Review Article

New findings and challenges in OCT angiography for diabetic retinopathy

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Abstract: Diabetic retinopathy (DR) is a leading cause of visual loss worldwide. Disease severity is graded from mild non-proliferative DR to proliferative DR. Optical coherence tomography angiography (OCTA) has become widely accepted as a useful noninvasive technique that provides detailed imaging of the ocular vessels. It is also becoming an increasingly essential tool for both qualitative and quantitative assessment of DR, especially with the advent of wider imaging capabilities. Various angiographic features of DR, such as microaneurysms, intraretinal microvascular abnormalities, neovascularization, and nonperfusion have been comprehensively studied and described using OCTA. Different quantitative OCTA metrics have been introduced, such as vessel density, foveal avascular zone (FAZ) area, and area of nonperfusion. Current research has been focusing on the application of quantitative OCTA for the diagnosis of DR and treatment monitoring. The primary purpose of this article is to review the use of OCTA, including its challenges, in the diagnosis and management of DR.

Review Article

Strategies to control myopia in children: a review of the findings from the Anyang Childhood Eye Study

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Abstract: Myopia in children remains a major public health problem worldwide, especially in some Asian countries such as China, Singapore and Japan. Although many interventions have been attempted, few has been proven to be effective in controlling onset and progression of myopia in children. Environmental factors, genetic susceptibility or ethnic differences can affect the efficacy of these interventions. However, many questions remain unclear and even controversial for controlling myopia. China has the biggest population with myopia, especially for children myopia. Thus, it is of importance to present what achievements Chinese scientists have made in the field of myopia control in children. We summarize the current findings on myopia control in children from the Anyang Childhood Eye Study, including epidemiological data, clinical trials, systematic reviews and meta-analyses, and compare them with studies in other countries to find potential clues for controlling myopia in children.

Review Article

The role of optical coherence tomography in neuro-ophthalmology

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Abstract: Optical coherence tomography (OCT) is an ocular imaging technique that can complement the neuro-ophthalmic assessment, and inform our understanding regarding functional consequences of neuroaxonal injury in the afferent visual pathway. Indeed, OCT has emerged as a surrogate end-point in the diagnosis and follow up of several demyelinating syndromes of the central nervous system (CNS), including optic neuritis (ON) associated with: multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies. Recent advancements in enhanced depth imaging (EDI) OCT have distinguished this technique as a new gold standard in the diagnosis of optic disc drusen (ODD). Moreover, OCT may enhance our ability to distinguish cases of papilledema from pseudopapilledema caused by ODD. In the setting of idiopathic intracranial hypertension (IIH), OCT has shown benefit in tracking responses to treatment, with respect to reduced retinal nerve fiber layer (RNFL) measures and morphological changes in the angling of Bruch’s membrane. Longitudinal follow up of OCT measured ganglion cell-inner plexiform layer thickness may be of particular value in managing IIH patients who have secondary optic atrophy. Causes of compressive optic neuropathies may be readily diagnosed with OCT, even in the absence of overt visual field defects. Furthermore, OCT values may offer some prognostic value in predicting post-operative outcomes in these patients. Finally, OCT can be indispensable in differentiating optic neuropathies from retinal diseases in patients presenting with vision loss, and an unrevealing fundus examination. In this review, our over-arching goal is to highlight the potential role of OCT, as an ancillary investigation, in the diagnosis and management of various optic nerve disorders.

Original Article

Using a rigid lens as endocapsular supporting device in cataract surgery for moderate subluxated cataracts

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Background: To present a surgical technique using a rigid intraocular lens as endocapsular supporting device in manual small incision cataract surgery (MSICS) for treating mild-moderate subluxated cataracts.

Methods: In our technique, a single-piece rigid polymethyl methacrylate (PMMA) lens was implanted in the bag following the nucleus removal, with its axis vertical to the zonular dialysis. This endocapsular-implanted IOL stretched the bag and provided sufficient stability and lens centration. This technique was performed in 19 eyes with subluxated cataracts, with zonulysis of ≤120 degree and nuclear sclerosis of grade ≤3. Mean follow-up time was 9.8 months.

Results: All eyes had endocapsular IOL implantation during surgery. Intraoperative extension of the dialysis did not occur in any eye. The IOL was placed in the bag in all but 1 case, in which dislocation of the IOL haptic into the vitreous occurred. Though the IOL was slightly decentered in 3 cases, it kept stable. All patients were asymptomatic.

Conclusions: This approach provides a simplified and practical strategy for surgically managing subluxation with mild-moderate zonular loss.

Original Article
Perspective

Degenerative myopia: mechanical theories revisited

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Abstract: The article discusses the early abandonment of mechanical theories about eye enlargement in degenerative myopia at the turn of the 20th century. At that time, the number of theories about myopia grew unrestricted, but with scant support from the experimental field. The mechanical theories vanished as a new wave of metabolism-based theories appeared, propelled by the huge advances in molecular biology. Modern techniques allow reconsidering those theories and to put them to test with higher confidence.

