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Cui X, Buonfiglio F, Pfeiffer N, Gericke A. Aging in Ocular Blood Vessels: Molecular Insights and the Role of Oxidative Stress. Biomedicines 2024; 12:817. [PMID: 38672172 PMCID: PMC11048681 DOI: 10.3390/biomedicines12040817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Acknowledged as a significant pathogenetic driver for numerous diseases, aging has become a focal point in addressing the profound changes associated with increasing human life expectancy, posing a critical concern for global public health. Emerging evidence suggests that factors influencing vascular aging extend their impact to choroidal and retinal blood vessels. The objective of this work is to provide a comprehensive overview of the impact of vascular aging on ocular blood vessels and related diseases. Additionally, this study aims to illuminate molecular insights contributing to vascular cell aging, with a particular emphasis on the choroid and retina. Moreover, innovative molecular targets operating within the domain of ocular vascular aging are presented and discussed.
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Affiliation(s)
- Xiuting Cui
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
| | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
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2
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De Ciuceis C, Rosei CA, Malerba P, Rossini C, Nardin M, Chiarini G, Famà F, Lemoli M, Baresi M, Petelca A, Bortoluzzi C, Porteri E, Salvetti M, Muiesan ML, Rosei EA, Rizzoni D. Prognostic significance of the wall to lumen ratio of retinal arterioles evaluated by adaptive optics. Eur J Intern Med 2024; 122:86-92. [PMID: 37914655 DOI: 10.1016/j.ejim.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Microvascular structural alterations may be considered an important form of hypertension-mediated organ damage. An increased media-to-lumen ratio of subcutaneous small arteries evaluated with locally invasive techniques (micromyography) predicts the development of cardiovascular (CV) events. However, it is not known whether retinal arteriole structural alterations evaluated with a noninvasive approach (Adaptive Optics) may have a prognostic significance. DESIGN AND METHODS Two-hundred and thirty-seven subjects (mean age 58.7 ± 16.1 years, age range 13-89 years; 116 males) were included in the study: 65 normotensive subjects (27.4 %) and 172 patients with essential hypertension or primary aldosteronism (72.6 %). All subjects underwent a non-invasive evaluation of retinal arteriolar wall-to-lumen ratio (WLR) by Adaptive Optics. Subjects were re-evaluated after an average follow-up time of 4.55 years in order to assess the occurrence of clinical events (non CV and/or CV death or events). RESULTS Fifty-four events occurred in the study population:26 were cardio-cerebrovascular events (ischemic or hemorragic stroke, atrial fibrillation, heart failure, coronary artery disease, peripheral artery disease, cardiac valvular disease) while the remaining were deaths for any cause, or neoplastic diseases. Subjects with events were older and had a WLR of retinal arterioles significantly greater than those without events. The event-free survival was significantly worse in those with a baseline WLR above the median value of the population (0.28) according to Kaplan-Mayer survival curves and multivariate analysis (Cox's proportional hazard model). The evidence was confirmed after restricting the analysis to CV events. CONCLUSIONS Structural alterations of retinal arterioles evaluated by Adaptive Optics may predict total and CV events.
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Affiliation(s)
- Carolina De Ciuceis
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy.
