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von der Burchard C, Gruben A, Roider J. Optical coherence tomography angiography suggests choriocapillaris perfusion deficit as etiology of acute macular neuroretinopathy. Graefes Arch Clin Exp Ophthalmol 2024; 262:2471-2479. [PMID: 38512510 PMCID: PMC11271325 DOI: 10.1007/s00417-024-06436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/19/2024] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE Acute macular neuroretinopathy (AMN) can cause sudden-onset and permanent scotoma in healthy young patients. Analysis of optical coherence tomography (OCT) and OCT angiography (OCTA) of AMN patients may provide insights into disease mechanism. METHODS We conducted a retrospective study of consecutive SARS-Cov-2-related AMN patients that presented in our clinic between Jan 1st, 2022, and April 30th, 2023, within 30 days of symptom onset. Retinal vessel area density (VAD) of AMN lesions in OCTA was quantified and compared to an adjacent tissue control (ATC). This quantification was performed for the superficial vascular plexus (SVP), the intermediate capillary plexus (ICP), the deep capillary plexus (DCP), the choriocapillaris (CC), and choroid. Furthermore, en face OCT images were analyzed. RESULTS Nine AMN patients were identified, 6 of these (4 female, 2 male, average age 25 years) fulfilled the inclusion criteria and were included into this study. Average time from symptom onset to OCTA was 14.3 days. No VAD differences between AMN and adjacent tissue were found in either retinal layer (SVP, ICP, DCP). In contrast, VAD in CC was reduced by 27% against the ATC (p = 0.007) and choroidal VAD was reduced by 41% (p = 0.017). Further analysis of en face OCT could show that the pathognomonic infrared hyporeflectivity in AMN is caused by photoreceptor alterations rather than changes in the inner retinal layers. CONCLUSIONS Our data suggests that a perfusion deficit in the choroidal layers is responsible for AMN rather than in the DCP, which is the predominant hypothesis in current literature.
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Affiliation(s)
- Claus von der Burchard
- Department of Ophthalmology, University Medical Center Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
| | - Arved Gruben
- Department of Ophthalmology, University Medical Center Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Johann Roider
- Department of Ophthalmology, University Medical Center Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany
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Ponugoti A, Ngo H, Stinnett S, Kelly MP, Vajzovic L. Repeatability and reproducibility of quantitative OCT angiography measurements from table-top and portable Flex Spectralis devices. Graefes Arch Clin Exp Ophthalmol 2024; 262:1785-1793. [PMID: 38270629 DOI: 10.1007/s00417-023-06351-3] [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: 07/09/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
PURPOSE The recent development of a portable investigational handheld OCT-angiography (OCTA) device has allowed for expansion of imaging into the operating room (OR) in addition to standard in-clinic imaging. The aim of this study was to assess intravisit repeatability and intervisit reproducibility of retinal microvasculature measures and central retinal thickness for in-clinic table-top and portable OR compatible OCTA devices. METHODS Repeated 10 × 10 OCTA images were acquired in 20 healthy adult participants on two separate visit days using Spectralis spectral-domain OCTA table-top and investigational armature suspended Flex systems. Intravisit and intervisit intraclass correlation coefficients and average absolute percent difference were calculated for quantitative microvasculature measures and CRT. RESULTS 120 OCTA images were acquired from 20 subjects (n = 20, mean age 26.7 ± 1.61 years, range 24-30 years) with both devices across two separate imaging days. FAZ and CRT measurements had near complete intravisit and intervisit agreement with ICCs between .97 and 1 for both table-top (FAZ ICC .97, .97; CRT ICC .98-1, .98-.99) and Flex (FAZ ICC .97, .95; CRT ICC .99-1, .98-.99) devices. Vessel density measures demonstrated greater variance with only fair to strong agreement (ICC .32-.75) and average absolute percent differences ranging from 2.96 to 6.63%. CONCLUSION FAZ and CRT measures for both devices demonstrated high repeatability and reproducibility; retinal vessel density measures demonstrated less. Differences of less than 7% for retinal microvasculature measurements across time and devices are most likely attributable to expectable variance between repeat scans.
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Affiliation(s)
- Arathi Ponugoti
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA.
| | - Hoan Ngo
- School of Biomedical Engineering, International University-VNU HCMC, Ho Chi Minh City, Vietnam
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA
| | - Michael P Kelly
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA
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Zheng X, Wang X, Zhu P. Clinical study on the influence of phacoemulsification on retinal structure of senile cataract based on data mining. Technol Health Care 2024:THC231966. [PMID: 38820033 DOI: 10.3233/thc-231966] [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: 06/02/2024]
Abstract
BACKGROUND With the improvement of the level of science and technology, diagnosis and treatment technology of ophthalmology has continuously improved, especially with the rise of optical coherence tomography. Alternative methods have enabled clinicians to obtain more information and make greater breakthroughs in the occurrence and development of many ophthalmic diseases. OBJECTIVE To investigate changes in retinal structure in the macular area of senile diabetic cataract patients undergoing cataract phacoemulsification. METHODS This was a prospective cohort study. A total of 68 cataract patients (78 eyes) who voluntarily received phacoemulsification combined with intraocular lens implantation in the Department of Ophthalmology of our hospital from December 2018 to December 2021 were selected. They were divided into A (diabetic) and B (non-diabetic) according to whether they were complicated with diabetes. There were 24 cases (28 eyes) in A and 44 cases (50 eyes) in B. Cataract patients were collected before and after surgery. Day, 1 week, and 1 month, data on the average thickness of the fovea retina and thickness of the retinal nerve fiber layer around the optic disc (average thickness, nasal thickness, topic side thickness, upper thickness, and lower thickness) were statistically analyzed analyze. RESULTS The average retinal thickness of the macular fovea in Group A was found to be greater than that of Group B, however, there was no statistically significant difference between the two groups. At week one and week thirty, Group A's layer of retinal nerve fibers surrounding the optic disc thickened; there was no discernible difference between the two groups. One week and one month following surgery, however, showed a one-week difference in upper thickness compared to preoperative days. There was no discernible change between the preoperative and 1-day times. CONCLUSION Both diabetic cataract patients and simple age-related cataract patients will have different degrees of increased foveal retinal thickness after surgery. However, the foveal retinal thickness of patients with diabetes increases more.
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Leclaire MD, Storp JJ, Lahme L, Esser EL, Eter N, Alnawaiseh M. Reduced Retinal Blood Vessel Densities Measured by Optical Coherence Tomography Angiography in Keratoconus Patients Are Negatively Correlated with Keratoconus Severity. Diagnostics (Basel) 2024; 14:707. [PMID: 38611620 PMCID: PMC11011292 DOI: 10.3390/diagnostics14070707] [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: 02/24/2024] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Keratoconus (KC) is the most common corneal ectasia. Optical coherence tomography angiography (OCT-A) is a relatively new non-invasive imaging technique that allows the visualization and quantification of retinal and choriocapillary blood vessels. The aim of this study is to assess retinal and choriocapillary vessel density (VD) differences between KC patients and healthy controls and to investigate correlations between VD and KC severity. Fifty-two eyes were included in this exploratory study: twenty-six eyes from 26 KC patients and twenty-six eyes from 26 age- and gender-matched healthy controls. All patients underwent Scheimpflug corneal topography with Pentacam, axis lengths measurement and optical coherence tomography angiography (OCT-A). The thinnest spot in corneal pachymetry, maximum K (Kmax) and KC severity indices from the Belin/Ambrósio enhanced ectasia display (BAD) were also assessed. There was a distinct reduction particularly in the retinal VD of the superficial capillary plexus (SCP). Correlation analyses showed strong and moderate negative correlations between the VD in the macular SCP and BAD KC scores and between the SCP VD and Kmax. There was no difference in retinal thickness between the KC and healthy controls. With this study, further evidence for altered VD measurements by OCT-A in KC patients is given. For the first time, we demonstrated negative correlations between BAD KC scores and retinal blood vessel alterations. A major limitation of the study is the relatively small sample size. Since an artefactual reduction of the quantitative OCT-A measurements due to irregular corneal topography in KC must be assumed, it remains to be investigated whether there are also actual changes in the retinal microcirculation in KC.
