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Refractive surgery is a constantly evolving field, with new techniques and technologies emerging at a rapid pace. As primary eyecare providers, it's crucial to stay up to date with these [...]

Author(s): Ruchi Goel [1]; Shalin Shah (corresponding author) [1]; Uddeshya Yadav [1] Thyroid eye disease (TED) is a major extrathyroidal manifestation of Graves' disease (GD), affecting the quality of life. [...], Purpose: To study choroidal vascularity changes in active and inactive TED orbits by using high-definition optical coherence tomography (HD-OCT) and correlate the changes with the duration and severity of TED and Barrets&apos; index. Methods: A cross-sectional study wherein 37 TED orbits and 30 healthy control (HC) orbits were enrolled. Choroid was imaged using HD-OCT scans centered at the fovea, and subfoveal choroidal thickness (SFCT) was measured. The OCT images were analyzed using ImageJ software to calculate choroidal vascularity index (CVI) and associated choroidal perfusion indices. Results: The study included eight active, 13 non-inflammatory active (NIA), and 16 inactive TED orbits. The mean age was 39.73 ± 12.91 years, and the male: female ratio was 1.18:1. Intraocular pressure and CVI were higher, while SFCT was similar in TED on comparison to healthy orbits. CVI and SFCT were raised in active as compared to inactive TED. CVI and SFCT correlated positively with Barrets&apos; index and negatively with the duration of thyroid disease. The area under curve of CVI (95% CI: 0.651-0.864, P < 0.001) helped in differentiating TED orbits from HC, while CVI (95% CI: 0.780-0.983, P < 0.001) had the maximum discriminatory power in predicting the activity of disease. Conclusions: CVI has greater sensitivity than SFCT in differentiating healthy from TED orbits. The blood flow stagnation in active orbits, which improves during the course of TED and tends to worsen with increase in Barret&apos;s index, can lead to choroidal vascularity changes. CVI and SFCT can act as adjunct to existing modalities for monitoring the disease activity. Keywords: Choroidal vascularity index, perfusion biomarkers, subfoveal choroidal thickness, thyroid eye disease

Author(s): Ramesh Venkatesh (corresponding author) [1]; Priyanka Gandhi [1]; Ayushi Choudhary [1]; Gaurang Sehgal [1]; Kanika Godani [1]; Shubham Darade [1]; Rupal Kathare [1]; Prathiba Hande [1]; Vishma Prabhu [1]; [...], Purpose: To evaluate various supervised machine learning (ML) statistical models to predict anatomical outcomes after macular hole (MH) surgery using preoperative optical coherence tomography (OCT) features. Methods: This retrospective study analyzed OCT data from idiopathic MH eyes at baseline and at 1-month post-surgery. The dataset was split 80:20 between training and testing. XLSTAT® statistical software (Lumivero, USA) was used to train different ML models on 10°CT parameters: prefoveal posterior cortical vitreous status, epiretinal membrane, intraretinal cysts, foveal retinal pigment epithelium hyperreflectivity, MH basal diameter, MH area (MHA), hole-forming factor, MH index, tractional hole index, and diameter hole index. The most effective statistical model was identified and was further assessed for accuracy, sensitivity, and specificity on a separate testing dataset. Results: Six ML statistical models were trained on 33,260°CT data points from 3326°CT images of 308 operated MH (300 patients) eyes. Following training and internal validation, the random forest (RF) model achieved the highest accuracy (0.92), precision (0.94), recall (0.97), and F-score (0.96), and lowest misclassification rate. RF model identified the MHA index as the best predictor of post-surgical anatomical success. Following external testing, the RF model confirmed the highest accuracy and lowest misclassification rate (8.8%). Conclusion: ML-based statistical models can be used to predict MH status after surgery. The RF model was the most accurate ML model, and the MHA index was the best predictor of postoperative hole closure after surgery based on preoperative OCT parameters. These predictions may help with future surgical planning for MH patients. Keywords: Machine learning, macular hole, outcomes, prediction, statistical models

