AIM:To evaluate the choroidopathy in patients with systemic lupus erythematosus(SLE)using enhanced depth imaging spectral domain optical coherence tomography(EDI SD-OCT)and optical coherence tomography angiography(OCT...AIM:To evaluate the choroidopathy in patients with systemic lupus erythematosus(SLE)using enhanced depth imaging spectral domain optical coherence tomography(EDI SD-OCT)and optical coherence tomography angiography(OCTA).METHODS:A total of 74 patients with SLE and 40 healthy volunteers were included in this cross-sectional study.SLE patients were further divided into three subgroups based on clinical and blood biochemistry findings.Ocular parameters obtained on ophthalmologic examination and optical imaging(EDI SD-OCT and OCTA)included the best corrected distance visual acuity(logMAR CDVA),subfoveal choroidal thickness(SCT),choroidal vascularity index(CVI)and vessel density(VD)of superficial capillary plexus(SCP)and deep capillary plexus(DCP).RESULTS:SLE patients had significantly lower values for CVI and VD of DCP(DVD)than control subjects.Amongst SLE patients,gender and chloroquine dose were found to be independent determinants of CVI while age predicted SCT.Steroid dose was a significant predictor for foveal VD of SCP(SVD),chloroquine dose for parafoveal SVD,gender for total DVD,and gender and steroid dose for perifoveal DVD.No correlation of logMAR CDVA and SCT was noted between SLE patients and control subjects.No correlation of SCT was noted with disease duration,Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score,hydroxychloroquine(HCQ)dose or steroid dose.No correlation of CVI was noted with patient age,disease duration,SLEDAI score,HCQ dose or steroid dose.No significant difference was noted between SLE subgroups in terms of any of the ocular parameters studied.CONCLUSION:The findings reveal the presence of ocular findings suggestive of early onset choroidopathy on EDI SD-OCT and OCTA in SLE patients,in the absence of ocular manifestations or active disease.展开更多
BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic im...BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.展开更多
AIM:To investigate the value of optical coherence tomography angiography(OCTA)indicators in the diagnosis of diabetic retinopathy(DR),and to provide patients with diabetic nephropathy(DN)with more sensitive OCTA scree...AIM:To investigate the value of optical coherence tomography angiography(OCTA)indicators in the diagnosis of diabetic retinopathy(DR),and to provide patients with diabetic nephropathy(DN)with more sensitive OCTA screening indicators to detect concurrent DR at an early stage.METHODS:A total of 200 patients who treated in the ophthalmology department of the Seventh Affiliated Hospital,Sun Yat-sen University from 2022 to 2023 were included,including 95 first-diagnosed DR patients and 105 patients without DR,and all patients underwent OCTA examination and a collection of demographics and renal function parameters.After a quality check,automated measurements of the foveal avascular zone area,vessel density(VD),and perfusion density(PD)of both 3 mm×3 mm and 6 mm×6 mm windows were obtained.RESULTS:Using random forest and multivariate Logistic regression methods,we developed a diagnostic model for DR based on 12 variables(age,FBG,SBP,DBP,HbA1c,ALT,ALP,urea/Scr,DM duration,HUA,DN,and CMT).Adding specific OCTA parameters enhanced the efficacy of the existing diagnostic model for DR(outer vessel density in 6 mm×6 mm window,AUC=0.837 vs 0.819,P=0.03).In the study of DN patients,the parameters in the 6 mm×6 mm window improved the diagnostic efficacy of DR(inner VD;outer VD;full VD;outer PD;full PD).CONCLUSION:The outer VD in the 6 mm×6 mm window can enhance the efficacy of the traditional DR diagnostic model.Meanwhile,compared with the 3 mm×3 mm window,the microvascular parameters in the 6 mm×6 mm window focusing on DN patients can be more sensitive to diagnosing the occurrence of DR.展开更多
AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This...AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.展开更多
BACKGROUND Optical coherence tomography(OCT)offers detailed cross-sectional imaging during percutaneous coronary intervention(PCI),aiding in anatomically complex coronary lesions.Despite its advantages,evidence on the...BACKGROUND Optical coherence tomography(OCT)offers detailed cross-sectional imaging during percutaneous coronary intervention(PCI),aiding in anatomically complex coronary lesions.Despite its advantages,evidence on the clinical effectiveness of OCT-guided PCI remains limited.Major databases were systematically searched for randomized controlled trials(RCTs)comparing OCT-guided and angiography-guided PCI in complex lesions.Primary outcomes included major adverse cardiovascular events(MACE)and target vessel failure(TVF);secondary outcomes included mortality,myocardial infarction(MI),and other procedural outcomes.A random-effects model was used to pool risk ratio(RR),with 95%CI.Statistical analysis was conducted in R software(v4.4.1),with significance set at P<0.05.RESULTS Five RCTs(5737 patients)showed OCT-guided PCI significantly reduced MACE(RR:0.63,95%CI:0.52-0.77,P<0.01),TVF(RR:0.68,95%CI:0.56-0.83,P<0.01),all-cause(RR:0.58,95%CI:0.38-0.87,P<0.01)and cardiac mortality(RR:0.43,95%CI:0.24-0.76,P<0.01),target-lesion revascularization(RR:0.53,95%CI:0.33-0.84,P<0.01),stent thrombosis(RR:0.52,95%CI:0.31-0.86,P=0.01),and target-vessel MI(RR:0.64,95%CI:0.42-0.97,P=0.04)vs angiography-guided PCI.Periprocedural MI,any revascularization,target-vessel revascularization,and contrast-associated kidney injury were similar between groups.CONCLUSION OCT-guided PCI improves outcomes in complex lesions by reducing MACE,TVF,mortality,stent thrombosis,and target-vessel MI.These findings highlight the need for further large-scale RCTs to confirm its benefits.展开更多
