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

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

background Pegaptanib, an anti–vascular endothelial growth factor therapy, was evaluated in the treatment of neovascular age-related macular degeneration. methods We conducted two concurrent, prospective, randomized, double-blind, multicenter, dose-ranging, controlled clinical trials using broad entry criteria. Intravitreous injection into one eye per patient of pegaptanib (at a dose of 0.3 mg, 1.0 mg, or 3.0 mg) or sham injections were administered every 6 weeks over a period of 48 weeks. The primary end point was the proportion of patients who had lost fewer than 15 letters of visual acuity at 54 weeks. results In the combined analysis of the primary end point (for a total of 1186 patients), efficacy was demonstrated, without a dose–response relationship, for all three doses of pegaptanib (P<0.001 for the comparison of 0.3 mg with sham injection; P<0.001 for the comparison of 1.0 mg with sham injection; and P=0.03 for the comparison of 3.0 mg with sham injection). In the group given pegaptanib at 0.3 mg, 70 percent of patients lost fewer than 15 letters of visual acuity, as compared with 55 percent among the controls (P<0.001). The risk of severe loss of visual acuity (loss of 30 letters or more) was reduced from 22 percent in the sham-injection group to 10 percent in the group receiving 0.3 mg of pegaptanib (P<0.001). More patients receiving pegaptanib (0.3 mg), as compared with sham injection, maintained their visual acuity or gained acuity (33 percent vs. 23 percent; P=0.003). As early as six weeks after beginning therapy with the study drug, and at all subsequent points, the mean visual acuity among patients receiving 0.3 mg of pegaptanib was better than in those receiving sham injections (P<0.002). Among the adverse events that occurred, endophthalmitis (in 1.3 percent of patients), traumatic injury to the lens (in 0.7 percent), and retinal detachment (in 0.6 percent) were the most serious and required vigilance. These events were associated with a severe loss of visual acuity in 0.1 percent of patients. conclusions Pegaptanib appears to be an effective therapy for neovascular age-related macular degeneration. Its long-term safety is not known.

/pdf/pegaptanib-for-neovascular-age-related-macular-degeneration-1v9fdtlpva.pdf

Pegaptanib for Neovascular Age-Related Macular Degeneration

结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

Sarcoidosis

Objective: To demonstrate optical coherence tomography for high-resolution, noninvasive imaging of the human retina. Optical coherence tomography is a new imaging technique analogous to ultrasound B scan that can provide cross-sectional images of the retina with micrometer-scale resolution. Design: Survey optical coherence tomographic examination of the retina, including the macula and optic nerve head in normal human subjects. Settings Research laboratory. Participants: Convenience sample of normal human subjects. Main Outcome Measures: Correlation of optical coherence retinal tomographs with known normal retinal anatomy. Results: Optical coherence tomographs can discriminate the cross-sectional morphologic features of the fovea and optic disc, the layered structure of the retina, and normal anatomic variations in retinal and retinal nerve fiber layer thicknesses with 10- μm depth resolution. Conclusion: Optical coherence tomography is a potentially useful technique for high depth resolution, cross-sectional examination of the fundus.

Optical Coherence Tomography of the Human Retina

Purpose:To investigate the interactions among drusen type and multimodal vision testing in eyes with nonexudative age-related macular degeneration.Methods:Fifty-one eyes of 39 patients with nonexudative age-related macular degeneration underwent fundus imaging including spectral domain optical coher

Multimodal visual function testing in eyes with nonexudative age-related macular degeneration.

PURPOSE Conventional macular hole surgery usually involves removing 80% of the intraocular contents to repair a hole a few hundred micrometers in diameter. Although the success rate for conventional surgery is good, it may be possible to reduce the number of complications with less invasive surgery. METHODS A newly designed microspatula knife was used to dissect the connection between the vitreous and the retina previously delineated by optical coherence tomography. The posterior vitreous was not stripped from the retinal surface. Limited vitrectomy over the hole was performed to create a space for a gas bubble. RESULTS The macular holes in three eyes of three patients were closed with this technique with no operative or postoperative complications after a mean follow-up of 8.7 months. The mean change in visual acuity was 6.3 lines. CONCLUSION It is possible to repair macular holes by using optical coherence tomography to guide the dissection of the vitreous from the macular hole followed by limited vitrectomy. By using a less invasive approach, it may be possible to repair macular holes in less operative time and with fewer complications.

Macular hole repair with minimal vitrectomy.

Purpose: To evaluate the autofluorescence findings of acute syphilitic posterior placoid chorioretinitis (ASPPC). Methods: Patients with ASPPC underwent complete ophthalmologic examinations, including biomicroscopy, fundus color photography, autofluorescence photography, and fluorescein angiography. Results: As expected, the patients had a yellowish lesion in the posterior pole. However, the lesion appeared to have two components, a diffuse placoid yellow discoloration at the level of the retinal pigment epithelium (RPE) and focal yellow spots that appeared to lie on the RPE. The diffuse placoid yellow color change at the RPE level showed a slight generalized increase in autofluorescence admixed with tiny spots of decreased autofluorescence. The yellow collections in front of the RPE were intensely hyperautofluorescent. The placoid area showed fluorescein staining, while the yellow deposits blocked the background fluorescence. Treatment of syphilis caused resolution of the placoid changes with associated improvement in the autofluorescence and fluorescein abnormalities. Conclusion: Patients with ASPPC have autofluorescence abnormalities during the acute manifestations of the disorder that help in interpretation of the fluorescein angiographic findings. We found evidence that the RPE is primarily involved and there does not appear to be choriocapillaris occlusion in early lesions.

Autofluorescence imaging of acute syphilitic posterior placoid chorioretinitis.

Intraretinal silicone oil vacuoles after macular hole surgery with internal limiting membrane peeling

Purpose:To determine if pseudodrusen seen in fundus photography, particularly infrared scanning laser ophthalmoscopy, colocalize with subretinal drusenoid deposits imaged by optical coherence tomography.Methods:The patients were scanned with spectral domain optical coherence tomography having an A-s

Richard F. Spaide

Papers

Multimodal visual function testing in eyes with nonexudative age-related macular degeneration.

Macular hole repair with minimal vitrectomy.

Autofluorescence imaging of acute syphilitic posterior placoid chorioretinitis.

Intraretinal silicone oil vacuoles after macular hole surgery with internal limiting membrane peeling

Colocalization of pseudodrusen and subretinal drusenoid deposits using high-density en face spectral domain optical coherence tomography.