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15 pages, 3519 KiB

Open AccessArticle

Evaluation of the Diagnostic Capability of Spectralis SD-OCT 8 × 8 Posterior Pole Software with the Grid Tilted at 7 Degrees and Horizontalized in Glaucoma

by Aurora Alvarez-Sarrion, Jose Javier Garcia-Medina, Ana Palazon-Cabanes, Maria Dolores Pinazo-Duran and Monica Del-Rio-Vellosillo

J. Clin. Med. 2024, 13(4), 1016; https://doi.org/10.3390/jcm13041016 - 09 Feb 2024

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Abstract

Background: The goal was to evaluate the diagnostic capability of different parameters obtained with the posterior pole (PP) software in Spectralis SD-OCT with the 8 × 8 grid tilted at 7° and horizontalized in glaucomatous eyes. Methods: A total of 299 [...] Read more.

Background: The goal was to evaluate the diagnostic capability of different parameters obtained with the posterior pole (PP) software in Spectralis SD-OCT with the 8 × 8 grid tilted at 7° and horizontalized in glaucomatous eyes. Methods: A total of 299 eyes were included, comprising 136 healthy eyes and 163 with primary open-angle glaucoma (POAG). The following segmentations were evaluated: complete retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), GCL and inner plexiform layer (GCLIPL), ganglion cell complex (GCC), outer plexiform layer and outer nuclear layer (OPLONL), inner retinal layer (IRL), and outer retinal layer (ORL). Different patterns of macular damage were represented using heatmaps for each studied layer, where the areas under the curve (AUROC) values and a retinal thickness cutoff point were defined to discriminate POAG patients. Results: There was not any difference in the diagnostic capability for detecting glaucoma between the grid tilted at 7° and horizontalized. The macular segmentations that offer the highest diagnostic ability in glaucoma discrimination were, in the following order, RNFL (AUROC = 0.796), GCC (AUROC = 0.785), GCL (AUROC = 0.784), GCLIPL (AUROC = 0.770), IRL (AUROC = 0.755), and the complete retina (AUROC = 0.752). In contrast, ORL and OPLONL do not appear to be helpful for discriminating POAG. Conclusions: Some results of PP software may be useful for discriminating POAG. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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11 pages, 1355 KiB

Open AccessArticle

Ocular Biometry Features and Their Relationship with Anterior and Posterior Segment Lengths among a Myopia Population in Northern China

by Linbo Bian, Wenlong Li, Rui Qin, Zhengze Sun, Lu Zhao, Yifan Zhou, Dehai Liu, Yiyun Liu, Tong Sun and Hong Qi

J. Clin. Med. 2024, 13(4), 1001; https://doi.org/10.3390/jcm13041001 - 09 Feb 2024

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Abstract

Objectives: The study aims to explore the ocular biometry of a myopic population in Northern China, focusing specifically on anterior and posterior segment lengths. Methods: This is a cross-sectional study. The medical records of 3458 myopic patients who underwent refractive surgery were evaluated. [...] Read more.

Objectives: The study aims to explore the ocular biometry of a myopic population in Northern China, focusing specifically on anterior and posterior segment lengths. Methods: This is a cross-sectional study. The medical records of 3458 myopic patients who underwent refractive surgery were evaluated. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and other biometric parameters were measured using the IOL Master 700. The study determined the anterior segment length (ASL = ACD + LT), the posterior segment length (PSL = AL − ASL) and the ratio of ASL to PSL (ASL/PSL). Results: This study included 3458 eyes from 3458 myopic patients (1171 men and 2287 women). The mean age was 27.38 ± 6.88, ranging from 16 to 48 years old. The mean ASL was 7.35 ± 0.27 mm, and the mean PSL was 18.39 ± 1.18 mm. The ASL and PSL trends demonstrate an age-related increase for both genders, with notable gender-specific variations. Across most age groups, males typically exhibited higher ASLs and PSLs than females, with the exception of the 35–40 and 40–45 age groups. The ASL and PSL consistently increased with a rising AL. The AL strongly correlates with the PSL and negatively correlates with the ASL/PSL ratio. The ACD and LT moderately correlate with the ASL, but an increased LT does not imply a longer posterior segment. The CCT and SE show little correlation with axial eye parameters. Conclusions: Among Chinese myopic patients, a longer ASL and PSL were correlated with older age and the male gender. The AL strongly correlates positively with the PSL and negatively correlates with the ASL/PSL ratio. An elongation of the posterior segment may primarily account for an eyeball’s lengthening. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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10 pages, 1172 KiB