Author(s): Shikha Talwar Bassi (corresponding author) [1]; Ramesh Pamu [2]; Selvakumar Ambika [3]; Smita Praveen [4]; Durga Priyadarshini [4]; Vidhya Dharini [4]; K Padmalakshmi [4] Papilledema is defined as optic [...], Purpose: To study the optic nerve head characteristics on optical coherence tomography (OCT) in patients with papilledema and correlate them with intracranial pressure (ICP). Methods: A retrospective hospital-based study of 46 eyes of 23 patients with bilateral optic disc edema secondary to increased ICP. The clinical profile and the OCT features in terms of retinal nerve fiber layer thickness (RNFL), ganglion cell inner plexiform layer (GCIPL) thickness, and enhanced depth imaging (EDI) B scan images of the optic nerve head were studied and correlated with the ICP. Results: Papilledema was secondary to idiopathic intracranial hypertension (IIH) (n = 20), obstructive hydrocephalus (n = 2), and communicating hydrocephalus (n = 1). The mean ICP in 20 IIH patients was 347 mmH[sub.2]O. The ICP and RNFL thickness in all four quadrants were found to be weakly positively correlated: superior RNFL r (38) = 0.17, P = 0.30, and nasal RNFL r (38) = 0.30, P = 0.05, inferior RNFL r (38) = 0.29, P = 0.07, and temporal RNFL, r (38) = -0.001, P = 0.99. The GCIPL layer thickness and the ICP were weakly negatively correlated in all sectors: superior (38) = -0.23, P = 0.16, superonasal, r (38) = -0.07, P = 0.67, inferonasal r (38) = -0.08, P = 0.64, inferior r (38) = -0.21, P = 0.19, inferotemporal r (38) = -0.23, P = 0.17, superotemporal, r (38) -0.21, P = 0.20. Descriptive features on the B scan, such as peripapillary hyperreflective ovoid mass-like structures and microcystic spaces, were observed most commonly with an ICP of 251-350 mmH[sub.2]O, and the hyperreflective dots in the RNFL layer and Bruch&apos;s membrane inward denting were observed more commonly with an ICP of 351-450 mmH[sub.2]O. Conclusion: The RNFL thickness in all four quadrants had a weak positive correlation, and the GCIPL layer had a weak negative correlation with the ICP. The EDI descriptive features on OCT may vary with ICP. Keywords: Enhanced depth imaging, idiopathic intracranial hypertension, optic nerve head drusen, optical coherence tomography

Author(s): Sugandha Goel [1]; Samarth Mishra [1]; Sampurna Bhattacharya [2]; Bristi Majumdar [2]; Ahana Sen [2]; Riya Mukherjee [2]; Raghul Nandan Ramandhane [2]; Nikita Goel [2]; Kumar Saurabh [1]; Rupak [...], Purpose: To describe the subretinal hyporeflective globule in cases of central serous chorioretinopathy (CSC). Methods: A retrospective analysis of consecutive cases of CSC presenting to a tertiary eye care center in eastern India was conducted. Subretinal hyporeflective globules were identified as small globular lesions below the external limiting membrane/ellipsoid zone, but above the RPE layer. They had a hyperreflective border with a hyporeflective core and a clear posterior tail of hyper-transmission. Results: The present study analyzed 137 eyes of 137 patients. Eighty (58.4%) eyes had acute disease at presentation, 48 (35%) eyes had chronic disease, and eight (5.8%) eyes had resolved CSC. Subretinal hyporeflective globules were seen in 27 (21.8%) eyes, of which choroidal caverns were seen in seven (5.1%) eyes. Twenty-five eyes with chronic CSC and only two eyes with acute CSC had subretinal hyporeflective globules. Three eyes with resolved CSC had subretinal hyporeflective globules. Conclusion: We describe subretinal hyporeflective globule as a novel optical coherence tomography (OCT) finding in cases of CSC and describe its clinical correlates. Keywords: Central serous chorioretinopathy, choroidal caverns, subretinal hyporeflective globule

