Zusammenfassung Hintergrund Die vorliegende Studie vergleicht die Ausprägung von Bewegungsartefakten bei Aufnahmen der optischen Kohärenztomografie-Angiografie (OCT-A) bei gesunden Probanden zwischen 2 OCT-A-Systemen verschiedener Hersteller mit unterschiedlicher technischer Ausstattung. Methodik In dieser Arbeit wurden 25 Augen von 25 gesunden Probanden (19 weiblich, mittleres Alter 31,12 ± 11,95 Jahre) ohne bestehende Augenerkrankungen oder zurückliegende Augenoperationen eingeschlossen. OCT-A-Aufnahmen wurden mit dem RTVue XR Avanti (Optovue Inc., Fremont, Kalifornien, USA) sowie mit dem Spectralis OCT-A-Modul (Heidelberg Engineering, Heidelberg, Deutschland) durchgeführt. In jeweils 2 Messungen der Makula (Optovue: 3 × 3 mm², äquivalent Heidelberg: 10 × 10°) je Proband mit aktivem Eye Tracking (ET) wurde die Ausprägung von Bewegungsartefakten im superfiziellen OCT-Angiogramm anhand eines Motion Artifact Scores (MAS) von 2 unabhängigen Readern erfasst. Ergebnisse Die Signalstärke (signal strength index, SSI) lag im Mittel bei 73,0 ± 7,8 (Optovue) und 39,6 ± 3,6 (Heidelberg), dies entsprach beim Optovue 73,0% des theoretischen Bestwerts (SSImax = 100 = 100%) und beim Heidelberg 79,2% der höchstmöglichen SSI (SSImax = 50 = 100%). Beide Geräte zeigten eine insgesamt geringe Artefaktausprägung mit einem entsprechend niedrigen MAS (mittlerer MAS [Optovue]: 1,32 ± 0,551; mittlerer MAS [Heidelberg]: 1,7 ± 0,789; p = 0,006). Die Übereinstimmung zwischen den beiden Readern lag bei beiden Geräten bei 88%. Ein Quilting/Banding zeigte sich in 20% (10/50, Optovue), resp. 6% (3/50, Heidelberg) aller Messungen, ein Stretching in 4% (2/50, Optovue) und in 6% (3/50, Heidelberg). Ein Vessel Doubling und Displacement zeigte sich jeweils in einer Optovue-Aufnahme (2%) und bei keiner Heidelberg-Aufnahme (0%). Blink Lines hingegen waren in 3 Heidelberg-Aufnahmen (6%) und in keiner Optovue-Aufnahme auffindbar (0%). Schlussfolgerung Beide Geräte ermöglichen trotz unterschiedlicher Soft- und Hardware im vorliegenden Kollektiv Aufnahmen mit nur geringer Ausprägung von Bewegungsartefakten. Jedoch kommen diese auch bei gesunden Probanden mit guter Fixation vor. Ferner zeigte sich eine hohe Übereinstimmung bei der Bildbeurteilung in Bezug auf den MAS zwischen den beiden Readern. Dennoch bleibt die Analyse von Bewegungsartefakten komplex und erfordert eine gewisse Erfahrung und genaue Betrachtung bei der Bewertung von OCT-A-Aufnahmen.
Abstract Background/aim The aim of this paper is to compare retinal nerve fiber layer thickness (RNFL) and Bruch’s membrane opening-based minimum rim width (BMO-MRW) in terms of their performance in detecting early and moderate/advanced glaucoma using receiver operating characteristics (ROC) analysis and the classification using the 5th percentile as a cut-off. Methods One hundred eyes from 100 patients with early glaucoma (mean deviation (MD): < -5.0 dB) and 100 eyes from 100 patients with moderate/advanced glaucoma (MD: > -5.0 dB) were carefully matched to healthy controls based on optic disc size. Then, the dataset was divided, based on the 50th percentile of the measured Bruch’s membrane opening area (BMO-A), into small (BMO-A < 1.95 mm 2 ) and large optic discs (BMO-A > 1.95 mm 2 ). Finally, the discriminative performance of BMO-MRW and RNFL between glaucoma and controls using ROC analysis and the manufacturer’s classification based on the 5th percentile was analyzed. Results In discriminating between glaucoma and matched healthy controls, global BMO-MRW and global RNFL thickness had comparable areas under the ROC curve for eyes with early glaucoma and both small BMO-As (ROC ± confidence interval [CI] 0.91 [0.87 to 0.95] and 0.88 [0.83 to 0.93]) and large BMO-As (0.86 [0.82 to 0.92] and 0.84 [0.79 to 0.90]), as well as in moderate/advanced glaucoma with small BMO-As (0.99 [0.98 to 1.00] and 0.97 [0.95 to 1.00]) and large BMO-As (0.94 [0.91 to 0.98] and 0.97 [0.94 to 1.00]). Using the calculated 5th percentile as a threshold value, the sensitivities for the detection of early and moderate/advanced glaucoma were comparable for BMO-MRW and RNFL in eyes with small optic discs (early glaucoma: fifty-two percent and 61%; moderate/advanced glaucoma: ninety-one percent and 92%). In eyes with large optic discs, the sensitivity of BMO-MRW was inferior to that of RNFL for both early (38% versus 51%) and moderate/advanced (80% versus 91%) glaucoma. Conclusion Based on an ROC analysis, the discriminative performance of BMO-MRW and RNFL between patients with early and moderate/advanced glaucoma and a healthy control group matched based on optic disc size is comparable in eyes with BMO-As smaller and larger 1.95 mm 2 . Using a classification based on the 5th percentile, as used in clinical practice, RNFL is shown to be superior to BMO-MRW regarding sensitivity in glaucoma detection with large optic discs. This study underscores the importance of RNFL imaging and measurement in the diagnostic evaluation of glaucoma, especially in cases of large optic discs.