Optical Coherence Tomography(OCT)provides cross-sectional and three-dimensional reconstructions of the target tissue,allowing precise imaging and quantitative analysis of individual retinal layers.These images,based o...Optical Coherence Tomography(OCT)provides cross-sectional and three-dimensional reconstructions of the target tissue,allowing precise imaging and quantitative analysis of individual retinal layers.These images,based on optical inhomogeneities,reveal intricate cellular structures and are vital for tasks like retinal segmentation.The proposed study uses OCT images to identify significant differences in peripapillary retinal nerve fiber layer thickness.Incorporating spectral-domain analysis of OCT images significantly enhances the evaluation of Purtcher Retinopathy.To streamline this process,the study introduces a Context Encoding Deep Neural Network(CEDNN),which eliminates the time-consuming manual segmentation process while improving the accuracy of retinal layer thickness measurements.Despite the excellent performance of deep learning-based Convolutional Neural Networks(CNNs)in multiclass ocular fluid segmentation and lesion identification,certain challenges remain.Specifically,segmentation accuracy declines in regions with very tiny patches of subretinal fluid,often due to limited training data.The proposed CEDNN addresses these limitations by reducing processing time and enhancing accuracy.The approach incorporates advanced diffusion techniques in the 2D segmentation process using a gradient convergence field that accounts for the anisotropic nature of image features.Experimental results on public datasets and clinical OCT images demonstrate that the CEDNN approach achieves remarkable performance,with an accuracy of 99.3%,sensitivity of 99.4%,and specificity of 99%.Furthermore,the use of 3D representations of surface data outperforms traditional 2D surface estimates,enhancing segmentation quality.The system also incorporates temporal dimension estimation,making it feasible to forecast rapid disease progression.This advanced approach holds significant potential for improving retinal disease detection and analysis,setting a new benchmark in automated OCT-based diagnostics.展开更多
AIM:To quantitatively assess central macular thickness(CMT),macular neovascularization(MNV)area,vascular tortuosity(VT),and vascular dispersion(VDisp)in neovascular age-related macular degeneration(nAMD),type 1 and ty...AIM:To quantitatively assess central macular thickness(CMT),macular neovascularization(MNV)area,vascular tortuosity(VT),and vascular dispersion(VDisp)in neovascular age-related macular degeneration(nAMD),type 1 and type 2 MNV,by means of optical coherence tomography(OCT)and OCT angiography(OCTA)techniques.METHODS:In this retrospective and observational case series,patients were classified into type 1 or type 2 MNV groups.A comprehensive panel of OCT and OCTA metrics was evaluated,including CMT,MNV area,VT,and VDisp.All subjects underwent a standardized intravitreal conbercept(IVC)regimen[3+pro re nata(PRN)]with a 12-month follow-up.MNV area was obtained by manual measurements with OCTA software,and VT and VDisp were calculated by automated analysis with Image J software.RESULTS:A total of 101 participants were included,with 51 patients in the type 1 MNV group(mean age 67.32±9.12y)and 50 patients in the type 2 MNV group(mean age 64.74±5.21y).The mean number of IVC injections was 3.98±1.53 for type 1 MNV and 3.73±0.81 for type 2 MNV.Both subtypes exhibited significant improvements in visual acuity,accompanied by marked reductions in CMT and MNV area(P<0.05)at 12mo after treatment.In type 2 MNV,VT significantly decreased(P<0.05),whereas no significant change was observed in VT for type 1 MNV.VDisp did not significantly changed in either sybtypes.Moreover,in type 1 MNV,final best-corrected visual acuity(BCVA)using logMAR correlated positively with both pre-and post-treatment CMT,while in type 2 MNV,a significant positive correlation was found between the number of injections and final CMT.CONCLUSION:This study shows that conbercept treatment significantly improves visual acuity and macular structure in both type 1 and type 2 MNV with reductions in CMT and MNV area.The significant reduction in VT in type 2 MNV suggests its potential as a biomarker for disease activity.The findings imply the quantitative assessment useful for the stratification,prognostication,and personalized management of MNV in nAMD.展开更多
BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sen...BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.展开更多
BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch a...BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.展开更多
AIM:To determine whether chronic smoking affects fundus blood flow density using optical coherence tomography angiography(OCTA)based on artificial intelligence(AI).METHODS:All participants underwent a comprehensive op...AIM:To determine whether chronic smoking affects fundus blood flow density using optical coherence tomography angiography(OCTA)based on artificial intelligence(AI).METHODS:All participants underwent a comprehensive ophthalmological examination in this study.The subjects were categorized into two groups:control and smoker.Fundus data obtained through the novel OCTA device were compared.RESULTS:Utilizing deep learning denoising techniques removed background noise and smoothed vessel surfaces.OCTA showed a significant decrease in fundus blood flow density after AI-based denoising on the right eyes of 36 smokers(36 males,average age 44.17±9.85y)and ageand sex-matched participants who never smoked.The thickness of the retina in both control and smoker groups failed to show any statistically significant differences.Smoking was associated with decreased blood flow density in the macula and the optic disk.CONCLUSION:Utilizing AI-based denoising to improve the sensitivity of OCTA images can be highly beneficial.展开更多
BACKGROUND Optical coherence tomography(OCT)enables high-resolution,non-invasive visualization of retinal structures.Recent evidence suggests that retinal layer alterations may reflect central nervous system changes a...BACKGROUND Optical coherence tomography(OCT)enables high-resolution,non-invasive visualization of retinal structures.Recent evidence suggests that retinal layer alterations may reflect central nervous system changes associated with psychiatric disorders such as schizophrenia(SZ).AIM To develop an advanced deep learning model to classify OCT images and distinguish patients with SZ from healthy controls using retinal biomarkers.METHODS A novel convolutional neural network,Self-AttentionNeXt,was designed by integrating grouped self-attention mechanisms,residual and inverted bottleneck blocks,and a final 1×1 convolution for feature refinement.The model was trained and tested on both a custom OCT dataset collected from patients with SZ and a publicly available OCT dataset(OCT2017).RESULTS Self-AttentionNeXt achieved 97.0%accuracy on the collected SZ OCT dataset and over 95%accuracy on the public OCT2017 dataset.Gradient-weighted class activation mapping visualizations confirmed the model’s attention to clinically relevant retinal regions,suggesting effective feature localization.CONCLUSION Self-AttentionNeXt effectively combines transformer-inspired attention mechanisms with convolutional neural networks architecture to support the early and accurate detection of SZ using OCT images.This approach offers a promising direction for artificial intelligence-assisted psychiatric diagnostics and clinical decision support.展开更多