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Affiliation(s)
- Martin Dominik Leclaire
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Jens Julian Storp
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Larissa Lahme
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Eliane Luisa Esser
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Nicole Eter
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33647 Bielefeld, Germany
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Ponugoti A, Ngo H, Stinnett S, Vajzovic L. Chronic Effects of e-Cigarette Aerosol Inhalation on Macular Perfusion Assessed Using OCT Angiography. JOURNAL OF VITREORETINAL DISEASES 2024; 8:21-28. [PMID: 38223771 PMCID: PMC10786087 DOI: 10.1177/24741264231205071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Purpose: To determine whether there are significant differences in the microvasculature and central retinal thickness (CRT) between e-cigarette users (user group) and age-matched nonusers (control group) using optical coherence tomography angiography (OCTA). Methods: In this prospective cross-sectional observational study, OCTA images were acquired of 52 eyes of 26 users and 25 eyes of 25 age-matched nonusers. Daily e-cigarette users with no ocular history were identified from provider information in the electronic medical record. A custom algorithm was used to calculate the foveal avascular zone (FAZ), vessel area density (VAD), and vessel length density (VLD). OCT software was used to calculate the foveal, superior, inferior, nasal, and temporal CRT. Generalized estimating equations using the Z-statistic were used to determine how the FAZ, VAD, VLD, and CRT parameters varied between groups and to assess the differential contribution of descriptive data in the user group. Results: No statistically significant difference was found between the user group and control group in the FAZ, superficial vascular complex (SVC) VAD, SVC VLD, or deep vascular complex (DVC) VAD. A statistically significant difference was found for DVC VLD (P = .002), with the user group having a slightly higher VLD on average. Superior, temporal, and inferior inner macular thicknesses were significantly thinner in the user group (P = .038, P = .012, and P = .035, respectively). Conclusions: Significant negative differences were found in CRT measures but not in retinal microvasculature parameters between e-cigarette users and nonusers. Decreased inferior, temporal, and superior inner macular thickness in e-cigarette users may show an early chronic structural effect that warrants further assessment of retinal effects as this population ages and continues to use e-cigarettes.
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Affiliation(s)
- Arathi Ponugoti
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Hoan Ngo
- School of Biomedical Engineering, International University–VNU HCMC, Ho Chi Minh City, Vietnam
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
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Joo CW, Choi HG, Kim KL, Park SP, Kim YK. Factors affecting optical coherence tomography angiography signal strength index in patients receiving intravitreal injection treatment. Graefes Arch Clin Exp Ophthalmol 2023; 261:3403-3413. [PMID: 37561146 DOI: 10.1007/s00417-023-06200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE To investigate the clinical factors affecting optical coherence tomography angiography (OCTA) signal strength index (SSI) and its change after intravitreal injection treatment in patients with retinal disorders. METHODS OCTA data from 186 eyes of 166 patients with various retinal disorders including age-related macular degeneration, diabetic macular edema (DME), and retinal vein occlusions who received intravitreal injections were analyzed. The associations between SSI and clinical factors, including age, best-corrected visual acuity (BCVA), media opacity severity, and central macular thickness (CMT), were evaluated both before and after injection. RESULTS After injection, BCVA improved and CMT decreased significantly, and SSI increased significantly (p = 0.030). BCVA showed a significant positive correlation with media opacity severity before and after injection and with CMT only before injection. In the multivariate analysis, age, presence of DME, BCVA, and media opacity severity were negatively associated with SSI both before and after injection, while CMT was negatively associated with SSI only before injection. After injection, a negative correlation was found between SSI change and both BCVA and CMT change. CONCLUSION Our findings suggest that OCTA SSI is influenced by various clinical factors, including age, visual acuity, media opacity severity, and macular thickening, especially in cases of DME. The results also indicate that SSI may decrease in patients with macular disorders due to the presence of macular edema and the associated decrease in visual acuity. Therefore, it is crucial to consider these factors when interpreting OCTA data and ensure an adequate level of SSI.
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Affiliation(s)
- Chan Woong Joo
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-Ro, Gangdong-Gu, Seoul, 05355, South Korea
| | - Hyeon Gyu Choi
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-Ro, Gangdong-Gu, Seoul, 05355, South Korea
| | - Kyoung Lae Kim
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-Ro, Gangdong-Gu, Seoul, 05355, South Korea
| | - Sung Pyo Park
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-Ro, Gangdong-Gu, Seoul, 05355, South Korea
| | - Yong-Kyu Kim
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-Ro, Gangdong-Gu, Seoul, 05355, South Korea.
