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Optical Coherence Tomography: Essential Tool in Macular Hole Management 光学相干断层扫描:黄斑孔管理的基本工具
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.79279
S. Tinwala
Optical coherence tomography (OCT) is a noninvasive, diagnostic technique for accu- rately identifying and quantitatively characterizing macular holes. OCT is crucial in assessing fellow eyes of patients with a macular hole to detect preclinical changes leading to subsequent hole formation. The tomographic information provided by OCT, akin to an in vivo biopsy, has led to a better understanding of the pathogenesis of hole formation. The cross-sectional view produced by OCT effectively distinguishes full-thickness macu lar holes from mimicking conditions like lamellar holes, macular pseudoholes, and cysts, which may sometimes be difficult to differentiate clinically. This information enables early diagnosis and can guide the intervention of choice when treatment is deemed nec- essary. OCT is useful to prognosticate cases, thereby facilitating discussions with patients and managing visual expectations preoperatively. Intraoperative OCT (iOCT) can iden- tify intraoperative changes in the macular anatomy during surgery that can influence functional outcomes. Postoperatively, OCT is extremely useful for documenting serial changes in the foveal architecture and is helpful in correlating functional and anatomic outcomes. As the technology continues to improve, OCT has become indispensable for all aspects of patient care for macular holes.
光学相干断层扫描(OCT)是一种无创的诊断技术,用于准确识别和定量表征黄斑孔。OCT在评估黄斑裂孔患者的同伴眼以检测导致随后裂孔形成的临床前变化是至关重要的。OCT提供的层析成像信息,类似于活体活检,可以更好地了解孔形成的发病机制。OCT生成的横断面视图有效地区分了全层黄斑大孔与类似板层孔、黄斑假孔和囊肿等情况,这些情况有时在临床上很难区分。这些信息有助于早期诊断,并可在认为有必要进行治疗时指导干预选择。OCT有助于预测病例,从而促进与患者的讨论,并在术前管理视觉期望。术中OCT (iOCT)可以识别术中黄斑解剖结构的变化,这些变化会影响手术的功能结局。术后,OCT对于记录中央凹结构的一系列变化非常有用,有助于将功能和解剖结果联系起来。随着技术的不断进步,OCT已经成为黄斑孔患者护理的各个方面不可或缺的一部分。
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引用次数: 0
OCT in Lamellar Corneal Transplantation 层状角膜移植的OCT研究
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78294
M. C. Ozmen, H. B. Özdemir
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引用次数: 0
Retinal Vasculature Identification and Characterization Using OCT Imaging 视网膜血管识别和表征的OCT成像
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78292
J. D. Moura, J. Novo, J. Rouco, N. Barreira, M. G. Penedo, M. Ortega
The eye fundus is the part of the human body where the blood vessels can be directly observed and studied. For this reason, the analysis and diagnosis of many relevant diseases that affect the circulatory system, for example, reference, hypertension, diabetes or arteriosclerosis can be supported by the use of this source of information, analyzing their degree of severity and impact by the study of the properties of the retinal microcirculation. The development of computer aided-diagnosis tools became relevant over the recent years as they support and facilitate the work of specialists, helping to accurately identify the target structures in many processes of analysis and diagnosis. In that sense, the automatic identification of the retinal vasculature is crucial as its manual identification is an exhaustive and tedious work when it is manually performed by the experts. This chapter presents an analysis of the characteristics of the optical coherence tomography imaging and its potential for the retinal vascular identification and characterization. In that sense, we also analyze computational approaches to automatically obtain and characterize the retinal vasculature and provide an intuitive visualization that facilitates the posterior clinical analysis of relevant diseases such as hypertension or diabetes.
眼底是人体可以直接观察和研究血管的部位。因此,利用这一信息来源,可以支持对许多影响循环系统的相关疾病的分析和诊断,例如,参考、高血压、糖尿病或动脉硬化,通过对视网膜微循环特性的研究来分析其严重程度和影响。近年来,计算机辅助诊断工具的发展变得相关,因为它们支持和促进了专家的工作,有助于在许多分析和诊断过程中准确识别目标结构。从这个意义上说,视网膜血管的自动识别是至关重要的,因为它的人工识别是一项详尽而繁琐的工作,当它是由专家手动执行。本章分析了光学相干断层成像的特点及其在视网膜血管识别和表征方面的潜力。在这个意义上,我们还分析了自动获取和表征视网膜血管系统的计算方法,并提供了直观的可视化,从而促进了高血压或糖尿病等相关疾病的后临床分析。
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引用次数: 1
Spectral Domain Optical Coherence Tomography in the Diagnosis and Monitoring of Diabetic Macular Edema 光谱域光学相干断层扫描诊断和监测糖尿病黄斑水肿
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78681
S. Nicoară
Currently, spectral domain optical coherence tomography (SD-OCT) is a basic tool in diagnosing and monitoring diabetic macular edema (DME), which is the most frequent cause of visual impairment in the diabetic patients. OCT technology has changed the classification of DME from the traditional criteria. Macular thickness measured on OCT is considered an outcome measure to evaluate the structural and functional outcome of various therapeutic means used in DME. SD-OCT evaluates ultrastructural retinal parameters, such as the ellipsoid zone, photoreceptor outer segment length and quantifies the individual layers according to various algorithms. The aim is to present the way in which SD-OCT technology has changed our clinical practice during the last years, in diagnosing, classifying and treating DME and to illustrate its impact with practical cases.
