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DuPont M, Arthur E, Shihab Y, Kenny M, Ravichandran S, Parsons-Wingerter P, Vyas R, Murray MC, Predovic M, Lim S, Jacobs N, Ramesh S, Vu A, Sekaran S, Chalam KV, Moorthy RS, Crosson J, Mason J, Grant MB. Use of VESsel GENeration with Optical Coherence Tomography Angiography and Fluorescein Angiography for Detection and Quantification of Vascular Changes in Mild and Moderate Diabetic Retinopathy. Life (Basel) 2024; 14:893. [PMID: 39063646 PMCID: PMC11277959 DOI: 10.3390/life14070893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: Previously, VESsel GENeration (VESGEN) software was used to map and quantify vascular changes observed on fluorescein angiography (FA) in subjects (n = 15 eyes) with retinal pathology ranging from mild non-proliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR). In the current study, we used VESGEN for the assessment of individuals with early-stage NPDR imaged by FA (Cohort 1) and by optical coherence tomography angiography (OCTA; Cohort 2). (2) Methods: Cohort 1 included type 2 diabetics (T2D), represented 21 eyes (ranging from no DR to moderate DR), and also included nondiabetic controls (NDC; n = 15 eyes). Cohort 2 consisted of 23 eyes from T2D subjects (including no DR subjects and moderate DR subjects) and NDC (n = 18 eyes). (3) Results: In the FA-VESGEN study, total tortuosity (Tv) of microvessels (G ≥ 6) increased in T2D with mild DR compared to the controls. In contrast, the VESGEN analysis of OCTA images showed that vessel length (characterized as density) was lower in T2D subjects before the diagnosis of DR and following the diagnosis of DR when compared to the controls. Additionally, T2D showed a significant decrease in vessel area (density). (4) Conclusions: FA elucidated the vessel morphology of small-generation microvessels to a greater degree than OCTA; however, OCTA identified changes in vessel density better than FA. VESGEN analysis can be used with both standard FA and OCTA to facilitate our understanding of early events in DR, including before the clinical diagnosis of DR.
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Affiliation(s)
- Mariana DuPont
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Department of Hematology-Oncology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Edmund Arthur
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.); (M.K.); (S.R.)
| | - Yazen Shihab
- Birmingham School of Medicine, University of Alabama, Birmingham, AL 35233, USA;
| | - Madelyn Kenny
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.); (M.K.); (S.R.)
| | - Swetha Ravichandran
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.); (M.K.); (S.R.)
| | | | - Ruchi Vyas
- Mori Associates, Ames Research Center, National Aeronautics and Space Administration (NASA), Moffett Field, CA 94035, USA;
| | - Matthew C. Murray
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Marina Predovic
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Shiyin Lim
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Nicole Jacobs
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Sneha Ramesh
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Amanda Vu
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Srinivaas Sekaran
- Blue Marble Space Institute of Science, Ames Research Center, NASA, Moffett Field, CA 94035, USA; (M.C.M.); (M.P.); (S.L.); (N.J.); (S.R.); (A.V.); (S.S.)
| | - Kakarla V. Chalam
- Department of Ophthalmology, Loma Linda University Health Care, Loma Linda, CA 92354, USA;
| | - Ramana S. Moorthy
- Associated Vitreoretinal and Uveitis Consultants, Indianapolis, IN 46290, USA;
| | - Jason Crosson
- Retina Consultants of Alabama Birmingham, Birmingham, AL 35233, USA; (J.C.); (J.M.)
| | - John Mason
- Retina Consultants of Alabama Birmingham, Birmingham, AL 35233, USA; (J.C.); (J.M.)