Open AccessArticle

Normative Database of the Superior–Inferior Thickness Asymmetry for All Inner and Outer Macular Layers of Adults for the Posterior Pole Algorithm of the Spectralis SD-OCT

by Ana Palazon-Cabanes, Begoña Palazon-Cabanes, Jose Javier Garcia-Medina, Aurora Alvarez-Sarrion and Monica del-Rio-Vellosillo

J. Clin. Med. 2023, 12(24), 7609; https://doi.org/10.3390/jcm12247609 - 11 Dec 2023

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Abstract

Background: This study aims to establish a reference for the superior–inferior hemisphere asymmetry in thickness values for all macular layers for the posterior pole algorithm (PPA) available for the Spectralis SD-OCT device. Methods: We examined 300 eyes of 300 healthy Caucasian volunteers aged [...] Read more.

Background: This study aims to establish a reference for the superior–inferior hemisphere asymmetry in thickness values for all macular layers for the posterior pole algorithm (PPA) available for the Spectralis SD-OCT device. Methods: We examined 300 eyes of 300 healthy Caucasian volunteers aged 18–84 years using the PPA, composed of a grid of 64 (8 × 8) cells, to analyze the thickness asymmetries of the following automatically segmented macular layers: retinal nerve fiber layer (RNFL); ganglion cell layer (GCL); inner plexiform layer (IPL); inner nuclear layer (INL); outer plexiform layer (OPL); outer nuclear layer (ONL); retinal pigment epithelium (RPE); inner retina; outer retina; complete retina. Mean ± standard deviation and the 2.5th and 97.5th percentiles of the thickness asymmetry values were obtained for all the corresponding cells. Results: All the macular layers had significant superior–inferior thickness asymmetries. GCL, IPL, INL, ONL and RPE showed significantly greater thicknesses in the superior than the inferior hemisphere, whereas RNFL and OPL were thicker in the inferior hemisphere. The largest differences between hemispheres were for RNFL and ONL. Conclusions: This is the first normative database of macular thickness asymmetries for the PPA and should be considered to distinguish normal from pathological values when interpreting superior–inferior macular asymmetries. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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11 pages, 2647 KiB

Open AccessArticle

Agreement and Reproducibility of Anterior Chamber Angle Measurements between CASIA2 Built-In Software and Human Graders

by Gustavo Espinoza, Katheriene Iglesias, Juan C. Parra, Ignacio Rodriguez-Una, Sergio Serrano-Gomez, Angelica M. Prada and Virgilio Galvis

J. Clin. Med. 2023, 12(19), 6381; https://doi.org/10.3390/jcm12196381 - 06 Oct 2023

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Abstract

Purpose: This study evaluated the agreement and reproducibility of ACA measurements obtained using the built-in software of the CASIA2 (Version 3G.1) and the measurements derived from expert clinicians. Methods: Healthy volunteers underwent ophthalmological evaluation and AS-OCT examination. ACA measurements derived from automated and [...] Read more.

