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Drusenoid retinal pigment epithelium detachments
摘要： The authors make a review of drusenoid retinal pigment epithelium detachments(DPDs), a form of retinal pigment epithelium detachment(PED) that evolves from confluent and large soft drusen.Drusenoidretinal pigment epithelial detachments are a recognized element of the “dry” AMD. Until now, no treatment is indicated in drusenoid PEDs. The authors describe the clinical characteristics of drusenoid retinal pigment epithelium detachments (DPEDs) and make a review of the DPEDs related in the international literature. We related in this revision paper the multimodal advanced image exams in two cases of dusenoid retinal pigment epithelium detachments (DPEDs) and the general characteristics of thisfinding associated with Dry Macular degeneration.Upon examination of the ocular fundusDPEDs emerge as well-circumscribed yellow or yellow–white elevations of the RPE that are usually found within the macula.They may show scalloped borders and a slightly irregular surface. When visualized using fluorescein angiography (FA),DPEDs are typically described as faint hyper-fluorescent in the early phase followed by a slow increase in fluorescence throughout the transit stage of the study without late leakage. With optical coherence tomography (OCT), drusenoid PEDs usually show a smooth contour of the detached hyperreflective RPE band that may have an undulating appearance.Drusenoid PEDs encompass far above the ground possibility type of “dry” AMD that develops in relationship with large confluent soft drusen.At this point no treatment is utilized in drusenoid retinal pigment epithelium detachment(DPEDs).
关键词： Macular degeneration,Aged,Fluorescein angiography,Age factors,fundus oculi,Retinal detachment,Retinal drusen
更新于2025-09-04 15:30:14
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A two-year study of diffused retinal pigment epitheliopathy treated with half-dose photodynamic therapy guided by simultaneous angiography and optical coherence tomography
摘要： Objectives Diffused retinal pigment epitheliopathy (DRPE) is not necessarily the same as chronic central serous chorioretinopathy (CSC), but a severe subgroup under the umbrella of chronic CSC. This study was to evaluate the efficacy and safety of half-dose PDT treating DRPE. Methods A retrospective case series design was used. Forty-eight consecutive patients (48 eyes) with DRPE treated with half-dose PDT underwent follow-up at baseline, 3 months, 6 months, 12 months and 24 months. Simultaneous FA, ICGA and OCT were used for the treatment and follow-up. The primary outcomes were the subretinal fluid and best-corrected visual acuity in optical coherence tomography. Results Complete fluid absorption was achieved in 95.8% of eyes at 3 months and 100.0% of eyes at 24 months. The baseline logarithm of the minimum angle of resolution (logMAR) BCVA, which was 0.51 ± 0.36, significantly improved to 0.43 ± 0.38 (p < 0.001) at 6 months. The boost continued to 0.29 ± 0.37 (p < 0.001) at 12 months and 0.19 ± 0.39 (p < 0.001) at 24 months. The integrities of the ellipsoid zone (EZ) and interdigitation zone (IZ) improved throughout. Regression analyses showed the BCVA in logMAR was inversely correlated with the EZ (p < 0.01) and IZ (p < 0.01). The recurrence rate was 6.3%. No severe complications were witnessed. Conclusions In 48 eyes with DRPE, simultaneous angiography and OCT facilitated a more comprehensive guidance for half-dose PDT treatment and follow-up. The BCVA improvement occurred at 6 months, which may be attributed to the restoration of the outer retinal structure.