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Storp JJ, Leclaire MD, Zimmermann JA, Englmaier VA, Albert F, Eter N, Al-Nawaiseh S. FURTHER EVIDENCE AGAINST BILATERAL MANIFESTATION OF COATS DISEASE IN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF THE MACULA. Retina 2023; 43:1525-1533. [PMID: 37184510 PMCID: PMC10442121 DOI: 10.1097/iae.0000000000003835] [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: 02/16/2023] [Revised: 03/22/2023] [Accepted: 04/19/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE Recent studies have questioned the traditional view, which regards Coats disease as a strictly unilateral entity. Applying optical coherence tomography angiography, this prospective, monocentric study investigates quantitative capillary changes of the macula associated with Coats disease. METHODS Twenty-four eyes (4 untreated, 8 pre-treated) of 12 patients with stage 2 Coats disease (age range: 9-61 years) and 15 eyes of healthy, age-matched controls from the University of Muenster Medical Center, Germany received macular optical coherence tomography angiography measurements of the superficial, deep, and choriocapillary capillary plexus. Flow density and parameters related to the foveal avascular zone were compared between Coats eyes and fellow eyes, and between fellow eyes and control eyes. Additional subanalyses investigated changes based on disease stage. RESULTS Flow density did not differ between fellow eyes of Coats disease patients and control eyes in any of the parameters investigated. Comparison of Coats eyes to their respective fellow eyes revealed Coats disease to be associated with lower flow density in superficial, deep, and choriocapillary capillary plexus regions, irrespective of disease stage (all P < 0.03). There were no noticeable differences regarding the size or symmetry of the foveal avascular zone. CONCLUSION In light of the recent discussion around the unilateral character of Coats disease, this trial provides evidence against a bilateral presentation of vascular changes in the macula.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; and
| | | | | | - Verena Anna Englmaier
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; and
| | - Felix Albert
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; and
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; and
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Storp JJ, Zimmermann JA, Danzer MF, Alnawaiseh M, Eter N, Al-Nawaiseh S. Characterizing Foveal Hypoplasia Using Optical Coherence Tomography Angiography: Evaluation of Microvascular Abnormalities and Clinical Significance. J Clin Med 2023; 12:4992. [PMID: 37568394 PMCID: PMC10419931 DOI: 10.3390/jcm12154992] [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: 07/04/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to evaluate foveal avascular zone (FAZ) features and macular flow density (FD) in various retinal layers in a cohort of patients with foveal hypoplasia (FH) using optical coherence tomography angiography (OCTA), in order to characterize microvascular abnormalities and explore their potential clinical significance. FAZ parameters and FD, as well as retinal thickness and volume values were analyzed and compared between patients with FH and an age- and gender-matched control cohort. Correlations between disease severity and visual acuity (VA), as well as between disease severity and FAZ features were evaluated. A total of 19 eyes with FH and 19 control eyes were included. The study group showed significantly higher FD values in the foveal sectors of the superficial and deep capillary plexus compared to controls. FAZ area, perimeter, and acircularity index (ACI) were noticeably altered in eyes with FH; however, they did not correlate with disease severity. Visual acuity was negatively correlated with disease severity. The results of this study provide evidence of altered microvasculature architecture specifically in the foveal sectors of patients with FH. The higher FD values in the foveal sectors of FH patients suggest a potential compensatory response of the retinal microvasculature. FAZ parameters and FD values of the foveal sectors could be used as part of an OCTA-based grading system in FH patients.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Moritz Fabian Danzer
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany;
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33604 Bielefeld, Germany;
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
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Lahme L, Storp JJ, Marchiori E, Esser E, Eter N, Mihailovic N, Alnawaiseh M. Evaluation of Ocular Perfusion in Patients with End-Stage Renal Disease Receiving Hemodialysis Using Optical Coherence Tomography Angiography. J Clin Med 2023; 12:jcm12113836. [PMID: 37298031 DOI: 10.3390/jcm12113836] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
Hemodialysis (HD) is known to affect ocular blood flow. This case-control study aims to evaluate macular and peripapillary vasculature in patients with end-stage renal disease (ESRD) receiving HD in comparison to matched controls. A total of 24 eyes of 24 ESRD patients receiving HD and 24 eyes of 24 healthy, age- and gender-matched control subjects were prospectively included in this study. Optical coherence tomography angiography was used to image the superficial (SCP), deep (DCP), and choriocapillary (CC) macular vascular plexus, as well as the radial peripapillary capillaries (RPC) of the optic disc. In addition, retinal thickness (RT) and retinal volume (RV) were compared between both groups. Flow density (FD) values of each retinal layer and data of parameters related to the foveal avascular zone (FAZ), as well as RT and RV, were analyzed using Mann-Whitney U tests. There was no significant difference in FAZ parameters between the two groups. Whole en face FD of the SCP and CC was noticeably reduced in the HD group in comparison to the control group. FD was negatively correlated with the duration of HD treatment. RT and RV were significantly smaller in the study group than in controls. Retinal microcirculation appears altered in patients with ESRD undergoing HD. Concurrently, the DCP appears more resilient towards hemodynamic changes in comparison to the other microvascular retinal layers. OCTA is a useful, non-invasive tool to investigate retinal microcirculation in ESRD patients.
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Affiliation(s)
- Larissa Lahme
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Elena Marchiori
- Department of Vascular and Endovascular Surgery, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Eliane Esser
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Natasa Mihailovic
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33604 Bielefeld, Germany
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33604 Bielefeld, Germany
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Huo YJ, Thomas R, Guo Y, Zhang W, Li L, Cao K, Wang HZ, Wang NL. Topographic Differences in Superficial Macular Vessel Density in Eyes with Early Primary Open-Angle Glaucoma and Normal Tension Glaucoma. Ophthalmic Res 2023; 66:465-473. [PMID: 36603555 DOI: 10.1159/000528877] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/08/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The aim of the study was to compare macular vascular microcirculation in early primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and normal subjects. METHODS 99 patients with early glaucoma (99 eyes: 60 POAG and 39 NTG) and 78 normal subjects were included. All subjects underwent optical coherence tomography angiography scan at 6 × 6 mm macular area. Macular vessel density (VD) and perfusion density (PD) and 9 sectors were compared between the controls, POAG, and NTG groups. Linear regression analysis was used to investigate the relationship between VD and other variables including macular PD, signal strength (SS), and mean macular ganglion cell-inner plexiform layer (mGCIPL) thickness. RESULTS Significant losses in total area of VD and PD were detected in POAG and NTG groups compared to the controls (all p < 0.01). There were no significant differences in all inner sectors of macular VD and PD between POAG and controls (all p > 0.05). Except for outer-nasal sector, all other outer sectors of macular VD and PD were significantly lower in POAG than in the controls (all p < 0.01). The inferior-inner sector and all outer sectors of VD and PD were significantly lower in NTG than in the controls (all p < 0.01). Macular VD was significantly correlated with macular PD (r = 0.99, p < 0.001), SS (r = 0.60, p < 0.001), and mGCIPL thickness (r = 0.51, p < 0.001). CONCLUSIONS Macular microcirculation declined significantly in early POAG and NTG patients. Macular microcirculation loss in the NTG group was more central and nasal compared with that in the POAG group. A decrease in macular VD was correlated with lower macular PD, lower SS, and thinner mGCIPL thickness.
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Affiliation(s)
- Yan-Jiao Huo
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ravi Thomas
- Queensland Eye Institute, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
- Beijing Institute of Ophthalmology, Beijing, China
| | - Yan Guo
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Li
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing, China
| | - Huai-Zhou Wang
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ning-Li Wang
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
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Interlandi E, Pellegrini F, Silvestrin C, Pece A, Pavesio C. Hellp syndrome-related hypertensive chorioretinopathy: A multimodal imaging and optical coherence tomography angiography (OCTA) study. Eur J Ophthalmol 2023; 33:NP88-NP91. [PMID: 34636695 DOI: 10.1177/11206721211051238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Pregnancy may be associated to unique retinal disorders and is associated to worsening of retinal disease that also occurs in non-pregnant females. We report a case of chorioretinopathy caused by pre-eclampsia associated to HELLP (Hemolysis-Elevated-Liver enzymes and Low Platelet count) syndrome. METHODS Multimodal Imaging features of HELLP syndrome-related hypertensive chorioretinopathy including retinography, Spectral Domain-Optical Coherence Tomography (SD-OCT), Fluorescein angiography (FA), Indocyanine-green angiography (ICG) along with OCT-angiography (OCTA) are presented and discussed. RESULTS Multimodal imaging and OCTA show both retinal and choroidal involvement by HELLP syndrome, resolved after hypertension treatment. CONCLUSIONS Multimodal imaging is useful to study HELLP syndrome-related hypertensive chorioretinopathy. Moreover, OCTA is a new technology able to study and follow the circulatory status of the choriocapillaris during the disease.