AIM:To describe the optical coherence tomography(OCT)features in the fellow eyes of individuals with full-thickness macular holes(FTMHs).METHODS:This multicenter retrospective study included observational and validati...AIM:To describe the optical coherence tomography(OCT)features in the fellow eyes of individuals with full-thickness macular holes(FTMHs).METHODS:This multicenter retrospective study included observational and validation groups,incorporating fellow eyes of patients diagnosed with idiopathic FTMH.OCT images were categorized according to International Vitreomacular Traction Study(IVTS)and Gass classification.Age-and sex-related cataract patients were served as control groups.Vertical and horizontal OCT images were chosen for further measurement.OCT parameters including foveal floor width(FFW),central foveal thickness(CFT)and FFW/CFT ratio were assessed and compared between observational and control groups and were validated by validation group.Receiver operating characteristic(ROC)curves were plotted for OCT parameters in identifying macular holes(MHs).RESULTS:A total of 73 patients were included in the observational group,comprising 51 females and 22 males,with an average age of 65.5±7.3y and an axial length of 23.9±0.8 mm.The validated group consisted of 47 patients,including 31 females and 16 males,with an average age of 65.0±7.4y and an average axial length of 23.6±0.8 mm.In the observational group,16.4%of the fellow eyes associated with FTMHs also exhibited MHs,while in the validated group,this prevalence was 12.7%.The 45.2%in the observational group and 44.6%in validated group of these fellow eyes displayed abnormalities including vitreomacular adhesion(VMA),vitreomacular traction(VMT),and MHs.Statistically significant differences were observed in FFW,CFT,and FFW/CFT ratio between control and observational group,as well as validated group(P<0.01),no matter in the vertical or horizontal layer.ROC curves revealed the area under the curve(AUC)for FFW and the FFW/CFT ratio was 0.85 and 0.90,respectively.CONCLUSION:In the case of unilateral idiopathic MHs,it was important to carefully monitor the condition of the fellow eye.The FFW and FFW/CFT ratio may be good metrics for predicting MHs.展开更多
AIM:To compare the macular and optic nerve perfusion and vascular architecture using optical coherence tomography angiography(OCTA)in normal eyes of Egyptian(Caucasians)and South Asian(Asians)volunteers.METHODS:Cross-...AIM:To compare the macular and optic nerve perfusion and vascular architecture using optical coherence tomography angiography(OCTA)in normal eyes of Egyptian(Caucasians)and South Asian(Asians)volunteers.METHODS:Cross-sectional analytical OCTA study performed on 90 eyes of South Asian(n=45)and Egyptians(n=45)were analyzed.All participants underwent bestcorrected visual acuity test,slit lamp,and fundus examination.OCTA images;macular 6×6 mm^(2) grid and optic nerve 4.5×4.5 mm^(2) grid were used to examine the parafoveal and peripapillary regions,respectively.RESULTS:The mean capillary vessel density(CVD)in macular sectors among South Asians and Egyptians participants were(50.31%±2.53%,51.2%±5.93%)and(49.71%±3.6%,51.94%±4.79%)in superficial(SCP)and deep capillary plexuses(DCP),respectively(P>0.05).Mean CVD in both groups was higher in DCP compared to SCP in all sectors but was not significant(P>0.05).Mean foveal CVD increases with an increase in central retinal thickness in both SCP and DCP(P<0.001),among both groups.Mean area of the foveal avascular zone(FAZ)was 0.28±0.09 and 0.27±0.08 mm2 in South Asian and Egyptians,respectively.FAZ area decreases with an increase in the thickness and foveal CVD(P<0.001).Mean CVD in the peripapillary area was 48.23%±5.78% in South Asian and 49.52%±2.38% in Egyptian volunteers.The mean retinal nerve fiber layer thickness was found to be higher in the nasal quadrant among South Asian females than the Egyptian females(P<0.05).CONCLUSION:No significant racial disparity is found in this study.The findings are helpful for assessing and improving the normative data on the differences in South Asian and Egyptian populations.展开更多
Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or ...Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or diseased coronary arteries.[1,2]The condition is typically triggered by various allergens including medications(particularly contrast media),environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure.展开更多
Optical coherence tomography angiography(OCTA)is a powerful tool for non-invasive,label-free,three-dimensional vi-sualization of blood vessels down to the capillary level in vivo.However,its widespread usage is hinder...Optical coherence tomography angiography(OCTA)is a powerful tool for non-invasive,label-free,three-dimensional vi-sualization of blood vessels down to the capillary level in vivo.However,its widespread usage is hindered by the trade-off between transverse sampling rate and signal-to-noise ratio(SNR).This trade-off results in either a limited field of view(FOV)to maintain sampling density or loss of capillary details to fulfil FOV requirement.It also restricts microvascular quantifications,including flow velocimetry,which typically demand higher transverse sampling rate and SNR compared with standard qualitative OCTA.We introduce spectrally extended line field OCTA(SELF-OCTA),a cost-effective imag-ing modality that improves transverse sampling rate and SNR through spectrally encoded parallel sampling and in-creased signal acquired over longer periods,respectively.In the human skin and retina in vivo,we demonstrate its ad-vantages in achieving significantly extended FOV without sacrificing microvascular resolution,high sensitivity to slower flow without compromising FOV,and flow velocity quantification with the highest dynamic range,emphasizing that these features can be achieved with readily available and standard OCTA hardware settings.SELF-OCTA has the potential to make wide-field,high-resolution,quantitative angiographic imaging accessible to a wider population,thereby facilitating the early detection and follow-up of vascular-related diseases.展开更多