| | - Claudia Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Paolo Malerba
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Claudia Rossini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Matteo Nardin
- Third Division of Medicine, ASST Spedali Civili di Brescia, Italy
| | - Giulia Chiarini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Francesca Famà
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Matteo Lemoli
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Mattia Baresi
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Alina Petelca
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Chiara Bortoluzzi
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Enzo Porteri
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Massimo Salvetti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Maria Lorenza Muiesan
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Enrico Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Damiano Rizzoni
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy; Division of Medicine, ASST Spedali Civili di Brescia, Montichiari, Brescia, Italy
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3
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Żmijewska MA, Wawrzyniak ZM, Janiszewski M, Zaleska-Żmijewska A. Retinal Microcirculation Measurements in Response to Endurance Exercises Analysed by Adaptive Optics Retinal Camera. Diagnostics (Basel) 2024; 14:710. [PMID: 38611623 PMCID: PMC11012106 DOI: 10.3390/diagnostics14070710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to precisely investigate the effects of intensive physical exercise on retinal microvascular regulation in healthy volunteers through adaptive optics retinal camera (AO) measurement. We included healthy volunteers (11 men and 14 women) aged 20.6 ± 0.9. The heart rate (HR) and systolic and diastolic blood pressures (SBP, DBP) were recorded before and after a submaximal physical exertion of continuously riding a training ergometer. The superior temporal retinal artery measurements were captured using the AO-rtx1TM (Imagine Eyes, Orsay, France) without pupil dilation. We compared measures of vessel diameter (VD), lumen diameter (LD), two walls (Wall 1, 2), wall-to-lumen ratio (WLR), and wall cross-sectional analysis (WCSA) before and immediately after the cessation of exercise. Cardiovascular parameter results: After exercise, SBP, DBP, and HR changed significantly from 130.2 ± 13.2 to 159.7 ± 15.6 mm Hg, 81.2 ± 6.3 to 77.1 ± 8.2 mm Hg, and 80.8 ± 16.1 to 175.0 ± 6.2 bpm, respectively (p < 0.002). Retinal microcirculation analysis showed no significant decrease in LD, Wall 1 after exercise: from 96.0 ± 6.8 to 94.9 ± 6.7 (p = 0.258), from 11.0 ± 1.5 to 10.4 ± 1.5 (p = 0.107), respectively, and significant reduction in VD from 118.5 ± 8.3 to 115.9 ± 8.3 (p = 0.047), Wall 2 from 11.5 ± 1.0 to 10.7 ± 1.3 (p = 0.017), WLR from 0.234 ± 0.02 to 0.222 ± 0.010 (p = 0.046), WCSA from 3802.8 ± 577.6 to 3512.3 ± 535.3 (p = 0.016). The AO is a promising technique for investigating the effects of exercise on microcirculation, allowing for the tracking of changes throughout the observation. Intensive dynamic physical exertion increases blood pressure and heart rate and causes the vasoconstriction of small retinal arterioles due to the autoregulation mechanism.
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Affiliation(s)
- Maria Anna Żmijewska
- Faculty of Medicine, Student Scientific Society “Eye”, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Zbigniew M. Wawrzyniak
- Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-065 Warsaw, Poland
| | - Maciej Janiszewski
- Faculty of Medicine and Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Anna Zaleska-Żmijewska
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, 00-576 Warsaw, Poland;
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Ji L, Waduge P, Wu Y, Huang C, Kaur A, Oliveira P, Tian H, Zhang J, Stout JT, Weng CY, Webster KA, Li W. Secretogranin III Selectively Promotes Vascular Leakage in the Deep Vascular Plexus of Diabetic Retinopathy. Int J Mol Sci 2023; 24:10531. [PMID: 37445707 DOI: 10.3390/ijms241310531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Diabetic retinopathy (DR), a leading cause of vision loss in working-age adults, induces mosaic patterns of vasculopathy that may be associated with spatial heterogeneity of intraretinal endothelial cells. We recently reported that secretogranin III (Scg3), a neuron-derived angiogenic and vascular leakage factor, selectively binds retinal vessels of diabetic but not healthy mice. Here, we investigated endothelial heterogeneity of three retinal vascular plexuses in DR pathogenesis and the therapeutic implications. Our unique in vivo ligand binding assay detected a 22.7-fold increase in Scg3 binding to retinal vessels of diabetic mice relative to healthy mice. Functional immunohistochemistry revealed that Scg3 predominantly binds to the DR-stressed CD31- deep retinal vascular plexus but not to the relatively healthy CD31+ superficial and intermediate plexuses within the same diabetic retina. In contrast, VEGF bound to healthy and diabetic retinal vessels indiscriminately with low activity. FITC-dextran assays indicated that selectively increased retinal vascular leakage coincides with Scg3 binding in diabetic mice that was independent of VEGF, whereas VEGF-induced leakage did not distinguish between diabetic and healthy mice. Dose-response curves showed that the anti-Scg3 humanized antibody (hAb) and anti-VEGF aflibercept alleviated DR leakage with equivalent efficacies, and that the combination acted synergistically. These findings suggest: (i) the deep plexus is highly sensitive to DR; (ii) Scg3 binding to the DR deep plexus coincides with the loss of CD31 and compromised endothelial junctions; (iii) anti-Scg3 hAb alleviates vascular leakage by selectively targeting the DR-stressed deep plexus within the same diabetic retina; (iv) combined anti-Scg3 and anti-VEGF treatments synergistically ameliorate DR through distinct mechanisms.