In keratoconus (KC) a progressive deformation and thinning of the cornea occurs. In contrast to Scheimpflug-based examinations, optical coherence tomography (OCT) can precisely measure the corneal layers separately, allowing separate analyses of corneal epithelial and corneal stromal thicknesses.The aim of this work was to analyze the corneal epithelial thickness measured by optical coherence tomography (OCT) in patients with KC in comparison to the corneal epithelial thickness in healthy subjects. The diagnostic value of the observed changes was evaluated.In a retrospective analysis 125 eyes of patients with KC and 140 eyes of healthy subjects were included. Corneal measurements were performed by OCT (Optovue, XR-Avanti, Fremont, CA, USA). Corneal stromal thicknesses and corneal epithelial thicknesses in different locations were measured and analyzed.There were significant differences in stromal and epithelial thickness measurements. Of the derived epithelial thickness parameters four showed a good discriminatory power between healthy controls and KC patients (area under the curve in the receiver operating characteristic analysis > 0.7).Patients with KC showed an altered epithelial thickness compared to healthy controls. The derived calculated parameters based on corneal epithelial thickness can distinguish between KC and a healthy cornea.HINTERGRUND: Beim Keratokonus (KK) kommt es zu einer progredienten Verformung und Ausdünnung der Hornhaut (HH). Im Gegensatz zu Scheimpflug-basierten Untersuchungen ist es mittels optischer Kohärenztomographie (OCT) möglich, die einzelnen Hornhautschichten separat präzise zu vermessen, sodass getrennte Analysen von Hornhautepithel- und Hornhautstromadicke möglich sind.Ziel dieser Arbeit ist es, die HH-Epitheldicke, gemessen mittels OCT, bei KK-Patienten im Vergleich mit der HH-Epitheldicke bei gesunden Probanden zu analysieren und den diagnostischen Wert der dargestellten Veränderungen zur evaluieren.In einer retrospektiven Analyse wurden 125 Augen von Patienten mit KK und 140 Augen von gesunden Probanden eingeschlossen. Messungen der Hornhaut erfolgten mittels OCT (Optovue, XR-Avanti, Fremont, CA, USA). Es wurden die HH-Stromadicke und die HH-Epitheldicke in unterschiedlichen Lokalisationen gemessen und analysiert.Es zeigten sich signifikante Unterschiede in der Stroma- und der Epitheldickenmessung. Vier der abgeleiteten Epitheldickenparameter zeigten eine gute Trennschärfe zwischen gesunden Kontrollen und Keratokonuspatienten („area under the curve“ in der Receiver-operating-characteristic-Analyse > 0,7).Patienten mit KK zeigen eine veränderte Epitheldicke im Vergleich zu gesunden Kontrollen. Hieraus abgeleitete berechnete Parameter, basierend auf der HH-Epitheldicke, können gut zwischen KK und gesunder HH unterscheiden.
