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Qiu B, Zhao L, Zhang X, Wang Y, Wang Q, Nie Y, Chen X, Cheung CYL. Associations Between Diabetic Retinal Microvasculopathy and Neuronal Degeneration Assessed by Swept-Source OCT and OCT Angiography. Front Med (Lausanne) 2021; 8:778283. [PMID: 34957152 PMCID: PMC8703043 DOI: 10.3389/fmed.2021.778283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To provide clinical evidence of the associations between retinal neuronal degeneration and microvasculopathy in diabetic retinopathy (DR). Methods: This case-control study included 76 patients (76 eyes) with type 2 diabetes mellitus (DM), and refraction error between -3.0 and +3.0 D. The eyes were assigned into DM (without DR), non-proliferative DR (NPDR), and proliferative DR (PDR) groups. Age-, sex-, and refractive error-matched normal subjects were enrolled as controls. The mean retinal thickness (mRT), the relative mean thickness of the retinal nerve fiber layer (rmtRNFL, mtRNFL/mRT), ganglion cell layer (rmtGCL), ganglion cell complex (rmtGCC) layer, foveal avascular zone area (FAZa), FAZ perimeter (FAZp), FAZ circularity index (FAZ-CI), and vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP) were assessed by swept-source optical coherence tomography (OCT) and OCT angiography (OCTA). Group comparison and Spearman's partial correlation coefficient analysis were applied to evaluate the correlation between these morphological parameters. Results: rmtRNFL, FAZa, and FAZp in SCP and DCP increased with the DR severity (p rmtRNFL < 0.001; p FAZa, SCP = 0.001; p FAZa , DCP = 0.005; p FAZp , SCP < 0.001; p FAZp , DCP < 0.001). The rmtGCL, FAZ-CI in SCP and DCP, and VD in DCP decreased with the DR severity (p rmtGCL = 0.002, p FAZ-CI , SCP = 0.002; p FAZ-CI, DCP < 0.001, p VD , DCP < 0.001). After controlling age, sex, duration of diabetes, and hypertension, the rmtRNFL, FAZa in SCP and DCP, and FAZp in SCP and DCP were correlated with the severity of DR (p < 0.05), while VD in SCP and DCP, FAZ-CI, and rmtGCL were negatively correlated with the severity of DR (p < 0.05). The rmtGCL was negatively correlated with the FAZa in SCP (r = -0.34, p = 0.002) and DCP (r = -0.23, p = 0.033), and FAZp in SCP (r = -0.37, p = 0.001) and DCP (r = -0.32, p = 0.003), but positively correlated with VD in SCP (r = 0.26, p = 0.016), VD in DCP (r = 0.28, p = 0.012), and FAZ-CI in DCP (r = 0.31, p = 0.006). Conclusions: rmtRNFL, FAZ-CI in SCP and DCP, and FAZp in SCP are strong predictors of the severity of DR. The ganglion cell body loss is highly correlated with increased FAZp and FAZa, decreased FAZ-CI, and reduced VD with the severity of DR.
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Affiliation(s)
- Bingjie Qiu
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Retinal Choroidal Vascular Diseases Study Group
| | - Lin Zhao
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xinyuan Zhang
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Retinal Choroidal Vascular Diseases Study Group
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences & School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Qiyun Wang
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Retinal Choroidal Vascular Diseases Study Group
| | - Yao Nie
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Retinal Choroidal Vascular Diseases Study Group
| | - Xiaosi Chen
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Retinal Choroidal Vascular Diseases Study Group
| | - Carol Y L Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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Feng Z, Wang G, Xia H, Li M, Liang G, Dong T, Xiao P, Yuan J. Macular Vascular Geometry Changes With Sex and Age in Healthy Subjects: A Fundus Photography Study. Front Med (Lausanne) 2021; 8:778346. [PMID: 34977079 PMCID: PMC8714757 DOI: 10.3389/fmed.2021.778346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To characterize the sex- and age-related alterations of the macular vascular geometry in a population of healthy eyes using fundus photography. Methods: A cross-sectional study was conducted with 610 eyes from 305 healthy subjects (136 men, 169 women) who underwent fundus photography examination and was divided into four age groups (G1 with age ≤ 25 years, G2 with age 26–35 years, G3 with age 36–45 years, and G4 with age ≥ 46 years). A self-developed automated retinal vasculature analysis system allowed segmentation and separate multiparametric quantification of the macular vascular network according to the Early Treatment Diabetic Retinopathy Study (ETDRS). Vessel fractal dimension (Df), vessel area rate (VAR), average vessel diameter (Dm), and vessel tortuosity (τn) were acquired and compared between sex and age groups. Results: There was no significant difference between the mean age of male and female subjects (32.706 ± 10.372 and 33.494 ± 10.620, respectively, p > 0.05) and the mean age of both sexes in each age group (p > 0.05). The Df, VAR, and Dm of the inner ring, the Df of the outer ring, and the Df and VAR of the whole macula were significantly greater in men than women (p < 0.001, p < 0.001, p < 0.05, respectively). There was no significant change of τn between males and females (p > 0.05). The Df, VAR, and Dm of the whole macula, the inner and outer rings associated negatively with age (p < 0.001), whereas the τn showed no significant association with age (p > 0.05). Comparison between age groups observed that Df started to decrease from G2 compared with G1 in the inner ring (p < 0.05) and Df, VAR, and Dm all decreased from G3 compared with the younger groups in the whole macula, inner and outer rings (p < 0.05). Conclusion: In the healthy subjects, macular vascular geometric parameters obtained from fundus photography showed that Df, VAR, and Dm are related to sex and age while τn is not. The baseline values of the macular vascular geometry were also acquired for both sexes and all age groups.
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Affiliation(s)
- Ziqing Feng
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Gengyuan Wang
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Honghui Xia
- Department of Ophthalmology, Zhaoqing Gaoyao People's Hospital, Zhaoqing, China
| | - Meng Li
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Guoxia Liang
- Department of Ophthalmology, Zhaoqing Gaoyao People's Hospital, Zhaoqing, China
| | - Tingting Dong
- Department of Ophthalmology, Zhaoqing Gaoyao People's Hospital, Zhaoqing, China
| | - Peng Xiao
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Peng Xiao
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Jin Yuan
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Diabetic macular ischaemia- a new therapeutic target? Prog Retin Eye Res 2021; 89:101033. [PMID: 34902545 DOI: 10.1016/j.preteyeres.2021.101033] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/21/2022]
Abstract
Diabetic macular ischaemia (DMI) is traditionally defined and graded based on the angiographic evidence of an enlarged and irregular foveal avascular zone. However, these anatomical changes are not surrogate markers for visual impairment. We postulate that there are vascular phenotypes of DMI based on the relative perfusion deficits of various retinal capillary plexuses and choriocapillaris. This review highlights several mechanistic pathways, including the role of hypoxia and the complex relation between neurons, glia, and microvasculature. The current animal models are reviewed, with shortcomings noted. Therefore, utilising the advancing technology of optical coherence tomography angiography (OCTA) to identify the reversible DMI phenotypes may be the key to successful therapeutic interventions for DMI. However, there is a need to standardise the nomenclature of OCTA perfusion status. Visual acuity is not an ideal endpoint for DMI clinical trials. New trial endpoints that represent disease progression need to be developed before irreversible vision loss in patients with DMI. Natural history studies are required to determine the course of each vascular and neuronal parameter to define the DMI phenotypes. These DMI phenotypes may also partly explain the development and recurrence of diabetic macular oedema. It is also currently unclear where and how DMI fits into the diabetic retinopathy severity scales, further highlighting the need to better define the progression of diabetic retinopathy and DMI based on both multimodal imaging and visual function. Finally, we discuss a complete set of proposed therapeutic pathways for DMI, including cell-based therapies that may provide restorative potential.