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Affiliation(s)
- Liyang Ji
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Prabuddha Waduge
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Yan Wu
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Chengchi Huang
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Avinash Kaur
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Paola Oliveira
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hong Tian
- Everglades Biopharma, LLC, Houston, TX 77098, USA
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang 110005, China
| | - J Timothy Stout
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Christina Y Weng
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Keith A Webster
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
- Everglades Biopharma, LLC, Houston, TX 77098, USA
| | - Wei Li
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
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Rosei CA, Gaggero A, Famà F, Malerba P, Chiarini G, Nardin M, Brami V, Rossini C, Coschignano MA, Porteri E, Salvetti M, Muiesan ML, Rizzoni D, De Ciuceis C. Skin capillary alterations in patients with acute SarsCoV2 infection. J Hypertens 2022; 40:2385-2393. [PMID: 35983856 PMCID: PMC9640263 DOI: 10.1097/hjh.0000000000003271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Acute SarsCov2 infection is associated with endothelial dysfunction and 'endothelitis', which might explain systemic microvascular impairment. The presence of endothelial damage may promote vasoconstriction with organ ischemia, inflammation, tissue oedema and a procoagulant state resulting in an increase in the incidence of cardiovascular and cerebrovascular events. Microvascular thrombosis has been demonstrated in postmortem autopsy of COVID-19 patients; however, few data are available about skin capillary alterations in these patients. MATERIALS AND METHODS We evaluated skin microvascular alteration in 22 patients admitted to our hospital with SarsCov2 infection. Capillary density was evaluated by capillaroscopy in the nailfold and the dorsum of the finger in the acute phase of the disease. Capillaroscopy was repeated after 3 months (recovery phase). In addition, blood chemistry parameters and inflammatory markers were obtained during acute infection and at the recovery after 3 months. RESULTS Patients with COVID-19 showed skin microvascular complications, such as thrombosis, microhaemorrhages and neoangiogenesis, which were not detected after 3 months from the discharge. A significant reduction of capillary density in the dorsum was observed after 3 months from the acute infection (97.2 ± 5.3 vs. 75.81 ± 3.9 n/mm 2P < 0.05). A significant inverse correlation between C-reactive protein and capillary density was observed in patients with acute SarsCov2 infection ( r = 0.44, P < 0.05). Conversely a direct correlation between capillary density during the acute phase and lymphocyte number was detected ( r = 0.49, P < 0.05). CONCLUSION This is the first in-vivo evidence of skin capillary thrombosis, microhaemorrhages and angiogenesis in patients with acute SarsCov2 infection, which disappeared after 3 months, supporting the presence of endothelial dysfunction and inflammation. Capillary alterations might reflect systemic vascular effects of viral infection.
