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Chen Q, Peng J, Zhao S, Liu W. Automatic artery/vein classification methods for retinal blood vessel: A review. Comput Med Imaging Graph 2024; 113:102355. [PMID: 38377630 DOI: 10.1016/j.compmedimag.2024.102355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
Automatic retinal arteriovenous classification can assist ophthalmologists in disease early diagnosis. Deep learning-based methods and topological graph-based methods have become the main solutions for retinal arteriovenous classification in recent years. This paper reviews the automatic retinal arteriovenous classification methods from 2003 to 2022. Firstly, we compare different methods and provide comparison tables of the summary results. Secondly, we complete the classification of the public arteriovenous classification datasets and provide the annotation development tables of different datasets. Finally, we sort out the challenges of evaluation methods and provide a comprehensive evaluation system. Quantitative and qualitative analysis shows the changes in research hotspots over time, Quantitative and qualitative analyses reveal the evolution of research hotspots over time, highlighting the significance of exploring the integration of deep learning with topological information in future research.
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Affiliation(s)
- Qihan Chen
- School of Intelligent Systems Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China
| | - Jianqing Peng
- School of Intelligent Systems Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; Guangdong Provincial Key Laboratory of Fire Science and Technology, Guangzhou 510006, China.
| | - Shen Zhao
- School of Intelligent Systems Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China.
| | - Wanquan Liu
- School of Intelligent Systems Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China
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Argentini J, Ouahchi M. [Familial retinal arteriolar tortuosity: A case report]. J Fr Ophtalmol 2023; 46:e234-e235. [PMID: 37481450 DOI: 10.1016/j.jfo.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 07/24/2023]
Affiliation(s)
- J Argentini
- Département d'ophtalmologie, CHRU de Lille, Lille, France.
| | - M Ouahchi
- Département d'ophtalmologie, CHRU de Lille, Lille, France.
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Ghoraba HH, Moshfeghi DM. Retinal Arterial Tortuosity in Marfan and Loeys-Dietz Syndromes. Ophthalmol Retina 2023:S2468-6530(23)00098-2. [PMID: 36907330 DOI: 10.1016/j.oret.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
Retinal arterial tortuosity (RAT) presents with various degrees of severity and vascular distribution in a significant number of patients with Marfan and Loeys-Dietz syndromes. RAT could be used as a marker for connective tissue diseases.
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Affiliation(s)
- Hashem H Ghoraba
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA
| | - Darius M Moshfeghi
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA.
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Chaudhry SG, Fung AT. 22q11 MICRODELETION (DIGEORGE) SYNDROME WITH MICROVASCULAR MACULOPATHY. Retin Cases Brief Rep 2023; 17:137-139. [PMID: 36821469 DOI: 10.1097/icb.0000000000001120] [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: 11/26/2022]
Abstract
PURPOSE To describe a novel retinal finding of 22q11 microdeletion syndrome. METHODS Retrospective chart review of a single patient. RESULTS A 32-year-old man with genetically confirmed 22q11.2 microdeletion syndrome was found to have bilateral tortuous retinal vessels and right microvascular microangiopathy with microaneurysms, hard exudate, and cystoid macular oedema. Other underlying causes for this including diabetic and hypertensive retinopathy were excluded. No treatment was required because he was asymptomatic, and the visual acuity remained 20/30 in that eye with over one year of follow-up. CONCLUSION 22q11 microdeletion syndrome can be associated with microvascular microangiopathy.
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Affiliation(s)
| | - Adrian T Fung
- Westmead Hospital, Sydney, Australia
- Westmead and Central Clinical Schools, Specialty of Ophthalmology and Eye Health, Faculty of Medicine and Health, the University of Sydney, Sydney, Australia; and
- Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Faure C, Castrale C, Benabed A, Cognard P, Lezé R, Castro-Farias D, Gérard M, Louapre C, Paques M. Structural and functional analysis of retinal vasculature in HANAC syndrome with a novel intronic COL4A1 mutation. Microvasc Res 2023; 145:104450. [PMID: 36372235 DOI: 10.1016/j.mvr.2022.104450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/17/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Mutations of the COL4A1 gene, a major structural protein of vessels, may cause hereditary angiopathy with nephropathy, aneurysms and muscle cramps (HANAC) syndrome. The vascular structure and function of patients with HANAC is poorly known. Here, we report a family with HANAC syndrome associated to a previously unreported mutation in COL4A1. The structure and function of retinal vessels were detailed by adaptive optics ophthalmoscopy (AOO) and optical coherence tomography (OCT) angiography. METHODS Clinical data from six affected individuals (43 to 72 years old) from a single family comprising two generations were collected. Imaging charts including conventional fundus imaging, OCT-angiography and AOO in static and dynamic (flicker) mode were reviewed. DNA sequencing was done in the proband. RESULTS DNA sequencing of the proband revealed a heterozygous deletion of COL4A1 (NM_001845) at position 1120 in the intron 20 resulting in the loss of splicing donor site for exon 20 (c.1120 + 2_1120 + 8del heterozygote). Four patients had arterial hypertension, and three had kidney dysfunction, one of which under dialysis. By fundus examination, five had typical retinal arteriolar tortuosity with arteriolar loops. Wall-to-lumen ratio of arteries was within normal limits, that is, lower than expected for hypertensive patients. Several foci of arteriolar irregularities were noted in the two oldest patients. In three affected subjects, evaluation of the neurovascular coupling showed a higher flicker-induced vasodilation than a control population (6 % to 11 %; n < 5 %). CONCLUSIONS Structural and dynamic analysis of retinal vessels in a HANAC family bearing a previously unreported intronic COL4 mutation was done. In addition to arteriolar tortuosity, we found reduced wall-to-lumen ratio, arteriolar irregularity and increased vasodilatory response to flicker light. These abnormalities were more marked in the oldest subjects. This abnormal flicker response affected also non-tortuous arteries, suggesting that microvascular dysfunction extends beyond tortuosity. Such explorations may help to better vascular dysfunction related to HANAC and hence better understand the mechanisms of end-organ damage.
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Affiliation(s)
- Céline Faure
- Ophthalmology department, Saint Martin hospital, Ramsay Générale de Santé, 18 rue des Roquemonts, 14000 Caen, France; Clinical Investigation Center 1423, Quinze-Vingts hospital, INSERM-DHOS, Paris F-75012, France.
