1
|
Akbarpour M, Jalali MM, Alizadeh Y, Nemati S, Akbari M, Dourandeesh M. The Association Between Choroidal Thickness and Meniere's Disease: A Cross-Sectional Study. Laryngoscope 2024; 134:1889-1893. [PMID: 37916786 DOI: 10.1002/lary.31136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/01/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To evaluate and compare choroidal thickness (CT) between patients with Meniere's disease (MD) and a control group. METHODS This case-control analytical study was conducted on 37 subjects with MD and 37 healthy subjects. Subfoveal CT (SCT), large choroidal vessel (LCV) layer thickness, and mean subfoveal LCV thickness/mean SCT ratio were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) in the eyes on the MD side (ipsilateral), the contralateral eyes, and the control group. RESULTS A statistically significant difference was observed in the mean SCT values between the ipsilateral and control groups after adjustment for age, sex, and migraine (p = 0.04). Moreover, there was a statistically significant difference between the mean subfoveal LCV thickness values and the mean subfoveal LCV thickness/mean SCT ratio between the ipsilateral and control groups (p = 0.006, and p < 0.001, respectively). Patients with a duration of disease over three years had a greater mean subfoveal LCV thickness/mean SCT ratio (67.35 ± 11.56 and 60.66 ± 11.27, respectively), which was statistically insignificant (p = 0.08). CONCLUSION We found a thicker choroid and Haller layer, and a greater subfoveal LCV thickness/SCT ratio on the MD side compared to the controls. Furthermore, patients with a greater duration of disease had a lower subfoveal LCV thickness/SCT ratio. These findings may reflect the role of the trigeminal vascular system (TVS) and neurovascular pathophysiology in MD patients. More extensive studies are required to reach more definitive conclusions about the association between CT and MD. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1889-1893, 2024.
Collapse
Affiliation(s)
- Maliheh Akbarpour
- Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mir Mohammad Jalali
- Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Yousef Alizadeh
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Shadman Nemati
- Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mitra Akbari
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Dourandeesh
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
2
|
Eski MT, Teberik K, Taha S, Büken B, Turan Sönmez F. Compare of optic coherence tomography parameters in recreational synthetic tetrahydrocannabinol use and healthy control. Cutan Ocul Toxicol 2023; 42:179-183. [PMID: 37417942 DOI: 10.1080/15569527.2023.2234042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/16/2023] [Accepted: 07/01/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To evaluate retinal thickness (RT), retinal nerve fiber layer thickness (RNFLT), and choroidal thickness (CT) changes in synthetic cannabinoid (SC) users. METHODS This prospective study evaluated the RT, RNFLT, and CT values of 56 SC users and 58 healthy controls. The individuals using SCs were referred to us by our hospital's forensic medicine department. Retinal and choroidal images were obtained using spectral-domain optical coherence tomography (OCT). Measurements (one subfoveal, three temporals, three nasal) were taken at 500 μm intervals up to 1500 μm using the caliper system. Only the right eye was used for subsequent analysis. RESULTS Mean ages were 27.7 ± 5.7 years in the SC-user group and 25.4 ± 6.7 in the control group. Subfoveal Global RNFLT was in the SCs group 102.3 ± 10.5 μm and 105.6 ± 20.2 μm in the control group (p = 0.271). Subfoveal CT was in the SC group mean of 316.1 ± 100.2 μm and in the control group mean 346.4 ± 81.8 μm (p = 0.065). RT, T500 (283.3 ± 36.7 μm, 296.6 ± 20.5 μm, p = 0.011) and N1500 (355.1 ± 14.3 μm, 349.3 ± 18.1 μm, p = 0.049) were significantly higher in the SC group than in the control group, respectively. CONCLUSION Analysis of OCT findings of individuals who had been using SC for more than one year revealed no statistically significant difference between RNFLT and CT, although N1500 was significantly higher in RT. Further studies in the field of OCT are important to explore the pathology of SC.