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Affiliation(s)
- Claudia Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Andrea Gaggero
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Francesca Famà
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Paolo Malerba
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Giulia Chiarini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Matteo Nardin
- Third Division of Medicine, ASST Spedali Civili, Brescia
| | - Valeria Brami
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Claudia Rossini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | | | - Enzo Porteri
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Massimo Salvetti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Maria Lorenza Muiesan
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
| | - Damiano Rizzoni
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
- Division of Medicine, ASST Spedali Civili di Brescia, Montichiari, Italy
| | - Carolina De Ciuceis
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia
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Sabharwal R, Chapleau MW, Gerhold TD, Baumbach GL, Faraci FM. Plasticity of cerebral microvascular structure and mechanics during hypertension and following recovery of arterial pressure. Am J Physiol Heart Circ Physiol 2022; 323:H1108-H1117. [PMID: 36269650 PMCID: PMC9678426 DOI: 10.1152/ajpheart.00292.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022]
Abstract
Changes in vascular structure contribute to vascular events and loss of brain health. We examined changes in cerebral arterioles at the onset of hypertension and the hypothesis that alterations during hypertension would recover with the return of mean arterial pressure (MAP) to normal. MAP was measured with radiotelemetry in awake male C57BL/6J mice at baseline and during infusion of vehicle or angiotensin II (ANG II, 1.4 mg/kg/day using osmotic pumps) for 28 days, followed by a 28-day recovery. With ANG II treatment, MAP increased through day 28. On day 30, MAP began to recover, reaching levels not different from vehicle on day 37. We measured intravascular pressure, diameter, wall thickness (WT), wall:lumen ratio (W:L), cross-sectional area (CSA), and slope of the tangential elastic modulus (ET) in maximally dilated arterioles. Variables were similar in both groups at day 1, with no significant change with vehicle treatment. With ANG II treatment, CSA, WT, and W:L increased on days 7-28. Internal and external diameter was reduced at 14 and 28 days. ET versus wall stress was reduced on days 7-28. During recovery, the diameter remained at days 14 and 28 values, whereas other variables returned partly or completely to normal. Thus, CSA, WT, W:L, and ET versus wall stress changed rapidly during hypertension and recovered with MAP. In contrast, inward remodeling developed slowly and did not recover. This lack of recovery has mechanistic implications for the long-term impact of hypertension on vascular determinants of brain health.NEW & NOTEWORTHY Changes in vascular structure contribute to vascular events and loss of brain health. We examined the inherent structural plasticity of cerebral arterioles during and after a period of hypertension. Arteriolar wall thickness, diameter, wall-to-lumen ratio, and biological stiffness changed rapidly during hypertension and recovered with blood pressure. In contrast, inward remodeling developed slowly and did not recover. This lack of recovery of arteriolar diameter has implications for the long-term impact of hypertension on vascular determinants of brain health.
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Affiliation(s)
- Rasna Sabharwal
- Department of Internal Medicine, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
- Department of Neuroscience and Pharmacology, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
| | - Mark W Chapleau
- Department of Internal Medicine, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
| | - Thomas D Gerhold
- Department of Internal Medicine, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
| | - Gary L Baumbach
- Department of Pathology, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
| | - Frank M Faraci
- Department of Internal Medicine, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
- Department of Neuroscience and Pharmacology, Carver College of Medicine, Francois M. Abboud Cardiovascular Center, University of Iowa, Iowa City, Iowa
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Tan W, Yao X, Le TT, Tan B, Schmetterer L, Chua J. The New Era of Retinal Imaging in Hypertensive Patients. Asia Pac J Ophthalmol (Phila) 2022; 11:149-159. [PMID: 35533334 DOI: 10.1097/apo.0000000000000509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
ABSTRACT Structural and functional alterations in the microcirculation by systemic hypertension can cause significant organ damage at the eye, heart, brain, and kidneys. As the retina is the only tissue in the body that allows direct imaging of small vessels, the relationship of hypertensive retinopathy signs with development of disease states in other organs have been extensively studied; large-scale epidemiological studies using fundus photography and advanced semi-automated analysis software have reported the association of retinopathy signs with hypertensive end-organ damage includes the following: stroke, dementia, and coronary heart disease. Although yielding much useful information, the vessels assessed from fundus photographs remain limited to the larger retinal arterioles and venules, and abnormalities observed may not be that of the earliest changes. Newer imaging modalities such as optical coherence tomography angiography and adaptive optics technology, which allow a greater precision in the structural quantification of retinal vessels, including capillaries, may facilitate the assessment and management of these patients. The advent of deep learning technology has also augmented the utility of fundus photographs to help create diagnostic and risk stratification systems. Particularly, deep learning systems have been shown in several large studies to be able to predict multiple cardiovascular risk factors, major adverse cardiovascular events within 5 years, and presence of coronary artery calcium, from fundus photographs alone. In the future, combining deep learning systems with the imaging precision offered by optical coherence tomography angiography and adaptive optics could pave way for systems that are able to predict adverse clinical outcomes even more accurately.
