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High-Definition Optical Coherence Tomography in the Diagnosis of Basal Cell Carcinoma Evaluated by an Experienced Versus Inexperienced Investigator
摘要： Background: Histopathology is the gold standard in the diagnosis of basal cell carcinoma (BCC) but biopsies are invasive and often not the preferred diagnostic method for patients. In this context, non-invasive diagnostic imaging tools such as high definition optical coherence tomography (HD-OCT) have shown promising results in diagnosing BCC in real time, atraumatically and repeatedly. Objective: To evaluate the sensitivity and specificity of HD-OCT in the diagnosis of BCC by an experienced versus an inexperienced investigator and describe typical features in common differential diagnosis of BCC. Patients and methods: Forty three patients with clinical suspicion for BCC were included. The HD-OCT images were evaluated in a blinded manner by an experienced and inexperienced investigator. The results were compared to the histopathological diagnosis. Results: Histopathology revealed 22 BCC, 10 fibrous papules of the face, 5 actinic keratoses, 3 intradermal nevi, 2 squamous cell carcinomas and 1 sebaceous hyperplasia. The sensitivity and specificity in diagnosing BCCs correctly by HD-OCT in the experienced investigator was 86.4% and 90.5%, respectively. In the inexperienced investigator the sensitivity and the specificity was 77.3% and 81.0%, respectively. There was a good inter-observer agreement found between experienced and inexperienced investigators. Conclusion: HD-OCT can be used as auxiliary diagnostic tool in the evaluation and treatment of BCC even by inexperienced investigators.
关键词： Differential,Basal cell carcinoma,Optical coherence tomography,Diagnosis
更新于2025-09-23 15:23:52
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Choroidal thickness in healthy eyes using enhanced depth imaging optical coherence tomography and comparison with cases of retinitis pigmentosa
摘要： Introduction. — The goal of this study was to measure by spectral domain optical coherence tomography (SD-OCT) with EDI the choroidal thickness in healthy subjects and to compare these parameters with those of patients with retinitis pigmentosa (RP). Methods. — Data were obtained from 60 healthy patients without history or family history of retinal or choroidal disease or glaucoma. A case-control study was also conducted on 40 eyes of 20 patients with RP and 40 eyes of 20 healthy refraction- and age-matched controls, selected from among the 60 healthy patients. OCT was used with the EDI protocol. The primary outcome measure was choroidal thickness. Results. — Among healthy patients, the overall choroidal thickness was 287.7 μm. Mean choroidal thickness was lower on the nasal side (236.6 μm from the fovea) compared with the temporal side (262.3 μm, P = 0.002). It also varied according to age, being highest among 20—29-year-old patients and decreasing thereafter with increasing age. Choroidal thickness was significantly higher in healthy patients than in RP patients, regardless of the location (P < 0.001). Conclusion. — This observational study confirms that choroidal thickness varies with age and location. It decreases in subjects with RP and is related to worsening of retinal damage, independently of age-related thinning. Further studies are needed to understand whether choroidal vascular alteration is a cause or a consequence of the degenerative pathology.
关键词： Photoreceptor degeneration,Choroidal thickness,Case-control study,Retinitis pigmentosa,Enhanced depth imaging optical coherence tomography
更新于2025-09-23 15:23:52
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Deep structure tensor graph search framework for automated extraction and characterization of retinal layers and fluid pathology in retinal SD-OCT scans
摘要： Maculopathy is a group of retinal disorders that affect macula and cause severe visual impairment if not treated in time. Many computer-aided diagnostic methods have been proposed over the past that automatically detect macular diseases. However, to our best knowledge, no literature is available that provides an end-to-end solution for analyzing healthy and diseased macular pathology. This paper proposes a vendor-independent deep convolutional neural network and structure tensor graph search-based segmentation framework (CNN-STGS) for the extraction and characterization of retinal layers and fluid pathology, along with 3-D retinal profiling. CNN-STGS works by first extracting nine layers from an optical coherence tomography (OCT) scan. Afterward, the extracted layers, combined with a deep CNN model, are used to automatically segment cyst and serous pathology, followed by the autonomous 3-D retinal profiling. CNN-STGS has been validated on publicly available Duke datasets (containing a cumulative of 42,281 scans from 439 subjects) and Armed Forces Institute of Ophthalmology dataset (containing 4,260 OCT scans of 51 subjects), which are acquired through different OCT machinery. The performance of the CNN-STGS framework is validated through the marked annotations, and it significantly outperforms the existing solutions in various metrics. The proposed CNN-STGS framework achieved a mean Dice coefficient of 0.906 for segmenting retinal fluids, along with an accuracy of 98.75% for characterizing cyst and serous fluid from diseased retinal OCT scans.
