Magnetic resonance imaging of the retina

Functional evaluation in inherited retinal disease

Functional assessments are a fundamental part of the clinical evaluation of patients with inherited retinal diseases (IRDs). Their importance and impact have become increasingly notable, given the significant breadth and number of clinical trials and studies investigating multiple avenues of intervention across a wide range of IRDs, including gene, pharmacological and cellular therapies. Moreover, the fact that many clinical trials are reporting improvements in vision, rather than the previously anticipated structural stability/slowing of degeneration, makes functional evaluation of primary relevance. In this review, we will describe a range of methods employed to characterise retinal function and functional vision, beginning with tests variably included in the clinic, such as visual acuity, electrophysiological assessment and colour discrimination, and then discussing assessments often reserved for clinical trials/research studies such as photoaversion testing, full-field static perimetry and microperimetry, and vision-guided mobility testing; addressing perimetry in greatest detail, given it is commonly a primary outcome metric. We will focus on how these tests can help diagnose and monitor particular genotypes, also noting their limitations/challenges and exploring analytical methodologies for better exploiting functional measurements, as well as how they facilitate patient inclusion and stratification in clinical trials and serve as outcome measures.

SGLT2 Inhibitor-Induced Low-Grade Ketonemia Ameliorates Retinal Hypoxia in Diabetic Retinopathy-A Novel Hypothesis

Diabetic retinopathy (DR) is a well-recognized microvascular complication of diabetes. Growing evidence suggests that, in addition to retinal vascular damage, there is significant damage to retinal neural tissue in DR. Studies reveal neuronal damage before clinically evident vascular lesions and DR is now classified as a neurovascular complication. Hyperglycemia causes retinal damage through complex metabolic pathways leading to oxidative stress, inflammation, vascular damage, capillary ischemia, and retinal tissue hypoxia. Retinal hypoxia is further worsened by high oxygen consumption in the rods. Persistent hypoxia results in increases in vascular endothelial growth factor (VEGF) and other pro-angiogenic factors leading to proliferative DR/macular edema and progressive visual impairment. Optimal glucose control has favorable effects in DR. Other treatments for DR include laser photocoagulation, which improves retinal oxygenation by destroying the high oxygen consuming rods and their replacement by low oxygen consuming glial tissue. Hypoxia is a potent stimulator of VEGF, and intravitreal anti-VEGF antibodies are effective in regressing macular edema and in some studies, retinal neovascularization. In this review, we highlight the complex pathophysiology of DR with a focus on retinal oxygen/fuel consumption and hypoxic damage to retinal neurons. We discuss potential mechanisms through which sodium-glucose cotransporter 2 (SGLT2) inhibitors improve retinal hypoxia-through ketone bodies, which are energetically as efficient as glucose and yield more ATP per molecule of oxygen consumed than fat, with less oxidative stress. Retinal benefits would occur through improved fuel energetics, less hypoxia and through the anti-inflammatory/oxidative stress effects of ketone bodies. Well-designed studies are needed to explore this hypothesis.

3-Dimensional magnetic resonance imaging of the freely moving human eye

Eye motion is a major confound for magnetic resonance imaging (MRI) in neuroscience or ophthalmology. Currently, solutions toward eye stabilisation include participants fixating or administration of paralytics/anaesthetics. We developed a novel MRI protocol for acquiring 3-dimensional images while the eye freely moves. Eye motion serves as the basis for image reconstruction, rather than an impediment. We fully reconstruct videos of the moving eye and head. We quantitatively validate data quality with millimetre resolution in two ways for individual participants. First, eye position based on reconstructed images correlated with simultaneous eye-tracking. Second, the reconstructed images preserve anatomical properties; the eye's axial length measured from MRI images matched that obtained with ocular biometry. The technique operates on a standard clinical setup, without necessitating specialized hardware, facilitating wide deployment. In clinical practice, we anticipate that this may help reduce burdens on both patients and infrastructure, by integrating multiple varieties of assessments into a single comprehensive session. More generally, our protocol is a harbinger for removing the necessity of fixation, thereby opening new opportunities for ethologically-valid, naturalistic paradigms, the inclusion of populations typically unable to stably fixate, and increased translational research such as in awake animals whose eye movements constitute an accessible behavioural readout.

