cannot show the three-dimensional anatomy of choroid layers or the retinal pigment epithelium. Optical coherence tomography (OCT) is a noninva- sive imaging modality, which is used in acquiring high-resolution sections of retina. Recently, enhanced depth imaging (EDI) spectral-domain OCT has been described.
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Choroidal thickness measured with swept source optical coherence tomography in posterior staphyloma strongly correlates with axial length and visual acuity

Choroidal thickness measured with swept source optical coherence tomography in posterior staphyloma strongly correlates with axial length and visual acuity

with staphyloma was 85.53 ± 48.61  μm as compared to normal 250.24 ± 71.01 μm. Stepwise multiple regression analysis confirmed that choroidal thickness measured in staphyloma patients, correlated with axial length and visual acuity. The choroid was the thinnest nasally, both in staphyloma and normal group. There was a strong cor- relation between the axial length and choroidal thick- ness (p < 0.001). With increase in axial length there was corresponding decrease in choroidal thickness. In some patients with staphyloma, the choroidal thickness was even less than 50 μm. This correlates with the previously published histological reports of loss of RPE and choroid in patients with staphyloma [2]. We noted there was a moderate correlation between the BCVA and choroidal thickness in staphyloma group (Fig.  8; r = 0.6), but there was a strong correlation when axial length was com- pared with choroidal thickness (Fig.  7, r = 0.83). This explains that visual acuity may not be a true predictor of the severity of staphyloma. Two of the patients in staphy- loma group had BCVA of 20/400 (logMAR BCVA 1.3) due to macular scar. This study also showed moderate correlation of refractive error with choroidal thickness (r = 0.5; r 2 = 0.3). This can be probably be explained by
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Comparison of peripapillary and subfoveal choroidal thickness in normal versus primary open-angle glaucoma (POAG) subjects using spectral domain optical coherence tomography (SD-OCT) and swept source optical coherence tomography (SS-OCT)

Comparison of peripapillary and subfoveal choroidal thickness in normal versus primary open-angle glaucoma (POAG) subjects using spectral domain optical coherence tomography (SD-OCT) and swept source optical coherence tomography (SS-OCT)

using Optovue RTVue. In patients newly diagnosed with glaucoma, CT was compared before and after starting treatment on bimatoprost in one group and brinzolamide with timolol in another group. They found increased CT in both the groups, however CT was significantly thicker in bimatoprost group compared with brinzolamide with timolol group. This difference was attributed to the mechanism of action of bimatoprost, which acts by increasing the uveoscleral outflow and which is likely to have contributed to increase in CT. Increase in CT was shown to be associated with reduction in IOP following cataract surgery and trabeculectomy. 16 17 Therefore,
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Swept-source optical coherence tomography imaging of macular retinal and choroidal structures in healthy eyes

Swept-source optical coherence tomography imaging of macular retinal and choroidal structures in healthy eyes

Fig. 1 Example of a healthy eye imaged using SS-OCT in the ETDRS area. Retina (A-1), GCC/GCIPL (C-1/B-1), and choroid (D-1) were automatically segmented, and thickness measurements were subsequently calculated through available built-in software (A-2,B-2,C-2,D-2). GCC/GCIPL showed similar topographic distributions with the retina (A-3,B-3,C-3), while in the same region of the macula, the choroid exhibited completely different patterns of topographic variation (D-3). ETDRS = the Early Treatment of Diabetic Retinopathy Study. Delineation of the nine macular sectors: center = within 1000 um of the central fovea; inner ring = 1500 – 3000 um from the central fovea; outer ring = 3000 – 6000 um from the central fovea; The inner and outer rings were segmented into four quadrants (inner/outer superior, inner/outer inferior, inner/outer nasal, and inner/outer temporal)
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Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography

Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography

 STUDY SUBJECTS: Consecutive diabetic patients were prospectively identified at CHUC/AIBILI and the MEE Retina Service, with the following exclusion criteria: refractive error greater than or equal to 6 diopters spherical equivalent; diagnosis of ocular hypertension or glaucoma with an optic nerve cup-to-disc ratio greater than 0.6; treat- ment in the 90 days prior to inclusion with laser capsulot- omy, focal laser, panretinal photocoagulation, or intravitreal injections; any previous retinal surgery; diag- nosis of other retinal or choroidal pathology, namely age- related macular degeneration, vitreomacular traction, epiretinal membrane, macular hole, uveitis; systemic dis- eases that might affect CT, such as uncontrolled hyperten- sion, systemic lupus erythematosus, anemia, leukemia, and obstructive sleep apnea; and decreased media transparency that precluded appropriate OCT imaging.
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Macular retinal and choroidal thickness in unilateral amblyopia using swept-source optical coherence tomography

Macular retinal and choroidal thickness in unilateral amblyopia using swept-source optical coherence tomography

Methods: This study examined 31 patients with hyperopic anisometropic amblyopia (6.9 ± 3.8 years, mean ± standard deviation), 15 patients with strabismic amblyopia without anisometropia (7.9 ± 4.2 years), and 24 age-matched controls (7.8 ± 3.3 years). Retinal and choroidal thickness was measured by 3D scans using SS-OCT. A 6-mm area around the fovea was automatically analyzed using the Early Treatment Diabetic Retinopathy Study map. The thickness from SS-OCT was corrected for magnification error using individual axial length, spherical refraction, cylinder refraction, and corneal radius. Retinal thickness was divided into the macular retinal nerve fiber layer (mRNFL), ganglion cell layer + inner plexiform layer (GCL+IPL), ganglion cell complex (GCC), and the inner limiting membrane to the retinal pigment epithelium (ILM-RPE) thickness. Retinal and choroidal thickness was compared among amblyopic, fellow, and normal eyes.
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Automated macular choroidal thickness measurement by swept-source optical coherence tomography in pseudoxanthoma elasticum

Automated macular choroidal thickness measurement by swept-source optical coherence tomography in pseudoxanthoma elasticum

The role of the choroid in the pathogenesis of the ocular involvement secondary to angioid streaks due to PXE is not well understood. Ellabban et al. [8] analyzed the man- ually measured choroidal thickness in cases of angiod streaks due to PXE and reported the presence of a thin- ner choroid in cases of NV associated with PXE. Other authors analyzed the changes on choroidal thickness in patients with PXE compared based on a classification of the grade of Bruch’s membrane damage, concluding that the severity of the Bruch’s membrane calcification was associated with thinner choroidal thickness [12, 13]. Our results are consistent with these findings, showing a significant thinning in cases with NV. An automatically measurement of the choroidal thickness by SS-OCT soft- ware was performed in the present study compared with previous studies analyzing the choroidal thickness with manual measuring. We found a significant decrease in the mean macular choroidal thickness and in the mean choroidal thickness measured in the central sector of the ETDRS grid in patients with NV due to PXE. Those Table 1 Mean retinal and  choroidal thickness values
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Retinal and choroidal thickness measurements using spectral domain optical coherence tomography in anterior and intermediate uveitis

Retinal and choroidal thickness measurements using spectral domain optical coherence tomography in anterior and intermediate uveitis

The limitations of this study are the small number of the patients and the lack of follow up measurements in the chronic inflammation phase. Further limitation is the lack of available inbuilt software for the automated measurement of choroidal thickness. Normative data- base is not uniform, the reported normal subfoveal chor- oidal thickness varied from 225 μm to 311 μm [19-21], Ikuno et al have however found good interobserver re- producibility of choroidal thickness measurement [22]. Detection of the choroid-sclera border could be im- proved by the recently introduced swept-source optical coherence tomography, which compared with SD-OCT has greater sensitivity at scanning deep choroidal struc- tures and the superficial retinal layers in the same image, and with longer wavelength enabling better imaging of deeper structures [23].
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Optical coherence tomography angiography in choroidal melanoma and nevus

