TY  - JOUR
AU  - Bolz, M
AU  - Ritter, M
AU  - Schneider, Miklós
AU  - Simader, C
AU  - Scholda, C
AU  - Schmidt-Erfurth, U
TI  - A systematic correlation of angiography and high-resolution optical coherence tomography in diabetic macular edema.
JF  - OPHTHALMOLOGY
J2  - OPHTHALMOLOGY
VL  - 116
PY  - 2009
IS  - 1
SP  - 66
EP  - 72
PG  - 7
SN  - 0161-6420
UR  - https://m2.mtmt.hu/api/publication/1698369
ID  - 1698369
AB  - PURPOSE: To correlate leakage patterns in fluorescein angiography (FA) images and retinal morphologic features in high-definition optical coherence tomography (HD OCT) images in diabetic macular edema. DESIGN: Prospective pilot study and case series. PARTICIPANTS: Nine consecutive patients (10 eyes) with diabetic macular edema. METHODS: All patients were examined using FA (HRA 2; Heidelberg Engineering) and HD OCT (Carl Zeiss Meditec; resolution, 512x128 pixels, 5.8x5.8 mm, and high-resolution scans consisting of 4096 A scans) on the same day. Using Adobe Photoshop (CS2 Version 9.0; Adobe Systems Incorporated, San Jose, CA) a grid containing 15x7 fields was superimposed on the HD OCT en face image and a late-phase FA image according to retinal landmarks. In each patient, a standardized analysis of 105 subfields was performed to provide a characterization of the type of vascular leakage in FA and the associated retinal morphologic changes in corresponding locations. MAIN OUTCOME MEASURES: Angiographic leakage type and structural alteration in retinal morphologic features in OCT. RESULTS: There was a high consistency between FA and OCT in the petaloid pattern of hyperfluorescence that correlated with the presence of large cystic spaces in the outer nuclear layer (ONL) and the outer plexiform layer (OPL) with or without subretinal fluid in 30.4% and 69.6% of graded fields, respectively. A honeycomblike pattern of hyperfluorescence was associated with swelling and cystic spaces in ONL, OPL, the inner nuclear, and the inner plexiform layer in 71.4% of graded fields. Diffuse patterns of hyperfluorescence did not correlate with characteristic retinal changes in HD OCT, but rather showed diversity in the type of morphologic alteration. The presence of central fluid pooling, such as subretinal fluid, could be identified only by HD OCT and not by FA. CONCLUSIONS: In the examined patients, a petaloid pattern and a honeycomb pattern of hyperfluorescence observed in FA were found to correlate to characteristic changes in HD OCT, whereas a diffuse leakage pattern was associated with nonuniform changes in retinal morphologic features. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
LA  - English
DB  - MTMT
ER  - 

TY  - JOUR
AU  - Bolz, Matthias
AU  - Schmidt-Erfurth, Ursula
AU  - Deák, Gábor György
AU  - Mylonas, Georgios
AU  - Kriechbaum, Katharina
AU  - Scholda, Christoph
TI  - Optical coherence tomographic hyperreflective foci. a morphologic sign of lipid extravasation in diabetic macular edema.
TS  - a morphologic sign of lipid extravasation in diabetic macular edema.
JF  - OPHTHALMOLOGY
J2  - OPHTHALMOLOGY
VL  - 116
PY  - 2009
IS  - 5
SP  - 914
EP  - 920
PG  - 7
SN  - 0161-6420
DO  - 10.1016/j.ophtha.2008.12.039
UR  - https://m2.mtmt.hu/api/publication/31008728
ID  - 31008728
N1  - Clinical Trial; Journal Article
AB  - To analyze hyperreflective foci typically seen in diabetic macular edema (DME) in optical coherence tomography (OCT).Prospective clinical trial.Twelve consecutive patients with treatment-naïve, clinically significant DME.During a same-day examination, a standardized visual acuity assessment (Early Treatment of Diabetic Retinopathy Study protocol), infrared fundus imaging, color fundus photography, and biomicroscopy were performed. Additionally, all patients were scanned using Stratus, Cirrus, and Spectralis OCT and results correlated.Morphologic changes secondary to DME.In all eyes with DME, distinct hyperreflective foci distributed throughout all retinal layers were found in the OCT scans of all 3 OCT devices. These deposits could not be identified by infrared imaging, fundus photography, or biomicroscopy as long as they were not confluent. Accumulations of such foci at the border of the outer nuclear and in the outer plexiform layer were recognizable clinically as hard exudates showing the same hyperreflective features in OCT. The hyperreflectivity of these foci did not correspond with intraretinal hemorrhage, nor did the lesions cause the characteristic OCT laser beam scattering phenomena typically seen secondary to intraretinal bleedings or microaneurysms. Further, they were detected within the walls of intraretinal microaneurysms.Well-demarcated, hyperreflective foci were identified in the retina of patients with DME. The deposits were located within walls of intraretinal microaneurysms and scattered throughout all retinal layers, forming confluent plaques in the outer plexiform layer. It is suggested that the foci represent extravasated lipoproteins and/or proteins being a very early subclinical barrier breakdown sign in DME.
LA  - English
DB  - MTMT
ER  -