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Xiang L, Zhou Y, Chen Y, Jiang S, Fei C, Wang Y, Bai Y, Zhang X, Li K, Shen X. Assessment of the retinal vasculature in healthy Chinese preschool children aged 4-6 years old using optical coherence tomography angiography. BMC Ophthalmol 2021; 21:415. [PMID: 34856943 PMCID: PMC8638475 DOI: 10.1186/s12886-021-02154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4-6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. METHODS In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. RESULTS A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. CONCLUSIONS Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.
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Affiliation(s)
- Lu Xiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yingming Zhou
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yanwei Chen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Siyu Jiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Chunli Fei
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yangyang Wang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yang Bai
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xuan Zhang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Kai Li
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China.
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Ko CK, Huang KI, Su FY, Ko ML. Vessel Density in the Macular and Peripapillary Areas in Preperimetric Glaucoma to Various Stages of Primary Open-Angle Glaucoma in Taiwan. J Clin Med 2021; 10:jcm10235490. [PMID: 34884191 PMCID: PMC8658219 DOI: 10.3390/jcm10235490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 01/19/2023] Open
Abstract
Peripapillary and macular vessel density (VD) are reduced in myopic non-glaucomatous eyes, the dynamic range of VD may be decreased by myopia, and whether VD measurement has the potential in differentiating stages of glaucoma severity in patients with myopic glaucoma remains questionable. This observational, cross-sectional study aimed to clarify the changes in peripapillary and macular VDs in preperimetric glaucoma (PPG) and primary open-angle glaucoma in the early, moderate, and late stages. A total of 1228 eyes from 661 participants (540 normal, 67 PPG, and 521 glaucomatous) were included. Participants underwent free blood tests at the internal medicine clinic to retrieve systemic data. Patients with glaucoma were grouped by disease severity, defined by glaucomatous visual field mean defect, including early-(224 eyes), moderate-(103 eyes), and late-stage glaucoma (194 eyes), and further divided into advanced (158 eyes) and terminal glaucoma (36 eyes). Macular VD, peripapillary VD, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and ganglion cell complex (GCC) thickness were evaluated and divided into superior and inferior parts. One-way analysis of variance was performed, followed by Tukey’s post-hoc test. The peripapillary VD was significantly different between the healthy and PPG groups and the early-, moderate-, and late-stage glaucoma subgroups (all p < 0.001). Peripapillary VD measurements are helpful in differentiating the various stages of glaucoma even in patients with myopic glaucoma.
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Affiliation(s)
- Chung-Kuang Ko
- Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kuan-I Huang
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan;
| | - Fang-Ying Su
- Institute of Statistics, National Chiao Tung University, Hsinchu 300, Taiwan;
| | - Mei-Lan Ko
- Department of Ophthalmology, National Taiwan University Hospital, Hsinchu 300, Taiwan
- Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-965-580-725
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Dastiridou A, Kassos I, Samouilidou M, Koutali D, Mataftsi A, Androudi S, Ziakas N. Age and signal strength-related changes in vessel density in the choroid and the retina: an OCT angiography study of the macula and optic disc. Acta Ophthalmol 2021; 100:e1095-e1102. [PMID: 34532980 DOI: 10.1111/aos.15028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 07/30/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the effects of ageing and signal strength index (SSI) on vessel density (VD) measurements of the radial peripapillary capillaries (RPC) in the optic disc, the retinal superficial (SCP) and deep (DCP) capillary plexi and the choriocapillaris (CC) of the macular area using optical coherence tomography angiography (OCT-A) imaging. METHODS This cross-sectional study included 138 eyes from 77 healthy participants. High-definition (HD) disc Angio scan (4.5X4.5 mm) and HD Angio retina scan (6X6 mm) were acquired. Whole image (WI) VDs, inside disc (ID) VD and global and hemifield peripapillary RPC VDs were evaluated from the Angio Disc scans. Global and hemifield VD for the SCP, DCP and CC slab in the macula area were also recorded across different age groups. RESULTS Mean age was 48.2 ± 15.0 years (range 25-82 years). Signal strength index (SSI) was 71.6 ± 7.6 in the macula and 74.6 ± 9.2 in the disc OCT-A image. VD for both SCP and DCP decreased by 0.084% and 0.188%/year (both p < 0.001). WI VD and ID VD also decreased by 0.037%/year (p = 0.005) and 0.092%/year (p < 0.001). Peripapillary RPC VD did not change with age or SSI. The effect of SSI was significant in SCP, DCP, WI RPC, ID RPC and CC VD. In the generalized estimating equation model testing for both SSI and age, SSI remained significant against SCP, DCP and ID RPC. CONCLUSION With ageing, a decrease in VD in the SCP, DCP, WI and ID RPC, as well as in SSI, is seen. SSI and age are associated with VD changes, but only SSI is the significant variable that explains the variation in the retina microvasculature in the macula and the optic disc in multivariate analysis. In the CC, a larger SSI was associated with a lower VD. These findings underscore the importance of controlling for SSI in future studies using OCT-A.