关键词： convolutional neural network (CNN),Optical coherence tomography (OCT),maculopathy,ophthalmology,graph search
更新于2025-09-23 15:23:52
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RefMoB, a Reflectivity Feature Model-Based Automated Method for Measuring Four Outer Retinal Hyperreflective Bands in Optical Coherence Tomography
摘要： PURPOSE. To validate a model-driven method (RefMoB) of automatically describing the four outer retinal hyperreflective bands revealed by spectral-domain optical coherence tomography (SDOCT), for comparison with histology of normal macula; to report thickness and position of bands, particularly band 2 (ellipsoid zone [EZ], commonly called IS/OS). METHODS. Foveal and superior perifoveal scans of seven SDOCT volumes of five individuals aged 28 to 69 years with healthy maculas were used (seven eyes for validation, five eyes for measurement). RefMoB determines band thickness and position by a multistage procedure that models reflectivities as a summation of Gaussians. Band thickness and positions were compared with those obtained by manual evaluators for the same scans, and compared with an independent published histological dataset. RESULTS. Agreement among manual evaluators was moderate. Relative to manual evaluation, RefMoB reported reduced thickness and vertical shifts in band positions in a band-specific manner for both simulated and empirical data. In foveal and perifoveal scans, band 1 was thick relative to the anatomical external limiting membrane, band 2 aligned with the outer one-third of the anatomical IS ellipsoid, and band 3 (IZ, interdigitation of retinal pigment epithelium and photoreceptors) was cleanly delineated. CONCLUSIONS. RefMoB is suitable for automatic description of the location and thickness of the four outer retinal hyperreflective bands. Initial results suggest that band 2 aligns with the outer ellipsoid, thus supporting its recent designation as EZ. Automated and objective delineation of band 3 will help investigations of structural biomarkers of dark-adaptation changes in aging.
关键词： age-related macular degeneration,retina,ellipsoid,segmentation,optical coherence tomography,photoreceptors,interdigitation,reflectivity,retinal pigment epithelium
更新于2025-09-23 15:23:52
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Peripapillary Retinal Pigment Epithelium Layer Shape Changes From Acetazolamide Treatment in the Idiopathic Intracranial Hypertension Treatment Trial
摘要： PURPOSE. Recent studies indicate that the amount of deformation of the peripapillary retinal pigment epithelium and Bruch’s membrane (pRPE/BM) toward or away from the vitreous may reflect acute changes in cerebrospinal fluid pressure. The study purpose is to determine if changes in optic-nerve-head (ONH) shape reflect a treatment effect (acetazolamide/placebo + weight management) using the optical coherence tomography (OCT) substudy of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) at baseline, 3, and 6 months. METHODS. The pRPE/BM shape deformation was quantified and compared with ONH volume, peripapillary retinal nerve fiber layer (pRNFL), and total retinal (pTR) thicknesses in the acetazolamide group (39 subjects) and placebo group (31 subjects) at baseline, 3, and 6 months. RESULTS. Mean changes of the pRPE/BM shape measure were significant and in the positive direction (away from the vitreous) for the acetazolamide group (P < 0.01), but not for the placebo group. The three OCT measures reflecting the reduction of optic disc swelling were significant in both treatment groups but greater in the acetazolamide group (P < 0.01). CONCLUSIONS. Change in the pRPE/BM shape away from the vitreous reflects the effect of acetazolamide + weight management in reducing the pressure differential between the intraocular and retrobulbar arachnoid space. Weight management alone was also associated with a decrease in optic nerve volume/edema but without a significant change in the pRPE/BM shape, implying an alternative mechanism for improvement in papilledema and axoplasmic flow, independent of a reduction in the pressure differential.