Brain and Perception

AB064. Product knowledge predicts greater willingness to buy and gaze-related attention, salience does not

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Background: Visual salience computed using algorithmic procedures have been shown to predict eye-movements in a number of contexts. However, despite calls to incorporate computationally-defined visual salience metrics as a means of assessing the effectiveness of advertisements, few studies have incorporated these techniques in a marketing context. The present study sought to determine the impact of visual salience and knowledge of a brand on eye-movement patterns and buying preferences.

Methods: Participants (N=38) were presented with 54 pairs of products presented on the left and right sides of a blank white screen. For each pair, one product was a known North American product, such as Fresca?, and one was an unknown British product of the same category, such as Irn Bru?. Participants were asked to select which product they would prefer to buy while their eye movements were recorded. Salience was computed using Itti & Koch’s [2001] computational model of bottom-up salience. Products were defined as highly salient if the majority of the first five predicted fixations were in the region of the product.

Results: Results showed that participants were much more likely to prefer to buy known products, and tentative evidence suggests that participants had longer total dwell times when looking at unknown products. Salience appears to have had little or no effect on preference for a product, nor did it predict total dwell time or time to first fixation. There also appears to be no interaction between knowledge of a product and visual salience on any of the measures analyzed.

Conclusions: The results indicate that product salience may not be a useful predictor of attention under the constraints of the present experiment. Future studies could use a different operational definition of visual salience which might be more predictive of visual attention. Furthermore, a more fine-grained analysis of product familiarity based on survey data may reveal patterns obscured by the definitional constraints of the present study.

Retina and Posterior Segment

AB025. Machine learning applied to the oxygen induced retinopathy model

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Background: The oxygen induced retinopathy rodent model is widely used, notably for the assessment of developmental dystrophies in preclinical studies of vascular retinal diseases. Typically, the quantification of vessel tufts and avascular regions is computed manually from flat mounted retinas imaged using fluorescent probes that highlight the vascular network. However, such manual measurements are time-consuming and hampered by user variability and bias, thus a rapid and objective alternative is required.

Methods: We employ a machine learning approach to segment and characterize vascular tufts. The proposed quantitative retinal vascular assessment (QuRVA) technique uses quadratic discrimination analysis and morphological techniques to provide reliable measurements of vascular density and pathological vascular tuft regions, devoid of user intervention within seconds. Our algorithms allow also delineating the whole vasculature network, and identifying and analyzing avascular regions.

Results: Our first experiment shows the high degree of error and variability of manual segmentations. In consequence, we developed a set of algorithms to perform this task automatically. We benchmark and validate the results of our analysis pipeline using the consensus of several manually curated segmentations using commonly used computer tools. We describe the method, provide details for reproducing the algorithm, and validate all aspects of the analysis.

Conclusions: Manual and semi-automated procedures for tuft detection present strong fluctuations among users, demonstrating the need for fast and unbiased tools in this highly active research field with tremendous implications for basic research and industry.

Review Article

The development of tissue engineering corneal scaffold: which one the history will choose?

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Abstract: Since the 21st century, the development of corneal tissue engineering technology has been developing rapidly. With the progress of biomaterials, cell culture and tissue engineering technology, tissue engineering cornea has gained great development in both basic scientific research and clinical application. In particular, tissue engineered corneal scaffolds are the core components of tissue engineered corneas. It is the focus of current research on tissue engineering cornea to search for scaffolds with good biocompatibility, high safety and good biomechanical properties. In this paper, the recent research progress of tissue engineering corneal materials is reviewed.

Review Article

Scleral remodelling in myopia and its manipulation: a review of recent advances in scleral strengthening and myopia control

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Abstract: The biological mechanisms of eye growth and refractive development are increasingly well characterised, a result of many careful studies that have been carried out over many years. As the outer coat of the eye, the sclera has the ultimate impact on the restraint or facilitation of eye growth, thus any changes in its biochemistry, ultrastructure, gross morphology and/or biomechanical properties are critical in refractive error development and, in particular, the development of myopia. The current review briefly revisits our basic understanding of the structure and biomechanics of the sclera and how these are regulated and modified during eye growth and myopia development. The review then applies this knowledge in considering recent advances in our understanding of how the mechanisms of scleral remodelling may be manipulated or controlled, in order to constrain eye growth and limit the development of myopia, in particular the higher degrees of myopia that lead to vision loss and blindness. In doing so, the review specifically considers recent approaches to the strengthening of the sclera, through collagen cross-linking, scleral transplantation, implantation or injection of biomaterials, or the direct therapeutic targeting and manipulation of the biochemical mechanisms known to be involved in myopia development. These latest approaches to the control of scleral changes in myopia are, where possible, placed in the context of our understanding of scleral biology, in order to bring a more complete understanding of current and future therapeutic interventions in myopia, and their consequences.

其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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