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Affiliation(s)
- Anna Dastiridou
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
- Ophthalmology Department Medical School, University of Thessalia Larissa Greece
| | - Ioannis Kassos
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Maria Samouilidou
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Despoina Koutali
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Asimina Mataftsi
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Sofia Androudi
- Ophthalmology Department Medical School, University of Thessalia Larissa Greece
| | - Nikolaos Ziakas
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
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Yoshikawa Y, Shoji T, Kanno J, Ibuki H, Ozaki K, Ishii H, Inami H, Shinoda K. Examination of Age-Related Retinal Vascular Changes in the Macula Using Optical Coherence Tomography Angiography of the Eyes After Cataract Surgery. Clin Ophthalmol 2021; 15:3687-3695. [PMID: 34511872 PMCID: PMC8420780 DOI: 10.2147/opth.s323882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose Optical coherence tomography angiography (OCTA) allows noninvasive observation of the retinal vasculature, and image analysis can be used to calculate the retinal vessel density and foveal avascular zone (FAZ) area. A previous study showed that macular vessel density and the signal strength index (SSI) of OCTA images increased significantly after cataract surgery. However, the effect of aging on OCTA analysis remains unclear. This study aimed to investigate age-related changes in macular vascularization while excluding the effects of cataracts. Patients and Methods OCTA imaging of the macula was performed in adult patients who had undergone cataract surgery between February 2018 and May 2019 and in young healthy participants between April 2017 and April 2018. Results The median (quartiles) age of the overall study population was 59.0 (27.0, 69.0) years, and no severe refractive error was observed (axial length: 24.2 ± 1.3 [mean ± SD] mm; spherical equivalent: 0.75 [−2.25, 0.00] diopter). When we investigated the relationship between macular vessel density and age after excluding the effects of cataracts, we found that the macular vessel density showed age-related changes even in the absence of the effects of the SSI. However, the FAZ area was not affected by age. Conclusion Macular vessel density decreased with age, even when the effects of cataracts were excluded. The effects of age and cataracts should be considered when designing studies and interpreting OCTA findings of the retinal vasculature.
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Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hisashi Ibuki
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kimitake Ozaki
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hiromi Inami
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
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Liu K, Guo Y, You Q, Hormel T, Hwang TS, Jia Y. Normative intercapillary distance and vessel density data in the temporal retina assessed by wide-field spectral-domain optical coherence tomography angiography. Exp Biol Med (Maywood) 2021; 246:2230-2237. [PMID: 34435914 DOI: 10.1177/15353702211036704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
A limitation of conventional optical coherence tomography angiography (OCTA) is the limited field of view normally used in data acquisition. As the technology improves, larger fields of view that capture information away from the macular are being explored in order to provide an enhanced ability to detect pathology. However, normative measurements for important OCTA metrics like vessel density and intercapillary distance are not currently well-characterized in the peripheral retina. In this prospective study, we measured vessel density and intercapillary distance of the superficial vascular complex, ganglion cell layer plexus, and deep capillary plexus in montaged macular/temporal scans from 53 (33 men) healthy volunteers. Vessel density and intercapillary distance were also compared across different regions of the retina, including along arcs at separate distance from the fovea. Compared to the central macular region, the temporal retina had significantly lower vessel density, decreased thickness, and greater intercapillary distance in the superficial vascular complex, GCLP ganglion cell layer plexus, and deep capillary plexus (Wilcoxon rank sum test P < 0.001), with each of the plexuses examined here showing a general decrease in vessel density and an increase in intercapillary distance towards the temporal region. No significant difference was noted comparing corresponding vessel density and intercapillary distance regions above and below the macula, and multiple linear regression showed that age and intraocular pressure were not associated with vessel density and intercapillary distance in most models. Repeatability analysis reported as intraclass correlation coefficients demonstrated moderate to excellent reliability of vessel density and intercapillary distance in all OCTA layers. These results should help provide an enhanced baseline to help identify vascular pathology in the peripheral retina.
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Affiliation(s)
- Keke Liu
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.,John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, USA
| | - Yukun Guo
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Qisheng You
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Tristan Hormel
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Thomas S Hwang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.,Department of Ophthalmology and Biomedical Engineering, School of Medicine, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
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Kaya M, Ayhan Z, Ozturk AT, Kocak N, Arikan G, Kaynak S. Evaluation of the Macular and Choroidal Perfusion in Healthy Turkish Population Using Optical Coherence Tomography Angiography. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 35:360-367. [PMID: 34344137 PMCID: PMC8521324 DOI: 10.3341/kjo.2020.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 07/08/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the effect of age- and sex-related differences on macular and choroidal perfusion in healthy Turkish individuals by optical coherence tomography angiography (OCTA). METHODS Two hundred-eight eyes of 116 healthy Turkish individuals (60 females and 56 males, mean age 40.35 ± 12.64 years) were included in this study. OCTA was performed on a 3 × 3-mm region on the macula. The superficial macula wholeimage vessel density (wiVD), foveal VD and parafoveal VD vessel density, foveal avascular zone (FAZ) as well as choriocapillaris flow index (CFI) were quantified. RESULTS The mean vessel density was 53.1% ± 2.8% in superficial macula wiVD, 31.7% ± 6.9% in superficial foveal VD and 55.2% ± 3.4% in superficial parafoveal VD for 3 × 3-mm OCTA images. Analysis of 3 × 3-mm scan has revealed a mean value of FAZ area was 0.313 ± 0.112 mm2. The mean CFI for 3 × 3-mm scan was 1.937 ± 0.059. A significant decrease was observed in the mean values of wiVD, parafoveal VD and CFI with age (p < 0.001, p = 0.001, and p < 0.001, respectively), with average yearly reductions of 0.3%, 0.4% and 0.4%, respectively. However, there was no correlation between age and foveal VD (p > 0.05). The FAZ area has shown an age-dependent annual increment, showing an average of 1.26%. The parafoveal VD and FAZ area were significantly higher in females than males (p = 0.027 and p = 0.015, respectively) while other parameters seemed similar (p > 0.05 for all). CONCLUSIONS Our results suggest that age- and sex-related variations were effective on macular and choroidal perfusion. These normative values obtained using OCTA may be clinically useful to the evaluation of retinal and choroidal disorders.