| | - Cindy Castrale
- Nephrology department, Saint Martin hospital, Ramsay Générale de Santé, 18 rue des Roquemonts, 14000 Caen, France
| | - Anaïs Benabed
- Nephrology department, Saint Martin hospital, Ramsay Générale de Santé, 18 rue des Roquemonts, 14000 Caen, France
| | - Pauline Cognard
- Ophthalmology department, Saint Martin hospital, Ramsay Générale de Santé, 18 rue des Roquemonts, 14000 Caen, France
| | - Romain Lezé
- Ophthalmology department, Saint Martin hospital, Ramsay Générale de Santé, 18 rue des Roquemonts, 14000 Caen, France
| | - Daniela Castro-Farias
- Clinical Investigation Center 1423, Quinze-Vingts hospital, INSERM-DHOS, Paris F-75012, France
| | - Marion Gérard
- Genetics department, CHU de Caen-Hôpital Clémenceau, avenue Georges Clémenceau, France
| | - Céline Louapre
- Sorbonne University, APHP, Pitié-Salpêtrière Hospital, Department of neurology, CIC Neurosciences, Paris Brain Institute, Paris, France
| | - Michel Paques
- Clinical Investigation Center 1423, Quinze-Vingts hospital, INSERM-DHOS, Paris F-75012, France
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Ghoraba HH, Moshfeghi DM. Retinal arterial tortuosity in Ehlers-Danlos syndromes. Eye (Lond) 2022:10.1038/s41433-022-02278-x. [PMID: 36241846 DOI: 10.1038/s41433-022-02278-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/07/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To report a novel finding of retinal arterial tortuosity (RAT) associated with Ehlers-Danlos syndromes (EDS). METHODS We queried the STAnford Research Repository (STARR) database to identify patients diagnosed with EDS. We included patients with a confirmed diagnosis of any subtype of EDS who had any form of readable retinal imaging including colour fundus photos, autofluorescence, red-free photos, red-free optical coherence tomography photos and fluorescein angiography. Patients who had no retinal imaging and those with no confirmed EDS diagnosis were excluded. Retinal images were reviewed for RAT and were graded into no, possible and definite RAT. Eyes with definite RAT were further graded into mild, moderate and severe. Eyes with definite RAT were again subclassified according to the type of involved vessels into first-order arteriolar, macular and arteriovenous. RESULTS A total of 307 patients were identified using the STARR tool and 142 patients were included. Mean age was 40.9 ± 18.1 years and 87% were female. Underlying EDS subtypes were hypermobile EDS (69.7%), classical EDS (2.8%), vascular EDS (2.1%), myopathic EDS (0.7%) and not specified (24.6%). We graded 37.3% of patients with definite RAT, 10.6% with possible RAT and 52.1% with no RAT. In patients with definite RAT, we graded 39.2% of eyes with mild RAT, 40.2% with moderate RAT and 20.6% with severe RAT. In all, 84.9% showed involvement of first-order retinal arterioles, 35.8% showed involvement of macular arterioles and 1.9% showed arteriovenous involvement. CONCLUSIONS Variable degrees of RAT are associated with EDS.
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Affiliation(s)
- Hashem H Ghoraba
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Darius M Moshfeghi
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
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Obayashi T, Kato A, Suzuki H, Ohashi K, Yoshida M, Shibata Y, Ogura Y, Yasukawa T. A case series from a single family of familial retinal arteriolar tortuosity with common history of sudden visual loss. Am J Ophthalmol Case Rep 2021; 24:101230. [PMID: 34825110 PMCID: PMC8603015 DOI: 10.1016/j.ajoc.2021.101230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/29/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose To report family members with familial retinal arteriolar tortuosity (FRAT) identified after sudden visual loss. Observations A 15-year-old boy had sudden visual loss in his left eye while playing on a horizontal bar. He was referred to Nagoya City University Hospital from an eye clinic. The ophthalmologic examination showed retinal hemorrhage bilaterally. His best-corrected visual acuity (BCVA) was 20/17 in the right eye and 20/67 in the left eye. Bilateral retinal arteriolar tortuosity as well as retinal hemorrhage was seen. Since his mother with 54 years of age also had a history of retinal hemorrhage that improved spontaneously, fundus examination was performed, revealing tortuosity of the retinal arterioles. Consequently, the patient and his mother were diagnosed as FRAT. He was followed without intervention. Retinal hemorrhage gradually decreased and resolved after 3 months. The BCVA of his left eye gradually improved and reached 20/20 after 1 year. Conclusions and importance In this case, the family history was very useful for early diagnosis. Immediate and accurate diagnosis allowed the patient to be followed without intervention and achieve subsequent resolution of retinal hemorrhage and improved vision. FRAT should be considered in cases of sub-internal limiting membrane hemorrhages in young patients even in the presence of discrete retinal arteriolar tortuosity.
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Affiliation(s)
- Tomohiro Obayashi
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | | | - Kei Ohashi
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Munenori Yoshida
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yu Shibata
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Ferreira FDQT, Nascimento de Queiroz MFD, Ayres da Fonseca AL, Holanda de Freitas ACL, Nascimento MA. Atypical Macular Presentation in a FRAT Case and HANAC Syndrome, A Case Report. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
Report an atypical Familial Retinal Arterial Tortuosity (FRAT) case associated with Hereditary Angiopathy with Nephropathy, Aneurysm and Cramps (HANAC).
Methods:
The authors report the case of a female patient with FRAT and HANAC, and an asymmetric ocular presentation which is unusual in Familial Retinal Arterial Tortuosity patients.
Conclusion:
These findings help in better understanding this rare disease. HANAC Syndrome is not a common issue; thus, it is essential to understand it to make the right diagnosis. Careful ophthalmological examination plays a key role in this process since, in the herein reported case, it could have helped to diagnose a disease capable of affecting a patient’s health, although it was an atypical ocular impairment.
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Hernandez M, González-Zamora J, Recalde S, Moreno-Orduña M, Bilbao-Malavé V, Saenz de Viteri M, Landecho MF, Fernandez-Robredo P, García-Layana A. Evaluation of Macular Retinal Vessels and Histological Changes in Two Cases of COVID-19. Biomedicines 2021; 9:1546. [PMID: 34829775 PMCID: PMC8615149 DOI: 10.3390/biomedicines9111546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to assess vascular and histological alterations in two COVID-19 and three control post-mortem retinas. The macular areas of flat-mounted samples were processed for immunofluorescence. Lectin and collagen IV positive vessels were captured under confocal microscopy, and endothelium loss and tortuosity were analyzed. Expression of ACE2 (angiotensin-converting enzyme 2) (the receptor for SARS-CoV-2), Iba1 (ionized calcium-binding adaptor molecule 1) and GFAP (glial fibrillary acidic protein) were quantified in retinal sections. The number of lectin vessels in COVID-19 retinas decreased by 27% compared to the control (p < 0.01) and the tortuosity increased in COVID-19 retinas (7.3 ± 0.2) vs. control retinas (6.8 ± 0.07) (p < 0.05). Immunofluorescence analysis revealed an increase in ACE2 (2.3 ± 1.3 vs. 1.0 ± 0.1; p < 0.0001) and Iba1 expression (3.06 ± 0.6 vs. 1.0 ± 0.1; p < 0.01) in COVID-19 sections whereas no changes in GFAP were observed. Analysis of the COVID-19 macular retinal tissue suggested that endothelial cells are a preferential target of SARS-CoV-2 with subsequent changes through their ACE2 receptor expression and morphology. Thus, microglial activation was hyperactive when facing an ensuing immunological challenge after SARS-CoV-2 infection.
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Affiliation(s)
- Maria Hernandez
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
- Navarra Institute for Health Research—IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares (Oftared), 31008 Pamplona, Spain
| | - Jorge González-Zamora
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
| | - Sergio Recalde
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
- Navarra Institute for Health Research—IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares (Oftared), 31008 Pamplona, Spain
| | - Maite Moreno-Orduña
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
- Navarra Institute for Health Research—IdiSNA, 31008 Pamplona, Spain
| | - Valentina Bilbao-Malavé
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
| | - Manuel Saenz de Viteri
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
- Navarra Institute for Health Research—IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares (Oftared), 31008 Pamplona, Spain
| | - Manuel F. Landecho
- COVID-19 Unit, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- Department of Internal Medicine, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - Patricia Fernandez-Robredo
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
- Navarra Institute for Health Research—IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares (Oftared), 31008 Pamplona, Spain
| | - Alfredo García-Layana
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-Z.); (M.M.-O.); (V.B.-M.); (M.S.d.V.); (P.F.-R.); (A.G.-L.)
- Navarra Institute for Health Research—IdiSNA, 31008 Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares (Oftared), 31008 Pamplona, Spain
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Abstract
BACKGROUND To evaluate the ocular symptoms and findings of children diagnosed with Crimean-Congo hemorrhagic fever (CCHF). METHODS In this prospective study, children diagnosed with CCHF who underwent a complete ophthalmologic examination during the hospitalization period were included. RESULTS Twenty-four children with a mean age of 12.4 ± 3.6 years were included study. The most common ocular finding was conjunctival hyperemia and was observed in 50% of patients. Nine (37.4%) children had abnormalities in fundus examination. Two (8.3%) of them had dilated retinal veins, and 7 (29.1%) had tortuous retinal vessels. No significant difference was found between mild to moderate and severe disease groups in terms of ocular symptoms and ophthalmologic examination findings (P > 0.05, for all). CONCLUSIONS The increased retinal vessel tortuosity was detected as a fundus examination finding in children with CCHF. Both ophthalmologists and pediatricians should be aware of the various ocular manifestations of CCHF for rapid diagnosis and management.