关键词： optical coherence tomography,Bruch’s membrane,shape analysis,papilledema,intracranial hypertension
更新于2025-09-23 15:23:52
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Improving Visual Field Examination of the Macula Using Structural Information
摘要： Purpose: To investigate a novel approach for structure-function modeling in glaucoma to improve visual field testing in the macula. Methods: We acquired data from the macular region in 20 healthy eyes and 31 with central glaucomatous damage. Optical coherence tomography (OCT) scans were used to estimate the local macular ganglion cell density. Perimetry was performed with a fundus-tracking device using a 10-2 grid. OCT scans were matched to the retinal image from the fundus perimeter to accurately map the tested locations onto the structural damage. Binary responses from the subjects to all presented stimuli were used to calculate the structure-function model used to generate prior distributions for a ZEST (Zippy Estimation by Sequential Testing) Bayesian strategy. We used simulations based on structural and functional data acquired from an independent dataset of 20 glaucoma patients to compare the performance of this new strategy, structural macular ZEST (MacS-ZEST), with a standard ZEST. Results: Compared to the standard ZEST, MacS-ZEST reduced the number of presentations by 13% in reliable simulated subjects and 14% with higher rates (≥20%) of false positive or false negative errors. Reduction in mean absolute error was not present for reliable subjects but was gradually more important with unreliable responses (≥10% at 30% error rate). Conclusions: Binary responses can be modeled to incorporate detailed structural information from macular OCT into visual field testing, improving overall speed and accuracy in poor responders. Translational Relevance: Structural information can improve speed and reliability for macular testing in glaucoma practice.
关键词： glaucoma,ganglion cells,optical coherence tomography,perimetry,visual field
更新于2025-09-23 15:23:52
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Zero contrast optical coherence tomography–guided percutaneous coronary intervention for in-stent restenosis of the saphenous vein graft using a non-contrast flush medium
摘要： Percutaneous coronary intervention (PCI) is often denied for individuals with coronary artery disease who are prone to develop contrast-induced acute kidney injury. We report a 73-year-old, stage 3 chronic kidney disease patient (CKD), who underwent coronary artery bypass surgery and saphenous vein graft (SVG) stenting in the past, presented with in-stent restenosis (ISR) of SVG stent. Zero contrast optical coherence tomography (OCT) guidedePCI was successfully performed using low molecular weight dextran-40 (LMWD-40) as the ?ush medium. Our report suggests the safety and feasibility of LMWD-40 ebased OCT-guided zero contrast PCI in ISR of SVG in a CKD patient, although further prospective studies are needed to evaluate this technique.
关键词： Zero contrast,Chronic kidney disease,Dextran-40,Contrast induced-Acute kidney injury,Percutaneous coronary intervention,Optical coherence tomography
更新于2025-09-23 15:23:52
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Impact of surface micromorphology and demineralization severity on enamel loss measurements by cross-polarization optical coherence tomography
摘要： Objectives: Optical Coherence tomography (OCT) is a promising clinical imaging technology for quantitative and objective assessment of dental erosion. We aimed to determine the influence of enamel surface roughness and demineralization severity (by erosive challenge) on dental surface loss measurements by cross-polarization OCT (CP-OCT). Materials and methods: Human enamel specimens were prepared with three surface roughness levels (very rough, rough and polished; n = 10 each). They were evaluated using CP-OCT and optical profilometry (gold standard) at baseline, and after 1, 2, 4, 6, 8, 16 and 24 h of erosion demineralization. The effects of roughness and demineralization on enamel loss were analyzed using ANOVA (alpha = 0.05). Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate inter-method agreement and intra-examiner repeatability. Results: CP-OCT surface loss measurements did not significantly differ with the changes in enamel surface roughness (p = 0.27). Among demineralization severities, CP-OCT surface loss measurements at 1, 2, 4 and 8 h did not differ among each other, but they showed significantly lower enamel loss than 16 and 24 h; 6 and 16 h were significantly lower than 24 h (p < 0.05). Overall, CP-OCT and optical profilometry measurements did not differ (p = 0.73); however, ICC was relatively low (ICC = 0.34). Enamel loss estimation by CP-OCT presented an error of approximately ± 150 μm compared to profilometry. Intra-examiner repeatability with CP-OCT was excellent (ICC = 0.98). Conclusions: Enamel roughness did not affect CP-OCT measurements. The estimated error of CP-OCT measurements limited the appropriate assessment of enamel erosion surface loss, in the magnitude simulated in this study. Clinical relevance: Enamel thickness measurement by CP-OCT presents potential as an objective method for monitoring dental erosion lesions; however, its use may be limited for the assessment of the initial stages of enamel surface loss by erosion.
