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Aspects of Optical Coherence Tomography (OCT) in Healthy Eyes and Eyes with Retinal Diseases
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
2010 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Optical coherence tomography (OCT) is a technique in which cross-sectional images from intraocular tissue can be obtained. The quantitative and qualitative examinations are used for evaluating retinal diseases. Conventional OCT (Stratus) is mainly used, but the new Spectral domain (Cirrus) OCT, which has improved technology, may provide more reliable measurements.

The aim of the study was to collect normal values of macular thickness in children and adults and to evaluate the effect of age and/or gender, to compare measurement variability in healthy eyes and eyes with age-related macular degeneration (AMD), to compare Stratus and Cirrus OCT and to study the effect of cataract surgery on macula.

Sixty-seven healthy adults and 56 children, 30 patients with AMD, 34 patients with diabetes and cataract and 35 healthy controls were included. The quantitative maps in Stratus and Cirrus were used and manual correction of foveal location was evaluated. Qualitative OCT was compared to fluorescein angiography (FA) after cataract surgery.

The mean values of macular thickness in Stratus OCT were 207µm in adults and 204 µm in children. The measurement variability was low. Macular thickness decreased with age in adults, but not in children. No correlation with gender was found. In eyes with wet AMD, there were small differences in measurement variability comparing Stratus and Cirrus OCT. After manual correction in Cirrus OCT, the coefficients of repeatability were improved to values close to the repeatability in normal eyes. Two thirds of the diabetic and half of the control eyes showed leakage on FA after cataract surgery. Qualitative OCT corresponded poorly to FA in diabetic eyes. A thicker macula, assessed with OCT, was often observed without any obvious effect on visual acuity.  OCT was as good as FA in revealing clinically relevant changes in macula after surgery, and was the technique recommended for follow-up.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitas Upsaliensis , 2010. , s. 53
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 580
Nationell ämneskategori
Oftalmologi
Forskningsämne
Oftalmiatrik
Identifikatorer
URN: urn:nbn:se:uu:diva-129163ISBN: 978-91-554-7851-3 (tryckt)OAI: oai:DiVA.org:uu-129163DiVA, id: diva2:337470
Disputation
2010-09-17, Grönwallsalen, Akademiska sjukhuset, entrance 70, ground floor, 75185, Uppsala, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2010-08-27 Skapad: 2010-08-05 Senast uppdaterad: 2012-11-20
Delarbeten
1. Repeatability in and interchangeability between the macular and the fast macular thickness map protocols: a study on normal eyes with Stratus optical coherence tomography
Öppna denna publikation i ny flik eller fönster >>Repeatability in and interchangeability between the macular and the fast macular thickness map protocols: a study on normal eyes with Stratus optical coherence tomography
2009 (Engelska)Ingår i: Acta ophthalmologica, ISSN 1755-3768, Vol. 87, nr 7, s. 725-730Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: To collect a normal material and to compare the macular and the fast macular thickness map protocols regarding normal values and repeatability. Methods: Sixty-seven individuals underwent three repeated scans with the macular thickness protocol; 45 of them also had three scans with the fast thickness protocol in Stratus optical coherence tomography (OCT). The maps were divided into nine ETDRS fields, where thickness values were presented. The repeatability was calculated as intraclass correlation coefficient (ICC), coefficient of variance (CV) and coefficient of repeatability (CR). For comparison between the two protocols, limits of agreement were determined according to Bland-Altman. Results: Normal values for the two protocols were very close. Repeatability was high. ICC for all areas was 0.92-0.98. CV was less than 1% and CR was 6-8 mum for both protocols, with the exception of the fovea in the fast protocol (where CV was 1.44% and CR 12.4 mum). Limits of agreement between the two protocols were less than 10 mum as a rule. Conclusion: Normal values for the protocols are equal and they both have excellent repeatability. The fast macular map is a good alternative with the possible exception of the fovea, where variation is twice that of the macular thickness map.