AIM:To determine the utility of the RS-1 spectral domain optical coherence tomography(SD-OCT),which incorporates an“OCT Analysis Correction Parameter”for approximating axial length,in comparison with measurements ob...AIM:To determine the utility of the RS-1 spectral domain optical coherence tomography(SD-OCT),which incorporates an“OCT Analysis Correction Parameter”for approximating axial length,in comparison with measurements obtained from the OA-2000.METHODS:Twenty-five right eyes of healthy individuals were included.Two horizontal line scans were conducted using the RS-1,and OCT Analysis Correction Parameters were recorded.Axial length was measured twice per eye using the OA-2000.Correlation between devices was assessed using Pearson correlation coefficient,coefficient of repeatability(CR%),and Bland-Altman analysis.RESULTS:High correlation was found between axial length measurements from RS-1 and OA-2000(r=0.986,P<0.0001).The coefficient of repeatability was 1.56%for RS-1 and 0.115%for OA-2000.Mean axial length was 25.12±1.38 mm for RS-1 and 24.90±1.54 mm for OA-2000,with RS-1 showing a statistically significant larger value(paired t-test,P=0.0009).CONCLUSION:The axial length measurements of RS-1 demonstrate a strong positive correlation with those from the OA-2000.This indicates that it could potentially be used to forecast scan ranges and choose suitable databases according to axial length categories.展开更多
AIM:To describe the optical coherence tomography(OCT)findings of the retinal nerve fiber layer thickness(RNFLT)and choroidal thickness(CT)in beta-thalassemia major.METHODS:A systematic search was conducted on PubMed,C...AIM:To describe the optical coherence tomography(OCT)findings of the retinal nerve fiber layer thickness(RNFLT)and choroidal thickness(CT)in beta-thalassemia major.METHODS:A systematic search was conducted on PubMed,Cochrane,and Embase using a combination of specific key words.The records found were screened in two phases(title/abstract,and full-text screening).All the original observational cross-sectional studies conducted on beta-thalassemia major cases and controls reporting the RNFLT and CT were included.The Meta-analysis was run for comparing the OCT measurements between betathalassemia cases and controls including pooled effect size,confidence intervals(CI),quality assessment,and publication bias.The measurements included were RNFLT(average,and in various quadrants),and CT.RESULTS:A total of 10 studies were included in this Meta-analysis including a total of 684 individuals,362 cases and 322 controls.The RNFLT and CT showed a significant reduction in the values of beta-thalassemia cases as compared to controls.The heterogeneity among the included studies was found to be 92.65%for the average RNFLT and 30.13%for the CT making it obvious to use random effects model for analyzing the RNFLT values while fixed effects model for the CT.The Egger’s test showed significant publication bias among all the parameters except for nasal RNFLT(P=0.507),and CT(P=0.281).The estimated average effect size for the average RNFLT was 1.04(95%CI:0.35 to 1.72,Z=2.961,P=0.003)and for CT was 0.74(95%CI:0.51 to 0.96,Z=6.523,P<0.001).CONCLUSION:This Meta-analysis concludes that the RNFLT and CT are significantly thinner in beta-thalassemia cases in comparison to healthy individuals.Therefore,the RNFLT and CT must be evaluated in routine clinical practice in order to avoid irreversible vision loss particularly in betathalassemia individuals.展开更多
AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 pat...AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups,respectively.The treatment group was instructed to apply generic latanoprost 0.005%once daily at night,while the control group received no medication.Anterior segment OCTA was performed on all eyes at baseline,3wk,and 12wk after initiation of latanoprost.The superficial bulbar conjunctival VD was measured in the superior,inferior,temporal,and nasal quadrants.A linear mixed model was used to compare the change in the VD between groups.RESULTS:The change in the VD was not different between groups in temporal,and nasal quadrants at 3-week and 12-week time points.The VD in the superior bulbar conjunctiva was significantly increased after 12wk(P=0.029)while the change from baseline after 3wk was not different between groups(P=0.218).After adjustment for age and gender superior hemi(P=0.006)and center(P=0.016)of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk.CONCLUSION:The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.展开更多
Background:We investigated retinal and choroidal microvascular parameters as potential biomarkers for vascular cognitive impairment in patients with internal carotid artery stenosis(ICAS).Methods:We enrolled 123 asymp...Background:We investigated retinal and choroidal microvascular parameters as potential biomarkers for vascular cognitive impairment in patients with internal carotid artery stenosis(ICAS).Methods:We enrolled 123 asymptomatic ICAS patients and categorized them into vascular mild cognitive impairment(VMCI)and vascular dementia(VaD)groups using the Montreal Cognitive Assessment.Optical coherence tomography angiography was used to evaluate vessel densities and perfusion areas in various retinal layers.Magnetic resonance imaging-based neuroimaging biomarkers for cerebral small vessel disease(CSVD)were also assessed.Least absolute shrinkage and selection operator logistic regression identified predictor variables,and receiver operating curve analysis assessed the ability of key parameters to distinguish between VMCI and VaD.Results:Compared with VMCI patients,VaD patients had lower radial peripapillary capillary(RPC)perfusion area,higher CSVD burden score,and larger white matter hyperintensity volume(all p<0.05).Receiver operating curve analysis revealed that the RPC perfusion area of the affected eye had superior discriminatory power for distinguishing VaD from VMCI compared with both the CSVD burden score(Z=1.99,p=0.047)and white matter hyperintensity(Z=1.97,p=0.049).The optimal cutoff value for the 0-1 mm macular RPC perfusion area was determined as 0.068 mm^(2).Conclusion:The optical coherence tomography angiography-derived RPC perfusion area can effectively differentiate VaD from VMCI,suggesting its potential as a noninvasive diagnostic method to support clinical decision-making for ICAS patients.展开更多