Purpose: This study evaluated the agreement and reproducibility of ACA measurements obtained using the built-in software of the CASIA2 (Version 3G.1) and the measurements derived from expert clinicians. Methods: Healthy volunteers underwent ophthalmological evaluation and AS-OCT examination. ACA measurements derived from automated and manual SS location were obtained using the CASIA2 automated software and clinician identification, respectively. The intraobserver, interobserver reproducibility, CASIA2–human grader reproducibility and CASIA2 repeatability were assessed using intraclass correlation coefficients (ICCs). Results: The study examined 58 eyes of 30 participants. The CASIA2 software showed excellent repeatability for all ACA parameters (ICC > 0.84). Intraobserver, interobserver, and CASIA2–human grader reproducibility were also excellent (ICC > 0.87). Interobserver agreement was high, except for nasal TISA500, differing between observers 1 and 2 (p < 0.05). The agreement between CASIA2 measurements and human graders was high, except for nasal TISA500, where observer 1 values were smaller (p < 0.05). Conclusion: The CASIA2 built-in software reliably measures ACA parameters in healthy individuals, demonstrating high consistency. Although a small difference was observed in nasal TISA500 measurements, interobserver and CASIA2–human grader reproducibility remained excellent. Automated SS detection has the potential to facilitate evaluation and monitoring of primary angle closure disease. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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15 pages, 1929 KiB

Open AccessFeature PaperArticle

Normative Data for Macular Thickness and Volume for Optical Coherence Tomography in a Diabetic Population without Maculopathies

by Carolina Arruabarrena, Antonio Rodríguez-Miguel, Fernando de Aragón-Gómez, Purificación Escámez, Ingrid Rosado and Miguel A. Teus

J. Clin. Med. 2023, 12(16), 5232; https://doi.org/10.3390/jcm12165232 - 11 Aug 2023

Viewed by 1151

Abstract

Purpose: The purpose was to establish normative data for the macular thicknesses and volume using spectral-domain optical coherence tomography (SD-OCT) in a diabetic population without maculopathies for use as a reference in diabetic retinopathy (DR) and diabetic macular edema screening programs. Methods: This [...] Read more.

Purpose: The purpose was to establish normative data for the macular thicknesses and volume using spectral-domain optical coherence tomography (SD-OCT) in a diabetic population without maculopathies for use as a reference in diabetic retinopathy (DR) and diabetic macular edema screening programs. Methods: This was an observational study nested in a cohort of diabetics from a telemedicine DR screening program. Each patient underwent SD-OCT centered on the fovea. Macular thickness and volume were described and compared using the built-in normative database of the device. Quantile regression models for the 97.5% percentile were fitted to evaluate the predictors of macular thickness and volume. Results: A total of 3410 eyes (mean age, 62.25 (SD, 0.22) years) were included. Mean (SD) central subfield thickness (CST) was 238.2 (23.7) µm, while center thickness (CT), average thickness (AT), and macular volume (MV) were 205.4 (31.6) µm, 263.9 (14.3) µm, and 7.46 (0.40) mm³, respectively. Para- and perifoveal thicknesses were clinically and statistically significantly thinner in our population than in the normative reference database. The 97.5% percentile of the thickness of all sectors was increased in males and in the para- and perifovea among those with DR. Conclusions: All ETDRS sectors were thinner in patients with diabetes than in the reference population, except for the CST, which was the most stable parameter that only changed with sex. The upper cutoff limit to detect diabetic macular edema (DME) was different from that of the reference population and was influenced by conditions related to diabetes, such as DR. Therefore, specific normative data for diabetic patients should be used for the screening and diagnosis of DME using SD-OCT. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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8 pages, 602 KiB

Open AccessArticle

Evaluation of Retinal Blood Flow in Patients with Monoclonal Gammopathy Using OCT Angiography

by Cecilia Czakó, Dóra Gerencsér, Kitti Kormányos, Klaudia Kéki-Kovács, Orsolya Németh, Gábor Tóth, Gábor László Sándor, Anita Csorba, Achim Langenbucher, Zoltán Zsolt Nagy, Gergely Varga, László Gopcsa, Gábor Mikala, Illés Kovács and Nóra Szentmáry

J. Clin. Med. 2023, 12(16), 5227; https://doi.org/10.3390/jcm12165227 - 11 Aug 2023

Viewed by 705

Abstract

Background: Monoclonal gammopathy (MG) is characterized by monoclonal protein overproduction, potentially leading to the development of hyperviscosity syndrome. Objective: To assess retinal circulation using optical coherence tomography angiography (OCTA) parameters in patients with monoclonal gammopathy. Methods: OCTA measurements were performed using the Optovue [...] Read more.