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Affiliation(s)
- Mahmut Kaya
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ziya Ayhan
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Arif Taylan Ozturk
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nilufer Kocak
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gul Arikan
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Suleyman Kaynak
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Vujosevic S, Cunha-Vaz J, Figueira J, Löwenstein A, Midena E, Parravano M, Scanlon PH, Simó R, Hernández C, Madeira MH, Marques IP, C-V Martinho A, Santos AR, Simó-Servat O, Salongcay RP, Zur D, Peto T. Standardisation of Optical Coherence Tomography Angiography Imaging Biomarkers in Diabetic Retinal Disease. Ophthalmic Res 2021; 64:871-887. [PMID: 34348330 DOI: 10.1159/000518620] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - José Cunha-Vaz
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Figueira
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Anat Löwenstein
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Edoardo Midena
- Department of Neuroscience, University of Padua, Padua, Italy
| | | | - Peter Henry Scanlon
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria H Madeira
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Inês P Marques
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - António C-V Martinho
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana R Santos
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Olga Simó-Servat
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Recivall P Salongcay
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
- Eye and Vision Institute, The Medical City, Pasig, Philippines
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
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61
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Zhou W, Yang J, Wang Q, Wang Y, Yan Y, Wu S, Chen S, Wei W. Systemic Stressors and Retinal Microvascular Alterations in People Without Diabetes: The Kailuan Eye Study. Invest Ophthalmol Vis Sci 2021; 62:20. [PMID: 33595612 PMCID: PMC7900855 DOI: 10.1167/iovs.62.2.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose The purpose of this study was to determine systemic stressors, including fasting plasma glucose (FPG), and other major atherosclerotic cardiovascular disease (ASCVD) risk factors of the retinal microvasculature in people without diabetes. Methods The Kailuan Eye Study enrolled applicants from the community-based longitudinal Kailuan Study. Applicants underwent optical coherence tomographic angiography (OCTA) and systemic examinations. Both the macula and optic disc were screened, whereas superficial capillary plexus (SCP), deep capillary plexus (DCP), foveal vessel density in the 300 µm ring (FD-300), and radial peripapillary capillaries (RPCs) density were measured in the study. Results This study included 353 eligible applicants (mean age = 49.86 ± 11.41 years; 47% men; FPG =5.32 ± 1.19 mmol/L). Lower DCP density was associated with elder age (P = 0.001), male gender (P < 0.001), and higher FPG (P = 0.008). Male gender (P < 0.001), axial length (P < 0.001), and FPG (P = 0.029) were inversely associated with RPC density. Meanwhile, a higher FPG concentration was significantly correlated with lower DCP density (P = 0.006) and higher intraocular pressure (P = 0.006), after adjusting mean arterial blood pressure (P = 0.001) and sex (P = 0.042). Conclusions DCP density showed a significantly negative correlation with FPG concentration in people without diabetes. These data suggest hyperglycemia could cause early retinal capillary alterations in patients without clinical signs of retinopathy and indicate the potential clinical applications of routine OCTA may be beneficial to screen for subclinical microvasculature and monitor patients with high risks of ASCVD.
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Affiliation(s)
- Wenjia Zhou
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing, China
| | - Jingyan Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing, China
| | - Qian Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing, China
| | - Yaxing Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Yanni Yan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Health Care Center, Kailuan Group, Tangshan, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Capital Medical University, Beijing, China
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62
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Liu DW, Haq Z, Yang D, Stewart JM. Association between smoking history and optical coherence tomography angiography findings in diabetic patients without diabetic retinopathy. PLoS One 2021; 16:e0253928. [PMID: 34242286 PMCID: PMC8270137 DOI: 10.1371/journal.pone.0253928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy. Design Retrospective, cross-sectional study. Participants 1099 eyes from 1099 diabetic patients with no clinical evidence of diabetic retinopathy (DR) were included in this study. Methods Diabetic patients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed. Main outcome measures OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner). Results The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected. Conclusions Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabetic patients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.
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Affiliation(s)
- Dong-Wei Liu
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zeeshan Haq
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
| | - Daphne Yang
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
| | - Jay M. Stewart
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
- * E-mail:
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63
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Lam AKC, Lau KKH, Wong HY, Lam JPK, Yeung MF. Fixation stability and deviation in optical coherence tomography angiography using soft contact lens correction in myopes. Sci Rep 2021; 11:11791. [PMID: 34083728 PMCID: PMC8175576 DOI: 10.1038/s41598-021-91403-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022] Open
Abstract
To compare fixation deviation and stability with soft contact lens correction and device built-in auto-focus system during optical coherence tomography angiography (OCTA). This observational study measured OCTA metrics first with contact lens correction, followed by removal of contact lenses, using the device auto-focus system at a University Optometry Clinic, Hong Kong. All participants were habitual soft contact lens wearers with either low or high myopia. OCTA measurements were obtained using a spectral domain OCTA. Fixation deviation was distance (in pixels) of the fovea to the center of the OCTA measurement grid. Fixation stability was test–retest repeatability (TRR) and coefficient of variation (CV) of fixation deviation from three consecutive OCTA measurements. OCTA metrics included vessel length density (VD), perfusion density (PD), and foveal avascular zone (FAZ) area. Averaged OCTA metrics were calculated from three measurements and compared between the two correction methods. The mean ± SD spherical equivalent of 74 eyes from 74 myopes measured was − 1.94D ± 0.75D in low myopes (n = 37) and − 7.97D ± 1.31D in high myopes (n = 37). When corrected with contact lenses, visual acuities of high myopes (median [IQR], − 0.06 [0.08] logMAR) and low myopes (− 0.02 ± 0.08 logMAR) were similar (P = 0.060), and with similar fixation deviation (5.0 ± 2.2 pixels vs 5.3 [3.6] pixels; P = 0.689). High myopes had poorer fixation stability than low myopes (TRR: 10.2 pixels vs 7.5 pixels; CV: 65% vs 54%, respectively). The worst fixation stability occurred when high myopes were corrected using the auto-focus system (TRR: 12.5 pixels, CV: 72%). The difference in VD and PD was within 1 mm−1 and 1%, respectively. The FAZ area was similar. Difference in OCTA metrics was small in each refractive group (< 1 mm−1 in VD, and < 2% in PD). High myopes had more stable fixation when corrected when wearing contact lenses. Subjects with good contact lens corrected visual acuity should wear their contact lenses during OCTA measurements.
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Affiliation(s)
- Andrew Kwok-Cheung Lam
- Center for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China. .,Center for Eye and Vision Research (CEVR), Kowloon, Hong Kong, China.
| | - Kenny Kin-Hei Lau
- Center for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ho-Yin Wong
- Center for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jasmine Pui-Kwan Lam
- Center for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Man-For Yeung
- Center for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Retinal and choriocapillaris perfusion are associated with ankle-brachial-pressure-index and Fontaine stage in peripheral arterial disease. Sci Rep 2021; 11:11458. [PMID: 34075122 PMCID: PMC8169779 DOI: 10.1038/s41598-021-90900-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022] Open
Abstract
The purpose of this prospective case–control study was to assess whether parameters of retinal and choriocapillaris perfusion are altered in patients with peripheral arterial disease (PAD). Patients with PAD and healthy controls were imaged with swept-source optical coherence tomography angiography (OCT-A). Macula centered 3 × 3 mm OCT-A scans were acquired, binarized and perfusion was evaluated for vessel density (VD) and choriocapillaris non-perfused area. Clinical examination and non-invasive assessment included Fontaine staging, ankle-brachial-pressure-index (ABI) and vascular color-coded Doppler sonography. Fifty-two patients with PAD and 23 healthy controls were included. Superficial retinal VD was reduced in patients compared to controls (difference = − 0.013, p = 0.02), decreased with higher Fontaine stage (p = 0.01) and correlated with ABI (r = 0.42, p < 0.0001, 95% confidence interval [CI] 0.23–0.58). Choriocapillaris non-perfused area was larger in patients compared to controls (difference = 3.64%, p = 0.002, 95% CI 1.38–5.90%) and significantly correlated with ABI (r = − 0.22, p = 0.03, 95% CI − 0.40– − 0.03). Multivariate multiple regression analysis revealed a significant association of all OCT-A parameters with ABI and of deep retinal vessel density and choriocapillaris non-perfused area with Fontaine stage. In this first study of retinal and choroidal perfusion in patients with PAD we found both retinal and choroidal perfusion to be significantly impaired. OCT-A parameters could aid as indirect imaging biomarkers for non-invasive PAD staging and monitoring.
