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Lal B, She Z, Beach KM, Hung LF, Patel NB, Smith EL, Ostrin LA. Inner Retinal Microvasculature With Refraction in Juvenile Rhesus Monkeys. Transl Vis Sci Technol 2024; 13:42. [PMID: 39186302 PMCID: PMC11361384 DOI: 10.1167/tvst.13.8.42] [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: 03/25/2024] [Accepted: 07/18/2024] [Indexed: 08/27/2024] Open
Abstract
Purpose To characterize inner retinal microvasculature of rhesus monkeys with a range of refractive errors using optical coherence tomography angiography. Method Refractive error was induced in right eyes of 18 rhesus monkeys. At 327 to 347 days of age, axial length and spherical equivalent refraction (SER) were measured, and optical coherence tomography and optical coherence tomography angiography scans (Spectralis, Heidelberg) were collected. Magnification-corrected metrics included foveal avascular zone area and perfusion density, fractal dimension, and lacunarity of the superficial vascular complex (SVC) and deep vascular complex (DVC) in the central 1-mm diameter and 1.0- to 1.5-mm, 1.5- to 2.0-mm, and 2.0- to 2.5-mm annuli. Pearson correlations were used to explore relationships. Results The mean SER and axial length were 0.78 ± 4.02 D (-7.12 to +7.13 D) and 17.96 ± 1.08 mm (16.41 to 19.93 mm), respectively. The foveal avascular zone area and SVC perfusion density were correlated with retinal thickness for the central 1 mm (P < 0.05). SVC perfusion density of 2.0- to 2.5-mm annulus decreased with increasing axial length (P < 0.001). SVC and DVC fractal dimensions of 2.0- to 2.5-mm were correlated with axial length and SER, and DVC lacunarity of 1.5- to 2.0-mm annulus was correlated with axial length (P < 0.05). Conclusions Several inner retinal microvasculature parameters were associated with increasing axial length and SER in juvenile rhesus monkeys. These findings suggest that changes in retinal microvasculature could be indicators of refractive error development. Translational Relevance In juvenile rhesus monkeys, increasing myopic refraction and axial length are associated with alterations in the inner retinal microvasculature, which may have implications in myopia-related changes in humans.
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Affiliation(s)
- Barsha Lal
- University of Houston College of Optometry, Houston, TX, USA
| | - Zhihui She
- University of Houston College of Optometry, Houston, TX, USA
| | - Krista M. Beach
- University of Houston College of Optometry, Houston, TX, USA
| | - Li-Fang Hung
- University of Houston College of Optometry, Houston, TX, USA
| | - Nimesh B. Patel
- University of Houston College of Optometry, Houston, TX, USA
| | - Earl L. Smith
- University of Houston College of Optometry, Houston, TX, USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, USA
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Lal B, Alonso-Caneiro D, Read SA, Carkeet A. Changes in retinal and choroidal optical coherence tomography angiography indices among young adults and children over 1 year. Clin Exp Optom 2024; 107:627-634. [PMID: 37848182 DOI: 10.1080/08164622.2023.2259907] [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: 05/15/2023] [Revised: 08/24/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
CLINICAL RELEVANCE Optical coherence tomography angiography (OCT-A) indices are likely to change across time and optometrists should be aware of the variability expected during childhood development and in healthy adults. BACKGROUND Cross-sectional studies have shown that OCT-A indices are associated with age in adults and children. The aim of this study is to investigate longitudinal changes in retinal and choroidal OCT-A indices over 1 year among healthy children and young adults. METHODS This prospective longitudinal study captured macular OCT-A and OCT scans, and biometry measures at baseline and 1-year follow-up for 22 adults (18-30 years; -6.87 to +0.37 D) and 21 children (6-15 years; -5.75 to +0.25 D). Superficial and deep retinal layer, choriocapillaris and deep choroidal en face OCT-A images were analysed to extract magnification-corrected vascular indices in foveal, parafoveal and perifoveal regions. The retinal indices included foveal avascular zone metrics, perfusion, and vessel density. Flow deficit number, size, and density were extracted from choriocapillaris and perfusion density from deep choroid. Associations between annual changes in the OCT-A indices and axial length and baseline refraction were also studied. RESULTS Among children, significant reductions were noted only in parafoveal superficial retinal and foveal and perifoveal deep retinal layer indices over 1 year (p < 0.05). Choroidal OCT-A indices in children and both retinal and choroidal OCT-A indices in adults did not show significant changes. Myopia was associated with a larger reduction in the perifoveal retinal OCT-A indices in children, and with increases in sub-foveal and sub-parafoveal choroidal indices in adults. There were associations between OCT-A indices and axial length changes but differently in adults and children. CONCLUSIONS Significant changes were noted in retinal OCT-A indices over 1 year among children but not adults. In comparison, choroidal OCT-A indices in adults and children showed a stable morphology over this period of time.
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Affiliation(s)
- Barsha Lal
- Centre for Vision and Eye Research, Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - David Alonso-Caneiro
- School of Science, Technology and Engineering, University of Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Andrew Carkeet
- Centre for Vision and Eye Research, Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
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3
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Ponugoti A, Ngo H, Stinnett S, Kelly MP, Vajzovic L. Repeatability and reproducibility of quantitative OCT angiography measurements from table-top and portable Flex Spectralis devices. Graefes Arch Clin Exp Ophthalmol 2024; 262:1785-1793. [PMID: 38270629 DOI: 10.1007/s00417-023-06351-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
PURPOSE The recent development of a portable investigational handheld OCT-angiography (OCTA) device has allowed for expansion of imaging into the operating room (OR) in addition to standard in-clinic imaging. The aim of this study was to assess intravisit repeatability and intervisit reproducibility of retinal microvasculature measures and central retinal thickness for in-clinic table-top and portable OR compatible OCTA devices. METHODS Repeated 10 × 10 OCTA images were acquired in 20 healthy adult participants on two separate visit days using Spectralis spectral-domain OCTA table-top and investigational armature suspended Flex systems. Intravisit and intervisit intraclass correlation coefficients and average absolute percent difference were calculated for quantitative microvasculature measures and CRT. RESULTS 120 OCTA images were acquired from 20 subjects (n = 20, mean age 26.7 ± 1.61 years, range 24-30 years) with both devices across two separate imaging days. FAZ and CRT measurements had near complete intravisit and intervisit agreement with ICCs between .97 and 1 for both table-top (FAZ ICC .97, .97; CRT ICC .98-1, .98-.99) and Flex (FAZ ICC .97, .95; CRT ICC .99-1, .98-.99) devices. Vessel density measures demonstrated greater variance with only fair to strong agreement (ICC .32-.75) and average absolute percent differences ranging from 2.96 to 6.63%. CONCLUSION FAZ and CRT measures for both devices demonstrated high repeatability and reproducibility; retinal vessel density measures demonstrated less. Differences of less than 7% for retinal microvasculature measurements across time and devices are most likely attributable to expectable variance between repeat scans.
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Affiliation(s)
- Arathi Ponugoti
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA.
| | - Hoan Ngo
- School of Biomedical Engineering, International University-VNU HCMC, Ho Chi Minh City, Vietnam
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA
| | - Michael P Kelly
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, 2351 Erwin Rd, Durham, NC, 27705, USA
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Wang J, Ying GS, Yu Y, Tomlinson L, Binenbaum G. Racial Differences in Retinopathy of Prematurity-Reply to Letter to the Editor. Ophthalmic Epidemiol 2024; 31:299-300. [PMID: 37635369 PMCID: PMC10897058 DOI: 10.1080/09286586.2023.2251153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Jingyun Wang
- State University of New York College of Optometry, New
York, NY
| | - Gui-Shuang Ying
- Department of Ophthalmology, Scheie Eye Institute,
University of Pennsylvania, Philadelphia, PA
| | - Yinxi Yu
- Department of Ophthalmology, Scheie Eye Institute,
University of Pennsylvania, Philadelphia, PA
| | - Lauren Tomlinson
- Division of Ophthalmology, Children’s Hospital of
Philadelphia, Philadelphia, PA
| | - Gil Binenbaum
- Department of Ophthalmology, Scheie Eye Institute,
University of Pennsylvania, Philadelphia, PA
- Division of Ophthalmology, Children’s Hospital of
Philadelphia, Philadelphia, PA
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5
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Ovik T, Lind A, Popovic Z, Dahlgren J, Aring E, Andersson Grönlund M. Foveal thickness and vascular variables in adolescents born moderate-to-late preterm. Acta Ophthalmol 2024. [PMID: 38683112 DOI: 10.1111/aos.16702] [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: 10/11/2023] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE It is well established that children born very preterm are at increased risk for ocular abnormalities including altered foveal morphology. However, little is known about how children born moderate-to-late preterm (MLP), gestational age 32 + 0-36 + 6 weeks, are affected later in life. This study investigates foveal avascular zone (FAZ) area, vascular density (VD), central foveal thickness (CFT) and ganglion cell layer thickness (GCL++) of adolescents born MLP without history of retinopathy of prematurity and compare the results with full-term controls. METHODS In a prospective population-based cohort study, 50 adolescents (26 girls; mean age 16.5 years) born MLP were examined with optical coherence tomography (OCT) and OCT angiography (OCT-A). FAZ and VD were obtained from OCT-A scans and adjusted for ocular magnification. CFT and GCL++ were obtained from the OCT scans. The results from the MLP individuals were compared with the results from 49 healthy full-term controls (29 girls; mean age 16.7 years). RESULTS The results showed statistically significant differences in FAZ area (0.22 vs 0.28 mm2; p = 0.0032) and CFT (198.1 vs 187.1 μm; p = 0.0010) between the MLP group and controls. Strong correlations between FAZ area and CFT (r = -0.773, p < 0.0001) and GCL++ (r = -0.924, p < 0.0001) were found in the MLP group. There were no differences in VD. CONCLUSIONS Our results show that adolescents born MLP have a smaller FAZ area and an increased CFT compared with full-term controls. These results indicate that adolescents born MLP have similar parafoveal changes as children born extreme or very preterm.
