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Zhou Y, Yang W, Dai Y. Optical coherence tomography angiography reveals macular microvascular changes in myopic adolescents following orthokeratology lens wear. Eur J Ophthalmol 2024:11206721241260456. [PMID: 38859764 DOI: 10.1177/11206721241260456] [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: 06/12/2024]
Abstract
BACKGROUND This study aimed to investigate the 6-month effects of wearing orthokeratology (OK) lenses on the retina vessel density (VD), vessel diameter index (VDI), and foveal avascular zone (FAZ) of myopia children using optical coherence tomography angiography, and to further investigate the underlying mechanisms of Orthokeratology in myopia control. METHODS Sixty-two eyes form 62 subjects were included in the study. Baseline and 6-month measurements of axial length (AL), anterior chamber depth (ACD), FAZ area, FAZ perimeter, FAZ circularity, vessel density (VD) and VDI from both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained. RESULTS The mean age of the participants was 11.02 years (range: 8 years to 15 years), with 41.9% males and 58.1% females. Six months after orthokeratology, ACD decreased significantly, and AL remain unchanged. SCP-VD and DCP-VD significantly increased after treatment without obvious change of VDI, and FAZ parameters remained unchanged. During follow-up period, SCP-VD increased in all subgroups especially in mild myopia group, and DCP-VD increased significantly in all subgroups except for the group 8-10 years. CONCLUSION After the 6-month treatment of orthokeratology in myopia children, the macular microvasculature changed significantly. We observed a significant increase of vessel densities in both SCP and DCP without obvious effect on vascular morphology. The changes of DCP-VD tended to be more sensitive in the elder subgroup, and the efficacy of orthokeratology might be greater in mild myopia group. OCT-A may provide additional information on myopia progression and the mechanisms of controlling myopia with OK lens treatment.
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Affiliation(s)
- Yali Zhou
- Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wenlei Yang
- Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yikang Dai
- Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Si Y, Pang K, Song Y, Zhang X, Yang H, Cui Y. Observation of structural and vascular features of retina and choroid in myopia using ultra-widefield SS-OCTA. BMC Ophthalmol 2024; 24:208. [PMID: 38715011 PMCID: PMC11075211 DOI: 10.1186/s12886-024-03473-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND To find the relationship between the changes of retinal and choriodal structure/ vascular densities (VD) and the myopia progress. METHODS 126 eyes of 126 age-matched young participants were divided into three groups: Emmetropia and Low Myopia (EaLM) (33 eyes), Moderate Myopia (MM) (39 eyes), and High Myopia (HM) (54 eyes). Fundus images measuring 12 × 12 mm were captured using ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA). Each image was uniformly divided into nine regions: supra-temporal (ST), temporal (T), infra-temporal (IT), superior (S), central macular area (C), inferior (I), supra-nasal (SN), nasal (N), and infra-nasal (IN). Various structural parameters, including inner retina thickness (IRT), outer retina thickness (ORT), and choroid thickness (CT), were assessed, and the VD of the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaries (CC), and choroid vessels (ChdV) were quantified. RESULTS CT in upper fundus exhibited a significant reduction from EaLM to MM. Additionally, ORT (ST, S. SN, C, N, IT, I, IN), CT (ST, S, SN, T, C, N, IT, I, IN) and VDs of SCP (ST, S, C, I, IN), DCP (ST, S, T, C, I) and ChdV (T, N, I, IN) were statistically diminished in EaLM compared to HM. Furthermore, IRT (N), ORT (N, IN), CT (S, SN, T, C, IT, I) and VDs of SCP (I, IN) and DCP (I) exhibited significant decreases as MM progressed towards HM. Intriguingly, there was a notable increase in the VD of CC (ST, S, T, C, N) as myopia progressed from MM to HM. CONCLUSION Significant changes in retinal and choroid structure and vascular density occur as moderate myopia advances to high myopia. Efforts to curb myopia progression to this stage are essential, as the failure to do so may lead to the development of corresponding retinopathy.
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Affiliation(s)
- Yuanyuan Si
- Department of Ophthalmology, Qilu Hospital of shandong University, Shandong University, 107 Wenhua Xi Road, Jinan, 250063, Shandong Province, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Kunpeng Pang
- Department of Ophthalmology, Qilu Hospital of shandong University, Shandong University, 107 Wenhua Xi Road, Jinan, 250063, Shandong Province, China
| | - Yanling Song
- Department of Ophthalmology, Qilu Hospital of shandong University, Shandong University, 107 Wenhua Xi Road, Jinan, 250063, Shandong Province, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xia Zhang
- Department of Ophthalmology, Qilu Hospital of shandong University, Shandong University, 107 Wenhua Xi Road, Jinan, 250063, Shandong Province, China
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hongling Yang
- Department of Ophthalmology, Qilu Hospital of shandong University, Shandong University, 107 Wenhua Xi Road, Jinan, 250063, Shandong Province, China.
| | - Yan Cui
- Department of Ophthalmology, Qilu Hospital of shandong University, Shandong University, 107 Wenhua Xi Road, Jinan, 250063, Shandong Province, China.
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Simms AG, Parrino R, Gameiro GR, Cipolla J, Wang J, Jiang H, Signorile JF. Decreased retinal capillary density as a beneficial response to 24-week high-speed circuit resistant training in healthy older adults. Microvasc Res 2024; 153:104668. [PMID: 38325749 PMCID: PMC10960248 DOI: 10.1016/j.mvr.2024.104668] [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: 12/05/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To determine the changes in retinal microvascular density after a 24-week high-speed circuit resistance training program (HSCT) in healthy older adults. METHODS Thirty healthy older adults were recruited and randomly assigned to either a training group (HSCT) or a non-training (CON) group. Fifteen subjects (age 73.3 ± 7.76 yrs) in the HSCT group exercised three times per week on non-consecutive days for 24 weeks. Fifteen subjects in the CON group (age 72.2 ± 6.04 yrs) did not have formal physical training. Both eyes of each subject were imaged using optical coherence tomography angiography (OCTA) at baseline and at the 24-week follow-up. The vessel densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured. RESULTS There were no demographic differences between the study groups. There were significant decreases in the retinal vessel densities of RVN, SVP and DVP in the HSCT group (P < 0.05). However, there were no significant changes in all three vascular measurements in the CON group (P > 0.05), although the changes showed a decreasing trend. The decreased vessel densities were doubled in the HSCT group in comparison to the CON group. However, the differences between groups did not reach a significant level (P > 0.05). CONCLUSIONS This is the first study to reveal the decreased retinal vessel densities as a possible imaging marker for the beneficial effects of the 24-week HSCT program in older adults.
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Affiliation(s)
- Ava-Gaye Simms
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rosalia Parrino
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - Gustavo Rosa Gameiro
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jack Cipolla
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Joseph F Signorile
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA.
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Liu Z, Liu M, Gou H, Li H, Sui J, Bai Y, He M, Liu X, Wei R. Retinal and choroidal structure and vascularity in Chinese emmetropic and myopic children. Ophthalmic Physiol Opt 2024; 44:514-524. [PMID: 38410019 DOI: 10.1111/opo.13291] [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: 10/05/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE This study evaluated the structural features of the retinal and choroidal regions and their correlations with ocular biometric and vascular parameters in Chinese children using optical coherence tomography angiography (OCTA). METHODS A total of 159 children, 6-13 years of age, were included in this prospective study. The sample consisted of 55 emmetropes (spherical equivalent ≤ +0.75 and > -0.50 D), 53 low-moderate myopes (≤ -0.50 to > -6.00 D) and 51 high myopes without pathological changes (≤ -6.00 D). Optical coherence biometry was used to measure axial length (AL) and anterior segment parameters. Swept-source optical coherence tomography/OCTA was used to assess the macular structures and vascular characteristics in a 6 × 6 mm region centred on the macula. RESULTS In a comprehensive analysis adjusting for age, sex, AL, macular blood perfusion, intraocular pressure and anterior segment parameters, retinal thickness (RT) showed a significant positive association with deep retinal vascular density and superficial retinal vascular density in the foveal area, but not with AL. Moreover, RT exhibited a significant negative association with AL in the parafoveal and perifoveal regions. Further, a significant positive correlation was observed between choroidal thickness and both choroidal vascular volume and choriocapillaris perfusion area, along with a negative correlation with AL across the entire macular region. CONCLUSIONS This study showed that the thickness of retina and choroid in Chinese children was not only associated with AL but also showed dynamic properties such as the blood perfusion of the retina and choroid, particularly in the foveal area.
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Affiliation(s)
- Zhuzhu Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Maria Liu
- UC Berkeley School of Optometry, Myopia Control Clinic, Berkeley, California, USA
| | - Huaixue Gou
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Haoru Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jinyuan Sui
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yang Bai
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Meinan He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xinyang Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Shi Y, Chen X, Tian Q, Bi C. OCTA on the density of optic nerve microvessels in myopic population with ocular hypertension. Photodiagnosis Photodyn Ther 2024; 46:104013. [PMID: 38346468 DOI: 10.1016/j.pdpdt.2024.104013] [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: 12/06/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To measure functional, structural, and blood flow parameters of the optic disk in myopic patients with ocular hypertension (OHT) and myopic patients using optical coherence tomography angiography (OCTA), this study aims to investigate the variability of each parameter between the two groups, and to analyze the correlation between the RNFL thickness and blood flow parameters, as well as the diagnostic value of these blood flow parameters for myopic patients with OHT. METHODS This was a cross-sectional study. Myopic adults who were attending the Eye Center of Jinan Second People's Hospital between December 2020 and January 2022, and who had a confirmed diagnosis of OHT, were enrolled. This cohort constituted the myopic group. In these subjects, retinal nerve fiber layer (RNFL) thickness and blood flow parameters within the superficial optic disk 6 × 6 mm area were measured using OCTA. The optic disk blood flow parameters included radial peripapillary capillaries (RPC) perfusion density (PD) in nasal, temporal, superior, and inferior sectors. Visual field assessments were conducted using a Humphrey visual field meter to obtain the visual field index (VFI) and pattern standard deviation (PSD). SPSS 22.0 statistical software was utilized to determine if statistical differences existed between the parameters of the two groups and to analyze the correlation between blood flow parameters and RNFL thickness. Additionally, the area under the subject's operating characteristic curve (AUROC) was used to assess the diagnostic value of blood flow parameters for myopic patients with OHT. RESULTS There was no statistical difference in PSD and VFI in the OHT group compared with the myopic group (P = 0.351, 0.242). The RNFL thickness was (103.64 ± 8.13) μm and (97.56 ± 12.94) μm in the myopic and OHT groups, respectively. There was no statistical difference in RNFL thickness between the OHT and myopic group (P = 0.052). The PD of radial peripapillary capillaries (RPC) in nasal, temporal, superior, and inferior sectors showed an overall decreasing trend between the myopic and OHT groups, but there was a statistical difference only in the temporal sector (P = 0.008). Correlation analysis of blood flow parameters and structural parameters showed that the PD in the temporal sector and RNFL thickness were not correlated (P = 0.263). By plotting the AUROC of blood flow parameter, it was found that OCTA had good value in diagnosing myopic patients with OHT, and the PD of the temporal sector had higher diagnostic value for differentiating the OHT group from myopic group (AUROC = 0.718, P = 0.008) CONCLUSIONS: Compared with the myopic group, blood flow parameters decreased in the OHT group, while structural and functional parameters did not change significantly, suggesting that blood flow damage may have occurred earlier in myopic patients with OHT, by the correlation analysis between structural and blood flow parameters. OCTA has good diagnostic value for myopic patients with OHT.
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Affiliation(s)
- Yeqiang Shi
- Ophthalmology Department, Jinan No. 2 People's Hospital, Jinan 250000, China
| | - Xuan Chen
- Ophthalmology Department, Jinan No. 2 People's Hospital, Jinan 250000, China
| | - Qingfen Tian
- Ophthalmology Department, Jinan No. 2 People's Hospital, Jinan 250000, China
| | - Chao Bi
- Ophthalmology Department, Jinan No. 2 People's Hospital, Jinan 250000, China.
