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Gao Y, Liu Y, Zhang Y, Lang Y, Xu H, Tao Y, Li Y, Mou K, Zhang Y, Man S, Chen Q, Zhou H, Zhang M. Assessment of Outer Retina and Choroid Using Swept Source Optical Coherence Tomography and Angiography in Patients With Multiple Sclerosis. J Neuroophthalmol 2024; 44:167-171. [PMID: 37624772 PMCID: PMC11081474 DOI: 10.1097/wno.0000000000001970] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
BACKGROUND For patients with multiple sclerosis (MS), both structure and microvasculature alterations in the inner retina have been investigated in several studies. However, little is known about the alterations in the outer retina and choroid. Hence, this study aimed to assess the outer retinal and choroidal changes in patients with MS with no history of optic neuritis (ON). METHODS Patients with MS and healthy control participants were enrolled in this cross-sectional study. Quantitative analyses were performed using swept source optical coherence tomography and swept source optical coherence tomography angiography images to assess outer retina thickness (ORT) and choroid thickness (CT), vessel density (VD) of choriocapillaris, and choroidal vascularity index (CVI), which were then compared between the groups. RESULTS A total of 37 participants with MS (72 eyes) and 74 healthy control participants (148 eyes) were included in this study. Compared with healthy controls, patients with MS with no history of ON showed reduced VD of the choriocapillaris and CVI. There was no significant difference in ORT and CT between 2 groups. Meanwhile, in patients with MS, no correlation between OCTA parameters and expanded disability status scale score were found in this study. CONCLUSIONS Our study indicates that patients with MS with no history of optical neuritis have reduced choriocapillaris vessel density and decreased choroidal vascularity index without detectable alteration in outer retina thickness and choroid thickness. The findings complement the outer retinal and choroidal component of MS, providing deeper insight into the pathophysiology of MS.
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Affiliation(s)
- Yuzhu Gao
- Departments of Ophthalmology (YG, Y Liu, Yifan Zhang, HX, YT, Y Li, KM, Yiteng Zhang, SM, QC, MZ), Ophthalmology and Research Laboratory of Ophthalmology (YG) and Neurology (Y Lang, HZ), West China Hospital, Sichuan University, Chengdu, China; and Department of Ophthalmology (YG, Y Liu, Yifan Zhang, HX, YT, Y Li, KM, Yiteng Zhang, SM, QC, MZ), West China School of Medicine, Sichuan University, Chengdu, China
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Zhang W, Li J, Zhu L, Zeng S, Lu Y, Zhang Y, Gu X, Wu H, Yang L. Choroidal Vascularity Index and Choroidal Structural Changes in Children With Nephrotic Syndrome. Transl Vis Sci Technol 2024; 13:18. [PMID: 38512284 PMCID: PMC10960224 DOI: 10.1167/tvst.13.3.18] [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: 09/27/2023] [Accepted: 02/11/2024] [Indexed: 03/22/2024] Open
Abstract
Purpose To investigate the choroidal vascularity index (CVI) and choroidal structural changes in children with nephrotic syndrome. Methods This was a cross-sectional study involving 45 children with primary nephrotic syndrome and 40 normal controls. All participants underwent enhanced depth imaging-optical coherence tomography examinations. An automatic segmentation method based on deep learning was used to segment the choroidal vessels and stroma, and the choroidal volume (CV), vascular volume (VV), and CVI within a 4.5 mm diameter circular area centered around the macular fovea were obtained. Clinical data, including blood lipids, serum proteins, renal function, and renal injury indicators, were collected from the patients. Results Compared with normal controls, children with nephrotic syndrome had a significant increase in CV (nephrotic syndrome: 4.132 ± 0.464 vs. normal controls: 3.873 ± 0.574; P = 0.024); no significant change in VV (nephrotic syndrome: 1.276 ± 0.173 vs. normal controls: 1.277 ± 0.165; P = 0.971); and a significant decrease in the CVI (nephrotic syndrome: 0.308 [range, 0.270-0.386] vs. normal controls: 0.330 [range, 0.288-0.387]; P < 0.001). In the correlation analysis, the CVI was positively correlated with serum total protein, serum albumin, serum prealbumin, ratio of serum albumin to globulin, and 24-hour urine volume and was negatively correlated with total cholesterol, low-density lipoprotein cholesterol, urinary protein concentration, and ratio of urinary transferrin to creatinine (all P < 0.05). Conclusions The CVI is significantly reduced in children with nephrotic syndrome, and the decrease in the CVI parallels the severity of kidney disease, indicating choroidal involvement in the process of nephrotic syndrome. Translational Relevance Our findings contribute to a deeper understanding of how nephrotic syndrome affects the choroid.