Application of Arterial Spin Labelling in the Assessment of Ocular Tissues

Arterial spin labelling (ASL) is a noninvasive magnetic resonance imaging (MRI) modality, capable of measuring blood perfusion without the use of a contrast agent. While ASL implementation for imaging the brain and monitoring cerebral blood flow has been reviewed in depth, the technique is yet to be widely used for ocular tissue imaging. The human retina is a very thin but highly stratified structure and it is also situated close to the surface of the body which is not ideal for MR imaging. Hence, the application of MR imaging and ASL in particular has been very challenging for ocular tissues and retina. That is despite the fact that almost all of retinal pathologies are accompanied by blood perfusion irregularities. In this review article, we have focused on the technical aspects of the ASL and their implications for its optimum adaptation for retinal blood perfusion monitoring. Retinal blood perfusion has been assessed through qualitative or invasive quantitative methods but the prospect of imaging flow using ASL would increase monitoring and assessment of retinal pathologies. The review provides details of ASL application in human ocular blood flow assessment.

Magnetic resonance imaging of the retina: from mice to men

This mini-review provides an overview of magnetic resonance imaging (MRI) applications to study rodent, cat, non-human primate, and human retinas. These techniques include T(1) - and T(2) -weighted anatomical, diffusion, blood flow, blood volume, blood-oxygenation level dependent, manganese-enhanced, physiological, and functional MRI. Applications to study the retinas in diabetic retinopathy, glaucoma, and retinal degeneration are also reviewed. MRI offers some unique advantages compared with existing imaging techniques and has the potential to further our understanding of physiology and function in healthy and diseased retinas.

Choroidal blood flow decreases with age: an MRI study

PURPOSE

To verify that a visual fixation protocol with cued eye blinks achieves sufficient stability for magnetic resonance imaging (MRI) blood-flow measurements and to determine if choroidal blood flow (ChBF) changes with age in humans.

METHODS

The visual fixation stability achievable during an MRI scan was measured in five normal subjects using an eye-tracking camera outside the MRI scanner. Subjects were instructed to blink immediately after recorded MRI sound cues but to otherwise maintain stable visual fixation on a small target. Using this fixation protocol, ChBF was measured with MRI using a 3 Tesla clinical scanner in 17 normal subjects (24-68 years old). Arterial and intraocular pressures (IOP) were measured to calculate perfusion pressure in the same subjects.

RESULTS

The mean temporal fluctuations (standard deviation) of the horizontal and vertical displacements were 29 ± 9 μm and 38 ± 11 μm within individual fixation periods, and 50 ± 34 μm and 48 ± 19 μm across different fixation periods. The absolute displacements were 67 ± 31 μm and 81 ± 26 μm. ChBF was negatively correlated with age (R = -0.7, p = 0.003), declining 2.7 ml/100 ml/min per year. There were no significant correlations between ChBF versus perfusion pressure, arterial pressure, or IOP. There were also no significant correlations between age versus perfusion pressure, arterial pressure, or IOP. Multiple regression analysis indicated that age was the only measured independent variable that was significantly correlated with ChBF (p = 0.03).

CONCLUSIONS

The visual fixation protocol with cued eye blinks was effective in achieving sufficient stability for MRI measurements. ChBF had a significant negative correlation with age.

Postocclusive reactive hyperemia occurs in the rat retinal circulation but not in the choroid

PURPOSE

We tested the hypothesis that retinal blood flow has a postocclusive reactive hyperemia response modulated by occlusion duration and metabolic activity, and that choroidal blood flow does not.

METHODS

Anesthetized and paralyzed rats (n = 34) were studied. Retinal and choroidal blood flow was measured by laser speckle imaging and laser Doppler flowmetry, respectively. Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to measure changes in relative blood oxygenation of the retinal and choroidal circulations. Transient carotid occlusion was elicited with a hydraulic occluder on the common carotid artery. Several occlusion durations were tested during dark, constant light, and flicker light conditions to modulate metabolic demand. The hyperemia response magnitude was quantified by integrating the area above the blood flow baseline for the 3 minutes after release of the occlusion.

RESULTS

Systemic arterial pressure (108.2 ± 1.4 mm Hg) was unaffected by the carotid occlusions, and was similar among animals and conditions. Retinal blood flow had a reactive hyperemia, but choroidal blood flow did not (e.g., 14 ± 2%.sec versus 0.5 ± 4%. sec after 60-second occlusion). The hyperemia magnitude increased as a nonlinear function of occlusion duration and reached a plateau at occlusion durations < 60 second. The hyperemia magnitude was not altered by different lighting conditions at occlusion durations of 15 and 60 seconds. BOLD fMRI results were similar to the laser-based blood flow measurements.