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Ferri A, Ramtohul P, Russo A, Introini U, Freund KB, Bandello F, Cicinelli MV. Central Bouquet Hemorrhages in Pathologic Myopia: Clinical Characteristics and Prognostic Relevance. Ophthalmol Retina 2024:S2468-6530(24)00114-3. [PMID: 38508519 DOI: 10.1016/j.oret.2024.03.010] [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: 01/29/2024] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To compare the clinical implications of central bouquet hemorrhages (CBHs) to primarily subretinal hemorrhages, both occurring in the setting of pathologic myopia with lacquer crack formation. DESIGN Multicenter retrospective cohort study. PARTICIPANTS Twenty-five eyes (11 primarily subretinal hemorrhages and 14 CBH) were monitored over a median of 35 (interquartile range [IQR], 9.50-54) months. MAIN OUTCOMES MEASURES Comprehensive ophthalmic examinations and OCT were reviewed. The study employed linear mixed-effects models to compare the impact of CBH versus primarily subretinal hemorrhages on baseline visual acuity (VA), rate of VA improvement, and final VA, adjusting for the follow-up period. Times of hemorrhages reabsorbtion and rate of ellipsoid zone (EZ) layer disruption on OCT were recorded. RESULTS Eyes with CBH exhibited significantly worse baseline VA (0.93 ± 0.45 logarithm of the minimum angle of resolution [logMAR]; 20/160 Snellen vs. 0.36 ± 0.26 logMAR [20/50 Snellen], P < 0.001), a slower rate of VA improvement (P = 0.04), and a trend toward worse final VA (0.48 ± 0.47 logMAR [20/60 Snellen] vs. 0.16 ± 0.16 logMAR [20/30 Snellen], P = 0.06) compared with eyes with primarily subretinal hemorrhages. The CBH group experienced longer median reabsorption times (10 [IQR, 4.6-23.3] months vs. 2.3 [IQR, 2-3.2] months), and a higher prevalence of EZ layer disruption (86% vs. 0%), than the group with primarily subretinal hemorrhages. Central bouquet hemorrhage reabsorption was followed by the appearance of vertical hyperreflective lines in the central fovea in 67% of eyes, persisting for up to 6 years of follow-up. CONCLUSIONS Central bouquet hemorrhage signifies a distinct condition in pathologic myopia, characterized by worse visual outcomes, prolonged structural impact, and possible irreversible damage, compared with primarily subretinal hemorrhages. Central bouquet hemorrhage regression should be taken into account in the differential diagnosis of vertical hyperreflective lesions in the central fovea on OCT in eyes with pathologic myopia. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Andrea Ferri
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Prithvi Ramtohul
- Ophthalmology Department, Hopital Nord, Aix-Marseille University, Marseille, France
| | - Alessandro Russo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Ugo Introini
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - K Bailey Freund
- Ophthalmology Department, Hopital Nord, Aix-Marseille University, Marseille, France; Vitreous Retina Macula Consultants of New York, New York, New York
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Zhang X, Jiang J, Kong K, Li F, Chen S, Wang P, Song Y, Lin F, Lin TPH, Zangwill LM, Ohno-Matsui K, Jonas JB, Weinreb RN, Lam DSC. Optic neuropathy in high myopia: Glaucoma or high myopia or both? Prog Retin Eye Res 2024; 99:101246. [PMID: 38262557 DOI: 10.1016/j.preteyeres.2024.101246] [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: 10/12/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/25/2024]
Abstract
Due to the increasing prevalence of high myopia around the world, structural and functional damages to the optic nerve in high myopia has recently attracted much attention. Evidence has shown that high myopia is related to the development of glaucomatous or glaucoma-like optic neuropathy, and that both have many common features. These similarities often pose a diagnostic challenge that will affect the future management of glaucoma suspects in high myopia. In this review, we summarize similarities and differences in optic neuropathy arising from non-pathologic high myopia and glaucoma by considering their respective structural and functional characteristics on fundus photography, optical coherence tomography scanning, and visual field tests. These features may also help to distinguish the underlying mechanisms of the optic neuropathies and to determine management strategies for patients with high myopia and glaucoma.
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Affiliation(s)
- Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Jingwen Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Kangjie Kong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Peiyuan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Timothy P H Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA.
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA.
| | - Dennis S C Lam
- The International Eye Research Institute of the Chinese University of Hong Kong (Shenzhen), Shenzhen, China; The C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China.
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Huang S, Bacchi S, Chan W, Macri C, Selva D, Wong CX, Sun MT. Detection of systemic cardiovascular illnesses and cardiometabolic risk factors with machine learning and optical coherence tomography angiography: a pilot study. Eye (Lond) 2023; 37:3629-3633. [PMID: 37221360 PMCID: PMC10686409 DOI: 10.1038/s41433-023-02570-4] [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: 03/07/2022] [Revised: 03/27/2023] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND/OBJECTIVES Optical coherence tomography angiography (OCTA) has been found to identify changes in the retinal microvasculature of people with various cardiometabolic factors. Machine learning has previously been applied within ophthalmic imaging but has not yet been applied to these risk factors. The study aims to assess the feasibility of predicting the presence or absence of cardiovascular conditions and their associated risk factors using machine learning and OCTA. METHODS Cross-sectional study. Demographic and co-morbidity data was collected for each participant undergoing 3 × 3 mm, 6 × 6 mm and 8 × 8 mm OCTA scanning using the Carl Zeiss CIRRUS HD-OCT model 5000. The data was then pre-processed and randomly split into training and testing datasets (75%/25% split) before being applied to two models (Convolutional Neural Network and MoblieNetV2). Once developed on the training dataset, their performance was assessed on the unseen test dataset. RESULTS Two hundred forty-seven participants were included. Both models performed best in predicting the presence of hyperlipidaemia in 3 × 3 mm scans with an AUC of 0.74 and 0.81, and accuracy of 0.79 for CNN and MobileNetV2 respectively. Modest performance was achieved in the identification of diabetes mellitus, hypertension and congestive heart failure in 3 × 3 mm scans (all with AUC and accuracy >0.5). There was no significant recognition for 6 × 6 and 8 × 8 mm for any cardiometabolic risk factor. CONCLUSION This study demonstrates the strength of ML to identify the presence cardiometabolic factors, in particular hyperlipidaemia, in high-resolution 3 × 3 mm OCTA scans. Early detection of risk factors prior to a clinically significant event, will assist in preventing adverse outcomes for people.
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Affiliation(s)
- Sonia Huang
- South Australian Institute of Ophthalmology, The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.
| | - Stephen Bacchi
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - WengOnn Chan
- South Australian Institute of Ophthalmology, The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Carmelo Macri
- South Australian Institute of Ophthalmology, The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Christopher X Wong
- Department of Cardiology, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Michelle T Sun
- South Australian Institute of Ophthalmology, The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia
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Zhang Z, Mu J, Wei J, Geng H, Liu C, Yi W, Sun Y, Duan J. Correlation between refractive errors and ocular biometric parameters in children and adolescents: a systematic review and meta-analysis. BMC Ophthalmol 2023; 23:472. [PMID: 37990308 PMCID: PMC10662558 DOI: 10.1186/s12886-023-03222-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Refractive errors are one of the most common ocular conditions among children and adolescents, with myopia showing an increasing prevalence and early onset in this population. Recent studies have identified a correlation between refractive errors and ocular biometric parameters. METHODS A systematic search was conducted in electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, and Medline from January 1, 2012, to May 1, 2023. Various ocular biometric parameters were summarized under different refractive states, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), corneal curvature (CC), Corneal curvature radius (CR),axial length-to-corneal radius ratio (AL/CR ratio), choroidal thickness (ChT), retinal thickness (RT), retinal nerve fiber layer thickness (RNFL), and retinal blood density (VD). The differences in these parameters among different refractive states were analyzed using Stata software with fixed or random-effects models, taking into account the assessed heterogeneity level. RESULTS This meta-analysis included a total of 69 studies involving 128,178 eyes, including 48,795 emmetropic eyes, 60,691 myopic eyes, 13,983 hyperopic eyes, 2,040 low myopic eyes, 1,201 moderate myopic eyes, and 1,468 high myopic eyes. The results of our study demonstrated that, compared to the control group (emmetropic group), the myopic group and low, moderate, and high myopic groups showed significant increases in AL, AL/CR ratio, and ACD, while the hyperopic group exhibited significant decreases. Compared to the control group, the myopic group had a significantly increase for CC, while CR, CCT, perifoveal RT, subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal (except nasal) ChT, and pRNFL (except temporal) significantly decreased. Compared to the control group, the hyperopic group had a significantly increase for subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal ChT, and nasal pRNFL. Compared to the control group, the low and moderate myopic groups had a significantly decreases for the CCT, parafoveal RT (except nasal), perifoveal RT (except nasal), and pRNFL (except superior and temporal). Compared to the control group, the high myopic group had a significantly increase for CR, while LT, perifoveal ChT (except nasal), parafoveal RT, perifoveal RT, and pRNFL (except temporal) had significant decreased. CONCLUSION The changes of ocular biometric parameters in children and adolescents are closely related to refractive errors. Ocular biometric parameters devices, as effective non-invasive techniques, provide objective biological markers for monitoring refractive errors such as myopia.
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Affiliation(s)
- Zengrui Zhang
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jingyu Mu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jing Wei
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Haoming Geng
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Chunmeng Liu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Wenhua Yi
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Yue Sun
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Junguo Duan
- Chengdu University of TCM, Chengdu, Sichuan, China.
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China.
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection with TCM Laboratory, Chengdu, Sichuan, China.
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ÇITIRIK M, YAVUZER K, BAĞCI F. Assessment of changes in macular structural retinal layers in patients with pathological myopia. Turk J Med Sci 2023; 53:1807-1816. [PMID: 38813500 PMCID: PMC10760540 DOI: 10.55730/1300-0144.5751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/09/2023] [Accepted: 10/25/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim This study aimed to examine changes in the thickness of individual macular retinal layers in eyes with pathological myopia (PM) and to compare the thickness of each retinal layer between the PM and control groups to gain insights into retinal perfusion. Materials and methods The study included 51 eyes in the PM group and 51 eyes in the control group. Optical coherence tomography (OCT) was used to measure the thickness of each retinal layer in the central fovea, parafoveal, and perifoveal regions. Optical coherence tomography angiography (OCT-A) was used to evaluate the retinal capillary density. Results In the PM group, the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL) were thicker than in the control group (p = 0.004, p = 0.027, p = 0.020, and p < 0.001, respectively), whereas the outer nuclear layer (ONL) and photoreceptor layer (PRL) were thinner (p = 0.001 and p = 0.003, respectively). In other regions, the RNFL was thicker in the myopic group, whereas the GCL, IPL, INL, and ONL were thinner. OCT-A did not reveal any significant difference between the groups in terms of radial capillary plexus density (p = 0.381); however, the densities of the other plexuses were lower in the PM group. Conclusions The results showed alterations in the thickness of retinal layers and capillary plexus density in PM. Thus, assessment of the thickness of individual retinal layers may serve as an indicator of vascular diseases that affect the circulation of the retina and choroid.
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Affiliation(s)
- Mehmet ÇITIRIK
- Department of Ophthalmology, University of Health Sciences, Ankara Etlik City Hospital, Ankara,
Turkiye
| | - Kamil YAVUZER
- Department of Ophthalmology, Dünya Göz Hospital, Gaziantep,
Turkiye
| | - Fatma BAĞCI
- Department of Ophthalmology, University of Health Sciences, Ankara Etlik City Hospital, Ankara,
Turkiye
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11
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Xu Y, Yang W, Niu L, Wang X, Zhou X, Li M. Myopic Vascular Changes Revealed by Optical Tomography Angiography and Their Association with Myopic Fundus Manifestations. Ophthalmic Res 2023; 66:1266-1277. [PMID: 37751724 PMCID: PMC10614496 DOI: 10.1159/000531877] [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: 03/15/2023] [Accepted: 06/19/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION We aimed to quantify and evaluate fundal vascular changes at different severities of myopia using optical tomography angiography (OCTA) and explore their association with fundus changes captured by ultra-widefield (UWF) fundus cameras. METHODS Seventy-four participants with myopia were enrolled in the study and underwent basic ophthalmic examination, OCTA, and UWF fundus photography. Multiple parameters were obtained using OCTA (flow area, structure thickness, and vessel density) and UWF fundus cameras (tessellation and parapapillary atrophy [PPA]). RESULTS The right eye of 30 participants with low and moderate myopia and 44 participants with high myopia (HM) were included. Patients with HM had a larger flow area of the outer retina (FA-OR) and a smaller thickness of choroid (TC). Axial length was significantly correlated with retinal and choroidal flow area and thickness in the different zones. The PPA area was positively correlated with FA-OR and negatively correlated with TC. Tessellation exhibited different levels of correlation with OCTA parameters regarding the flow area, thickness, and vessel density of the fundal layers, mainly in the inner retina. CONCLUSION FA-OR and TC exhibited sensitive changes in patients with HM and axial elongation; therefore, they could serve as predictive OCTA biomarkers. The PPA and tessellation were connected to the vascular and structural changes revealed by OCTA.