| | - Maria B. Grant
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
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Huang H, Wang XY, Wei H, Kang M, Zou J, Ling Q, Xu SH, Huang H, Chen X, Wang YX, Shao Y, Yu Y. Retinal microvascular and microstructural alterations in the diagnosis of meibomian gland dysfunction in severely obese population: a new approach. Int J Ophthalmol 2023; 16:1977-1985. [PMID: 38111945 PMCID: PMC10700072 DOI: 10.18240/ijo.2023.12.09] [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: 05/27/2023] [Accepted: 11/01/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To study retinal microvascular and microstructural alterations in meibomian gland dysfunction (MGD) in severely obese population using optical coherence tomography angiography (OCTA). METHODS Twelve MGD patients with severely obese population (PAT group; 24 eyes) and 12 healthy controls (HC group; 24 eyes) were recruited. OCTA images were segmented into five [superior (S), nasal (N), inferior (I), temporal (T), and central foveal (C)] or nine [inner superior (IS), outer superior (OS), inner nasal (IN), outer nasal (ON), inner inferior (II), outer inferior (OI), inner temporal (IT), outer temporal (OT), and C] subregions. The superficial vessel density (SVD), retinal thickness (RT), foveal avascular zone (FAZ) parameters, and retinal volume were measured. RESULTS Visual acuity was significantly different between two groups (0.8±0.17 in PAT group vs 0.2±0.06 in HC group). SVD was significantly lower in PATs in N, T, OS, IN, OT, and ON. The area under the receiver operating characteristic curve (AUC) for T was 0.961 [95% confidence interval (CI): 0.908 to 1.000], for OS was 0.962 (95%CI: 0.915 to 1.000). RT was significantly lower in PATs in IS, OS, OI, OT, ON, IT, IN, and II. AUC for OT was 0.935 (95%CI: 0.870 to 0.999), for IS was 0.915 (95% CI: 0.838 to 0.992). Angiography results showed significantly lower area and perimeter of FAZ, SVD of the inner retina and both retinal volume and the average volume thickness in the PAT group. CONCLUSION Vision may be affected in patients with MGD due to changes in retinal microvessels and microstructures. These changes detected by OCTA may be a potential marker for diagnosing MGD in severe obesity.
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Affiliation(s)
- Hai Huang
- Nanchang Aier Eye Hospital, Nanchang 330006, Jiangxi Province, China
| | - Xiao-Yu Wang
- Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang 330006, Jiangxi Province, China
- The First Clinical Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Hong Wei
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - Min Kang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - Jie Zou
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - Qian Ling
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - San-Hua Xu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - Hui Huang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - Xu Chen
- Department of Ophthalmology and Visual Sciences, Maastricht University, Maastricht 6200MA, Limburg Province, Netherlands
| | - Yi-Xin Wang
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF244HQ, United Kingdom
| | - Yi Shao
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200433, China
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang 330006, Jiangxi Province, China
| | - Yao Yu
- Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang 330006, Jiangxi Province, China
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Arthur E, Ravichandran S, Snyder PJ, Alber J, Strenger J, Bittner AK, Khankan R, Adams SL, Putnam NM, Lypka KR, Piantino JA, Sinoff S. Retinal mid-peripheral capillary free zones are enlarged in cognitively unimpaired older adults at high risk for Alzheimer's disease. Alzheimers Res Ther 2023; 15:172. [PMID: 37828548 PMCID: PMC10568786 DOI: 10.1186/s13195-023-01312-8] [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: 07/31/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Compared to standard neuro-diagnostic techniques, retinal biomarkers provide a probable low-cost and non-invasive alternative for early Alzheimer's disease (AD) risk screening. We have previously quantified the periarteriole and perivenule capillary free zones (mid-peripheral CFZs) in cognitively unimpaired (CU) young and older adults as novel metrics of retinal tissue oxygenation. There is a breakdown of the inner retinal blood barrier, pericyte loss, and capillary non-perfusion or dropout in AD leading to potential enlargement of the mid-peripheral CFZs. We hypothesized the mid-peripheral CFZs will be enlarged in CU older adults at high risk for AD compared to low-risk individuals. METHODS 20 × 20° optical coherence tomography angiography images consisting of 512 b-scans, 512 A-scans per b-scan, 