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Affiliation(s)
- Titus Ovik
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alexandra Lind
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Zoran Popovic
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Aring
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Ophthalmology, Mölndal, Sweden
| | - Marita Andersson Grönlund
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Shuaib A, Salem SA, Elnahry AG, Ghalwash DA, Mohalhal AA. Correlation of the macular microvasculature to the axial length in pediatric patients with high axial refractive errors. Eye (Lond) 2024; 38:507-513. [PMID: 37660199 PMCID: PMC10858025 DOI: 10.1038/s41433-023-02712-8] [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: 03/14/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 09/04/2023] Open
Abstract
AIMS To compare the vascular density (VD) of the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), and the foveal avascular zone (FAZ) among high hyperopic, high myopic, and emmetropic children using optical coherence tomography angiography (OCTA). METHODS This was a cross sectional comparative study of otherwise healthy children with different refractive errors. Patients were recruited from Cairo University Children's Hospital. OCTA imaging was performed using the RTVue XR Avanti device with AngioVue software. Both the 3 × 3 and 6 × 6 mm macular scans were utilized. Automated measurements were obtained from the built-in machine software. Axial length (AL) measurements were done using Lenstar LS 900 optical biometer. RESULTS Ninety eyes from 51 healthy children were included. Among high myopes, there was significant thinning of the parafovea (p < 0.001). SCP-VD was also lower in high myopes in all areas except the fovea (all p < 0.001). The DCP-VD was significantly lower in high myopes in the parafovea and perifovea. High hyperopes had lower subfoveal CC-VD. Despite high myopes showing a significantly lower OCTA signal strength, linear regression analysis revealed that AL was an independent and significant predictor for the FAZ-area, as well as parafoveal and perifoveal SCP and DCP-VD. CONCLUSION High myopia results in a reduction of VD in both the SCP and DCP, which can be non-invasively detected and monitored using OCTA. While lower VD may, in part, be attributed to lower OCTA image quality, our findings demonstrate that AL independently and significantly predicts macular vascular parameters on OCTA in children.
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Affiliation(s)
- Asmaa Shuaib
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Somaya A Salem
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman G Elnahry
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Dalia A Ghalwash
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed A Mohalhal
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Ponugoti A, Ngo H, Stinnett S, Vajzovic L. Chronic Effects of e-Cigarette Aerosol Inhalation on Macular Perfusion Assessed Using OCT Angiography. JOURNAL OF VITREORETINAL DISEASES 2024; 8:21-28. [PMID: 38223771 PMCID: PMC10786087 DOI: 10.1177/24741264231205071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Purpose: To determine whether there are significant differences in the microvasculature and central retinal thickness (CRT) between e-cigarette users (user group) and age-matched nonusers (control group) using optical coherence tomography angiography (OCTA). Methods: In this prospective cross-sectional observational study, OCTA images were acquired of 52 eyes of 26 users and 25 eyes of 25 age-matched nonusers. Daily e-cigarette users with no ocular history were identified from provider information in the electronic medical record. A custom algorithm was used to calculate the foveal avascular zone (FAZ), vessel area density (VAD), and vessel length density (VLD). OCT software was used to calculate the foveal, superior, inferior, nasal, and temporal CRT. Generalized estimating equations using the Z-statistic were used to determine how the FAZ, VAD, VLD, and CRT parameters varied between groups and to assess the differential contribution of descriptive data in the user group. Results: No statistically significant difference was found between the user group and control group in the FAZ, superficial vascular complex (SVC) VAD, SVC VLD, or deep vascular complex (DVC) VAD. A statistically significant difference was found for DVC VLD (P = .002), with the user group having a slightly higher VLD on average. Superior, temporal, and inferior inner macular thicknesses were significantly thinner in the user group (P = .038, P = .012, and P = .035, respectively). Conclusions: Significant negative differences were found in CRT measures but not in retinal microvasculature parameters between e-cigarette users and nonusers. Decreased inferior, temporal, and superior inner macular thickness in e-cigarette users may show an early chronic structural effect that warrants further assessment of retinal effects as this population ages and continues to use e-cigarettes.
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Affiliation(s)
- Arathi Ponugoti
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Hoan Ngo
- School of Biomedical Engineering, International University–VNU HCMC, Ho Chi Minh City, Vietnam
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
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Ceylanoglu KS, Sen EM, Karamert SS, Erdeve SS, Cetinkaya S. Optical coherence tomography angiography findings in pediatric patients with graves ophthalmopathy. Int Ophthalmol 2023; 43:3609-3614. [PMID: 37392258 DOI: 10.1007/s10792-023-02769-0] [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: 02/03/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE The aim of this study was to evaluate peripapillary, macular microvascular structure, and retinal nerve fiber layer (RNFL) thickness profile in children with Graves Ophthalmopathy (GO). MATERIAL AND METHODS Thirty-six eyes of 18 children with GO were prospectively compared with 40 eyes of 20-age and sex-matched controls. The severity and activity of the disease were evaluated according to the criteria of the European Group on Graves' Ophthalmopathy (EUGOGO) and Clinical Activity Score (CAS). After complete ophthalmologic and endocrinologic examination, all patients underwent optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) measurements. Retinal nerve fiber layer (RNFL) thickness, macular superficial capillary plexus (SCP), deep capillary plexus (DCP), foveal avascular zone (FAZ) area, acircularity index (AI) of the FAZ and peripapillary microvascular structure were analyzed. RESULTS The mean age was 12.1 ± 2.4 years in the GO group and 11.2 ± 2.6 years in healthy control group (p = 0.11). Duration of disease was 8.9 ± 4.2 months in the GO group. All patients in GO group had mild and inactive ophthalmopathy. In temporal inferior quadrant, RNFL thickness was significantly thinner in the GO group compared to the control group (p = 0.03). No significant difference was seen between groups both peripapillary and macular microvascular structure (all p > 0.05). CONCLUSION GO has no effect on optic nerve thickness, peripapillary and macular vascular parameters except inferior temporal RNFL in children.
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Affiliation(s)
| | - Emine Malkoc Sen
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Selin Sahin Karamert
- University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynaecology, Children's Health and Disease Education and Research Hospital, Ophthalmology Department, Ankara, Turkey
| | - Senay Savas Erdeve
- University of Health Science, Dr. Sami Ulus Obstetrics and Gynaecology, Children's Health and Disease Education and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Semra Cetinkaya
- University of Health Science, Dr. Sami Ulus Obstetrics and Gynaecology, Children's Health and Disease Education and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
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Sun KX, Xiang YG, Zhang T, Yi SL, Xia JY, Yang X, Zheng SJ, Ji Y, Wan WJ, Hu K. Evaluation of childhood developing via optical coherence tomography-angiography in Qamdo, Tibet, China: A prospective cross-sectional, school-based study. World J Clin Cases 2023; 11:5479-5493. [PMID: 37637695 PMCID: PMC10450379 DOI: 10.12998/wjcc.v11.i23.5479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/11/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Optical coherence tomography angiography (OCTA) is a new and reliable machine used to evaluate retinal structure and macular perfusion in children. The use of OCTA under bad condition such as high altitude, low atmospheric oxygen, and low humidity, in children is rarely. AIM To quantify the macular micro-vasculature in healthy children of various ages using OCTA in Qamdo. METHODS Design: Prospective cross-sectional, school-based study. Three hundred and forty-seven normal students from 9 schools in 4 different areas in Qamdo were included. OCTA was performed on a 3 mm × 3 mm area centered on the macular region and macular cube 512 × 128 showed details in macular. Early treatment of diabetic retinopathy study Vessel Flow Density (VD) of the macular central vascular plexus density (CVD), inner vascular plexus density (IVD), full vascular plexus density (FVD), and the size of the foveal avascular zone (FAZ) were measured. All these results corrected by t/s = 3.382 × 0.01306 × (axial length-1.82). The differences were compared among various ages, sexes and living environments. RESULTS The mean FAZ area in all eyes was 0.27 mm2 ± 0.12 mm2. The mean foveal thickness (MFT) in the macular cube was 227.64 μm ± 23.51 μm. Compared with girls, boys had a lager FAZ (P = 0.0029). Among the different age groups, MFT (P < 0.001) and FVD (P < 0.0001), IVD (P < 0.0001), and CVD (P = 0.0050) increased with age. FAZ areas were not correlated with age (P = 0.8853) or others (MFT, area). CONCLUSION OCTA can use to evaluate macular perfusion in children. Our data bridge the gap between structural OCT and perfusion density in children in high altitude. Even though these were not a longitudinal study, it may provide us with hints about retina development during puberty and clinical implications of OCTA in children.
