BACKGROUND: There is conflicting evidence on the role of acetylsalicylic acid (ASA) use in the development of cardiac allograft vasculopathy (CAV). METHODS: A nationwide prospective two-center study investigated changes in the coronary artery vasculature by highly automated 3-D optical coherence tomography (OCT) analysis at 1 month and 12 months after heart transplant (HTx). The influence of ASA use on coronary artery microvascular changes was analyzed in the overall study cohort and after propensity score matching for selected clinical CAV risk factors. RESULTS: In total, 175 patients (mean age 52 ± 12 years, 79% male) were recruited. During the 1-year follow-up, both intimal and media thickness progressed, with ASA having no effect on its progression. However, detailed OCT analysis revealed that ASA use was associated with a lower increase in lipid plaque (LP) burden (p = .013), while it did not affect the other observed pathologies. Propensity score matching of 120 patients (60 patient pairs) showed similar results, with ASA use associated with lower progression of LPs (p = .002), while having no impact on layered fibrotic plaque (p = .224), calcification (p = .231), macrophage infiltration (p = .197), or the absolute coronary artery risk score (p = .277). According to Kaplan-Meier analysis, ASA use was not associated with a significant difference in survival (p = .699) CONCLUSION: This study showed a benefit of early ASA use after HTx on LP progression. However, ASA use did not have any impact on the progression of other OCT-observed pathologies or long-term survival.
- MeSH
- alografty patologie MeSH
- aterosklerotický plát * komplikace MeSH
- dospělí MeSH
- koronární angiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci koronárních tepen * etiologie MeSH
- optická koherentní tomografie škodlivé účinky metody MeSH
- prospektivní studie MeSH
- transplantace srdce * škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: Cílem této studie bylo ověřit možné změny konvenčně nediagnostikované nasální části zorného pole u pacientů s diagnózou včasného primárního glaukomu s otevřeným úhlem (PGOÚ) s vysokou tenzí. Materiál a metody: Vyšetření vzdálené nasální části zorného pole bylo provedeno u 30 nemocných (60 očí) s počínajícím PGOÚ (preperimetrické stadium změn). Soubor tvořilo 16 žen (průměrného věku 46,5 let) a 14 mužů (průměrného věku 44,7 let). U všech očí bylo zjištěno glaukomovým programem (rychlý prahový program v rozsahu 50 stupňů nasálně a 22 stupňů temporálně) přístrojem Medmont M700 fyziologické zorné pole. Zraková ostrost byla 1,0 s případnou korekcí menší nebo rovnou ±3 dioptrie, a kromě glaukomového onemocnění neměli jinou oční vadu. Zorné pole bylo následně vyšetřeno stejným přístrojem posunutím fixačního bodu o 40 stupňů temporálně (prostorově adaptabilní program) a současným otočením hlavy o 10 stupňů nasálně. Celkem bylo zahrnuto 89 vyšetřovacích bodů s použitím flicker podnětů a rozsahem 0–120 stupňů nasálně. Výsledky: U všech očí byla zjištěna deprese vzdálené periferie nasální části zorného pole v rozsahu od 50 do 95 stupňů, při normální zorném poli vyšetřeným glaukomovým programem. Závěr: Při normálním zorném poli vyšetřeném rychlým prahovým glaukomovým programem byly u všech nemocných PGOÚ zjištěny změny v distální části nasální periferie zorného pole.
Aim: The aim of this study was to examine possible changes in the conventionally undiagnosed nasal visual field in patients diagnosed with early primary open angle glaucoma. Material and Methods: Examination of the far nasal part of the visual field was performed in 30 patients (60 eyes) with early stage of primary open angle glaucoma (preperimetric stage of changes). The cohort consisted of 16 women (mean age 46.5 years) and 14 men (mean age 44.7 years). In all eyes, the glaucoma program (rapid threshold program of 50 degrees nasally and 22 degrees temporally) was performed with the Medmont M700 instrument to determine the physiological visual field. Visual acuity was 1.0 with a possible correction less than or equal to ±3 diopters and they had no other ocular defect except glaucoma disease. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli and a range of 0–120 degrees nasally. Results: The far nasal limit of the visual field reached 100° in 13.33% of eyes, 105° in 20% of eyes and up to 110° in 66.67% of eyes. Conclusion: In all eyes, depression of the distal periphery of the nasal part of the visual field was found to range from 50 to 95 degrees, with a normal visual field examined by the glaucoma program.