CONCLUSIONS

The results indicate that metabolic local control has a negligible role in choroidal blood flow regulation and only partially accounts for the blood flow behavior in the retinal circulation.

Decreased retinal-choroidal blood flow in retinitis pigmentosa as measured by MRI

PURPOSE

To evaluate retinal and choroidal blood flow (BF) using high-resolution magnetic resonance imaging (MRI) as well as visual function measured by the electroretinogram (ERG) in patients with retinitis pigmentosa (RP).

METHODS

MRI studies were performed in 6 RP patients (29-67 years) and 5 healthy volunteers (29-64 years) on a 3-Tesla scanner with a custom-made surface coil. Quantitative BF was measured using the pseudo-continuous arterial spin-labeling technique at 0.5 × 0.8 × 6.0 mm. Full-field ERGs of all patients were recorded. Amplitudes and implicit times of standard ERGs were analyzed.

RESULTS

Basal BF in the posterior retinal-choroid was 142 ± 16 ml/100ml/min (or 1.14 ± 0.13 μl/mm(2)/min) in the control group and was 70 ±19 ml/100ml/min (or 0.56 ± 0.15 μl/mm(2)/min) in the RP group. Retinal-choroidal BF was significantly reduced by 52 ± 8 % in RP patients compared to controls (P<0.05). ERG a- and b-wave amplitudes of RP patients were reduced, and b-wave implicit times were delayed. There were statistically significant correlations between a-wave amplitude and BF value (r=0.9, P<0.05) but not between b-wave amplitude and BF value (r =0.7, P=0.2).

CONCLUSIONS

This study demonstrates a novel non-invasive MRI approach to measure quantitative retinal and choroidal BF in RP patients. We found that retinal-choroidal BF was markedly reduced and significantly correlated with reduced amplitudes of the a-wave of the standard combined ERG.

Ultra high-resolution fMRI and electrophysiology of the rat primary somatosensory cortex

High-resolution functional-magnetic-resonance-imaging (fMRI) has been used to study brain functions at increasingly finer scale, but whether fMRI can accurately reflect layer-specific neuronal activities is less well understood. The present study investigated layer-specific cerebral-blood-volume (CBV) fMRI and electrophysiological responses in the rat cortex. CBV fMRI at 40×40 μm in-plane resolution was performed on an 11.7-T scanner. Electrophysiology used a 32-channel electrode array that spanned the entire cortical depth. Graded electrical stimulation was used to study activations in different cortical layers, exploiting the notion that most of the sensory-specific neurons are in layers II-V and most of the nociceptive-specific neurons are in layers V-VI. CBV response was strongest in layer IV of all stimulus amplitudes. Current source density analysis showed strong sink currents at cortical layers IV and VI. Multi-unit activities mainly appeared at layers IV-VI and peaked at layer V. Although our measures showed scaled activation profiles during modulation of stimulus amplitude and failed to detect specific recruitment at layers V and VI during noxious electrical stimuli, there appears to be discordance between CBV fMRI and electrophysiological peak responses, suggesting neurovascular uncoupling at laminar resolution. The technique implemented in the present study offers a means to investigate intracortical neurovascular function in the normal and diseased animal models at laminar resolution.

Review: magnetic resonance imaging techniques in ophthalmology

Imaging the eye with magnetic resonance imaging (MRI) has proved difficult due to the eye's propensity to move involuntarily over typical imaging timescales, obscuring the fine structure in the eye due to the resulting motion artifacts. However, advances in MRI technology help to mitigate such drawbacks, enabling the acquisition of high spatiotemporal resolution images with a variety of contrast mechanisms. This review aims to classify the MRI techniques used to date in clinical and preclinical ophthalmologic studies, describing the qualitative and quantitative information that may be extracted and how this may inform on ocular pathophysiology.