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Affiliation(s)
- Ke-Xin Sun
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yong-Guo Xiang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Tong Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400016, China
| | - Sheng-Lan Yi
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jiu-Yi Xia
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Shi-Jie Zheng
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yan Ji
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Wen-Juan Wan
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ke Hu
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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10
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Wang CT, Chang YH, Tan GSW, Lee SY, Chan RVP, Wu WC, Tsai ASH. Optical Coherence Tomography and Optical Coherence Tomography Angiography in Pediatric Retinal Diseases. Diagnostics (Basel) 2023; 13:diagnostics13081461. [PMID: 37189561 DOI: 10.3390/diagnostics13081461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/10/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
Indirect ophthalmoscopy and handheld retinal imaging are the most common and traditional modalities for the evaluation and documentation of the pediatric fundus, especially for pre-verbal children. Optical coherence tomography (OCT) allows for in vivo visualization that resembles histology, and optical coherence tomography angiography (OCTA) allows for non-invasive depth-resolved imaging of the retinal vasculature. Both OCT and OCTA were extensively used and studied in adults, but not in children. The advent of prototype handheld OCT and OCTA have allowed for detailed imaging in younger infants and even neonates in the neonatal care intensive unit with retinopathy of prematurity (ROP). In this review, we discuss the use of OCTA and OCTA in various pediatric retinal diseases, including ROP, familial exudative vitreoretinopathy (FEVR), Coats disease and other less common diseases. For example, handheld portable OCT was shown to detect subclinical macular edema and incomplete foveal development in ROP, as well as subretinal exudation and fibrosis in Coats disease. Some challenges in the pediatric age group include the lack of a normative database and the difficulty in image registration for longitudinal comparison. We believe that technological improvements in the use of OCT and OCTA will improve our understanding and care of pediatric retina patients in the future.
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Affiliation(s)
- Chung-Ting Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333, Taiwan
| | - Yin-Hsi Chang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333, Taiwan
| | - Gavin S W Tan
- Singapore National Eye Centre, Singapore, Singapore 168751, Singapore
- DUKE NUS Medical School, Singapore 169857, Singapore
| | - Shu Yen Lee
- Singapore National Eye Centre, Singapore, Singapore 168751, Singapore
- DUKE NUS Medical School, Singapore 169857, Singapore
| | - R V Paul Chan
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL 60612, USA
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Andrew S H Tsai
- Singapore National Eye Centre, Singapore, Singapore 168751, Singapore
- DUKE NUS Medical School, Singapore 169857, Singapore
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11
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Alvarez-Falcón S, Glaser T, Go MS, Kelly MP, Chen X, Freedman SF, El-Dairi M. Retinal injury identified by overhead-mounted optical coherence tomography in two young children with infantile-onset glaucoma. J AAPOS 2023; 27:28.e1-28.e6. [PMID: 36567044 DOI: 10.1016/j.jaapos.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To report and characterize unexpected retinal findings identified by imaging with overhead-mounted optical coherence tomography (OCT) in 2 young children with infantile-onset glaucoma. METHODS Children with glaucoma were imaged during clinically indicated examinations under anesthesia using overhead-mounted HRA+OCT Spectralis with Flex module (Flex-OCT, Heidelberg, Germany) from February 2017 through February 2022. Imagers prioritized scans of the peripapillary retinal nerve fiber layer (pRNFL), optic nerve head, and macula. Children imaged before age 2 years with images adequate for evaluation were included. Age at glaucoma diagnosis, glaucoma type, highest intraocular pressure (IOP), corneal diameter (CD), and axial length (AL) were recorded. RESULTS A total of 41 children (71 eyes with glaucoma) were imaged before age 2 years. Macular imaging identified both inner and outer retinal thinning in 3 eyes of 2 young children (both eyes of a child with newborn primary congenital glaucoma (PCG) and 1 eye of a child with glaucoma following cataract surgery), which remained stable over time. These findings were present in 2 of 41 children (4.9%) and 3 of 71 eyes (4.2%) imaged with Flex-OCT. Neither highest IOP, CD, nor AL at imaging differentiated the 3 eyes with retinal changes from the larger group. CONCLUSIONS Three eyes of 2 young children with refractory glaucoma of different etiologies and highly elevated IOP demonstrated areas of inner and outer retinal thinning, consistent with retinal injury from probable prior macular ischemia. Unexpected retinal pathology identified on Flex-OCT imaging in infantile-onset glaucomas highlights the need for continued study of the pathophysiology of this disease.
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Affiliation(s)
| | - Tanya Glaser
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Michelle S Go
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina
| | - Michael P Kelly
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Xi Chen
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Mays El-Dairi
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
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12
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Comba OB, Paşaoğlu E, Beyazal M, Karakaya M, Albayrak S. Quantitative analysis of retinal microvascular structure and correlation with ocular parameters: A normative database of pediatric OCT angiography. Photodiagnosis Photodyn Ther 2023; 41:103301. [PMID: 36682428 DOI: 10.1016/j.pdpdt.2023.103301] [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: 09/15/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE To analyze the vascular structure of the healthy pediatric population using optical coherence tomography angiography (OCTA), and to investigate its relationship with ocular parameters. MATERIALS AND METHOD This cross-sectional, prospective study included 142 eyes of 71 healthy subjects aged 8-18 years. All patients underwent a complete ocular assessment, biometric evaluation and OCTA analysis. Anterior chamber depth, axial length, corneal thickness values were also reported and their relationship with OCTA measurements was evaluated. RESULTS There was no statistical difference between girls and boys in terms of demographic characteristics (p>0.05). Neither vascular density in the deep and superficial capillary plexus nor FAZ area was significantly related to the ocular parameters or age of any patient in the study. CONCLUSIONS Despite the relatively small number of participants, this study may represent normative data for the Turkish pediatric population. It was also shown that vascular density and FAZ area in childhood are not affected by age, axis length, anterior chamber depth, cornea and foveal thickness.
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Affiliation(s)
| | | | | | | | - Sinan Albayrak
- Yeniyüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
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13
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Moir J, Rodriguez SH, Chun LY, Massamba N, Skondra D. Racial differences in quantitative optical coherence tomography angiography findings between older non-diabetics with co-morbidities. PLoS One 2023; 18:e0285360. [PMID: 37146056 PMCID: PMC10162566 DOI: 10.1371/journal.pone.0285360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023] Open
Abstract
This cross-sectional study compared optical coherence tomography angiography (OCTA) parameters between older Black and White adults with systemic comorbidities in an effort to further understand racial differences in the retinal microvasculature. We analyzed vessel density at the superficial (SCP), intermediate (ICP), and deep capillary plexuses (DCP), foveal avascular zone (FAZ) parameters, and blood flow area (BFA) at the choriocapillaris. We used a mixed-effects linear regression model, controlling for hypertension and two eyes from the same subject, to compare OCTA parameters. Black subjects had lower foveal vessel density at the SCP and ICP, while no differences were observed at the parafovea or 3x3 mm macular area of any capillary layer. Black subjects had greater FAZ area, perimeter, and FD-300, a measurement of vessel density in a 300 μm wide ring around the FAZ. Black subjects also had lower BFA at the choriocapillaris. Within a cohort of subjects without hypertension, these differences remained statistically significant, with the exception of foveal vessel density at the SCP and foveal BFA of the choriocapillaris. These findings suggest that normative databases of OCTA parameters must strive to be diverse in nature to adequately capture differences across patient populations. Further study is required to understand if baseline differences in OCTA parameters contribute to epidemiological disparities in ocular diseases.
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Affiliation(s)
- John Moir
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Sarah H Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States of America
| | - Lindsay Y Chun
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States of America
| | - Nathalie Massamba
- Department of Ophthalmology, Handicap, and Vision, Pitie Salpetriere Hospital, Sorbonne University, Paris, France
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States of America
- J. Terry Ernest Ocular Imaging Center, University of Chicago, Chicago, Illinois, United States of America
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14
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Verma A, Magesan K, Amose T, Alagorie AR, Gnanaraj R, Sadda SR, Sen P. Age-related assessment of foveal avascular zone and surrounding capillary networks with swept source optical coherence tomography angiography in healthy eyes. Eye (Lond) 2022; 36:1857-1864. [PMID: 35948688 PMCID: PMC9500041 DOI: 10.1038/s41433-022-02146-8] [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: 10/17/2021] [Revised: 03/09/2022] [Accepted: 06/13/2022] [Indexed: 11/09/2022] Open
Abstract
AIM To assess the macular capillary networks and foveal avascular zone (FAZ) with swept-source optical coherence tomography angiography in healthy eyes. METHODS This cross-sectional, prospective, observational study enrolled 222 eyes of 116 healthy participants with no ocular or systemic disease. SS-OCTA images were captured using the PLEX Elite 9000 (Carl Zeiss Meditec Inc., Dublin, CA, USA) with a 6 × 6 mm pattern centered on the foveal center. Vessel length density (VLD), perfusion density (PD), and FAZ parameters were analyzed using the manufacturer's automated software. RESULTS A significant negative correlation was observed between age and average VLD in the superficial plexus, and average PD in both the superficial plexus and the whole retina. A significant positive correlation between age and foveal avascular zone perimeter and area was also noted. Age-wise comparisons showed a trend for an increase in VLD and PD until 40 years of age, with a subsequent decrease in the older age in the macular region. The central subfield showed a decrease in the vessel density measurements in the 21-40 age group. FAZ area and perimeter were the mirror inverse of the central subfield vessel density measurements with a numerically greater area and perimeter in the 21-40 age group compared to the 0-20 and 41-60 age groups. FAZ circularity was significantly reduced after 40 years of age. CONCLUSION Age-related changes in the vessel density and FAZ parameters in the healthy macula are complex and vary with the macular location. These results carry significance when interpreting the data from diseased eyes.