Collapse
Affiliation(s)
- Mehmet Tahir Eski
- Department of Ophthalmology, Erzincan Private Neon Hospital, Erzincan, Turkey
| | - Kuddusi Teberik
- Department of Ophthalmology, Duzce University School of Medicine, Duzce, Turkey
| | - Sezer Taha
- Department of Ophthalmology, Duzce University School of Medicine, Duzce, Turkey
| | - Bora Büken
- Department of Forensic Medicine, Duzce University
| | | |
Collapse
|
3
|
Dehghani A, Kargar S, Faghihi G, Adibi N, Noorshargh P, Dehghani S, Pourazizi M, Abtahi-Naeini B. Systemic isotretinoin therapy and central macular and choroidal thicknesses in acne vulgaris: is there any association? Cutan Ocul Toxicol 2023; 42:174-178. [PMID: 37399081 DOI: 10.1080/15569527.2023.2227895] [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: 08/22/2022] [Revised: 11/29/2022] [Accepted: 06/16/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE To investigate the effect of oral isotretinoin therapy on central macular thickness (CMT) thickness and choroidal thickness (CT) using optical coherence tomography (OCT). METHODS CT and CMT thickness of 43 eyes were evaluated at baseline, the third, and sixth month of isotretinoin therapy by spectral-domain OCT. For assessment of CT, OCT measurements were obtained at the fovea with six additional measurements at adjacent locations (at 500-1000 µm temporal to the fovea and 500-1000 µm nasal to the fovea). RESULTS Forty-three eyes from 43 patients with acne vulgaris, including 33 females (76.7%), who had a mean age of 24.81 ± 6.60 years, completed the study. The mean CMT was 231.49 ± 19.52 at the baseline and significantly decreased to 229.0 ± 19.57 (p = 0.02) and 229.28 ± 18.83 after three and six months, respectively (p < 0.03). The change in the macular thicknesses measured at four quadrants and choroidal thicknesses were not statistically significant during the study (p > 0.05). CONCLUSION The result of our study demonstrated choroidal thickness change is not significant in patients with acne vulgaris after systemic isotretinoin therapy during six months of follow-up. The decreased CMT amount was 2.2 microns; even if statistically significant, this amount is clinically insignificant.
Collapse
Affiliation(s)
- Alireza Dehghani
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Science, Isfahan, Iran
| | - Saeed Kargar
- School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Gita Faghihi
- Skin Diseases and Leishmaniosis Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Neda Adibi
- Skin Diseases and Leishmaniosis Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Pegah Noorshargh
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Science, Isfahan, Iran
| | - Shakiba Dehghani
- Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Science, Tehran, Iran
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Science, Isfahan, Iran
| | - Bahareh Abtahi-Naeini
- Skin Diseases and Leishmaniosis Research Center, Isfahan University of Medical Science, Isfahan, Iran
| |
Collapse
|
4
|
Lu Y, Cui Y, Zhu Y, Lu ES, Zeng R, Garg I, Katz R, Le R, Wang JC, Vavvas DG, Husain D, Miller JW, Wu D, Miller JB. Quantitative Wide-Field Swept-Source Optical Coherence Tomography Angiography and Visual Outcomes in RAO. Clin Ophthalmol 2023; 17:2505-2513. [PMID: 37637969 PMCID: PMC10460179 DOI: 10.2147/opth.s418370] [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: 05/09/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcomes and is associated with an increased risk of stroke and cardiovascular events. Wide-field swept-source OCT-A (WF SS-OCTA) can provide quick and non-invasive angiographic information with a wide field of view. Here, we looked for associations between OCT-A vascular imaging metrics and vision in RAO patients. Methods Patients with diagnoses of central (CRAO) or branched retinal artery occlusion (BRAO) were included. 6mm × 6mm Angio and 15mm × 15mm AngioPlex Montage OCT-A images were obtained for both eyes in each patient using Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm × 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. Non-perfusion area (NPA) was manually measured using 15mm × 15mm images. A linear regression model was utilized to identify correlation between imaging metrics and vision. P-values less than 0.05 were considered as statistically significant. Results Twenty-five subjects were included. For RAO eyes, there was a statistically significant inverse correlation between retinal thickness as well as superficial capillary plexus (SCP) vessel density (VD) and vision. An inverse correlation was found between deep capillary plexus (DCP) VD and vision without statistical significance. There was a positive correlation between choroidal thickness as well as choroidal volume and vision without statistical significance. No significant correlation was found between the metrics and vision in contralateral eyes. For NPA and vision, no significant correlation was identified. Conclusion This is the first study to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between retinal vascular imaging metrics and visual outcomes. The results of this study provide a basis to understand the structural changes involved in vision in RAO and may guide management of RAO and prevention of cerebral stroke and cardiovascular accidents.