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Affiliation(s)
- Yijia Xu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Weiming Yang
- Children’s Hospital of Fudan University, Shanghai, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
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Liu J, He Y, Kong L, Yang D, Lu N, Yu Y, Zhao Y, Wang Y, Ma Z. Study of Foveal Avascular Zone Growth in Individuals With Mild Diabetic Retinopathy by Optical Coherence Tomography. Invest Ophthalmol Vis Sci 2023; 64:21. [PMID: 37698529 PMCID: PMC10501493 DOI: 10.1167/iovs.64.12.21] [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: 04/06/2023] [Accepted: 08/18/2023] [Indexed: 09/13/2023] Open
Abstract
Purpose The purpose of this study was to investigate the association between foveal vessels and retinal thickness in individuals with diabetic retinopathy (DR) and control subjects, and to reveal foveal avascular zone (FAZ) growth in early individuals with DR. Methods The regions with a thickness less than 60 µm were marked from the intima thickness maps and named FAZThic. The avascular zones extracted from the deep vascular plexus were designated as FAZAngi. The boundary of the two FAZ forms a ring region, which we called FAZRing. The FAZ growth rate was defined as the ratio of the FAZRing area to the FAZThic area. Thirty healthy controls and 30 individuals with mild nonproliferative DR were recruited for this study. Results The FAZThic area in individuals with mild DR and control subjects showed similar distribution. The FAZAngi area in individuals with mild DR are higher than that in control subjects on the whole, but there was no significant difference (P > 0.05). The FAZRing area in individuals with mild DR was significantly higher than that in control subjects (P < 0.001). However, there is still a small amount of overlap data between the two groups. For the FAZ growth rate, the individuals with mild DR were also significantly larger than the control subjects (P < 0.001). But there were no overlapping data between the two groups. Conclusions The growth of FAZ in individuals with mild DR can be inferred by comparing FAZAngi with FAZThic. This method minimizes the impact of individual variations and helps researchers to understand the progression mechanism of DR more deeply.
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Affiliation(s)
- Jian Liu
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao City, China
| | - Yang He
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
| | - Linghui Kong
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
| | - Dongni Yang
- Department of Ophthalmology, The First Hospital of Qinhuangdao, Qinhuangdao City, Hebei Province, China
| | - Nan Lu
- Department of Ophthalmology, The First Hospital of Qinhuangdao, Qinhuangdao City, Hebei Province, China
| | - Yao Yu
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao City, China
| | - Yuqian Zhao
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
| | - Yi Wang
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao City, China
| | - Zhenhe Ma
- School of Control Engineering, Northeastern University at Qinhuangdao, Qinhuangdao City, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao City, China
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Li S, Li F, Sun J, Yang M, Zhang D, Wu S. Microvasculature and microstructure alteration in dry-type high myopia. JOURNAL OF BIOPHOTONICS 2023; 16:e202200390. [PMID: 37099397 DOI: 10.1002/jbio.202200390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 06/11/2023]
Abstract
BACKGROUND To investigate the alterations in the retinal vasculature and microstructure in dry-type high myopia. METHODS One hundred and eighty-nine dry-type high myopia eyes were classified into three groups. Group 1 consisted of 86 eyes with no myopic retinal degenerative lesion (C0). Group 2 consisted of 71 eyes with tessellated fundus (C1). Group 3 consisted of 32 eyes with diffuse chorioretinal atrophy (C2). Retinal vascular density and retinal thickness were measured with optical coherence tomography angiography. The scanning area was a 3 × 3 mm2 ring with the fovea of the macular. All data were analyzed with the SPSS 23.0 by one-way ANOVA test among comparison groups. Pearson's correlation analysis was used to determine the relations among measurements. Univariate linear regression showed a correlation between the vascular densities and retinal thicknesses. RESULTS The microvessel density significantly decreased and significant thinning of the superior and temporal macular thickness in the C2 group. The vascular densities of macular decreased significantly with the increase of axial length (AL) and refractive diopter in the C2 group. The retinal thicknesses of the macular fovea increased significantly with the increase of vascular densities in the C0 group and C1 group. CONCLUSIONS The impairment of retinal microstructure is more likely related to reduced oxygen and nutrients due to microvessel density decreases.
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Affiliation(s)
- Shanshan Li
- Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Fengshuang Li
- Department of Ophthalmology, Dalian Women and Children's Medical Group, Dalian, China
| | - Jiao Sun
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Min Yang
- Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Dawei Zhang
- Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Shengwei Wu
- Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
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14
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AM S, Anany M, Awwad MA, Sanad E, Eltohamy SMM. The Effect of Myopia on Vessel Density in Glaucomatous Patients by Optical Coherence Tomography Angiography. Clin Ophthalmol 2023; 17:2429-2441. [PMID: 37609643 PMCID: PMC10441653 DOI: 10.2147/opth.s418194] [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: 05/10/2023] [Accepted: 06/27/2023] [Indexed: 08/24/2023] Open
Abstract
Background Glaucoma is a degenerative optic neuropathy that causes anatomical and functional visual impairment. Aim and Objectives This investigation's primary goal was to perform a qualitative and quantitative assessment of macular and peripapillary vessels to detect the impairment of blood flow in glaucomatous patients with or without myopia which can affect the prognosis of glaucoma and visual field. Subjects and Methods This prospective, cross-sectional, observational research was performed for glaucomatous patients with and without myopia who attend the outpatient clinic at the ophthalmology department, at Benha University. The study was conducted on 50 subjects with glaucomatous eyes, divided into two groups: the first group consisted of (25 subjects) of glaucoma with myopia and the second group (25 subjects) of glaucoma with the same severity of mean deviation in the visual field of group 1 without myopia, using OCTA to measure retinal vessel density (superficial vessel density) and OCT thickness ILM-RPE, RNFL thickness, GCL and small vessel density (RADIAL PERI PAPILLARY PLEXUS). Results Regarding demographic data of myopia in the studied eyes, there were (9) 18% with low myopia with no significance, (32) 64% with moderate myopia, and (9) 18% with high myopia, with open-angle glaucoma patients showed a highly significant decline in total retinal nerve fiber layer thickness, superior-nasal RNFL thickness, Inferior-nasal RNFL thickness, superior-temporal RNFL and inferior-temporal RNFL thickness compared to open-angle glaucoma patients without myopia. Conclusion Our results show that microvascular attenuation occurs more significantly in OAG than in myopia. When both myopia and OAG are present, there is a higher reduction in microvascular attenuation than with either disease alone. The development and progression of glaucoma in individuals with high myopia are more aggressive than in low or non-myopia, so by using OCTA detection of early microvascular changes in high myopia, individuals help the early detection and management of glaucoma.
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Affiliation(s)
- Saeed AM
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Mohamed Anany
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Mohamed A Awwad
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Eman Sanad
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Soha M M Eltohamy
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
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15
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Liang J, Xie T, Chen L, Huang C, Wei P, Li P, Liu K, Zou Z, Fang D, Zhang S. Retinal Artery Angles in High Axial Myopia and Its Relationship With Visual Function. Transl Vis Sci Technol 2023; 12:22. [PMID: 37642634 PMCID: PMC10476439 DOI: 10.1167/tvst.12.8.22] [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: 02/19/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023] Open
Abstract
Purpose To evaluate the retinal artery angles in high axial myopia and assess the correlation with other morphometric and functional parameters. Methods This cross-sectional study included 112 eyes of 112 patients with high axial myopia. Based on axial length (AL), the participants were divided into three groups: group 1 (26 ≤ AL < 28 mm), group 2 (28 ≤ AL < 31 mm), and group 3 (≥31 mm). Scanning laser ophthalmoscopy imaging was used to analyze the retinal artery angle (Yugami correlated angle [YCA]). Retinal vascular densities (VDs) in both superficial capillary plexuses (SCPs) and deep capillary plexuses were evaluated. Fixation behavior, including retinal mean sensitivity (MS), macular fovea 2°, 4° fixation rate (P1, P2), and 68.2% bivariate contour ellipse area, were analyzed by microperimetry. Finally, the correlation between YCAs and AL, VDs, best-corrected visual acuity (BCVA), and fixation behavior was assessed. Results The YCAs showed significant differences among the three groups (all P < 0.001, respectively). Compared to group 1, the YCA decreased in group 2 (P < 0.001) and continued to decrease in group 3 (P = 0.043). The correlation analysis revealed that smaller YCAs (YCA, YCA1/2, YCA1/4) were positively correlated with the longer AL (ρ = 0.580, 0.545, 0.448, P < 0.001) and lower VDs in any sector in SCPs (all P ≤ 0.05). Furthermore, smaller YCAs were positively correlated with decreased BCVA (ρ = 0.392, 0.387, 0.262; all P < 0.001) and reduced MS (ρ= 0.300, 0.269, 0.244; all P < 0.05). Conclusions Smaller YCAs were correlated with longer AL, lower VD in SCP, decreased BCVA, and reduced MS. The YCAs might reflect vascular deformation caused by axial elongation and could potentially be useful in predicting visual function in high axial myopia. Translational Relevance The quantitative analysis of YCAs in fundus photography holds potential clinical value in predicting visual function in high axial myopia.
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Affiliation(s)
- Jia Liang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Ting Xie
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
- Guizhou Medical University, Guiyang, Guizhou, China
| | - Lu Chen
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Canfeng Huang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Pengxue Wei
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Pengfeng Li
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Ke Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zhenhua Zou
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Dong Fang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Zeng L, Li X, Pan W, Tang Y, Lin D, Wang M, Cai W, Zhu R, Wan J, Huang L, Xu H, Yang Z. Intraocular complement activation is related to retinal vascular and neuronal degeneration in myopic retinopathy. Front Cell Neurosci 2023; 17:1187400. [PMID: 37448698 PMCID: PMC10336352 DOI: 10.3389/fncel.2023.1187400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Purpose To investigate the relationship between the intraocular levels of complement proteins and myopia-related retinal neuronal and vascular degeneration. Methods Aqueous humour from 147 myopic patients, including 60 low-myopia and 87 high-myopia were collected during Implantable Collamer Lens implantation surgery. All participants received comprehensive ophthalmic examinations, including logMAR best corrected visual acuity, axial length measurement, fundus photography and ocular B-scan ultrasonography. The myopic eyes were further classified into simple myopia (SM, n = 78), myopic posterior staphyloma (PS, n = 39) and PS with myopic chorioretinal atrophy (PS + CA, n = 30). Retinal thickness and vascular density in the macula (6 mm × 6 mm) and optic nerve head (4.5 mm × 4.5 mm) were measured using Optical Coherence Tomography (OCT) and OCT angiography (OCTA). The levels of complement proteins including C1q, C3, C3b/iC3b, C4, CFB, CFH, C2, C4b, C5, C5a, CFD, MBL and CFI in the aqueous humour were measured using the Luminex Multiplexing system. The real-time RT-PCR was conducted to examine the expression of complement genes (C1q, C2, C3, C4, CFI and CFD) in the guinea pig model of long-term form deprivation-induced myopic retinal degeneration. Results OCTA showed that retinal neuronal thickness and vascular density in superficial and deep layers of the macular zone as well as vascular density in the optic nerve head were progressively decreased from SM to PS and PS + CA (p < 0.05). The aqueous humour levels of C1q, C3, C3b/iC3b, C4, CFB, CFH, C2, C4b, C5 and CFI were significantly higher in high-myopic eyes compared to those in low-myopic eyes. Further subgroup analysis revealed the highest levels of complement components/fragments in the PS + CA group. The intraocular levels of complement factors particularly C3b/iC3b and C4 were negatively correlated with macular zone deep layer retinal thickness and vascular density and optic nerve head vascular density. The expression of C2, C3 and C4 genes was significantly higher in guinea pig eyes with myopic retinal degeneration compared to control eyes. Conclusions The intraocular classical pathway and alternative pathway of the complement system are partially activated in pathological myopia. Their activation is related to the degeneration of retinal neurons and the vasculature in the macula and the vasculature in the optic nerve head.
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Affiliation(s)
- Ling Zeng
- Aier School of Ophthalmology, Central South University, Changsha, China
- Changsha Aier Eye Hospital, Changsha, Hunan, China
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
| | - Xiaoning Li
- Changsha Aier Eye Hospital, Changsha, Hunan, China
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
| | - Wei Pan
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
| | - Yao Tang
- Changsha Aier Eye Hospital, Changsha, Hunan, China
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
| | - Ding Lin
- Changsha Aier Eye Hospital, Changsha, Hunan, China
| | - Min Wang
- Shanghai Aier Eye Hospital, Shanghai, China
| | - Wang Cai
- Changsha Aier Eye Hospital, Changsha, Hunan, China
| | - Ruiling Zhu
- Changsha Aier Eye Hospital, Changsha, Hunan, China
| | - Jianbo Wan
- Changsha Aier Eye Hospital, Changsha, Hunan, China
| | | | - Heping Xu
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
- The Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Changsha Aier Eye Hospital, Changsha, Hunan, China
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
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Markeviciute A, Januleviciene I, Antman G, Siesky B, Harris A. Differences in structural parameters in patients with open-angle glaucoma, high myopia and both diseases concurrently. A pilot study. PLoS One 2023; 18:e0286019. [PMID: 37347758 PMCID: PMC10286979 DOI: 10.1371/journal.pone.0286019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 05/06/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE To evaluate the differences in structural parameters in patients with open-angle glaucoma (OAG), high myopia (M), and both diseases (OAG-M) concurrently. METHODS 42 subjects with OAG (n = 14), M (n = 14) and OAG-M (n = 14) were included in a prospective pilot study. Mean peripapillary retinal nerve fiber layer (RNFL) thickness, RNFL in superior, temporal, inferior, nasal quadrants, macular ganglion cell complex (GCC) and its' layers, vessel density (VD) of optic nerve head (ONH) and macula were evaluated. RESULTS The OAG-M group showed significantly lowest thickness of mean peripapillary RNFL 89 (49-103) μm (p = 0.021), temporal quadrant 64.5 (51-109) μm (p = 0.001) and inferior quadrant 107 (64-124) μm (p = 0.025). The macular RNFL was thinnest in the OAG-M group (p <0.001). Macular VD in inferior quadrant was lowest in OAG-M group at superficial capillary plexus 45.92 (40.39-51.72) % (p = 0.014) and choriocapillaris 51.62 (49.87-56.63) % (p = 0.035). The lowest ONH VD of temporal quadrant was found in the OAG-M group 52.15 (35.73-59.53) % (p = 0.001) in the superficial capillary plexus. Similarly, the lowest VD of inferior quadrant was found in OAG-M group in the choriocapillaris 54.42 (46.31-64.64) % (p<0.001). CONCLUSIONS The M group showed the least thinning in the peripapillary RNFL thickness in the temporal quadrant and macular RNFL compared to other two groups. The highest macular VD in the inferior quadrant was in the M group in the superficial capillary plexus, deep capillary plexus and choriocapillaris. The M group showed highest VD in the temporal quadrant and in total VD of ONH at the superficial capillary plexus and in total VD of ONH at the deep capillary plexus. PRACTICAL RECOMMENDATIONS The observed decrease in peripapillary RNFL thickness of the temporal quadrant, macular RNFL thickness, the decrease of macular VD at the inferior quadrant and decrease in VD of the ONH temporal quadrant in deep capillary plexus could be beneficial for diagnosing glaucoma in high myopia.