Connectivity of thalamo-cortical pathway in rat brain: combined diffusion spectrum imaging and functional MRI at 11.7 T

Fiber tracking in combination with functional MRI has recently attracted strong interest, as it may help to elucidate the structural basis for functional connectivities and may be selective in the determination of the fiber bundles responsible for a particular circuit. Diffusion spectrum imaging provides a more complex analysis of fiber circuits than the commonly used diffusion tensor imaging approach, also allowing the discrimination of crossing fibers in the brain. For the understanding of pathophysiological alterations during brain lesion and recovery, such studies need to be extended to small-animal models. In this article, we present the first study combining functional MRI with high-resolution diffusion spectrum imaging in vivo. We have chosen the well-characterized electrical forepaw stimulation paradigm in the rat to examine the thalamo-cortical pathway. Using the functionally activated areas in both thalamus and somatosensory cortex as seed and target regions for fiber tracking, we are able to characterize the fibers responsible for this stimulation pathway. Moreover, we show that the selection of the thalamic nucleus and primary somatosensory cortex on the basis of anatomical description results in a larger fiber bundle, probably encompassing connectivities between the thalamus and other areas of the somatosensory cortex, such as the hindpaw and large barrel field cortex.

MR imaging of papilledema and visual pathways: effects of increased intracranial pressure and pathophysiologic mechanisms

Papilledema, defined as swelling of the optic disc, frequently occurs in the setting of increased ICP and in a variety of medical conditions, including pseudotumor cerebri, sinus thrombosis, intracerebral hemorrhage, frontal lobe neoplasms, and Chiari malformation. Noninvasive imaging of the ON is possible by using MR imaging, with a variety of findings occurring in the setting of papilledema, including flattening of the posterior sclera, protrusion of the optic disc, widening of the ONS, and tortuosity of the ON. Early recognition of papilledema and elevated ICP is of paramount importance for ensuring restoration of vision. Newer advanced MR imaging techniques such as fMRI and DTI may prove useful in the future to assess the potential effects of papilledema on retinal and visual pathway integrity.

Magnetic resonance imaging indicates decreased choroidal and retinal blood flow in the DBA/2J mouse model of glaucoma

PURPOSE

This study tests the hypothesis that reduced retinal and choroidal blood flow (BF) occur in the DBA/2J mouse model of glaucoma.

METHODS

Quantitative BF magnetic resonance imaging (MRI) with a resolution of 42 × 42 × 400 μm was performed on DBA/2J mice at 4, 6, and 9 months of age and C57BL/6 age-matched controls under isoflurane anesthesia. BF MRI images were acquired with echo-planar imaging using an arterial spin labeling technique and a custom-made eye coil at 7 Tesla. Automated profile analysis was performed to average layer-specific BF along the length of the retina and choroid. In separate experiments, servo-null micropressure measurements of iliac arterial pressure were performed in old mice of both strains.

RESULTS

Choroidal BF was lower in DBA/2J mice than in age-matched C57BL/6 control mice at 4, 6, and 9 months of age (P < 0.01 for all age-matched groups). Retinal BF was lower in DBA/2J mice than in C57BL/6 mice at the 9-month time point (P < 0.01). Mean arterial pressure was not significantly different in aged C57BL/6 mice compared with aged DBA/2J mice.

CONCLUSIONS

The reduced ocular blood flow in DBA/2J mice compared with C57BL/6 control mice suggests that ischemia or hypoxia should be considered as a possible contributing factor in the optic neuropathy in the DBA/2J mouse model of glaucoma.

Manganese-enhanced MRI reveals multiple cellular and vascular layers in normal and degenerated retinas

PURPOSE

To use manganese-enhanced magnetic resonance imaging (MEMRI) at 25 × 25 × 800 μm(3) to image different retinal and vascular layers in the rat retinas.

MATERIALS AND METHODS

Manganese-chloride was injected intraocularly in normal (n = 5) and Royal College of Surgeons (RCS, an model of photoreceptor degeneration) (n = 5) rats at postnatal day 90. MEMRI at 4.7 T was performed 24 hours later. MRI was repeated following intravenous Gd-DTPA in the same animals to highlight the vasculatures. Layer assignment and thickness were compared to histology.

RESULTS

MEMRI 24 hours after intravitreal manganese-chloride injection revealed seven bands of alternating hyper- and hypointensities, corresponding histologically to the ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer, outer nuclear layer, photoreceptor-segment layer, and choroidal vascular layer. Intravenous Gd-DTPA-which does not cross the blood-retinal barrier and the retinal pigment epithelium-further enhanced the two layers bounding the retina, corresponding to the retinal and choroidal vascular layers, but not the avascular outer nuclear layer and the photoreceptor-segment layer. MEMRI of the RCS retinas revealed the loss of the outer plexiform layer, outer nuclear layer, and photoreceptor-segment layer. Histological analysis corroborated the MRI laminar assignments and thicknesses.