Collapse
Affiliation(s)
- Yifan Lu
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Ying Cui
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
| | - Ying Zhu
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Edward S Lu
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Rebecca Zeng
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Itika Garg
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Rongrong Le
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Wenzhou Medical University Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Jay C Wang
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Demetrios G Vavvas
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Deeba Husain
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - David Wu
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
5
|
Keles A, Karaman SK, Duzgun AC, Buyuksireci M, Bayraktaroglu MS. Association between lower extremity venous insufficiency and increased choroidal thickness. J Fr Ophtalmol 2023:S0181-5512(23)00120-1. [PMID: 36948916 DOI: 10.1016/j.jfo.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/23/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE The goal of this study is to investigate the association between the choroid and lower extremity venous insufficiency (LEVI). METHODS This prospective cross-sectional study includes 56 patients with LEVI and 50 age/sex-similar control subjects. Choroidal thickness (CT) measurements from 5 different points were captured from all participants by optical coherence tomography. In the group with LEVI on physical examination, reflux at the saphenofemoral junction, and the diameter of the great and small saphenous veins were evaluated via color Doppler ultrasonography. RESULTS The mean subfoveal CT was higher in the varicose group than in the control group (363.04±99.75μm vs. 320.30±73.46μm, P=0.013). In addition, the CTs at the temporal 3mm, temporal 1mm, nasal 1mm, and nasal 3mm distance from the fovea were higher in the LEVI group compared to the controls (for all, P<0.05). There was no correlation between CT and diameter of the great and small saphenous vein in patients with LEVI (for all, P>0.05). However, the great and small saphenous veins of patients with CT above 400μm were observed to be wider in patients with LEVI (P=0.027 and P=0.007, respectively). CONCLUSION Varicose veins can be a feature of systemic venous pathology. Another component of systemic venous disease may be increased CT. Patients with high CT should be investigated for susceptibility to LEVI.
Collapse
Affiliation(s)
- A Keles
- Department of Ophthalmology, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik, Turkey.
| | - S K Karaman
- Department of Ophthalmology, University of Health Sciences, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - A C Duzgun
- Department of Cardiovascular Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - M Buyuksireci
- Department of Radiology, Çorum Private Hospital, Çorum, Turkey
| | - M S Bayraktaroglu
- Department of Cardiovascular Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
6
|
Somisetty S, Santina A, Sarraf D, Mieler WF. The Impact of Systemic Medications on Retinal Function. Asia Pac J Ophthalmol (Phila) 2023; 12:115-157. [PMID: 36971705 DOI: 10.1097/apo.0000000000000605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/02/2023] [Indexed: 03/29/2023] Open
Abstract
This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of retinal toxicity. The diagnosis is established by taking a thorough medication and drug history, and then by pattern recognition of the clinical retinal changes and multimodal imaging features. Examples of all of these types of toxicity will be thoroughly reviewed, including agents that cause retinal pigment epithelial disruption (hydroxychloroquine, thioridazine, pentosan polysulfate sodium, dideoxyinosine), retinal vascular occlusion (quinine, oral contraceptives), cystoid macular edema/retinal edema (nicotinic acid, sulfa-containing medications, taxels, glitazones), crystalline deposition (tamoxifen, canthaxanthin, methoxyflurane), uveitis, miscellaneous, and subjective visual symptoms (digoxin, sildenafil). The impact of newer chemotherapeutics and immunotherapeutics (tyrosine kinase inhibitor, mitogen-activated protein kinase kinase, checkpoint, anaplastic lymphoma kinase, extracellular signal-regulated kinase inhibitors, and others), will also be thoroughly reviewed. The mechanism of action will be explored in detail when known. When applicable, preventive measures will be discussed, and treatment will be reviewed. Illicit drugs (cannabinoids, cocaine, heroin, methamphetamine, alkyl nitrite), will also be reviewed in terms of the potential impact on retinal function.