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Affiliation(s)
- Aditya Verma
- Shri Bhagwan Mahavir VitreoRetinal Services, Medical Research Foundation, Tamil Nadu, India.
| | - Kowsigan Magesan
- Elite School of Optometry, Unit of Medical Research Foundation, Tamil Nadu, India
| | - T Amose
- Elite School of Optometry, Unit of Medical Research Foundation, Tamil Nadu, India
| | | | - Ramya Gnanaraj
- Shri Bhagwan Mahavir VitreoRetinal Services, Medical Research Foundation, Tamil Nadu, India
| | - SriniVas R Sadda
- Doheny Eye Institute, Los Angeles, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Parveen Sen
- Shri Bhagwan Mahavir VitreoRetinal Services, Medical Research Foundation, Tamil Nadu, India
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15
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He Y, Chen X, Tsui I, Vajzovic L, Sadda SR. Insights into the developing fovea revealed by imaging. Prog Retin Eye Res 2022; 90:101067. [PMID: 35595637 DOI: 10.1016/j.preteyeres.2022.101067] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022]
Abstract
Early development of the fovea has been documented by histological studies over the past few decades. However, structural distortion due to sample processing and the paucity of high-quality post-mortem tissue has limited the effectiveness of this approach. With the continuous progress in high-resolution non-invasive imaging technology, most notably optical coherence tomography (OCT) and OCT angiography (OCT-A), in vivo visualization of the developing retina has become possible. Combining the information from histologic studies with this novel imaging information has provided a more complete and accurate picture of retinal development, and in particular the developing fovea. Advances in neonatal care have increased the survival rate of extremely premature infants. However, with enhanced survival there has been an attendant increase in retinal developmental complications. Several key abnormalities, including a thickening of the inner retina at the foveal center, a shallower foveal pit, a smaller foveal avascular zone, and delayed development of the photoreceptors have been described in preterm infants when compared to full-term infants. Notably these abnormalities, which are consistent with a partial arrest of foveal development, appear to persist into later childhood and adulthood in these eyes of individuals born prematurely. Understanding normal foveal development is vital to interpreting these pathologic findings associated with prematurity. In this review, we first discuss the various advanced imaging technologies that have been adapted for imaging the infant eye. We then review the key events and steps in the development of the normal structure of the fovea and contrast structural features in normal and preterm retina from infancy to childhood. Finally, we discuss the development of the perifoveal retinal microvasculature and highlight future opportunities to expand our understanding of the developing fovea.
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Affiliation(s)
- Ye He
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; 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, China
| | - Xi Chen
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
| | - Irena Tsui
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
| | - Srinivas R Sadda
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA.
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16
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Nguyen TTP, Ni S, Liang G, Khan S, Wei X, Skalet A, Ostmo S, Chiang MF, Jia Y, Huang D, Jian Y, Campbell JP. Widefield Optical Coherence Tomography in Pediatric Retina: A Case Series of Intraoperative Applications Using a Prototype Handheld Device. Front Med (Lausanne) 2022; 9:860371. [PMID: 35860728 PMCID: PMC9289179 DOI: 10.3389/fmed.2022.860371] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Optical coherence tomography (OCT) has changed the standard of care for diagnosis and management of macular diseases in adults. Current commercially available OCT systems, including handheld OCT for pediatric use, have a relatively narrow field of view (FOV), which has limited the potential application of OCT to retinal diseases with primarily peripheral pathology, including many of the most common pediatric retinal conditions. More broadly, diagnosis of all types of retinal detachment (exudative, tractional, and rhegmatogenous) may be improved with OCT-based assessment of retinal breaks, identification of proliferative vitreoretinopathy (PVR) membranes, and the pattern of subretinal fluid. Intraocular tumors both benign and malignant often occur outside of the central macula and may be associated with exudation, subretinal and intraretinal fluid, and vitreoretinal traction. The development of wider field OCT systems thus has the potential to improve the diagnosis and management of myriad diseases in both adult and pediatric retina. In this paper, we present a case series of pediatric patients with complex vitreoretinal pathology undergoing examinations under anesthesia (EUA) using a portable widefield (WF) swept-source (SS)-OCT device.
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Affiliation(s)
- Thanh-Tin P. Nguyen
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Shuibin Ni
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Guangru Liang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Shanjida Khan
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Xiang Wei
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Alison Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, United States
- Department of Dermatology, Oregon Health and Science University, Portland, OR, United States
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD, United States
| | - Yali Jia
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - David Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Yifan Jian
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- *Correspondence: J. Peter Campbell,
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17
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Campagna GA, Chew L, Pettenkofer M, Nicoletti E, Schwartz JD, Choi G, Fernandes AO, Terrazas D, Kohn DB, Tsui I. Findings on Optical Coherence Tomography in Malignant Infantile Osteopetrosis. Ophthalmic Surg Lasers Imaging Retina 2022; 53:398-402. [PMID: 35858232 DOI: 10.3928/23258160-20220613-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Malignant infantile osteopetrosis is a rare inherited disorder with neurological complications and a shortened life expectancy. Vision loss is typically attributed to osseous compression of the optic nerves at the level of the optic canal. Fundus imaging is reported, as well as the first optical coherence tomography and optical coherence tomography angiography in this rare condition. Imaging revealed optic nerve pallor, subfoveal ellipsoid zone disruption, and an enlarged foveal avascular zone. These results provide insight regarding other potential mechanisms of vision loss in these patients. [Ophthalmic Surg Lasers Imaging Retina 2022; 53:398-402.].
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18
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Ponugoti A, Baumal CR, Vajzovic L. Optical Coherence Tomography Angiography in Pediatric Retinal Disorders. JOURNAL OF VITREORETINAL DISEASES 2022; 6:221-228. [PMID: 37008546 PMCID: PMC9976129 DOI: 10.1177/24741264221083873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The rapid and noninvasive nature of optical coherence tomography angiography (OCTA) makes it a potentially valuable tool for imaging the retina in children. With the optimization of tabletop systems and the development of experimental handheld OCTA devices, there is expanded potential for OCTA in the clinic and the operating room. This article reviews the utility of OCTA in some of the most common pediatric retinal disorders. Methods: A thorough computerized PubMed search was performed to review relevant published journal articles to contextualize and identify the role of OCTA in common retinal disorders with vascular involvement affecting children. Pertinent results and findings from original investigations and case reports were summarized. Results: The ability to quickly collect both qualitative and quantitative information about retinal microvasculature, in both the clinic and operating room settings, with OCTA, has led to the uncovering of microvascular features and morphologic changes in many pediatric retinal disorders such as Coats Disease, familial exudative vitreoretinopathy, incontinentia pigmenti, sickle cell retinopathy, Stargardt Disease, X-linked juvenile retinoschisis, retinopathy of prematurity, diabetic retinopathy in type 1 diabetes, pediatric retinal tumors, and choroidal neovascularization. Conclusions: OCTA is a relevant tool to aid early detection, guide intervention, monitor treatment response, and understand pathogenesis in a number of pediatric retinal disorders.
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Affiliation(s)
- Arathi Ponugoti
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Caroline R. Baumal
- Department of Ophthalmology, New England Eye Center, Tufts University School of Medicine, Boston, MA, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
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19
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Demir P, Hovsepian N, Pagels P, Petersson V, Baskaran K, Macedo AF. All retinas are not created equal: Fovea‐to‐macula thickness ratio and foveal microvasculature in healthy young children. Ophthalmic Physiol Opt 2022; 42:644-652. [PMID: 35156728 PMCID: PMC9304185 DOI: 10.1111/opo.12958] [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: 09/10/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 12/01/2022]
Abstract
Purpose Markers for the relationships between structural and microvasculature measures given by optical coherence tomography angiography are necessary to increase the diagnostic and prognostic value of this technique. The aim of this study was to investigate relationships between structural and microvasculature measures around the fovea in healthy eyes of healthy children. Methods Observational cross‐sectional study involving children aged 8–17 years, born at full‐term, with no eye disease. The better of two 3 × 3 mm macular scans obtained with a Cirrus 5000HD‐OCT was analysed. Images were corrected for lateral magnification errors. Vessel density and perfusion were measured with ImageJ/Fiji software for the superficial capillary plexus. Structural measures including foveal and macular thicknesses were performed manually. Results The sample included 86 participants, 51 (59%) females. Mean age was 12.4 years (SD = 2.5); mean best‐corrected acuity was −0.10 logMAR (SD = 0.09); mean refractive error was +0.59 D (SD = 1.3) and mean axial length was 23.1 mm (SD = 0.86). Mean area of the foveal avascular zone (AFAZ) was 0.20 mm2 (SD = 0.88); median fovea‐to‐macula thickness ratio (FMTR) was 0.63 (IQR = 0.08); mean central vessel density was 12.42 mm−1 (SD = 2.78) and mean central perfusion was 38.66% (SD = 3.83). AFAZ was correlated with central vessel density (p < 0.001), perfusion (p < 0.001), foveal thickness (p < 0.001) and FMTR (p < 0.001). Central vessel density was correlated with foveal thickness (p < 0.001) and FMTR, (p = 0.01). Central perfusion was correlated with foveal thickness (p < 0.001) and FMTR, (p = 0.003). Conclusion In this study, foveal thickness, FMTR and foveal microvasculature measurements were correlated. Clinicians need to be aware that shallow foveal pits and persistent foveal microvasculature are likely to occur in optical coherence tomography angiography images. In healthy eyes from healthy children, an atypical high FMTR and a small AFAZ may be associated with incomplete foveal development. The mechanism and functional implications of this remain unknown.