CONCLUSION

Lamina-specific retinal structures neurodegenerative changes to structure in retinal diseases can be detected using MEMRI.

Lamina-specific functional MRI of retinal and choroidal responses to visual stimuli

PURPOSE

To demonstrate lamina-specific functional magnetic resonance imaging (MRI) of retinal and choroidal responses to visual stimulation of graded luminance, wavelength, and frequency.

MATERIALS AND METHODS

High-resolution (60 × 60 μm) MRI was achieved using the blood-pool contrast agent, monocrystalline iron oxide nanoparticles (MION) and a high-magnetic-field (11.7 T) scanner to image functional changes in the normal rat retina associated with various visual stimulations. MION functional MRI measured stimulus-evoked blood-volume (BV) changes. Graded luminance, wavelength, and frequency were investigated. Stimulus-evoked fMRI signal changes from the retinal and choroidal vascular layers were analyzed.

RESULTS

MRI revealed two distinct laminar signals that corresponded to the retinal and choroidal vascular layers bounding the retina and were separated by the avascular layer in between. The baseline outer layer BV index was 2-4 times greater than the inner layer BV, consistent with higher choroidal vascular density. During visual stimulation, BV responses to flickering light of different luminance, frequency, and wavelength in the inner layer were greater than those in the outer layer. The inner layer responses were dependent on luminance, frequency, and wavelength, whereas the outer layer responses were not, suggesting differential neurovascular coupling between the two vasculatures.

CONCLUSIONS

This is the first report of simultaneous resolution of layer-specific functional responses of the retinal and choroid vascular layers to visual stimulation in the retina. This imaging approach could have applications in early detection and longitudinal monitoring of retinal diseases where retinal and choroidal hemodynamics may be differentially perturbed at various stages of the diseases.

Layer-specific functional and anatomical MRI of the retina with passband balanced SSFP

The retina consists of multiple cellular and synaptic layers and is nourished by two distinct (retinal and choroidal) circulations bounding the retina, separated by an avascular layer. High spatiotemporal resolution, layer-specific MRI of the retina remains challenging due to magnetic inhomogeneity-induced artifacts. This study reports passband balanced steady-state free-precession (bSSFP) MRI at 45×45×500 μm and 1.6 s temporal resolution to image the mouse retina, overcoming geometric distortion and signal dropout while maintaining rapid acquisition and high signal-to-noise ratio. bSSFP images revealed multiple alternating dark-bright-dark-bright retinal layers. Hypoxic (10% O(2) ) inhalation decreased bSSFP signals in the two layers bounding the retina, corresponding to the retinal and choroidal vasculatures. The layer in between showed no substantial response and was assigned the avascular photoreceptor layers. Choroidal responses (-25.9 ± 6.4%, mean ± SD, n=6) were significantly (P<0.05) larger than retinal vascular responses (-11.6±2.4%). bSSFP offers very high spatiotemporal resolution and could have important applications in imaging layer-specific changes in retinal diseases.

Effects of common anesthetics on eye movement and electroretinogram

High-resolution magnetic resonance imaging (MRI) provides non-invasive images of retinal anatomy, physiology, and function with depth-resolved laminar resolution. Eye movement and drift, however, could limit high spatial resolution imaging, and anesthetics that minimize eye movement could significantly attenuate retinal function. The aim of this study was to determine the optimal anesthetic preparations to minimize eye movement and maximize visual-evoked retinal response in rats. Eye movements were examined by imaging of the cornea with a charge-coupled device (CCD) camera under isoflurane, urethane, ketamine/xylazine, and propofol anesthesia at typical dosages in rats. Combination of the paralytic pancuronium bromide with isoflurane or ketamine/xylazine anesthesia was also examined for the eye movement studies. Visual-evoked retinal responses were evaluated using full-field electroretinography (ERG) under isoflurane, ketamine/xylazine, urethane, and ketamine/xylazine + pancuronium anesthesia in rats. The degree of eye movement, measured as displacement per unit time, was the smallest under 1% isoflurane + pancuronium anesthesia. The ketamine/xylazine groups showed larger dark-adapted ERG a- and b-waves than other anesthetics tested. The isoflurane group showed the shortest b-wave implicit times. Photopic ERGs in the ketamine/xylazine groups showed the largest b-waves with the isoflurane group showing slightly shorter implicit times at the higher flash intensities. Oscillatory potentials revealed an early peak in the isoflurane group compared with ketamine/xylazine and urethane groups. Pancuronium did not affect the a- and b-wave, but did increase oscillatory potential amplitudes. Compared with the other anesthetics tested here, ketamine/xylazine + pancuronium was the best combination to minimize eye movement and maximize retinal function. These findings should set the stage for further development and application of high-resolution functional imaging techniques, such as MRI, to study retinal anatomy, physiology, and function in anesthetized rats.