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Tüten A, Hamzaoğlu K, Gönen B, Tüten N, Uçar D. Does exogenous androgen use affect the retinal blood flow: An OCTA study in transgender men. Eur J Ophthalmol 2021; 32:1570-1576. [PMID: 34053312 DOI: 10.1177/11206721211020639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study aims to investigate the effect of using exogenous androgen on retinal microvascular structures in transgender men. METHODS Retinal microvascular structures of transgender men and healthy women in the control group were visualized with optical coherence tomography angiography (OCTA). Foveal avascular zone (FAZ), superficial capillary vascular density (sCVD), deep capillary vascular density (dCVD), and radial peripapillary capillary (RPC) vascular density were evaluated. RESULTS Thirty transgender men and 30 healthy women were included in the study. There were no significant differences between transgender men and the control group in terms of FAZ, central macular thickness, parafoveal, and perifoveal retinal thicknesses (p = 0.859, 0.288, 0.561, and 0.719; respectively). sCVD were found to be low in transgender men in the whole image, parafoveal, and perifoveal zones (p = 0.006, 0.025, and 0.005; respectively). Although there were low values of dCVD of the whole image, parafoveal, and perifoveal zones in transgender men, the difference was not statistically significant (p = 0.295, 0.085, and 0.270; respectively). RPC vessel densities in the whole image, peripapillary zone, and the inferior of the optic disc were found to be significantly low in transgender men (p = 0.003, 0.005, and 0.003; respectively). CONCLUSION In this study, a decrease in vessel density in the superficial retinal layers and around the optic disc was detected in transgender men. These findings suggest that routine ophthalmological examination may be important in individuals who use exogenous androgens.
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Affiliation(s)
- Abdullah Tüten
- Department of Gynecology and Obstetrics, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Kübra Hamzaoğlu
- Department of Gynecology and Obstetrics, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Busenur Gönen
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nevin Tüten
- Department of Gynecology and Obstetrics, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | - Didar Uçar
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Zhu MM, Choy BNK, You QS, Chan JCH, Ng ALK, Shih K, Cheung JJC, Wong JKW, Shum J, Ni MY, Lai JSM, Leung GM, Wong IY. Optic disc and peripapillary vessel density measured with optical coherence tomography angiography and its associations in Chinese adults: a large population-based study. Br J Ophthalmol 2021; 106:1411-1416. [PMID: 34016574 PMCID: PMC9510412 DOI: 10.1136/bjophthalmol-2020-318199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/19/2021] [Accepted: 04/14/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To investigate the optic disc and peripapillary vessel density, as well as its ocular and systemic associations, in healthy eyes among adult Chinese population. METHODS A population-based cross-sectional eye survey was conducted on Chinese adults residing in Hong Kong. 1891 eyes from 1891 participants who completed 4.5×4.5 mm optical coherence tomography angiography scans were recruited. Among the 1891 eyes, 404 were excluded due to low scan quality, optic disc or retinal disorders and non-Chinese ethnicity. The vessel densities (VDs) at nerve fibre layer plexus (NFLP) at both optic disc and peripapillary were collected for analysis. Multiple linear regression analysis was performed to determine the ocular and systemic associations of NFLP VD. RESULTS The study included 1487 participants (men: 41.2%) with a mean age of 48.8±15.4 years. The mean NFLP VD of the whole en face image, inside disc and peripapillary region was 53.8%, 42.7% and 60.3%, respectively. In the multivariable model, decreased NFLP VDs were significantly associated with older age, male gender, longer axial length (AL) and lower Signal Strength Index. CONCLUSIONS This large population-based cross-sectional study provided quantitative data of optic disc and peripapillary NFLP VD which may serve as a normative reference for clinical use. Apart from age, gender and AL, the scan signal strength also should be taken into consideration during the assessment of NFLP VD.
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Affiliation(s)
- Ming Ming Zhu
- Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
| | - Bonnie N K Choy
- Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
| | - Qi Sheng You
- Oregon Health & Science University Casey Eye Institute, Portland, Oregon, USA
| | | | - Alex L K Ng
- Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
| | - Kendrick Shih
- Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
| | | | | | - Jennifer Shum
- Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
| | - Michael Y Ni
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, Hong Kong
| | | | - Gabriel M Leung
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Ian Y Wong
- Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong .,Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
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67
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Zhou LJ, Luo XZ, Shen PY, Li X, Su P, Zhu Z, Yan SG, Kong XB, Lu XH. Quantitative assessment and determinants of the papillary microvasculature in healthy subjects. BMC Ophthalmol 2021; 21:140. [PMID: 33743618 PMCID: PMC7981900 DOI: 10.1186/s12886-021-01896-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/05/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND It is critical to monitor the optic disc's vessel density using Optical coherence tomography angiography (OCTA) and evaluate its determinants. In the current study, we investigate the superficial vessel density (VD) of the papillary microvasculature and its determinants in healthy subjects of Southern China. METHODS This was a prospective, cross-sectional study. Superficial VD in healthy individuals' optic disc region was measured by OCTA. The factors associated with ocular and systemic parameters were analyzed using a generalized estimation equation (GEE) model. RESULTS A total of 510 eyes of 260 healthy subjects were analyzed in the study. The total VD in the optic disc area was 17.21 ± 2.15 mm- 1 (95% CI, 17.02-17.40 mm- 1). The VD in the inner ring and the outer ring of the optic disc were significantly higher compared with the central ring, while the VD of the superior quadrant and inferior quadrant was significantly higher compared with the temporal and nasal quadrant. After adjusting for the ocular factors and systemic factors, AL (β = - 0.4917, P = 0.0003), disc area (β = - 0.3748, P = 0.0143), CMT (β = - 0.0183, P = 0.0003) and SSI (β = 1.0588, P < 0.001) were significantly associated with total VD of the optic disc. CONCLUSION The mean total VD in the optic disc area was 17.21 ± 2.15 mm- 1 in healthy subjects, and the superior and inferior VD was significantly higher than the temporal and nasal VD. AL, disc area, CMT, and SSI may affect the total VD in the optic disc area and should be considered in clinical practice.
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Affiliation(s)
- Li-Jun Zhou
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, 515282, China
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Xiu-Zhi Luo
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Pei-Yang Shen
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, 515282, China
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Xin Li
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Peng Su
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Zhe Zhu
- Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, 92037, USA
| | - Shi-Gang Yan
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Xiang-Bin Kong
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China.
| | - Xiao-He Lu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, 515282, China.
