Publications (35) View all
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Article: Detection of new-onset choroidal neovascularization using optical coherence tomography: the AMD DOC Study.
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ABSTRACT: To determine the sensitivity of time domain optical coherence tomography (OCT) in detecting conversion to neovascular age-related macular degeneration (AMD) in eyes at high risk for choroidal neovascularization (CNV), compared with detection using fluorescein angiography (FA) as the gold standard. Prospective, multicenter, observational study. Individuals aged ≥50 years with nonneovascular AMD at high risk of progressing to CNV in the study eye and evidence of neovascular AMD in the fellow eye. At study entry and every 3 months through 2 years, participants underwent best-corrected visual acuity, supervised Amsler grid testing, preferential hyperacuity perimetry (PHP) testing, stereoscopic digital fundus photographs with FA, and OCT imaging. A central Reading Center graded all images. The sensitivity of OCT in detecting conversion to neovascular AMD by 2 years, using FA as the reference standard. Secondary outcomes included comparison of sensitivity, specificity, positive predictive value, and negative predictive value of OCT, PHP, and supervised Amsler grid relative to FA for detecting incident CNV. A total of 98 participants were enrolled; 87 (89%) of these individuals either completed the 24-month visit or exited the study after developing CNV. Fifteen (17%) study eyes had incident CNV confirmed on FA by the Reading Center. The sensitivity of each modality for detecting CNV was: OCT 0.40 (95% confidence interval [CI], 0.16-0.68), supervised Amsler grid 0.42 (95% CI, 0.15-0.72), and PHP 0.50 (95% CI, 0.23-0.77). Treatment for incident CNV was recommended by the study investigator in 13 study eyes. Sensitivity of the testing modalities for detection of CNV in these 13 eyes was 0.69 (95% CI, 0.39-0.91) for OCT, 0.50 (95% CI, 0.19-0.81) for supervised Amsler grid, and 0.70 (95% CI, 0.35-0.93) for PHP. Specificity of the OCT was higher than that of the Amsler grid and PHP. Time-domain OCT, supervised Amsler grid, and PHP have low to moderate sensitivity for detection of new-onset CNV compared with FA. Optical coherence tomography has greater specificity than Amsler grid or PHP. Among fellow eyes of individuals with unilateral CNV, FA remains the best method to detect new-onset CNV.Ophthalmology 01/2012; 119(4):771-8. · 5.45 Impact Factor -
Article: Natural history of choroidal neovascularization in high myopia.
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ABSTRACT: High myopia, or pathologic myopia, usually refers to a condition in which individuals have greater than 6 diopters of myopia or an axial length greater than 26 to 27 mm. The natural history of choroidal neovascularization in high myopia is variable, and reports to date have some conflicting information, but analysis shows fairly poor final visual outcomes. This outcome complicates recommendations for treatment and must be considered in future studies aimed at managing this disease.Current Opinion in Ophthalmology 07/2001; 12(3):222-4. · 2.65 Impact Factor -
Article: The detection and quantification of retinopathy using digital angiograms
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ABSTRACT: An algorithm is presented for the analysis and quantification of the vascular structures of the human retina. Information about retinal blood vessel morphology is used in grading the severity and progression of a number of diseases. These disease processes are typically followed over relatively long time courses, and subjective analysis of the sequential images dictates the appropriate therapy for these patients. In this research, retinal fluorescein angiograms are acquired digitally in a 1024×1024 16-b image format and are processed using an automated vessel tracking program to identify and quantitate stenotic and/or tortuous vessel segments. The algorithm relies on a matched filtering approach coupled with a priori knowledge about retinal vessel properties to automatically detect the vessel boundaries, track the midline of the vessel, and extract useful parameters of clinical interest. By modeling the vessel profile using Gaussian functions, improved estimates of vessel diameters are obtained over previous algorithms. An adaptive densitometric tracking technique based on local neighborhood information is also used to improve computational performance in regions where the vessel is relatively straightIEEE Transactions on Medical Imaging 01/1995; · 3.64 Impact Factor -
Article: Laser treatment of choroidal neovascularization.
Seminars in Ophthalmology 04/1994; 9(1):10-22. · 0.90 Impact Factor -
Article: The detection and quantification of retinopathy using digital angiograms.
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ABSTRACT: An algorithm is presented for the analysis and quantification of the vascular structures of the human retina. Information about retinal blood vessel morphology is used in grading the severity and progression of a number of diseases. These disease processes are typically followed over relatively long time courses, and subjective analysis of the sequential images dictates the appropriate therapy for these patients. In this research, retinal fluorescein angiograms are acquired digitally in a 1024x1024 16-b image format and are processed using an automated vessel tracking program to identify and quantitate stenotic and/or tortuous vessel segments. The algorithm relies on a matched filtering approach coupled with a priori knowledge about retinal vessel properties to automatically detect the vessel boundaries, track the midline of the vessel, and extract useful parameters of clinical interest. By modeling the vessel profile using Gaussian functions, improved estimates of vessel diameters are obtained over previous algorithms. An adaptive densitometric tracking technique based on local neighborhood information is also used to improve computational performance in regions where the vessel is relatively straight.IEEE Transactions on Medical Imaging 02/1994; 13(4):619-26. · 3.64 Impact Factor