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Affiliation(s)
| | | | - Chiara Silvestrin
- Department of Anesthesiology, 18173AULSS2 Marca Trevigiana, Conegliano, Italy
| | - Alfredo Pece
- Eye Clinic, 18720Melegnano Hospital, Vizzolo Predabissi, Italy
| | - Carlos Pavesio
- Moorfields Eye Hospital, 4960NHS Foundation Trust, London, UK
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12
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Effects of Tafluprost on Ocular Blood Flow. Ophthalmol Ther 2022; 11:1991-2003. [DOI: 10.1007/s40123-022-00566-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/26/2022] [Indexed: 10/14/2022] Open
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13
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Gonzalez de la Rosa M, de-la-Huerga-Moreno S, Alfonso-Lopez F, Cabrera-Lopez F, Pareja-Rios A, Gonzalez-Hernandez D, Gonzalez-Hernandez M. Comparison of age-related vascular changes in the optic disc of patients with diabetes, with glaucomatous and non-glaucomatous features. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001100. [PMID: 36161853 PMCID: PMC9389122 DOI: 10.1136/bmjophth-2022-001100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/05/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To identify age-related vascular changes in the optic discs of patients with diabetes with and without signs of glaucoma. Methods and analysis A total of 2153 eyes of 1797 patients with diabetes without significant retinopathy were monitored with 10 Topcon-NW400 images obtained over 10.27±1.58 years. 571 non-diabetics eyes were selected as controls. Laguna ONhE uses convolutional neural networks to identify optic disc edges, vessels, cup and rim, and provides a glaucoma assessment index—Globin Distribution Function (GDF). Results In the first image, vessel pixels accounted for 33.88% of the disc area (SD=3.72) in non-glaucoma (DN) and 31.35% (SD=4.05; p<0.0001) in glaucoma cases (DG). This number of pixels was reduced by −0.55% each year (SD=0.77) in the DN and −0.76% (SD=0.86; p=0.0014) in the DG. In the first image, 76.55% of the disc pixels (SD=11.13) belonged to the rim in the DN and 62.05% (SD=11.00; p=0.0014) in the DG, decreasing annually by −0.33% (SD=0.99) in the DN and −0.68% (SD=1.08; p<0.00001) in the DG groups. All rim sectors were reduced over time in the DG group, particularly superotemporal (41°–80°) and inferotemporal (271°–310°). The reduction was smaller in DN, presenting as progressive thickening of the temporal sector (311°–40°). No changes in age were observed in healthy controls. Conclusion Patients with diabetes show progressive reduction of vessels and neuroretinal rim at the optic disc, which is more intense in association with glaucoma. In the absence of glaucoma, the temporal sector of the diabetic rim was not reduced but thickened, displacing the cup nasally.
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Affiliation(s)
| | | | | | - Francisco Cabrera-Lopez
- Ophthalmology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | | | - Marta Gonzalez-Hernandez
- Ophthalmology, Hospital Universitario de Canarias, University of La Laguna, Spain, La Laguna, Spain
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14
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Eid P, Arnould L, Gabrielle PH, Aho LS, Farnier M, Creuzot-Garcher C, Cottin Y. Retinal Microvascular Changes in Familial Hypercholesterolemia: Analysis with Swept-Source Optical Coherence Tomography Angiography. J Pers Med 2022; 12:jpm12060871. [PMID: 35743656 PMCID: PMC9224994 DOI: 10.3390/jpm12060871] [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: 04/07/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
Familial hypercholesterolemia (FH) is a common but underdiagnosed genetic disorder affecting cholesterol metabolism, leading to atherosclerotic disease. The relationship between retinal microvascular changes and the presence of atheroma in patients with FH (FH group), and in comparison to volunteers without FH (CT group), needs further investigation. This cross-sectional study was conducted in a university hospital between October 1, 2020 and May 31, 2021. Cardiovascular data, including the Coronary Artery Calcium (CAC) score, were recorded for FH patients. Macula angiograms were acquired using swept-source optical coherence tomography angiography (SS OCT-A) to analyze both the superficial capillary plexus (SCP) and deep capillary plexus (DCP). A total of 162 eyes of 83 patients were enrolled in the FH group and 121 eyes of 78 volunteers in the CT group. A statistically significant association was found between the CAC score and both vessel density (β = −0.002 [95% CI, −0.004; −0.0005], p = 0.010) and vessel length (β = −0.00005 [95% CI, −0.00008; −0.00001], p = 0.010) in the DCP. The FH group had a significantly lower foveal avascular zone circularity index than the CT group in multivariate analysis (0.67 ± 0.16 in the FH group vs. 0.72 ± 0.10 in the CT group, β = 0.04 [95% CI, 0.002; 0.07], p = 0.037). Retinal microvascularization is altered in FH and retinal vascular densities are modified according to the CAC score.
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Affiliation(s)
- Pétra Eid
- Ophthalmology Department, University Hospital, 21000 Dijon, France; (P.E.); (L.A.); (P.-H.G.)
| | - Louis Arnould
- Ophthalmology Department, University Hospital, 21000 Dijon, France; (P.E.); (L.A.); (P.-H.G.)
- INSERM, CIC1432, Clinical Epidemiology Unit, Dijon University Hospital, 21000 Dijon, France
| | - Pierre-Henry Gabrielle
- Ophthalmology Department, University Hospital, 21000 Dijon, France; (P.E.); (L.A.); (P.-H.G.)
- Centre des Sciences du Gout et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, University of Burgundy Franche-Comté, 21000 Dijon, France
| | - Ludwig S. Aho
- Epidemiology Department, University Hospital, 21000 Dijon, France;
| | - Michel Farnier
- Lipid Clinic, Point Medical and Department of Cardiology, University Hospital, 21000 Dijon, France;
| | - Catherine Creuzot-Garcher
- Ophthalmology Department, University Hospital, 21000 Dijon, France; (P.E.); (L.A.); (P.-H.G.)
- Centre des Sciences du Gout et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, University of Burgundy Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380293536
| | - Yves Cottin
- Cardiology Department, University Hospital, 21000 Dijon, France;
- PEC 2, University Bourgogne Franche-Comte, 21000 Dijon, France
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15
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Vorperian A, Khan N, Lee J, Burkemper B, Zhou X, Grisafe D, LeTran V, Chu Z, Wong B, Xu B, Song B, Wang RK, Richter G. Intrasession Repeatability and Intersession Reproducibility of Macular Vessel Parameters on Optical Coherence Tomography Angiography in Glaucomatous and Non-Glaucomatous Eyes. Curr Eye Res 2022; 47:1068-1076. [PMID: 35385336 DOI: 10.1080/02713683.2022.2061004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Using optical coherence tomography angiography (OCTA), this study compared intrasession repeatability versus intersession reproducibility of macular vessel parameters in glaucoma and non-glaucoma subjects. METHODS 6x6 mm2 macular OCTA scans (Cirrus HD-OCT 5000) were acquired from glaucomatous and non-glaucomatous subjects as part of an observational, longitudinal study. Vessel area density (VAD) and vessel skeleton density (VSD) were calculated using research-based quantification software while perfusion density (PDZ) and vessel density (VDZ) were calculated using commercially developed software (Cirrus 11.0, Carl Zeiss Meditec). Intrasession repeatability and intersession reproducibility were determined using within-eye standard deviation (SW), within-eye coefficient of repeatability (CRW), within-eye coefficient of variation (CVW), and intraclass correlation coefficients (ICC). RESULTS The intrasession repeatability and intersession reproducibility for macular OCTA parameters were similar to one another for both non-glaucomatous and glaucomatous eyes. Intrasession CVW from the non-glaucoma group (n = 73) was 1.097% for VAD, 1.007% for VSD, 2.980% for PDZ, and 2.714% for VDZ. Intersession CVW from the non-glaucoma group (n = 55) was 1.389% for VAD, 1.279% for VSD, 2.935% for PDZ, and 2.695% for VDZ. Intrasession CVW from the glaucoma group (n = 59) was 1.189% for VAD, 0.970% for VSD, 3.827% for PDZ, and 3.542% for VDZ. Intersession CVW from the glaucoma group (n = 45) was 1.412% for VAD, 1.132% for VSD, 3.915% for PDZ, and 3.654% for VDZ. Non-glaucomatous intrasession ICC ranged from 0.711 to 0.824, non-glaucomatous intersession ICC ranged from 0.649 to 0.762, glaucomatous intrasession ICC ranged from 0.710 to 0.853, and glaucomatous intersession ICC ranged from 0.661 to 0.827. CONCLUSIONS Macular OCTA scans can be a useful tool in monitoring the longitudinal progression of glaucoma due to its high repeatability and reproducibility.