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Jones I, Hägglund AC, Carlsson L. Reduced mTORC1-signaling in retinal ganglion cells leads to vascular retinopathy. Dev Dyn 2021; 251:321-335. [PMID: 34148274 DOI: 10.1002/dvdy.389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The coordinated wiring of neurons, glia and endothelial cells into neurovascular units is critical for central nervous system development. This is best exemplified in the mammalian retina where interneurons, astrocytes and retinal ganglion cells sculpt their vascular environment to meet the metabolic demands of visual function. Identifying the molecular networks that underlie neurovascular unit formation is an important step towards a deeper understanding of nervous system development and function. RESULTS Here, we report that cell-to-cell mTORC1-signaling is essential for neurovascular unit formation during mouse retinal development. Using a conditional knockout approach we demonstrate that reduced mTORC1 activity in asymmetrically positioned retinal ganglion cells induces a delay in postnatal vascular network formation in addition to the production of rudimentary and tortuous vessel networks in adult animals. The severity of this vascular phenotype is directly correlated to the degree of mTORC1 down regulation within the neighboring retinal ganglion cell population. CONCLUSIONS This study establishes a cell nonautonomous role for mTORC1-signaling during retinal development. These findings contribute to our current understanding of neurovascular unit formation and demonstrate how ganglion cells actively sculpt their local environment to ensure that the retina is perfused with an appropriate supply of oxygen and nutrients.
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Affiliation(s)
- Iwan Jones
- Umeå Center for Molecular Medicine (UCMM), Umeå University, Umeå, Sweden
| | | | - Leif Carlsson
- Umeå Center for Molecular Medicine (UCMM), Umeå University, Umeå, Sweden
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12
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Hua R, Zhang M. Bilateral Retinal Vein Occlusion-Simulated Coats' Disease. Diagnostics (Basel) 2021; 11:diagnostics11050909. [PMID: 34069682 PMCID: PMC8160671 DOI: 10.3390/diagnostics11050909] [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: 04/07/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 02/05/2023] Open
Abstract
Retinal vein occlusion (RVO) is a differential diagnosis for Coats' disease due to retinal arterial Leber's aneurysms. Occasionally, RVO shows a Coats-like appearance. The differential diagnosis between Coats' disease and RVO is essential for clinical therapy, especially for those obsolete RVOs with collateral vessels and without retinal hemorrhage. In this case report, we describe and discuss the imaging characteristics of bilateral RVO-simulated Coats' disease with tortuous retinal arterioles and its prognosis after anti-vascular endothelial growth factor therapy, which will be beneficial for its definite diagnosis and aid further investigation.
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Affiliation(s)
- Rui Hua
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China;
- Department of Ophthalmology, First Hospital of China Medical University, Shenyang 110001, China
- Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China;
- Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence:
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13
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Sinner V, Heckmann J, Sturm V, Valmaggia C, Todorova MG. Optic Disc Features in Familial Retinal Arteriolar Tortuosity. Klin Monbl Augenheilkd 2021; 238:410-413. [PMID: 33853191 DOI: 10.1055/a-1386-5788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Describing optic disc appearance in familial retinal arteriolar tortuosity (fRAT) using multimodal imaging and raising awareness of peripapillary arterial changes due to this disorder. METHODS A cross-sectional study was performed in four consecutive patients of two non-related families. Detailed ophthalmological examination was performed and supported by medical and family history and multimodal imaging. RESULTS In all subjects, increased tortuosity of second- and third-order retinal arteries in superior and deeper vascular plexus was documented. Furthermore, tortuosity in the peripapillary circle of Zinn-Haller was found. In addition, retinal vessel oximetry confirmed tortuosity only of the arterial vessels. CONCLUSION The present data suggests that a blurry bordered, hyperemic optic disc in the presence of abnormally tortuous arteriolar vessels and asymptomatically or oligosymptomatically spontaneously resolved hemorrhages could be associated with a fRAT. This finding could be linked to peripapillary arterial vessel tortuosity.
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Affiliation(s)
- Veronika Sinner
- Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Ophthalmology (Chairman Prof. Dr. med. H. Scholl), University of Basel, Basel, Switzerland
| | - Jan Heckmann
- Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Veit Sturm
- Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christophe Valmaggia
- Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Ophthalmology (Chairman Prof. Dr. med. H. Scholl), University of Basel, Basel, Switzerland
| | - Margarita G Todorova
- Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Ophthalmology (Chairman Prof. Dr. med. H. Scholl), University of Basel, Basel, Switzerland
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Retinal Fundus Multi-Disease Image Dataset (RFMiD): A Dataset for Multi-Disease Detection Research. DATA 2021. [DOI: 10.3390/data6020014] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The world faces difficulties in terms of eye care, including treatment, quality of prevention, vision rehabilitation services, and scarcity of trained eye care experts. Early detection and diagnosis of ocular pathologies would enable forestall of visual impairment. One challenge that limits the adoption of computer-aided diagnosis tool by ophthalmologists is the number of sight-threatening rare pathologies, such as central retinal artery occlusion or anterior ischemic optic neuropathy, and others are usually ignored. In the past two decades, many publicly available datasets of color fundus images have been collected with a primary focus on diabetic retinopathy, glaucoma, age-related macular degeneration and few other frequent pathologies. To enable development of methods for automatic ocular disease classification of frequent diseases along with the rare pathologies, we have created a new Retinal Fundus Multi-disease Image Dataset (RFMiD). It consists of 3200 fundus images captured using three different fundus cameras with 46 conditions annotated through adjudicated consensus of two senior retinal experts. To the best of our knowledge, our dataset, RFMiD, is the only publicly available dataset that constitutes such a wide variety of diseases that appear in routine clinical settings. This dataset will enable the development of generalizable models for retinal screening.
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15
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Vilela MA, Amaral CE, Ferreira MAT. Retinal vascular tortuosity: Mechanisms and measurements. Eur J Ophthalmol 2020; 31:1497-1506. [PMID: 33307777 DOI: 10.1177/1120672120979907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Retinal vessel tortuosity has been used in the diagnosis and management of different clinical situations. Notwithstanding, basic concepts, standards and tools of measurement, reliable normative data and clinical applications have many gaps or points of divergence. In this review we discuss triggering causes of retinal vessel tortuosity and resources used to assess and quantify it, as well as current limitations.
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Affiliation(s)
- Manuel Ap Vilela
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Carlos Ev Amaral
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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16
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Mookiah MRK, Hogg S, MacGillivray TJ, Prathiba V, Pradeepa R, Mohan V, Anjana RM, Doney AS, Palmer CNA, Trucco E. A review of machine learning methods for retinal blood vessel segmentation and artery/vein classification. Med Image Anal 2020; 68:101905. [PMID: 33385700 DOI: 10.1016/j.media.2020.101905] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022]
Abstract
The eye affords a unique opportunity to inspect a rich part of the human microvasculature non-invasively via retinal imaging. Retinal blood vessel segmentation and classification are prime steps for the diagnosis and risk assessment of microvascular and systemic diseases. A high volume of techniques based on deep learning have been published in recent years. In this context, we review 158 papers published between 2012 and 2020, focussing on methods based on machine and deep learning (DL) for automatic vessel segmentation and classification for fundus camera images. We divide the methods into various classes by task (segmentation or artery-vein classification), technique (supervised or unsupervised, deep and non-deep learning, hand-crafted methods) and more specific algorithms (e.g. multiscale, morphology). We discuss advantages and limitations, and include tables summarising results at-a-glance. Finally, we attempt to assess the quantitative merit of DL methods in terms of accuracy improvement compared to other methods. The results allow us to offer our views on the outlook for vessel segmentation and classification for fundus camera images.