Author(s): Gopal S Pillai [1]; Akhila Kutumbaka (corresponding author) [1]; P K Nazar [2]; Anvesh Chandiri [2]; Greeshma C Ravindran [3] Diabetes mellitus (DM) is a leading cause of ocular [...], Purpose: Diabetic retinopathy (DR) is a leading cause of ocular morbidity. Its progression depends mainly on retinal vasculature and ocular blood flow. Color Doppler imaging (CDI) is a noninvasive imaging technique that measures blood flow velocity. The resistivity index (RI), calculated by the CDI, reflects the vascular resistance distal to the measuring location. RI is independent of the doppler angle and position of the patient, making it a reliable and reproducible parameter. To the best of our knowledge, there is only one study in literature studying the association between resistivity index (RI) of the central retinal artery (CRA) and severity of DR. Aim: To determine the association between RI of CRA and severity of DR. To determine the association between RI of CRA and spectral-domain optical coherence tomography (SD-OCT) biomarkers for DR. Methods: Type II diabetics visiting our OPD underwent DR screening and were graded into three categories according to ETDRS classification which include Group A--No diabetic retinopathy (No DR), Group B--Nonproliferative diabetic retinopathy (Moderate-Severe-Very Severe NPDR), and Group C--Proliferative diabetic retinopathy (PDR). SD-OCT was performed. Ultrasonic color doppler imaging was done. RI of the CRA was noted. It was compared between the three groups and its association with severity of DR and OCT biomarkers (central subfield thickness, cube average thickness and ellipsoid zone disruption) was studied. Results: 56 eyes of 28 patients were included in our study with 20 in Group A,14 in Group B, and 22 in Group C. RI of CRA compared within groups showed statistically significant association with severity of DR (P < 0.001). The presenting BCVA (LogMar) showed positive correlation with RI in all groups. OCT biomarker central subfield thickness showed a positive correlation with RI in Groups A (P < 0.001) and B. Ellipsoid zone (EZ) disruption showed a statistically significant association with RI in Group C (P < 0.001). Conclusion: The RI of CRA is a reliable biomarker for the assessment of the severity of DR. Patients with high RI of CRA had higher chances of EZ disruption and presented with poor visual acuity. Keywords: Color Doppler imaging, OCT biomarkers, resistivity index of central retinal artery

Author(s): Shikha Talwar Bassi (corresponding author) [1]; Ramesh Pamu [2]; Anjaly Varghese [3] Pseudopapilledema has been classically described as a noncongested, irregularly elevated optic disc, which lacks a physiologic cup [...], Purpose: Optic nerve head drusen (ONHD), peripapillary hyperreflective ovoid mass-like structures (PHOMS), and horizontal hyperreflective lines (HHL) are commonly seen in eyes with pseudopapilledema on enhanced depth imaging (EDI) spectral domain optical coherence tomography (SDOCT). The objective of this study is to assess the frequency of ONHD, PHOMS, and HHL on spectral domain OCT in the eyes diagnosed to have pseudopapilledema. Methods: A retrospective case-control study included patients diagnosed as pseudopapilledema and had EDI SD OCT imaging of the optic nerve head (n = 48 eyes) and controls (n = 20 eyes). OCT scans through the optic nerve head were studied to diagnose ONHD, HHL, and PHOMS. One proportion z test was used to find the difference in proportions. Results: Forty eight eyes of 27 subjects were studied. ONHD as described by the optic disc drusen Studies consortium was noted in 19 eyes (39.48%), P value-0.032, PHOMS in 31 eyes (64.6%), P value 0.043, HL in 19 eyes (39.48%), P value 0.032, and none of the normals had ONHD, PHOMS, and HHL. Conclusions: PHOMS are more frequently seen than ONHD and HHL in eyes with pseudopapilledema. Keywords: Optic nerve head drusen, optical coherence tomography, pseudopapilledema

Purpose: To study the long-term microvasculature changes at the macula and the optic disk in eyes with nonarteritic anterior ischemic optic neuropathy (NAION). Methods: Patients with acute NAION of less than 6 weeks duration were included. Optical coherence tomography angiography (OCTA) of the macula and the optic disk was performed at baseline, 3 and 6 months and compared with the controls. Results: The mean age of 15 patients was 52.25 (±9.06) years. The whole image superficial peripapillary density (42.49 ± 5.28) was significantly low when compared to that of control eyes (46.36 ± 2.09); similarly, radial peripapillary capillary density (49.35 ± 5.64) was also significantly reduced when compared to controls (53.45 ± 1.96, P < 0.05). These parameters showed significant progressive decrease at 3 and 6 months (P < 0.05). At the macula, both superficial (41.83 ± 3.64) and deep macular vasculature densities (47.30 ± 2.04) were significantly reduced when compared to control eyes (52.15 ± 4.84 and 55.13 ± 1.81, respectively). The vascular density at the macula remained stable at 3- and 6-months period. Conclusion: The study shows that the microvasculature in case of NAION is significantly reduced both in peripapillary area and in macular area. Keywords: NAION, OCTA, vasculature, Author(s): Swati Phuljhele (corresponding author) [1]; Sumant Sharma [1]; Rohan Chawla [2]; Rohit Saxena [1]; Pradeep Sharma [1] Nonarteritic anterior ischemic optic neuropathy (NAION) is the commonest acute optic neuropathy [...]

