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Quantitative assessment of retinal microvasculature in optical coherence tomography angiography (OCTA) images is important for studying, diagnosing, monitoring, and guiding the treatment of ocular and systemic diseases. However, the OCTA user community lacks universal and transparent image analysis tools that can be applied to images from a range of OCTA instruments and provide reliable and consistent microvascular metrics from diverse datasets. We present a retinal extension to the OCTA Vascular Analyser (OCTAVA) that addresses the challenges of providing robust, easy-to-use, and transparent analysis of retinal OCTA images. OCTAVA is a user-friendly, open-source toolbox that can analyse retinal OCTA images from various instruments. The toolbox delivers seven microvascular metrics for the whole image or subregions and six metrics characterising the foveal avascular zone. We validate OCTAVA using images collected by four commercial OCTA instruments demonstrating robust performance across datasets from different instruments acquired at different sites from different study cohorts. We show that OCTAVA delivers values for retinal microvascular metrics comparable to the literature and reduces their variation between studies compared to their commercial equivalents. By making OCTAVA publicly available, we aim to expand standardised research and thereby improve the reproducibility of quantitative analysis of retinal microvascular imaging. Such improvements will help to better identify more reliable and sensitive biomarkers of ocular and systemic diseases., (© 2024. The Author(s).)

Purpose: To determine the utility of Split-Window optical coherence tomography OCT (SW-OCT) biometry in measuring ocular axial dimensions as well as imaging the intraocular lens (IOL) and posterior capsule in pseudophakic eyes., Methods: Sixty-nine pseudophakic eyes of 69 subjects were enrolled in the study. The results of SW-OCT biometry implemented in the SD OCT device for posterior and anterior segment imaging (REVO NX, Optopol Technology) were compared with those obtained with the SS-OCT-based biometer IOLMaster 700 (Carl Zeiss Meditec). Differences in measurement values between the two biometers were determined using the paired t-test. Agreement was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots., Results: The correlation between measurements obtained with SW-OCT and SS-OCT was very high (ICC for: axial length (AL) = 1.000; anterior chamber depth (ACD) = 0.997; IOL thickness (IOL LT) = 0.997; central corneal thickness (CCT) = 0.987). The mean AL measurement difference was 0.003 ± 0.021 mm (the 95% LoA ranged from -0.04 to 0.05); the mean ACD difference was -0.009 ± 0.025 mm (95% LoA, -0.06 to 0.04); mean LT difference was 0.001 ± 0.021 mm (95% LoA, -0.04 to 0.04); and mean CCT difference was 1.4 ± 5.4 μm (95% LoA, -9 to 12)., Conclusion: The study shows small, non-significant differences between the biometric measurements obtained with REVO NX SW-OCT and IOLMaster 700 SS-OCT in pseudophakic eyes. However, SW-OCT offered significantly lower ACD and LT measurement failure rates. With high-resolution imaging, SW-OCT enables accurate assessment of IOL position relative to the posterior capsule and visualization of capsular fibrosis., (© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

Despite the rapid development of optical imaging methods, high-resolution in vivo imaging with penetration into deeper tissue layers is still a major challenge. Optical coherence tomography (OCT) has been used successfully for non-invasive human retinal volumetric imaging in vivo , advancing the detection, diagnosis, and monitoring of various retinal diseases. However, there are important limitations of volumetric OCT imaging, especially coherent noise and the limited axial range over which high resolution images can be acquired. The limited range prevents simultaneous measurement of the retina and choroid with adequate lateral resolution. In this article, we address these limitations with a technique that we term spatio-temporal optical coherence tomography (STOC-T), which uses light with controlled spatial and temporal coherence and advanced signal processing methods. STOC-T enabled the acquisition of high-contrast and high-resolution coronal projection images of the retina and choroid at arbitrary depths., Competing Interests: M.W. and D.B. are founders and shareholders of InCelVu start-up company. Other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2022 The Author(s).)

Purpose: To evaluate the safety and therapeutic effects of orally administered AKST4290 (formerly BI 144807 and ALK4290) in treatment-naive patients with neovascular age-related macular degeneration., Methods: In this prospective, multicenter, open-label Phase 2a pilot clinical study, 30 patients with newly diagnosed neovascular age-related macular degeneration self-administered AKST4290 (400 mg) orally twice daily for 6 weeks. Patients were examined weekly for safety, to measure best-corrected visual acuity (BCVA), and to perform exploratory morphologic assessments. The primary endpoint was the mean change in BCVA from baseline to end of treatment, and the secondary endpoint was safety. Exploratory endpoints investigated potential changes in macular morphology., Results: Mean BCVA improved by +7.0 letters (95% CI, 2.2-11.7); 24 patients (82.8%) had stable or improved BCVA, with 6 (20.7%) gaining ≥15 letters. No patients experienced severe or serious adverse events., Conclusion: In this 6-week study, AKST4290 treatment was associated with improved BCVA scores in patients with treatment-naive neovascular age-related macular degeneration. All adverse events were mild or moderate in severity and no safety issues were identified. Treatment of neovascular age-related macular degeneration with AKST4290 warrants further investigation in randomized, placebo-controlled trials.