关键词： Tooth wear,Optical coherence tomography,Surface roughness,Enamel,Dental erosion,Demineralization
更新于2025-09-23 15:23:52
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Retinal photoreceptor apoptosis is associated with impaired serum ionized calcium homeostasis in diabetic retinopathy: An in-vivo analysis
摘要： Purpose: The aim of this work was to study the association of serum ionized calcium with retinal photoreceptor apoptosis on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR). Methods: Sixty consecutive cases with Type 2 diabetes mellitus were categorized into three groups: no diabetic retinopathy; non-proliferative DR; proliferative DR. The eye with more severe form of the disease was considered. Twenty healthy controls were also included. Best corrected visual acuity (BCVA) was measured on logMAR scale. Retinal photoreceptor apoptosis was defined as disruption of retinal photoreceptor ellipsoid zone (EZ). Ellipsoid zone disruption was assessed using SD-OCT. Serum levels of total and ionized calcium were measured using standard protocol. Results: EZ disruption was found to be positively associated with serum total calcium and ionized calcium. Also, EZ disruption was found to be positively associated with logMAR BCVA. Conclusion: Increased serum ionized calcium induces retinal photoreceptor apoptosis resulting in increased EZ disruption in DR.
关键词： Ionized calcium,Retinal photoreceptor apoptosis,Diabetic retinopathy,Autophagy,Ellipsoid zone,Spectral-domain optical coherence tomography
更新于2025-09-23 15:23:52
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Progrès dans les méthodes diagnostiques du déficit en cellules souches limbiques. Apport de la microscopie confocale et de la tomographie en cohérence optique
摘要： The limbus is the anatomical and functional barrier between corneal and conjunctival epithelia. It is characterized by presence of the limbal stem cell niche which allows corneal homeostasis to be maintained. Limbal stem cell deficiency is characterized by a dual process: insufficient regeneration of corneal epithelium, which cannot therefore assure its function of physiological support, associated with corneal invasion by conjunctival proliferation. Diagnosis is currently made via routine clinical examination, corneal impression cytology and in vivo confocal microscopy (IVCM). Slit lamp examination shows abnormal limbal anatomy, thin and irregular epithelium with late fluorescein staining, and superficial vascularization. With its high resolution, IVCM allows identification of limbal and corneal epithelial changes at a cellular level in en face views, parallel to the corneal surface, but with a restricted viewing field of the corneal surface. It shows a poor transition between the corneal and conjunctival epithelia, associated with a loss of the normal corneal epithelial stratification, low basal cell and sub-basal nerve plexus densities, even with sub-epithelial fibrosis. Optical coherence tomography in central cornea and at the limbus, with scans in different orientations, allows a quick, global and non-invasive analysis of normal eyes and those with limbal stem cell deficiency. It shows a thin limbal epithelium, lacking normal thickening, featuring absence of stromal undulations and limbal crypts in cross-sections and sections parallel to the limbus, lack of visible limbal crypts in en face sections, loss of clear transition between the hyporeflective corneal epithelium and the hyperreflective conjunctival epithelium, and hyperreflective sub-epithelial fibrosis.
关键词： Limbal stem cell deficiency,Limbus,Optical coherence tomography,In vivo confocal microscopy
更新于2025-09-23 15:23:52