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Affiliation(s)
- Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ingrida Januleviciene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gal Antman
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Ophthalmology, Rabin Medical Center, Petach Tikwa, Israel
| | - Brent Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Lu Y, Ji Z, Jia J, Shi R, Liu Y, Shu Q, Lu F, Ge T, He Y. Progress in clinical characteristics of high myopia with primary open-angle glaucoma. Biotechnol Genet Eng Rev 2023:1-20. [PMID: 37243698 DOI: 10.1080/02648725.2023.2218765] [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: 04/11/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
High myopia (HM) is a significant risk factor for the occurrence and progression of primary open-angle glaucoma (POAG). Identification with POAG in the HM population is an emergent challenge. Patients with HM have a significantly higher probability of complicating POAG than those without HM. When HM is associated with POAG, the changes to the fundus caused by both of them are confused with each other, making the diagnosis of early glaucoma difficult. This article reviews available researches on HM with POAG, summarizing the characteristics of the fundus structure such as epidemiology, intraocular pressure, optic disc, ganglion cell layer, retinal nerve fiber layer, vascular density, and visual field.
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Affiliation(s)
- Yao Lu
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Zhi Ji
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jun Jia
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Rui Shi
- Department of Ophthalmology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Ying Liu
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Qiong Shu
- The Xi'an Medical University, Xi'an, Shaanxi, China
| | - Fulin Lu
- The Xi'an Medical University, Xi'an, Shaanxi, China
| | - Teng Ge
- The Xi'an Medical University, Xi'an, Shaanxi, China
| | - Yuan He
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
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Meng J, Fang Y, Lian J, Chen X, Zhou J, He W, Zhang K, Yang F, Lu Y, Zhu X. Visual and patient-reported outcomes of a diffractive trifocal intraocular lens in highly myopic eyes: a prospective multicenter study. EYE AND VISION (LONDON, ENGLAND) 2023; 10:19. [PMID: 37020245 PMCID: PMC10077756 DOI: 10.1186/s40662-023-00336-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND To investigate the visual and patient-reported outcomes of a diffractive trifocal intraocular lens (IOL) in highly myopic eyes. METHODS Patients with planned cataract removal by phacoemulsification and implantation of a trifocal IOL (AT LISA tri 839MP) were enrolled in the prospective, multicenter cohort study. Patients were allocated into three groups according to their axial length (AL): control group, AL < 26 mm; high myopia group, AL 26-28 mm; extreme myopia group, AL ≥ 28 mm. At 3 months post-surgery, data for 456 eyes of 456 patients were collected, including visual acuity, defocus curve, contrast sensitivity (CS), visual quality, spectacle independence, and overall satisfaction. RESULTS After surgery, the uncorrected distance visual acuity improved from 0.59 ± 0.41 to 0.06 ± 0.12 logMAR (P < 0.001). In all three groups, about 60% of eyes achieved uncorrected near and intermediate visual acuity of 0.10 logMAR or better, but significantly fewer eyes in the extreme myopia group achieved uncorrected distance visual acuity of 0.10 logMAR or better (P < 0.05). Defocus curves revealed that the visual acuity was significantly worse in the extreme myopia group than others at 0.00, - 0.50, and - 2.00 diopters (P < 0.05). CS did not differ between the control and high myopia groups but was significantly lower in the extreme myopia group at 3 cycles per degree. The extreme myopia group also had greater higher-order aberrations and coma, lower modulation transfer functions and VF-14 scores, more glare and halos, worse spectacle independence at far distance, and consequently lower patient satisfaction than others (all P < 0.05). CONCLUSIONS In eyes with a high degree of myopia (AL < 28 mm), trifocal IOLs have been shown to provide similar visual outcomes to those in non-myopic eyes. However, in extremely myopic eyes, acceptable results may be obtained with trifocal IOLs, but a reduced level of uncorrected distance vision is expected.
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Affiliation(s)
- Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Yanwen Fang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Jingcai Lian
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Xu Chen
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Jing Zhou
- Shanghai Bright Eye Hospital, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Keke Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Fan Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, 200032, China.
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Li YK, Fung NSK, Chan JC, Choy BN, Chow LL, Shih KC, Wong JK, Wong IY. OCTA biomarkers in adults aged 50 and above: a prospective and cross-sectional community-based study. BMC Ophthalmol 2023; 23:71. [PMID: 36797698 PMCID: PMC9936659 DOI: 10.1186/s12886-023-02815-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND/AIMS To assess the normative values and parameters of optical coherence tomography angiography (OCTA) influencing the best corrected visual acuity (BCVA) in adults aged 50 and above. METHODS This was a prospective cross-sectional study from an eye screening programme in Hong Kong for 4188 citizens aged 50 and above. Images were analysed using a validated quantification software calculating vessel density and capillary perfusion density (CPD), along with other OCTA parameters, such as the foveal avascular zone area (FAZ) and circularity. OCTA data was collected from May 2019 to December 2020, including a total of 4188 healthy eyes from 4188 subjects. RESULTS Mean superficial vessel density (MSVD) was 14.48 ± 3.60 mm- 1, while the mean capillary perfusion density (MCPD) was 0.41 ± 0.06. Multivariate analysis revealed ageing (β = 0.321, p < 0.001), being male (β=-0.089, p < 0.001), having a high body mass index (BMI) (β = 0.039, p = 0.006), high FAZ area and low FAZ circularity (β = 0.039 and - 0.034, p = 0.01 and 0.024 respectively), low MSVD in the outer ring (β=-0.513, p < 0.001), specifically in the nasal and temporal outer quadrants (β = -0.226 and - 0.259, p < 0.001 for both), and low MCPD in the outer superior quadrant (β= -0.123, p = 0.016) being independently associated with BCVA. CONCLUSION High FAZ area and low FAZ circularity, low MSVD in the outer ring, specifically the nasal and temporal outer quadrants, and low MCPD in the outer superior quadrant can be used as biomarkers in predicting a low visual acuity in adults aged 50 and above.
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Affiliation(s)
- Yan Kiu Li
- grid.194645.b0000000121742757LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Nicholas Siu-Kay Fung
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong, China.
| | - Jonathan C.H Chan
- grid.194645.b0000000121742757Department of Ophthalmology, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong China
| | - Bonnie N.K. Choy
- grid.194645.b0000000121742757Department of Ophthalmology, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong China
| | - Loraine L.W. Chow
- grid.194645.b0000000121742757Department of Ophthalmology, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong China
| | - Kendrick C. Shih
- grid.194645.b0000000121742757Department of Ophthalmology, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong China
| | - Jasper K.W. Wong
- grid.194645.b0000000121742757Department of Ophthalmology, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong China
| | - Ian Y.H. Wong
- grid.414329.90000 0004 1764 7097Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
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21
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Lei J, Fan Y, Wu Y, Yuan S, Ye Y, Huang K, Chen Q, Yang B, Xie P. Microvascular Alterations of Peripapillary Choriocapillaris in Young Adult High Myopia Detected by Optical Coherence Tomography Angiography. J Pers Med 2023; 13:jpm13020289. [PMID: 36836523 PMCID: PMC9965566 DOI: 10.3390/jpm13020289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
(1) Background: The microstructural alterations of the peripapillary choriocapillaris in high myopes remain elusive. Here, we used optical coherence tomography angiography (OCTA) to explore factors involved in these alterations. (2) Methods: This cross-sectional control study included 205 young adults' eyes (95 with high myopia and 110 with mild to moderate myopia). The choroidal vascular network was imaged using OCTA, and the images underwent manual adjustments to determine the peripapillary atrophy (PPA)-β zone and microvascular dropout (MvD). The area of MvD and the PPA-β zone, spherical equivalent (SE), and axial length (AL) were collected and compared across groups. (3) Results: The MvD was identified in 195 eyes (95.1%). Highly myopic eyes exhibited a significantly greater area for the PPA-β zone (1.221 ± 0.073 vs. 0.562 ± 0.383 mm2, p = 0.001) and MvD (0.248 ± 0.191 vs. 0.089 ± 0.082 mm2, p < 0.001) compared with mildly to moderately myopic eyes, and a lower average density in the choriocapillaris. Linear regression analysis showed that the MvD area correlated with age, SE, AL, and the PPA-β area (all p < 0.05). (4) Conclusions: This study found that MvDs represent choroidal microvascular alterations in young-adult high myopes, which were correlated with age, SE, AL, and the PPA-β zone. In this disorder, OCTA is important for characterizing the underlying pathophysiological adaptations.
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Affiliation(s)
- Jie Lei
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuanyuan Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yan Wu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yurong Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Kun Huang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Bin Yang
- Department of Ophthalmology, Yangzhong People’s Hospital, Yangzhong 212299, China
- Correspondence: (B.Y.); (P.X.); Tel.: +86-13812356086 (B.Y.); +86-13901585755 (P.X.)
| | - Ping Xie
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- Correspondence: (B.Y.); (P.X.); Tel.: +86-13812356086 (B.Y.); +86-13901585755 (P.X.)
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22
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Tang C, Zhang Y, Sun T, Xie J, Liu Y, Liu R, Sun Z, Qi H. Prospective clinical study of retinal microvascular alteration after ICL implantation. Front Cell Dev Biol 2023; 11:1115822. [PMID: 36743408 PMCID: PMC9892709 DOI: 10.3389/fcell.2023.1115822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
Purpose: To evaluate the retinal microvascular alteration after implantable collamer lens (ICL) implantation in moderate to high myopia patients using quantitative optical coherence tomography angiography (OCTA). Methods: This prospective cohort study included 50 eyes of 25 patients with preoperative spherical equivalent ≥ -3.00 D. Patients underwent bilateral ICL implantation at the Department of Ophthalmology, Peking University Third Hospital, from November 2018 to July 2019. OCTA was used to image the superficial and deep retinal capillary plexuses before ICL implantation surgery and at 3 months follow-up. Results: There was no significant difference in the microvascular density within each annular zone and all quadrantal zones of the superficial and deep layers found in myopia patients before and after ICL surgery. Conclusion: Levels of microvascular density in retinal capillary plexuses were stable, as detected by the OCTA, showing the high security of ICL implantation, which would not leave adverse effects on retinal microvasculature in myopia patients.
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Affiliation(s)
- Chuhao Tang
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Yu Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Tong Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Jianyang Xie
- Cixi Institute of BioMedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yiyun Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Rongjun Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Zhengze Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Hong Qi
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China,*Correspondence: Hong Qi,
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Liu Y, Shen J, Yang L, Bian G, Yu H. ResDO-UNet: A deep residual network for accurate retinal vessel segmentation from fundus images. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Moon JY, Garg I, Cui Y, Katz R, Zhu Y, Le R, Lu Y, Lu ES, Ludwig CA, Elze T, Wu DM, Eliott D, Miller JW, Kim LA, Husain D, Vavvas DG, Miller JB. Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia. Br J Ophthalmol 2023; 107:102-108. [PMID: 34385166 DOI: 10.1136/bjophthalmol-2021-319540] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/23/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIMS Pathological myopia (PM) is a leading cause of blindness worldwide. We aimed to evaluate microvascular and chorioretinal changes in different stages of myopia with wide-field (WF) swept-source (SS) optical coherence tomography angiography (OCTA). METHODS This prospective cross-sectional observational study included 186 eyes of 122 patients who had undergone imaging between November 2018 and October 2020. Vessel density (VD) and vessel skeletonised density (VSD) of superficial capillary plexus, deep capillary plexus and whole retina, as well as foveal avascular zone parameters, retinal thickness (RT) and choroidal thickness (CT), were calculated. RESULTS This study evaluated 75 eyes of 48 patients with high myopia (HM), 43 eyes of 31 patients with mild to moderate myopia and 68 eyes of 53 age-matched controls. Controlling for age and the presence of systemic hypertension, we found that HM was associated with decrease in VD and VSD in all layers on 12×12 mm² scans. Furthermore, HM was associated with a VD and VSD decrease in every Early Treatment Diabetic Retinopathy Study grid, with a larger decrease temporally (βVD=-0.39, βVSD=-10.25, p<0.01). HM was associated with decreased RT and CT. Reduction in RT was outside the macular region, while reduction in CT was in the macular region. CONCLUSION Using WF SS-OCTA, we identified reduction in microvasculature and structural changes associated with myopia. Decrease in VD and VSD was greater in the temporal quadrant, and reductions in RT and CT were uneven across the retina. Further work may help identify risk factors for the progression of PM and associated vision-threatening complications.