Anatomical, blood oxygenation level-dependent, and blood flow MRI of nonhuman primate (baboon) retina

The goal of this study was to demonstrate high-resolution anatomical, blood oxygenation level-dependent, and blood flow MRI on large nonhuman primate retinas using a 3-Tesla clinical scanner as a first step toward translation. Baboon was chosen because of its evolutionary similarity to human. Anesthetized preparation, free of eye-movement artifacts, was used to evaluate clinical scanner hardware feasibility and optimize multimodal protocols for retinal MRI. Anatomical MRI (0.1×0.2×2.0 mm3) before contrast-agent injection detected three alternating bright-dark-bright layers. The hyperintense inner strip nearest to the vitreous was enhanced by an intravascular contrast agent, which likely included the ganglion and bipolar cell layer and the embedded retinal vessels. The hypointense middle strip showed no contrast enhancement, which likely included the avascular outer unclear layer and photoreceptor segments. The hyperintense outer strip showed contrast enhancement, which likely corresponded to the choroid vascular layer. In the posterior retina, the total thickness including the choroid was 617±101 μm (±standard deviation, n=7). Blood oxygenation level-dependent functional MRI (0.3×0.6×2.0 mm3) of oxygen inhalation relative to air increased the signals by 6.5±1.4%. Basal blood flow (2×2×2 mm3) was 83±30 mL/100 g/min (air), and hypercapnia increased blood flow by 25±9% (P<0.05). This study demonstrates multimodal MRI to image anatomy, physiology, and function on large nonhuman primate retinas using a clinical scanner, offering encouraging data to explore human applications.

Blood oxygenation level-dependent (BOLD) functional MRI of visual stimulation in the rat retina at 11.7 T

Although optically based imaging techniques provide valuable functional and physiological information of the retina, they are mostly limited to the probing of the retinal surface and require an unobstructed light path. MRI, in contrast, could offer physiological and functional data without depth limitation. Blood oxygenation level-dependent functional MRI (BOLD fMRI) of the thin rat retina is, however, challenging because of the need for high spatial resolution, and the potential presence of eye movement and susceptibility artifacts. This study reports a novel application of high-resolution (111 × 111 × 1000 µm(3)) BOLD fMRI of visual stimulation in the anesthetized rat retina at 11.7 T. A high-field MRI scanner was utilized to improve the signal-to-noise ratio, spatial resolution and BOLD sensitivity. Visual stimuli (8 Hz diffuse achromatic light) robustly increased BOLD responses in the retina [5.0 ± 0.8% from activated pixels and 3.1 ± 1.1% from the whole-retina region of interest (mean ± SD), n = 12 trials on six rats, p < 0.05 compared with baseline]. Some activated pixels were detected surrounding the pupil and ciliary muscle because of accommodation reflex to visual stimuli, and were reduced with atropine and phenylephrine eye drops. BOLD fMRI scans without visual stimulations showed no significantly activated pixels (whole-retina BOLD changes were 0.08 ± 0.34%, n = 6 trials on five rats, not statistically different from baseline, p > 0.05). BOLD fMRI of visual stimulation has the potential to provide clinically relevant data to probe hemodynamic neurovascular coupling and dysfunction of the retina with depth resolution.