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Affiliation(s)
- Pelsin Demir
- Department of Medicine and Optometry Linnaeus University Kalmar Sweden
| | | | - Peter Pagels
- Department of Sport Sciences Linnaeus University Kalmar Sweden
| | | | | | - Antonio Filipe Macedo
- Department of Medicine and Optometry Linnaeus University Kalmar Sweden
- Centre of Physics – Optometry and Vision Science University of Minho Braga Portugal
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20
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Thangamathesvaran L, Ong SS, Wang J, Lance E, Tekes A, Scott AW. EVALUATION OF MACULAR FLOW VOIDS ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AS POTENTIAL BIOMARKERS FOR SILENT CEREBRAL INFARCTION IN SICKLE CELL DISEASE. Retina 2022; 42:340-347. [PMID: 34608107 DOI: 10.1097/iae.0000000000003309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the relationship between macular microvascular abnormalities on optical coherence tomography angiography and silent cerebral infarctions (SCIs) on cerebral magnetic resonance imaging in sickle cell disease. METHODS Patients (age <18 years old) from our previous pediatric sickle cell disease study cohort who had prior optical coherence tomography angiography and brain magnetic resonance imaging were identified. Brain magnetic resonance imaging images were compared with macular optical coherence tomography angiography scans to identify macular vascular density differences between patients with SCI and without SCI. RESULTS Sixty-eight eyes from 34 patients who underwent optical coherence tomography angiography were evaluated, of whom 28 eyes from 14 patients met the inclusion criteria for this study. Eight patients (57%) with SCI and 6 patients (43%) without SCI were identified. The mean age (17 years in SCI and 16.3 years in non-SCI) was comparable between groups. There was no statistically significant difference in systemic complications. Deep capillary plexus vessel density was lower in the temporal quadrant in patients with SCI (49.3% vs. 53.7%, P = 0.014). CONCLUSION Patients with SCI were found to have lower vessel density in the deep capillary plexus compared with those without SCI. This finding suggests that deep capillary plexus vessel density may have utility as an imaging biomarker to predict the presence of SCI.
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Affiliation(s)
- Loka Thangamathesvaran
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sally S Ong
- Department of Ophthalmology and Visual Science, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Jiangxia Wang
- Department of Biostatistics, Wilmer Biostats Center, Johns Hopkins University, Baltimore, Maryland
| | - Eboni Lance
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Aylin Tekes
- Department of Pediatric Radiology and Pediatric Neuroradiology, Russell Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Adrienne W Scott
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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21
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Linderman RE, Heffernan E, Ferrante S, Bachman Groth J, Carroll J. The Impact of Axial Eye Growth on Foveal Avascular Zone Measurements in Children. Optom Vis Sci 2022; 99:127-136. [PMID: 34897231 PMCID: PMC8816819 DOI: 10.1097/opx.0000000000001854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE Foveal avascular zone (FAZ) area is a frequently used biomarker in diseases impacting the retinal vasculature in pediatric populations. Variation in axial length between individuals results in differences in lateral image scale, which affect the accuracy of FAZ area measurements. Accordingly, changes in axial length over time within individual children would affect estimates of FAZ area change. PURPOSE This study aimed to quantify how changes in axial length over time affect estimates of FAZ area change using optical coherence tomography angiography (OCT-A) images. METHODS Twenty pediatric participants (<18 years old) and 40 adult participants were imaged on Optovue's Avanti system (Fremont, CA) and had axial length measurements acquired at two time points. The FAZ was segmented twice using the OCT-A image at each time point. Foveal avascular zone area was estimated at both time points using the assumed/fixed axial length of the OCT-A device (unscaled) and using the participant's axial length (scaled). Changes in FAZ area over time were compared between the pediatric and adult groups using both unscaled and scaled data. RESULTS The average ± standard deviation follow-up time was 3.35 ± 1.66 years for the pediatric group and 2.90 ± 1.65 years for the adult group. Using unscaled data, FAZ area seemed to decrease between visits in the pediatric group (P = .004), whereas the FAZ area increased between visits in the adult group (P = .003). When correctly scaled data were used, the FAZ area still increased between visits for the adult group (P < .001), although the FAZ area no longer showed a significant change between visits for the pediatric group (P = .37). When comparing the normalized FAZ area change across visits between unscaled and scaled data, a significant difference was found between the adult and pediatric groups (P < .001). CONCLUSIONS Scaled data should be used when measuring FAZ area in pediatric populations, especially in longitudinal studies.
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Affiliation(s)
- Rachel E. Linderman
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Elizabeth Heffernan
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Samantha Ferrante
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jane Bachman Groth
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
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22
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Jun TH, Moon JW. Macular Microvasculature Features of the Eyes of Healthy Korean Children Using Optical Coherence Tomography Angiography. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We used optical coherence tomography angiography to analyze the macular microvasculature of normal eyes of healthy Korean children; we derived normative data stratified by age.Methods: We retrospectively analyzed the medical records of 68 children (126 eyes) aged from 3 to 15 years. Optical coherence tomography angiography was performed on 3-mm2 regions centered on the fovea. The vascular densities of the superficial and deep capillary plexuses and the foveal avascular zone were determined, and analyzed by age. We sought correlations between age, gender, axial length, and the spherical equivalent.Results: The foveal, superficial capillary plexus vessel densities were 17.41 ± 5.41, 20.53 ± 4.76, 21.78 ± 5.73, and 22.95 ± 3.91% in children aged 3-5, 6-8, 9-11, and 12-15 years, respectively. The vessel densities of the foveal deep capillary plexus were 30.20 ± 6.59, 34.54 ± 7.16, 35.81 ± 6.02, and 37.38 ± 5.16% in those aged 3-5, 6-8, 9-11, and 12-15 years, respectively. Significant differences by age were apparent (p = 0.002, p < 0.001, respectively). The foveal vessel densities of the superficial and deep capillary plexuses were positively correlated with axial length (R2 = 0.153, p < 0.001; R2 = 0.158, p < 0.001, respectively) and the foveal avascular zone area was negatively correlated with axial length (R2 = 0.085, p < 0.001).Conclusions: The vessel densities of the superficial and deep capillary plexuses measured via optical coherence tomography angiography in normal eyes of healthy Korean children differed by age, and correlated significantly with axial length.
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Xiang L, Zhou Y, Chen Y, Jiang S, Fei C, Wang Y, Bai Y, Zhang X, Li K, Shen X. Assessment of the retinal vasculature in healthy Chinese preschool children aged 4-6 years old using optical coherence tomography angiography. BMC Ophthalmol 2021; 21:415. [PMID: 34856943 PMCID: PMC8638475 DOI: 10.1186/s12886-021-02154-4] [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: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4-6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. METHODS In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. RESULTS A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. CONCLUSIONS Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.
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Affiliation(s)
- Lu Xiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yingming Zhou
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yanwei Chen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Siyu Jiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Chunli Fei
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yangyang Wang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yang Bai
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xuan Zhang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Kai Li
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China.
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Fernandez JP, Haider AA, Vajzovic L, Ponugoti A, Kelly MP, Materin MA. Optical Coherence Tomography Angiography Microvascular Variations in Pre- and Posttreatment of Retinoblastoma Tumors. Ocul Oncol Pathol 2021; 7:330-339. [PMID: 34722489 DOI: 10.1159/000515142] [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: 08/26/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction The purpose of this study is to describe variations in microvasculature before and after treatment of treatment-naive lesions and during consolidation therapy of retinoblastoma lesions using an investigational portable optical coherence tomography angiography (OCTA) system. Methods This study is a single-center, prospective, observational case series. Recruited subjects were either undergoing surveillance for retinoblastoma or had newly detected retinoblastoma. Nine tumors from 7 eyes in 6 patients were included. During exams under anesthesia, the tumors were imaged with an investigational portable OCTA system. OCTA images were analyzed to assess vascular changes before and after treatment. Results In all 6 presented cases, OCTA imaging revealed distinctive vascular patterns, such as dilated feeder arteries and draining veins, disorganized and complex branching patterns, irregular vessel calibers, and dilation and tortuosity of vessels. After treatment, OCTA imaging revealed decreased intrinsic tumor vascularity and reduced dilation of draining and feeder vessels. Tumor relapse demonstrated prominent vascularity (n = 1) that resolved on repeat OCTA after transpupillary thermotherapy treatment. Type 2 (n = 1), 3 (n = 6), and 4 (n = 1) tumor regression patterns were seen in our patients after treatment, and OCTA findings were consistent with a previously published report. Interestingly, in one of the presented cases, OCTA demonstrated clear feeder, draining, and intrinsic tumor vessels that were not as evident on fluorescein angiography. Conclusions OCTA may offer a noninvasive and sensitive technique to evaluate the vasculature of both the tumor and the surrounding retina in retinoblastoma. With additional research and development into its use in patients with retinoblastoma, OCTA may one day be useful in assessing treatment response and residual tumor activity.
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Affiliation(s)
- Juan P Fernandez
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Asghar A Haider
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Arathi Ponugoti
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Michael P Kelly
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Miguel A Materin
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
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Ghassemi F, Hatami V, Salari F, Bazvand F, Shamouli H, Mohebbi M, Sabour S. Quantification of macular perfusion in healthy children using optical coherence tomography angiography. Int J Retina Vitreous 2021; 7:56. [PMID: 34600586 PMCID: PMC8487563 DOI: 10.1186/s40942-021-00328-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/16/2021] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed at defining the variance of vessel density (VD) characteristics in the macula of children with normal eyes. Methods This was a cross-sectional study in which subjects with normal eyes aged 3–18 years were enrolled. The macula was scanned by optical coherence tomography angiography (OCTA). Four age groups as under 7 years, 7–10 years, 11–14 years and more than 14 years of age were defined. The influences of age, gender, and body mass index on VD were analyzed. Results A total of 108 normal eyes from 54 participants with a mean age of 10.9 years were enrolled in the study. At the superficial and deep retina capillary plexus (SCP and DCP) and choriocapillaris (CC), respectively, the mean VD of the fovea was 20.10%, 36.99%, and 75.67%; at parafovea, these measurements were 53.12%, 55.81%, and 69.76%; and at perifovea, these measures were 51.38%, 52.46%, and 73.47%. The median foveal avascular zone (FAZ) was 0.30 mm2. No significant differences between superior-hemi VD and inferior-hemi VD were found in the studied plexuses. The VD at parafovea and perifovea CC differed significantly between groups. There was no variation in VD of macular retina and CC between eyes or sex. FAZ areas were different between genders. Conclusions No difference between eyes and genders in the retina and CC VD of macular area was noted. FAZ area was larger in male. Even though this is not a longitudinal study, it may provide us with hints about macular vascular development during puberty and clinical implications of OCTA in children.
