Computerized macular pathology diagnosis in spectral domain optical coherence tomography scans based on multiscale texture and shape features.

Purpose: To develop an automated method to identify the normal macula and three macular pathologies (macular hole [MH], macular edema [ME], and age-related macular degeneration [AMD]) from the fovea-centered cross sections in three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) images.

Methods: A sample of SD-OCT macular scans (macular cube 200 × 200 or 512 × 128 scan protocol; Cirrus HD-OCT; Carl Zeiss Meditec, Inc., Dublin, CA) was obtained from healthy subjects and subjects with MH, ME, and/or AMD (dataset for development: 326 scans from 136 subjects [193 eyes], and dataset for testing: 131 scans from 37 subjects [58 eyes]).

Endophthalmitis in microincision vitrectomy: outcomes of gas-filled eyes.

Purpose: To assess whether performing an air or gas exchange at the conclusion of a microincision vitrectomy procedure is beneficial regarding the rate of endophthalmitis.

Methods: This was a collaborative, multicenter, retrospective chart review of 2,336 eyes that underwent microincision sutureless vitrectomy (23 or 25 gauge) with either SF6 or C3F8 gas endotamponade for macular hole between January 2008 and December 2009. For all eyes, the search methodology was structured to identify the main outcome measure, which was the occurrence of acute postoperative endophthalmitis (<6 weeks after pars plana vitrectomy).

The role of spectral-domain OCT in the diagnosis and management of neovascular age-related macular degeneration.

Spectral-domain optical coherence tomography (SD-OCT) has emerged as the ancillary examination of choice to assist the diagnosis and management of neovascular age-related macular degeneration (AMD). SD-OCT provides more detailed images of intraretinal, subretinal, and subretinal pigment epithelium fluid when compared to time-domain technology, leading to higher and earlier detection rates of neovascular AMD activity. Improvements in image analysis and acquisition speed make it important for decision-making in the diagnosis and treatment of this disease.

Intraretinal deposition of triamcinolone acetonide after treatment of diabetic macular edema.

Purpose: To report a case of intraretinal triamcinolone acetonide crystal deposition visualized both clinically and on optical coherence tomography after intravitreal injection for diabetic macular edema refractory to focal/grid laser treatment.

Methods: Observational case report. A 46-year-old man with severe bilateral diabetic macular edema underwent focal/grid laser therapy, Avastin (Genetech, Inc.

Analysis of choroidal thickness in age-related macular degeneration using spectral-domain optical coherence tomography.

Purpose: To understand the relationship between choroidal thickness and various disease factors in patients with age-related macular degeneration (AMD) using spectral-domain optical coherence tomography.

Design: Cross-sectional, retrospective analysis.

Methods: Fifty-seven eyes of 47 patients with wet and dry AMD seen between November 2009 and January 2010 at the New England Eye Center, Boston, Massachusetts, were analyzed.

Analysis of normal peripapillary choroidal thickness via spectral domain optical coherence tomography.

Purpose: To analyze the normal peripapillary choroidal thickness utilizing a commercial spectral domain optical coherence tomography (OCT) device and determine the intergrader reproducibility of this method.

Design: Retrospective, noncomparative, noninterventional case series.

Participants: Thirty-six eyes of 36 normal patients seen at the New England Eye Center between April and September 2010.

Total retinal blood flow measurement with ultrahigh speed swept source/Fourier domain OCT.

Doppler OCT provides depth-resolved information on flow in biological tissues. In this article, we demonstrate ultrahigh speed swept source/Fourier domain OCT for visualization and quantitative assessment of retinal blood flow. Using swept laser technology, the system operated in the 1050-nm wavelength range at a high axial scan rate of 200 kHz.

Diffuse retinal pigment epithelial disease in an adult with cystic fibrosis.