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Affiliation(s)
- Wenbo Zhang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Junmeng Li
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Lei Zhu
- Institute of Medical Technology, Peking University Health Science Center, Peking University, Beijing, China
- National Biomedical Imaging Center, Peking University, Beijing, China
| | - Shuang Zeng
- Institute of Medical Technology, Peking University Health Science Center, Peking University, Beijing, China
- National Biomedical Imaging Center, Peking University, Beijing, China
| | - Yanye Lu
- Institute of Medical Technology, Peking University Health Science Center, Peking University, Beijing, China
- National Biomedical Imaging Center, Peking University, Beijing, China
| | - Yadi Zhang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Xiaopeng Gu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Hailong Wu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Liu Yang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
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Choroidal structural analysis in ultra-high risk and first-episode psychosis. Eur Neuropsychopharmacol 2023; 70:72-80. [PMID: 36931136 DOI: 10.1016/j.euroneuro.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/02/2023] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
Both structural and functional alterations in the retina and the choroid of the eye, as parts of the central nervous system, have been shown in psychotic disorders, especially in schizophrenia. In addition, genetic and imaging studies indicate vascular and angiogenesis anomalies in the psychosis spectrum disorders. In this ocular imaging study, choroidal structure and vascularity were investigated using enhanced depth imaging (EDI) optical coherence tomography (OCT) in first-episode psychosis (FEP), ultra-high risk for psychosis (UHR-P), and age- and gender- matched healthy controls (HCs). There were no significant differences between groups in central choroidal thickness, stromal choroidal area (SCA), luminal choroidal area (LCA) and total subfoveal choroidal area. The LCA/SCA ratio (p<0.001) and the choroidal vascularity index (CVI) (p<0.001) were significantly different between FEP, UHR-P and HCs. CVI and LCA/SCA ratio were significantly higher in patients with FEP compared to help-seeking youth at UHR-P. CVI and LCA/SCA ratio were not different between UHR-P and HCs. However, CVI was higher in UHR-P compared to HCs after excluding the outliers for the sensitivity analysis (p = 0.002). Current findings suggest that choroidal thickness is normal, but there are abnormalities in choroidal microvasculature in prodromal and first-episode psychosis. Further longitudinal studies are needed to investigate oculomics, especially CVI, as a promising biomarker for the prediction of conversion to psychosis in individuals at clinical high-risk.
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Long-term follow-up of choroidal changes following COVID-19 infection: analysis of choroidal thickness and choroidal vascularity index. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:59-65. [PMID: 34302757 PMCID: PMC8255099 DOI: 10.1016/j.jcjo.2021.06.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate subclinical choroidal involvement in patients with systemic coronavirus disease 2019 (COVID-19) infection and evaluate its long-term course. MATERIALS AND METHODS This prospective, longitudinal study included 32 eyes of 16 COVID-19 patients and 34 eyes of 17 age-matched healthy control subjects. All the participants had a detailed ophthalmologic assessment, including visual acuity assessment, slit-lamp examination, and indirect ophthalmoscopy. Enhanced depth optical coherence tomography imaging of the posterior pole and peripapillary region was performed in the early (days 15-40) and late (ninth month) postinfectious periods. Choroidal vascularity index (CVI) was calculated using ImageJ software (National Institutes of Health, Bethesda, Md.). RESULTS None of the patients had any examination finding associated with the ocular involvement of COVID-19. Subfoveal choroidal thickness (SFCT) decreased significantly in the early postinfectious period compared with the healthy control individuals (p = 0.045). SFCT increased significantly in the late postinfectious period compared with the early period (p = 0.002), and the difference between patients and control individuals became statistically insignificant (p = 0.362). There was a similar trend for the peripapillary choroidal thickness measurements. CVI remained unchanged (p = 0.721) despite the significant decrease in SFCT and total choroidal area (p = 0.042), indicating that this decrease occurred both in choroidal stroma and in blood vessels. CVI remained unchanged in the late postinfectious period (p = 0.575) compared with the early period, indicating that recovery occurred in the entire choroidal tissue. CONCLUSION This study demonstrates that choroidal thickness was reduced in all measured areas and that this decrease affected all choroidal layers. This choroidopathy was reversible and recovered in the ninth postinfectious month.
