Purpose of Review
The article reviews the recent findings on the use of optical coherence tomography angiography (OCTA) in neurology
.
Recent Findings
OCTA is a new addition to the powerful and ...complementary technology of the OCT. Due to its noninvasiveness, and reproducibility, it is possible to obtain high-resolution 3D images of the vessels of the human eye. As the vessels of the retina with the presence of endothelial cell’s tight junctions resemble the brain vessels, it was hypothesized that the imaging of the retinal vessels might bring insight into brain vessels. OCTA has been effectively used to predict retinal vessel abnormalities in dementia, demyelization, optic disc neuropathies, and inherited degenerative diseases. Most common findings were decrease of vascular density and flow and an increase of avascular zones.
Summary
Although OCTA is a relative new technology, recent studies show that it can be successfully applied in neurology.
To test the repeatability and reproducibility of the topography module in posterior segment spectral domain optical coherence tomography with Revo NX (new device) and to compare keratometry values ...obtained by a Scheimpflug tomography (Galilei G6) and a swept source OCT (Casia 2).
In this prospective study, healthy subjects with nonoperated eyes had their central corneal thickness (CCT), anterior and posterior K1/K2 corneal power measured with the new device. Two operators made 6 measurements on the new device to check intraobserver repeatability and reproducibility, and measurement on Casia 2 and Galilei G6. Bland-Altman plots were used to assess the agreement between the devices for each analyzed variable.
94 eyes (94 patients) were studied. All devices produced significantly different mean CCT, the highest for Galilei 569.13±37.58 μm followed by Casia 545.00 ±36.15 μm and Revo 537.39±35.92 μm. The mean anterior K1 was 43.21 ± 1.37 for Casia 2 43.21 ± 1.55 for Revo NX and 43.19 ± 1.39 for Galilei G6, and the differences were insignificant p = 0.617. The posterior K1 for Revo NX was -5.77 ± 0.25 whereas for Casia 2 it was -5.98±0.22 and for Galilei G6-6.09±0.28 D p< 0.0001. The Revo NX showed intraclass correlation coefficient ranging from 0.975 for the posterior K2 surface, and 0.994 for anterior K1 and 0.998 for CCT.
Revo NX is independent of the user and offers a high level of repeatability for the anterior and posterior cornea. The wide range of differences between the devices suggests they should not be used interchangeably.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The study aimed to evaluate changes over a period of time in techniques and indications for corneal transplantation in a single center in Poland. Retrospective analysis of corneal transplants ...performed at the Ophthalmology Department of the District Railway Hospital in Katowice in 2001-2020. Data on indications and surgical technique were collected. A total of 3021 corneal transplantations were performed in the years 2000-2020. The most common technique was penetrating keratoplasty (69,54%), then lamellar grafts-both anterior and posterior (19,63%), and limbal grafts (10,82%). Only in 2007 the number of lamellar keratoplasties exceeded the number of penetrating grafts and accounted for 108 (54,55%), including 85 (42,93%) of Descemet Stripping Automated Endothelial Keratoplasty. The only noticeable trend in changing techniques was a decrease in the number of performed deep anterior lamellar keratoplasties (r 2 = -0.21) over the last seven years. Main indications included bullous keratopathy (23,22%), following keratoconus (18,59%), leukoma (14,67%), keratitis and perforation (14,3%), Fuchs dystrophy (11,4%), and regrafts (7,22%). Leukoma and bullous keratopathy as an indications for corneal transplant have been declining over the years (r2 = 0.60 and r2 = 0.30 respectively). Consecutively, indications such as fuchs dystrophy, regraft and keratitis perforation have increased (r2 = 0.05, r2 = 0.50, r2 = 0.33) The number of keratoplasties gradually increased from 2001 to 2020. It could be possible that the development and spread of new therapeutic alternatives, like corneal cross-linking and scleral lenses, have contributed to the decrease in deep anterior lamellar keratoplasty performed. There was an increasing trend in the percentage of penetrating keratoplasties for failed grafts, Fuchs dystrophy and infectious keratitis.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The purpose of this study was to analyze corneal sub-basal nerve plexus (SBNP) density and morphology and their relationships with corneal parameters and refractive status. In this single center ...study, in vivo confocal microscopy (IVCM) was performed in 76 eyes of 38 healthy subjects aged 19-87 (mean age 34.987 ± 1.148). Nerve fiber analysis was performed using Confoscan 4 microscope with semi-automated software (Nidek Technologies, Italy) The nerve fiber length (NFL) µm/mm
, nerve fiber density (NFD) no./mm
, tortuosity coefficient (TC), and nerve beadings density (NBD) no./mm were considered. Relationship between SBNP parameters and corneal curvature, thickness, diameter, and refraction were analyzed. Additionally, the association with gender, laterality and age were determined. NFL was inversely correlated with age (r = - 0.528, p < 0.001), myopic refractive error (spherical value) (r = - 0.423, p < 0.001), and cylindrical power (r = - 0.340, p = 0.003). NFD was inversely correlated with age (r = - 0.420, p < 0.001) and myopic refractive error (r = - 0.341, p = 0.003). NBD showed a low inverse correlation with cylindrical power (r = - 0.287, p = 0.012) and a slight positive correlation with K (r = 0.230, p = 0.047). TC showed a significant negative correlation between age (r = - 0.500, p < 0.001) and myopic refractive error (r = - 0.351, p = 0.002). Additionally, there were strong positive correlations between NFL and NFD (r = 0.523, p < 0.001), NFL and TI (r = 0.603, p < 0.001), and NFD and TC (r = 0.758, p < 0.001). Multiple regression analysis revealed age to be the most significant factor affecting SBNP density (B = - 0.467, p = 0.013) and length (B = - 61.446, p < 0.001); myopic refractive error reduced both SBNP density (B = - 2.119, p = 0.011) and length (B = - 158.433, p = 0.016), while gender and laterality had no significant effects (p > 0.005). SBNP fiber length decreases with age, myopic refractive error and cylindrical power. SBNP fiber density reduces with age and myopic refractive error. Corneal nerve parameters are not influenced by gender or laterality.