Background: Monoclonal gammopathy (MG) is characterized by monoclonal protein overproduction, potentially leading to the development of hyperviscosity syndrome. Objective: To assess retinal circulation using optical coherence tomography angiography (OCTA) parameters in patients with monoclonal gammopathy. Methods: OCTA measurements were performed using the Optovue AngioVue system by examining 44 eyes of 27 patients with MG and 62 eyes of 36 control subjects. Superficial and deep retinal capillary vessel density (VD SVP and DVP) in the whole 3 × 3 mm macular and parafoveal area, foveal avascular zone (FAZ) area, and central retinal thickness (CRT) were measured using the AngioAnalytics software. The OCTA parameters were evaluated in both groups using a multivariate regression model, after controlling for the effect of imaging quality (SQ). Results: There was no significant difference in age between the subjects with monoclonal gammopathy and the controls (63.59 ± 9.33 vs. 58.01 ± 11.46 years; p > 0.05). Taking into account the effect of image quality, the VD SVP was significantly lower in the MG group compared to the control group (44.54 ± 3.22% vs. 46.62 ± 2.84%; p < 0.05). No significant differences were found between the two groups regarding the other OCTA parameters (p > 0.05). Conclusions: A decreased superficial retinal capillary vessel density measured using OCTA in patients with MG suggests a slow blood flow, reduced capillary circulation, and consequent tissue hypoperfusion. An evaluation of retinal circulation using OCTA in cases of monoclonal gammopathy may be a sensitive method for the non-invasive detection and follow-up of early microcirculatory dysfunction caused by increased viscosity. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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17 pages, 1728 KiB

Open AccessArticle

Assessment by Optical Coherence Tomography of Short-Term Changes in IOP-Related Structures Caused by Wearing Scleral Lenses

by Juan Queiruga-Piñeiro, Alberto Barros, Javier Lozano-Sanroma, Andrés Fernández-Vega Cueto, Ignacio Rodríguez-Uña and Jesús Merayo-LLoves

J. Clin. Med. 2023, 12(14), 4792; https://doi.org/10.3390/jcm12144792 - 20 Jul 2023

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Abstract

Background: The mechanism that could increase intraocular pressure (IOP) during scleral lens (SL) wear is not fully understood, although it may be related to compression of the landing zone on structures involved in aqueous humor drainage. Methods: Thirty healthy subjects were fitted with [...] Read more.

Background: The mechanism that could increase intraocular pressure (IOP) during scleral lens (SL) wear is not fully understood, although it may be related to compression of the landing zone on structures involved in aqueous humor drainage. Methods: Thirty healthy subjects were fitted with two SLs of different sizes (L1 = 15.8 mm, L2 = 16.8 mm) for 2 h in the right eye and left eye as a control. Central corneal thickness (CCT), parameters of iridocorneal angle (ICA), Schlemm’s canal (SC), and optic nerve head were measured before and after wearing both SLs. IOP was measured with a Perkins applanation tonometer before and after lens removal and with a transpalpebral tonometer before, during (0 h, 1 h, and 2 h), and after lens wear. Results: CCT increased after wearing L1 (8.10 ± 4.21 µm; p < 0.01) and L2 (9.17 ± 4.41 µm; p < 0.01). After L1 removal, the ICA parameters decreased significantly (p < 0.05). With L2 removal, nasal and temporal SC area and length were reduced (p < 0.05). An increased IOP with transpalpebral tonometry was observed at 2 h of wearing L1 (2.55 ± 2.04 mmHg; p < 0.01) and L2 (2.53 ± 2.22 mmHg; p < 0.01), as well as an increased IOP with Perkins applanation tonometry after wearing L1 (0.43 ± 1.07 mmHg; p = 0.02). Conclusions: In the short term, SL resulted in a slight increase in IOP in addition to small changes in ICA and SC parameters, although it did not seem to be clinically relevant in healthy subjects. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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10 pages, 1287 KiB

