Review of En-Face Choroidal Imaging Using Spectral-Domain Optical Coherence Tomography

Investigations of choroidal vasculature have been of particular interest given choroidal vascular dysfunction are thought to be related with a number pathologic conditions such as central serous chorioretinopathy and various forms of AMD, including polypoidal choroidal vasculopathy. On the other hand, en face imaging of the choroid allows an exceptional alternative to histopathologic evaluation of the choroid, and can be used to quantify choroidal vascular structures. Our former study verified differences in the macular choroid in AMD and control patients previously noted on histopathologic studies. The use of phase-resolved approaches in larger population longitudinal studies reveal the sequence of RPE and choroidal changes in the pathogenesis of various AMD subtypes, which cannot be done using histopathology. Issues with lateral resolution of the OCT system in measuring choriocapillaris size could be solved by incorporating the axial dimension of the choriocapillaris into choriocapilaris diameter assessment (assuming the choriocapillaris are round in vivo), and by correcting for anisometric pixel resolution. Forthcoming studies are required to determine whether areas of choriocapillaris correlate with areas of RPD lesions

The Effectiveness if the Intervention Programming the Framework of Professional General Practice to Educate Social Workers Working in the Elderly Patients Field Treated for Alzheimer 'sand Their Families

There are changes associated with aging, including deficiencies in mental capacity and lack of emotional balance and diseases of aging like Alzheimer which is lackof mental capacity and functional brain disorder Patient social care has a direct impact on the worsening condition of the patient; where studies indicated that patient care delays the worsening of their health status.Social work isgenerally regardedas one of the professionsthat cares for and looks after elderly and their families in cases of wellness and illness.Social worker plays an important role in helping patient family to deal with problems arising from the disease as well as guiding the family to join psychological and social support groups in order to help them toovercome their problems.The general practice in social work could have effective results whensocial workers dealwith Alzheimer's patient’s families.Social work is considered one of the recent trends. It is an applied trend dealing with all patterns and by applyingthis trendon social workers working in elderly fieldcould achieve two objectives.The first objective istrainingsocial workers to use this trend with all clientsgenerally and the objective is training them to apply itonthe patient families particularly.Hence, problem of the study is identified as: effectiveness testing of general practice utilization in social work for raising the awareness of social workers working in the field ofelderlypatientstreatedforAlzheimer'sand patient social caremethod. Keywords: Professional intervention - Alzheimer – effectiveness – awareness - general practice.

Optical Coherence Tomographic Angiography Imaging in Age-Related Macular Degeneration.

Optical coherence tomographic angiography (OCTA) is emerging as a rapid, noninvasive imaging modality that can provide detailed structural and flow information on retinal and choroidal vasculature. This review contains an introduction of OCTA and summarizes the studies to date on OCTA imaging in age-related macular degeneration

Review of En-Face Choroidal Imaging Using Spectral-Domain Optical Coherence Tomography

Investigations of choroidal vasculature have been of particular interest given choroidal vascular dysfunction are thought to be related with a number pathologic conditions such as central serous chorioretinopathy and various forms of AMD, including polypoidal choroidal vasculopathy. On the other hand, en face imaging of the choroid allows an exceptional alternative to histopathologic evaluation of the choroid, and can be used to quantify choroidal vascular structures. Our former study verified differences in the macular choroid in AMD and control patients previously noted on histopathologic studies. The use of phase-resolved approaches in larger population longitudinal studies reveal the sequence of RPE and choroidal changes in the pathogenesis of various AMD subtypes, which cannot be done using histopathology. Issues with lateral resolution of the OCT system in measuring choriocapillaris size could be solved by incorporating the axial dimension of the choriocapillaris into choriocapilaris diameter assessment (assuming the choriocapillaris are round in vivo), and by correcting for anisometric pixel resolution. Forthcoming studies are required to determine whether areas of choriocapillaris correlate with areas of RPD lesions

A combined method to quantify the retinal metabolic rate of oxygen using photoacoustic ophthalmoscopy and optical coherence tomography