An adult with cystic fibrosis presented for decreased vision in the right eye of several months' duration. Biomicroscopy and fluorescein angiography demonstrated bilateral large subretinal drusenoid deposits concentrated temporal to the fovea, as well as a small subretinal hemorrhage associated with focal leakage of fluid within the macula in the right eye. Optical coherence tomography demonstrated subretinal fluid consistent with choroidal neovascular membrane in the right eye with the absence of fluid in the left eye.

Retinal nerve fibre layer and visual function loss in glaucoma: the tipping point.

Aims: To determine the retinal nerve fibre layer (RNFL) thickness at which visual field (VF) damage becomes detectable and associated with structural loss.

Methods: In a prospective cross-sectional study, 72 healthy and 40 glaucoma subjects (one eye per subject) recruited from an academic institution had VF examinations and spectral domain optical coherence tomography (SD-OCT) optic disc cube scans (Humphrey field analyser and Cirrus HD-OCT, respectively). Comparison of global mean and sectoral RNFL thicknesses with VF threshold values showed a plateau of threshold values at high RNFL thicknesses and a sharp decrease at lower RNFL thicknesses.

A 17-year retrospective study of institutional results for eye plaque brachytherapy of uveal melanoma using (125)I, (103)Pd, and (131)Cs and historical perspective.

Purpose: To compare overall survival, local and distant failure rates, ocular toxicity, and vision preservation in patients treated with eye plaque brachytherapy at Tufts Medical Center with those in the published literature.

Methods And Materials: Records were reviewed for 53 patients with the diagnosis of uveal melanoma treated with plaque brachytherapy at Tufts Medical Center over the past 17 years. American Joint Committee on Cancer staging (T1, T2, or T3) were 4, 39, and 10 patients, respectively.

Intact retinal tissue and retinal pigment epithelium identified within a coloboma by high-speed, ultrahigh-resolution optical coherence tomography.

Purpose: The purpose of this study was to report on a posterior segment coloboma manifesting unusual morphology as determined by high-speed, ultrahigh-resolution optical coherence tomography imaging.

Methods: A 47-year-old woman with bilateral colobomas was evaluated by fundus examination and high-speed, ultrahigh-resolution optical coherence tomography imaging.

Results: Imaging with high-speed, ultrahigh-resolution optical coherence tomography showed intact retinal pigment epithelium within the posterior segment coloboma.

Ocular melanoma.

Context: Intraocular melanoma of the ciliary body and choroid is the most common primary ocular malignant tumor in adults and the most common noncutaneous melanoma.

Objective: To describe the most salient clinical features, histopathologic findings, and treatment modalities of intraocular melanoma, as well as the novel therapies currently being tested.

Data Sources: Clinically, it is important to determine which lesions carry a worse prognosis so as to offer patients the best treatment modalities available.

Posterior lattice degeneration characterized by spectral domain optical coherence tomography.

Purpose: The purpose of this study was to use high-resolution spectral domain optical coherence tomography in the characterization of retinal and vitreal morphological changes overlying posterior lattice degeneration.

Methods: A cross-sectional retrospective analysis was performed on 13 eyes of 13 nonconsecutive subjects with posterior lattice degeneration seen at the New England Eye Center, Tufts Medical Center between October 2009 and January 2010. Spectral domain optical coherence tomography images taken through the region of lattice degeneration were qualitatively analyzed.

Documentation of intraretinal retinal pigment epithelium migration via high-speed ultrahigh-resolution optical coherence tomography.

Purpose: To describe the features of intraretinal retinal pigment epithelium (RPE) migration documented on a prototype spectral-domain, high-speed, ultrahigh-resolution optical coherence tomography (OCT) device in a group of patients with early to intermediate dry age-related macular degeneration (AMD) and to correlate intraretinal RPE migration on OCT to RPE pigment clumping on fundus photographs.

Design: Retrospective, noncomparative, noninterventional case series.

Participants: Fifty-five eyes of 44 patients seen at the New England Eye Center between December 2007 and June 2008 with early to intermediate dry AMD.