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Affiliation(s)
| | - Stephen Hogg
- VAMPIRE project, Computing (SSEN), University of Dundee, Dundee DD1 4HN, UK
| | - Tom J MacGillivray
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Vijayaraghavan Prathiba
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai 600086, India
| | - Rajendra Pradeepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai 600086, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai 600086, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai 600086, India
| | - Alexander S Doney
- Division of Population Health and Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK
| | - Colin N A Palmer
- Division of Population Health and Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK
| | - Emanuele Trucco
- VAMPIRE project, Computing (SSEN), University of Dundee, Dundee DD1 4HN, UK
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17
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A Rare Coexistence of Isolated Unilateral Conjunctival Telangiectasia and Retinal Vascular Tortuosity. Case Rep Ophthalmol Med 2020; 2020:8814961. [PMID: 32908748 PMCID: PMC7463343 DOI: 10.1155/2020/8814961] [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: 07/22/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 11/18/2022] Open
Abstract
A 55-year-old woman with no known systemic disorder and without any history of ocular disease, trauma, and surgery presented with a nonremitting conjunctival redness on her left eye that was existing since her childhood. On ophthalmological examination, an extremely rare coexistence of isolated unilateral bulbar conjunctival telangiectasia and ipsilateral retinal vascular tortuosity without any systemic and neuroradiological association was detected. We aimed to demonstrate this rare vascular coexistence and discuss differential diagnosis of the underlying causes.
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18
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O'Neill RA, Maxwell AP, Kee F, Young I, McGuinness B, Hogg RE, Gj M. Association of retinal venular tortuosity with impaired renal function in the Northern Ireland Cohort for the Longitudinal Study of Ageing. BMC Nephrol 2020; 21:382. [PMID: 32883218 PMCID: PMC7469276 DOI: 10.1186/s12882-020-02031-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 08/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous studies have identified retinal microvascular features associated with renal dysfunction. Biopsies are necessary to confirm kidney microvascular damage and retinal imaging may enable evaluation of microangiopathic characteristics reflecting renal changes associated with chronic kidney disease (CKD). We evaluated retinal microvascular parameters (RMPs) for associations with renal function in a cross-sectional analysis of the Northern Ireland Cohort for the Longitudinal Study of Ageing. METHODS RMPs (central retinal arteriolar/ venular equivalents [CRAE/CRVE], arteriolar to venular ratio [AVR], fractal dimension and tortuosity) were measured from optic disc centred fundus images using semi-automated software. Associations were assessed with multivariable regression analyses between RMPs and estimated glomerular filtration rate (eGFR) defined by serum creatinine (eGFRscr) and cystatin C (eGFRcys) and also CKD status characterised by eGFR < 60 mL/min/1.73m2. Regression models were adjusted for potential confounders including age, sex, diabetes, smoking status, educational attainment, cardiovascular disease, body mass index, antihypertensive medication, systolic blood pressure, triglycerides, high- and low-density lipoprotein levels. RESULTS Data were included for 1860 participants that had measures of renal function and retinal fundus images of sufficient quality for analysis. Participants had a mean age of 62.0 ± 8.5 yrs. and 53% were female. The mean eGFR for scr and cys were 82.2 ± 14.9 mL/min/1.73m2 and 70.7 ± 18.6 mL/min/1.73m2 respectively. eGFRcys provided lower estimates than eGFRscr resulting in a greater proportion of participants categorised as having CKD stages 3-5 (eGFRcys 26.8%; eGFRscr 7.9%). Multivariable regression analyses showed that increased venular tortuosity (OR = 1.30; 95%CI: 1.10, 1.54; P < 0.01) was associated with CKD stages 3-5 characterised by eGFRscr < 60 mL/min/1.73 m2. No additional associations between CKD status characterised by eGFRscr or with eGFRcys, were detected (P > 0.05). Multivariable regression failed to detect associations between CRAE, CRVE, AVR, fractal dimension or tortuosity and eGFRscr or eGFRcys (P > 0.05). CONCLUSION Increased retinal venular tortuosity was associated with CKD stages 3-5 defined by eGFRscr < 60 mL/min/1.73 m2, in an older population independent of potential confounding factors. These retinal measures may provide non-invasive microvascular assessment of associations with CKD.
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Affiliation(s)
- R A O'Neill
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - A P Maxwell
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - F Kee
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - I Young
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - B McGuinness
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - R E Hogg
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - McKay Gj
- Centre for Public Health, Queens University Belfast, Belfast, UK.
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19
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Hsu CC, Feng KM, Chang YH. Unilateral Situs Inversus of the Optic Disc in a Patient With Retinal Arteriolar Tortuosity. Ophthalmic Surg Lasers Imaging Retina 2020; 51:533-535. [DOI: 10.3928/23258160-20200831-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/09/2020] [Indexed: 11/20/2022]
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20
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Patel PS, Mughal M, Wheatley HM, Prenner JL. Unilateral vascular abnormality: A case of peripheral retinal arteriolar tortuosity associated with a prepapillary vascular loop. Am J Ophthalmol Case Rep 2020; 20:100869. [PMID: 32875154 PMCID: PMC7452084 DOI: 10.1016/j.ajoc.2020.100869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/14/2020] [Accepted: 08/09/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To report a case of unilateral prepapillary vascular loop along with peripheral third order retinal arteriolar tortuosity in the same eye, and to discuss potential diagnostic considerations. Observations Color fundus pictures and wide-angle fluorescein angiography (FA) demonstrated a pre-papillary vascular loop and a region of retinal arteriolar tortuosity in third order arterioles superotemporally in the left eye. The examination and ancillary testing on the right eye were normal. Conclusion and Importance The vascular abnormality in this case does not fit a pattern present in other disease states both hereditary or acquired. The patient's immediate family do not demonstrate a similar abnormality and the patient remains visually asymptomatic upon one-year follow-up.
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Affiliation(s)
- Parth S Patel
- Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Mansoor Mughal
- Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.,NJRetina, New Brunswick, NJ, USA
| | - Harold M Wheatley
- Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.,NJRetina, New Brunswick, NJ, USA
| | - Jonathan L Prenner
- Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.,NJRetina, New Brunswick, NJ, USA
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21
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Prepapillary vascular loop-a new classification. Eye (Lond) 2020; 35:425-432. [PMID: 32291404 DOI: 10.1038/s41433-020-0859-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES To analyze the ophthalmic characteristics of congenital prepapillary vascular loop (PVL) and to propose a new morphologic classification dividing the loops into six types. SUBJECTS/METHODS Collaborative multinational multicentre retrospective study of PVL cases. RESULTS There was a total of 49 cases (61 eyes), 37 unilateral (75.5%) and 12 bilateral (24.5%), 32 arterial type (65.3%) and 18 venous type (36.7%) (one patient had either kind in each eye). The mean number of loops per eye was 2.7 (range, 1-7). The loops were asymptomatic in 42 cases (85.7%). Other findings included: the presence of cilioretinal artery (14 cases), retinal vascular tortuosity (26 cases), amaurosis fugax (1 case), branch retinal artery occlusion (1 case) and vitreous haemorrhage (3 cases). Six morphologic loop types could be discerned based on elevation (flat vs. elevated), shape (figure of 8 or corkscrew with hyaline sheath), number (multiple or single), location (central or peripheral), lumen size (arterial vs. arteriolar) and presence of vascular tortuosity or vitreous traction. CONCLUSIONS PVL are usually asymptomatic and can be divided into six morphologic types with different pathogenesis during early embryogenesis.