Visualizing blood flow velocity distribution is essential for comprehending the pathogenesis of various diseases and facilitating early diagnosis and treatment.Current hemodynamic studies utilizing optical coherence t...Visualizing blood flow velocity distribution is essential for comprehending the pathogenesis of various diseases and facilitating early diagnosis and treatment.Current hemodynamic studies utilizing optical coherence tomography(OCT)primarily rely on Doppler OCT(D-OCT)and OCT Angiography(OCTA),which measure axial blood vessel velocity or visualize the vascular architecture,respectively.However,these techniques have limitations in accurately quantifying the absolute velocity of red blood cells(RBCs).This study presents a novel method based on microsphere tracking,which enables precise quantification of absolute blood flow velocity along a blood vessel.In phantom experiments,freshly harvested blood mixed with microspheres was infused into a cellulose tube to simulate a single blood vessel.Experimental results,demon-strating an error margin of less than 10%,validated the effectiveness of this method.Blood flow velocities ranging from 0.472 mm/s to 18.9 mm/s were accurately measured.A preliminary in vivo examination of rabbit ear vessels was conducted,further validating the reliability of this method.This study presents a potential method for specific disease diagnosis by detecting tar-geted vessel flow velocity variations using swept-source optical coherence tomography(SS-OCT)combined with microsphere tracking.展开更多
文摘AIM:To evaluate the choroidopathy in patients with systemic lupus erythematosus(SLE)using enhanced depth imaging spectral domain optical coherence tomography(EDI SD-OCT)and optical coherence tomography angiography(OCTA).METHODS:A total of 74 patients with SLE and 40 healthy volunteers were included in this cross-sectional study.SLE patients were further divided into three subgroups based on clinical and blood biochemistry findings.Ocular parameters obtained on ophthalmologic examination and optical imaging(EDI SD-OCT and OCTA)included the best corrected distance visual acuity(logMAR CDVA),subfoveal choroidal thickness(SCT),choroidal vascularity index(CVI)and vessel density(VD)of superficial capillary plexus(SCP)and deep capillary plexus(DCP).RESULTS:SLE patients had significantly lower values for CVI and VD of DCP(DVD)than control subjects.Amongst SLE patients,gender and chloroquine dose were found to be independent determinants of CVI while age predicted SCT.Steroid dose was a significant predictor for foveal VD of SCP(SVD),chloroquine dose for parafoveal SVD,gender for total DVD,and gender and steroid dose for perifoveal DVD.No correlation of logMAR CDVA and SCT was noted between SLE patients and control subjects.No correlation of SCT was noted with disease duration,Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score,hydroxychloroquine(HCQ)dose or steroid dose.No correlation of CVI was noted with patient age,disease duration,SLEDAI score,HCQ dose or steroid dose.No significant difference was noted between SLE subgroups in terms of any of the ocular parameters studied.CONCLUSION:The findings reveal the presence of ocular findings suggestive of early onset choroidopathy on EDI SD-OCT and OCTA in SLE patients,in the absence of ocular manifestations or active disease.
文摘BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.
文摘AIM:To investigate the value of optical coherence tomography angiography(OCTA)indicators in the diagnosis of diabetic retinopathy(DR),and to provide patients with diabetic nephropathy(DN)with more sensitive OCTA screening indicators to detect concurrent DR at an early stage.METHODS:A total of 200 patients who treated in the ophthalmology department of the Seventh Affiliated Hospital,Sun Yat-sen University from 2022 to 2023 were included,including 95 first-diagnosed DR patients and 105 patients without DR,and all patients underwent OCTA examination and a collection of demographics and renal function parameters.After a quality check,automated measurements of the foveal avascular zone area,vessel density(VD),and perfusion density(PD)of both 3 mm×3 mm and 6 mm×6 mm windows were obtained.RESULTS:Using random forest and multivariate Logistic regression methods,we developed a diagnostic model for DR based on 12 variables(age,FBG,SBP,DBP,HbA1c,ALT,ALP,urea/Scr,DM duration,HUA,DN,and CMT).Adding specific OCTA parameters enhanced the efficacy of the existing diagnostic model for DR(outer vessel density in 6 mm×6 mm window,AUC=0.837 vs 0.819,P=0.03).In the study of DN patients,the parameters in the 6 mm×6 mm window improved the diagnostic efficacy of DR(inner VD;outer VD;full VD;outer PD;full PD).CONCLUSION:The outer VD in the 6 mm×6 mm window can enhance the efficacy of the traditional DR diagnostic model.Meanwhile,compared with the 3 mm×3 mm window,the microvascular parameters in the 6 mm×6 mm window focusing on DN patients can be more sensitive to diagnosing the occurrence of DR.
基金Supported by the Suzhou Medical Innovation Application Research Project(SZM2023027).
文摘AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.
文摘BACKGROUND Optical coherence tomography(OCT)offers detailed cross-sectional imaging during percutaneous coronary intervention(PCI),aiding in anatomically complex coronary lesions.Despite its advantages,evidence on the clinical effectiveness of OCT-guided PCI remains limited.Major databases were systematically searched for randomized controlled trials(RCTs)comparing OCT-guided and angiography-guided PCI in complex lesions.Primary outcomes included major adverse cardiovascular events(MACE)and target vessel failure(TVF);secondary outcomes included mortality,myocardial infarction(MI),and other procedural outcomes.A random-effects model was used to pool risk ratio(RR),with 95%CI.Statistical analysis was conducted in R software(v4.4.1),with significance set at P<0.05.RESULTS Five RCTs(5737 patients)showed OCT-guided PCI significantly reduced MACE(RR:0.63,95%CI:0.52-0.77,P<0.01),TVF(RR:0.68,95%CI:0.56-0.83,P<0.01),all-cause(RR:0.58,95%CI:0.38-0.87,P<0.01)and cardiac mortality(RR:0.43,95%CI:0.24-0.76,P<0.01),target-lesion revascularization(RR:0.53,95%CI:0.33-0.84,P<0.01),stent thrombosis(RR:0.52,95%CI:0.31-0.86,P=0.01),and target-vessel MI(RR:0.64,95%CI:0.42-0.97,P=0.04)vs angiography-guided PCI.Periprocedural MI,any revascularization,target-vessel revascularization,and contrast-associated kidney injury were similar between groups.CONCLUSION OCT-guided PCI improves outcomes in complex lesions by reducing MACE,TVF,mortality,stent thrombosis,and target-vessel MI.These findings highlight the need for further large-scale RCTs to confirm its benefits.
基金funded by the Deanship of Research and Graduate Studies at King Khalid University through small group research under grant number RGP1/180/46.