Purpose: To evaluate the performance of corneal epithelial thickness mapping (ETM) and demonstrate simultaneous measurement of ETMs and corneal topography using REVO NX (Optopol Technology, Zawiercie, Poland)-an OCT device for anterior and posterior segment imaging., Methods: One hundred thirty-seven eyes of 137 normal subjects and patients with corneal diseases were recruited to the study. Each subject was scanned with REVO NX. ETMs and corneal topography maps were reconstructed from a single measurement. Corneal topography was also carried out using Pentacam (Oculus, Wetzlar, Germany). One hundred twenty-eight eyes were qualified for the final analysis. Forty healthy eyes were used to evaluate the performance of ETM, and 88 eyes were used to compare ETMs and corneal topography. The repeatability and reproducibility of ETMs in healthy subjects were assessed on the basis of 17 spatial zones derived from an 8-mm diameter corneal scan using within-subject standard deviation, test-retest repeatability, within-subject coefficient of variation (CoV), and intraclass correlation coefficient (ICC)., Results: The ICC for both repeatability and reproducibility of ETMs for the central sector was 0.95. The ICC value for the other sectors was only moderately lower. However, the CoV for repeatability (≤1.55%) was slightly higher than the value reported for the RTVue device (Optovue, Inc, Fremont, California, USA), for which a CoV in the central zone of 1.07% was reported in unoperated eyes. The superior quadrants were found to be the thinnest while the inferior ones were the thickest. ETMs and topography maps created from a single OCT measurement present a complementary image of the cornea., Conclusions: ETMs obtained using REVO NX show high levels of repeatability and reproducibility in normal eyes. Because the topographic and epithelial thickness analyses are performed using the same data, which means they are based on the exact same 3D corneal model, they do not require reciprocal centration and map matching. This ensures a complete point-to-point correlation between ETMs and corneal topography maps, which paints a fuller picture of a given pathology., Competing Interests: The author declares that he has no conflicts of interest and no commercial relationship with Optopol Technology and Oculus. Dr. Sikorski has provided clinical consultation to Optopol Technology, free of charge., (Copyright © 2022 Bartosz L. Sikorski.)

Fourier-domain full-field optical coherence tomography (FD-FF-OCT) is an emerging tool for high-speed eye imaging. However, cross-talk formation in images limits the imaging depth. To this end, we have recently shown that reducing spatial coherence with a fast deformable membrane can suppress the noise but over a limited axial range and with substantial data processing. Here, we demonstrate that a multimode fiber with carefully chosen parameters enables cross-talk-free imaging over a long axial range and without significant artifacts. We also show that it can be used to image the human retina and choroid in vivo with exceptional contrast.

BackgroundNoninvasive assessment of metabolic processes that sustain regeneration of human retinal visual pigments (visual cycle) is essential to improve ophthalmic diagnostics and to accelerate development of new treatments to counter retinal diseases. Fluorescent vitamin A derivatives, which are the chemical intermediates of these processes, are highly sensitive to UV light; thus, safe analyses of these processes in humans are currently beyond the reach of even the most modern ocular imaging modalities.MethodsWe present a compact, 2-photon-excited fluorescence scanning laser ophthalmoscope and spectrally resolved images of the human retina based on 2-photon excitation (TPE) with near-infrared light. A custom Er:fiber laser with integrated pulse selection, along with intelligent postprocessing of data, enables excitation with low laser power and precise measurement of weak signals.ResultsWe demonstrate spectrally resolved TPE fundus images of human subjects. Comparison of TPE data between human and mouse models of retinal diseases revealed similarity with mouse models that rapidly accumulate bisretinoid condensation products. Thus, visual cycle intermediates and toxic byproducts of this metabolic pathway can be measured and quantified by TPE imaging.ConclusionOur work establishes a TPE instrument and measurement method for noninvasive metabolic assessment of the human retina. This approach opens the possibility for monitoring eye diseases in the earliest stages before structural damage to the retina occurs.FundingNIH, Research to Prevent Blindness, Foundation for Polish Science, European Regional Development Fund, Polish National Agency for Academic Exchange, and Polish Ministry of Science and Higher Education.