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Affiliation(s)
- Fariba Ghassemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran. .,Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vahid Hatami
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran
| | - Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran
| | - Fatemeh Bazvand
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran.,Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Shamouli
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran
| | - Masoumeh Mohebbi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, 1336616351, Tehran, Iran.,Cornea Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, School of Health and Safety, Safety Promotion and Injury Prevention Research Centre, Tehran, Iran.,Department of Clinical Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Plaitano C, Periti F, Guagliano R, Bertone C, Barillà D, Arpa C, Tinelli C, Gallo FG, Bianchi A, Magli A. Optical coherence tomography angiography in healthy children: A comparison of macular structure. Eur J Ophthalmol 2021; 32:2005-2010. [PMID: 34493114 DOI: 10.1177/11206721211043749] [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: 11/16/2022]
Abstract
PURPOSE The purpose of the present study was to investigate the perfusion density (PD) of macular superficial (SCP) and deep capillary plexus (DCP), the size of foveal avascular zone (FAZ) and central macular thickness (CMT) in healthy children using optical coherence tomography angiography (OCT-A). PATIENTS AND METHODS About 206 eyes of 111 children were analyzed. The correlation of gestational age (GA), birth weight (BW), age, sex, refractive errors, and visual acuity (VA) with OCT-A parameters were investigated. RESULTS The mean PD of the fovea and the mean FAZ area of SCP were 17.1% (DS: 4.26) and 234.47 (DS: 106.39) µm2. The mean PD of the fovea and the mean FAZ area of DCP were 13.5% (DS: 5.23) and 298.32 (DS: 112.37) µm2. Superficial and deep FAZ areas were not correlated with sex, age, BW, refractive errors, or VA. FAZ area of SCP was correlated with foveal PD (r = -0.76) and with CMT (r = -0.68). FAZ area of DCP was correlated with foveal's PD (r = -0.61). There was no correlation between CMT and refractive errors. CONCLUSION OCT-A may provide a non-invasive and reliable approach to evaluate macular perfusion in children. As the FAZ area, PD, and CMT change during the growth period, we performed established a reference range for different ages.
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Affiliation(s)
- Carmen Plaitano
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
| | | | | | - Chiara Bertone
- Eye Clinic, University Hospital, IRCCS S. Matteo, Pavia, Italy
| | | | - Cristina Arpa
- Eye Clinic, University Hospital, IRCCS S. Matteo, Pavia, Italy
| | - Carmine Tinelli
- Biometric Service, University Hospital, IRCCS S. Matteo, Pavia, Italy
| | - Flavio Gioele Gallo
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
| | | | - Adriano Magli
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
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Ong SS, Hsu ST, Ponugoti A, Toth CA, Vajzovic L. An Evaluation of the Microvasculature of Macular Nodules in Coats Disease Using Optical Coherence Tomography Angiography: A Report of 3 Cases. JOURNAL OF VITREORETINAL DISEASES 2021; 5:431-437. [PMID: 37008706 PMCID: PMC9976116 DOI: 10.1177/2474126420983679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This work aimed to examine the microvasculature of macular fibrosis in Coats disease. Methods: Three boys (aged 3, 4, and 6 years) with Coats disease (stages 2B to 3A2) and macular fibrotic nodules were imaged using optical coherence tomography angiography (OCTA) on the Spectralis spectral-domain OCT tabletop and investigational portable Spectralis Flex module (version 6.9, Heidelberg Engineering). Results: In 2 eyes, a neovascular complex was observed in the avascular slab on OCTA. This neovascular complex had vessels connected to diving vessels from the superficial vascular complex that traveled through the deep vascular complex to the avascular complex. In the third eye, no neovascular complex was observed on OCTA at presentation, but on subsequent examinations fluorescein leakage was observed and cross-sectional OCTA further confirmed the presence of angiographic flow in the nodule. Conclusions: OCTA demonstrates the presence of type 3 neovascularization in fibrotic nodules in Coats disease.
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Affiliation(s)
- Sally S. Ong
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - S. Tammy Hsu
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Arathi Ponugoti
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
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Zhou L, Wang F, Wang L, Shen P, Cao Y, He Y, Yan S, Kong X, Lu X. Quantitative assessment and determinants of foveal avascular zone in healthy volunteers. J Int Med Res 2021; 49:3000605211014994. [PMID: 33990149 PMCID: PMC8127766 DOI: 10.1177/03000605211014994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objectives To evaluate the foveal avascular zone (FAZ) area in healthy volunteers using optical coherence tomography angiography (OCTA) and identify factors that influence the FAZ. Methods This single-center cross-sectional study included 526 eyes of 263 healthy volunteers who underwent macular scanning by Zeiss OCTA. A linear mixed model was used to investigate the effects of systemic factors (age, sex, blood pressure, height, and weight) and ocular factors (intraocular pressure, biometric parameters, and central macular thickness) on FAZ. Results In total, 520 eyes of 262 healthy volunteers were included in the analysis. The mean volunteer age was 38.59 ± 22.03 years (range, 5–84 years); 124 volunteers were male (47.33%) and 138 volunteers were female (52.67%). The mean FAZ area was 0.30 ± 0.03 mm2 (95% confidence interval [CI], 0.29–0.31 mm2). Univariate analysis showed that FAZ area was associated with age (β = 0.0011), anterior chamber depth (β = −0.0513), and axial length (β = −0.0202). Multivariate analysis showed that FAZ area was negatively correlated with axial length (β = −0.0181). Conclusions The mean FAZ area in healthy volunteers, measured using Zeiss OCTA, was 0.30 ± 0.03 mm2. Furthermore, FAZ area was negatively associated with axial length; this relationship should be considered in clinical practice.
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Affiliation(s)
- Lijun Zhou
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China.,Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fengqun Wang
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Ling Wang
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Peiyang Shen
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China.,Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yi Cao
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Yushen He
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Shigang Yan
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Xiangbin Kong
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Xiaohe Lu
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
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Jin J, Friess A, Hendricks D, Lehman S, Salvin J, Reid JE, Wang J. Effect of gestational age at birth, sex, and race on foveal structure in children. Graefes Arch Clin Exp Ophthalmol 2021; 259:3137-3148. [PMID: 33961109 DOI: 10.1007/s00417-021-05191-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/25/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Premature birth, race, and sex are contributing risk factors for retinopathy of prematurity (ROP) and have long-term impact on children's retinal structure. Few studies investigate impact of race and sex on macular structure in children born preterm. This study compared foveal structure in preterm and full-term children. METHODS Children aged 4-18 years were enrolled into three groups: (1) ROP-risk group (n = 81), born at < 32 weeks gestational age with and without history of ROP; (2) preterm group (n = 46), born at 32-36 weeks gestational age; and (3) control group (n = 68) with full-term birth. Using spectral-domain optical coherence tomography volume-scan images, foveal structure within 1-mm and 3-mm early treatment diabetic retinopathy study circular grid was measured and segmented. Total inner and outer retina thickness of the right eye was compared among the three groups. RESULTS The mean total foveal thickness (in microns) was 287 ± 26 for the ROP-risk group, 276 ± 19 for the preterm group, and 263 ± 20 for the control group (F = 26, p < 0.001). Foveal thickness of the ROP-risk group was significantly higher than that of the preterm group and the control group (all p < 0.05). Foveal thickness was thinner in black children than in white children and thinner in females than in males (all p < 0.001). A similar disparity in race and sex was found in the thickness of the inner and outer layers. CONCLUSIONS The fovea was significantly thicker in the ROP-risk group than the control group. Foveal thickness decreases with increased gestational age. Race and sex are significant factors in foveal structure in children.
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Affiliation(s)
- Jing Jin
- Department of Pediatric Ophthalmology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 296, Wilmington, DE, 19899, USA.
| | - Amanda Friess
- Department of Pediatric Ophthalmology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 296, Wilmington, DE, 19899, USA
| | - Dorothy Hendricks
- Department of Pediatric Ophthalmology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 296, Wilmington, DE, 19899, USA
| | - Sharon Lehman
- Department of Pediatric Ophthalmology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 296, Wilmington, DE, 19899, USA
| | - Jonathan Salvin
- Department of Pediatric Ophthalmology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 296, Wilmington, DE, 19899, USA
| | - Julia E Reid
- Department of Pediatric Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jingyun Wang
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
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Pérez-García P, Morales-Fernández L, Fernández-Vigo JI, Sáenz-Francés F, Burgos-Blasco B, Güemes-Villahoz N, Oribio-Quinto C, Garcia-Feijoo J, Martinez-de-la-Casa JM. Repeatability of Macular and Optic Nerve Head Measurements by Optical Coherence Tomography Angiography in Healthy Children. Curr Eye Res 2021; 46:1574-1580. [PMID: 33759665 DOI: 10.1080/02713683.2021.1908568] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aims: To evaluate the repeatability of the peripapillary and macular vascular parameters using optical coherence tomography angiography (OCT-A) in healthy children.Materials and methods: Cross-sectional study including 34 eyes of 34 healthy children. After a complete medical examination, two consecutive OCT-A exams were done using AngioPlex Cirrus 5000 (Carl Zeiss Meditec, Dublin, CA, USA) in the same session. The scan area used was 6 × 6 mm for the analysis of the superficial vascular plexus (SVP) in the macula, and 4.5 × 4.5 mm for the peripapillary plexus. To study the repeatability of the measurements, the intraclass correlation coefficient (ICC) and the coefficient of variation (CV) of each pair of exams were calculated.Results: The mean age of the children included was 10.77 ± 2.49 years (range 6 to 15 years). Good and excellent ICCs were obtained for all the parameters considered. Peripapillary vascular parameters showed greater reproducibility than macular ones (global peripapillary perfusion density (pPD): ICC = 0.834 CV = 0.89% vs. whole macular area PD (w-mPD): ICC = 0.697 CV = 3.49%; global peripapillary flux index (FI): ICC = 0.858 CV = 1.28%; whole macular area vascular density (VD): ICC = 0.699 CV = 3.30%). Amongst the macular parameters, the characteristics of the foveal avascular zone (FAZ) were the ones showing higher rates of repeatability (FAZ circularity: ICC = 0.858 CV = 8.83%).Conclusion: OCT-A is a non-invasive, time-efficient technology that may be useful in the evaluation of the retinal and peripapillary vascular network in healthy children. The repeatability of the measures will allow the follow-up and evaluation of any change occurring in the macular or optic nerve perfusion.