Subconjunctival dirofilariasis Wylęgała, Adam; Wróblewska-Czajka, Ewa; Wylęgała, Edward
American journal of ophthalmology,
January 2022, 2022-01-00, 20220101, Letnik:
233
Journal Article
Recenzirano
Seventy-seven-year-old women observed conjunctival hyperemia, pruritus, and tearing of the left eye that started two days ago.
The study investigated a profile of chemokines and growth factors in the aqueous humor (AH) of eyes with Fuch's endothelial corneal dystrophy (FECD) and cataracts in comparison with cataract patients ...as a control group. A total of 52 AH samples (26 FECD + cataract and 26 cataract/control) were collected before cataract surgery. None of the patients had any clinically apparent inflammation at the time of AH collection. The AH levels of MCP-1 (CCL2), MIP-1α (CCL3), MIP-1β(CCL4), RANTES (CCL5), eotaxin (CCL11), IP-10 (CXCL10), FGF basic, G-CSF, GM-CSF, PDGF-bb, and VEGF were compared between the groups. The analyses were performed using the Bio-Plex 200 System from Bio-Rad. Among the studied parameters, the AH levels of RANTES, eotaxin, and IP-10 significantly increased in the FECD + cataract eyes, compared with the cataract controls (
< 0.05). Elevated levels of the RANTES, Eotaxin, and IP-10 indicate more intense inflammation in the eyes of patients in the FECD + cataract group. Moreover, these factors exhibit potential as predictive biomarkers for early detection of FECD in cataract patients. The discovery of elevated concentrations of biochemical markers in a patient, who has not yet received a clinical diagnosis, may suggest the need for heightened observation of the other eye to monitor the potential development of FECD.
Purpose
The present study aimed to evaluate the efficacy and safety of ultrasound ciliary plasty (UCP) in patients with open‐angle glaucoma for three consecutive years.
Methods
Sixty‐one patients (62 ...eyes) with primary and secondary glaucoma were enrolled to undergo UCP. The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use and visual acuity after UCP. An IOP reduction of 20% compared to the baseline value without re‐intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, 18, 24, 30 and 36 months postoperatively.
Results
A total of 41 patients (41 eyes) were evaluated 36‐month after UCP. The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1; 3; 6; 12; 18; 24; 30 and 36 months postoperatively were 22.7 ± 5.0 mmHg, 17.1 ± 4.2 mmHg (p < 0.001), 15.7 ± 4.8 mmHg (p < 0.001), 18.8 ± 4.8 mmHg (p < 0.001), 17.3 ± 3.7 mmHg (p < 0.001), 16.9 ± 3.2 mmHg (p < 0.001), 16.6 ± 2.7 mmHg (p < 0.001), 16.3 ± 3.0 mmHg (p < 0.001), 15.8 ± 3.4 mmHg (p < 0.001), 15.3 ± 2.1 mmHg (p < 0.001) and 16.3 ± 3.0 mmHg (p < 0.001), respectively. The mean IOP at the last follow‐up was reduced by 28.5%. The qualified success rate was 64.0%. All patients at 36‐month follow‐up visit required the use of antiglaucoma medications – none of the patients achieved complete success. The decrease in the number of antiglaucoma medications was statistically significant at each follow‐up visit compared to the baseline. Choroid detachment was observed in three patients (4.8%), while macular oedema was observed in three patients (4.8%) after the procedure. No other major intraoperative or postoperative complications occurred.
Conclusion
Ultrasound ciliary plasty seems to be an effective and well‐tolerated method to reduce IOP in patients with refractory glaucoma. Further studies with a larger group are needed to confirm the efficacy of this procedure.
Intraoperative OCT microscopy in 3D Wylęgała, Adam; Sendecki, Adam; Wylęgała, Edward
Expert review of medical devices,
03/2021, Letnik:
18, Številka:
3
Journal Article
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