文摘Optical Coherence Tomography(OCT)provides cross-sectional and three-dimensional reconstructions of the target tissue,allowing precise imaging and quantitative analysis of individual retinal layers.These images,based on optical inhomogeneities,reveal intricate cellular structures and are vital for tasks like retinal segmentation.The proposed study uses OCT images to identify significant differences in peripapillary retinal nerve fiber layer thickness.Incorporating spectral-domain analysis of OCT images significantly enhances the evaluation of Purtcher Retinopathy.To streamline this process,the study introduces a Context Encoding Deep Neural Network(CEDNN),which eliminates the time-consuming manual segmentation process while improving the accuracy of retinal layer thickness measurements.Despite the excellent performance of deep learning-based Convolutional Neural Networks(CNNs)in multiclass ocular fluid segmentation and lesion identification,certain challenges remain.Specifically,segmentation accuracy declines in regions with very tiny patches of subretinal fluid,often due to limited training data.The proposed CEDNN addresses these limitations by reducing processing time and enhancing accuracy.The approach incorporates advanced diffusion techniques in the 2D segmentation process using a gradient convergence field that accounts for the anisotropic nature of image features.Experimental results on public datasets and clinical OCT images demonstrate that the CEDNN approach achieves remarkable performance,with an accuracy of 99.3%,sensitivity of 99.4%,and specificity of 99%.Furthermore,the use of 3D representations of surface data outperforms traditional 2D surface estimates,enhancing segmentation quality.The system also incorporates temporal dimension estimation,making it feasible to forecast rapid disease progression.This advanced approach holds significant potential for improving retinal disease detection and analysis,setting a new benchmark in automated OCT-based diagnostics.
基金Supported by Natural Science Foundation of Shandong Province(No.ZR2023MH363)Bethune Langmu Young Scholars Research Fund Project(No.BJ-LM2021007J).
文摘AIM:To quantitatively assess central macular thickness(CMT),macular neovascularization(MNV)area,vascular tortuosity(VT),and vascular dispersion(VDisp)in neovascular age-related macular degeneration(nAMD),type 1 and type 2 MNV,by means of optical coherence tomography(OCT)and OCT angiography(OCTA)techniques.METHODS:In this retrospective and observational case series,patients were classified into type 1 or type 2 MNV groups.A comprehensive panel of OCT and OCTA metrics was evaluated,including CMT,MNV area,VT,and VDisp.All subjects underwent a standardized intravitreal conbercept(IVC)regimen[3+pro re nata(PRN)]with a 12-month follow-up.MNV area was obtained by manual measurements with OCTA software,and VT and VDisp were calculated by automated analysis with Image J software.RESULTS:A total of 101 participants were included,with 51 patients in the type 1 MNV group(mean age 67.32±9.12y)and 50 patients in the type 2 MNV group(mean age 64.74±5.21y).The mean number of IVC injections was 3.98±1.53 for type 1 MNV and 3.73±0.81 for type 2 MNV.Both subtypes exhibited significant improvements in visual acuity,accompanied by marked reductions in CMT and MNV area(P<0.05)at 12mo after treatment.In type 2 MNV,VT significantly decreased(P<0.05),whereas no significant change was observed in VT for type 1 MNV.VDisp did not significantly changed in either sybtypes.Moreover,in type 1 MNV,final best-corrected visual acuity(BCVA)using logMAR correlated positively with both pre-and post-treatment CMT,while in type 2 MNV,a significant positive correlation was found between the number of injections and final CMT.CONCLUSION:This study shows that conbercept treatment significantly improves visual acuity and macular structure in both type 1 and type 2 MNV with reductions in CMT and MNV area.The significant reduction in VT in type 2 MNV suggests its potential as a biomarker for disease activity.The findings imply the quantitative assessment useful for the stratification,prognostication,and personalized management of MNV in nAMD.
文摘BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.
文摘BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.
基金Supported by the Shanghai Health Commission(No.202240097).
文摘AIM:To determine whether chronic smoking affects fundus blood flow density using optical coherence tomography angiography(OCTA)based on artificial intelligence(AI).METHODS:All participants underwent a comprehensive ophthalmological examination in this study.The subjects were categorized into two groups:control and smoker.Fundus data obtained through the novel OCTA device were compared.RESULTS:Utilizing deep learning denoising techniques removed background noise and smoothed vessel surfaces.OCTA showed a significant decrease in fundus blood flow density after AI-based denoising on the right eyes of 36 smokers(36 males,average age 44.17±9.85y)and ageand sex-matched participants who never smoked.The thickness of the retina in both control and smoker groups failed to show any statistically significant differences.Smoking was associated with decreased blood flow density in the macula and the optic disk.CONCLUSION:Utilizing AI-based denoising to improve the sensitivity of OCTA images can be highly beneficial.
文摘BACKGROUND Optical coherence tomography(OCT)enables high-resolution,non-invasive visualization of retinal structures.Recent evidence suggests that retinal layer alterations may reflect central nervous system changes associated with psychiatric disorders such as schizophrenia(SZ).AIM To develop an advanced deep learning model to classify OCT images and distinguish patients with SZ from healthy controls using retinal biomarkers.METHODS A novel convolutional neural network,Self-AttentionNeXt,was designed by integrating grouped self-attention mechanisms,residual and inverted bottleneck blocks,and a final 1×1 convolution for feature refinement.The model was trained and tested on both a custom OCT dataset collected from patients with SZ and a publicly available OCT dataset(OCT2017).RESULTS Self-AttentionNeXt achieved 97.0%accuracy on the collected SZ OCT dataset and over 95%accuracy on the public OCT2017 dataset.Gradient-weighted class activation mapping visualizations confirmed the model’s attention to clinically relevant retinal regions,suggesting effective feature localization.CONCLUSION Self-AttentionNeXt effectively combines transformer-inspired attention mechanisms with convolutional neural networks architecture to support the early and accurate detection of SZ using OCT images.This approach offers a promising direction for artificial intelligence-assisted psychiatric diagnostics and clinical decision support.
基金Supported by Jiangsu Provincial Medical Innovation Team(No.CXTDA2017039)the Soochow Scholar Project of Soochow University(No.R5122001).