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Shaw LT, Khanna S, Chun LY, Dimitroyannis RC, Rodriguez SH, Massamba N, Hariprasad SM, Skondra D. Quantitative Optical Coherence Tomography Angiography (OCTA) Parameters in a Black Diabetic Population and Correlations with Systemic Diseases. Cells 2021; 10:cells10030551. [PMID: 33806492 PMCID: PMC7998203 DOI: 10.3390/cells10030551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 01/02/2023] Open
Abstract
This is a cross-sectional, prospective study of a population of black diabetic participants without diabetic retinopathy aimed to investigate optical coherence tomography angiography (OCTA) characteristics and correlations with systemic diseases in this population. These parameters could serve as novel biomarkers for microvascular complications; especially in black populations which are more vulnerable to diabetic microvascular complications. Linear mixed models were used to obtain OCTA mean values ± standard deviation and analyze statistical correlations to systemic diseases. Variables showing significance on univariate mixed model analysis were further analyzed with multivariate mixed models. 92 eyes of 52 black adult subjects were included. After multivariate analysis; signal strength intensity (SSI) and heart disease had statistical correlations to superficial capillary plexus vessel density in our population. SSI and smoking status had statistical correlations to deep capillary plexus vessel density in a univariate analysis that persisted in part of the imaging subset in a multivariate analysis. Hyperlipidemia; hypertension; smoking status and pack-years; diabetes duration; creatinine; glomerular filtration rate; total cholesterol; hemoglobin A1C; and albumin-to-creatinine ratio were not significantly associated with any OCTA measurement in multivariate analysis. Our findings suggest that OCTA measures may serve as valuable biomarkers to track systemic vascular functioning in diabetes mellitus in black patients.
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Affiliation(s)
- Lincoln T. Shaw
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Saira Khanna
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Lindsay Y. Chun
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Rose C. Dimitroyannis
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
- University of Chicago, Chicago, IL 60637, USA
| | - Sarah H. Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Nathalie Massamba
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
- J. Terry Ernest Ocular Imaging Center, University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Seenu M. Hariprasad
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
- J. Terry Ernest Ocular Imaging Center, University of Chicago Medical Center, Chicago, IL 60637, USA
- Correspondence: ; Tel.: 1-773-702-3937
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Rifai OM, McGrory S, Robbins CB, Grewal DS, Liu A, Fekrat S, MacGillivray TJ. The application of optical coherence tomography angiography in Alzheimer's disease: A systematic review. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12149. [PMID: 33718582 PMCID: PMC7927164 DOI: 10.1002/dad2.12149] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/12/2020] [Accepted: 12/02/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Discovering non-invasive and easily acquired biomarkers that are conducive to the accurate diagnosis of dementia is an urgent area of ongoing clinical research. One promising approach is retinal imaging, as there is homology between retinal and cerebral vasculature. Recently, optical coherence tomography angiography (OCT-A) has emerged as a promising new technology for imaging the microvasculature of the retina. METHODS A systematic review and meta-analysis was conducted to examine the application of OCT-A in dementia. RESULTS Fourteen studies assessing OCT-A in preclinical Alzheimer's disease (AD), mild cognitive impairment, or AD were included. Exploratory meta-analyses revealed a significant increase in the foveal avascular zone area and a significant decrease in superficial parafoveal and whole vessel density in AD, although there was significant heterogeneity between studies. DISCUSSION Although certain OCT-A metrics may have the potential to serve as biomarkers for AD, the field requires further standardization to allow conclusions to be reached regarding their clinical utility.
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Affiliation(s)
- Olivia M. Rifai
- Translational Neuroscience PhD ProgrammeUniversity of EdinburghEdinburghUK
- Centre for Clinical Brain SciencesCollege of Medicine and Veterinary MedicineUniversity of EdinburghEdinburghUK
| | - Sarah McGrory
- Centre for Clinical Brain SciencesCollege of Medicine and Veterinary MedicineUniversity of EdinburghEdinburghUK
| | - Cason B. Robbins
- Department of OphthalmologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Dilraj S. Grewal
- Department of OphthalmologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Andy Liu
- Department of NeurologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Sharon Fekrat
- Department of OphthalmologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Thomas J. MacGillivray
- Centre for Clinical Brain SciencesCollege of Medicine and Veterinary MedicineUniversity of EdinburghEdinburghUK
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Ye C, Wang X, Yu MCY, Shang X, Zhou K, Tao Y, Lu F, Liang Y. Progression of Macular Vessel Density in Primary Open-Angle Glaucoma: A Longitudinal Study. Am J Ophthalmol 2021; 223:259-266. [PMID: 33351744 DOI: 10.1016/j.ajo.2020.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the rate of progression of macular vessel density (mVD) in primary open-angle glaucoma (POAG) and explore the relationship between the progression of mVD and macular ganglion cell-inner plexiform layer (mGCIPL) thickness and parapapillary retinal nerve fiber layer (pRNFL) thickness. DESIGN Prospective cohort study. METHODS In this study, 102 eyes with POAG were followed for 36.6 ± 6.4 months. The rates of progression were estimated by linear models. The agreement of progression detection among the 3 parameters was evaluated with Kappa statistics. The influence of baseline measurements on the rates of progression of mGCIPL thickness, pRNFL thickness, and mVD was investigated by linear mixed modeling. Kaplan-Meier survival analysis was adopted to calculate the survival probabilities. RESULTS The respective rate of progression by linear regression was -0.102 ± 0.054 μm/month, -0.160 ± 0.086 μm/month, and -0.199 ± 0.073 %/month for mGCIPL thickness, pRNFL thickness, and mVD. The agreement in detection of progression among them was poor with the Conger's Kappa coefficient of 0.098 (95% confidence interval: -0.025~0.220, P = .116). The significant factors influencing the rate of progression of mVD were baseline mGCIPL thickness, baseline pRNFL thickness, and baseline mVD (P ≤ .001), while baseline mVD was not a significant factor influencing the rates of progression of mGCIPL thickness and pRNFL thickness (P ≥ .659). Also, pRNFL thickness had a better survival probability compared with the other 2 parameters (P = .025). CONCLUSIONS The mGCIPL thickness, pRNFL thickness, and mVD decreased over time in POAG eyes. The rate of reduction of mVD was significantly influenced by the baseline measurements of mGCIPL thickness, pRNFL thickness, and mVD.