关键词： chronic central serous chorioretinopathy,half-dose photodynamic therapy,Diffused retinal pigment epitheliopathy,angiography,CSC,optical coherence tomography,OCT,DRPE,PDT
更新于2025-09-04 15:30:14
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An ellipsoid convex enhancement filter for detection of asymptomatic intracranial aneurysm candidates in CAD frameworks
摘要： Various kinds of enhancement filters have been developed in computer-aided diagnostic (CAD) frameworks for asymptomatic intracranial aneurysms in magnetic resonance angiography (MRA). However, many bending or branching portions on vessels are also enhanced by the conventional filters as false positives in 3.0 T MRA, which can visualize smaller vessels compared with 1.5 T MRA. To overcome this problem, this study focused on developing an ellipsoid convex enhancement (ECE) filter, which can selectively enhance aneurysms while reducing false positive contrasts on bending or branching portions on vessels, for detection of asymptomatic intracranial aneurysm candidates in CAD frameworks. The ECE filter was mathematically designed to enhance various convex regions in the intensity space such as convex aneurysms, in which the ratio of the shortest and longest diameters for aneurysms corresponds to the ratio of reciprocals of the square roots of the first and third eigenvalues of a Hessian matrix. The proposed ECE filter was evaluated by measuring an average contrast for false positive models and free-response receiver operating characteristic curves between two simple CAD frameworks using the ECE and conventional filters based on a leave-one-out-by-patient test. MRA images for thirty patients (male: 10, female: 20; age: 48–86 yr, mean: 69.2) with 31 unruptured aneurysms (longest diameter: 2.0–5.5 mm, mean: 3.7 mm) were selected for this study. The average contrast for false positive models was reduced by 51.4% using the ECE filter, compared with the conventional filter for the convex regions with ratios of the shortest and longest diameters less than 0.4. The number of false positives per case was decreased from 41.1 to 22.8 on average at a sensitivity of 87% by using the ECE filter. The ECE filter would be useful for boosting the performance of the CAD framework of asymptomatic intracranial aneurysms by providing higher contrast aneurysms and lower contrast false positives such as bending or branching portions on vessels.
关键词： unruptured intracranial aneurysm,ellipsoid convex enhancement (ECE) filter,magnetic resonance angiography (MRA),computer-aided diagnosis (CAD)
更新于2025-09-04 15:30:14
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Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians
摘要： Purpose: To investigate myopic choroidal neovascularization (mCNV) by fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), near-infrared (NIR) reflectance, and autofluorescence (AF). Methods: This retrospective study included 65 eyes of 62 Caucasian patients with a mean age of 66.72 years (95% confidence interval [CI] 63–70 years) and a mean refraction of -9.72 diopters (95% CI -8.74 to -10.70 diopters). Results: Most of the mCNV cases were foveal-juxtafoveal (60/65, 92.3%), with thickening of the corresponding retina (62/65, 95.3%) and leakage on FA (44/65, 67.6%). No retinal fluid was detectable in 32 (49.2%) eyes and there was no hemorrhage in 25 (38.4%) eyes. Papillary chorioretinal atrophy was evident in 58 (89.2%), a shadowing effect in 48 (73.8%), and an epiretinal membrane in 38 (58.4%) eyes. If an area of macular chorioretinal atrophy was present, mCNV frequently developed adjacent to it and was hyperfluorescent rather than with leakage (P<0.001). In eyes with edema or hemorrhage, hyper-reflective foci were more frequent (P<0.005). NIR and AF features were indeterminable in 19 (29.2%) and 27 (41.5%) eyes, respectively. The predominant feature was black or grayish on NIR (34/65, 52.3%) and patchy (hypo- and hyperfluorescence was observed) on AF (25/65, 38.4%). FA and SD-OCT correctly detected mCNV in 49 (75.3%) and 48 (73.8%) eyes, respectively, whereas NIR and AF exhibited limited diagnostic sensitivity. Doubtful diagnosis was associated with hyperfluorescent mCNV (P<0.001), absence of retinal fluid and epiretinal membrane (P<0.05), and presence of macular chorioretinal atrophy (P<0.01). Conclusion: Tomographic, angiographic, AF, and NIR features of mCNV are described in this study. Combination of SD-OCT and FA is recommendable for diagnosis.
关键词： fluorescein angiography,pathologic myopia,myopic neovascularization,SD-OCT,CNV,imaging
更新于2025-09-04 15:30:14