Purpose: To evaluate the visual and surgical outcomes of cataract surgery in patients with posterior polar cataract (PPC) and to evaluate the benefits of preoperative anterior segment optical coherence tomography (AS-OCT). Methods: This was a retrospective, single-center study. Case records of patients diagnosed with PPC who underwent cataract surgery either by phacoemulsification or manual small-incision cataract surgery (MSICS) from January to December 2019 were analyzed. Data collected include demographic details, preoperative best corrected visual acuity (BCVA), AS-OCT, type of cataract surgery, intraoperative and postoperative complications, and visual outcome at 1-month follow-up. Results: One hundred patients were included in the study. Preoperative posterior capsular defect was noted on AS-OCT in 14 patients (14). Seventy-eight underwent phacoemulsification and 22 underwent MSICS. Intraoperatively, posterior capsular rupture (PCR) was seen in 13 patients (13) and cortex drop was noted in one among them (1). Out of 13 PCRs, 12 were found to have posterior capsular dehiscence preoperatively in AS-OCT. The sensitivity of AS-OCT for detecting posterior capsule dehiscence was 92.3 and specificity was 97.7. The positive predictive value and negative predictive value were 85.7 and 98.8, respectively. There was no significant difference in the incidence of PCR between phacoemulsification and MSICS (P = 0.475). The mean BCVA at 1 month was found to be better with phacoemulsification than MSICS (P = 0.004). Conclusion: Preoperative AS-OCT has excellent specificity and negative predictive value in identifying posterior capsular dehiscence. It thus helps to plan the surgery and counsel patients appropriately. Both phacoemulsification and MSICS provide good visual outcome with similar complication rates. Keywords: Anterior segment optical coherence tomography, cataract surgery, posterior capsule rupture, posterior polar cataract, Author(s): Thamizhselvi Dhanaseelan (corresponding author) [1]; Annamalai Odayappan [2]; Vellam Ramakrishnan Vivekanandan [1]; Rengaraj Venkatesh [3] Posterior polar cataract (PPC) is a rare form of congenital cataract with incidence ranging [...]

Purpose: To evaluate choroidal lesions with spectral domain optical coherence tomography (SD-OCT) scan in varicella zoster virus (VZV) uveitis. Methods: VZV-uveitis cases which underwent OCT scan for choroidal lesions were studied. SD-OCT scan passing through these lesions was studied in detail. Subfoveal choroidal thickness (SFCT) during active and resolved stages was studied. Angiogaphic features were studied where available. Results: Thirteen out of 15 cases had same-sided herpes zoster ophthalmicus skin rashes. All except three patients had old or active kerato-uveitis. All eyes demonstrated clear vitreous and a single or multiple hypopigmented orangish-yellow choroidal lesions. The number of lesions remained unchanged during the follow-up on clinical examination. SD-OCT over lesions (n = 11) showed choroidal thinning (n = 5), hyporeflective choroidal elevation during active inflammation (n = 3), transmission effects (n = 4), and ellipsoid zone disruption (n = 7). The mean change in SFCT (n = 9) after resolution of the inflammation was 26.3 μm (range: 3-90 μm). Fundus fluorescein angiography showed iso-fluorescence over lesions in all (n = 5), but indocyanine green angiography (n = 3) showed hypofluorescence at lesions. Mean follow-up was 1.38 years (range: 3 months-7 years). De-novo appearance of choroidal lesion during the first relapse of VZV-uveitis was captured in one case. Conclusion: VZV-uveitis can cause focal or multifocal hypopigmented choroidal lesions with thickening or scarring of choroidal tissue, depending on the disease activity. Keywords: Choroidal granuloma, choroidal vitiligo, choroiditis, FFA, herpes, hypopigmented choroidal lesion, ICG, OCT, OCTA, varicella zoster, VZV, Author(s): Ankush Kawali (corresponding author) [1]; Aayesha Khanum [2]; Padmamalini Mahendradas [1]; Srinivasan Sanjay [1]; Sai-Bhakti Mishra [1]; Rohit Shetty [3] Varicella zoster virus (VZV) is known to cause keratitis, [...]

