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1.  Ultrahigh resolution optical coherence tomography in non‐exudative age related macular degeneration 
Aim
To describe the appearance of the non‐exudative forms of age related macular degeneration (AMD) as imaged by ultrahigh resolution optical coherence tomography (UHR‐OCT).
Methods
A UHR‐OCT ophthalmic imaging system, which utilises a femtosecond laser light source capable of ∼3 μm axial resolution, was employed to obtain retinal cross sectional images of patients with non‐exudative AMD. Observational studies of the resulting retinal images were performed.
Results
52 eyes of 42 patients with the clinical diagnosis of non‐exudative AMD were imaged using the UHR‐OCT system. 47 of the 52 (90%) eyes had the clinical diagnosis of drusen and/or retinal pigment epithelial (RPE) changes. In these patients, three patterns of drusen were apparent on UHR‐OCT: (1) distinct RPE excrescences, (2) a saw toothed pattern of the RPE, and (3) nodular drusen. On UHR‐OCT, three eyes (6%) with a clinical diagnosis of non‐exudative AMD had evidence of fluid under the retina or RPE. Two of these three patients had findings suspicious for subclinical choroidal neovascularisation on UHR‐OCT.
Conclusion
With the increased resolution of UHR‐OCT compared to standard OCT, the involvement of the outer retinal layers are more clearly defined. UHR‐OCT may allow for the detection of early exudative changes not visible clinically or by angiography.
doi:10.1136/bjo.2005.076612
PMCID: PMC1860181  PMID: 16424532
ultra high resolution optical coherence tomography; age related macular degeneration; drusen
2.  Ultrahigh resolution optical coherence tomography in non-exudative age related macular degeneration 
Aim
To describe the appearance of the non-exudative forms of age related macular degeneration (AMD) as imaged by ultrahigh resolution optical coherence tomography (UHR-OCT).
Methods
A UHR-OCT ophthalmic imaging system, which utilises a femtosecond laser light source capable of ~3 μm axial resolution, was employed to obtain retinal cross sectional images of patients with non-exudative AMD. Observational studies of the resulting retinal images were performed.
Results
52 eyes of 42 patients with the clinical diagnosis of non-exudative AMD were imaged using the UHR-OCT system. 47 of the 52 (90%) eyes had the clinical diagnosis of drusen and/or retinal pigment epithelial (RPE) changes. In these patients, three patterns of drusen were apparent on UHR-OCT: (1) distinct RPE excrescences, (2) a saw toothed pattern of the RPE, and (3) nodular drusen. On UHR-OCT, three eyes (6%) with a clinical diagnosis of non-exudative AMD had evidence of fluid under the retina or RPE. Two of these three patients had findings suspicious for subclinical choroidal neovascularisation on UHR-OCT.
Conclusion
With the increased resolution of UHR-OCT compared to standard OCT, the involvement of the outer retinal layers are more clearly defined. UHR-OCT may allow for the detection of early exudative changes not visible clinically or by angiography.
doi:10.1136/bjo.2005.076612
PMCID: PMC1860181  PMID: 16424532
3.  The International Intravitreal Bevacizumab Safety Survey: using the internet to assess drug safety worldwide 
The British Journal of Ophthalmology  2006;90(11):1344-1349.
Aim
Off‐label intravitreal injections of bevacizumab (Avastin) have been given for the treatment of neovascular and exudative ocular diseases since May 2005. Since then, the use of intravitreal bevacizumab has spread worldwide, but the drug‐related adverse events associated with its use have been reported only in a few retrospective reviews. The International Intravitreal Bevacizumab Safety Survey was initiated to gather timely information regarding adverse events from doctors around the world via the internet.
Methods
An internet‐based survey was designed to identify adverse events associated with intravitreal bevacizumab treatment. The survey web address was disseminated to the international vitreoretinal community via email. Rates of adverse events were calculated from participant responses.
Results
70 centres from 12 countries reported on 7113 injections given to 5228 patients. Doctor‐reported adverse events included corneal abrasion, lens injury, endophthalmitis, retinal detachment, inflammation or uveitis, cataract progression, acute vision loss, central retinal artery occlusion, subretinal haemorrhage, retinal pigment epithelium tears, blood pressure elevation, transient ischaemic attack, cerebrovascular accident and death. None of the adverse event rates exceeded 0.21%.
Conclusion
Intravitreal bevacizumab is being used globally for ocular diseases. Self‐reporting of adverse events after intravitreal bevacizumab injections did not show an increased rate of potential drug‐related ocular or systemic events. These short‐term results suggest that intravitreal bevacizumab seems to be safe.
doi:10.1136/bjo.2006.099598
PMCID: PMC1857484  PMID: 16854824
4.  Projection OCT fundus imaging for visualising outer retinal pathology in non-exudative age-related macular degeneration 
Aims
To demonstrate ultrahigh-resolution, three-dimensional optical coherence tomography (3D-OCT) and projection OCT fundus imaging for enhanced visualisation of outer retinal pathology in non-exudative age-related macular degeneration (AMD).
Methods
A high-speed, 3.5 μm resolution OCT prototype instrument was developed for the ophthalmic clinic. Eighty-three patients with non-exudative AMD were imaged. Projection OCT fundus images were generated from 3D-OCT data by selectively summing different retinal depth levels. Results were compared with standard ophthalmic examination, including fundus photography and fluorescein angiography, when indicated.
Results
Projection OCT fundus imaging enhanced the visualisation of outer retinal pathology in non-exudative AMD. Different types of drusen exhibited distinct features in projection OCT images. Photoreceptor disruption was indicated by loss of the photoreceptor inner/outer segment (IS/OS) boundary and external limiting membrane (ELM). RPE atrophy can be assessed using choroid-level projection OCT images.
Conclusions
Projection OCT fundus imaging facilities rapid interpretation of large 3D-OCT data sets. Projection OCT enhances contrast and visualises outer retinal pathology not visible with standard fundus imaging or OCT fundus imaging. Projection OCT fundus images enable registration with standard ophthalmic diagnostics and cross-sectional OCT images. Outer retinal alterations can be assessed and drusen morphology, photoreceptor impairment and pigmentary abnormalities identified.
doi:10.1136/bjo.2007.136101
PMCID: PMC2743133  PMID: 18662918

Results 1-4 (4)