- MeSH
- časná diagnóza MeSH
- glaukom s otevřeným úhlem diagnóza MeSH
- glaukom * diagnóza MeSH
- lidé MeSH
- optická koherentní tomografie MeSH
- testy zrakového pole metody MeSH
- zraková pole MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
Úvod: Torpédo makulopatia je vzácna, vrodená ložisková lézia sietnice. Klinický obraz je typický unilaterálnou, ohraničenou, oválnou, hypopigmentovou léziou v inferotemporálnej časti makuly. Vo väčšine prípadov sa lézia nachádza pozdĺž horizontálneho rafé, má tvar torpéda a nazálny okraj smeruje do foveoly. Diagnóza je stanovená na základe jej charakteristického tvaru, lokalizácie a nálezu na optickej koherentnej tomografii (OCT). Etiológia a patogenéza vzniku torpédo makulopatie je nejasná, ale predpokladá sa, že ide o vrodený defekt retinálneho pigmentového epitelu (RPE). Cieľom publikácie je poukázať na túto diagnózu a odprezentovať nález torpédo makulopatie u dospelej pacientky. Kazuistika: 30-ročná pacientka sa dostavila na rutinné očné vyšetrenie. Vyšetrenie očného pozadia pravého oka odhalilo inferotemporálne od fovey oválnu hypopigmentovú léziu veľkosti 1 priemeru disku, na ktorú nadväzovalo satelitné ložisko v rovnakej osi smerujúcej do foveoly. Na základe OCT, OCT angiografie, fundusautofluorescencie, odberu anamnézy, typického tvaru a lokality lézie bola pacientke diagnostikovaná torpédo makulopatia na pravom oku. Záver: Vo všeobecnosti je torpédo makulopatia asymptomatická, vrodená, benígna lézia sietnice. Väčšinou je náhodne diagnostikovaná pri vyšetrení očného pozadia. Ide o stabilný nález s minimálnym rizikom poškodenia zrakových funkcií, ktorý nevyžaduje žiadnu liečbu. Napriek tomu sa vzhľadom na malé riziko vzniku choroidálnej neovaskulárnej membrány odporúča sledovanie pacientov raz ročne. Na túto diagnózu je nutné myslieť pri náleze unilaterálneho hypopigmentového ložiska inferotemporálne od fovey a v rámci diferenciálnej diagnostiky ho odlíšiť od chorioretinálnej atrofie, jazvy, kolobómu, viteliformnej dystrofie, či iných lézií RPE.
Aim: Torpedo maculopathy is an incidental, congenital retinal lesion. The typical clinical finding is a unilateral, symmetric, oval, hypopigmented lesion in the inferotemporal macula. In most cases, the lesion is along the horizontal raphe, is torpedo-shaped, and the nasal edge is directed into the foveola. The diagnosis is determined on the basis of its characteristic shape, localization and findings on optical coherence tomography (OCT). The etiology and pathogenesis of torpedo maculopathy is unclear, but it is believed to be a congenital defect of the retinal pigment epithelium (RPE). The aim of this publication is highlight this diagnosis and to present an incidental finding of torpedo maculopathy in an adult patient. Case report: A 30-year-old female patient reported for a routine eye examination. Fundus examination of the right eye revealed an oval hypopigmented lesion with a size of 1 disk diameter inferotemporally from the fovea, which was followed by a satellite lesion in the same axis directed into the foveola. Based on OCT, OCT angiography, fundus autofluorescence, and the typical shape and location of the lesion, the patient was diagnosed with torpedo maculopathy in the right eye. Conclusion: In general, torpedo maculopathy is an asymptomatic, congenital, benign retinal lesion, which is mostly diagnosed accidentally during a routine fundus examination. TM is non-progressive retinal finding with a minimal risk of deterioration of visual functions, which does not require any treatment. Nevertheless, due to the rare risk of a choroidal neovascular membrane, it is recommended to examine patients once a year. It is necessary to consider this diagnosis when a unilateral hypopigmented lesion is found inferotemporally from the fovea, and to distinguish it from chorioretinal atrophy, scar, vitelliform dystrophy, or other RPE lesions as part of the differential diagnosis.
