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Flecks in Recessive Stargardt Disease: Short-Wavelength Autofluorescence, Near-Infrared Autofluorescence, and Optical Coherence Tomography
摘要： PURPOSE. We evaluated the incongruous observation whereby ?ecks in recessive Stargardt disease (STGD1) can exhibit increased short-wavelength auto?uorescence (SW-AF) that originates from retinal pigment epithelium (RPE) lipofuscin, while near-infrared AF (NIR-AF), emitted primarily from RPE melanin, is usually reduced or absent at ?eck positions. METHODS. Flecks in SW- and NIR-AF images and spectral-domain optical coherence tomography (SD-OCT) scans were studied in 19 STGD1 patients carrying disease-causing ABCA4 mutations. Fleck spatial distribution and progression were recorded in serial AF images. RESULTS. Flecks observed in SW-AF images typically colocalized with darkened foci in NIR-AF images; the NIR-AF pro?les were larger. The decreased NIR-AF signal from ?ecks preceded apparent changes in SW-AF. Spatiotemporal changes in ?eck distribution usually progressed centrifugally, but in one case centripetal expansion was observed. Flecks in SW-AF images corresponded to hyperre?ective deposits that progressively traversed photoreceptor-attributable bands in SD-OCT images. Outer nuclear layer (ONL) thickness negatively correlated with expansion of ?ecks from outer to inner retina. CONCLUSIONS. In the healthy retina, RPE lipofuscin ?uorophores form in photoreceptor cells but are transferred to RPE; thus the SW-AF signal from photoreceptor cells is negligible. In STGD1, NIR-AF imaging reveals that ?ecks are predominantly hypo?uorescent and larger and that NIR-AF darkening occurs prior to heightened SW-AF signal. These observations indicate that RPE cells associated with ?ecks in STGD1 are considerably changed or lost. Spectral-domain OCT ?ndings are indicative of ongoing photoreceptor cell degeneration. The bright SW-AF signal of ?ecks likely originates from augmented lipofuscin formation in degenerating photoreceptor cells impaired by the failure of RPE.
关键词： lipofuscin,fundus auto?uorescence,recessive Stargardt disease,optical coherence tomography,retinal pigment epithelium,ABCA4,scanning laser ophthalmoscope
更新于2025-09-09 09:28:46
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Expanding the role of medical retina virtual clinics using multimodal ultra-widefield and optical coherence tomography imaging
摘要： Background: An increasingly elderly population with a corresponding increase in ophthalmic conditions has led to increased pressure on hospital eye services (HES). In this study, we evaluated the use of a medical retina virtual clinic (MRVC), which has expanded into assessing all new medical retina referrals, where the need for urgent treatment was not clear. Methods: Retrospective analysis of all new patients who were seen in the MRVC between April 2016 and May 2018. Pro forma sheets were used in the MRVC to record the patient history, visual acuity, and type of imaging required. Two consultants reviewed the completed pro formas and images and provided a final diagnosis and management plan. These results and reasons for face-to-face (F2F) clinic appointment requests were analyzed. Results: Six hundred ten new referrals were enrolled in the virtual clinic. The most common diagnosis was diabetic eye disease (59.9%). In the virtual clinic 44.1% were followed up, 28.1% were discharged, and 27.8% were booked an F2F clinic appointment (urgent/routine). The main reason for F2F clinic was to offer treatment. Urgent F2F appointments took place on average 11.9 days after virtual clinic attendance. In only two cases was the image quality felt to be inadequate to assess the retina. Conclusions: MRVC is an effective way of triaging medical retina referrals to allow those patients needing treatment to be seen promptly in the medical retinal service. The use of multimodal ultra-widefield and optical coherence tomography imaging allows assessment of a wide range of retinal pathologies and is a promising solution to alleviate the burden on HES.
