Heidelberg eye explorer

The presence of β-PPA was based on the results of enhanced depth imaging OCT scanning of the optic disc and infrared fundus images obtained by Spectralis OCT (Fig. 1B). A potential magnification error was removed by entering the corneal curvature of each eye into the Spectralis OCT system before scanning. The PPA can be divided into areas with Bruch's membrane (BM) and underlying choroid (β-zone) and areas devoid of BM and choroidal tissue (γ-zone). This study only included eyes without any type of PPA (PPA- group) and those with a β-zone of horizontal width of more than 200 µm on at least one scan (PPA+ group).¹⁸ (link) Eyes with PPA of longest horizontal width between 0 and 200 µm were not included in either group. When PPA+ group had a γ-zone of longest horizontal width of more than 100 µm, those eyes were excluded. In our experience, these criteria are best for differentiating β- and γ-zones, and characterizing the differences in clinical nature and rate of glaucoma progression between the groups.¹⁸ (link)^,20 (link) The horizontal width of the β-zone was manually measured using the built-in caliper tool of the Spectralis OCT system (Heidelberg Eye Explorer software version 1.7.0.0; Heidelberg Engineering). Only eyes with acceptable scans and good-quality images (i.e., quality score of ≥15) were included in the analysis.

SD-OCT images were obtained with a Spectralis^® OCT machine (Spectralis^® Family Acquisition Module, version 4.0.2.0; Heidelberg Engineering) and Heidelberg Eye Explorer (version 1.6.1.0; Heidelberg Engineering) before induction therapy and every month thereafter. Horizontal and vertical scans of the macula were recorded for each eye. The measurements were performed under pupillary dilation. CRT was defined as the distance between the vitreoretinal border and the edge of the retinal pigment epithelial cells. We determined the presence or absence of pigment epithelial detachment (PED), IRF, and SRF. These procedures were performed within a foveal area of 1.8-mm diameters, which is considered to be the macula.15 VA was measured with a Landolt C chart and then converted to a logarithm of the minimum angle of resolution (logMAR) equivalent. Clinical characteristics, including age, sex, greatest linear dimension (GLD), and disease subtypes such as typical AMD, polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation, were also reviewed and analyzed. We also studied the possible pretreatment factors (age, sex, subtype, VA, CRT, GLD, PED, IRF, SRF, and treatment history) that would affect the response to or dependence on aflibercept.

The primary end point was defined as the change in size of retinal neovascularization (NVD and NVE) from baseline to 24 weeks of follow-up. All retinal neovascularizations were included in case they could be imaged by FA at baseline and Week 24. Images until 2 minutes were used to evaluate neovascularizations planimetrically. The planimetrical tool of the Heidelberg Eye Explorer (version 1.7.1.0; Heidelberg Engineering) was used to measure the total area of NVE/NVD in square millimeters. Regression of DME comparing baseline and Week 24 was one of the secondary end points being assessed by spectral domain OCT (512 A-scans, 20 × 15°) using parameters, such as foveal central point, foveal central subfield thickness, and total macular volume. In addition, the change in BCVA from baseline to 24 weeks and number of additional PRP were evaluated. Because canakinumab treatment was given systemically, HbA1c levels, systemic inflammatory markers (IL-6, IL-8, TNFα, hs-CRP, and serum amyloid A), and lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride) from baseline (Day 0 predose) to Week 24 were analyzed.