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22
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Chen T, Zheng H, Wang Y, Hu J, Chen C. Bilateral and multiple sub-internal limiting membrane hemorrhages in a familial retinal arteriolar tortuosity patient by Valsalva-like mechanism: an observational case report. BMC Ophthalmol 2020; 20:151. [PMID: 32293357 PMCID: PMC7161018 DOI: 10.1186/s12886-020-01413-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Bilateral and multiple Valsalva-related sub-internal limiting membrane (ILM) hemorrhages in a familial retinal arteriolar tortuosity (FRAT) patient is rare, and we treated this patient by both observation and Neodymium yttrium aluminum garnet (Nd: YAG) laser membranotomy methods. Case presentation A 13-year-old female student presented with sudden visual loss and central scotoma in both eyes after running 800 m at the school gym. The examination revealed six sub-ILM hemorrhages with the biggest hemorrhage measuring approximately 1.5-disc diameters (DD) in the right eye and two sub-ILM hemorrhages with the biggest one measuring 5.5 DD in the left eye. The patient was diagnosed as having Valsalva retinopathy associated with FRAT. Nd: YAG laser membranotomy was performed at the biggest hemorrhages and the rest hemorrhages were treated with observation in both eyes. The visual acuity recovered to 20/16 in the right eye and 20/20 in the left eye. Epiretinal membrane (ERM) formation was observed in the left eye. Conclusions Nd: YAG laser could be considered for treating premacular hemorrhage in FRAT patient especially when a quick vision recovery was needed. This is the first reported case of a FRAT patient suffering from bilateral and multiple Valsalva-related sub-ILM hemorrhages which were treated by both observation and Nd: YAG laser treatment.
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Affiliation(s)
| | | | - Yunyun Wang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Junyi Hu
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Changzheng Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China.
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23
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Denk N, Maloca PM, Steiner G, Booler H, Freichel C, Niklaus S, Schnitzer TK, Hasler PW. Retinal Features in Cynomolgus Macaques ( Macaca fascicularis) Assessed by Using Scanning Laser Ophthalmoscopy and Spectral Domain Optical Coherence Tomography. Comp Med 2020; 70:145-151. [PMID: 32164796 DOI: 10.30802/aalas-cm-19-000088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cynomolgus macaques are an important and commonly used species in preclinical toxicology studies, but structural reports of in vivo retinal findings are rare in this species. The purpose of this study was to diminish this gap and document optical coherence tomography and scanning laser ophthalmoscopy imaging data in the healthy posterior pole of cynomolgus monkeys' eyes at predose examinations. The current study is a retrospective assessment of baseline spectral domain OCT data obtained from the 768 eyes of 384 cynomolgus monkeys (192 males and 192 females) of Mauritian origin. The data set was obtained from studies conducted over a 4-y period in the context of ocular safety evaluations of various compounds under preclinical development. The most prevalent findings were the presence of Bergmeister papilla and intravitreal hyperreflective spots. Less common findings included disorganization of retinal zones, abnormalities of the retinal vasculature, partial posterior vitreous detachment, and abnormally shaped foveal pits. Thoughtful consideration of these physiologic findings will aid in distinguishing normal features from toxic outcomes in future preclinical ophthalmic studies.
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Affiliation(s)
- Nora Denk
- Pharma Research and Early Development (pRED), Pharmaceutical Sciences (PS), Roche Innovation Center Basel, Basel, Switzerland;,
| | - Peter M Maloca
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland; Moorfields Eye Hospital, London, United Kingdom; OCTlab Research Laboratory, Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Guido Steiner
- Pharma Research and Early Development (pRED), Pharmaceutical Sciences (PS), Roche Innovation Center Basel, Basel, Switzerland
| | | | - Christian Freichel
- Pharma Research and Early Development (pRED), Pharmaceutical Sciences (PS), Roche Innovation Center Basel, Basel, Switzerland
| | - Stephanie Niklaus
- Pharma Research and Early Development (pRED), Pharmaceutical Sciences (PS), Roche Innovation Center Basel, Basel, Switzerland
| | - Tobias K Schnitzer
- Pharma Research and Early Development (pRED), Pharmaceutical Sciences (PS), Roche Innovation Center Basel, Basel, Switzerland
| | - Pascal W Hasler
- OCTlab Research Laboratory, Department of Ophthalmology, University of Basel, Basel, Switzerland
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24
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U-COSFIRE filters for vessel tortuosity quantification with application to automated diagnosis of retinopathy of prematurity. Neural Comput Appl 2020. [DOI: 10.1007/s00521-019-04697-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Kisilevsky E, Kohly RP, Margolin EA. Dilated and tortuous retinal vessels as a sign of Cantu syndrome. Ophthalmic Genet 2019; 40:453-454. [PMID: 31584310 DOI: 10.1080/13816810.2019.1666415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
When encountering patients with markedly dilated and tortuous retinal vessels, Wyburn-Mason syndrome (WMS) or racemous angiomatosis (phacomatosis) is commonly thought of as the archetypal entity that can produce these findings. We describe a patient with Cantu syndrome with phenotypical findings identical to those seen in patients with WMS and want to highlight this as another entity that can present with tortuous and dilated retinal vessels.
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Affiliation(s)
- Eli Kisilevsky
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Radha P Kohly
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Edward A Margolin
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
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26
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Appaji A, Nagendra B, Chako DM, Padmanabha A, Jacob A, Hiremath CV, Varambally S, Kesavan M, Venkatasubramanian G, Rao SV, Webers CAB, Berendschot TTJM, Rao NP. Retinal vascular tortuosity in schizophrenia and bipolar disorder. Schizophr Res 2019; 212:26-32. [PMID: 31466896 DOI: 10.1016/j.schres.2019.08.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/23/2019] [Accepted: 08/18/2019] [Indexed: 11/20/2022]
Abstract
The micro-vasculature of retina and brain share common morphological, physiological, and pathological properties. Retina being easily accessible, retinal vascular examination provides an indirect assessment of cerebral vasculature. Considering the high prevalence of vascular morbidity in SCZ and BD a few studies have examined retinal vascular caliber and have reported increased retinal venular caliber in schizophrenia (SCZ). Retinal vascular tortuosity could serve as a better structural measure than caliber as it is static and less susceptible to pulse period variations. However, to date, no study has examined retinal vascular tortuosity in SCZ and bipolar disorder (BD). Hence, we examined retinal vascular tortuosity in comparison with healthy volunteers (HV). We included 255 subjects (78 HV, 79 SCZ, and 86 BD) in the age range of 18 to 50 years. Trained personnel acquired images using a non-mydriatic fundus camera. To measure the average retinal arteriolar tortuosity index (RATI) and retinal venular tortuosity index (RVTI), we used a previously validated, semi-automatic algorithm. The results showed significant differences across the three groups in RATI but not in RVTI; both BD and SCZ had significantly increased RATI compared to HV. There was also a significant difference between SCZ and BD, with BD having higher RATI. If shown to be of predictive utility in future longitudinal studies, it has the potential to identify patients at risk of development of adverse vascular events. As retinal vascular imaging is non-invasive and inexpensive, it could serve as a proxy marker and window to cerebral vasculature.