目前,光谱域光学相干断层扫描(SD-OCT)是诊断和监测糖尿病黄斑水肿(DME)的基本工具,糖尿病黄斑水肿是糖尿病患者最常见的视力损害原因。OCT技术改变了二甲醚的传统分类标准。OCT测量的黄斑厚度被认为是评估DME中使用的各种治疗手段的结构和功能结果的结果指标。SD-OCT评估视网膜的超微结构参数,如椭球区、光感受器外段长度,并根据各种算法对各层进行量化。目的是展示SD-OCT技术在过去几年中在诊断、分类和治疗二甲醚方面改变我们临床实践的方式,并通过实际病例说明其影响。
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引用次数: 1
Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery 角膜和屈光手术中角膜、前房和晶状体的成像
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78293
T. Eppig, S. Mäurer, L. Daas, B. Seitz, A. Langenbucher
Anterior segment OCT (AS-OCT) is an optical and noncontact imaging technology, which has numerous fields of application in the imaging of the cornea, anterior chamber, and the lens. In this chapter, we will present some of the application fields of AS-OCT in corneal, cataract, and refractive surgery. We will emphasize the potential of AS-OCT by several clinical examples including corneal imaging (keratoconus, keratoplasty, and refractive surgery) and intraocular lens imaging after refractive surgery. AS-OCT shows special potential for corneal imaging in case of corneal edema and for postoperative control after Descemet’s membrane endothelial keratoplasty (DMEK). The postoperative follow-up of a posterior chamber Collamer lens’ses vault and measuring the anterior chamber angle could be identified as another promising field of application for AS-OCT.
前段OCT (AS-OCT)是一种光学和非接触式成像技术,在角膜、前房和晶状体成像等领域有着广泛的应用。在本章中,我们将介绍AS-OCT在角膜、白内障和屈光手术中的一些应用领域。我们将通过几个临床例子来强调AS-OCT的潜力,包括角膜成像(圆锥角膜、角膜移植和屈光手术)和屈光手术后的人工晶状体成像。AS-OCT在角膜水肿和Descemet膜内皮角膜移植术(DMEK)后的术后控制方面显示出特殊的潜力。术后对后房眼Collamer晶状体穹窿的随访和前房角的测量是as - oct的另一个应用领域。
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引用次数: 8
Novel Insight into Morphological Features and Vascular Profile of Selected Macular Dystrophies Using Swept-Source Optical Coherence Tomography and Optical Coherence Tomography Angiography 利用扫描源光学相干断层扫描和光学相干断层扫描血管造影对选定的黄斑营养不良症的形态特征和血管分布的新见解
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78679
M. Moussa, M. Leila
Our perception of macular dystrophies has evolved overtime from collective grouping into hereditary disorders of unclear etiology and no effective treatment to avid search for the underlying pathogenic mechanism that would provide base for future therapy. A causal conjunction between abnormalities in the photoreceptors layer and the RPE— Bruch’s membrane complex and abnormal profile of the retinal vascular plexuses and the choriocapillaris—stands out as a plausible theory of pathogenesis. The recently introduced swept-source optical coherence tomography (SS-OCT) technology incorpo- rates long-wavelength (1050-nm) scanning light, less susceptibility to sensitivity roll-off, and ultrahigh-speed image acquisition. These features enabled in vivo noninvasive visualization of different strata of the outer retina and the choriocapillaris with unprec edented finesse. Furthermore, the SS-OCT technology incorporated a blood flow detec - tion algorithm; OCTARA that in tandem with the deeper penetration and superior axial resolution of SS-OCT enabled detailed assessment of the retinal capillary plexuses and the choriocapillaris in terms of structure and density. This novel technology could help explore yet undiscovered frontiers in the pathophysiology of macular dystrophies and guide future therapeutic approaches. This chapter includes a review of literature along with the authors’ experience in imaging selected macular dystrophies using SS-OCT and SS-OCT angiography (SS-OCTA). stem cell transplantation before irreversible visual dysfunction sets in.