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Affiliation(s)
- Jade Y Moon
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Retinal Imaging Lab, Boston, Massachusetts, USA
| | - Itika Garg
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Retinal Imaging Lab, Boston, Massachusetts, USA
| | - Ying Cui
- Harvard Retinal Imaging Lab, Boston, Massachusetts, USA.,Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Raviv Katz
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Retinal Imaging Lab, Boston, Massachusetts, USA
| | - Ying Zhu
- Harvard Retinal Imaging Lab, Boston, Massachusetts, USA.,Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Rongrong Le
- Harvard Retinal Imaging Lab, Boston, Massachusetts, USA.,Wenzhou Medical University affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Yifan Lu
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Retinal Imaging Lab, Boston, Massachusetts, USA
| | - Edward S Lu
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Retinal Imaging Lab, Boston, Massachusetts, USA
| | - Cassie A Ludwig
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, MA, USA
| | - David M Wu
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Dean Eliott
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Joan W Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Leo A Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Demetrios G Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - John B Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA .,Harvard Retinal Imaging Lab, Boston, Massachusetts, USA
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25
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Duan MM, Liu H, Zhong YL. Effect of shape deprivation on retinal thickness in myopic mice using an OCT method. Front Neurosci 2023; 17:1156990. [PMID: 37090795 PMCID: PMC10115968 DOI: 10.3389/fnins.2023.1156990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose The purpose of this study was to study in retina thickness changes in myopic mice using optical coherence tomography (OCT). Methods There were 18 mice in the form-deprivation myopia (FDM) group,in which the left eye was not treated as a control;18 untreated mice served as a normal control group. The diopter of all mice was measured 21 days after birth (P21), before form deprivation. After 4 weeks of form deprivation (P49), the refraction, fundus, and retinal sublayer thickness of all mice were measured. Results After 4 weeks of form deprivation, the refractive power of the right eye in the FDM group was significantly higher than that in the left eye (p < 0.05). There was no significant change in the refractive power of the left eye in the FDM group compared with the normal control group. The retina, nerve fiber layer (NFL), inner nuclear layer (INL), and outer nuclear layer (ONL) in the right eye of the FDM group were significantly thinner than those of both the FDM and control groups (p < 0.05). There was no significant change in photoreceptor (PR). Conclusion Our study highlights that the myopic mice have decreased R thickness, which might reflect the potential pathological mechanism of myopia.
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Affiliation(s)
- Ming-Ming Duan
- Department of ophthalmology, the First People's Hospital of Jiujiang City, Jiujiang, Jiangxi, China
| | - Hui Liu
- Department of ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yu-Lin Zhong
- Department of ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- *Correspondence: Yu-Lin Zhong,
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Nam KY, Lee MW, Lee KH, Kim JY. Superficial capillary plexus vessel density/deep capillary plexus vessel density ratio in healthy eyes. BMC Ophthalmol 2022; 22:482. [PMID: 36494798 PMCID: PMC9733217 DOI: 10.1186/s12886-022-02673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/05/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To identify factors differently affecting the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in healthy eyes using their vessel density (VD) ratio. METHODS Healthy eyes were enrolled. The ratio between the VD of SCP and DCP (SVD/DVD ratio) was calculated. Pearson correlation analyses were performed to identify the relationships between this ratio and other factors. RESULTS The mean SVD and DVD were 36.2 ± 5.7 and 37.7 ± 4.9%, respectively, and the mean SVD/DVD ratio was 0.96 ± 0.15. The SVD was significantly correlated with the best-corrected visual acuity (BCVA) (r = - 0.368, P < 0.001), age (r = - 0.408, P < 0.001), and OCTA quality (r = 0.520, P < 0.001). The DVD was significantly correlated with the BCVA (r = - 0.150, P = 0.008), age (r = - 0.229, P < 0.001), and OCTA quality (r = 0.555, P < 0.001). Among various factors, age (r = - 0.296, P < 0.001), the BCVA (r = - 0.237, P < 0.001), axial length (r = 0.234, P < 0.001), and OCTA quality (r = 0.270, P < 0.001) were significantly correlated with the SVD/DVD ratio. CONCLUSIONS Age, BCVA, axial length, and OCTA image quality were significantly correlated with the SVD/DVD ratio. Age, the BCVA, and OCTA quality were more strongly correlated with the SCP, and the axial length was more strongly correlated with the DCP.
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Affiliation(s)
- Ki-Yup Nam
- grid.254230.20000 0001 0722 6377Department of Ophthalmology, Chungnam National University Sejong Hospital, Daejeon, Republic of Korea
| | - Min-Woo Lee
- grid.411143.20000 0000 8674 9741Department of Ophthalmology, Konyang University College of Medicine, #1643 Gwanjeo-dong, Seo-gu, Daejeon, South Korea
| | - Kook-Hyung Lee
- grid.411143.20000 0000 8674 9741Department of Ophthalmology, Konyang University College of Medicine, #1643 Gwanjeo-dong, Seo-gu, Daejeon, South Korea
| | - Jung-Yeul Kim
- grid.254230.20000 0001 0722 6377Department of Ophthalmology, Chungnam National University College of Medicine, #640 Daesa-dong, Jung-gu, Daejeon, 301-721 South Korea ,1.0 Eye clinic, Daejeon, Republic of Korea
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Glaucoma Detection in Myopic Eyes: Structural and Vascular Assessment by Optic Coherence Tomography Methods. J Glaucoma 2022; 31:947-954. [PMID: 36223326 DOI: 10.1097/ijg.0000000000002121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/22/2022] [Indexed: 11/07/2022]
Abstract
PRCIS Retinal nerve fiber layer (RNFL) thickness is helpful in the diagnosis of glaucoma in myopic eyes but neuroretinal rim (NRR) thickness is the most valuable measure. However, changes in optical coherence tomography angiography (OCT-A) parameters are insufficient for the diagnosis of mild to moderate glaucoma in myopia. PURPOSE To detect how a multimodal evaluation, which includes RNFL, NRR thickness, and optic nerve head (ONH) OCT-A, affects glaucoma diagnosis in myopic patients. MATERIALS AND METHODS Parameters of healthy myopic and myopic glaucoma eyes with an axial length of ≥24 mm were compared. The ONH structural features and peripapillary RNFL thickness were determined with Cirrus 5000 HD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA). The Cirrus 5000 HD-OCT with AngioPlex was utilized to perform OCT-A imaging. The sensitivity and specificity levels were calculated by the best cut-off values with area under curve (AUC). RESULTS One hundred healthy myopic and 54 myopic glaucoma eyes were evaluated. In all areas, myopic glaucoma patients exhibited lower RNFL and NRR thickness than healthy myopic individuals ( P <0.05), with the exception of nasal quadrant RNFL thickness ( P =0.152). The mean entire and 4 quadrants of global radial peripapillary capillary (RPC)-perfusion and global RPC flux index (FI) were significantly lower in the group of myopic glaucoma patients except for the nasal quadrant mean RPC perfusion ( P =0.224). The average RNFL and NRR thickness had a significant difference in AUC for the diagnosis of glaucoma in myopic individuals ( P =0.001, for each). The average NRR showed excellent diagnostic performance, whereas the average RNFL showed good diagnostic performance. Average RPC perfusion and average RPC FI showed poor diagnostic ability. The average NRR AUC was more significant than average RPC perfusion and average RPC FI AUC ( P <0.001). CONCLUSIONS Although RNFL thickness was helpful to diagnose glaucoma in patients with myopia, the diagnostic power of NRR thickness performed best. OCT-A parameters showed poor diagnostic accuracy for glaucoma and the observed perfusion decrease in myopic glaucoma eyes was not sufficiently discriminative compared with NRR and RNFL thickness measurements.
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Zhang X, Yu X, Wen Y, Jin L, Zhang L, Zhu H, Zhang D, Xie C, Guo D, Tong J, Shen Y. Functions of retinal astrocytes and Müller cells in mammalian myopia. BMC Ophthalmol 2022; 22:451. [PMID: 36418970 PMCID: PMC9686084 DOI: 10.1186/s12886-022-02643-0] [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: 08/09/2021] [Accepted: 09/27/2022] [Indexed: 11/26/2022] Open
Abstract
Background Changes in the retina and choroid blood vessels are regularly observed in myopia. However, if the retinal glial cells, which directly contact blood vessels, play a role in mammalian myopia is unknown. We aimed to explore the potential role and mechanism of retinal glial cells in form deprived myopia. Methods We adapted the mice form-deprivation myopia model by covering the right eye and left the left eye open for control, measured the ocular structure with anterior segment optical coherence tomography, evaluated changes in the morphology and distribution of retinal glial cells by fluorescence staining and western blotting; we also searched the online GEO databases to obtain relative gene lists and confirmed them in the form-deprivation myopia mouse retina at mRNA and protein level. Results Compared with the open eye, the ocular axial length (3.54 ± 0.006 mm v.s. 3.48 ± 0.004 mm, p = 0.027) and vitreous chamber depth (3.07 ± 0.005 mm v.s. 2.98 ± 0.006 mm, p = 0.007) in the covered eye became longer. Both glial fibrillary acidic protein and excitatory amino acid transporters 4 elevated. There were 12 common pathways in human myopia and anoxic astrocytes. The key proteins were also highly relevant to atropine target proteins. In mice, two common pathways were found in myopia and anoxic Müller cells. Seven main genes and four key proteins were significantly changed in the mice form-deprivation myopia retinas. Conclusion Retinal astrocytes and Müller cells were activated in myopia. They may response to stimuli and secretory acting factors, and might be a valid target for atropine. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02643-0.
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Affiliation(s)
- Xuhong Zhang
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Xin Yu
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Yingying Wen
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Le Jin
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Liyue Zhang
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Hong Zhu
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Dongyan Zhang
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China ,Department of Ophthalmology, Shaoxing Central Hospital, Shaoxing, 312030 Zhejiang China
| | - Chen Xie
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Dongyu Guo
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Jianping Tong
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
| | - Ye Shen
- grid.452661.20000 0004 1803 6319Ophthalmology department, the First Affiliated Hospital of Zhejiang University, Qingchun Road No.79, Hangzhou, 310003 China
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Luo H, Sun J, Chen L, Ke D, Zhong Z, Cheng X, Yu H, Sun X. Compartmental analysis of three-dimensional choroidal vascularity and thickness of myopic eyes in young adults using SS-OCTA. Front Physiol 2022; 13:916323. [PMID: 36160870 PMCID: PMC9490056 DOI: 10.3389/fphys.2022.916323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: We aimed to investigate the change of three-dimensional (3D) choroidal thickness (ChT), choroidal vessel volume (CVV), and choroidal vessel index (CVI) in young myopic adults using swept-source optical coherence tomography angiography (SS-OCTA) and compare the difference of these indicators in different quadrants of the macula and optic disc. Methods: A total of 248 eye samples from 135 participants were used in this cross-sectional study. Each participant underwent detailed history taking and ocular examinations. Based on axial length (AL), patients were divided into the emmetropia (EM) group, mild-myopia (MIM) group, moderate-myopia (MOM) group, and high-myopia (HM) group. 6 mm × 6 mm (1,024 × 1024 B-scans) SS-OCTA scans were performed centered on the fovea and optic disc. 3D ChT, CVV, and CVI were measured based on a built-in deep learning algorithm. Differences in ChT, CVV, and CVI were analyzed in different regions and different myopic groups. Results: Significant reduction in the global CVV were found in the HM group (1.930 ± 0.865) in comparison with the EM (3.486 ± 0.992), MIM (3.238 ± 1.033), and MOM (2.589 ± 1.083) groups (p < 0.001). The global CVI was also lower in the HM group (0.258 ± 0.061) than in the EM (0.320 ± 0.055), MIM (0.320 ± 0.051), and MOM (0.286 ± 0.066) groups (p < 0.001). The ChT was thinner in eyes with HM (242.753 ± 65.641) than in eyes with EM (377.532 ± 80.593), MIM (348.367 ± 78.191), or MOM (300.197 ± 87.175) (p < 0.001). Compartmental analysis revealed that ChT, CVV, and CVI in the nasal quadrant of the macula and temporal and inferior quadrants of the optic disc were much lower than those in other quadrants (p < 0.05). Correlation analyses found that ChT, CVV, and CVI were negatively correlated with AL and spherical equivalence. Conclusion: 3D ChT, CVV, and CVI gradually decreased as the degree of myopia increased. The changes were more dramatic on the nasal side of the macula and the temporal and inferior sides of the optic disc. These findings demonstrated the 3D choroidal change and highlighted the papillo-macular bundle as a sensitive region in myopic development.