Open AccessArticle

Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System

by José Ignacio Fernández-Vigo, Bárbara Burgos-Blasco, Lucía De-Pablo-Gómez-de-Liaño, Inés Sánchez-Guillén, Virginia Albitre-Barca, Susana Fernández-Aragón, José Ángel Fernández-Vigo and Ana Macarro-Merino

J. Clin. Med. 2023, 12(6), 2351; https://doi.org/10.3390/jcm12062351 - 17 Mar 2023

Cited by 5 | Viewed by 1663

Abstract

Purpose: To propose a classification of the glistening in intraocular lenses (IOL) using swept-source optical coherence tomography (SS-OCT) by means of a simple, objective and reproducible method that allows the quantification of the presence and severity of glistening. Methods: A cross-sectional study on [...] Read more.

Purpose: To propose a classification of the glistening in intraocular lenses (IOL) using swept-source optical coherence tomography (SS-OCT) by means of a simple, objective and reproducible method that allows the quantification of the presence and severity of glistening. Methods: A cross-sectional study on a sample of 150 eyes of 150 patients who underwent cataract surgery in at least 600 days before the exam and attended a routine examination. Each subject was examined by SS-OCT after pupil dilation, identifying the presence of glistening or hyperreflective foci (HRF) in the central area of the IOL. The degree of glistening was classified into four categories: 0: ≤5 HRF; 1: 6 to 15 HRF; 2: 16 to 30 HRF; and 3: >30 HRF. The intra and interobserver reproducibility (intraclass correlation coefficient, ICC) in the quantification and classification of the glistening were calculated. The correlation between the horizontal and vertical scan of the IOL was also assessed. Results: Glistening was present in the IOL in 42.7% of the patients. The mean number of HRF or glistening microvacuoles was 10.4 ± 26.2 (range 0 to 239). In total, 63.3% of the IOLs had a grade 0, 20% grade a 1, 6.7% grade a 2 and 10% a grade 3. The intraobserver and interobserver reproducibility were very high, both for the absolute quantification of the glistening (ICC ≥ 0.994) and for the severity scale (ICC ≥ 0.967). There was an excellent correlation in the quantification of the IOL glistening between the horizontal and vertical scans (R ≥ 0.834; p < 0.001). Conclusions: The use of SS-OCT makes it possible to identify, quantify and classify IOL glistening in a simple, objective and reproducible way. This technique could provide relevant information for the study of the glistening on IOLs. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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11 pages, 3284 KiB

Open AccessArticle

Intervortex Venous Anastomosis in the Macula in Central Serous Chorioretinopathy Imaged by En Face Optical Coherence Tomography

by José Ignacio Fernández-Vigo, Daniela Rego-Lorca, Francisco Javier Moreno-Morillo, Bárbara Burgos-Blasco, Alicia Valverde-Megías, Carmen Méndez-Hernández, Lorenzo López-Guajardo and Juan Donate-López

J. Clin. Med. 2023, 12(6), 2088; https://doi.org/10.3390/jcm12062088 - 07 Mar 2023

Cited by 5 | Viewed by 1096

Abstract

Purpose: To assess the presence of macular intervortex venous anastomosis in central serous chorioretinopathy (CSCR) patients using en face optical coherence tomography (EF-OCT). Methods: A cross-sectional study where EF-OCT 6 × 6 and 12 × 12 mm macular scans of patients with unilateral [...] Read more.