MRI of retinal and choroidal blood flow with laminar resolution

The retina is nourished by two distinct circulations: the retinal vessels within the inner retina and the choroidal vessels behind the neural retina. The outer nuclear layer and the inner and outer segments of the photoreceptors in between are avascular. The aim of this study was to determine whether arterial spin labeling MRI could provide sufficient resolution to differentiate between quantitative retinal blood flow (rBF) and choroidal blood flow (chBF), and whether this technique is sufficiently sensitive to detect vascular-specific blood flow (BF) changes modulated by anesthetics. Arterial spin labeling MRI was performed at 42 × 42 × 400 µm(3) in the mouse retina at 7 T, and was used to investigate the effects of isoflurane and ketamine/xylazine anesthesia on rBF and chBF. MRI yielded unambiguous differentiation of rBF, chBF and the avascular layer in between. Under isoflurane, chBF was 7.7 ± 2.1 mL/g/min and rBF was 1.3 ± 0.44 mL/g/min (mean ± SD, n = 7, p < 0.01). Under ketamine/xylazine anesthesia in the same animals, chBF was 4.3 ± 1.9 mL/g/min and rBF was 0.88 ± 0.22 mL/g/min (p < 0.01). Under ketamine/xylazine anesthesia, rBF was lower by 29% (P < 0.01) and chBF by 42% (P < 0.01) relative to isoflurane. This study demonstrates, for the first time, the quantitative imaging of rBF and chBF in vivo, providing a new method to study basal values and alterations of rBF and chBF.

MRI of retinal and choroidal blood flow with laminar resolution

The retina is nourished by two distinct circulations: the retinal vessels within the inner retina and the choroidal vessels behind the neural retina. The outer nuclear layer and the inner and outer segments of the photoreceptors in between are avascular. The aim of this study was to determine whether arterial spin labeling MRI could provide sufficient resolution to differentiate between quantitative retinal blood flow (rBF) and choroidal blood flow (chBF), and whether this technique is sufficiently sensitive to detect vascular-specific blood flow (BF) changes modulated by anesthetics. Arterial spin labeling MRI was performed at 42 × 42 × 400 µm(3) in the mouse retina at 7 T, and was used to investigate the effects of isoflurane and ketamine/xylazine anesthesia on rBF and chBF. MRI yielded unambiguous differentiation of rBF, chBF and the avascular layer in between. Under isoflurane, chBF was 7.7 ± 2.1 mL/g/min and rBF was 1.3 ± 0.44 mL/g/min (mean ± SD, n = 7, p < 0.01). Under ketamine/xylazine anesthesia in the same animals, chBF was 4.3 ± 1.9 mL/g/min and rBF was 0.88 ± 0.22 mL/g/min (p < 0.01). Under ketamine/xylazine anesthesia, rBF was lower by 29% (P < 0.01) and chBF by 42% (P < 0.01) relative to isoflurane. This study demonstrates, for the first time, the quantitative imaging of rBF and chBF in vivo, providing a new method to study basal values and alterations of rBF and chBF.

MRI reveals differential regulation of retinal and choroidal blood volumes in rat retina

The retina is nourished by two unique (retinal and choroidal) circulations. The lack of depth-resolved blood volume (BV) imaging techniques hampers investigation of vascular-specific regulation of the retina in vivo. This study presents a high-resolution, laminar-specific magnetic resonance imaging (MRI) study to image retinal and choroidal BVs, their responses to physiologic challenges in normal and Royal-College-of-Surgeons (RCS) rats (a model of retinal degeneration). Retinal and choroidal BVs were imaged by MRI (30×30×800 μm) with intravascular administration of monocrystalline iron oxide nanocolloid (MION) contrast agent. Relative baseline BV and BV changes due to physiologic challenges were calculated in normal and RCS rat retinas. BV-MRI revealed two well-resolved retinal and choroidal vascular layers located on either side of the retina and an intervening avascular layer. The ratio of choroidal:retinal BV in normal rats at baseline was 9.8±3.2 in control rat retinas (N=7). Hyperoxia decreased retinal BV (-51±17%, p<0.05) more than choroidal BV (-28±14%), and hypercapnia increased retinal BV (52±11%, p<0.01) more than choroidal BV (12±11%). BV-MRI in degenerated retinas of RCS rats (N=7) revealed thinning of the avascular layer and an increase in relative baseline retinal and choroidal BVs. Only hypercapnia-induced BV changes in the retinal vasculature of RCS rats were significantly different (smaller) from controls (p<0.05). These findings suggest that BV in both retinal vasculatures is regulated. The relative baseline BV in both vasculatures increased in retinal degeneration. BV-MRI provides clinically relevant data that may prove useful for early detection and longitudinal probing of retinal diseases, and could complement optical imaging techniques.