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Affiliation(s)
- Abhishek Appaji
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore, India; University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Bhargavi Nagendra
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Dona Maria Chako
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ananth Padmanabha
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore, India
| | - Arpitha Jacob
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Chaitra V Hiremath
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shivarama Varambally
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Muralidharan Kesavan
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Shyam Vasudeva Rao
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore, India; University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Naren P Rao
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
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27
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Ciurică S, Lopez-Sublet M, Loeys BL, Radhouani I, Natarajan N, Vikkula M, Maas AH, Adlam D, Persu A. Arterial Tortuosity. Hypertension 2019; 73:951-960. [DOI: 10.1161/hypertensionaha.118.11647] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Simina Ciurică
- From the Cardiology Department, Marie Curie Civil Hospital, CHU Charleroi, Lodelinsart, Belgium (S.C.)
| | - Marilucy Lopez-Sublet
- Department of Internal Medicine, ESH Hypertension Excellence Centre (M.L.-S.), CHU Avicenne, AP-HP, Bobigny, France
| | - Bart L. Loeys
- Cardiogenetics, Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Belgium (B.L.L.)
| | | | - Nalin Natarajan
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, United Kingdom (N.N., D.A.)
| | - Miikka Vikkula
- Human Molecular Genetics, de Duve Institute (M.V.), Université Catholique de Louvain, Brussels, Belgium
| | - Angela H.E.M. Maas
- Department of Cardiology, Radboud University Medical Center Nijmegen, The Netherlands (A.H.E.M.M.)
| | - David Adlam
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, United Kingdom (N.N., D.A.)
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
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28
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Saraf SS, Tyring AJ, Chen CL, Le TP, Kalina RE, Wang RK, Chao JR. Familial retinal arteriolar tortuosity and quantification of vascular tortuosity using swept-source optical coherence tomography angiography. Am J Ophthalmol Case Rep 2019; 14:74-78. [PMID: 30931409 PMCID: PMC6425085 DOI: 10.1016/j.ajoc.2019.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/25/2019] [Accepted: 03/04/2019] [Indexed: 01/13/2023] Open
Abstract
Purpose Familial retinal arteriolar tortuosity (FRAT) is a rare autosomal dominant disorder that is characterized by tortuosity of the second and higher order retinal arterioles. We implement swept-source optical coherence tomography angiography (SS-OCTA) to quantify vessel tortuosity in patients with FRAT. We hypothesize that patients with FRAT will have higher retinal arteriole tortuosity when compared to controls. Methods Patients were scanned with a SS-OCTA device (Plex Elite 9000, Carl Zeiss Meditec, Dublin, CA). Images of a 12 × 12 mm2 area centered on the fovea were processed, and retinal vessels >23.5 μm in diameter were identified. An automatic tortuosity measurement program written in MATLAB was used to assess vessel tortuosity. Branch points in the vessels were detected and used to separate the vasculature into individual segments. The tortuosity was measured by calculating the arc-chord ratio of each vessel segment, where a minimum value of 1 indicated a straight vessel and higher values corresponded to increasing tortuosity. Results Two patients (4 eyes) with a known history of FRAT and six controls (12 eyes) were enrolled in the study. The mean tortuosity of all vessel segments (MTVS) in scans of FRAT eyes was on average 1.1244 [range: 1.1044–1.1438] while for control eyes it was 1.0818 [range: 1.0746–1.0872]. Average MTVS of FRAT eyes was significantly higher compared to control eyes (p = 0.03). Conclusions and Importance Our results are consistent with the hypothesis that patients with FRAT have higher objective measurements of tortuosity compared to controls. Broader applications of this method may be of benefit in other retinal diseases with changes in retinal vessel configuration.
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Affiliation(s)
- Steven S Saraf
- University of Washington Department of Ophthalmology 325 Ninth Avenue, Box 359608, Seattle, WA, 98104, USA
| | - Ariel J Tyring
- University of Washington Department of Ophthalmology 325 Ninth Avenue, Box 359608, Seattle, WA, 98104, USA
| | - Chieh-Li Chen
- Department of Bioengineering, University of Washington, Foege N410E, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Thao Phuong Le
- University of Washington Department of Ophthalmology 325 Ninth Avenue, Box 359608, Seattle, WA, 98104, USA
| | - Robert E Kalina
- Department of Bioengineering, University of Washington, Foege N410E, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Ruikang K Wang
- University of Washington Department of Ophthalmology 325 Ninth Avenue, Box 359608, Seattle, WA, 98104, USA.,Department of Bioengineering, University of Washington, Foege N410E, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Jennifer R Chao
- University of Washington Department of Ophthalmology 325 Ninth Avenue, Box 359608, Seattle, WA, 98104, USA
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[Autosomal dominant syndrome of retinal arterial tortuosity: A case report]. J Fr Ophtalmol 2018; 41:e437-e439. [PMID: 30389176 DOI: 10.1016/j.jfo.2017.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022]
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Giocanti-Auregan A, Gaudric A, Buffon F, Mine M, Delahaye-Mazza C, Cohen SY, Erginay A, Chabriat H, Lasserve ET, Krivosic V. Optical Coherence Tomography Angiography of Familial Retinal Arteriolar Tortuosity. Ophthalmic Surg Lasers Imaging Retina 2018; 49:397-401. [DOI: 10.3928/23258160-20180601-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/01/2017] [Indexed: 01/03/2023]
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L Srinidhi C, Aparna P, Rajan J. Recent Advancements in Retinal Vessel Segmentation. J Med Syst 2017; 41:70. [DOI: 10.1007/s10916-017-0719-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/01/2017] [Indexed: 11/28/2022]
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Abstract
PURPOSE Ectodermal dysplasia (ED) results from abnormal development of the ectodermal layer. Although coexistence of ED and retinal pathology has been described, concomitance with retinal venous tortuosity has not been reported in the literature. METHODS Case report. RESULTS We report the case of a 23-year-old man with ED with bilateral retinal venous tortuosity, trichomegaly, meibomian gland dysfunction, and dry eye. Although the coexistence of ED with trichomegaly and meibomian gland dysfunction has been previously reported, to the best of our knowledge, this is the first reported case of retinal venous tortuosity associated with ED. CONCLUSION Coexistence of retinal venous tortuosity and ED may be the consequence of a genetic mutation affecting cellular signaling pathways during retinal angiogenesis.
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Li DQ, Golding J, Choudhry N. Swept-Source Optical Coherence Tomography Angiography and Vascular Perfusion Map Findings in Obstructive Sleep Apnea. Ophthalmic Surg Lasers Imaging Retina 2016; 47:880-4. [PMID: 27631487 DOI: 10.3928/23258160-20160901-14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/19/2016] [Indexed: 11/20/2022]
Abstract
Obstructive sleep apnea (OSA) is a highly prevalent chronic sleep disorder associated with considerable systemic and ophthalmic consequences. The authors present the retinal vascular findings of a visually asymptomatic 56-year-old man clinically diagnosed with OSA using swept-source optical coherence tomography and vascular perfusion mapping. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:880-884.].
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Effects of Vessel Tortuosity on Coronary Hemodynamics: An Idealized and Patient-Specific Computational Study. Ann Biomed Eng 2015; 44:2228-39. [PMID: 26498931 DOI: 10.1007/s10439-015-1492-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/16/2015] [Indexed: 01/09/2023]
Abstract
Although coronary tortuosity can influence the hemodynamics of coronary arteries, the relationship between tortuosity and flow has not been thoroughly investigated partly due to the absence of a widely accepted definition of tortuosity and the lack of patient-specific studies that analyze complete coronary trees. Using a computational approach we investigated the effects of tortuosity on coronary flow parameters including pressure drop, wall shear stress, and helical flow strength as measured by helicity intensity. Our analysis considered idealized and patient-specific geometries. Overall results indicate that perfusion pressure decreases with increased tortuosity, but the patient-specific results show that more tortuous vessels have higher physiological wall shear stress values. Differences between the idealized and patient-specific results reveal that an accurate representation of coronary tortuosity must account for all relevant geometric aspects, including curvature imposed by the heart shape. The patient-specific results exhibit a strong correlation between tortuosity and helicity intensity, and the corresponding helical flow contributes directly to the observed increase in wall shear stress. Therefore, helicity intensity may prove helpful in developing a universal parameter to describe tortuosity and assess its impact on patient health. Our data suggest that increased tortuosity could have a deleterious impact via a reduction in coronary perfusion pressure, but the attendant increase in wall shear stress could afford protection against atherosclerosis.