Nyckelord
macular thickness maps, normal values, optical coherence tomography, repeatability
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-104911 (URN)10.1111/j.1755-3768.2008.01345.x (DOI)000270999300006 ()18937816 (PubMedID)
Tillgänglig från: 2009-05-30 Skapad: 2009-05-30 Senast uppdaterad: 2022-01-28Bibliografiskt granskad
2. A population-based study of macular thickness in full-term children assessed with Stratus OCT: normative data and repeatability.
Öppna denna publikation i ny flik eller fönster >>A population-based study of macular thickness in full-term children assessed with Stratus OCT: normative data and repeatability.
2009 (Engelska)Ingår i: Acta ophthalmologica, ISSN 1755-3768, Vol. 87, nr 7, s. 741-745Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: We aimed to determine normal macular thickness values, assessed with optical coherence tomography (OCT), in a population of full-term children of normal birthweight. Methods: A total of 56 children, aged 5-16 years, randomly chosen from the population register, were examined with Stratus OCT. Only children with visual acuity < 0.2 logMAR, spherical equivalent of - 3 to + 3 D and astigmatism < 2 D were included. The fast macular map protocol was used and three examinations were performed in each eye. One eye was then randomized for further analyses. Mean values for the nine ETDRS areas, foveal minimum thickness and macular volume were calculated for 55 eyes. Coefficients of variance and intraclass correlations were calculated for each area. Results: All children co-operated well and no child was excluded for lack of concentration. Mean +/- standard deviation central macular thickness was 204 +/- 19 mum. Mean total macular volume was 7.11 +/- 0.35 mm(3). No correlations were found between age, gender and macular thickness. Coefficients of variance were < 2% and intraclass correlations were > 0.9 in all areas, except the foveal minimum. Conclusions: Normal values for macular thickness in healthy full-term children were reported. As the Stratus OCT provides normal values only for adults, these data are a better alternative for comparison with children with retinal abnormalities. We concluded that OCT is suitable for examining the retina in children aged 5-16 years and has the same high level of repeatability as in adults.

Nyckelord
children, full-term, macular thickness, optical coherence tomography (OCT), repeatability
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-104400 (URN)10.1111/j.1755-3768.2008.01357.x (DOI)000270999300009 ()18811639 (PubMedID)
Tillgänglig från: 2009-05-30 Skapad: 2009-05-28 Senast uppdaterad: 2022-01-28Bibliografiskt granskad
3. Macular thickness decreases with age in normal eyes: A study on the macular thickness map protocol in the Stratus OCT
Öppna denna publikation i ny flik eller fönster >>Macular thickness decreases with age in normal eyes: A study on the macular thickness map protocol in the Stratus OCT
2008 (Engelska)Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 93, nr 11, s. 1148-1452Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND/AIM: Retinal and retinal nerve fibre layer (RNFL) thinning with age have been described in histological studies. In vivo techniques like optical coherence tomography (OCT), has shown thinning of optic nerve RNFL and the retina in specific areas. One would expect thinning of the total macula, but so far, a correlation with the quantitative OCT macular map tool and age has not been found. METHODS: Sixty-seven healthy individuals underwent three repeated scans in both eyes with the macular thickness map protocol in the Stratus OCT. That protocol divides the macula area in nine ETDRS fields.The RNFL was measured in one specific location close to the optic disc. Correlations between retinal, RNFL thickness, macular volume and age were determined. RESULTS: We found a statistically significant negative relationship between retinal thickness and age for all ETDRS areas, total macular volume and RNFL thickness. Retinal thickness decreased with 0,26-0,46 microm, the macula volume 0,01 mm(3) and RNFL with 0,09 microm per year. CONCLUSION: Retinal thickness within the area covered by the macular map significantly decreases with age. In the area examined in the papillomacular bundle, 20% of the retinal thinning is due to the RNFL and 80% due to thinning of other layers of the retina.

Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-104910 (URN)10.1136/bjo.2007.131094 (DOI)000271091900009 ()19019921 (PubMedID)
Tillgänglig från: 2009-05-30 Skapad: 2009-05-30 Senast uppdaterad: 2022-01-28Bibliografiskt granskad
4. Is quantitative spectral-domain superior to time-domain optical coherence tomography (OCT) in eyes with age-related macular degeneration?
Öppna denna publikation i ny flik eller fönster >>Is quantitative spectral-domain superior to time-domain optical coherence tomography (OCT) in eyes with age-related macular degeneration?
2012 (Engelska)Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 90, nr 7, s. 620-627Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: The aim of this study was to determine the variability of macular map measurements, for two generations of optical coherence tomography (OCT) instruments, in eyes with wet age related macular degeneration (AMD) and low visual acuity. Methods: Patients were examined with Stratus OCT and Cirrus HD-OCT. The macular thickness was assessed with the 'macular thickness map scan' and 'fast protocol' in Stratus and with the 512 × 128 and 200 × 200 cube protocols in Cirrus OCT. Two measurements were taken one directly after the other, at the first visit to analyse repeatability. Approximately 1 week later, a third measurement was taken to analyse reproducibility. In Cirrus OCT, a manual correction of foveal location was also performed. Repeatability and reproducibility were calculated as a coefficient of variance (CoV) and a coefficient of repeatability/reproducibility. Results: Repeatability for central macular thickness (expressed as CoV) was about three per cent for all protocols, and the coefficient of repeatability between 34 and 54 μm. Reproducibility (also expressed as CoV) was between four to seven per cent and coefficient of repeatability between 64 and 89 μm. After manual adjustment of foveal location in Cirrus OCT, the coefficient of repeatability improved to 12-18 μm, and the coefficient of reproducibility to 44-47 μm. Conclusions: In eyes affected by wet AMD, there were small differences in repeatability and reproducibility when comparing quantitative maps in Stratus and Cirrus OCT. However, when the software for manual correction of foveal position in Cirrus OCT was used, the variability decreased markedly, and the repeatability was close to what had been reported in normal eyes, demonstrating a significant, potential advantage of spectral-domain over time-domain OCT.

Nyckelord
age-related macular degeneration, quantitative optical coherence tomography, repeatability, reproducibility
Nationell ämneskategori
Oftalmologi
Forskningsämne
Oftalmiatrik
Identifikatorer
urn:nbn:se:uu:diva-184945 (URN)10.1111/j.1755-3768.2011.02112.x (DOI)000310548500017 ()
Tillgänglig från: 2012-11-19 Skapad: 2012-11-15 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
5. Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls
Öppna denna publikation i ny flik eller fönster >>Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls
Visa övriga...
2011 (Engelska)Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 249, nr 3, s. 349-359Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Cystoid macular edema (CME) is a well-known complication after cataract surgery, and diabetic retinopathy is reported to be an important risk factor for impaired visual recovery. In this prospective study, we compared visual outcome 6 months after surgery in eyes with moderate retinopathy and no previous ME with a control group, and observed the incidence of ME seen on fluorescein angiography (FA) and optical coherence tomography (OCT).

Thirty-four patients with type-2 diabetes and 35 controls were enrolled. Best-corrected visual acuity (VA) letters ETDRS was measured pre-op, at day 7, week 6 and month 6. FA performed pre-op and at week 6 was divided into three leakage patterns. OCT performed pre-op, at week 6 and month 6 was qualitatively divided into three types. Macular thickness was measured in three circular fields (central subfield, inner and outer circle) from the macular maps.

There was no statistically significant difference in VA before surgery, at day 7 or at 6 months, but at 6 weeks there was a significant difference with lower VA in the diabetic group. Six percent of control and 12% of diabetic eyes developed a clinical CME defined as a loss of > 5 letters between day 7 and week 6. Incidence of FA leakage was 23% in control and 76% in diabetic eyes. At 6 weeks, 20% of control and 44% of the diabetic eyes had qualitative changes on OCT. A statistically significant increase in thickness was observed for all three macular areas in both groups, part of it remaining at 6 months. There were, however, no differences in central macular thickness between the groups at any visit. Retinal thickening had poor correlation with VA.

The final visual outcome in eyes with mild to moderate retinopathy, without previous ME, is as good as in normal eyes, but an increased frequency of macular changes may protract recovery of full vision. Changes on OCT or FA are often seen without any obvious effect on VA. OCT is as good as FA at detecting a clinical CME, and is the technique recommended for follow-up before FA is considered.

Nyckelord
Visual outcome, Phacoemulsification, Cystoid macular edema, Optical coherence tomography, Fluorescein angiography, Sub-clinical macular thickening
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Oftalmiatrik
Identifikatorer
urn:nbn:se:uu:diva-128901 (URN)10.1007/s00417-010-1484-9 (DOI)000288454200003 ()20827486 (PubMedID)
Tillgänglig från: 2010-08-03 Skapad: 2010-08-02 Senast uppdaterad: 2022-01-28Bibliografiskt granskad

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