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Affiliation(s)
- Alexander Vorperian
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Nasir Khan
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Jae Lee
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Bruce Burkemper
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Xiao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Dominic Grisafe
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Vivian LeTran
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Zhongdi Chu
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Brandon Wong
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Benjamin Xu
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Brian Song
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Grace Richter
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, CA, United States.,Department of Ophthalmology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, United States
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16
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Lal B, Alonso-Caneiro D, Read SA, Tran B, Van Bui C, Tang D, Fiedler JT, Ho S, Carkeet A. Changes in Retinal Optical Coherence Tomography Angiography Indexes Over 24 Hours. Invest Ophthalmol Vis Sci 2022; 63:25. [PMID: 35348589 PMCID: PMC8976927 DOI: 10.1167/iovs.63.3.25] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate changes in the retinal microvasculature of young adults over 24 hours using optical coherence tomography angiography (OCT-A). Methods Participants (n = 44, mean age 23.2 ± 4.1 years, 24 myopes and 20 nonmyopes) with normal ophthalmological findings were recruited. Two macular OCT-A and OCT scans, systemic blood pressure, intraocular pressure (IOP), and biometry measurements were taken every four hours over 24 hours. Superficial and deep retinal layer en face images were analyzed to extract magnification-corrected vascular indexes using image analysis including foveal avascular zone metrics, vessel density, and perfusion density for the foveal, parafoveal, and perifoveal zones. Results Significant diurnal variations (P < 0.001) were observed in the vessel and perfusion density in the three superficial retinal layer regions, with acrophase between 4:30 PM and 8:30 PM. Only foveal and parafoveal regions of the deep retinal layer exhibited significant diurnal variations with acrophase between 9 AM and 3 PM. Myopes and nonmyopes had different acrophases but not amplitudes in the parafoveal perfusion density of superficial retinal layer (P = 0.039). Significant correlations were observed between diurnal amplitudes or acrophases of superficial retinal layer indexes and systemic pulse pressure, IOP, axial length and retinal thickness. Conclusions This study shows, for the first time, that significant diurnal variation exists in OCT-A indexes of macular superficial and deep retinal layer over 24 hours and were related to variations in various ocular and systemic measurements. Myopes and nonmyopes showed differences in the timing but not in amplitude of the superficial retinal layer parafoveal perfusion density variations but not in deep retinal layer.
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Affiliation(s)
- Barsha Lal
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - David Alonso-Caneiro
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Scott A Read
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Binh Tran
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Cong Van Bui
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Daniel Tang
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Joshua T Fiedler
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Steven Ho
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Andrew Carkeet
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
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Correlation of retinal alterations with vascular structure of macular neovascularisation in swept-source optical coherence tomography angiography in age-related macular degeneration. Int Ophthalmol 2022; 42:1553-1562. [PMID: 35028773 PMCID: PMC9122889 DOI: 10.1007/s10792-021-02149-6] [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: 10/27/2021] [Accepted: 12/17/2021] [Indexed: 11/12/2022]
Abstract
Purpose The aim of this study was to find out whether the vascular architecture of untreated macular neovascularisations (MNV) in neovascular age-related macular degeneration (nAMD) as visualised with optic coherence tomography angiography (OCTA) is associated with functional and known morphological alterations of the retina in optic coherence tomography (SD-OCT). Methods The study design was retrospective with consecutive patient inclusion. In 107 patients with newly diagnosed nAMD, MNV were detected by means of OCTA and automated quantitative vascular analysis was performed. The MNV characteristics measured were area, flow density, total vascular length (sumL), density of vascular nodes (numN), fractal dimension (FD) and average vascular width (avgW). These parameters were assessed for associations with vision (BCVA), central retinal thickness (CRT), fluid distribution, the elevation of any pigment epithelial detachment (PED), the occurrence of subretinal haemorrhage and atrophy. Results BCVA was significantly worse with greater MNV area and sumL. Fluid distribution differed significantly in relation to area (p < 0.005), sumL (p < 0.005) and FD (p = 0.001). Greater PED height was significantly associated with higher numN (p < 0.05) and lower avgW (p < 0.05). Atrophy was present significantly more often in MNV with larger area (p < 0.05), higher sumL (p < 0.05) and higher flow density (p = 0.002). None of the MNV parameters had a significant association with CRT or the occurrence of haemorrhage. Conclusion OCTA is not restricted to evaluation of secondary changes but offers the opportunity to analyse the vascular structure of MNV in detail. Differences in vascular morphology are associated with certain secondary changes in retinal morphology. There are thus grounds for optimism that further research may identify and classify OCTA-based markers to permit more individualised treatment of nAMD.
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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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Lal B, Alonso-Caneiro D, Read SA, Carkeet A. Induced Refractive Error Changes the Optical Coherence Tomography Angiography Transverse Magnification and Vascular Indices. Am J Ophthalmol 2021; 229:230-241. [PMID: 33905748 DOI: 10.1016/j.ajo.2021.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To assess the effect of changing anterior eye refractive power with contact lenses on the transverse magnification of en face images and associated vascular indices from optical coherence tomographic angiography (OCT-A). DESIGN Prospective crossover study. METHODS Spherical soft contact lenses (-6 diopter [D] to +6 D in 2 D steps) were used to induce anterior eye refractive power changes in 11 healthy young adults and 3 × 3-mm macular scans were captured using OCT-A (Zeiss AngioPlex, software version 11.0; Cirrus HD-OCT 5000, Carl Zeiss Meditec Inc). Image transverse magnification was predicted based on refraction and biometry measurements and compared with empirical changes in the en face images measured with image analysis. Linear regression analysis was performed to assess the relationship between induced refractive ametropia and foveal avascular zone (FAZ) area, perimeter, circularity, and vessel density and perfusion density. RESULTS The predicted transverse magnification was linearly related to induced refractive ametropia and to the empirical transverse magnification changes (average slope: 1.02, 95% CI: 0.90-1.34). All the OCT-A indices showed linear relationships with induced refractive ametropia (P < .05) with the 12 D tested range altering the indices by 7% to 12%. After correcting for transverse magnification, all OCT-A indices except FAZ area were linearly related to induced refractive ametropia (P < .05) and were reduced to 1% to 9%. CONCLUSIONS This study is the first to show that induced refractive ametropia can affect OCT-A image magnification and indices. These changes are clinically important and need to be considered along with biometry effects when interpreting OCT-A indices. Transverse magnification changes can affect the ability of OCT-A to precisely measure linear dimensions of blood vessels.