我们对黄斑营养不良症的认识已经从集体分组演变为病因不明且无有效治疗的遗传性疾病,并渴望寻找潜在的致病机制,为未来的治疗提供基础。光感受器层和RPE异常之间的因果关系- Bruch膜复合体和视网膜血管丛和绒毛膜毛细血管的异常轮廓-作为发病机制的合理理论而突出。最近推出的扫源光学相干层析成像(SS-OCT)技术结合了长波(1050 nm)扫描光,对灵敏度滚降的敏感性较小,以及超高速图像采集。这些特征使得体外视网膜和绒毛膜毛细血管的不同层的无创可视化具有前所未有的技巧。此外,SS-OCT技术结合了血流检测算法;OCTARA与SS-OCT更深的穿透性和更高的轴向分辨率相结合,可以在结构和密度方面详细评估视网膜毛细血管丛和绒毛毛细血管。这项新技术可以帮助探索尚未发现的黄斑营养不良的病理生理学前沿,并指导未来的治疗方法。本章包括文献综述以及作者使用SS-OCT和SS-OCT血管造影(SS-OCTA)对选定的黄斑营养不良症进行成像的经验。在不可逆的视力障碍出现之前进行干细胞移植。
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引用次数: 2
Clinical Use of OCT in the Management of Epiretinal Membranes OCT在视网膜前膜治疗中的临床应用
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.79770
N. Acar
Epiretinal membranes (ERM) are frequently seen in an aging eye, especially after posterior vitreous detachment, and can cause decreased vision, and/or metamorphopsia. Not all of the ERMs detected in routine ophthalmological examination are indicated to be removed with surgery. Optical coherence tomography (OCT) examination reveals the microanatomy of all the retinal layers and enables the vitreoretinal surgeon to make decision to follow-up or to perform a vitrectomy to peel the ERM. OCT imaging clearly shows all the tractions on the retina and the intraretinal layers; and can have a prognostic value for the surgery. OCT imaging is also very valuable in the differential diagnosis of pseudoholes with macular and lameller holes; much better than the clinical examination. It is a routine part of the detailed retinal examination of an eye with an ERM. This chapter covers OCT findings in ERMs, and examples of cases with ERMs indicated for surgery of follow-up will be shown, explaining the clinical results of the cases.
视网膜上膜(ERM)常见于老化的眼睛,尤其是玻璃体后脱离后,并可导致视力下降和/或变形。并非所有常规眼科检查中发现的erm都需要手术切除。光学相干断层扫描(OCT)检查揭示了视网膜各层的显微解剖结构,使玻璃体视网膜外科医生能够决定是否随访或进行玻璃体切除术以剥离ERM。OCT成像清晰显示视网膜及视网膜内各层的牵引力;对手术有预测价值。OCT成像对假孔与黄斑孔、片状孔的鉴别诊断也有重要价值;比临床检查好得多。这是用ERM对眼睛进行详细视网膜检查的常规部分。本章涵盖了erm的OCT表现,并将展示erm需要手术随访的病例示例,解释这些病例的临床结果。
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引用次数: 1
iOCT in PVR Surgical Management iOCT在PVR手术管理中的应用
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78774
Salvatore Di Lauro, S. P. Idoate, J. Pastor
Recent advances in optical coherence tomography (OCT) technology have allowed the introduction of OCT into the operating room. Intraoperative OCT (iOCT) has been utilized to visualize the retinal architecture prior, during, and following several retinal surgical technics. The identification of epiretinal, subretinal, and intraretinal changes is one of the crucial points in PVR management. The iOCT can identify intraretinal changes and/ or subretinal PVR membranes which cannot be easily peeled as epiretinal membranes. Intraretinal forms are especially difficult to identify preoperatively but their presence may be crucial in surgical management because the attempt to remove the presumed membrane may result in severe retinal tissue damage and iatrogenic tears. Therefore, surgical technique and even tamponade choice may be seriously affected by OCT imaging results.