Imaging with optical coherence tomography (OCT) has become standard in retina care. Its widespread use can be attributed to its ability to deliver a vast amount of high-resolution information regarding [...]

While not as popular or widely used as its posterior segment counterpart, AS-OCT has earned its rightful place as a valuable, adjunctive tool to diagnose and monitor corneal and anterior [...]

This technology plays a pivotal role in clinical practice. With answers to these key points, learn how it can help you assess these complex conditions. Approaching neuro-ophthalmic disease may be [...]

Glaucoma is a progressive optic neuropathy characterized by the death of retinal ganglion cells and their axons. (1) Per this definition then, it behooves the optometric community to examine retinal [...]

Optical coherence tomography (OCT) is a valuable tool in optometric practice that plays a key role in various aspects of care, including managing posterior segment disease, glaucoma and even some [...]

With the escalating global prevalence of myopia, tilted optic disc in myopes has become increasingly recognized as a concern and garnered significant attention in recent years. Given the crucial role [...]

The principles of optical coherence tomography (OCT) were first described just over 30 years ago and the first commercial device came on the market in 1996. This technology offers a [...]

2023 JAN 14 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in macular edema. According to news originating from [...]

2023 JAN 14 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in ischemic optic neuropathy. According to news reporting [...]

While clinicians who care for glaucoma patients are increasingly relying on optical coherence tomography (OCT), many are not taking full advantage of this powerful technology. (1,2) First, clinicians often turn [...]

Interpreting an abnormality on a macular optical coherence tomography (OCT) image can be daunting for practitioners relatively new to OCT. However, with some review and experience under your belt, you [...]

This new imaging device may be a part of your diagnostic toolkit in the near future. Here's why. Optical coherence tomography angiography (OCT-A) is a noninvasive, dyeless imaging modality that [...]

Glaucoma can be defined as a chronic, progressive loss of retinal ganglion cells (RGCs) that results in characteristic structural--optic nerve head (ONH) and retinal nerve fiber layer (RNFL)--damage and corresponding [...]

2022 DEC 17 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in cardiology. According to news reporting from Aichi, [...]

2022 NOV 12 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in lung cancer. According to news originating from [...]

2022 AUG 20 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Vascular Diseases and Conditions - Ischemia. According [...]

The pace of technological advancement has granted optometrists a more targeted, more robust and more comprehensive ability to diagnose, evaluate and treat a plethora of ocular pathologies. Specifically, new retinal [...]

This handy tool can help you assess everything from peripheral retinal lesions to the tear meniscus. Here's how. OCT can add value to any optometric practice; it can provide you [...]

Optical coherence tomography angiography (OCTA) was introduced commercially in 2015, (1) and it ushered in a different way of viewing retinal and choroidal vasculature. Utilizing optical coherence tomography (OCT) technology, [...]

Early and optimal detection of glaucoma and its progression is critical in preventing a burden on optometry's patients and to society as a whole. The difficulty arises in how to [...]

Author(s): Abhishek Singh [1]; Anil Babanrao Gangwe (corresponding author) [1]; Swapnil Parchand [1] An 11-year-old boy presented with a history of gradual, painless diminution of vision in both eyes (OU), [...]

2022 JUN 25 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on Drugs and Therapies - Ophthalmic Glaucoma Agents are presented [...]

2022 JUN 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in acute myocardial infarction. According to news originating [...]

2022 JUN 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Heart Disorders and Diseases - Heart Attack is [...]

2022 JUN 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in brain sciences. According to news reporting out [...]

2022 JUN 11 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on cardiology are presented in a new report. According to [...]

2022 MAY 28 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New study results on cardiovascular medicine have been published. According to news [...]

2022 MAY 28 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Cardiovascular Diseases and Conditions - Atherosclerosis is now [...]