- MeSH
- dospělí MeSH
- lidé MeSH
- nemoci retiny * diagnóza terapie MeSH
- optická koherentní tomografie metody MeSH
- retina patologie MeSH
- retinální pigmentový epitel patologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Úvod: Alzheimerova nemoc (AN), nejčastější příčina demence, postihuje podle odhadů 3–40 % populace hlavně vyššího věku a její incidence narůstá. Představuje velkou zátěž pro zdravotnický systém. Standardní diagnostická neurokognitivní vyšetření jsou náročná jak časově, tak finančně, proto je snaha o nalezení vhodné screeningové metody rizikových pacientů. Sítnice oka je embryologicky prodloužením mozku a lze předpokládat úzkou souvislost mezi stavem sítnice, detekovaným pomocí optické koherentní tomografie (OCT), a kognitivními funkcemi. Cílem práce bylo provést systematický přehled studií, které se zabývaly vztahem mezi tloušťkou nervových vláken sítnice (RNFL – retinal nerve fibre layer), a kognitivními funkcemi u pacientů Alzheimerovou nemocí. Metody: Z databází PubMed a Google Scholar byly na základě zvolených klíčových slov: Optical coherence tomography, dementia, retinal nerve fibre layer, cognitive function vybrány relevantní studie, které sledovaly změny tloušťky nervových vláken sítnice pomocí OCT a jejich vztah s výskytem Alzheimerovy nemoci. Výsledky: Do analýzy bylo zařazeno 16 studií. Většina prací konzistentně prokázala vztah mezi tloušťkou nervových vláken při OCT a výskytem Alzheimerovy nemoci. V naprosté většině studií bylo pozorováno snížení tloušťky pRNFL (papilární tloušťka nervových vláken) v horních a dolních kvadrantech, zatímco v nasálních a temporálních kvadrantech tento pokles nebyl zaznamenán. Snížení tloušťky pRNFL bylo detekováno i u pacientů s mírným kognitivním deficitem. Závěr: Snížení tloušťky nervových vláken pomocí neinvazivního vyšetření OCT koreluje s výskytem Alzheimerovy nemoci. OCT by ta
: Alzheimer disease (AD) as the most common cause of dementia, is affecting approximately 3-40 % of the elderly population and its incidence grows. It is a great burden for healthcare system. Standard diagnostic neurocognitive examination is time consuming and quite expensive. Therefore there is need for fast and accurate screening test. The retina of the eye is embryologically extension of the brain so it is assumed that there is correlation between status of the retina detected by optical coherence tomography and cognitive function. The aim of this study is to create a systematic review of studies which analysed correlation betwen retinal nerve fiber layer thickness (RNFL) and cognitive functions in patients with Alzheimer disease. Methods: Relevant studies from PubMed and Google scholar were searched using key words: Optical coherence tomography, dementia, retinal nerve fibre layer, cognitive function. Only results of studies where RNFL was measured with OCT scan and their association with Alzheimer disease were then analysed. Results: There were 16 studies eligible for the analysis. Most studies consistently proved association between RNFL thickness at the OCT and the presence of Alzheimer disease. In nearly every available study there is thinning of RNFL in superior and inferior quadrants, while in nasal and temporal quadrants there was no significant thinning present. Conclusion: So far as the results are being reviewed, there is an evidence that patients with Alzheimer disease have their retinal nerve fibre layer thickness decreased. This finding could lead to faster diagnosis of this disease and better therapeutical approach in this group of patients. There is sought for other studies with larger cohort and with modern imaging devices and software.