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Affiliation(s)
- Huan Luo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinfu Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lan Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dandan Ke
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zheng Zhong
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xi Cheng
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huimin Yu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- *Correspondence: Huimin Yu, ; Xufang Sun,
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- *Correspondence: Huimin Yu, ; Xufang Sun,
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Wang X, Wang Y, Liu H, Zhu X, Hao X, Zhu Y, Xu B, Zhang S, Jia X, Weng L, Liao X, Zhou Y, Tang B, Zhao R, Jiao B, Shen L. Macular Microvascular Density as a Diagnostic Biomarker for Alzheimer’s Disease. J Alzheimers Dis 2022; 90:139-149. [DOI: 10.3233/jad-220482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Some previous studies showed abnormal pathological and vascular changes in the retina of patients with Alzheimer’s disease (AD). However, whether retinal microvascular density is a diagnostic indicator for AD remains unclear. Objective: This study evaluated the macular vessel density (m-VD) in the superficial capillary plexus and fovea avascular zone (FAZ) area in AD, explored their correlations with clinical parameters, and finally confirmed an optimal machine learning model for AD diagnosis. Methods: 77 patients with AD and 145 healthy controls (HCs) were enrolled. The m-VD and the FAZ area were measured using optical coherence tomography angiography (OCTA) in all participants. Additionally, AD underwent neuropsychological assessment, brain magnetic resonance imaging scan, cerebrospinal fluid (CSF) biomarker detection, and APOE ɛ4 genotyping. Finally, the performance of machine learning algorithms based on the OCTA measurements was evaluated by Python programming language. Results: The m-VD was noticeably decreased in AD compared with HCs. Moreover, m-VD in the fovea, superior inner, inferior inner, nasal inner subfields, and the whole inner ring declined significantly in mild AD, while it was more serious in moderate/severe AD. However, no significant difference in the FAZ was noted between AD and HCs. Furthermore, we found that m-VD exhibited a significant correlation with cognitive function, medial temporal atrophy and Fazekas scores, and APOE ɛ4 genotypes. No significant correlations were observed between m-VD and CSF biomarkers. Furthermore, results revealed the Adaptive boosting algorithm exhibited the best diagnostic performance for AD. Conclusion: Macular vascular density could serve as a diagnostic biomarker for AD.
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Affiliation(s)
- Xin Wang
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
| | - Yaqin Wang
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Liu
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
| | - Xiangyu Zhu
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
| | - Xiaoli Hao
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
| | - Yuan Zhu
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
| | - Bei Xu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
| | - Sizhe Zhang
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
| | - Xiaoliang Jia
- School of Computer Science and Engineering, Central South University, Changsha, China
| | - Ling Weng
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province inNeurodegenerative Disorders, Central South University, Changsha, China
| | - Xinxin Liao
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province inNeurodegenerative Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Yafang Zhou
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province inNeurodegenerative Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province inNeurodegenerative Disorders, Central South University, Changsha, China
| | - Rongchang Zhao
- School of Computer Science and Engineering, Central South University, Changsha, China
| | - Bin Jiao
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province inNeurodegenerative Disorders, Central South University, Changsha, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, CentralSouth University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province inNeurodegenerative Disorders, Central South University, Changsha, China
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Su R, Jia Z, Fan F, Li J, Li K. Clinical Observation of Macular Vessel Density in Type 2 Diabetics with High Myopia. Ophthalmic Res 2022; 66:124-130. [PMID: 35995034 DOI: 10.1159/000526487] [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: 06/06/2022] [Accepted: 07/08/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to compare the macular retinal vessel density (VD) of diabetics with high myopia, diabetics without high myopia, and healthy controls. METHODS This cross-sectional study recruited type 2 diabetic (T2D) people with no history of ocular treatment in our hospital. Thirty T2D people with high myopia (30 eyes) were included in group A, while 30 T2D people (30 eyes) without myopia were included in group B. Another 30 healthy volunteers (30 eyes) were included in group C. The superficial and deep capillary plexuses VD of the macula were measured in all subjects by optical coherence tomography angiography. In T2D people with high myopia, the correlation between VD in macular regions and baseline data was investigated. RESULTS (1) Overall comparison of the 3 groups: no statistically significant differences in macular central superficial vessel density (SVD) were found in the three groups (p > 0.05). There were significant differences in the temporal, superior, nasal, inferior SVD between the 3 groups (p < 0.05). There were significant differences in macular central, temporal, superior, nasal, and inferior deep vessel density (DVD) between the three groups (p < 0.05). (2) Comparison of B (no myopia, T2D group) and C (healthy control group): inferior SVD in group B was lower than that in group C (p < 0.05). Temporal, superior, nasal, and inferior DVD in group B were lower than those in group C (p < 0.05). (3) A (high myopia group, T2D) compared with B (no myopia, T2D group), A group compared with C (healthy control group): temporal, superior, nasal, inferior SVD and DVD in group A were all lower than those in group B and C (p < 0.05), DVD in group B was lower than those in group C (p < 0.05). (4) The mean SVD and DVD were not correlated with age, IOP, anterior chamber depth, corneal curvature, but they were negatively correlated with axial length and duration of diabetes in the T2D people with high myopia. CONCLUSION Myopia and diabetes are two important factors affecting macular retinal VD. Comparing with the eyes of T2D people without high myopia, the VD in macular regions shows a higher decline in the eyes of T2D people with high myopia.
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Affiliation(s)
- Ruifeng Su
- Department of Ophthalmology, Hebei Medical University, Shijiazhuang, China,
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China,
- Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College, Chengde, China,
| | - Zhiyang Jia
- Department of Ophthalmology, Hebei Medical University, Shijiazhuang, China
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
| | - Fang Fan
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
| | - Juan Li
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
| | - Kejun Li
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
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Analysis of White and Dark without Pressure in a Young Myopic Group Based on Ultra-Wide Swept-Source Optical Coherence Tomography Angiography. J Clin Med 2022; 11:jcm11164830. [PMID: 36013068 PMCID: PMC9410463 DOI: 10.3390/jcm11164830] [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: 06/30/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: This study aimed to investigate the incidence of white without pressure (WWOP) and dark without pressure (DWOP) in a young myopic group based on multimode imaging and to explore the quantitative changes in DWOP based on ultra-wide swept-source optical coherence tomography angiography (SS-OCTA). Methods: A total of 138 patients with high myopia (SE < −6.00 D) were recruited. Examinations, including indirect ophthalmoscope, ultra-wide color fundus photograph, and ultra-wide SS-OCTA, were conducted for each eye. A total of 50 of the 138 patients were selected for further analysis since their DWOP lesions in SS-OCTA could be well quantified. Results: The incidence rates of WWOP and DWOP in the young myopic group were 35.24% and 29.96%, respectively. The patients with a lower spherical equivalent (SE) showed a tendency to have a higher axial length (AL) and higher prevalence of WWOP. Multivariate regression analysis illustrated that a more serious SE and a longer AL were risk factors for both WWOP and DWOP. Eyes with DWOP lesions had lower vessel density (VD) in the whole retina (p < 0.001) and a deep vascular complex (DVC) (p < 0.001), and lower thickness of the outer retina (p < 0.001) compared with healthy counterparts. Conclusion: Ultra-wide SS-OCTA provided new insights into myopic-related peripheral retinal degenerations. DWOP was characterized by thinning of the outer retina and lower perfusion in DVC.
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Wang X, Xia L. Effect of macular vascular density on visual quality in young myopic adults. Front Med (Lausanne) 2022; 9:950731. [PMID: 36052335 PMCID: PMC9424549 DOI: 10.3389/fmed.2022.950731] [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: 05/23/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate macular vascular density using optical coherence tomography angiography (OCTA) and to investigate its impact on best-corrected visual acuity (BCVA), contrast sensitivity function (CSF), and higher-order aberrations (HOAs) in young myopic adults. Methods This cross-sectional study included 109 eyes with axial length (AL) between 22 and 26 mm in the medium AL group and 90 eyes with AL > 26 mm in the long AL group. OCTA was used to obtain 3 × 3 mm en face images, and the vessel length density (VLD), perfusion density (PD), and fovea avascular zone (FAZ) of the superficial layer were evaluated. Visual quality was assessed using the CSF and HOAs. Results Significant differences were found in the inferior VLD, parafoveal PD, and FAZ areas between the groups. AL and macular vascular density showed negative correlations in the inferior and nasal areas. The spherical correction (SE) also showed a positive correlation with vascular density in these two areas. FAZ area and perimeter had a significant negative association with AL, and FAZ circularity was correlated with SE. CSF with bright around 6 and 12 spatial frequencies showed positive correlations with nasal PD. The parafoveal PD showed a significant correlation with BCVA after adjusting for other factors. Conclusion The superficial macular vascular density of young myopic adults decreased with lower SE and longer AL in the parafovea area. An eye with a long AL has a smaller FAZ, and myopia decreases the FAZ circularity index. The decrease in vessel density could contribute to worse BCVA and may be correlated with lower CSF, but not with HOAs.
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Zhang W, Li C, Gong Y, Liu N, Cao Y, Li Z, Zhang Y. Advanced ultrawide-field optical coherence tomography angiography identifies previously undetectable changes in biomechanics-related parameters in nonpathological myopic fundus. Front Bioeng Biotechnol 2022; 10:920197. [PMID: 36051579 PMCID: PMC9424555 DOI: 10.3389/fbioe.2022.920197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose: To detect previously undetectable changes in vessel density and structural thickness, the two biomechanics-related parameters reflecting hemodynamics and tensile strength, respectively, in the peripheral and central fundi of nonpathological myopic eyes with an advanced ultrawide-field optical coherence tomography angiography (OCTA) system. Methods: A cross-sectional observational clinical study was carried out by recruiting 155 eyes from 79 college students aged 18–28 years. The eyes were stratified into normal, low-myopia, medium-myopia, and high-myopia groups according to diopter. A newly developed OCTA system with scanning dimensions of 24 mm × 20 mm, acquisition speed of 400 kHz, and imaging range of 6 mm was used to examine the vessel densities of superficial vascular complex (SVC), deep vascular complex (DVC), choriocapillary (ChC), and choroidal vessel (ChV) layers, as well as the thicknesses of the inner retina, outer retina, and choroid in the nonpathological myopic eyes. Results: The vessel densities in ChV at the temporal, inferotemporal, inferior, and inferonasal regions in the fundus periphery were significantly reduced in myopic subjects as compared to normal controls (all p < 0.05). The thicknesses of the inner retinal segments in most peripheral regions of the fundus became attenuated along with myopia severity (all p < 0.05). The thicknesses of the outer retinal segments were diminished at the superior and supranasal regions of the peripheral fundi of myopic subjects as compared to normal controls (all p < 0.05). At the central macular region, the decreased vessel densities of SVC and DVC were correlated with the attenuated thicknesses of inner retinal segments, respectively (all p < 0.05). Conclusion: As revealed for the first time by the advanced ultrawide-field OCTA system, the two biomechanics-related parameters that include the densities of the choroidal vessels and thicknesses of the inner retina segments were significantly reduced in the periphery of nonpathological myopic fundi and the reductions were associated with myopia severity. At the central macular region, the newly developed device provides consistent results with the previous findings. Therefore, it is important to use the noninvasive, ultrawide-field OCTA with high resolution for early detection of fundus changes in subjects with nonpathological high myopia. Clinical Trial Registration: clinicaltrials.gov, identifier ChiCTR2100054093.