Collapse
Affiliation(s)
- Swathi Somisetty
- Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - Ahmad Santina
- Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - David Sarraf
- Jules Stein Eye Institute, University of California, Los Angeles, CA
| | | |
Collapse
|
7
|
Grimes KR, Aloney A, Skondra D, Chhablani J. Effects of systemic drugs on the development and progression of age-related macular degeneration. Surv Ophthalmol 2023; 68:332-346. [PMID: 36731638 DOI: 10.1016/j.survophthal.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
Age-related macular degeneration (AMD) is the leading cause of severe loss of central vision among people over 50. The pathophysiology of the disease is multifactorial and can be attributed to genetics, aging, inflammation, environmental factors, and lifestyle factors including smoking, diet, obesity, and alcohol consumption. While there is no treatment for dry AMD, the current standard treatment for wet AMD is an intraocular injection of anti-vascular endothelial growth factor-an effective, yet expensive, therapy that requires ongoing treatment. As the aging population continues to grow, and AMD diagnoses continue to rise, new treatments should be explored to reduce vision complications and decrease treatment burdens. Many systemic conditions have progressive pathological changes that may affect AMD, particularly those affecting systemic vasculature like diabetes and cardiovascular status. Consequently, systemic drugs used to treat coexistent systemic diseases may influence some of the pathogenic mechanisms of AMD and lead its progression or delay. In this review we explore the current literature to summarize the findings of the reported effects of antihypertensive, immunosuppressants, cholesterol lowering agents, nonsteroidal anti-inflammatory drugs, dopamine precursors, hypoglycemic agents, and anticoagulants on AMD.
Collapse
Affiliation(s)
- Kara R Grimes
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Abhilasha Aloney
- Eye Care Institute, PBMA'S H.V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, IL, USA
| | - Jay Chhablani
- Department of Ophthalmology, The University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
8
|
Zarnegar A, Ong J, Matsyaraja T, Arora S, Chhablani J. Pathomechanisms in central serous chorioretinopathy: A recent update. Int J Retina Vitreous 2023; 9:3. [PMID: 36670451 PMCID: PMC9854068 DOI: 10.1186/s40942-023-00443-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Central serous chorioretinopathy (CSCR) is a potentially blinding choroidal disease. Despite decades of research, the pathological mechanisms of CSCR are still poorly understood. In recent years, there has been a strong emphasis on choroidal dysfunction as a primary cause of CSCR. MAIN BODY The concept of the pachychoroid disease spectrum and pachychoroid-driven processes are central to current theories regarding the pathophysiological underpinnings of CSCR. Choroidal hyperpermeability and subsequent leakage of fluid seen in CSCR may be due to several causes. Among them are venous congestion, inflammation, mineralocorticoid receptor activation, systemic factors including hemodynamic changes, obstructive sleep apnea, phosphodiesterase inhibitor use, pregnancy, and genetic predispositions. Congestion of vortex veins that drain blood from the choroid may contribute to the dilation of Haller vessels and cause fluid leakage. Vortex veins exit the eye through the sclera; thus, increased scleral thickness has been proposed to be a factor in venous congestion. Asymmetric vortex vein drainage may similarly result in congestion of the local venous system. Vortex vein anastomoses may overload the venous system and form secondary to venous congestion. Recent studies suggest inflammation and mineralocorticoid activation may factor into the development of CSCR, though more research in these areas is called for. Systemic conditions and genetics may predispose individuals to develop CSCR. CONCLUSIONS By striving to understand the molecular and physiological mechanisms of this disease, we can better diagnose and treat CSCR to improve outcomes for patients.