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Standardization of OCT Angiography Nomenclature in Retinal Vascular Diseases: First Survey Results. Ophthalmol Retina 2021; 5:981-990. [PMID: 33388471 DOI: 10.1016/j.oret.2020.12.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/16/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE To develop a consensus nomenclature for OCT angiography (OCTA) findings in retinal vascular diseases. DESIGN Online survey using the Delphi Method. PARTICIPANTS Members of The Retina Society, the European Society of Retina Specialists, and the Japanese Retina and Vitreous Society. METHODS An online questionnaire on OCTA terminology in retinal vascular diseases was sent to members of The Retina Society, the European Society of Retina Specialists, and the Japanese Retina and Vitreous Society. The respondents were divided into 2 groups ("experts" vs. "users") according to the number of their publications in this field. The respondents who had more than 5 publications in the field of OCTA and retinal vascular diseases were considered the OCTA "experts" group. MAIN OUTCOME MEASURES Consensus and near consensus on OCTA nomenclature. RESULTS The complete responses of 85 retina specialists were included in the analysis. Thirty-one were categorized as "experts." There was a consensus in both groups that OCTA parameters such as foveal avascular zone (FAZ) parameters, areas of nonperfusion, and presence of neovascularization (NV) should be implemented in the identification and staging of diabetic retinopathy (DR) and that OCTA can be applied to differentiate between ischemic and nonischemic retinal vein occlusion (RVO). Diabetic macular ischemia (DMI) also can be assessed via OCTA. Further, there was consensus that the terminology should differ on the basis of the underlying causes of decreased vascular flow signal. There was disagreement in other areas, such as which terms should be applied to describe decreased OCTA signal from different causes, the definition of wide-field OCTA, and how to quantify DMI and area of decreased flow signal. These discrepancies form the basis for the upcoming expert Delphi rounds that aim to develop a standardized OCTA nomenclature. CONCLUSIONS Although there was agreement in some areas, significant differences were found in many areas of OCTA terminology among all respondents, but also between the expert and user groups. This indicates the need for standardization of the nomenclature among all specialists in the field of retinal vascular diseases.
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Polascik BW, Thompson AC, Yoon SP, Powers JH, Burke JR, Grewal DS, Fekrat S. Association of OCT Angiography Parameters With Age in Cognitively Healthy Older Adults. Ophthalmic Surg Lasers Imaging Retina 2020; 51:706-714. [PMID: 33339052 DOI: 10.3928/23258160-20201202-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/09/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the association of changes in retinal anatomy and microvasculature with age and sex in cognitively healthy older adults. PATIENTS AND METHODS Cross-sectional study of cognitively healthy subjects aged 50 years and older who underwent optical coherence tomography angiography (OCTA) to estimate the association between age and sex with ganglion cell layer-inner plexiform layer (GC-IPL); central subfield thickness (CST); subfoveal choroidal thickness (CT); foveal avascular zone (FAZ) size; and superficial (SCP), deep (DCP), and whole capillary plexus (WCP) vessel density (VD) and perfusion density (PD) measured in the ETDRS 3-mm and 6-mm circle and rings. RESULTS Among 141 older adults (72.9% female; median age: 69 years), 282 eyes were imaged. Females had a greater CT, GC-IPL thickness, and FAZ size and a lower CST than males. After controlling for sex, both CT (P = .001) and GC-IPL thickness (P < .001) decreased with age, whereas FAZ size and CST did not. There was a reduction in VD and PD in SCP, DCP, and WCP with age in the 3-mm circle, 3-mm ring, and 6-mm circle (all P < .05). CONCLUSIONS There is a significant reduction in both VD and PD, as well as decreased choroidal and GC-IPL thickness associated with aging, even beyond the fifth decade, in cognitively healthy adults. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:706-714.].
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Sarabi MS, Khansari MM, Zhang J, Kushner-Lenhoff S, Gahm JK, Qiao Y, Kashani AH, Shi Y. 3D Retinal Vessel Density Mapping With OCT-Angiography. IEEE J Biomed Health Inform 2020; 24:3466-3479. [PMID: 32986562 PMCID: PMC7737654 DOI: 10.1109/jbhi.2020.3023308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Optical Coherence Tomography Angiography (OCTA) is a novel, non-invasive imaging modality of retinal capillaries at micron resolution. Recent studies have correlated macular OCTA vascular measures with retinal disease severity and supported their use as a diagnostic tool. However, these measurements mostly rely on a few summary statistics in retinal layers or regions of interest in the two-dimensional (2D) en face projection images. To enable 3D and localized comparisons of retinal vasculature between longitudinal scans and across populations, we develop a novel approach for mapping retinal vessel density from OCTA images. We first obtain a high-quality 3D representation of OCTA-based vessel networks via curvelet-based denoising and optimally oriented flux (OOF). Then, an effective 3D retinal vessel density mapping method is proposed. In this framework, a vessel density image (VDI) is constructed by diffusing the vessel mask derived from OOF-based analysis to the entire image volume. Subsequently, we utilize a non-linear, 3D OCT image registration method to provide localized comparisons of retinal vasculature across subjects. In our experimental results, we demonstrate an application of our method for longitudinal qualitative analysis of two pathological subjects with edema during the course of clinical care. Additionally, we quantitatively validate our method on synthetic data with simulated capillary dropout, a dataset obtained from a normal control (NC) population divided into two age groups and a dataset obtained from patients with diabetic retinopathy (DR). Our results show that we can successfully detect localized vascular changes caused by simulated capillary loss, normal aging, and DR pathology even in presence of edema. These results demonstrate the potential of the proposed framework in localized detection of microvascular changes and monitoring retinal disease progression.
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Yildirim A, Kurt E, Altinisik M, Uyar Y. Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study. Eur J Ophthalmol 2020; 32:501-507. [PMID: 33081497 DOI: 10.1177/1120672120966566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). METHODS Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. RESULTS The mean gestational age was 34 (28-41) weeks. Mean age was comparable in the groups (p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD (p = 0.015), FAZ area (p = 0.044), and FD (p = 0.002). Mean subfoveal CT was 21 µm higher in pregnant women but was not significant (p = 0.472). There was no difference in CMT (p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group (p < 0.05). Parafoveal VD was negatively correlated with CT in the control group (p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted (p < 0.05), while the difference in FAZ area lost significance (p > 0.05). CONCLUSIONS Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP.