关键词： teleophthalmology,diabetic retinopathy,optical coherence tomography,macular degeneration,choroidal naevus,virtual clinic
更新于2025-09-09 09:28:46
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The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy
摘要： We read with interest the article by Tan et al.1 entitled "The Evolution of the Plateau, an Optical Coherence Tomography Signature Seen in Geographic Atrophy." We congratulate the authors for the excellent description of the origins and long-term evolution of an optical coherence tomography (OCT) in nascent geographic atrophy and for proposing its histologic correlate. Querques et al.2 first reported this tomographic signature in geographic atrophy with the name of "wedge-shaped subretinal hyporeflectivity." However, the authors renamed this finding for the following reasons.
关键词： wedge-shaped subretinal hyporeflectivity,optical coherence tomography,plateau,geographic atrophy
更新于2025-09-09 09:28:46
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Diagnostic Ability of Macular Ganglion Cell Layer Measurements in Glaucoma Using Swept Source Optical Coherence Tomography
摘要： Purpose: To evaluate diagnostic ability of macular ganglion cell complex (mGCC), macular ganglion cell inner plexiform layer (mGCIPL) measurements in glaucoma using swept source deep range imaging optical coherence tomography (DRI OCT-1, Topcon Co., Tokyo, Japan). Methods: From August of 2014 to July of 2015, 109 eyes of 109 subjects were assessed for the average thickness and sectional thickness of both mGCC and mGCIPL to determine whether there exists any significant difference among advanced stage glaucoma group, early stage glaucoma group and normal group in Swept source OCT. Comparisons were also made between the above measurements and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements in their diagnostic accuracy, sensitivity, and specificity. Results: The diagnostic ability of mGCC based-mean thickness value (area under the curve [AUC] = 0.78/ 0.99) in detecting early stage glaucoma group as well as advanced stage group was not significantly different from that of cpRNFL thickness measurement. However, there was a significant difference in thickness between mGCIPL (AUC = 0.70) and cpRNFL in early stage glaucoma groups (p = 0.018). The sensitivities and specificities of mGCC were 0.95/0.97, and those of mGCIPL were 0.92/0.97, respectively. Conclusions: The two swept source OCT based methods measuring retinal ganglion cell layer thickness appeared to have a good diagnostic accuracy, high sensitivity and specificity in detecting glaucomatous eyes. Nevertheless, of the two methods, mGCC thickness measurement was more efficient in detecting early glaucomatous changes.
关键词： Macular ganglion cell complex,Swept source optical coherence tomography,Glaucoma,Macular ganglion cell and inner plexiform layer
更新于2025-09-09 09:28:46
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Analysis of Foveal Microvascular Structures Using Optical Coherence Tomography Angiography in Age-stratified Healthy Koreans
摘要： Purpose: To evaluate foveal avascular zone (FAZ) microvascular structural changes in healthy Korean subjects stratified by age using optical coherence tomography angiography (OCTA). Methods: Eighty eyes of 43 healthy volunteer subjects who had 20/20 or better best corrected visual acuity without other ocular or systemic disease except vitreous floaters and dry eye syndrome were enrolled and stratified by age group. To measure FAZ size and vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), OCTA (DRI OCT Triton, Swept Source OCT, Topcon, Tokyo, Japan) scans were performed over fovea-centered 3 × 3 mm2 regions, and then compared with central macular thickness (CMT) and subfoveal choroidal thickness. Results: Mean age of the participants was 46.4 ± 16.1 (20–78). The SCP and DCP FAZ sizes were 0.32 ± 0.11 mm2 and 0.41 ± 0.14 mm2, respectively. There was a significant difference by age group (p < 0.001, p < 0.001), respectively. The FAZ VD for SCP and DCP was 28.96 ± 3.05% and 33.15 ± 3.64%, respectively. There was no difference between age groups (p = 0.118, p = 0.637). Univariate and multiple linear regression analysis showed that the FAZ size of SCP and DCP was significantly correlated with age (p = 0.039, p = 0.002) and CMT (p = 0.007, p = 0.013), respectively. The SCP and DCP FAZ size were positively correlated with age (R2 = 0.279, p < 0.001, R2 = 0.344, p < 0.001), and negatively correlated with CMT (R2 = 0.354, p < 0.001, R2 = 0.285, p < 0.001), respectively. Conclusions: The FAZ size of SCP and DCP increased with age and were negatively correlated with CMT. These results suggest that consideration of age and CMT is important when performing the clinical evaluation of FAZ size in healthy subjects.