Quantitatively determining physiological parameters at a microscopic level in the retina furthers the understanding of the molecular pathways of blinding diseases, such as diabetic retinopathy and glaucoma. An essential parameter, which has yet to be quantified noninvasively, is the retinal oxygen metabolic rate (rMRO(2)). Quantifying rMRO(2) is challenging because two parameters, the blood flow rate and hemoglobin oxygen saturation (sO(2)), must be measured together. We combined photoacoustic ophthalmoscopy (PAOM) with spectral domain-optical coherence tomography (SD-OCT) to tackle this challenge, in which PAOM measured the sO(2) and SD-OCT mapped the blood flow rate. We tested the integrated system on normal wild-type rats, in which the measured rMRO(2) was 297.86 +/- 70.23 nl/minute. This quantitative method may shed new light on both fundamental research and clinical care in ophthalmology in the future

Recovery of macular pigment spectrum in vivo using hyperspectral image analysis

We investigated the feasibility of a novel method for hyperspectral mapping of macular pigment (MP) in vivo. Six healthy subjects were recruited for noninvasive imaging using a snapshot hyperspectral system. The three-dimensional full spatial-spectral data cube was analyzed using non-negative matrix factorization (NMF), wherein the data was decomposed to give spectral signatures and spatial distribution, in search for the MP absorbance spectrum. The NMF was initialized with the in vitro MP spectrum and rank 4 spectral signature decomposition was used to recover the MP spectrum and optical density in vivo. The recovered MP spectra showed two peaks in the blue spectrum, characteristic of MP, giving a detailed in vivo demonstration of these absorbance peaks. The peak MP optical densities ranged from 0.08 to 0.22 (mean 0.15+/−0.05) and became spatially negligible at diameters 1100 to 1760 μm (4 to 6 deg) in the normal subjects. This objective method was able to exploit prior knowledge (the in vitro MP spectrum) in order to extract an accurate in vivo spectral analysis and full MP spatial profile, while separating the MP spectra from other ocular absorbers. Snapshot hyperspectral imaging in combination with advanced mathematical analysis provides a simple cost-effective approach for MP mapping in vivo

Dark hypopyon in Streptococcus bovis endogenous endophthalmitis: clinicopathologic correlations

# The Author(s) 2010. This article is published with open access at Springerlink.com Purpose The aim of this report is to present a previously unreported causative organism associated with brownpigmented hypopyon in a patient with endophthalmitis. Methods This is a retrospective case report which includes clinicopathologic correlations. Results Vitreous cultures demonstrated Streptococcus bovis infection resulting in a brown-pigmented hypopyon, with uveal pigment found intra- and extracellularly on pathologic examination of the pupillary membrane. Conclusions S. bovis endophthalmitis may be a cause of dark hypopyon, especially in patients with a history of liver disease, and, when identified, warrants colonoscopy and cardiac workup. Keywords Streptococcus bovis. Brown/dark hypopyon

Idiopathic multifocal choroiditis/punctate inner choroidopathy with acute photoreceptor loss or dysfunction out of proportion to clinically visible lesions.

PURPOSE To report acute/subacute vision loss and paracentral scotomata in patients with idiopathic multifocal choroiditis/punctate inner choroidopathy due to large zones of acute photoreceptor attenuation surrounding the chorioretinal lesions. METHODS Multimodal imaging case series. RESULTS Six women and 2 men were included (mean age, 31.5 ± 5.8 years). Vision ranged from 20/20-1 to hand motion (mean, 20/364). Spectral domain optical coherence tomography demonstrated extensive attenuation of the external limiting membrane, ellipsoid and interdigitation zones, adjacent to the visible multifocal choroiditis/punctate inner choroidopathy lesions. The corresponding areas were hyperautofluorescent on fundus autofluorescence and were associated with corresponding visual field defects. Full-field electroretinogram (available in three cases) showed markedly decreased cone/rod response, and multifocal electroretinogram revealed reduced amplitudes and increased implicit times in two cases. Three patients received no treatment, the remaining were treated with oral corticosteroids (n = 4), oral acyclovir/valacyclovir (n = 2), intravitreal/posterior subtenon triamcinolone acetate (n = 3), and anti-vascular endothelial growth factor (n = 2). Visual recovery occurred in only three cases of whom two were treated. Varying morphological recovery was found in six cases, associated with decrease in hyperautofluorescence on fundus autofluorescence. CONCLUSION Multifocal choroiditis/punctate inner choroidopathy can present with transient or permanent central photoreceptor attenuation/loss. This presentation is likely a variant of multifocal choroiditis/punctate inner choroidopathy with chorioretinal atrophy. Associated changes are best evaluated using multimodal imaging