Collapse
Affiliation(s)
- Arman Zarnegar
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Joshua Ong
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | | | - Supriya Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau, NP Bahamas
| | - Jay Chhablani
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| |
Collapse
|
9
|
Fung AT, Yang Y, Kam AW. Central serous chorioretinopathy: A review. Clin Exp Ophthalmol 2023; 51:243-270. [PMID: 36597282 DOI: 10.1111/ceo.14201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/18/2022] [Accepted: 12/18/2022] [Indexed: 01/05/2023]
Abstract
Central serous chorioretinopathy (CSC) is the fourth most common non-surgical retinopathy associated with fluid leakage. The pathogenesis is not yet completely understood, but changes in the choroid, sclera and RPE have been described associated with venous congestion of choroidal outflow. CSC can be categorised into acute, chronic, and recurrent subtypes with recent classifications of simple and complex based on the area of RPE change seen on fundus autofluorescence. A multimodal imaging approach is helpful in the diagnosis and management of CSC and secondary complications such as type 1 neovascularisation. Although spontaneous resolution with relatively good visual outcomes is common, treatment should be considered in patients with persistent or recurrent SRF. Treatment options include laser, systemic medications, intravitreal therapy, and surgery. Of these, argon laser for focal extramacular fluid leaks and photodynamic therapy of leakage identified by indocyanine-green angiography currently have the greatest supportive evidence.
Collapse
Affiliation(s)
- Adrian T Fung
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Yi Yang
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Andrew W Kam
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
10
|
Gouravani M, Salehi MA, Mohammadi S, Arevalo JF. Choroidal thickness in eyes of migraine patients measured using spectral domain-optical coherence tomography: A meta-analysis. Surv Ophthalmol 2023; 68:67-77. [PMID: 35093402 DOI: 10.1016/j.survophthal.2022.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
Recent developments in high-resolution optical coherence tomography allow evaluation of even the slightest changes of choroidal thickness in various disorders, including migraine. In this review, we analyze the choroidal thickness measurements reported in various studies that compare results between migraineurs and healthy individuals. We searched PubMed, Scopus, and EMBASE to identify relevant literature reporting choroidal thickness in the migraineurs' different macular regions compared with healthy controls. A fixed-effects or random-effects model was applied for the meta-analysis based on the heterogeneity level. Moreover, subgroup analyses, meta-regression, publication bias, and quality assessment were also performed. We identified ten studies involving 580 migraineurs (173 with aura, 128 without aura, and 279 without specification for the presence of aura) and 407 healthy controls to be included in this meta-analysis. Results indicated that average choroidal thickness was significantly decreased in the migraine cases (SMD, -1.28; 95% CI, -2.47 to -0.08; P = 0.04) compared to healthy individuals. Furthermore, both with aura (SMD, -1.16; 95% CI, -1.39 to -0.92; P < 0.0001) and without aura migraine patients (SMD, -0.81; 95% CI, -1.28 to -0.34; P < 0.001) had significantly thinner subfoveal choroid compared to healthy controls. Moreover, subfoveal choroidal thickness in the migraineurs with aura was significantly lower than those without aura (SMD, -0.45; 95% CI, -0.84 to -0.05; P = 0.03). The alterations in choroidal thickness, suggestive of migraine's neurovascular pathophysiology, were tentatively confirmed by this study's findings. Further longitudinal studies with more diverse settings are required to derive more definitive conclusions.