BACKGROUND AND OBJECTIVES: Optical coherence tomography angiography (OCTA) is a noninvasive high-resolution imaging technique for assessing the retinal vasculature and is increasingly used in various ophthalmologic, neuro-ophthalmologic, and neurologic diseases. To date, there are no validated consensus criteria for quality control (QC) of OCTA. Our study aimed to develop criteria for OCTA quality assessment. METHODS: To establish criteria through (1) extensive literature review on OCTA artifacts and image quality to generate standardized and easy-to-apply OCTA QC criteria, (2) application of OCTA QC criteria to evaluate interrater agreement, (3) identification of reasons for interrater disagreement, revision of OCTA QC criteria, development of OCTA QC scoring guide and training set, and (4) validation of QC criteria in an international, interdisciplinary multicenter study. RESULTS: We identified 7 major aspects that affect OCTA quality: (O) obvious problems, (S) signal strength, (C) centration, (A) algorithm failure, (R) retinal pathology, (M) motion artifacts, and (P) projection artifacts. Seven independent raters applied the OSCAR-MP criteria to a set of 40 OCTA scans from people with MS, Sjogren syndrome, and uveitis and healthy individuals. The interrater kappa was substantial (κ 0.67). Projection artifacts were the main reason for interrater disagreement. Because artifacts can affect only parts of OCTA images, we agreed that prior definition of a specific region of interest (ROI) is crucial for subsequent OCTA quality assessment. To enhance artifact recognition and interrater agreement on reduced image quality, we designed a scoring guide and OCTA training set. Using these educational tools, 23 raters from 14 different centers reached an almost perfect agreement (κ 0.92) for the rejection of poor-quality OCTA images using the OSCAR-MP criteria. DISCUSSION: We propose a 3-step approach for standardized quality control: (1) To define a specific ROI, (2) to assess the occurrence of OCTA artifacts according to the OSCAR-MP criteria, and (3) to evaluate OCTA quality based on the occurrence of different artifacts within the ROI. OSCAR-MP OCTA QC criteria achieved high interrater agreement in an international multicenter study and is a promising QC protocol for application in the context of future clinical trials and studies.
PURPOSE: Narrow-band imaging is the state of the art in the diagnosis of mucosal lesions of the vocal cords. It is also used in the follow-up of patients after surgical therapy. Unfortunately, if a patient has received radiotherapy the follow-up is much more difficult. Radiation induces inflammatory changes in the mucosa, which lead to changes in the vascular architecture and thus affect the results of the examination. The dynamics and time dependence of vascular changes after radiotherapy have not yet been described. The purpose of this study is to describe the evolution of the vascular pattern in vocal cords after primary radiotherapy for glottic cancer. METHODS: This was a retrospective cohort study. Each patient underwent NBI videolaryngoscopy and was followed every 3 months. RESULTS: The tumor-related mucosal changes diminished at 3 months after radiotherapy. Afterward, growth of new longitudinal vasculature was observed and significantly slowed after 9 months. No perpendicular vasculature or tumor recurrence was observed during the course of the study. CONCLUSIONS: According to our data, we can conclude that post-radiation mucosal vasculature changes are only longitudinal.
BACKGROUND: The authors present a case study which describes the development of bilateral optic neuropathy as a complication of allogeneic hematopoietic stem cell transplantation (HSCT) in a patient who underwent a transplant for B-cell acute lymphoblastic leukemia (B-ALL). The patient, who was in remission with regard to the underlying hematological disease, developed edema of both optic discs and maculas three months after transplantation. The morphological finding regressed after treatment with corticoids and comprehensive systemic anti-infective therapy. However, the loss of function was not entirely restored. CASE REPORT: One year after the healing, the atrophy of the optic discs persisted, with corresponding findings in vessel density (VD), retinal nerve fibre layer (RNFL) and visual field changes. Electrophysiological examination by pattern electroretinogram (PERG) showed an alteration in retinal ganglion cells in the left eye, but with significant damage to nerve fibres on both sides. Visual evoked potential (VEP) verified bilateral non-inflammatory neurogenic lesions. This finding was also confirmed by functional magnetic resonance imaging (fMRI). Examination by structural magnetic resonance imaging (MRI) showed inflammatory changes in the optic nerve sheaths over time and a consequent marked narrowing of them. CONCLUSION: The authors believe that edema of the optic discs and maculas was caused by a combination of several factors. Firstly, MRI showed inflammatory changes in the optic nerve sheaths, which led to a blockade of axoplasmic transport. Another factor that may have played a part in the outcome was endothelial damage to blood vessels with impaired microcirculation supplying the optic nerve fibres, which contributed to the occurrence of macular edema.