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Affiliation(s)
- Weiran Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Chang Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yibo Gong
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nianen Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yunshan Cao
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, China
| | - Zhiqing Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- *Correspondence: Zhiqing Li, ; Yan Zhang,
| | - Yan Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- *Correspondence: Zhiqing Li, ; Yan Zhang,
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Lee A, Shin JW, Lee JY, Baek MS, Kook MS. Association of Superficial and Deep Macular Microvasculature with Central Visual Field Sensitivity in Glaucomatous Eyes with High Myopia. J Clin Med 2022; 11:jcm11154430. [PMID: 35956048 PMCID: PMC9369454 DOI: 10.3390/jcm11154430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: To investigate the relationship between two distinct layers of macular vessel density (superficial vascular plexus (SVP) and deep vascular plexus (DVP)) and central visual field sensitivity (cVFS) in open-angle glaucoma (OAG) eyes with high myopia. Method: This retrospective cross-sectional study included 148 OAG eyes (64 highly myopic (HMG) and 84 non-highly myopic glaucomas (NMG)) as well as 54 healthy eyes. High myopia was defined as a spherical equivalent of less than −6.0 diopters or an axial length of ≥26.0 mm. The global and sectoral SVP–cVFS and DVP–cVFS relationships were compared in each group. Macular ganglion cell-inner plexiform layer thickness (mGCIPLT)–cVFS relationships were also investigated as reference standards. Linear regression analysis was performed to identify the clinical factors associated with cVFS. Results: DVP–cVFS correlations were as strong as those for SVP–cVFS and mGCIPLT–cVFS in HMG eyes. In contrast, DVP–cVFS correlations were significantly lower than SVP–cVFS and mGCILT–cVFS correlations in NMG eyes. In linear regression analysis, both SVP and DVP were significantly associated with cVFS in HMG eyes, but only SVP showed a significant correlation with cVFS in NMG eyes. Conclusion: DVP assessment using OCT-A may be a useful tool for detecting and monitoring OAG eyes with high myopia.
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Li Y, Zheng F, Foo LL, Wong QY, Ting D, Hoang QV, Chong R, Ang M, Wong CW. Advances in OCT Imaging in Myopia and Pathologic Myopia. Diagnostics (Basel) 2022; 12:diagnostics12061418. [PMID: 35741230 PMCID: PMC9221645 DOI: 10.3390/diagnostics12061418] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Advances in imaging with optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) technology, including the development of swept source OCT/OCTA, widefield or ultra-widefield systems, have greatly improved the understanding, diagnosis, and treatment of myopia and myopia-related complications. Anterior segment OCT is useful for imaging the anterior segment of myopes, providing the basis for implantable collamer lens optimization, or detecting intraocular lens decentration in high myopic patients. OCT has enhanced imaging of vitreous properties, and measurement of choroidal thickness in myopic eyes. Widefield OCT systems have greatly improved the visualization of peripheral retinal lesions and have enabled the evaluation of wide staphyloma and ocular curvature. Based on OCT imaging, a new classification system and guidelines for the management of myopic traction maculopathy have been proposed; different dome-shaped macula morphologies have been described; and myopia-related abnormalities in the optic nerve and peripapillary region have been demonstrated. OCTA can quantitatively evaluate the retinal microvasculature and choriocapillaris, which is useful for the early detection of myopic choroidal neovascularization and the evaluation of anti-vascular endothelial growth factor therapy in these patients. In addition, the application of artificial intelligence in OCT/OCTA imaging in myopia has achieved promising results.
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Affiliation(s)
- Yong Li
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Feihui Zheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
| | - Li Lian Foo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Qiu Ying Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
| | - Daniel Ting
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Quan V. Hoang
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Department of Ophthalmology, Columbia University, New York, NY 10027, USA
| | - Rachel Chong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Marcus Ang
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Chee Wai Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 169856, Singapore; (Y.L.); (F.Z.); (L.L.F.); (Q.Y.W.); (D.T.); (Q.V.H.); (R.C.); (M.A.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence:
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Li Q, Gong P, Ho PH, Kennedy BF, Mackey DA, Chen FK, Charng J. Evaluating Distribution of Foveal Avascular Zone Parameters Corrected by Lateral Magnification and Their Associations with Retinal Thickness. OPHTHALMOLOGY SCIENCE 2022; 2:100134. [PMID: 36249684 PMCID: PMC9560651 DOI: 10.1016/j.xops.2022.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
Purpose To examine the distribution of foveal avascular zone (FAZ) parameters, with and without correction for lateral magnification, in a large cohort of healthy young adults. Design Cross-sectional, observational cohort study. Participants A total of 504 healthy adults, 27 to 30 years of age. Methods Participants underwent a comprehensive ophthalmic examination including axial length measurement and OCT angiography (OCTA) imaging of the macula. OCT angiography images of combined superficial and deep retinal vessel plexuses were processed via a custom software to extract foveal avascular zone area (FAZA) and foveal density-300 (FD-300), the vessel density in a 300-μm wide annulus surrounding the FAZ, with and without correction for lateral magnification. Bland–Altman analyses were performed to examine the effect of lateral magnification on FAZA and FD-300, as well as to evaluate the interocular agreement in both parameters. Linear mixed-effects models were used to examine the relationship between retinal thicknesses and OCTA parameters. Main Outcome Measures The FAZA and FD-300, corrected for lateral magnification. Results The mean (standard deviation [SD]) of laterally corrected FAZA and FD-300 was 0.22 mm2 (0.10 mm2) and 51.9% (3.2%), respectively. Relative to uncorrected data, 55.6% of corrected FAZA showed a relative change > 5%, whereas all FD-300 changes were within 5%. There was good interocular symmetry (mean right eye–left eye difference, 95% limits of agreement [LoA]) in both FAZA (0.006 mm2, -0.05 mm2, to 0.07 mm2) and FD-300 (-0.05%, -5.39%, to 5.30%). There were significant negative associations between central retinal thickness and FAZA (β = -0.0029), as well as between central retinal thickness and FD-300 (β = -0.044), with the relationships driven by inner, not outer, retina. Conclusions We reported lateral magnification adjusted normative values for FAZA and FD-300 in a large cohort of young, healthy eyes. Clinicians should strongly consider accounting for lateral magnification when evaluating FAZA. Good interocular agreement in FAZA and FD-300 suggests the contralateral eye can be used as control data.
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Affiliation(s)
- Qiang Li
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
| | - Peijun Gong
- BRITElab, Harry Perkins Institute of Medical Research, Centre for Medical Research, QEII Medical Centre, The University of Western Australia, Perth, WA, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, Australia
| | - Phuoc Hao Ho
- BRITElab, Harry Perkins Institute of Medical Research, Centre for Medical Research, QEII Medical Centre, The University of Western Australia, Perth, WA, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, Centre for Medical Research, QEII Medical Centre, The University of Western Australia, Perth, WA, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Melbourne, Australia
| | - David A. Mackey
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Fred K. Chen
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Correspondence: Fred K. Chen, FRANZCO, PhD, Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia.
| | - Jason Charng
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, Australia
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Han R, Wang X, Kong X, Zhang X, Cao Y, Lu Y, Liu L, Zhou X, Zhao F, Ma X. Clinical efficacy of electroacupuncture in controlling myopia in children and its influence on retinal blood flow. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2022. [DOI: 10.1007/s11726-022-1317-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lv L, Li M, Chang X, Zhu M, Liu Y, Wang P, Xiang Y. Macular Retinal Microvasculature of Hyperopia, Emmetropia, and Myopia in Children. Front Med (Lausanne) 2022; 9:900486. [PMID: 35669923 PMCID: PMC9163362 DOI: 10.3389/fmed.2022.900486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/22/2022] [Indexed: 12/15/2022] Open
Abstract
PurposeTo compare macular retinal microcirculation in myopia, emmetropia, and hyperopia groups and investigate the relationship between macular retinal microcirculation and axial length (AL) in children.MethodsForty myopic, 29 emmetropic, and 34 hyperopic eyes were included. All the recruited eyes underwent optical coherence tomography angiography (OCTA) examinations. After adjusting the image size by the Littmann method and Bennett formula, the vessel density (VD) of the deep capillary plexus (DCP) and superficial vascular plexus (SVP) were assessed.ResultsThe VD of the DCP was significantly lower in the myopia group than in the hyperopia group, whereas no significant differences in the VD of the SVP were observed among the myopia, emmetropia, and hyperopia groups. The VD of the DCP was significantly associated with AL, spherical equivalent (SE), and foveal retinal thickness (FRT), whereas the VD of the SVP was only significantly associated with FRT but not with AL or SE.ConclusionsThe myopic VD of the DCP was significantly lower than the hyperopic one, and the VD of the DCP was significantly associated with AL, indicating that myopia has a lower VD of the DCP, and AL could have a negative effect on the VD of the DCP. Thus, early myopic axial stretching might decrease retinal blood perfusion of the DCP in children.
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Affiliation(s)
- Liang Lv
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Ophthalmology, Hankou Aier Eye Hospital, Wuhan, China
| | - Mu Li
- Department of Ophthalmology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuejiao Chang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengxia Zhu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Ping Wang,
| | - Yan Xiang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yan Xiang,
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Xu Y, Yang W, Long T, Shang W, Xu X, Wang J, Yao J, Li K. Analysis of Microcirculation Changes in the Macular Area and Para-Optic Disk Region After Implantable Collamer Lens Implantation in Patients With High Myopia. Front Neurosci 2022; 16:867463. [PMID: 35663554 PMCID: PMC9160968 DOI: 10.3389/fnins.2022.867463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Myopia has become an important public health problem to be solved urgently. Posterior chamber phakic implantable Collamer lens (ICL) implantation is one of the latest and safest products for myopia correction worldwide. This prospective cross-sectional case series aimed to observe changes in the macular retinal thickness, retinal nerve fiber layer (RNFL) thickness of para-optic disk region, and blood flow density after posterior ICL implantation in patients with high myopia using optical coherence tomography angiography (OCTA). A total of 67 eyes of 67 patients with high myopia, who underwent ICL implantation at The Affiliated Eye Hospital of Nanjing Medical University from January 2020 and December 2020, were included. The spherical equivalent (SE) of the operative eyes was >−6.00 D. The changes in vision, intraocular pressure (IOP), SE, and vault were observed pre-operatively, and follow-up were performed 1 week, 1 month, and 3 months. OCTA was used to observe the changes in the CRT, retinal thickness of paracentral fovea, FAZ, superficial and deep retinal blood flow density in the macular area, RNFL thickness of para-optic disk region, and blood flow density before and after ICL implantation. The uncorrected distance visual acuity (UDVA) and best corrected distance visual acuity (CDVA) of the patients post-operation were significantly improved (P < 0.001). The IOP increased in comparison with other time points at 1 week post-operation (P < 0.05). There were no significant changes in CRT post-operation. The retinal thickness in the upper, lower, nasal, and temporal quadrants of the paracentral fovea increased significantly at 1 month and 3 months post-operation (P < 0.05). The FAZ area at all postoperative time points were decreased (P < 0.001). At 3 months post-operation, the blood flow density of the superficial and deep retinal layers in the upper, lower, and nasal macular area were significantly reduced (P < 0.05). At 1 month post-operation, the RNFL thickness in the temporal para-optic disk region and blood flow density were significantly reduced (P = 0.001 and P < 0.05, respectively). ICL implantation for highly myopic eyes led to an increase of the retinal thickness in the upper, lower, nasal, and temporal regions of the paracentral fovea; reduction of RNFL thickness in the temporal area of para-optic disk; decrease in FAZ area; and decrease in the blood flow density of some deep and superficial retinal layers as well as that of the temporal para-optic disk region.
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Affiliation(s)
- Yingnan Xu
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Weihua Yang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Tan Long
- Department of Ophthalmology, Xi’an No. 1 Hospital, Xi’an, China
| | - Weihong Shang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangzhong Xu
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Jinfan Wang
- School of Marxism, Nanjing Medical University, Nanjing, China
- *Correspondence: Jinfan Wang,
| | - Jin Yao
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- Jin Yao,
| | - Keran Li
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- Keran Li,
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Hong KE, Kim SA, Shin DY, Park CK, Park HYL. Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 35604665 PMCID: PMC9150826 DOI: 10.1167/iovs.63.5.26] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the ocular and hemodynamic factors contributing to the central visual function in glaucoma patients with myopia. Methods This study was a prospective observational study, which included 236 eyes of 140 patients with normal-tension glaucoma (NTG), which includes 114 eyes with mild myopia (axial length ≥24 and <26 mm) and 122 eyes with moderate-to-severe myopia (axial length ≥26 mm). Ocular characteristics were axial length and posterior pole profiles, including peripapillary atrophy (PPA) to disc area ratio, disc tilt ratio, disc torsion, and disc-foveal angle. Hemodynamic factors included standard deviation of the mean of qualified normal-to-normal intervals (SDNN) of a heart rate variability (HRV) test and vessel density (VD) parameters from optical coherence tomography angiography (OCTA). The root mean square error was estimated as a measure of the VD fluctuation. Association between ocular characteristics and VD parameters of the OCTA with the central sensitivity of the 10-degree visual field or the presence of central scotoma were analyzed. Results Deep layer VD of the peripapillary and macular areas showed significant differences between mild and moderate-to-severe myopia (P = 0.034 and P = 0.045, respectively). Structural parameters, especially PPA to disc area ratio, had significant correlation with peripapillary VD parameters in myopic eyes. Lower SDNN value (ß = 0.924, P = 0.011), lower deep VD of the macular area (ß = 0.845, P = 0.001), and greater fluctuation of deep VD in the peripapillary area (ß = 1.517, P = 0.005) were associated with the presence of central scotoma in patients with glaucoma with myopia in multivariate logistic regression analysis. Conclusions The structural changes by myopia, especially in the peripapillary region, affected VD parameters in myopic eyes. Lower deep VD and greater VD fluctuation in the peripapillary region showed association with central scotoma in patients with glaucoma with myopia, suggesting both structural and vascular changes by myopia may be related to central visual function in glaucoma patients with myopia.