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Affiliation(s)
- Barsha Lal
- From the School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia.
| | - David Alonso-Caneiro
- From the School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Scott A Read
- From the School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Andrew Carkeet
- From the School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
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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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21
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Alnawaiseh M, Leclaire MD, Eter N. [Optical coherence tomography angiography (OCT-A) : Overview of the technique and the possible clinical and scientific applications]. Ophthalmologe 2021; 118:617-629. [PMID: 33881588 DOI: 10.1007/s00347-021-01375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
Abstract
Optical coherence tomography angiography (OCT-A) is a very promising noninvasive imaging modality. For the first time it enables a precise 3‑dimensional depiction of the retinal microcirculation without the use of contrast medium and can be carried out rapidly and simply. This makes OCT‑A interesting for both scientific and clinical applications. In many ophthalmological diseases, such as glaucoma and diabetic retinopathy, OCT‑A can detect vascular alterations even in the early stages of the disease. These alterations partially correlate with functional parameters. The use of OCT‑A in the clinical routine is currently still limited due to imaging artifacts, high acquisition costs and large amounts of data; however, the scientific interest in this new technology is enormous and from our point of view it will become established in the clinical routine in the future.
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Affiliation(s)
- Maged Alnawaiseh
- Klinik für Augenheilkunde, Klinikum Fulda, Campus Fulda, Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland.
| | | | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
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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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23
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Huo Y, Thomas R, Guo Y, Zhang W, Li L, Cao K, Wang H, Wang N. Superficial macular vessel density in eyes with mild, moderate, and severe primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2021; 259:1955-1963. [PMID: 33616755 DOI: 10.1007/s00417-021-05120-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/21/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The aim of this study is to report changes in and associations of macular vessel density (VD) and perfusion density (PD) using optical coherence tomography angiography (OCTA) in mild, moderate, and severe open-angle glaucoma. METHODS One hundred thirty-three patients with open-angle glaucoma (133 eyes: 47 mild, 33 moderate, and 53 severe glaucoma) and 73 normal subjects (right eyes) were included in this cross-sectional study. All subjects underwent Cirrus OCTA measurements. One-way analysis of variance (ANOVA) was used to compare macular VD and PD between the controls and mild, moderate, and severe glaucoma groups. Multiple linear regression was performed with OCTA parameters as the predicted variable and age, gender, spherical equivalent (SE), intraocular pressure (IOP), mean deviation (MD), signal strength (SS), and mean macular ganglion cell-inner plexiform layer (mGCIPL) thickness as the predictor variables. RESULTS The total area of VD showed significant differences between the controls vs. mild (p < 0.001) and moderate vs. severe glaucoma (p = 0.003); no significant difference was found between mild and moderate glaucoma (p = 1.000). Macular VD was associated with age (β = -0.02, p = 0.003), MD (β = 0.04, p = 0.001), SS (β = 1.43, p < 0.001), and mGCIPL thickness (β = 0.04, p = 0.002) but not with gender, SE, and IOP (all p > 0.05). CONCLUSIONS Macular microcirculation declined significantly in mild and severe glaucoma. No significant difference was found between mild and moderate glaucoma. Decrease macular VD was independently associated with age, severe MD, lower SS, and thinner mGCIPL thickness.
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Affiliation(s)
- Yanjiao Huo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Ravi Thomas
- Queensland Eye Institute, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,Beijing Institute of Ophthalmology, Beijing, China
| | - Yan Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Wei Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, NO. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China. .,Beijing Institute of Ophthalmology, Beijing, China.
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24
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[Optical coherence tomography angiography and cardiovascular diseases. An overview of the current knowledge]. Ophthalmologe 2021; 118:1119-1127. [PMID: 33616736 PMCID: PMC8568759 DOI: 10.1007/s00347-021-01336-1] [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: 11/09/2020] [Revised: 12/23/2020] [Accepted: 01/26/2021] [Indexed: 11/24/2022]
Abstract
Hintergrund Kardiovaskuläre Erkrankungen (KVE) sind die Haupttodesursache weltweit. Die Beobachtbarkeit von Veränderungen der retinalen Gefäße im Zusammenhang mit KVE mittels Fundoskopie ist schon seit Langem bekannt. Ein neuartiges Verfahren zur nichtinvasiven und detaillierten Darstellung und Quantifizierung der retinalen und papillären Gefäße stellt die optische Kohärenztomographie-Angiographie (OCT-A) dar. Durch die OCT‑A ist es möglich, Gefäßveränderungen einfach und gut reproduzierbar zu visualisieren, weswegen ihr Einsatz nicht nur auf augenärztliche Fragestellungen beschränkt ist. In den vergangenen Jahren sind einige experimentelle und klinische Studien zur Darstellbarkeit und Quantifizierung von Gefäßveränderungen durch die OCT‑A bei Erkrankungen des kardiovaskulären Spektrums publiziert worden. In der vorliegenden Übersicht werden die wichtigsten Erkenntnisse aus diesen Studien zusammengefasst. Methoden Grundlage dieser Arbeit bilden eine umfassende selektive Literaturrecherche und die Darstellung eigener Daten. Ergebnisse Mittlerweile liegen zu vielen Erkrankungen des kardiovaskulären Spektrums OCT-A-Studien vor, die verdeutlichen, dass systemische Gefäßerkrankungen mit Veränderungen der retinalen Mikrozirkulation verbunden sind. Mit der OCT‑A können diese Veränderungen visualisiert und reproduzierbar quantifiziert werden. Oftmals ist es möglich, subklinische Veränderungen aufzuzeigen, bevor die zugrunde liegende Erkrankung anderweitig messbare Veränderungen oder für den Patienten merkbare Symptome verursacht. Schlussfolgerung Die OCT‑A ist eine vielversprechende Bildgebungsmethode auf dem Gebiet der KVE in Wissenschaft und klinischer Anwendung. Sie kann zur Diagnostik und Quantifizierung retinaler Gefäßveränderungen eingesetzt werden. Weitere Studien werden zeigen, ob die OCT‑A bei der Einschätzung des individuellen kardiovaskulären Risikoprofils helfen kann.