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Affiliation(s)
- Wilson Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Xinwen Yao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
| | - Thu-Thao Le
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore
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Bakker E, Dikland FA, van Bakel R, Andrade De Jesus D, Sánchez Brea L, Klein S, van Walsum T, Rossant F, Farías DC, Grieve K, Paques M. Adaptive optics ophthalmoscopy: a systematic review of vascular biomarkers. Surv Ophthalmol 2021; 67:369-387. [PMID: 34090882 DOI: 10.1016/j.survophthal.2021.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 12/28/2022]
Abstract
Retinal vascular diseases are a leading cause for blindness and partial sight certifications. By applying adaptive optics (AO) to conventional imaging modalities, the microstructures of the retinal vasculature can be observed with high spatial resolution, hence offering a unique opportunity for the exploration of the human microcirculation. The objective of this systematic review is to describe the current state of retinal vascular biomarkers imaged by AO flood illumination ophthalmoscopy (FIO) and AO scanning laser ophthalmoscopy (SLO). A literature research was conducted in the PubMed and Scopus databases on July 9, 2020. From 217 screened studies, 42 were eligible for this review. All studies underwent a quality check regarding their content. A meta-analysis was performed for the biomarkers reported for the same pathology in at least three studies using the same modality. The most frequently studied vascular biomarkers were the inner diameter (ID), outer diameter (OD), parietal thickness (PT), wall cross-sectional area (WCSA), and wall-to-lumen ratio (WLR). The applicability of AO vascular biomarkers has been mostly explored in systemic hypertension using AO FIO and in diabetes using AO SLO. The result of the meta-analysis for hypertensive patients showed that WLR, PT, and ID were significantly different when compared to healthy controls, while WCSA was not (P < 0.001, P = 0.002, P < 0.001, and P = 0.070, respectively). The presented review shows that, although a substantial number of retinal vascular biomarkers have been explored in AO en face imaging, further clinical research and standardization of procedures is needed to validate such biomarkers for the longitudinal monitoring of arterial hypertension and other diseases.
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Affiliation(s)
- Elise Bakker
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands
| | - Felix Anne Dikland
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands
| | - Roan van Bakel
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands
| | - Danilo Andrade De Jesus
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
| | - Luisa Sánchez Brea
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Theo van Walsum
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Florence Rossant
- ISEP, Institut Supérieur d'Electronique de Paris, Issy-les-Moulineaux, France
| | - Daniela Castro Farías
- Paris Eye Imaging Group, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS Clinical Investigation Center, Paris, France
| | - Kate Grieve
- Paris Eye Imaging Group, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS Clinical Investigation Center, Paris, France
| | - Michel Paques
- Paris Eye Imaging Group, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS Clinical Investigation Center, Paris, France
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9
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Bruno RM, Climie R, Gallo A. Aortic pulsatility drives microvascular organ damage in essential hypertension: New evidence from choroidal thickness assessment. J Clin Hypertens (Greenwich) 2021; 23:1039-1040. [PMID: 33484605 PMCID: PMC8678812 DOI: 10.1111/jch.14195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Rosa Maria Bruno
- INSERM U970, Paris Cardiovascular Research Centre-PARCC, Université de Paris, Paris, France.,Pharmacology Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Rachel Climie
- INSERM U970, Paris Cardiovascular Research Centre-PARCC, Université de Paris, Paris, France.,Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Antonio Gallo
- Department of Endocrinology and Prevention of Cardiovascular Disease, Institute of Cardio Metabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Laboratoire d'imagerie Biomédicale, INSERM, CNRS, Sorbonne University, Paris, France
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