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Garlı M, Kurna SA, Alış A, Akın Çakır E, Yükselen NP, Açıkalın B. Evaluation of peripapillary and subfoveal choroidal vascularity index in patients with multiple sclerosis. Photodiagnosis Photodyn Ther 2022; 38:102810. [PMID: 35304309 DOI: 10.1016/j.pdpdt.2022.102810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/02/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the changes in the peripapillary choroidal vascularity index (PCVI) and subfoveal choroidal vascularity index (SFCVI) in multiple sclerosis (MS) patients and healthy subjects METHODS: A total of 145 eyes of 73 patients were investigated in this cross-sectional study. 78 eyes of 39 MS patients (Group 1) and 67 eyes of 34 healthy subjects (Group 2) were evaluated. MS patients with a history of optic neuritis (ON) constituted Group 1a, those without a history of ON constituted Group 1b. RESULTS The mean PCVI was significantly lower in Group 1 than Group 2 (61,39±3,00 % vs 64,49±2,29 % respectively, p<0.001). The mean SFCVI scores of Group 1 was significantly lower than Group 2 (64,01±2,66 % vs. 66,87±2,14 % respectively, p<0.001). The mean PCVI of Group 1a (59,26±2,85 %) was significantly lower compared to Group 1b (62,87±2,08 %) and Group 2 (64,49±2,29 %, p1<0.001, p2<0.001). The mean SFCVI of Group 1a was significantly lower than Group 2 (64.26±2.75 % vs. 66.87±2.14 % respectively, p<0.001). CONCLUSION PCVI and SFCVI scores were significantly lower in MS patients compared to healthy controls. PCVI scores of MS patients who had a history of ON were significantly lower than those of patients without a previous ON attack, as were SFCVI scores. We consider that evaluation of PCVI and SFCVI might be useful for monitoring ocular involvement in patients with MS.
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Affiliation(s)
- Murat Garlı
- Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul 34752, Turkey.
| | - Sevda Aydın Kurna
- Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul 34752, Turkey
| | - Abdülkadir Alış
- Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul 34752, Turkey
| | - Esra Akın Çakır
- Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul 34752, Turkey
| | - Nihan Parasız Yükselen
- Department of Neurology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul 34752, Turkey
| | - Banu Açıkalın
- Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul 34752, Turkey
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Temel E, Aşıkgarip N, Koçak Y, Örnek K, Kocamış Ö, Özcan G. Analysis of choroidal vascularity index in multiple sclerosis patients without optic neuritis attack. Photodiagnosis Photodyn Ther 2022; 38:102823. [DOI: 10.1016/j.pdpdt.2022.102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/26/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
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Choroidal vascularity index and retinal nerve fiber layer reflectivity in newly diagnosed migraine patients. Photodiagnosis Photodyn Ther 2021; 36:102531. [PMID: 34520878 DOI: 10.1016/j.pdpdt.2021.102531] [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: 06/26/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the choroidal structural parameters, peripapillary retinal nerve fiber layer (RNFL) thickness, and optic density index (ODI) and their correlations in patients with migraine. METHODS Twenty-eight newly diagnosed migraine patients and 28 age-matched healthy controls were included in this prospective cross-sectional study. The enhanced depth-optical coherence tomography images were evaluated. The choroidal area (CA) was binarized to the luminal area (LA) and stromal area (SA) using Image J. The choroidal vascularity index (CVI), the mean peripapillary RNFL thickness, superior-inferior-nasal-temporal quadrant RNFL thicknesses, and the ODI were compared statistically. RESULTS The difference in the mean CVI between the patient group and controls reached a statistical significance (p=0.035). The mean RNFL thickness was significantly decreased in patients with migraine compared with the controls (p=0.040). The mean RNFL thickness in the superior, temporal, and inferior quadrants was significantly decreased in the patient group in comparison to the control subjects (p=0.030, p=0.001, and p=0.022, respectively). There were no significant differences between the migraine group and the controls for the mean ODI of RNFL (p=0.399). CONCLUSION The CVI and the RNFL thickness except for the nasal quadrant were significantly decreased in newly diagnosed migraine patients.
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