Collapse
Affiliation(s)
- Mahdi Gouravani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, USA
| |
Collapse
|
11
|
Davanian A, Williamson L, Taylor C, Harrover A, Bollinger K, Chaudhary B, Taskar V, Lee TJ, Liu Y, Chen Q, Marcus DM. Optical coherence tomography angiography and Humphrey visual field in patients with obstructive sleep apnea. J Clin Sleep Med 2022; 18:2133-2142. [PMID: 35532117 PMCID: PMC9435350 DOI: 10.5664/jcsm.10054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To determine if obstructive sleep apnea syndrome (OSAS) predisposes patients to glaucoma and macular disease due to vascular compromise by evaluating retinal and optic nerve vasculature and function using optical coherence tomography angiography and Humphrey visual field testing, respectively. METHODS In this prospective, observational, cross-sectional study 45 patients undergoing polysomnography ordered per standard of care were selected and stratified based on apnea-hypopnea index (AHI). Medical history, visual acuity testing, 24-2 Humphrey visual field, intraocular pressure measurement, and optical coherence tomography angiography studies of the macular and peripapillary retina were obtained. Correlations between polysomnography parameters and imaging data were analyzed. RESULTS The radial peripapillary capillary vascular density demonstrated no relationship to AHI (95% confidence interval [CI] [-0.026,0.038]) or severity of OSAS (95% CI: [-0.772, 3.648]) for moderate OSAS compared to mild/normal and (-1.295, 3.1421) for severe compared to mild/normal. Optical coherence tomography angiography superficial parafoveal vascular density (95% CI: [-0.068,0.011], deep parafoveal vascular density (95% CI: [-0.080,0.009]), and foveal avascular zone (95% CI: [-0.001, 0.001]) showed no statistically significant relationship to AHI or OSAS severity after controlling for confounders. Optical coherence tomography retinal nerve fiber layer thickness increased with AHI (P = .014), but there was no statistically significant correlation with OSAS severity with retinal nerve fiber layer thickness (95% CI: [-12.543, 6.792] for moderate comparing to normal and [-2.883, 16.551] for severe comparing to normal). Visual field parameters were unaffected by OSAS (95% CI: mean deviation [-0.21,0.29], pattern standard deviation: [-0.351, 0.121], visual field index: [-0.166, 0.329]). Optical coherence tomography choroidal thickness showed a statistically significant decrease when OSAS was grouped by severity (P = .0092) but did not correlate with AHI (P = .129, 95% CI: [-1.210, 0.095]). CONCLUSIONS The severity of OSAS did not show a statistically significant effect on parameters associated with glaucoma or macular vascular disease. Larger cohorts may be required to determine the physiologic consequences of OSAS on the macular and optic nerve vasculature, structure, and function. CITATION Davanian A, Williamson L, Taylor C, et al. Optical coherence tomography angiography and Humphrey visual field in patients with obstructive sleep apnea. J Clin Sleep Med 2022;18(9):2133-2142.
Collapse
Affiliation(s)
- Arash Davanian
- Department of Ophthalmology, Augusta University Medical Center, Augusta, Georgia
- Vanderbilt Eye Institute, Nashville, Tennessee
| | | | | | - Abigail Harrover
- Department of Ophthalmology, Augusta University Medical Center, Augusta, Georgia
| | - Kathryn Bollinger
- Department of Ophthalmology, Augusta University Medical Center, Augusta, Georgia
| | | | - Varsha Taskar
- Department of Sleep Medicine, Augusta University Medical Center, Augusta, Georgia
| | - Tae Jin Lee
- Department of Ophthalmology, Augusta University Medical Center, Augusta, Georgia
| | - Yuhan Liu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Qingxia Chen
- Vanderbilt Eye Institute, Nashville, Tennessee
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dennis M. Marcus
- Department of Ophthalmology, Augusta University Medical Center, Augusta, Georgia
- Southeast Retina Center, PC, Augusta, Georgia
| |
Collapse
|
12
|
Choroidal vascularity index in pseudoexfoliation syndrome: a review of the literature. SPEKTRUM DER AUGENHEILKUNDE 2022. [DOI: 10.1007/s00717-022-00529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
13
|
Mohammadi S, Salehi MA, Gouravani M, Arevalo JF. Response to "Choroidal thickness in eyes of migraine patients measured using spectral domain-optical coherence tomography: A meta-analysis". Surv Ophthalmol 2022; 67:1734-1735. [DOI: 10.1016/j.survophthal.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/01/2022] [Accepted: 07/25/2022] [Indexed: 10/31/2022]
