A technique called optical coherence tomography (OCT) has been developed for noninvasive cross-sectional imaging in biological systems. OCT uses low-coherence interferometry to produce a two-dimensional image of optical scattering from internal tissue microstructures in a way that is analogous to ultrasonic pulse-echo imaging. OCT has longitudinal and lateral spatial resolutions of a few micrometers and can detect reflected signals as small as approximately 10(-10) of the incident optical power. Tomographic imaging is demonstrated in vitro in the peripapillary area of the retina and in the coronary artery, two clinically relevant examples that are representative of transparent and turbid media, respectively.

/pdf/optical-coherence-tomography-3zqbp7mpwb.pdf

Optical coherence tomography

Aim: To estimate the number of people with open angle (OAG) and angle closure glaucoma (ACG) in 2010 and 2020. Methods: A review of published data with use of prevalence models. Data from population based studies of age specific prevalence of OAG and ACG that satisfied standard definitions were used to construct prevalence models for OAG and ACG by age, sex, and ethnicity, weighting data proportional to sample size of each study. Models were combined with UN world population projections for 2010 and 2020 to derive the estimated number with glaucoma. Results: There will be 60.5 million people with OAG and ACG in 2010, increasing to 79.6 million by 2020, and of these, 74% will have OAG. Women will comprise 55% of OAG, 70% of ACG, and 59% of all glaucoma in 2010. Asians will represent 47% of those with glaucoma and 87% of those with ACG. Bilateral blindness will be present in 4.5 million people with OAG and 3.9 million people with ACG in 2010, rising to 5.9 and 5.3 million people in 2020, respectively. Conclusions: Glaucoma is the second leading cause of blindness worldwide, disproportionately affecting women and Asians.

The number of people with glaucoma worldwide in 2010 and 2020

Optical coherence tomography (OCT) has developed rapidly since its first realisation in medicine and is currently an emerging technology in the diagnosis of skin disease. OCT is an interferometric technique that detects reflected and backscattered light from tissue and is often described as the optical analogue to ultrasound. The inherent safety of the technology allows for in vivo use of OCT in patients. The main strength of OCT is the depth resolution. In dermatology, most OCT research has turned on non-melanoma skin cancer (NMSC) and non-invasive monitoring of morphological changes in a number of skin diseases based on pattern recognition, and studies have found good agreement between OCT images and histopathological architecture. OCT has shown high accuracy in distinguishing lesions from normal skin, which is of great importance in identifying tumour borders or residual neoplastic tissue after therapy. The OCT images provide an advantageous combination of resolution and penetration depth, but specific studies of diagnostic sensitivity and specificity in dermatology are sparse. In order to improve OCT image quality and expand the potential of OCT, technical developments are necessary. It is suggested that the technology will be of particular interest to the routine follow-up of patients undergoing non-invasive therapy of malignant or premalignant keratinocyte tumours. It is speculated that the continued technological development can propel the method to a greater level of dermatological use.

https://link.springer.com/content/pdf/bfm%3A978-3-319-06419-2%2F1.pdf

Optical Coherence Tomography

AIM: To estimate the prevalence of glaucoma among people worldwide. METHODS: Available published data on glaucoma prevalence were reviewed to determine the relation of open angle and angle closure glaucoma with age in people of European, African, and Asian origin. A comparison was made with estimated world population data for the year 2000. RESULTS: The number of people with primary glaucoma in the world by the year 2000 is estimated at nearly 66.8 million, with 6.7 million suffering from bilateral blindness. In developed countries, fewer than 50% of those with glaucoma are aware of their disease. In the developing world, the rate of known disease is even lower. CONCLUSIONS: Glaucoma is the second leading cause of vision loss in the world. Improved methods of screening and therapy for glaucoma are urgently needed.

https://bjo.bmj.com/content/bjophthalmol/80/5/389.full.pdf

Number of people with glaucoma worldwide.

Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis.

Diabetes, Intraocular Pressure, and Primary Open-angle Glaucoma in the Baltimore Eye Survey

• We compared the clinical appearance of the retinal nerve fiber layer (NFL) and its histology in primate eyes. In 12 eyes with NFL lesions induced by orbital optic nerve trauma, clinical detection of NFL atrophy was possible after loss of 50% of the neural tissue in a given area. Some retinal areas with no visible NFL striations had remaining nerve fibers. The detectability of NFL atrophy was directly affected both by the pattern of nerve fiber loss as well as by the zone of the retina in which the loss occurred. While each nerve bundle gives rise to a single light striation nasal and temporal to the nerve head, this one-to-one correspondence is not true above and below the disc, where bundles are thicker and incompletely divided by glial septa.

Quantitative Studies of Retinal Nerve Fiber Layer Defects

Objective: To detect characteristics of persons with ocular hypertension that are associated with a higher risk of future glaucomatous field loss. Methods: Annual examinations of the optic disc, nerve fiber layer, and visual field in 647 persons with bilateral intraocular pressure higher than 21 mm Hg and initially normal visual field test results with the Goldmann perimeter. Results: Sixty-eight persons developed a field defect on two consecutive Goldmann visual field tests in at least one eye, while 579 others retained normal fields. Moderate or severe nerve fiber layer atrophy at baseline was associated with a seven to eight times greater risk of development of visual field loss. Attributes that were significantly associated with the incidence of field loss ineluded older age, larger cup-disc ratio, smaller rim—disc area ratio, larger cup asymmetry, presence of disc crescent, and higher intraocular pressure. Characteristics found not to be associated with incidence were gender, race, hypertension, diabetes, refractive error, family history of glaucoma, smoking or alcohol drinking history, and disc area. Conclusions: Increasing nerve fiber layer atrophy judged by a semiquantitative grading system was associated with increasing risk of development of visual field loss among persons with ocular hypertension. The relationship of the development of field loss to race, myopia, family history of glaucoma, and medical history are more complex than has been presumed.

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=OPHTH&articleId=640670&pdfFileName=archopht_112_5_028.pdf

Risk factors for the development of glaucomatous visual field loss in ocular hypertension

POPULATION STUDIES AND RISK FACTORSDuring the last 5 years, population-based prevalence surveys, large-scale clinical evaluations, and technological advances in diagnostic methods have contributed to our understanding of primary angle-closure glaucoma (PACG). During the early 20th century, the assoc

Possible mechanisms of primary angle-closure and malignant glaucoma.

Axonal transport in primate optic nerve axons was studied by autoradiography, scintillation counting, and electron microscopy under conditions of short-term intraocular pressure elevation. With elevation of intraocular pressure to 30 mm. Hg below mean arterial blood pressure, blockage of transport was detected within 2 hours by autoradiography and within 1 hour by electron microscopy. The earliest buildup of radioactively labeled protein and ultrastructurally visible cellular organelles was within the scleral lamina cribrosa. The degree of blockage, judged by amount of label buildup, increased with time. Some transported material traversed the lamina cribrosa despite pressure elevation at the level tested. Reversal of transport blockade occurred rapidly after normalization of intraocular pressure.

Harry A. Quigley

Papers

Diabetes, Intraocular Pressure, and Primary Open-angle Glaucoma in the Baltimore Eye Survey

Quantitative Studies of Retinal Nerve Fiber Layer Defects

Risk factors for the development of glaucomatous visual field loss in ocular hypertension

Possible mechanisms of primary angle-closure and malignant glaucoma.

The dynamics and location of axonal transport blockade by acute intraocular pressure elevation in primate optic nerve.