光学相干断层扫描(OCT)技术的最新进展使OCT进入手术室成为可能。术中OCT (Intraoperative OCT, iOCT)已被用于在几种视网膜手术技术之前、期间和之后观察视网膜结构。视网膜上、视网膜下和视网膜内病变的识别是PVR治疗的关键之一。iOCT可以识别视网膜内病变和/或视网膜下PVR膜,这些膜不容易被剥离为视网膜前膜。视网膜内形态尤其难以术前识别,但其存在对外科治疗至关重要,因为试图去除假定的膜可能导致严重的视网膜组织损伤和医源性撕裂。因此,OCT成像结果可能严重影响手术技术甚至填塞的选择。
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引用次数: 0
OCT in Glaucoma Diagnosis, Detection and Screening OCT在青光眼诊断、检测和筛查中的应用
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.78683
Aydın Yildiz
Glaucoma is a chronic and progressive optic neuropathy in which increased intraocular pressure is the most important risk factor in the etiopathogenesis. The basic pathology is the progressive loss of retinal ganglion cells (RGCs) especially the death of the axons of ganglion cells initially (apoptosis), followed by peripapillary retinal nerve fiber layer (RNFL) defects. Since optical coherence tomography (OCT)’s first demonstration in 1991 by Huang et al. and introduction commercially in 1996, it began gaining popularity in 2000s for retinal evaluation and the detection, diagnosis, and follow-up of glaucoma. Previously available OCT instruments used a technique referred to as time-domain (TD-) OCT, followed by spectral-domain (SD-) OCT, which has an increased scan acquisition rate, allowing for a more detailed sampling of the area of interest. Recently, swept-source OCT (SS-OCT), a newer generation of OCT, has been introduced. Clinical assessment using multiple parameters, including peripapillary RNFL, ganglion cells, optic nerve head, and macular parameters, has proven useful for managing and diagnosing glaucoma as well as for evaluating risk in glaucoma suspects. In this chapter, we aim to evaluate the use of OCT and its modalities in diagnosis, screening, and progression of glaucoma.
青光眼是一种慢性进行性视神经病变,眼压升高是其发病的重要危险因素。其基本病理表现为视网膜神经节细胞(RGCs)的进行性丧失,尤其是神经节细胞轴突的初步死亡(凋亡),随后出现乳头周围视网膜神经纤维层(RNFL)缺损。自光学相干断层扫描(OCT)于1991年由Huang等人首次展示并于1996年商业化引入以来,它在2000年代开始普及,用于视网膜评估和青光眼的检测、诊断和随访。以前可用的OCT仪器使用一种称为时域(TD-) OCT的技术,其次是频谱域(SD-) OCT,它具有更高的扫描采集率,允许对感兴趣的区域进行更详细的采样。近年来,新一代的扫描源OCT (SS-OCT)被引入。使用多种参数进行临床评估,包括乳头周围RNFL、神经节细胞、视神经头和黄斑参数,已被证明对青光眼的管理和诊断以及青光眼疑似患者的风险评估有用。在本章中,我们的目的是评估OCT及其在青光眼的诊断、筛查和进展中的应用。
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引用次数: 1
OCT Application Before and After Cataract Surgery 白内障手术前后OCT应用
Pub Date : 2018-09-19 DOI: 10.5772/INTECHOPEN.77281
Xiaogang Wang, Jing Dong, Suhua Zhang, Bin Sun
Optical coherence tomography (OCT), especially anterior segment OCT (AS-OCT), plays an important role in ophthalmology. With the technology evolving from time-domain to spectral-domain, more and more detailed ocular information has become available. Anterior segment OCT provides particularly useful information for cataract surgeons. This chapter focuses mainly on AS-OCT evaluation of eyes before and after cataract surgery. Four aspects including: (1) anterior lens capsule and lens epithelium evaluation using spectral-domain OCT (SD-OCT); (2) investigation of clear corneal incision in femtosecond laser assisted cataract surgery using SD-OCT; (3) capsular block syndrome evaluation before and after treatment using SD-OCT; (4) IOL power calculation in post- myopic excimer laser eyes using SD-OCT, will be discussed in this chapter.
光学相干断层扫描(OCT),特别是前段OCT (AS-OCT)在眼科中起着重要的作用。随着技术从时域向谱域的发展,人们可以获得越来越详细的眼部信息。前段OCT为白内障外科医生提供了特别有用的信息。本章主要介绍白内障手术前后眼睛的AS-OCT评价。四个方面包括:(1)利用光谱域OCT (SD-OCT)评价晶状体前囊和晶状体上皮;(2)飞秒激光辅助白内障手术中角膜透明切口的SD-OCT观察;(3)应用SD-OCT评价治疗前后囊膜阻滞综合征;(4)本章将讨论SD-OCT准分子激光近视眼人工晶状体度数的计算。
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引用次数: 4
期刊
OCT - Applications in Ophthalmology
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