Editorial Advances in Diagnostic Imaging Technologies to...
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Editorial Advances in Diagnostic Imaging Technologies to Evaluate the Retina and the Optic Disc Antonio Ferreras, 1,2 Michele Figus, 3 Paolo Frezzotti, 4 and Michele Iester 5 1 Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain 2 University of Zaragoza, 50009 Zaragoza, Spain 3 Department of Neurosciences, University of Pisa, 56100 Pisa, Italy 4 Department of Ophthalmology, University of Siena, 53100 Siena, Italy 5 Clinica Oculistica, DINOGMI, University of Genoa, 16132 Genoa, Italy Correspondence should be addressed to Antonio Ferreras; [email protected] Received 30 April 2015; Accepted 30 April 2015 Copyright © 2015 Antonio Ferreras et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Current diagnostic and therapeutic decisions based on the outcomes of imaging technologies have become a common practice in every ophthalmic subspecialty. New devices and tools for evaluating the retina and optic nerve head, such as scanning laser polarimetry and spectral-domain optical coherence tomography (OCT), are widely used in clinical practice. ese technologies provide objective quantitative measurements and in vivo real-time images of ocular struc- tures. e performance of imaging devices is continuously being improved, and thus knowledge of their applica- tions, advantages, and limitations must also be continuously updated to optimize their management by clinicians. While imaging technologies require relatively transparent media, the variability of the measurements acquired by these devices is low, making these instruments useful for monitor- ing changes over time. In this issue, M. Ara et al. report excel- lent reproducibility of scanning laser polarimetry in healthy and glaucoma patients. In their review article, J. J. Garcia- Medina et al. evaluated the effects of posterior capsule opaci- fication and found that image quality improves aſter capsu- lotomy, but a new baseline for future comparisons should be established. Additionally, R. L. Brautaset et al. report that OCT allows for the acquisition of reliable macular measure- ments in individuals with moderate to severe keratoconus. M. Cavallari et al. developed a semiautomated, computer- based method to detect and quantify retinal vessel abnor- malities by analyzing digital fundus photographs. is tool was successfully used to evaluate patients with hypertensive retinopathy and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. G. S. K. Yau et al. compared central macular thickness measured by OCT in Chinese children and found that it was thicker in myopic eyes compared to emmetropic and hyperopic eyes. ree papers regarding the role of the ganglion cell complex in different disorders, multiple sclerosis, age-related macular degeneration, and glaucoma, demonstrated that the same tool could be used with different approaches depending on the disease: “Comparative Diagnostic Accuracy of Gan- glion Cell-Inner Plexiform and Retinal Nerve Fiber Layer ickness Measures by Cirrus and Spectralis Optical Coher- ence Tomography in Relapsing-Remitting Multiple Sclerosis” by J. J. Gonzalez-Lopez et al.; “Can Variability of Pattern ERG Signal Help to Detect Retinal Ganglion Cells Dysfunction in Glaucomatous Eyes?” by A. Mavilio et al.; and “Ganglion Cell Complex Evaluation in Exudative Age-Related Mac- ular Degeneration aſter Repeated Intravitreal Injections of Ranibizumab” by A. Perdicchi et al. J. J. Gonzalez-Lopez et al. observed a better sensitivity-specificity balance for the mac- ular ganglion cell complex measured with OCT in relapsing- remitting multiple sclerosis than peripapillary retinal nerve fiber layer thickness, while A. Mavilio et al. found that reduction of the ganglion cell complex was related to reduced amplitude and increased variability of the phase of the Hindawi Publishing Corporation BioMed Research International Volume 2015, Article ID 371312, 2 pages http://dx.doi.org/10.1155/2015/371312
Transcript of Editorial Advances in Diagnostic Imaging Technologies to...
EditorialAdvances in Diagnostic Imaging Technologies toEvaluate the Retina and the Optic Disc
Antonio Ferreras,1,2 Michele Figus,3 Paolo Frezzotti,4 and Michele Iester5
1Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain2University of Zaragoza, 50009 Zaragoza, Spain3Department of Neurosciences, University of Pisa, 56100 Pisa, Italy4Department of Ophthalmology, University of Siena, 53100 Siena, Italy5Clinica Oculistica, DINOGMI, University of Genoa, 16132 Genoa, Italy
Correspondence should be addressed to Antonio Ferreras; [email protected]
Received 30 April 2015; Accepted 30 April 2015
Copyright © 2015 Antonio Ferreras et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.
Current diagnostic and therapeutic decisions based on theoutcomes of imaging technologies have become a commonpractice in every ophthalmic subspecialty. New devices andtools for evaluating the retina and optic nerve head, suchas scanning laser polarimetry and spectral-domain opticalcoherence tomography (OCT), are widely used in clinicalpractice. These technologies provide objective quantitativemeasurements and in vivo real-time images of ocular struc-tures. The performance of imaging devices is continuouslybeing improved, and thus knowledge of their applica-tions, advantages, and limitations must also be continuouslyupdated to optimize their management by clinicians.
While imaging technologies require relatively transparentmedia, the variability of the measurements acquired by thesedevices is low, making these instruments useful for monitor-ing changes over time. In this issue, M. Ara et al. report excel-lent reproducibility of scanning laser polarimetry in healthyand glaucoma patients. In their review article, J. J. Garcia-Medina et al. evaluated the effects of posterior capsule opaci-fication and found that image quality improves after capsu-lotomy, but a new baseline for future comparisons shouldbe established. Additionally, R. L. Brautaset et al. report thatOCT allows for the acquisition of reliable macular measure-ments in individuals with moderate to severe keratoconus.