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Affiliation(s)
| | - Emin Kurt
- Ophthalmology Department, Manisa Celal Bayar University, Manisa, Turkey
| | | | - Yildiz Uyar
- Obstetrics and Gynecology Department, Manisa Celal Bayar University, Manisa, Turkey
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Sardone R, Sborgia G, Niro A, Giuliani G, Pascale A, Puzo P, Guerra V, Castellana F, Lampignano L, Donghia R, Bortone I, Zupo R, Griseta C, Logroscino G, Lozupone M, Giannelli G, Panza F, Boscia F, Alessio G, Quaranta N. Retinal Vascular Density on Optical Coherence Tomography Angiography and Age-related Central and Peripheral Hearing Loss in a Southern Italian Older Population. J Gerontol A Biol Sci Med Sci 2020; 76:2169-2177. [PMID: 33064801 DOI: 10.1093/gerona/glaa269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Age-related hearing loss (ARHL) and retinal vessel changes have both been associated to neurodegeneration/dementia, suggesting a possible link between these two conditions in older age. We aimed to determine whether superficial and deep vascular density (SVD and DVD) of the capillary plexi of macular vasculature can be associated with peripheral ARHL and age-related central auditory central processing (CAPD). METHODS We analyzed data on 886 older participants (65 years+, age range:65-92 years) in the cross-sectional population-based Salus in Apulia Study. Optical coherence tomography angiography (OCT-A) was used to measure SVD and DVD of the capillary plexi of the macula at the 3-mm circle area centered on the fovea (whole retina), the parafoveal quadrant, and foveal quadrant. Disabling peripheral ARHL was defined as >40 dB HL of pure tone average on the frequencies from 0.5, 1, 2, and 4 KHz in the better ear, and age-related CAPD as <50% at the Synthetic Sentence Identification with Ipsilateral Competitive Message test in at least one ear. RESULTS DVD at the whole retina and at the parafoveal quadrant were inversely associated only with age-related CAPD [odds ratio (OR):0.93; 95% confidence interval (CI): 0.88-0.96 and OR:0.94; 95 CI:0.90-0.99, respectively]. No further associations with peripheral ARHL were evident. CONCLUSIONS Retinal vasculature is associated with central auditory processing pathology, possibly playing an important role in early detection and intervention. The association of retinal vascular density with age-related CAPD may bring us a further step forward in understanding the biological mechanisms underlying the links between neurodegeneration/dementia and ARHL.
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Affiliation(s)
- Rodolfo Sardone
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Sborgia
- Eye Clinic, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Alfredo Niro
- Eye Clinic, Hospital "S. G. MOSCATI," ASL TA, Taranto, Italy
| | - Gianluigi Giuliani
- Eye Clinic, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Angelo Pascale
- Eye Clinic, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Pasquale Puzo
- Eye Clinic, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Vito Guerra
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Luisa Lampignano
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Rossella Donghia
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Chiara Griseta
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
- Unit of Neurodegenerative Disease, Department of Clinical Research in Neurology, University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico," Tricase, Lecce, Italy
| | - Madia Lozupone
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Gianluigi Giannelli
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Francesco Panza
- Population Health Unit, "Salus in Apulia Study," National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Francesco Boscia
- Eye Clinic, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Giovanni Alessio
- Eye Clinic, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Italy
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Italy
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Zabek O, Camenzind Zuche H, Müller U, Scholl HPN, Rickmann A, Della Volpe Waizel M. Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol 2020; 259:1167-1177. [PMID: 33037922 PMCID: PMC8102288 DOI: 10.1007/s00417-020-04963-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/01/2020] [Accepted: 10/02/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose Transcorneal electrical stimulation (TES) is a novel treatment approach for patients with retinitis pigmentosa (RP). The aim of our study was to observe changes in optical coherence tomography angiography (OCTA) that would be attributed to TES treatment. Methods A total of 73 eyes were included: 43 eyes of 22 subjects (11 ♀, 11 ♂) suffering from RP were examined at baseline (BL), after first stimulation (TS), 1 week (1W), and 6 months (6M) after treatment initiation and were compared with 30 control eyes of 15 subjects (8 ♀, 7 ♂). TES was performed simultaneously on both eyes for 30 min weekly. OCTA scans of 9 × 15 mm were recorded with a PLEX Elite 9000 swept-source OCTA device (Carl Zeiss Meditec AG, Jena). Vascular density metrics such as perfusion density (PD) and vessel density (VD) were calculated automatically for the macular area by using standardised extended early treatment diabetic retinopathy study (ETDRS) grids centred around the fovea. In addition, the capillary perfusion density (CPD) and the capillary flux index (CFI) of the peripapillary nerve fibre layer microvasculature in all four quadrants of an annulus centred at the optic disc were measured. All parameters were determined over all retinal layers and separately for the superficial (SCP) and deep capillary plexus (DCP). ANOVA-based linear mixed-effects models were calculated with SPSS®. Results Throughout the course of TES treatment, the macular VD and PD of all retinal layers in all subsections showed a slight decrement without reaching statistical significance, also when analysed separately in the SCP and DCP (p > 0.08). In analogy, the average CPD and CFI also presented with a slight decrement (p > 0.20). However, when compared with controls, most OCTA parameters showed a significant decrement (p < 0.05). When analysed systematically in all subsections of the extended ETDRS grid, the temporal macular subsections within the outer ring (radius 1.5–3 mm) and also of the peripheral C1, C2, and C3 rings (radius 3–7.5 mm) showed lower VD and PD values when compared with the other subsections (p < 0.05). Conclusion Vascular density metrics in the macular region and the peripapillary microvasculature appear to remain unaffected by continuous TES treatment within a period of 6 months. Electronic supplementary material The online version of this article (10.1007/s00417-020-04963-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Olga Zabek
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Hanna Camenzind Zuche
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ursula Müller
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Hendrik P N Scholl
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | | | - Maria Della Volpe Waizel
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland.
- Eye Clinic, Knappschaft Hospital Sulzbach, Sulzbach, Saar, Germany.
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Impact of blood pressure control on retinal microvasculature in patients with chronic kidney disease. Sci Rep 2020; 10:14275. [PMID: 32868805 PMCID: PMC7459351 DOI: 10.1038/s41598-020-71251-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022] Open
Abstract
Chronic kidney disease (CKD) is an emerging disease worldwide. We investigated the relationship between blood pressure (BP) control and parafoveal retinal microvascular changes in patients with CKD. This case–control study enrolled 256 patients with CKD (stage 3–5) and 70 age‐matched healthy controls. Optical coherence tomography angiography showed lower superficial vascular plexus (SVP) vessel density, lower deep vascular plexus (DVP) vessel density, and larger SVP flow void area in the CKD group. The BP parameters at enrollment and during the year before enrollment were collected in patients with CKD. Partial correlation was used to determine the relationship between BP parameters and microvascular parameters after controlling for age, sex, diabetes mellitus, axial length, and intraocular pressure. The maximum systolic blood pressure (SBP) (p = 0.003) and within-patient standard deviation (SD) of SBP (p = 0.006) in 1 year were negatively correlated with SVP vessel density. The average SBP (p = 0.040), maximum SBP (p = 0.001), within-patient SD of SBP (p < 0.001) and proportion of high BP measurement (p = 0.011) in 1 year were positively correlated with the SVP flow void area. We concluded that long-term SBP was correlated with SVP microvascular injury in patients with CKD. Superficial retinal microvascular changes may be a potential biomarker for prior long-term BP control in these patients.
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