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Affiliation(s)
- Pilar Pérez-García
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Laura Morales-Fernández
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - José Ignacio Fernández-Vigo
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Federico Sáenz-Francés
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Bárbara Burgos-Blasco
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Noemí Güemes-Villahoz
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Carlos Oribio-Quinto
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Julian Garcia-Feijoo
- Instituto de Investigaciones Oftalmológicas Ramon Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,Cooperative Research Network on Age-Related Ocular Disease, and Visual and Life Quality, Instituto de Salud Carlos III, Madrid, Spain.,Ophthalmology Unit, Hospital Clinico San Carlos, Department of Ophthalmology and ORL, Faculty of Medicine, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Jose María Martinez-de-la-Casa
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain.,Instituto de Investigaciones Oftalmológicas Ramon Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,Ophthalmology Unit, Hospital Clinico San Carlos, Department of Ophthalmology and ORL, Faculty of Medicine, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
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Thickness, vessel density of retina and choroid on OCTA in young adults (18-24 years old). Microvasc Res 2021; 136:104169. [PMID: 33839109 DOI: 10.1016/j.mvr.2021.104169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/15/2021] [Accepted: 04/01/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to quantify thickness, vessel density (VD) of retina and choroid in young adults (18-24 years old) using OCTA. METHODS This observational, cross-sectional study included 154 eyes from 77 young myopic adults. En-face angiogram OCTA was performed on a 3.00 × 3.00 mm region centered on the macula. Automated thickness calculations and macular maps were measured. Spherical equivalent refraction (SER) and AL were examined to determine associations with thickness, vessel density (VD) of retina and choroid. RESULTS A total of 148 healthy eyes from 77 young myopic adults (29 males and 48 females) with a mean age of 21.80 ± 1.32 years (range: 18-24 years) were included. The mean SER and AL were - 4.06 ± 2.26D and 25.25 ± 1.28 mm, respectively. The mean retinal thickness (RT, ILM-RPE layer) was 240.91 ± 13.36 μm, the retinal superficial (SVD) and deep vessel density (DVD) in fovea region were 18.35 ± 4.77% and 32.99 ± 6.01%, respectively. The foveal avascular zone (FAZ) area was 0.31 ± 0.10 mm2. The mean subfoveal choroidal thickness (SFCT) and choriocapillaris (CC) perfusion area were 232.16 ± 56.65 μm and 2.17 ± 0.10 mm2, respectively. By Pearson's correlation analysis, SER was revealed to be negatively correlated with RT (r = -0.180, p = 0.028) and DVD (r = -0.185, p = 0.025) in fovea region. SER was revealed to be positively correlated with RT in nasal (r = 0.224, p = 0.006) and inferior (r = 0.217, p = 0.008) regions. AL was revealed to be positively correlated with RT (r = 0.250, p = 0.002) and DVD (r = 0.284, p < 0.001) in fovea region. SER was revealed to be positively correlated with SFCT (r = 0.486, p < 0.001). AL was revealed to be negatively correlated with FAZ area (r = -0.232, p = 0.005) and SFCT (r = -0.407). RT was revealed to be negatively correlated with FAZ area (r = -0.645, p < 0.001). SER (r = -0.079), AL (r = 0.071) and SFCT (r = 0.089) did not correlate significantly with the CC perfusion area (all p > 0.05). CONCLUSION Myopic eyes present increased RT, DVD and thinned SFCT in fovea, while no significant correlation could be found between SER, AL, SFCT and CC perfusion area. It may indicate that the SFCT thinning may be secondary to ocular elongation, while the CC perfusion area may be a factor independent of AL growth.
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Wei W, Cogliati A, Canavesi C. Model-based optical coherence tomography angiography enables motion-insensitive vascular imaging. BIOMEDICAL OPTICS EXPRESS 2021; 12:2149-2170. [PMID: 33996221 PMCID: PMC8086452 DOI: 10.1364/boe.420091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
We present a significant step toward ultrahigh-resolution, motion-insensitive characterization of vascular dynamics. Optical coherence tomography angiography (OCTA) is an invaluable diagnostic technology for non-invasive, label-free vascular imaging in vivo. However, since it relies on detecting moving cells from consecutive scans, high-resolution OCTA is susceptible to tissue motion, which imposes challenges in resolving and quantifying small vessels. We developed a novel OCTA technique named ultrahigh-resolution factor angiography (URFA) by modeling repeated scans as generative latent variables, with a common variance representing shared features and a unique variance representing motion. By iteratively maximizing the combined log-likelihood probability of these variances, the unique variance is largely separated. Meanwhile, features in the common variance are decoupled, in which vessels with dynamic flow are extracted from tissue structure by integrating high-order factors. Combined with Gabor-domain optical coherence microscopy, URFA successfully extracted high-resolution cutaneous vasculature despite severe involuntary tissue motion and scanner oscillation, significantly improving the visualization and characterization of micro-capillaries in vivo. Compared with the conventional approach, URFA reduces motion artifacts by nearly 50% on average, evaluated on local differences.
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Affiliation(s)
- Wei Wei
- LighTopTech Corp., 150 Lucius Gordon Drive, Suite 201, West Henrietta, NY 14586, USA
| | - Andrea Cogliati
- LighTopTech Corp., 150 Lucius Gordon Drive, Suite 201, West Henrietta, NY 14586, USA
| | - Cristina Canavesi
- LighTopTech Corp., 150 Lucius Gordon Drive, Suite 201, West Henrietta, NY 14586, USA
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Shaw LT, Khanna S, Chun LY, Dimitroyannis RC, Rodriguez SH, Massamba N, Hariprasad SM, Skondra D. Quantitative Optical Coherence Tomography Angiography (OCTA) Parameters in a Black Diabetic Population and Correlations with Systemic Diseases. Cells 2021; 10:cells10030551. [PMID: 33806492 PMCID: PMC7998203 DOI: 10.3390/cells10030551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 01/02/2023] Open
Abstract
This is a cross-sectional, prospective study of a population of black diabetic participants without diabetic retinopathy aimed to investigate optical coherence tomography angiography (OCTA) characteristics and correlations with systemic diseases in this population. These parameters could serve as novel biomarkers for microvascular complications; especially in black populations which are more vulnerable to diabetic microvascular complications. Linear mixed models were used to obtain OCTA mean values ± standard deviation and analyze statistical correlations to systemic diseases. Variables showing significance on univariate mixed model analysis were further analyzed with multivariate mixed models. 92 eyes of 52 black adult subjects were included. After multivariate analysis; signal strength intensity (SSI) and heart disease had statistical correlations to superficial capillary plexus vessel density in our population. SSI and smoking status had statistical correlations to deep capillary plexus vessel density in a univariate analysis that persisted in part of the imaging subset in a multivariate analysis. Hyperlipidemia; hypertension; smoking status and pack-years; diabetes duration; creatinine; glomerular filtration rate; total cholesterol; hemoglobin A1C; and albumin-to-creatinine ratio were not significantly associated with any OCTA measurement in multivariate analysis. Our findings suggest that OCTA measures may serve as valuable biomarkers to track systemic vascular functioning in diabetes mellitus in black patients.
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Affiliation(s)
- Lincoln T. Shaw
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Saira Khanna
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Lindsay Y. Chun
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Rose C. Dimitroyannis
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
- University of Chicago, Chicago, IL 60637, USA
| | - Sarah H. Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Nathalie Massamba
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
- J. Terry Ernest Ocular Imaging Center, University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Seenu M. Hariprasad
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA; (L.T.S.); (S.K.); (L.Y.C.); (R.C.D.); (S.H.R.); (N.M.); (S.M.H.)
- J. Terry Ernest Ocular Imaging Center, University of Chicago Medical Center, Chicago, IL 60637, USA
- Correspondence: ; Tel.: 1-773-702-3937
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Hohberger B, Lucio M, Schlick S, Wollborn A, Hosari S, Mardin C. OCT-angiography: Regional reduced macula microcirculation in ocular hypertensive and pre-perimetric glaucoma patients. PLoS One 2021; 16:e0246469. [PMID: 33571215 PMCID: PMC7877568 DOI: 10.1371/journal.pone.0246469] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/19/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE OCT-angiography (OCT-A) offers a non-invasive method to visualize retinochoroidal microvasculature. As glaucoma disease affects retinal ganglion cells in the macula, macular microcirculation is of interest. The purpose of the study was to investigate regional macular vascular characteristics in patients with ocular hypertension (OHT), pre-perimetric primary open-angle glaucoma (pre-POAG) and controls by OCT-A in three microvascular layers. MATERIAL AND METHODS 180 subjects were recruited from the Erlangen Glaucoma Registry, the Department of Ophthalmology, University of Erlangen and residents: 38 OHT, 20 pre-POAG, 122 controls. All subjects received an ophthalmological examination including measurements of retinal nerve fibre layer (RNFL), retinal ganglion cell layer (RGC), inner nuclear layer (INL), and Bruch's Membrane Opening-Minimum Rim Width (BMO-MRW). Macular vascular characteristics (vessel density, VD, foveal avascular zone, FAZ) were measured by OCT-A (Spectralis OCT II) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). RESULTS With age correction of VD data, type 3 tests on fixed effects showed a significant interaction between diagnosis and sectorial VD in SVP (p = 0.0004), ICP (p = 0.0073), and DCP (p = 0.0003). Moreover, a significance in sectorial VD was observed within each layer (p<0.0001) and for the covariate age (p<0.0001). FAZ differed significantly between patients' groups only in ICP (p = 0.03), not in SVP and DCP. For VD the AUC values of SVP, ICP, and DCP were highest among diagnostic modalities (AUC: 0.88, 95%-CI: 0.75-1.0, p<0.001). CONCLUSION Regional reduced macula VD was observed in all three retinal vascular layers of eyes with OHT and pre-POAG compared to controls, indicating localized microvascular changes as early marker in glaucoma pathogenesis.