M. Cavallari et al. developed a semiautomated, computer-based method to detect and quantify retinal vessel abnor-malities by analyzing digital fundus photographs. This tool
was successfully used to evaluate patients with hypertensiveretinopathy and cerebral autosomal dominant arteriopathywith subcortical infarcts and leukoencephalopathy.
G. S. K. Yau et al. compared central macular thicknessmeasured by OCT in Chinese children and found that itwas thicker in myopic eyes compared to emmetropic andhyperopic eyes.
Three papers regarding the role of the ganglion cellcomplex in different disorders, multiple sclerosis, age-relatedmacular degeneration, and glaucoma, demonstrated that thesame tool could be used with different approaches dependingon the disease: “Comparative Diagnostic Accuracy of Gan-glion Cell-Inner Plexiform and Retinal Nerve Fiber LayerThickness Measures by Cirrus and Spectralis Optical Coher-ence Tomography in Relapsing-RemittingMultiple Sclerosis”by J. J. Gonzalez-Lopez et al.; “Can Variability of Pattern ERGSignal Help to Detect Retinal Ganglion Cells Dysfunctionin Glaucomatous Eyes?” by A. Mavilio et al.; and “GanglionCell Complex Evaluation in Exudative Age-Related Mac-ular Degeneration after Repeated Intravitreal Injections ofRanibizumab” by A. Perdicchi et al. J. J. Gonzalez-Lopez et al.observed a better sensitivity-specificity balance for the mac-ular ganglion cell complex measured with OCT in relapsing-remitting multiple sclerosis than peripapillary retinal nervefiber layer thickness, while A. Mavilio et al. found thatreduction of the ganglion cell complex was related to reducedamplitude and increased variability of the phase of the
Hindawi Publishing CorporationBioMed Research InternationalVolume 2015, Article ID 371312, 2 pageshttp://dx.doi.org/10.1155/2015/371312
2 BioMed Research International
steady-state pattern electroretinogram in glaucoma. On theother hand, A. Perdicchi et al. demonstrated that the loadingphase for ranibizumab in aged-related macular degenerationhad no toxic effects on the ganglion cell complex.
R. Mastropasqua et al. and M. Di Nicola et al. providereviews regarding advanced morphologic and functionalmagnetic resonance techniques in glaucoma and functionaland structural abnormalities in deferoxamine retinopathy,respectively. Information concerning magnetic resonanceimaging in glaucoma is limited and mostly based on mousemodels and patients with advanced glaucoma. Nevertheless,some results support the potential for these techniques todetect early glaucomatous changes. M. Di Nicola et al.revealed that imaging technologies (color fundus photo-graphs, autofluorescence, and OCT) may facilitate the man-agement of deferoxamine retinopathy and their report high-lights the need for guidelines to enhance the diagnosis andfollow-up of these patients.
A wide variety of image modalities and optic enhance-ments, including fundus autofluorescence, microperimetry,adaptive optics, or faster OCTs, recently emerged. Using dif-ferent imagemodalities, clinicians can emphasize the featuresof a particular anatomic structure of a tissue. M. Bertolottoet al. evaluated various paracentral hyperautofluorescenceretinal patterns and their relationship with changes in theretinal layers. Hyperautofluorescence was mainly related toa “window effect” rather than an accumulation of lipofuscin.Adaptive optics combined with OCT or fundus photographyallow for high-resolution images due to the improvementin lateral resolution by correcting for aberrations in theeye. This technology reaches resolutions close to 2 to 4𝜇m,which is high enough to identify even cone photoreceptors.D. Supriya et al. report strong correlations between retinalsensitivity, evaluated by microperimetry, and the mean conepacking density at different macular eccentricities measuredwith an adaptive optics retinal camera. Further studies arerequired, however, to determine normative variations in conestructure-function correlation.
OCT has changed many protocols and ways of manag-ing different ocular diseases. Moreover, OCT has modifiedhow clinicians look at the retina. The assessment of retinalabnormalities based on evaluation of every layer rather thanthe global thickness has advanced ophthalmology. Becauseimages evaluated through OCT provide information of theactual retina anatomy, but not exactly the same informationas obtained with histology; last year an international panelof experts in vitreoretinal diseases and imaging suggested aconsensus nomenclature for the classification of retinal andchoroidal layers and bands observed in OCT scans (IN∙OCTconsensus). P. Tortorella et al. evaluated the changes intwo of these retinal layers, the photoreceptor inner segmentellipsoid band and the interdigitation zone, in eyes withuveiticmacular edema. Interruption of these lines was relatedto poor visual acuity. R. L.M.Wong et al. report that the outerretinal layer thickness (distance between the external limitingmembrane and retinal pigment epithelium) correlated betterthan total thickness with visual acuity in patients withdiabetic macular edema.
In summary, this issue includes different points of viewpresented by diverse authors covering several topics related toadvances in imaging techniques for ophthalmic diseases.Thispublication will provide valuable information that should behelpful in clinical practice.
Antonio FerrerasMichele Figus
Paolo FrezzottiMichele Iester
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