关键词： Healthy subjects,Foveal avascular zone,Vascular density,Age,Optical coherence tomography angiography
更新于2025-09-09 09:28:46
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Quantitative analysis of the retinal nerve fiber layer, ganglion cell layer and optic disc parameters by the swept source optical coherence tomography in patients with migraine and patients with tension-type headache
摘要： The aim of the study was to measure the thicknesses of the inner retinal segments and optic nerve head (ONH) parameters in migraineurs and patients with tension-type headache (TTH) in headache-free period using swept source optical coherence tomography (SS-OCT) and to compare the outcomes with each other and those of healthy subjects. The study population consisted of 23 migraineurs, 22 TTH patients, and 25 controls with a best-corrected visual acuity of 20/20 and without a history of systemic or ocular disease. Macular ganglion cell inner plexiform layer (mGCIPL), macular ganglion cell complex (mGCC), circumpapillary retinal nerve fiber layer (cpRNFL), and ONH parameters were evaluated using SS-OCT, and the areas under the receiver-operating characteristic (ROC) curves were calculated to determine the ability of these parameters to distinguish between the patient and normal eyes. There were not statistically significant differences between the measurements acquired from migraineurs, TTH patients, and the controls. The outcomes of the patients with TTH were very similar to those of the normal participants. The areas under the ROC curves (AUC) correlated highly with the measurements obtained from the same subfields for the mGCC, MGCIPL, cpRNFL, and ONH parameters. In conclusion, SS-OCT presented reproducible and reliable measurements of posterior segment layers of the eyes, especially in sectoral configuration, and the parameters did not show significant difference between the groups.
关键词： Migraine,Swept source optical coherence tomography,Retinal nerve fiber layer,Ganglion cell layer,Tension-type headache
更新于2025-09-09 09:28:46
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Repeatability and Reproducibility of Quantification of Superficial Peri-papillary Capillaries by four Different Optical Coherence Tomography Angiography Devices
摘要： This study was performed to test the repeatability and reproducibility of measurements of peri-papillary capillaries from four optical coherence tomography angiography (OCTA) devices. 109 healthy eyes were imaged with four OCTA devices (Spectralis, Optovue, Triton and Cirrus). A 3 × 3 mm scan pattern centered on the disc was repeated twice by each device. En face images of superficial capillary plexus were screened and processed for calculation. Vessel length density (VLD) was calculated on four equally divided parts of a ring between two concentric circles manually centered on the disc. General linear model (GLM) was used to test the impact of device and location on VLD. Intraclass correlation coefficient (ICC) of VLD between repeated scans was calculated. Of 218 acquisitions, 36%, 92%, 76% and 88% were eligible for analysis from Spectralis, Optovue, Triton and Cirrus, respectively. ICC was 0.94, 0.90, 0.84 and 0.87 for the four devices. GLM showed measurements significantly varied among devices (P < 0.001) and locations (P < 0.001). Pairwise comparison showed Triton = Spectralis >Optovue >Cirrus, and temporal = nasal >superior = inferior in measuring capillary VLD. This study revealed the repeatability of measuring peri-papillary capillaries was high for all four devices, while the reproducibility among the machines was unfavorable.
关键词： optical coherence tomography angiography,vessel length density,peri-papillary capillaries,reproducibility,repeatability
更新于2025-09-09 09:28:46
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Coherence and non-classicality of quantum Markov processes
摘要： Although quantum coherence is a basic trait of quantum mechanics, the presence of coherences in the quantum description of a certain phenomenon does not rule out the possibility to give an alternative description of the same phenomenon in purely classical terms. Here, we give definite criteria to determine when and to what extent quantum coherence is equivalent to non-classicality. We prove that a Markovian multi-time statistics obtained from repeated measurements of a non-degenerate observable cannot be traced back to a classical statistics if and only if the dynamics generates coherences and subsequently turns them into populations. Furthermore, we show with simple examples that such connection between quantum coherence and non-classicality is generally absent if the statistics is non-Markovian.