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Zenteno JC, Crespí J, Buentello-Volante B, Buil JA, Bassaganyas F, Vela-Segarra JI, Diaz-Cascajosa J, Marieges MT. Next generation sequencing uncovers a missense mutation in COL4A1 as the cause of familial retinal arteriolar tortuosity. Graefes Arch Clin Exp Ophthalmol 2014; 252:1789-94. [PMID: 25228067 DOI: 10.1007/s00417-014-2800-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/28/2014] [Accepted: 09/02/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES Our aim was to determine the molecular cause of autosomal dominant familial retinal arteriolar tortuosity (FRAT) in a family with three affected subjects. MATERIAL AND METHODS Ophthalmologic evaluation included determination of best-corrected visual acuity (BCVA), slit-lamp and dilated fundus inspection, applanation tonometry, fundus photography, and fluorescein retinal angiography (FA). Molecular methods included whole exome sequencing analysis and Sanger sequencing validation of putative causal mutation in DNA from affected individuals. RESULTS Typical signs of familial retinal arteriolar tortuosity were observed in all three patients. Exome sequencing identified a heterozygous c.1528G > A (p. Gly510Arg) mutation in COL4A1. Sanger sequencing confirmed that all three patients harbored the same pathogenetic mutation in COL4A1. The p. Gly510Arg variant in COL4A1 was absent in DNA from an available unaffected daughter, from a set of control alleles, and from publicly available databases. CONCLUSIONS The molecular basis of familial retinal arteriolar tortuosity was identified for the first time, thus expanding the human phenotypes linked to COL4A1 mutations. Interestingly, the COL4A1 p.Gly510Arg mutation has been previously identified in a family with HANAC (Hereditary Angiopathy with Nephropathy, Aneurysm and Cramps), a multisystemic disease featuring retinal arteriolar tortuosity. No cerebral, neurologic, renal, cardiac or vascular anomalies were recognized in the pedigree described here. These data indicate that identical mutations in COL4A1 can originate both eye-restricted and systemic phenotypes.
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Affiliation(s)
- Juan C Zenteno
- Genetics Department and Research Unit, Institute of Ophthalmology "Conde de Valenciana" and Biochemistry Department, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Chimalpopoca 14, Col. Obrera, Mexico City, CP, 06800, Mexico,
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Ghim WH, Lee MW. A Case of Posner-Schlossman Syndrome with Retinal Arterial Tortuosity in a Young Male. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.11.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Woon Hyung Ghim
- Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea
| | - Myung Won Lee
- Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea
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38
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Lorthois S, Lauwers F, Cassot F. Tortuosity and other vessel attributes for arterioles and venules of the human cerebral cortex. Microvasc Res 2014; 91:99-109. [DOI: 10.1016/j.mvr.2013.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 11/13/2013] [Accepted: 11/18/2013] [Indexed: 01/02/2023]
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Chavala SH, Williamson JF. Retinal arteriolar tortuosity and artery occlusion. Lancet 2013; 382:1655. [PMID: 23623391 DOI: 10.1016/s0140-6736(13)60143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sai H Chavala
- Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, USA.
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MacCormick IJC, Somner J, Morris DS, MacGillivray TJ, Bourne RRA, Huang SS, MacCormick A, Aspinall PA, Baillie JK, Thompson AAR, Dhillon B. Retinal vessel tortuosity in response to hypobaric hypoxia. High Alt Med Biol 2013; 13:263-8. [PMID: 23270443 DOI: 10.1089/ham.2011.1097] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Retinal vascular tortuosity is associated with retinopathy of differing etiologies, including hypertension, diabetes, and hypoxia. However, detailed understanding of the underlying pathophysiology is lacking. The aim of this study was to map changes in tortuosity associated with hypoxia at high altitude, and to determine the influence of sildenafil and an antioxidant preparation on altitude-induced tortuosity. METHODS We measured the tortuosity of retinal vessels using a semi-automated method in 35 young, healthy subjects exposed to hypobaric hypoxia for 7 days at 5200 m, and compared the measurements to those from the same vessels at sea level. These subjects simultaneously took part in a randomized double-blind placebo-controlled trial of sildenafil and antioxidant. Comparison of tortuosity between these subgroups was performed. RESULTS High altitude was associated with the development of retinal tortuosity in individual vessels. A nonsignificant trend suggests this is limited by prophylaxis with sildenafil or antioxidant. CONCLUSIONS Retinal vessel tortuosity increases rapidly at high altitude. We suggest that retinal vessel tortuosity at altitude may result from increased sheer stress causing elongation of vessel segments and that this might be limited by agents that act to preserve nitric oxide dependent vasodilation. TRIAL REGISTRATION NUMBERS NCT00664001, NCT00627965.
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Affiliation(s)
- Ian J C MacCormick
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi.
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De Niro JE, Randhawa S, McDonald HR. Retinal vascular tortuosity in DiGeorge syndrome complicated by solar retinopathy. Retin Cases Brief Rep 2013; 7:343-346. [PMID: 25383826 DOI: 10.1097/icb.0b013e3182919cb2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To report a case of vascular tortuosity associated with DiGeorge syndrome that was complicated by solar retinopathy. METHODS Case report and literature review. RESULTS A 56-year-old woman with DiGeorge syndrome with secondary schizophrenia and developmental delay presented with decreased vision that was worse in her left eye. Ocular examination revealed bilateral retinal vascular tortuosity involving both the arteries and veins. Both eyes had an abnormal foveal light reflex with a central yellowish hue, which was more pronounced in the left eye. Optical coherence tomography showed disruption of the photoreceptor inner segment-outer segment junction and retinal pigment epithelium centrally, which was also more prominent in the left eye. CONCLUSION DiGeorge syndrome is associated with retinal vascular tortuosity in a large percentage of patients. The patient's decreased vision is likely caused by solar retinopathy (prolonged sun gazing as a result of the secondary schizophrenia and developmental delay).
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Affiliation(s)
- Jennifer E De Niro
- *Department of Ophthalmology, California Pacific Medical Center, San Francisco, California; and †West Coast Retina Medical Group, San Francisco, California
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Kalitzeos AA, Lip GYH, Heitmar R. Retinal vessel tortuosity measures and their applications. Exp Eye Res 2012; 106:40-6. [PMID: 23146682 DOI: 10.1016/j.exer.2012.10.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 10/05/2012] [Accepted: 10/30/2012] [Indexed: 10/27/2022]
Abstract
Structural retinal vascular characteristics, such as vessel calibers, tortuosity and bifurcation angles are increasingly quantified in an objective manner, slowly replacing subjective qualitative disease classification schemes. This paper provides an overview of the current methodologies and calculations used to compute retinal vessel tortuosity. We set out the different parameter calculations and provide an insight into the clinical applications, while critically reviewing its pitfalls and shortcomings.