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25
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Chu Z, Zhang Q, Gregori G, Rosenfeld PJ, Wang RK. Guidelines for Imaging the Choriocapillaris Using OCT Angiography. Am J Ophthalmol 2021; 222:92-101. [PMID: 32891694 DOI: 10.1016/j.ajo.2020.08.045] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/12/2020] [Accepted: 08/28/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE To provide guidance on how to appropriately quantitate various choriocapillaris (CC) parameters with optical coherence tomography angiography (OCTA). DESIGN Evidence-based perspective. METHODS Review of literature and experience of authors. RESULTS Accurate and reliable quantification of CC using OCTA requires that CC can be visualized and that the measurements of various CC parameters are validated. For accurate visualization, the selected CC slab must be physiologically sound, must produce images consistent with histology, and must yield qualitatively similar images when viewing repeats of the same scan or scans of different sizes. For accurate quantification, the measured intercapillary distances (ICDs) should be consistent with known measurements using histology and adaptive optics and/or OCTA, the selected CC parameters must be physiologically and physically meaningful based on the resolution of the instrument and the density of the scans, the selected algorithm for CC binarization must be appropriate and generate meaningful results, and the CC measurements calculated from multiple scans of the same and different sizes should be quantitatively similar. If the Phansalkar local thresholding method is used, then its parameters must be optimized for CC based on the OCTA instrument and scan patterns used. It is recommended that the window radius used in the Phansalkar method should be related to the expected average ICD in normal eyes. CONCLUSIONS Quantitative analysis of CC using commercially available OCTA instruments is complicated, and researchers need to tailor their strategies based on the instrument, scan patterns, anatomy, and thresholding strategies to achieve accurate and reliable measurements.
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26
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Weindler H, Spitzer MS, Schultheiß M, Kromer R. OCT angiography analysis of retinal vessel density in primary open-angle glaucoma with and without Tafluprost therapy. BMC Ophthalmol 2020; 20:444. [PMID: 33183272 PMCID: PMC7663898 DOI: 10.1186/s12886-020-01707-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Primary open-angle glaucoma (POAG) is a progressive neurodegenerative disease which leads to irreversible blindness. An elevated intraocular pressure (IOP) is considered to be the main risk factor for the disease progression. It is known that retinal blood flow is altered in POAG eyes. Tafluprost, a prostaglandin analogue which lowers the IOP, has shown to also improve the retinal blood flow in animals. Methods The current study therefore evaluated the retinal vessel density in the peripapillary and macular region of POAG patients with normal IOP treated with topical Tafluprost (n = 20) compared to surgically treated patients with normal IOP (n = 22) using optical coherence tomography angiography (OCT-A). The retinal flow density was obtained after binarisation and evaluated in five sectors. Results There was a significantly higher peripapillary flow density in all sectors in Tafluprost treated eyes when compared to post-surgery eyes. The flow density in the inferior sector of the superficial plexus in the macular region was also significantly higher in the Tafluprost group. Conclusions: These results indicate that Tafluprost not only lowers IOP, but may also enhance retinal blood flow in POAG patients with a normal IOP.
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Affiliation(s)
- Hannah Weindler
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Martin S Spitzer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Maximilian Schultheiß
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Robert Kromer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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27
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Tiryaki Demir S, Bas EK, Karapapak M, Karatas ME, Uslu HS, Bulbul A, Guven D. Effect of Prematurity on Foveal Development in Early School-Age Children. Am J Ophthalmol 2020; 219:177-185. [PMID: 32569738 DOI: 10.1016/j.ajo.2020.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the foveal development in preterm children with optical coherence tomography and OCT angiography. DESIGN Retrospective cohort study. METHODS This study included children aged 6-8 years who were born prematurely and who did not receive retinopathy treatment. They were evaluated between September 2018 and July 2019, categorized according to gestational age (GA) (group I: GA ≤30 weeks; group II: GA between 31 and 34 weeks), and compared with full-term children (group III). Central foveal thickness (CFT), inner retinal thickness (IRT), outer retinal thickness (ORT), subfoveal choroidal thickness (CT), temporal and nasal CT, foveal avascular zone (FAZ) diameter, and vessel densities of superficial (SCP-VD) and deep capillary plexuses (DCP-VD) of the foveal and parafoveal areas were examined in detail. RESULTS The study included 126 eyes of 63 patients (group I: 40 eyes; group II: 46 eyes; and group III: 40 eyes). In group I, CFT, IRT, ORT, foveal SCP-VD, and foveal DCP-VD were significantly greater than those in the other groups, and temporal CT and FAZ diameter were significantly lower (P < .05). GA showed a significant negative correlation with CFT, IRT, ORT, foveal SCP-VD, and foveal DCP-VD and a significant positive correlation with subfoveal CT, temporal and nasal CT, and FAZ diameter (P < .05). CONCLUSION The morphological and vascular foveal structures in early school-age children who were born premature were different from those of full-term children. These differences were correlated with GA and more pronounced in those with GA of ≤30 weeks.
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Affiliation(s)
- Semra Tiryaki Demir
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Evrim Kiray Bas
- Department of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Karapapak
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Egemen Karatas
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hasan Sinan Uslu
- Department of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali Bulbul
- Department of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Guven
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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28
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Lee JC, Grisafe DJ, Burkemper B, Chang BR, Zhou X, Chu Z, Fard A, Durbin M, Wong BJ, Song BJ, Xu BY, Wang R, Richter GM. Intrasession repeatability and intersession reproducibility of peripapillary OCTA vessel parameters in non-glaucomatous and glaucomatous eyes. Br J Ophthalmol 2020; 105:1534-1541. [PMID: 32917629 DOI: 10.1136/bjophthalmol-2020-317181] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/04/2020] [Accepted: 08/21/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare intrasession repeatability versus intersession reproducibility of the peripapillary vessel parameters using optical microangiography-based optical coherence tomography angiography (OCTA) in non-glaucomatous and glaucomatous eyes. METHODS In an observational, longitudinal study, peripapillary OCTA scans were collected to evaluate intrasession repeatability and intersession reproducibility using within-eye coefficient of variation (CVW) and intraclass correlation coefficient (ICC). Images were quantified using a custom research-oriented quantification software calculating vessel area density (VAD) and flux and a commercially developed, clinic-oriented quantification software (Cirrus 11.0, Carl Zeiss Meditec) calculating perfusion density (PD) and flux index (FI). Effect of signal strength on the reliability of OCTA parameters was also evaluated. RESULTS Among 120 non-glaucomatous eyes, intrasession CVW were 4.2% for VAD, 5.3% for flux, 1.5% for PD and 2.0% for FI. The intersession CVW were 6.5% for VAD, 8.0% for flux, 2.0% for PD and 3.2% for FI. The intrasession ICC ranged from 0.928 to 0.945, and intersession ICC ranged from 0.811 to 0.866. From 118 glaucomatous eyes, intrasession CVW was 9.0% for VAD, 10.3% for flux, 1.7% for PD and 2.3% for FI. The intersession CVW was 12.1% for VAD, 14.2% for flux, 2.3% for PD and 3.5% for FI. The intrasession ICC ranged from 0.904 to 0.972, and intersession ICC ranged from 0.855 to 0.955. Signal strength was significantly positively associated with OCTA vessel parameters (p<0.0001) for both groups. CONCLUSION Peripapillary OCTA vessel parameters had greater intrasession repeatability compared to intersession reproducibility in both non-glaucomatous and glaucomatous eyes. The built-in commercially developed quantification software demonstrated greater agreement than the custom research-oriented quantification software.