文摘AIM:To describe the optical coherence tomography(OCT)features in the fellow eyes of individuals with full-thickness macular holes(FTMHs).METHODS:This multicenter retrospective study included observational and validation groups,incorporating fellow eyes of patients diagnosed with idiopathic FTMH.OCT images were categorized according to International Vitreomacular Traction Study(IVTS)and Gass classification.Age-and sex-related cataract patients were served as control groups.Vertical and horizontal OCT images were chosen for further measurement.OCT parameters including foveal floor width(FFW),central foveal thickness(CFT)and FFW/CFT ratio were assessed and compared between observational and control groups and were validated by validation group.Receiver operating characteristic(ROC)curves were plotted for OCT parameters in identifying macular holes(MHs).RESULTS:A total of 73 patients were included in the observational group,comprising 51 females and 22 males,with an average age of 65.5±7.3y and an axial length of 23.9±0.8 mm.The validated group consisted of 47 patients,including 31 females and 16 males,with an average age of 65.0±7.4y and an average axial length of 23.6±0.8 mm.In the observational group,16.4%of the fellow eyes associated with FTMHs also exhibited MHs,while in the validated group,this prevalence was 12.7%.The 45.2%in the observational group and 44.6%in validated group of these fellow eyes displayed abnormalities including vitreomacular adhesion(VMA),vitreomacular traction(VMT),and MHs.Statistically significant differences were observed in FFW,CFT,and FFW/CFT ratio between control and observational group,as well as validated group(P<0.01),no matter in the vertical or horizontal layer.ROC curves revealed the area under the curve(AUC)for FFW and the FFW/CFT ratio was 0.85 and 0.90,respectively.CONCLUSION:In the case of unilateral idiopathic MHs,it was important to carefully monitor the condition of the fellow eye.The FFW and FFW/CFT ratio may be good metrics for predicting MHs.
文摘AIM:To compare the macular and optic nerve perfusion and vascular architecture using optical coherence tomography angiography(OCTA)in normal eyes of Egyptian(Caucasians)and South Asian(Asians)volunteers.METHODS:Cross-sectional analytical OCTA study performed on 90 eyes of South Asian(n=45)and Egyptians(n=45)were analyzed.All participants underwent bestcorrected visual acuity test,slit lamp,and fundus examination.OCTA images;macular 6×6 mm^(2) grid and optic nerve 4.5×4.5 mm^(2) grid were used to examine the parafoveal and peripapillary regions,respectively.RESULTS:The mean capillary vessel density(CVD)in macular sectors among South Asians and Egyptians participants were(50.31%±2.53%,51.2%±5.93%)and(49.71%±3.6%,51.94%±4.79%)in superficial(SCP)and deep capillary plexuses(DCP),respectively(P>0.05).Mean CVD in both groups was higher in DCP compared to SCP in all sectors but was not significant(P>0.05).Mean foveal CVD increases with an increase in central retinal thickness in both SCP and DCP(P<0.001),among both groups.Mean area of the foveal avascular zone(FAZ)was 0.28±0.09 and 0.27±0.08 mm2 in South Asian and Egyptians,respectively.FAZ area decreases with an increase in the thickness and foveal CVD(P<0.001).Mean CVD in the peripapillary area was 48.23%±5.78% in South Asian and 49.52%±2.38% in Egyptian volunteers.The mean retinal nerve fiber layer thickness was found to be higher in the nasal quadrant among South Asian females than the Egyptian females(P<0.05).CONCLUSION:No significant racial disparity is found in this study.The findings are helpful for assessing and improving the normative data on the differences in South Asian and Egyptian populations.
基金supported by the National Key Research and Development Program of China(No.2022YFB380-7300)the National Natural Science Foundation of China(No.12471455)+2 种基金the Clinical Cohort Construction Program of Peking University Third Hospital(BYSYDL2022005)the Key Clinical Projects of Peking University Third Hospital(BYSYZD2023006)the Innovation&Transfer Fund of Peking University Third Hospital(BYSYZHKC2023-109).
文摘Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or diseased coronary arteries.[1,2]The condition is typically triggered by various allergens including medications(particularly contrast media),environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure.
基金support from the Ministry of Education Singapore under its Academic Research Funding Tier 2 grant(MOE-T2EP30120-0001)Academic Research Funding Tier 1 grant(RG35/22)+1 种基金Singapore National Medical Research Council CS-NIG grant(MOH-CNIG24jan-0004)Guangzhou National Laboratory grant(GZNL2025C03014).
文摘Optical coherence tomography angiography(OCTA)is a powerful tool for non-invasive,label-free,three-dimensional vi-sualization of blood vessels down to the capillary level in vivo.However,its widespread usage is hindered by the trade-off between transverse sampling rate and signal-to-noise ratio(SNR).This trade-off results in either a limited field of view(FOV)to maintain sampling density or loss of capillary details to fulfil FOV requirement.It also restricts microvascular quantifications,including flow velocimetry,which typically demand higher transverse sampling rate and SNR compared with standard qualitative OCTA.We introduce spectrally extended line field OCTA(SELF-OCTA),a cost-effective imag-ing modality that improves transverse sampling rate and SNR through spectrally encoded parallel sampling and in-creased signal acquired over longer periods,respectively.In the human skin and retina in vivo,we demonstrate its ad-vantages in achieving significantly extended FOV without sacrificing microvascular resolution,high sensitivity to slower flow without compromising FOV,and flow velocity quantification with the highest dynamic range,emphasizing that these features can be achieved with readily available and standard OCTA hardware settings.SELF-OCTA has the potential to make wide-field,high-resolution,quantitative angiographic imaging accessible to a wider population,thereby facilitating the early detection and follow-up of vascular-related diseases.
文摘AIM:To determine the utility of the RS-1 spectral domain optical coherence tomography(SD-OCT),which incorporates an“OCT Analysis Correction Parameter”for approximating axial length,in comparison with measurements obtained from the OA-2000.METHODS:Twenty-five right eyes of healthy individuals were included.Two horizontal line scans were conducted using the RS-1,and OCT Analysis Correction Parameters were recorded.Axial length was measured twice per eye using the OA-2000.Correlation between devices was assessed using Pearson correlation coefficient,coefficient of repeatability(CR%),and Bland-Altman analysis.RESULTS:High correlation was found between axial length measurements from RS-1 and OA-2000(r=0.986,P<0.0001).The coefficient of repeatability was 1.56%for RS-1 and 0.115%for OA-2000.Mean axial length was 25.12±1.38 mm for RS-1 and 24.90±1.54 mm for OA-2000,with RS-1 showing a statistically significant larger value(paired t-test,P=0.0009).CONCLUSION:The axial length measurements of RS-1 demonstrate a strong positive correlation with those from the OA-2000.This indicates that it could potentially be used to forecast scan ranges and choose suitable databases according to axial length categories.