关键词： non-classicality,quantum Markovianity,multi-time statistics,quantum coherence
更新于2025-09-09 09:28:46
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Abnormal choroidal flow on optical coherence tomography angiography in central serous chorioretinopathy
摘要： Importance: Analyzing choroidal flow in central serous chorioretinopathy (CSC) with novel device Background: To examine the abnormal morphology of choriocapillary flow with optical coherence tomography angiography (OCTA) according to the presence of subretinal fluid (SRF) in CSC. Design: A hospital-based retrospective study Participants: We analyzed OCTA results of 68 eyes (68 patients) diagnosed as CSC with or without SRF (active and resolved CSC, respectively) at the Asan Medical Center. Methods: We classified OCTA choriocapillary images into three pattern groups: mixed perfusion, hyper-perfusion, and normal perfusion. Data analysis included age, follow-up duration, treatment modalities, number of treatments, subfoveal choroidal thickness, and SRF height. Main outcome measure: The relationship between CSC activity and choriocapillary pattern Results: Abnormal choroidal flow (mixed and hyper-perfusion) was more frequently found in eyes with active CSC (100%) than resolved CSC (47.5%, p < 0.001). In active CSC eyes, mixed perfusion was predominant (71.4%), while hyper-perfusion was predominant in those with resolved CSC (73.7%). Eyes with recently resolved CSC (SRF absorption present for <2 months) had abnormal choriocapillary flow more often than the remaining eyes with resolved CSC (83.3% vs. 32.1%, p = 0.005). Resolved CSC eyes with abnormal choriocapillary flow demonstrated more recurrence than eyes with normal choriocapillary flow (42.1% vs 9.5%, p = 0.017). Conclusions and Relevance: The pattern of choriocapillary flow abnormalities on OCTA can indicate CSC disease activity. Because eyes with resolved CSC showing abnormal choroidal flow have a high recurrence rate, they should be carefully followed-up.
关键词： Abnormal choroidal flow,central serous chorioretinopathy,optical coherence tomography angiography
更新于2025-09-09 09:28:46
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Loss of horizontal macular ganglion cell complex asymmetry: an optical coherence tomography indicator of chiasmal compression
摘要： Objective To estimate the macular ganglion cell complex (GCC) asymmetry in patients with suprasellar tumours, to compare its diagnostic performance to the nasal GCC thickness and visual field (VF) and to investigate how the parameters correlate with magnetic resonance imaging (MRI) findings. Methods and analysis Cross-sectional study of patients with suprasellar tumours affecting the optic chiasm. Macular optical coherence tomography (OCT) scans were evaluated for nasal GCC sector thinning and loss of normal GCC asymmetry between corresponding nasal-temporal sectors. Equivalently, VFs were analysed for defects compatible with chiasm dysfunction. The relationship between optic chiasm and tumour was measured on MRI. results Thirty-three eyes of 33 patients were included. There were OCT findings in 14 eyes. Nasal GCC thinning was found in 9 eyes and loss of GCC asymmetry in 12 eyes; the two parameters were not significantly different with respect to number of positive findings (p=0.45). Loss of GCC asymmetry, however, occurred in 5 eyes among 24 without GCC thinning (proportion 0.21; 95% confidence interval 0.071 to 0.42). In 8 eyes, VF indicated pathology; of these, 7 had concurring OCT findings. The prevalence of OCT and VF findings increased significantly with suprasellar tumour extension on MRI. Conclusion The diagnostic capabilities of nasal GCC thinning and loss of GCC asymmetry were comparable, whilst their complementary performances increased the proportion of eyes in which OCT suggested compression. The prevalence of both OCT and VF findings grew with suprasellar tumour extension. In several cases, however, structural findings on OCT preceded detectable VF deficits.
关键词： suprasellar tumours,visual field,optical coherence tomography,chiasmal compression,macular ganglion cell complex
更新于2025-09-09 09:28:46