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Affiliation(s)
- Kyung Euy Hong
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong Ah Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Da-Young Shin
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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The Role of Atropine in Preventing Myopia Progression: An Update. Pharmaceutics 2022; 14:pharmaceutics14050900. [PMID: 35631486 PMCID: PMC9147984 DOI: 10.3390/pharmaceutics14050900] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 12/24/2022] Open
Abstract
Several approaches have been investigated for preventing myopia progression in children and teenagers. Among them, topical atropine has shown promising results and it is being adopted in clinical practice more and more frequently. However, the optimal formulation and treatment algorithm are still to be determined. We discuss the pharmacokinetic, pharmacodynamic, clinical, and tolerability profile revealed first by the multicenter, randomized ATOM 1 and 2 trials and, more recently, by the LAMP Study. Results from these trials confirmed the efficacy of low-concentration atropine with a concentration-dependent response. Although atropine at 0.025% and 0.05% concentrations has shown the most encouraging results in large-scale studies, these formulations are not yet commonplace in worldwide clinical practice. Moreover, their rebound effect and the possibility of reaching a stabilization effect have not been fully investigated with real-life studies. Thus, further larger-scale studies should better characterize the clinical efficacy of atropine over longer follow-up periods, in order to define the optimal dosage and treatment regimen.
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Quantitative changes in iris vasculature and blood flow in patients with different refractive errors. Graefes Arch Clin Exp Ophthalmol 2022; 260:3123-3129. [DOI: 10.1007/s00417-022-05632-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/04/2022] Open
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Youssef MM, Sadek SH, Hatata RM. Macular and Optic Nerve Microvascular Alteration in Relation to Axial Length, by Optical Coherence Tomography Angiography (OCTA). Clin Ophthalmol 2022; 16:885-892. [PMID: 35345824 PMCID: PMC8957341 DOI: 10.2147/opth.s354235] [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: 12/26/2021] [Accepted: 02/15/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To study the effect of axial length (AL) on quantitative characterization of macular and optic nerve microvasculature using optical coherence tomography angiography (OCTA) in healthy individuals. Methods A cross-sectional study where participants were divided into 3 groups according to AL; A: ≤22.5 mm, B: 22.6–24.5 mm, C: >24.5 mm. Superficial vascular density (SVD), deep vascular density (DVD), foveal avascular zone (FAZ), and radial peripapillary capillary density (RPCD) were calculated using OCTA. Pearson correlation was run to identify the relation between AL and study parameters. Results One hundred and twelve eyes of 56 participants (20 males, 36 females) were included. Mean FAZ was 0.33 ± 0.15 mm2, 0.27 ± 0.1 mm2 and 0.28 ± 0.2 mm2 in Groups A, B, and C, respectively (p value 0.073). No significant difference was found between 3 groups, as regards superficial foveal density and vessel density inside the disc. Deep foveal density was significantly lower in Group A in comparison to Groups B and C (p value 0.021 and 0.005, respectively). As for other parameters of SVD, DVD and RPCD, no significant difference was observed between Groups A and B; however, the same parameters were significantly lower in Group C when compared to Group A and B. AL was found to be negatively correlated to FAZ (r −0.191, p value 0.043) and most of parameters of SVD, DVD, and RPCD (p value < 0.0001). Conclusion Most of optic nerve and macular microvascular parameters were significantly lower in eyes with longer axial lengths when compared to those with shorter axial lengths. Moreover, most of these parameters were negatively correlated with AL.
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Affiliation(s)
- Maha Mohamed Youssef
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sherin Hassan Sadek
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Ragai Magdy Hatata
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Fan X, Xu H, Zhai R, Sheng Q, Sun Y, Shao T, Kong X. Peripapillary Vascular Reactivity in Primary Open-Angle Glaucoma With High Myopia by Using Optical Coherence Tomography Angiography. Front Med (Lausanne) 2022; 9:850483. [PMID: 35372433 PMCID: PMC8971362 DOI: 10.3389/fmed.2022.850483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To evaluate peripapillary vascular reactivity in primary open-angle glaucoma (POAG) with and without high myopia (HM) by using optical coherence tomography angiography (OCTA). Methods This prospective study enrolled 48 eyes with POAG, including 16 and 32 eyes with and without HM, respectively. The retinal peripapillary vessel density (VD) was repeatedly assessed using OCTA at baseline and after a hyperoxia test (breathing 80% oxygen). The VD changes between different oxygenation conditions were calculated to reflect the vasoreactivity. Linear regression was performed to determine the relationship between myopia and retinal vascular reactivity in patients with POAG. Systemic hemodynamic characteristics were also evaluated under both conditions. Results The VD was significantly reduced after hyperoxia in the whole image (baseline and hyperoxia: 41.4 ± 4.5 and 38.8 ± 4.4, respectively, P < 0.001) and in the peripapillary regions (44.3 ± 5.7 and 41.1 ± 5.4, respectively, P < 0.001) in POAG eyes without HM. However, in eyes with HM, the whole-image VD in hyperoxia was not significantly different from the baseline (baseline and hyperoxia: 40.5 ± 6.2 and 40.2 ± 6.2, respectively, P = 0.481). The VD changes in eyes with HM were significantly smaller than those in eyes without HM in both the whole image (0.3 ± 1.8 and 2.6 ± 2.0, respectively, P < 0.001) and peripapillary regions (1.1 ± 2.0 and 3.2 ± 2.3, respectively, P = 0.003). Linear regression results showed a significant correlation between retinal vascular reactivity and spherical equivalent (SE) (β = 0.28, P < 0.001, R2 = 0.31) and axial length (AL) (β = −0.72, P < 0.001, R2 = 0.33). Conclusion Retinal vasoreactivity of peripapillary capillaries in POAG eyes with HM was significantly impaired in comparison with that in POAG eyes without HM. A lower peripapillary vascular response was significantly associated with worse SE and elongated AL.
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Affiliation(s)
- Xintong Fan
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Huan Xu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Ruyi Zhai
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qilian Sheng
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yanan Sun
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Tingting Shao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Tingting Shao,
| | - Xiangmei Kong
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- *Correspondence: Xiangmei Kong,
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Zhong H, Dong Q, Cun Q, He G, Tao Y, Song K, Lu Y, Zhu Q, Chen X, Chen Q. Peripapillary vessel density correlates with visual field mean sensitivity in highly myopic eyes. J Transl Med 2022; 20:119. [PMID: 35272676 PMCID: PMC8908572 DOI: 10.1186/s12967-022-03323-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/28/2022] [Indexed: 12/21/2022] Open
Abstract
Purpose To identify the global and regional distribution of peripapillary vessel density (pVD) and try to find out the relationships between pVD and the visual field mean sensitivity (VFMS) in healthy myopic eyes. Design Prospective cross-sectional study. Methods Two hundred and twenty-two participants (393 eyes) with myopia (myopic refractive error < − 0.5 diopters) from two clinical centers were recruited in this study and were divided into 4 groups according to the spherical equivalent (SE): Group1:− 0.5D ≥ SE > − 6.00D, Group2: − 6.00D ≥ SE > − 8.00D, Group3:− 8.00D ≥ SE > − 10.00D, Group4:SE ≤ -10.00D.The pVD assessed with optical coherence tomography angiography (OCTA) was quantified in 8 sectors. Peripapillary retinal nerve fibre layer (pRNFL) imaging was performed with SD-OCT. Visual field (VF) tests were performed with the 30-2 SITA standard program on the Humphrey 750i Visual Field Analyzer and were grouped into 8 regions that matched the structure. Results The pRNFL had no significant difference in all groups (p = 0.422). The average pVD were significantly lower in group 4 (47.61 ± 6.58) than in group 2 and 3 (51.49 ± 3.21, 50.48 ± 3.43 respectively) (p < 0.05). While both pVD in group2 and 3 were statistically lower than group1 (52.77 ± 2.86). The average VFMS was significantly lower in group 4 (901.85 ± 386.54) than other three groups (1169.15 ± 328.94, 1081.77 ± 338.83, 1076.89 ± 358.18, for group1,2,3 respectively). The pVD and VFMS were positively correlated in group3 (r = 0.184) and group4 (r = 0.476) (p < 0.05). Linear regression analysis demonstrated that VFMS were positively associated with pVD especially in temporal and nasal quadrants in myopic eyes. Conclusions The pVD shows a significant positive correlation with VFMS in highly myopic eyes with SE ≤ − 8.00D. We suggest that pVD measurement by OCTA could be a sensitive and useful method for monitoring myopic functional change.
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Affiliation(s)
- Hua Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Qingqing Dong
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China.,Department of Ophthalmology, Dazhou Central Hospital, Dazhou, 635099, China
| | - Qing Cun
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Guangyu He
- The First People's Hospital of Yunnan Province, Kunming, 650011, China
| | - Yijin Tao
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Keyao Song
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Yunqing Lu
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Qin Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China.,Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, 650051, China
| | - Xi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China.,Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Qin Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China.
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Macular vascular density and visual function after phacoemulsification in cataract patients with non-pathological high myopia: a prospective observational cohort study. Graefes Arch Clin Exp Ophthalmol 2022; 260:2597-2604. [PMID: 35258718 DOI: 10.1007/s00417-022-05606-9] [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: 11/13/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 02/08/2023] Open
Abstract
PURPOSES This study aimed to evaluate changes in macular vascular density and macular function in patients with high myopia cataract (HMC) after phacoemulsification surgery, using optical coherence tomography angiography (OCTA) and multifocal electroretinography (mfERG). METHODS Patients with cataracts scheduled for phacoemulsification surgery were divided into a high myopia group (axial length > 26.5 mm) and a control group (22 mm < axial length ≤ 24.5 mm). OCTA examinations were performed before surgery and at 1 day, 1 week, 1 month, and 3-6 months post-surgery, while mfERG was conducted before surgery and at 3-6 months post-surgery. RESULTS A total of 38 patients were included, of whom 20 were HMC patients and 18 were control patients. The macular vascular density significantly increased after phacoemulsification surgery in both groups, while foveal avascular zone area decreased significantly (HMC group: all p < 0.01; control group: all p < 0.05). Mean changes in macular vascular density were significantly greater in HMC patients than in the control group at 1 day after surgery (all p < 0.05). The amplitude density and latency of P1 wave in all macular rings (Ring1-5) did not differ significantly before or after surgery in either group (all p > 0.1). CONCLUSION Phacoemulsification may not affect HMC patients' macular mfERG responses within 3-6 months post-surgery, but it may influence macular microcirculation. HMC patients should be closely monitored after surgery, as their retinal vascular density may fluctuate substantially in the early postoperative period.
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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: 2] [Impact Index Per Article: 1.0] [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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Wang Y, Zhu X, Xuan Y, Wang M, Zhou X, Qu X. Short-Term Effects of Atropine 0.01% on the Structure and Vasculature of the Choroid and Retina in Myopic Chinese Children. Ophthalmol Ther 2022; 11:833-856. [PMID: 35184254 PMCID: PMC8927555 DOI: 10.1007/s40123-022-00476-0] [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: 01/04/2022] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To explore the short-term effects of atropine 0.01% on the structure and vasculature of the choroid and retina in myopic Chinese children. Methods This study was a single-center randomized clinical trial. A total of 40 subjects with myopia < − 6.0 D were enrolled and randomized to receive atropine 0.01% once nightly with regular single-vision lenses or to simply wear regular single-vision lenses at an allocation ratio of 1:1. Follow-up visits were planned at 1 month and 3 months. Choroidal thickness (ChT) was obtained by optical coherence tomography (OCT). Retinal vessel density (RVD), retinal thickness (RT), foveal avascular zone (FAZ) and choriocapillaris flow (CCF) were measured by optical coherence tomography angiography (OCTA). The RVD and RT were measured at fovea, parafovea and perifovea area and four quadrants. Results Twenty-one subjects were allocated into the atropine group and 19 subjects into the control group. Over 3 months, the control group showed greater progression of myopia than those in the atropine group. ChT in the atropine group increased 11.12 ± 13.96 μm, which was not significant compared with that of the control group. None of the retinal sectors in atropine-treated eyes showed significant changes of RT and RVD compared with the control group. Besides, FAZ and CCF of the atropine group were not affected by atropine use over time, and there was no difference between the two groups. Conclusion Administration of atropine 0.01% eye drops demonstrated no effect on RVD, FAZ and CCF over 3 months, while a modest increase of ChT was observed in atropine-treated eyes. Trial Registration Number ChiCTR1800017154. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00476-0.
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Li Z, Yang Z, Liao Y, Zhan Z, Zeng R, Zhang Y, Lan Y. Relative Peripheral Refraction Characteristics and Their Relationship with Retinal Microvasculature in Young Adults: Using a Novel Quantitative Approach. Photodiagnosis Photodyn Ther 2022; 38:102750. [DOI: 10.1016/j.pdpdt.2022.102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/16/2022]
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