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Affiliation(s)
- Jae Chang Lee
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Dominic J Grisafe
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Bruce Burkemper
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Brenda R Chang
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Xiao Zhou
- Bioengineering, University of Washington, Seattle, Washington, USA
| | - Zhongdi Chu
- Bioengineering, University of Washington, Seattle, Washington, USA
| | - Ali Fard
- Carl Zeiss Meditec Inc, Dublin, California, USA
| | - Mary Durbin
- Carl Zeiss Meditec Inc, Dublin, California, USA
| | - Brandon J Wong
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Brian J Song
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Benjamin Y Xu
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Ruikang Wang
- Bioengineering, University of Washington, Seattle, Washington, USA
| | - Grace M Richter
- Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
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29
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Faatz H, Rothaus K, Gunnemann ML, Book M, Wilming P, Gutfleisch M, Spital G, Lommatzsch A, Pauleikhoff D. Morphologic analysis of macular neovascularizations by OCT angiography-Technical limitations in the comparison of 3×3mm and 6×6mm images. PLoS One 2020; 15:e0237785. [PMID: 32822371 PMCID: PMC7446777 DOI: 10.1371/journal.pone.0237785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background The aim of this study was to ascertain whether there are relevant differences between the vascular morphology of macular neovascularizations (MNV) in 3×3mm and 6×6mm images, produced by optical coherence tomography angiography (OCTA). Methods MNV of 49 patients were automated quantitative analysed, measuring area, flow, the fractal dimension, average vessel length, vascular density, and average vessel caliber. These parameters were compared between the 3×3mm and the 6×6mm images. Results A strong linear association was found between the 3×3mm and the 6×6mm images. While area, flow, and FD of the MNV were very similar, the 3×3mm images showed significantly lower average total vessel length, greater vascular density, and lower average vessel caliber. Conclusion In quantitative analysis of the morphologic parameters of MNV in 3×3mm and 6×6mm images, the structures are not directly equivalent in the two sizes of scan. The images must be evaluated on an individual basis.
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Affiliation(s)
- Henrik Faatz
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
- * E-mail:
| | - Kai Rothaus
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | | | - Marius Book
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | - Pia Wilming
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | | | - Georg Spital
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | - Albrecht Lommatzsch
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
- Department of Ophthalmology, University of Essen–Duisburg, Duisburg, Germany
- Achim Wessing Institute for Imaging in Ophthalmology, University Hospital Duisburg-Essen, Duisburg, Germany
| | - Daniel Pauleikhoff
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
- Department of Ophthalmology, University of Essen–Duisburg, Duisburg, Germany
- Achim Wessing Institute for Imaging in Ophthalmology, University Hospital Duisburg-Essen, Duisburg, Germany
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30
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Cai Y, Sun GS, Zhao L, Han F, Zhao MW, Shi X. Quantitative evaluation of retinal microvascular circulation in patients with obstructive sleep apnea-hypopnea using optical coherence tomography angiography. Int Ophthalmol 2020; 40:3309-3321. [PMID: 32743760 DOI: 10.1007/s10792-020-01518-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/17/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To compare capillaries perfusion in macular areas at different layers and peripapillary region in radial peripapillary capillaries (RPC) between healthy subjects and subjects with obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA). METHODS Totally 16 eyes with mild-to-moderate OSA, 14 eyes with severe OSA and 22 control eyes were enrolled in this study. Every subject filled out the Berlin questionnaire and received a comprehensive ocular and physical examination. The clinical characteristics were collected, OCT and OCTA scans using OCTA RT XR Avanti (AngioVue software, Optovue Inc., Fremont, CA, USA) were performed and analyzed. RESULTS Compared to the control group, the severe group had significantly higher VD in parafovea and perifoveal regions (p = 0.031; p = 0.029) at the level of deep capillary plexus (DCP), whereas the mild-to-moderate group had a significantly lower VD in the peripapillary region on RPC network in disc areas (p = 0.013). CONCLUSIONS Blood flow changes in macular areas might first appear at the DCP layer in OSA patients. Reduced VD in the peripapillary region at the RPC layer might be associated with OSA and cause subsequent RNFL changes.
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Affiliation(s)
- Yi Cai
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.,Eye Diseases and Optometry Institute, Beijing, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.,College of Optometry, Peking University Health Science Center, Beijing, China
| | - Guo-Sheng Sun
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.,Eye Diseases and Optometry Institute, Beijing, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.,College of Optometry, Peking University Health Science Center, Beijing, China
| | - Long Zhao
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Fang Han
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Ming-Wei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.,Eye Diseases and Optometry Institute, Beijing, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.,College of Optometry, Peking University Health Science Center, Beijing, China
| | - Xuan Shi
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China. .,Eye Diseases and Optometry Institute, Beijing, China. .,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China. .,College of Optometry, Peking University Health Science Center, Beijing, China.
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31
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Fernández-Vigo JI, Kudsieh B, Shi H, De-Pablo-Gómez-de-Liaño L, Serrano-Garcia I, Ruiz-Moreno JM, Martínez-de-la-Casa JM, García-Feijóo J, Fernández-Vigo JÁ. Normative Database of Peripapillary Vessel Density Measured by Optical Coherence Tomography Angiography and Correlation Study. Curr Eye Res 2020; 45:1430-1437. [PMID: 32188270 DOI: 10.1080/02713683.2020.1744164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose: To provide a normative data set of swept-source optical coherence tomography angiography (SS-OCTA) peripapillary vessel density (VD) measurements and assess correlations with age, gender, disc area and axial length (AL). Material and Methods: This was an observational cross-sectional study conducted on 346 right eyes of healthy subjects. Peripapillary SS-OCTA VD measurements were obtained in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) in all four quadrants using the Triton device (Topcon, Nagoya, Japan). AL measurements were made by optical biometry. Results: Mean participant age was 37.7 ± 19.8 years (range 5- 83), AL was 23.9 ± 1.3 mm (21-27), and 59% were women. Mean VDs for all quadrants were 57.2 ± 5.7% for SCP (52.4 ± 4.0% - 62.1 ± 4.2%), 46.3 ± 6.5% for DCP (41.9 ± 5.8% - 49.7 ± 4.8%) and 60.8 ± 7.4% for CC (53.4 ± 5.8% - 65.7 ± 5.5%). Negative correlation was detected between SCP VD and age (R = -0.264; P < .001), while correlation between DCP densities and age was positive (R = 0.202; P = .002). No associations were detected between peripapillary VD and gender (P ≥ 0.087) and negative correlation was found with AL and disc area only in the CC (P ≤ 0.004). In a subgroup analysis of 33 individuals, we noted no differences in VD between fellow eyes (P ≥ 0.139). Conclusion: Peripapillary VD showed wide individual variation when measured with the Triton SS-OCTA in the different retinal plexuses and CC. While correlations were observed with age, no relationships emerged with gender and only CC showed negative correlation with AL and disc area.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain.,Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain
| | - Bachar Kudsieh
- Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain.,Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda , Madrid, Spain
| | - Hang Shi
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain.,Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain
| | - Lucía De-Pablo-Gómez-de-Liaño
- Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain.,Department of Ophthalmology, Hospital 12 de Octubre , Madrid, Spain
| | - Irene Serrano-Garcia
- Department of Preventive Medicine, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Universitario Clínico San Carlos , Madrid, Spain
| | - José María Ruiz-Moreno
- Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda , Madrid, Spain.,Department of Ophthalmology, Castilla La Mancha University , Albacete, Spain
| | - José María Martínez-de-la-Casa
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain
| | - Julián García-Feijóo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain
| | - José Ángel Fernández-Vigo
- Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain.,Department of Ophthalmology, Universidad de Extremadura , Badajoz, Spain
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