文摘AIM:To describe the optical coherence tomography(OCT)findings of the retinal nerve fiber layer thickness(RNFLT)and choroidal thickness(CT)in beta-thalassemia major.METHODS:A systematic search was conducted on PubMed,Cochrane,and Embase using a combination of specific key words.The records found were screened in two phases(title/abstract,and full-text screening).All the original observational cross-sectional studies conducted on beta-thalassemia major cases and controls reporting the RNFLT and CT were included.The Meta-analysis was run for comparing the OCT measurements between betathalassemia cases and controls including pooled effect size,confidence intervals(CI),quality assessment,and publication bias.The measurements included were RNFLT(average,and in various quadrants),and CT.RESULTS:A total of 10 studies were included in this Meta-analysis including a total of 684 individuals,362 cases and 322 controls.The RNFLT and CT showed a significant reduction in the values of beta-thalassemia cases as compared to controls.The heterogeneity among the included studies was found to be 92.65%for the average RNFLT and 30.13%for the CT making it obvious to use random effects model for analyzing the RNFLT values while fixed effects model for the CT.The Egger’s test showed significant publication bias among all the parameters except for nasal RNFLT(P=0.507),and CT(P=0.281).The estimated average effect size for the average RNFLT was 1.04(95%CI:0.35 to 1.72,Z=2.961,P=0.003)and for CT was 0.74(95%CI:0.51 to 0.96,Z=6.523,P<0.001).CONCLUSION:This Meta-analysis concludes that the RNFLT and CT are significantly thinner in beta-thalassemia cases in comparison to healthy individuals.Therefore,the RNFLT and CT must be evaluated in routine clinical practice in order to avoid irreversible vision loss particularly in betathalassemia individuals.
文摘AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups,respectively.The treatment group was instructed to apply generic latanoprost 0.005%once daily at night,while the control group received no medication.Anterior segment OCTA was performed on all eyes at baseline,3wk,and 12wk after initiation of latanoprost.The superficial bulbar conjunctival VD was measured in the superior,inferior,temporal,and nasal quadrants.A linear mixed model was used to compare the change in the VD between groups.RESULTS:The change in the VD was not different between groups in temporal,and nasal quadrants at 3-week and 12-week time points.The VD in the superior bulbar conjunctiva was significantly increased after 12wk(P=0.029)while the change from baseline after 3wk was not different between groups(P=0.218).After adjustment for age and gender superior hemi(P=0.006)and center(P=0.016)of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk.CONCLUSION:The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.
基金supported by the Medical Science and Technology Project of Zhejiang Province[Grant Nos.2022KY600 and 2024KY019]Zhejiang Provincial Natural Science Foundation of China[Grant No.LGF22H090020]+1 种基金Social Development Science and Technology Projects of Wenling City in 2023[Grant No.2023S00131]Social Development Science and Technology Projects of Wenling City in 2024[Grant No.2024S00181].
文摘Background:We investigated retinal and choroidal microvascular parameters as potential biomarkers for vascular cognitive impairment in patients with internal carotid artery stenosis(ICAS).Methods:We enrolled 123 asymptomatic ICAS patients and categorized them into vascular mild cognitive impairment(VMCI)and vascular dementia(VaD)groups using the Montreal Cognitive Assessment.Optical coherence tomography angiography was used to evaluate vessel densities and perfusion areas in various retinal layers.Magnetic resonance imaging-based neuroimaging biomarkers for cerebral small vessel disease(CSVD)were also assessed.Least absolute shrinkage and selection operator logistic regression identified predictor variables,and receiver operating curve analysis assessed the ability of key parameters to distinguish between VMCI and VaD.Results:Compared with VMCI patients,VaD patients had lower radial peripapillary capillary(RPC)perfusion area,higher CSVD burden score,and larger white matter hyperintensity volume(all p<0.05).Receiver operating curve analysis revealed that the RPC perfusion area of the affected eye had superior discriminatory power for distinguishing VaD from VMCI compared with both the CSVD burden score(Z=1.99,p=0.047)and white matter hyperintensity(Z=1.97,p=0.049).The optimal cutoff value for the 0-1 mm macular RPC perfusion area was determined as 0.068 mm^(2).Conclusion:The optical coherence tomography angiography-derived RPC perfusion area can effectively differentiate VaD from VMCI,suggesting its potential as a noninvasive diagnostic method to support clinical decision-making for ICAS patients.
基金supported by the National Natural Science Foundation of China(62175156,81827807)the Science and Technology Commission of Shanghai Municipality(22S31903000)+3 种基金the Collaborative Innovation Project of Shanghai Institute of Technology(XTCX2022-27)the Shenzhen Basic Research Key Project(JCYJ20220818103212026)the Shenzhen Key Technology Project(JSGGZD20220822095200002)the Shenzhen Outstanding Scientific and Technological Innovation Talents Distinguished Young Scientists(RCJC20210609104443085).
文摘Visualizing blood flow velocity distribution is essential for comprehending the pathogenesis of various diseases and facilitating early diagnosis and treatment.Current hemodynamic studies utilizing optical coherence tomography(OCT)primarily rely on Doppler OCT(D-OCT)and OCT Angiography(OCTA),which measure axial blood vessel velocity or visualize the vascular architecture,respectively.However,these techniques have limitations in accurately quantifying the absolute velocity of red blood cells(RBCs).This study presents a novel method based on microsphere tracking,which enables precise quantification of absolute blood flow velocity along a blood vessel.In phantom experiments,freshly harvested blood mixed with microspheres was infused into a cellulose tube to simulate a single blood vessel.Experimental results,demon-strating an error margin of less than 10%,validated the effectiveness of this method.Blood flow velocities ranging from 0.472 mm/s to 18.9 mm/s were accurately measured.A preliminary in vivo examination of rabbit ear vessels was conducted,further validating the reliability of this method.This study presents a potential method for specific disease diagnosis by detecting tar-geted vessel flow velocity variations using swept-source optical coherence tomography(SS-OCT)combined with microsphere tracking.
