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Wang J, Wang YC, Zhang P, Wang X, Zong RR, Jiang J, Zhang Y, Qian YW, Li QJ, Wang ZL. Retinal thickness and fundus blood flow density changes in chest pain subjects with dyslipidemia. Int J Ophthalmol 2023; 16:1860-1866. [PMID: 38028521 PMCID: PMC10626367 DOI: 10.18240/ijo.2023.11.19] [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: 03/05/2023] [Accepted: 08/24/2023] [Indexed: 12/01/2023] Open
Abstract
AIM To assess the retinal thickness and fundus blood flow density changes in chest pain patients with dyslipidemia using optical coherence tomography angiography (OCTA). METHODS All subjects with chest pain as the main symptom accepted a comprehensive ophthalmological examination. According to the serum lipid levels, the participants were divided into the control group and the dyslipidemia group. The retina thickness and fundus blood flow density were determined using OCTA. RESULTS The study enrolled 87 left eyes from 87 adults with dyslipidemia and 87 left eyes from age- and sex-matched participants without dyslipidemia. The retina of dyslipidemia subjects was significantly thinner than that of the controls in the inferior (P=0.004 and P=0.014, respectively) and temporal (P=0.015 and P=0.019, respectively) regions, both inner and outer layers. In terms of blood flow density in the macula or optic disk, there was a decreasing trend in the dyslipidemia group compared with the control group, especially in the inferior and temporal regions. CONCLUSION Dyslipidemia may contribute to the decrease in retinal thickness and fundus blood flow density. Further validation of the association between abnormal lipid metabolism and fundus microcirculation alterations needs to be carried out in chest pain patients.
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Affiliation(s)
- Jin Wang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200010, China
| | - Yu-Cen Wang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Pei Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
- Department of Ophthalmology, Shanghai Gonghui Hospital, Shanghai 200040, China
| | - Xin Wang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Rong-Rong Zong
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science; Fujian Engineering and Research Center of Eye Regenerative Medicine; Eye Institute of Xiamen University; Xiamen University School of Medicine, Xiamen 361005, Fujian Province, China
| | - Jing Jiang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yu Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yi-Wen Qian
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qing-Jian Li
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhi-Liang Wang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
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Menean M, Apuzzo A, Mastaglio S, Bernardi M, Ciceri F, Modorati G, Miserocchi E, Bandello F, Cicinelli MV. Imaging biomarkers of leukaemic choroidopathy. Acta Ophthalmol 2023. [PMID: 36703240 DOI: 10.1111/aos.15637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/13/2022] [Accepted: 01/08/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE To longitudinally investigate choroidal and choriocapillaris perfusion metrics and the number of choroidal hyperreflective foci (HRF) in patients with acute leukaemia (AL) before and after disease remission and to correlate these metrics with systemic parameters during active disease. METHODS Prospective, longitudinal study of 26 eyes of 14 AL patients. All patients underwent optical coherence tomography (OCT) and OCT-angiography (OCTA) in the acute phase. Subfoveal choroidal thickness (CT), total, luminal and stromal choroidal area (TCA, LCA, SCA), choroidal vascularity index (CVI), choriocapillaris flow deficits (cFD) density, and choroidal HRF number were computed. In a subset, the measurements were repeated after AL remission. Age- and gender-matched 26 healthy controls were recruited for cross-sectional comparisons. RESULTS Patient's mean age was 59 ± 12 years. The TCA, LCA, SCA and choroidal HRF number were significantly higher in patients than controls (p = 0.028, p = 0.044, p = 0.024 and p = 0.001, respectively). Lower haemoglobin levels were associated with lower CT (r = 0.58, p = 0.008). Higher D-dimer values were associated with lower TCA (r = -0.52, p = 0.008), lower LCA (r = -0.50, p = 0.006), higher cFD density (r = 0.41, p = 0.044) and higher choroidal HRF number (r = 0.47, p = 0.008). The CT, TCA, SCA and choroidal HRF number significantly reduced after AL remission (p = 0.001, p = 0.047, p = 0.007 and p = 0.002 respectively). The CVI increased significantly compared to the active phase (p = 0.013). CONCLUSION The study demonstrates a subclinical choroidal involvement in patients with AL, with relative stromal thickening in the acute phase, and normalization after disease remission. Choroidal HRF were identified as a biomarker of leukaemic choroidopathy. Choriocapillaris and choroidal vascularity were inversely correlated with a systemic pro-coagulant state.
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Affiliation(s)
- Matteo Menean
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Aurelio Apuzzo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Mastaglio
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Bernardi
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulio Modorati
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Miserocchi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Duan J, An J, Li M, Zhang Z, Zhou L, Yin P, Ma J, Shang Q. Topographical Relationship Between Acute Macular Neuroretinopathy and Choroidal Watershed Zone or Patchy Choroidal Filling. Front Med (Lausanne) 2022; 9:762609. [PMID: 35178410 PMCID: PMC8843832 DOI: 10.3389/fmed.2022.762609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To study the topographical relationship between acute macular neuroretinopathy (AMN) lesions and the choroidal watershed zone (CWZ) or patchy choroidal filling (PCF) using multimodal imaging. METHODS Lesions in patients diagnosed with AMN were clinically examined using multimodal imaging, including fundus photography, near-infrared reflectance imaging, spectral-domain optical coherence tomography (OCT), fluorescein angiography, indocyanine green angiography, OCT angiography, and microperimetry. The topographical relationship between AMN and the CWZ or PCF was evaluated. RESULTS Seven eyes of six patients were included in the study. The mean age of the patients was 35.8 ± 11.7 years. The AMN lesions were collocated with the CWZ in five eyes and the PCF in one eye. Among these eyes, three had complete patterns, and three had partial patterns. Only one eye showed no topographical relationship between AMN and the CWZ or PCF. CONCLUSION The colocation of AMN and CWZ/PCF suggests that the AMN lesions were within an area with a dual-watershed zone: the watershed zone between the retinal deep capillary plexus and choriocapillaris, and the choroidal watershed zone or patchy choroidal filling. This retinal area was highly vulnerable to hypoperfusion. Our results suggest a novel pathophysiological mechanism for AMN.
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Affiliation(s)
- Jialiang Duan
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianbin An
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Minhao Li
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhengwei Zhang
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, China
| | - Liang Zhou
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Pengfei Yin
- Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jingxue Ma
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qingli Shang
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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