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Affiliation(s)
- Angelos A Kalitzeos
- Aston University, School of Life and Health Sciences, Aston Triangle, Birmingham B4 7ET, UK
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Kulik TJ, Clark RL, Hasan BS, Keane JF, Springmuller D, Mullen MP. Pulmonary arterial hypertension: what the large pulmonary arteries tell us. Pediatr Cardiol 2011; 32:759-65. [PMID: 21455751 DOI: 10.1007/s00246-011-9963-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 03/16/2011] [Indexed: 11/26/2022]
Abstract
The morphology of the large intrapulmonary arteries (PAs) in pulmonary hypertension (PH) has received limited attention. Dilation, pruning, abrupt tapering, and tortuosity of PAs occur, but whether different patients have distinct PA phenotypes is unknown. Pulmonary arteriograms from 41 pediatric patients with PH were blindly reviewed by four experts who assigned each angiogram one of three designations: straight (S), tortuous (T), or ambiguous (A). Hemodynamic variables and outcomes were compared to the phenotypes. Thirty patients were either T (19) or S (11); 11 were A. The phenotypes were not associated with age. Tortuous patients had higher PA pressure and resistance than the S group and less likely to react to inhaled nitric oxide than S patients (p < 0.05). Clinical outcomes were similar for the three groups. Thus, in PH patients two subtypes of PA morphology can often be discerned, a reflection of variability in PA tortuosity. These morphological subtypes have differing hemodynamic characteristics. The mechanism(s) underlying these differences is unknown, but neither hydrodynamic factors nor duration of PH are fully explanatory. Because PA morphology might reveal information regarding the biology of pathological remodeling, it might prove enlightening to assess the large PA phenotype in future studies of PH.
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Affiliation(s)
- Thomas J Kulik
- Department of Cardiology, Division of Cardiac Critical Care, Children's Hospital Boston, Boston, MA 02115, USA.
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Familial retinal arteriolar tortuosity associated with retinal and vitreous hemorrhages. Retin Cases Brief Rep 2011; 5:157-9. [PMID: 25389889 DOI: 10.1097/icb.0b013e3181cd1d78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to report a patient with familial retinal arteriolar tortuosity who presented with both retinal and vitreous hemorrhages. METHODS This was a single case report. RESULTS A young woman affected by severe spina bifida with myelomeningocele and hydrocephalus presented with a 4-month history of blurred vision in both eyes. The patient had a history of severe constipation. Fundus examination of both eyes showed tortuosity of the retinal arterioles and multiple hemorrhages throughout the fundus at the sub-, intraretinal, subhyaloid, and intravitreal levels. The bleeding was likely because of a Valsalva effect. CONCLUSION Familial retinal arteriolar tortuosity is a rare disease characterized by the selective tortuosity of the second- and third-order retinal arterioles in the macula and peripapillary area. Patients may experience episodes of vision loss secondary to retinal hemorrhages. To our knowledge, this is the first report of vitreous hemorrhage in a patient with familial retinal arteriolar tortuosity.
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Trucco E, Azegrouz H, Dhillon B. Modeling the Tortuosity of Retinal Vessels: Does Caliber Play a Role? IEEE Trans Biomed Eng 2010; 57:2239-47. [DOI: 10.1109/tbme.2010.2050771] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Al-Diri B, Hunter A, Steel D. An active contour model for segmenting and measuring retinal vessels. IEEE TRANSACTIONS ON MEDICAL IMAGING 2009; 28:1488-97. [PMID: 19336294 DOI: 10.1109/tmi.2009.2017941] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This paper presents an algorithm for segmenting and measuring retinal vessels, by growing a "Ribbon of Twins" active contour model, which uses two pairs of contours to capture each vessel edge, while maintaining width consistency. The algorithm is initialized using a generalized morphological order filter to identify approximate vessels centerlines. Once the vessel segments are identified the network topology is determined using an implicit neural cost function to resolve junction configurations. The algorithm is robust, and can accurately locate vessel edges under difficult conditions, including noisy blurred edges, closely parallel vessels, light reflex phenomena, and very fine vessels. It yields precise vessel width measurements, with subpixel average width errors. We compare the algorithm with several benchmarks from the literature, demonstrating higher segmentation sensitivity and more accurate width measurement.
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Affiliation(s)
- Bashir Al-Diri
- Department of Computing and Informatics, University of Lincoln, Lincoln, UK
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Seo JH, Kim I, Yu HG. A case of carotid aneurysm in familial retinal arterial tortuosity. KOREAN JOURNAL OF OPHTHALMOLOGY 2009; 23:57-8. [PMID: 19337483 PMCID: PMC2655750 DOI: 10.3341/kjo.2009.23.1.57] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 01/05/2009] [Indexed: 11/23/2022] Open
Abstract
A 44-year-old woman who showed recurrent vitreous hemorrhages with vascular tortuosity received CT angiography which revealed an internal carotid artery aneurysm. A case of internal carotid aneurysm was associated with a pattern of retinal arteriolar tortuosity pathognomic for familial retinal arterial tortuosity (fRAT), suggesting possible involvement of the cerebral circulation. We present a case of internal carotid aneurysm associated with a pattern of retinal arteriolar tortuosity pathognomic for fRAT.
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Affiliation(s)
- Je Hyun Seo
- Department of Ophthalmology, College of Medicine, and Medical Research Center, Seoul National University, Seoul, Korea
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Schmidt D, Pache M, Schumacher M. The congenital unilateral retinocephalic vascular malformation syndrome (bonnet-dechaume-blanc syndrome or wyburn-mason syndrome): review of the literature. Surv Ophthalmol 2008; 53:227-49. [PMID: 18501269 DOI: 10.1016/j.survophthal.2007.10.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Retinal arteriovenous malformations represent a rare syndrome in which a direct connection of major vessels without interposition of capillaries may lead to various complications such as thrombosis and vessel occlusion. This review comprises the computer-stored data of all the 121 patients with arteriovenous malformations described in the literature. Twenty-seven patients had typical Bonnet-Dechaume-Blanc syndrome (in this article designated as congenital retinocephalofacial vascular malformation syndrome), 25 had incomplete congenital retinocephalofacial vascular malformation syndrome (without facial skin lesions), 57 had isolated retinal arteriovenous malformations, and 12 had arteriovenous communications of the retina and distinct neurological signs, but without neuroradiological evidence of cerebral arteriovenous malformations (presumed cerebral arteriovenous malformations). Concerning the retinal findings, we found a distinct difference by comparing patients with congenital retinocephalofacial vascular malformation syndrome and those with isolated retinopathy without cerebral or facial malformations: extensive retinal malformations of vessels of most parts of the fundus occurred conspicuously more often in patients with retinal and cerebral arteriovenous malformations. In contrast, local retinal arteriovenous malformations occurred in all patients with isolated retinopathy without cerebral or facial malformations and rarely in patients with congenital retinocephalofacial vascular malformation syndrome. In conclusion, patients with arteriovenous communications of the retina should be examined early with brain and orbital neuroimaging to rule out cerebral arteriovenous malformations. Current therapeutic strategies include endovascular, surgical, and radiation procedures.
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Affiliation(s)
- Dieter Schmidt
- Department of Ophthalmology, University Freiburg, Freiburg, Germany
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Grisan E, Foracchia M, Ruggeri A. A novel method for the automatic grading of retinal vessel tortuosity. IEEE TRANSACTIONS ON MEDICAL IMAGING 2008; 27:310-9. [PMID: 18334427 DOI: 10.1109/tmi.2007.904657] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Tortuosity is among the first alterations in the retinal vessel network to appear in many retinopathies, such as those due to hypertension. An automatic evaluation of retinal vessel tortuosity would help the early detection of such retinopathies. Quite a few techniques for tortuosity measurement and classification have been proposed, but they do not always match the clinical concept of tortuosity. This justifies the need for a new definition, able to express in mathematical terms the tortuosity as perceived by ophthalmologists. We propose here a new algorithm for the evaluation of tortuosity in vessels recognized in digital fundus images. It is based on partitioning each vessel in segments of constant-sign curvature and then combining together each evaluation of such segments and their number. The algorithm has been compared with other available tortuosity measures on a set of 30 arteries and one of 30 veins from 60 different images. These vessels had been preliminarily ordered by a retina specialist by increasing perceived tortuosity. The proposed algorithm proved to be the best one in matching the clinically perceived vessel tortuosity.
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Affiliation(s)
- Enrico Grisan
- Department of Information Engineering, University of Padova, 35131 Padova, Italy
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