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Optical Coherence Tomographic Angiography in Diabetic Macular Ischemia A New Step Forward
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Optical coherence tomography angiography
No full textOptical coherence tomography angiography (OCT-A) is one of the most recent advances in ophthalmic imaging. It allows a depth-resolved assessment of retinal and choroidal blood flow, exceeding the levels of detail commonly obtained with fluorescein or indocyanine green angiographies. One of the first applications of OCT-A was detecting choroidal neovascularizations (CNV) in central serous chorioretinopathy (CSCR) within those flat irregular pigmented epithelium detachments (PED) that are observed commonly in cases of long-standing disease. Thanks to the long wavelength and to the poor influence of the light scattering phenomenon of OCT-A devices, a distinct CNV is easier to detect than FA. Qualitative and quantitative assessments of OCT-A findings in CSCR have been investigated within the last 3 years, both in clinical and experimental settings. This chapter constitutes an overview of all the potential findings and applications of OCT-A in CSCR to better understand how to translate its theoretical usefulness into clinical practice
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY VERSUS TRADITIONAL MULTIMODAL IMAGING IN ASSESSING THE ACTIVITY OF EXUDATIVE AGE-RELATED MACULAR DEGENERATION A New Diagnostic Challenge
No full textRe: Zur et al.: OCT biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant (Ophthalmology. 2018;125:267-275) Reply
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New insight on choroidal vasculature: multimodal morphofunctional approach
No full textmaging the choroid in vivo using standard modalities is difficult because of light scattering within overlying tissue, particularly the retinal pigment epithelium (RPE). Although the choriocapillaris is composed of relatively large-diameter capillaries, they are interconnected in a dense arrangement. The flow in the choriocapillaris is fast and because of the prominent fluorescein leakage vascular structure is obscured. Indocyanine green dye shows less leakage than fluorescein, but it still leaks from the choriocapillaris and stains Bruch’s membrane and the choroidal stroma. Optical coherence tomography angiography has high axial resolution, but the lateral resolution is insufficient to visualize the choriocapillaris clearly in the posterior pole. Nevertheless, it can detect choriocapillaris blood flow, producing contrast between the RPE and choriocapillaris. However, because of signal loss, fringe
wash-out, and thresholding used in signal processing, the vessels in Sattler’s layer and certainly in Haller’s layer appear dark in normal eyes. Purpose of the lecture is to evaluate various choroidal multimodal imaging findings and to allocate them in the context of different macular diseases
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