Optical coherence tomography angiography in choroidal melanoma and nevus

Methods: In this retrospective, noninvasive, observational study, 11 patients diagnosed with small choroidal mass (five with choroidal nevus and six with malignant melanoma) who under- went dilated fundus examination, ocular ultrasonography and OCTA images were compared. Results: In choroidal nevus of all patients, OCTA demonstrated a hyporeflective mass with no significant deformity of choroidal vasculature and an intact retinal pigment epithelium (RPE)– Bruch’s membrane complex. The flow void mass was surrounded by an intense vascular rim named as surface microvasculature (SMV) that had an approximately similar flow rate median of 63.68 mm 2 (60.42–67.62 mm 2 ), comparable with the median of the contralateral normal
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Morphometrical evaluation of the choriocapillaris imaged by swept-source optical coherence tomography angiography

Morphometrical evaluation of the choriocapillaris imaged by swept-source optical coherence tomography angiography

Subjects and methods: This observational, cross-sectional case series included 35 eyes of healthy individuals and 32 eyes of 32 patients. Two images of the fovea were taken using SS-OCTA with 3×3 mm squares. Images of the choriocapillaris within 800×800 pixel squares centered at the fovea were analyzed morphometrically using open-source software “AngioTool” that applies a Gaussian recursive filter and multiscale Hessian enhancement. This program’s vessel thickness and intensity parameters can be changed to aid vessel detection. We measured the pairs of images per eye with different parameter sets and calculated the intraclass correlation (ICC) for the morphometrical results. After determining the parameters that produced high repro- ducibility, we evaluated regional variations in 800×800 pixel mm squares within the fovea. Results: The ICCs for vessel area, total vessel length, vessel diameter index, and mean lacunarity were over 0.9 using the parameters of “vessel thickness” 3–4 and intensity 15 in the group including all subjects. When measurements were performed using these same parameter values, the vessel density and mean vessel diameter index were 60.5% and 19.1±0.389, respectively. Vessel density, vessel length, vessel diameter index, and mean lacunarity did not change sig- nificantly within an 800×800 pixel square centered at the fovea except for the 200×200 pixel square at the foveal center.
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Choroidal imaging by spectral domain-optical coherence tomography

Choroidal imaging by spectral domain-optical coherence tomography

The pathogenesis of a pigment epithelial detachment (PED) associated with exudative AMD has been a subject of controversy for several years. On the one hand, Gass proposed that a PED arises from either serous exudation from choriocapillaris hyper- permeability through an intact Bruch ’s membrane or as a conse- quence of choroidal neovascularization (CNV) with secondary exudation directly into the sub-RPE space. On the other hand, Bird and Marshall 57 proposed that increasing lipid deposition into Bruch ’s membrane rendered it hydrophobic and blocked the normal passage of fluid. 58,59 The build-up of fluid would create a PED. Furthermore, they stated that if CNV occurred it would be as a consequence of the PED and not the other way around. 57e59 Part of the reason why it has been dif ficult to study the pathogenesis of PED is the fact that there are no adequate histopathological studies. In addition, imaging modalities such as OCT characteristically reveal an empty hypore flective space in the internal structure of a serous PED. Given the limitations of conventional OCT choroidal imaging, it was unclear if the optically empty space was really optically empty or was filled with material that simply was not imaged due to its location deep down in the choroid. Spaide 60 used EDI-OCT to demonstrate that PEDs were often filled with material suggestive of choroidal neovascularization lending support to Gass ’s theory of neovascular origin for PEDs ( Fig. 6 ). Coscas et al 61 have recently used en face EDI-OCT to image fibrovascular PED. They reported clear CNV visualization and localization within the fibrovascular PED.
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Diagnostic Ability of Swept Source and Spectral Domain Optical Coherence Tomography for Glaucoma

Diagnostic Ability of Swept Source and Spectral Domain Optical Coherence Tomography for Glaucoma

Materials and Methods: This retrospective study involved measuring peripapillary retinal nerve fiber layer (PP-RNFL) thickness, full macular thickness, and ganglion cell-inner plexiform layer (GC-IPL) thickness on two different OCT systems. We used three- dimensional optic disc scanning of DRI-OCT and included 12 clock-hour sectors for measurement of the PP-RNFL. Areas under receiver operating characteristic curves (AUCs) were calculated and compared to determine how well each system could distin- guish control and glaucomatous patients.

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