Purpose: To assess the presence of macular intervortex venous anastomosis in central serous chorioretinopathy (CSCR) patients using en face optical coherence tomography (EF-OCT). Methods: A cross-sectional study where EF-OCT 6 × 6 and 12 × 12 mm macular scans of patients with unilateral chronic CSCR were evaluated for anastomosis between vortex vein systems in the central macula. The presence of prominent anastomoses was defined as a connection with a diameter ≥150 µm between the inferotemporal and superotemporal vortex vein systems which crossed the temporal raphe. Three groups were studied: CSCR eyes (with an active disease with the presence of neurosensorial detachment; n = 135), fellow unaffected eyes (n = 135), and healthy eyes as controls (n = 110). Asymmetries, abrupt termination, sausaging, bulbosities and corkscrew appearance were also assessed. Results: In 79.2% of the CSCR eyes there were prominent anastomoses in the central macula between the inferotemporal and superotemporal vortex vein systems, being more frequent than in fellow eyes and controls (51.8% and 58.2% respectively). The number of anastomotic connections was higher in the affected eye group (2.9 ± 1.8) than in the unaffected fellow eye group (2.1 ± 1.7) and the controls (1.5 ± 1.6) (p < 0.001). Asymmetry, abrupt terminations and the corkscrew appearance of the choroidal vessels were more frequent in the affected eyes, although no differences in sausaging or bulbosities were observed. Conclusions: Intervortex venous anastomoses in the macula were common in CSCR, being more frequently observed in affected eyes than in fellow unaffected eyes and healthy controls. This anatomical variation could have important implications concerning the pathogenesis and classification of the disease. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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Review

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16 pages, 3168 KiB

Open AccessReview

Update on the Utility of Optical Coherence Tomography in the Analysis of the Optic Nerve Head in Highly Myopic Eyes with and without Glaucoma

by Bachar Kudsieh, José Ignacio Fernández-Vigo, Ignacio Flores-Moreno, Jorge Ruiz-Medrano, Maria Garcia-Zamora, Muhsen Samaan and Jose Maria Ruiz-Moreno

J. Clin. Med. 2023, 12(7), 2592; https://doi.org/10.3390/jcm12072592 - 29 Mar 2023

Cited by 2 | Viewed by 2000

Abstract

Glaucoma diagnosis in highly myopic subjects by optic nerve head (ONH) imaging is challenging as it is difficult to distinguish structural defects related to glaucoma from myopia-related defects in these subjects. Optical coherence tomography (OCT) has evolved to become a routine examination at [...] Read more.

Glaucoma diagnosis in highly myopic subjects by optic nerve head (ONH) imaging is challenging as it is difficult to distinguish structural defects related to glaucoma from myopia-related defects in these subjects. Optical coherence tomography (OCT) has evolved to become a routine examination at present, providing key information in the assessment of glaucoma based on the study of the ONH. However, the correct segmentation and interpretation of the ONH data employing OCT is still a challenge in highly myopic patients. High-resolution OCT images can help qualitatively and quantitatively describe the structural characteristics and anatomical changes in highly myopic subjects with and without glaucoma. The ONH and peripapillary area can be analyzed to measure the myopic atrophic-related zone, the existence of intrachoroidal cavitation, staphyloma, and ONH pits by OCT. Similarly, the lamina cribosa observed in the OCT images may reveal anatomical changes that justify visual defects. Several quantitative parameters of the ONH obtained from OCT images were proposed to predict the progression of visual defects in glaucoma subjects. Additionally, OCT images help identify factors that may negatively influence the measurement of the retinal nerve fiber layer (RNFL) and provide better analysis using new parameters, such as Bruch’s Membrane Opening-Minimum Rim Width, which serves as an alternative to RNFL measurements in highly myopic subjects due to its superior diagnostic ability. Full article

(This article belongs to the Special Issue Clinical Utility of Optical Coherence Tomography in Ophthalmology)

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