12-µm spacing between b-scans, and 5 frames averaged per each b-scan location of the central fovea and of paired major arterioles and venules with their surrounding capillaries inferior to the fovea of 57 eyes of 37 CU low-risk (mean age: 66 years) and 50 eyes of 38 CU high-risk older adults (mean age: 64 years; p = 0.24) were involved in this study. High-risk participants were defined as having at least one APOE e4 allele and a positive first-degree family history of AD while low-risk participants had neither of the two criteria. All participants had Montreal Cognitive Assessment scores ≥ 26. The mid-peripheral CFZs were computed in MATLAB and compared between the two groups. RESULTS The periarteriole CFZ of the high-risk group (75.8 ± 9.19 µm) was significantly larger than that of the low-risk group (71.3 ± 7.07 µm), p = 0.005, Cohen's d = 0.55. The perivenule CFZ of the high-risk group (60.4 ± 8.55 µm) was also significantly larger than that of the low-risk group (57.3 ± 6.40 µm), p = 0.034, Cohen's d = 0.42. There were no significant differences in foveal avascular zone (FAZ) size, FAZ effective diameter, and vessel density between the two groups, all p > 0.05. CONCLUSIONS Our results show larger mid-peripheral CFZs in CU older adults at high risk for AD, with the potential for the periarteriole CFZ to serve as a novel retinal vascular biomarker for early AD risk detection.
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Affiliation(s)
- Edmund Arthur
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Swetha Ravichandran
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter J Snyder
- Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA
| | - Jessica Alber
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, USA
- Butler Hospital Memory & Aging Program, Providence, RI, USA
| | - Jennifer Strenger
- Butler Hospital Memory & Aging Program, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Ava K Bittner
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Rima Khankan
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, CA, USA
| | | | - Nicole M Putnam
- State University of New York College of Optometry, New York, NY, USA
| | - Karin R Lypka
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Juan A Piantino
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
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Tomita M, Tagami M, Misawa N, Sakai A, Haruna Y, Honda S. En-face widefield optical coherence tomography angiography for understanding vascular networks changes in two cases of acute retinal necrosis. J Ophthalmic Inflamm Infect 2023; 13:9. [PMID: 36881194 PMCID: PMC9992468 DOI: 10.1186/s12348-023-00331-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/12/2023] [Indexed: 03/08/2023] Open
Abstract
PURPOSE The present study assesses the utility of en-face widefield optical coherence tomography angiography (OCTA) imaging for evaluating the retinal vascular network during the course of treatment in acute retinal necrosis(ARN). OBSERVATIONS OCTA images of two cases of acute retinal necrosis were analyzed. Case 1 was a 15-year-old male with visual crowding in his right eye who had best-corrected visual acuity of 16/20 and intraocular pressure of 25 mmHg in his right eye on initial evaluation. Case 2 was a 57-year-old male with visual crowding in his left eye who had best-corrected visual acuity of 20/20 in his left eye on initial examination and intraocular pressure of 19.3 mmHg. In both patients, dynamic changes could be tracked by en-face ultra-widefield OCTA imaging before and up to 1 year after surgical treatment. The images showed arteriovenous anastomosis and the nonperfused area on the surface of the retina. CONCLUSIONS AND IMPORTANCE En-face widefield OCTA is useful for monitoring the structure of retinal vessels over time in acute retinal necrosis. Wide-angle OCTA is used to non-invasively examine retinal vascular dynamic changes in ARN. OCTA artifacts due to intraocular inflammation appeared, making interpretation difficult. These will remain as issues in the future. It seems difficult for a while to completely replace FA due to the problem of image clarity.
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Affiliation(s)
- Mami Tomita
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, 545-8586, Japan
| | - Mizuki Tagami
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, 545-8586, Japan.
| | - Norihiko Misawa
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, 545-8586, Japan
| | - Atsushi Sakai
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, 545-8586, Japan
| | - Yusuke Haruna
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, 545-8586, Japan
| | - Shigeru Honda
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, 545-8586, Japan
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