INTRODUCTION: Narrow band imaging (NBI) is an endoscopic imaging method intended for the diagnosis of mucosal lesions of the larynx that are not visible in white-light endoscopy, but are typical of pre-tumor and tumor lesions of the larynx. THE PURPOSE OF THE STUDY: To compare preoperative/perioperative white light endoscopy and NBI endoscopy with the results of histopathological examinations in pre-tumor and tumor lesions of the larynx. METHODS: A prospective study, over a period of five years (5/2018-5/2023), included 87 patients with laryngeal lesions aged 24-80 years. We evaluated preoperative/ perioperative white light and NBI endoscopy, established a working prehistological diagnosis, and compared this with the definitive histopathological results of laryngeal biopsies. RESULTS: In relation to the definitive histology score, a statistically significant correlation was found between the evaluation of the finding and the definitive histology for preoperative and perioperative white light endoscopy and NBI endoscopy (p < 0.001). Both methods showed higher precision when used perioperatively. CONCLUSION: NBI endoscopy is an optical method that allows us to improve the diagnosis of laryngeal lesions, perform a controlled perioperative biopsy, and refine the surgical scope. The NBI endoscopy is a suitable method for the diagnosis of early cancerous lesions of the larynx. The use of preoperative/perioperative NBI endoscopy allowed us to achieve a high level of agreement correlation (p < 0.001) between the prehistological working diagnosis and the final histopathological result. The NBI method proves its application in the diagnosis of pre-tumor and tumor lesions of the larynx.
- MeSH
- gastrointestinální endoskopie MeSH
- larynx * diagnostické zobrazování chirurgie patologie MeSH
- lidé MeSH
- nádory hrtanu * diagnostické zobrazování chirurgie MeSH
- prospektivní studie MeSH
- úzkopásmové zobrazení metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Narrow band imaging (NBI) is an endoscopic imaging method intended for the diagnosis of mucosal lesions of the larynx that are not visible in white-light endoscopy, but are typical of pre-tumor and tumor lesions of the larynx. THE PURPOSE OF THE STUDY: To compare preoperative/perioperative white light endoscopy and NBI endoscopy with the results of histopathological examinations in pre-tumor and tumor lesions of the larynx. METHODS: A prospective study, over a period of five years (5/2018-5/2023), included 87 patients with laryngeal lesions aged 24-80 years. We evaluated preoperative/ perioperative white light and NBI endoscopy, established a working prehistological diagnosis, and compared this with the definitive histopathological results of laryngeal biopsies. RESULTS: In relation to the definitive histology score, a statistically significant correlation was found between the evaluation of the finding and the definitive histology for preoperative and perioperative white light endoscopy and NBI endoscopy (p < 0.001). Both methods showed higher precision when used perioperatively. CONCLUSION: NBI endoscopy is an optical method that allows us to improve the diagnosis of laryngeal lesions, perform a controlled perioperative biopsy, and refine the surgical scope. The NBI endoscopy is a suitable method for the diagnosis of early cancerous lesions of the larynx. The use of preoperative/perioperative NBI endoscopy allowed us to achieve a high level of agreement correlation (p < 0.001) between the prehistological working diagnosis and the final histopathological result. The NBI method proves its application in the diagnosis of pre-tumor and tumor lesions of the larynx.
- MeSH
- gastrointestinální endoskopie MeSH
- larynx * diagnostické zobrazování chirurgie patologie MeSH
- lidé MeSH
- nádory hrtanu * diagnostické zobrazování chirurgie MeSH
- prospektivní studie MeSH
- úzkopásmové zobrazení metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Optical Coherence Tomography (OCT) is an intravascular imaging modality enabling detailed evaluation of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). However, its clinical application remains hampered by time-consuming manual quantitative analysis. We aimed to validate a semi-automated quantitative OCT analysis software (Iowa Coronary Wall Analyzer, ICWA-OCT) to improve OCT-analysis in HTx patients. 23 patients underwent OCT evaluation of all three major coronary arteries at 3 months (3M) and 12 months (12M) after HTx. We analyzed OCT recordings using the semiautomatic software and compared results with measurements from a validated manual software. For semi-automated analysis, 31,228 frames from 114 vessels were available. The validation was based on a subset of 4287 matched frames. We applied mixed model statistics to accommodate the multilevel data structure with method as a fixed effect. Lumen (minimum, mean, maximum) and media (mean, maximum) metrics showed no significant differences. Mean and maximum intima area were underestimated by the semi-automated method (β-methodmean = - 0.289 mm2, p < 0.01; β-methodmax = - 0.695 mm2, p < 0.01). Bland-Altman analyses showed increasing semi-automatic underestimation of intima measurements with increasing intimal extent. Comparing 3M to 12M progression between methods, mean intimal area showed minor underestimation (β-methodmean = - 1.03 mm2, p = 0.04). Lumen and media metrics showed excellent agreement between the manual and semi-automated method. Intima metrics and progressions from 3M to 12M were slightly underestimated by the semi-automated OCT software with unknown clinical relevance. The semi-automated software has the future potential to provide robust and time-saving evaluation of CAV progression.