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Affiliation(s)
- Bettina Hohberger
- Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Marianna Lucio
- Helmholtz Zentrum München - German Research Center for Environmental Health, Research Unit Analytical BioGeoChemistry, Neuherberg, Germany
| | - Sarah Schlick
- Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Antonia Wollborn
- Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Sami Hosari
- Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Mardin
- Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
- * E-mail:
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Zhou K, Song S, Legocki A, Cheng Y, Ding L, Rezaei KA, Wang RK, Cabrera MT. Quantitative Handheld Swept-Source Optical Coherence Tomography Angiography in Awake Preterm and Full-Term Infants. Transl Vis Sci Technol 2020; 9:19. [PMID: 33344063 PMCID: PMC7735945 DOI: 10.1167/tvst.9.13.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/20/2020] [Indexed: 12/23/2022] Open
Abstract
Purpose To compare retinal vascular parameters acquired by handheld swept-source optical coherence tomography angiography (SS-OCTA) between nonsedated preterm and full-term infants. Methods Preterm and full-term infants at the University of Washington Medical Center were enrolled. Retinal angiograms (nominal size ∼7 × 7 mm2) were obtained at each routine retinopathy of prematurity (ROP) screening session for preterms and once during the first 72 hours of life for full-terms. Macular vessel area density and nonperfusion area were evaluated on the binarized vasculature map in both small (1.5 × 1.5 mm) and large (3 × 3 mm) quadrants. Average vessel diameter and tortuosity values were obtained from each large vessel branch (length >200 µm). All vascular analyses used previously published algorithms. Results Handheld SS-OCTA captured 31 of 55 (56%) high-quality volumes on 8 awake preterm infants (gestational age 28 ± 4 weeks, birth weight 891 ± 314 g, postmenstrual age at first imaging session 37 ± 2 weeks) and 48 of 54 (89%) volumes on 12 awake full-term infants (gestational age 39 ± 1 weeks, birth weight 3405 ± 329 g). Signal-to-noise ratio was 5.08 ± 1.52 dB in preterm and 4.90 ± 1.12 dB in full-term infants. Preterm infants had higher mean large vessel tortuosity compared to full-term infants (P = 0.004). The large nasal quadrant vessel area density of infants with stage 3 and/or pre-plus or worse ROP was higher than other preterm infants (P = 0.007). Conclusions Although inadequate image quality limited usable imaging sessions, handheld SS-OCTA achieved adequate signal-to-noise ratio in nonsedated infants for quantitative retinal vascular parameter analysis. Translational Relevance Large- and small-vessel parameters were associated with prematurity and ROP severity, respectively.
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Affiliation(s)
- Kanheng Zhou
- School of Science and Engineering, University of Dundee, Dundee, UK.,Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Shaozhen Song
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Alex Legocki
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Leona Ding
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Kasra A Rezaei
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Michelle T Cabrera
- Department of Ophthalmology, University of Washington, Seattle, WA, USA.,Division of Ophthalmology, Seattle Children's Hospital, Seattle, WA, USA
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Li S, Yang X, Li M, Sun L, Zhao X, Wang Q, Huang S, Chen C, Wang Z, Luo X, Yu B, Ding X. Developmental Changes in Retinal Microvasculature in Children: A Quantitative Analysis Using Optical Coherence Tomography Angiography. Am J Ophthalmol 2020; 219:231-239. [PMID: 32413409 DOI: 10.1016/j.ajo.2020.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE To quantify the macular microvasculature in healthy children of various ages by using optical coherence tomography angiography (OCTA). DESIGN Prospective cross-sectional study. METHODS A total of 333 normal children from 4 to 16 years old were included. OCTA was performed on a 3- × 3-mm area centered on the macular region. Vascular density, perfusion density, fovea avascular zone (FAZ) area, FAZ perimeter, and FAZ acircularity index (AI) were measured and adjusted for axial length. Differences were compared among various ages. RESULTS Among the different age groups, both macular vascular density and perfusion density increased with age (P < .0001 and P = .0028, respectively). After adjustments were made for the spherical equivalent (SE) and axial length, macular vascular density was significantly associated with age (r = 0.183; P = .001) No factors were significantly correlated with the perfusion density after adjustment for the age, SE, or axial length. The FAZ area and FAZ perimeter did not change among groups of different ages. Nevertheless, the AI of FAZ in the 4.00-6.99-year-old group was smaller to that of the 13.00-15.99-year-old group (P = .03). Younger children had significantly higher rates of nonconsecutive vessels branched toward the macular center (P = .0002) and vascular loops contributing to irregular shapes of FAZ (P = .024). CONCLUSIONS Macular vascular density and perfusion density continuously increase with age in children. Despite the fact that FAZ area and perimeter did not change, the microstructure of FAZ pruned and tended to form a smooth and regular avascular area during development.
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In vivo assessment of foveal geometry and cone photoreceptor density and spacing in children. Sci Rep 2020; 10:8942. [PMID: 32487997 PMCID: PMC7265395 DOI: 10.1038/s41598-020-65645-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/04/2020] [Indexed: 12/02/2022] Open
Abstract
The fovea undergoes significant developmental changes from birth into adolescence. However, there is limited data examining cone photoreceptor density, foveal pit shape, and foveal avascular zone (FAZ) size in children. The purpose of this study was to determine whether overall foveal structure differs as a function of age and refractive status in children. Forty-eight healthy children (ages 5.8 to 15.8 years) underwent optical coherence tomography imaging to quantify foveal point thickness and foveal pit diameter, depth, and slope. Adaptive optics scanning laser ophthalmoscope (AOSLO) images of foveal capillaries and cone photoreceptors were acquired in a subset of children to quantify FAZ metrics and cone densities at 0.2, 0.3, and 0.5 mm eccentricities. Results show that foveal pit and FAZ metrics were not related to age, axial length, or refractive status. However, linear cone density was lower in myopic versus non-myopic children at eccentricities of 0.2 mm (mean ± SD = 50,022 ± 5,878 cones/mm2 vs 58,989 ± 4,822 cones/mm2, P < 0.001) and 0.3 mm (43,944 ± 5,547 cones/mm2 vs 48,622 ± 3,538 cones/mm2, P < 0.001). These results suggest FAZ and foveal pit metrics do not systematically differ with age in children, while myopic eyes have decreased linear cone density near the foveal center. Significance Statement: The development of the fovea begins prior to birth and continues through the early teenage years until it reaches adult-like properties. Although the majority of changes during childhood are related to the maturation and migration of cone photoreceptors, in vivo data describing cone packing in children is limited. We assessed overall foveal structure in children as young as 5.8 years old by quantifying cone density and spacing, foveal avascular zone size, and foveal pit morphometry to investigate potential structural differences as a function of age and refractive status. While foveal avascular zone and foveal pit metrics did not significantly differ with age, results indicate that myopic children have lower linear cone densities close to the foveal center compared to non-myopic children.
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Cilioretinal Arteries and Macular Vasculature in Highly Myopic Eyes: An OCT Angiography-Based Study. Ophthalmol Retina 2020; 4:965-972. [PMID: 32470652 DOI: 10.1016/j.oret.2020.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE To determine the association between the presence of cilioretinal arteries and the macular vasculature in highly myopic eyes using OCT angiography (OCTA). DESIGN Retrospective, observational case series. PARTICIPANTS Four hundred eighty-one highly myopic eyes of 481 patients. METHODS Fundus photographs were reviewed to determine the presence of a cilioretinal artery and its distribution, based on whether its path or visible branches reached the region within 500 μm of the foveal center. The macular vasculature was analyzed in OCTA images, including the vessel density (VD), fractal dimension (FD), and foveal avascular zone (FAZ). The associations between the presence of a cilioretinal artery and its distribution and between the macular vasculature and visual acuity were evaluated. MAIN OUTCOME MEASURES Cilioretinal arteries, macular vasculature, and their associations. RESULTS Of the eyes included, 17.05% (82/481) had a cilioretinal artery. Based on the OCTA analysis, the eyes with cilioretinal arteries showed significantly higher VD and FD in both superficial and deep capillary plexuses and smaller FAZ than those without (all P < 0.001). However, these differences were not found in the subgroup of eyes with an axial length of more than 30 mm. Eyes with cilioretinal arteries that reached the central foveal area showed significantly higher VD and FD in both capillary plexuses and smaller FAZ than those that did not (all P < 0.05). Better best-corrected visual acuity was identified in the eyes with cilioretinal arteries than in those without (0.09 ± 0.14 logarithm of the minimum angle of resolution [logMAR] vs. 0.21 ± 0.27 logMAR, respectively; P < 0.001). In particular, eyes with cilioretinal arteries that reached the central foveal area had better visual acuity than those without (0.05 ± 0.06 logMAR vs. 0.16 ± 0.20logMAR, respectively; P = 0.005). CONCLUSIONS This OCTA-based study suggested that cilioretinal arteries in highly myopic eyes potentially may improve the macular vasculature and influence visual function.
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