Ultrahigh speed 1050nm swept source/Fourier domain OCT retinal and anterior segment imaging at 100,000 to 400,000 axial scans per second.

We demonstrate ultrahigh speed swept source/Fourier domain ophthalmic OCT imaging using a short cavity swept laser at 100,000 - 400,000 axial scan rates. Several design configurations illustrate tradeoffs in imaging speed, sensitivity, axial resolution, and imaging depth. Variable rate A/D optical clocking is used to acquire linear-in-k OCT fringe data at 100 kHz axial scan rate with 5.

Analysis of peripapillary atrophy using spectral domain optical coherence tomography.

Objective: To study retinal morphologic changes around the optic disc in patients with peripapillary atrophy (PPA) with high-resolution spectral domain optical coherence tomography (SD OCT).

Design: Cross-sectional, retrospective analysis.

Participants: A total of 103 eyes of 73 patients with PPA and 21 eyes of 12 normal patients seen at the New England Eye Center, Tufts Medical Center, between January 2007 and August 2009.

Anatomic and visual outcomes of vitrectomy for vitreomacular traction syndrome.

Background And Objective: To assess anatomic and visual outcomes after pars plana vitrectomy for vitreomacular traction syndrome.

Patients And Methods: Charts of 746 patients who had vitrectomy surgery with membrane peel between January 2002 and December 2007 were reviewed. Vitreomacular traction syndrome (VMT) was diagnosed based on optical coherence tomography (OCT) appearance.

Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography.

Purpose: To examine choroidal thickness and area in healthy eyes using spectral-domain optical coherence tomography (SD-OCT).

Design: Retrospective, observational case series.

Methods: Thirty-four eyes (34 subjects), with no retinal or choroidal disease, underwent high-definition raster scanning using SD-OCT with frame enhancement software.

Using ranibizumab to successfully treat choroidal neovascularization in a patient with persistent placoid maculopathy.

Purpose: The purpose of this study was to report the successful treatment of persistent placoid maculopathy with intravitreal ranibizumab.

Methods: A 60-year-old man with an 8-year history of blurry vision was diagnosed with bilateral persistent placoid maculopathy complicated by a choroidal neovascular membrane. The left eye received two laser photocoagulation treatments.

Anatomic and visual outcomes of vitrectomy for lamellar macular holes.

Background And Objective: To assess anatomic and visual outcomes after pars plana vitrectomy for lamellar macular holes.

Patients And Methods: Charts of 746 patients who had vitrectomy surgery with membrane peel were reviewed. Preoperative diagnosis of lamellar macular hole was based on optical coherence tomography (OCT) appearance; 16 eyes of 16 patients met the inclusion criteria.

Foveoschisis Without High Myopia.

Two patients presented complaints of visual acuity worsening in one eye. During examination they showed optical coherence tomography (OCT) and clinical findings indistingishable from myopic foveoschisis, although both had minimal refractive errors. One of the patients was followed without surgery until the disease progressed and the visual acuity decreased.

Spontaneous Progression of a Long-Standing Lamellar Macular Hole into a Full-Thickness Macular Hole.

One patient with past ocular history of full thickness macular hole surgically closed in the right eye was followed with diagnostic of lamellar macular hole in the left eye since 2000. After uncomplicated cataract surgery in the left eye in March 2008, the lamellar hole spontaneously progressed to full thickness macular hole. The patient underwent pars plana vitrectomy, membrane peel and gas bubble injection, with successful closure of the macular hole and improvement in the visual acuity.

Clinical assessment of mirror artifacts in spectral-domain optical coherence tomography.

PURPOSE. To investigate the characteristics of a spectral-domain optical coherence tomography (SD-OCT) image phenomenon known as the mirror artifact, calculate its prevalence, analyze potential risk factors, measure severity, and correlate it to spherical equivalent and central visual acuity (VA). METHODS.