Correction to: Retrospective Analysis of Bicanalicular Lacrimal Silicone Tube Intubation in Patients with Congenital Nasolacrimal Duct Obstruction: A Long-term Follow-up StudyKlin Monbl Augenheilkd eFirstDOI: 10.1055/a-2237-1139
To evaluate retinal and optic nerve head (ONH) perfusion in patients with atrial fibrillation (AF) before and after catheter ablation of AF with pulmonary vein isolation (PVI).34 eyes of 34 patients with AF and 35 eyes of 35 healthy subjects were included in this study. Flow density data were obtained using spectral-domain OCT-A (RTVue XR Avanti with AngioVue, Optovue, Inc, Fremont, California, USA). The data of the superficial and deep vascular layers of the macula and the ONH (radial peripapillary capillary network, RPC) before and after PVI were extracted and analysed.The flow density in the superficial OCT-angiogram (whole en face) and the ONH (RPC) in patients with AF was significantly lower compared to healthy controls (OCT-A superficial: study group: 48.77 (45.19; 52.12)%; control group: 53.01 (50.00; 54.25)%; p < 0.001; ONH: study group: 51.82 (48.41; 54.03)%; control group: 56.00 (54.35; 57.70)%; p < 0.001;). The flow density in the ONH (RPC) improved significantly in the study group following PVI (before: 51.82 (48.41; 54.03)%; after: 52.49 (50.34; 55.62)%; p = 0.007).Patients with AF showed altered ocular perfusion as measured using OCTA when compared with healthy controls. Rhythm control using PVI significantly improved ocular perfusion as measured using OCT-A. Non-contact imaging using OCTA provides novel information about the central global microperfusion of patients with AF.
The aim of the study presented here was to evaluate retinal and optic nerve head (ONH) perfusion in patients with severe asymptomatic carotid artery stenosis (CAS) compared with healthy controls and to analyze the impact of carotid endarterectomy using optical coherence tomography angiography (OCT-A). 25 eyes of 25 patients with CAS (study group) and 25 eyes of 25 healthy controls (control group) were prospectively included in this study. OCT-A was performed using RTVue XR Avanti (Optovue, Inc, Fremont, California, USA). The flow density data in the superficial and deep retinal OCT-angiogram of the macula and in the radial peripapillary capillary network (RPC) of the ONH were extracted and analyzed. The flow density in the superficial retinal OCT angiogram of the macula and in the ONH were significantly lower in the study group compared with the control group (macula: p = 0.003) (ONH: p = 0.013). The flow density in the ONH improved significantly after carotid endarterectomy (p = 0.004). A reduced flow density was observed in patients with CAS when compared with healthy controls. The flow density also improved after carotid endarterectomy. Quantitative changes in the microvascular density, as measured using OCT-A, could well be useful in the diagnosis of CAS and the evaluation of therapy success.
Background/Objectives: This study aims to investigate the long-term effect of inactive systemic lupus erythematosus (SLE) on the retinal microcirculation measured via optical coherence tomography angiography (OCT-A). Methods: Twenty-four eyes of 24 patients with inactive SLE under hydroxychloroquine (HCQ) therapy were included. The OCT-A data (mainly vessel density (VD) and foveal avascular zone (FAZ) data of the superficial and of the deep capillary plexus (SCP, DCP) and the choriocapillaris (CC)) were analyzed and compared between the baseline examination (t0) and 2 years later (t1). Results: At t1, VD in the whole en face SCP and in the CC was notably reduced compared to t0 (SCP: p = 0.001, CC: p = 0.013). VD in the DCP, CRT and FAZ area showed no difference at t1 compared to t0 (DCP: p = 0.128, FAZ: p = 0.332, CRT fovea: p = 0.296). Correlation analysis between the increase in cumulative doses of HCQ between t0 and t1 and the VD of the whole en face SCP did not show any correlation (Spearman r = 0.062 (95% CI −0.367; 0.477). Conclusions: SLE patients demonstrated a decrease in the retinal VD of the SCP and CC over a 2-year period. There was no correlation with the change in cumulative doses of HCQ. These results suggest an ongoing effect of the disease on the retinal and choriocapillary microcirculation.
Purpose To evaluate the repeatability, the reproducibility and the agreement of foveal avascular zone (FAZ) measurements using three different optical coherence tomography angiography (OCT-A) devices. Procedures This prospective study included 24 eyes of 24 healthy volunteers. OCT-A imaging was performed using RTVue XR Avanti, Canon OCT-HS100 and Spectralis OCT-A. Repeated measurements were performed under the same conditions on two separate days, and the area of the FAZ was determined and analyzed using the above devices. Results All three devices showed a high ICC and there was no significant difference between the ICCs (pairwise comparison) of the three devices (Optovue–Canon (p = 0.66); Canon–Heidelberg (p = 0.21); Heidelberg–Optovue (p = 0.37). Agreement analysis of the three devices revealed a significant elevation of FAZ area values with the Heidelberg device and a slight underestimation of the FAZ area with the Canon device. Nevertheless, overall we found a high level of agreement between all of the three devices (ICC ≥ 0.958 (0.905–0.982)). Conclusions Good reproducibility and repeatability were observed for all three devices. However, the agreement analysis revealed slight, but significant differences, which might limit alternating use of these devices for clinical research and follow-up examinations.
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