|
14
|
Yeung SC, Park JY, Park D, You Y, Yan P. The effect of systemic and topical ophthalmic medications on choroidal thickness: a review. Br J Clin Pharmacol 2022; 88:2673-2685. [DOI: 10.1111/bcp.15237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Shanna C. Yeung
- Faculty of Medicine The University of British Columbia Vancouver Canada
| | | | - Daniel Park
- Faculty of Medicine University of Toronto Toronto Canada
| | - Yuyi You
- Department of Clinical Medicine Macquarie University Sydney Australia
- Save Sight Institute The University of Sydney Sydney Australia
| | - Peng Yan
- Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, University Health Network University of Toronto Toronto Canada
- Kensington Vision and Research Center Toronto Canada
| |
Collapse
|
15
|
Askarizadeh F, Heirani M, Khorrami-Nejad M, Narooie-Noori F, Khabazkhoob M, Ostadrahimi A. Is there any connection between choroidal thickness and obesity? Ther Adv Ophthalmol 2022; 14:25158414221100649. [PMID: 35795720 PMCID: PMC9251961 DOI: 10.1177/25158414221100649] [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: 11/29/2021] [Accepted: 04/27/2022] [Indexed: 11/16/2022] Open
Abstract
Obesity is a health-threatening and epidemic medical condition that can affect individuals of different ages and is potentially associated with an increased risk of systemic and ocular disorders. Despite the well-documented adverse effects of obesity on different parts of the body vasculature, less published data are available concerning obesity-related consequences on the ocular vasculature. As the human choroid is a highly vascularized tissue, its morphology and function might be altered in obese individuals. The micro-structural changes within the choroid could also trigger development of subsequent functional abnormalities of the eye. Previous population-based studies have asserted an association between obesity and choroidal thickness; however, they reported conflicting patterns of association between obesity and changes in choroidal thickness. Therefore, to enhance our understanding of the changes in choroidal morphology secondary to obesity, we reviewed studies describing the micro-structural consequences of obesity on the choroidal thickness profile and its underlying physiological and anatomical basis. This review includes all original publications related to the association between choroidal thickness and obesity published until mid-2021 that were indexed in PubMed, Google Scholar, ScienceDirect, or Scopus.
Collapse
Affiliation(s)
- Farshad Askarizadeh
- Department of Optometry, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Masoud Khorrami-Nejad
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Foroozan Narooie-Noori
- Department of Optometry, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IranNoor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
16
|
Lu J, Zhou H, Shi Y, Choe J, Shen M, Wang L, Chen K, Zhang Q, Feuer WJ, Gregori G, Rosenfeld PJ, Wang RK. Interocular asymmetry of choroidal thickness and vascularity index measurements in normal eyes assessed by swept-source optical coherence tomography. Quant Imaging Med Surg 2022; 12:781-795. [PMID: 34993118 DOI: 10.21037/qims-21-813] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND To investigate the symmetry of interocular choroidal thickness and vascularity index measurements in normal eyes using swept-source optical coherence tomography (SS-OCT). Cross-sectional and observational study. This study included 244 eyes of 122 normal adults with ages uniformly distributed from 19 to 89 years. METHODS SS-OCT imaging was performed using a scanning pattern of 12×12 mm. Mean choroidal thickness (MCT) and choroidal vascularity index (CVI) measurements in the entire scanning region were obtained using a validated and published automatic method. The correlation and differences (including signed and absolute differences) between bilateral MCT and CVI measurements were analyzed at the following 6 regions: 3 concentric circles centered on the fovea with diameters of 2.5, 5, and 11 mm; the inner rim from 2.5 to 5 mm circle; the outer rim from 5 to 11 mm circle; and the entire 12×12-mm scan region, respectively. Comparison of interocular MCT and CVI measurements. RESULTS MCT measurements in right and left eyes were strongly correlated in all regions [all intraclass correlation (ICC) >0.73], but MCT measurements in right eyes were significantly thicker than in left eyes. CVI measurements in right and left eyes were moderately correlated in all regions (all ICC >0.46), but CVI measurements in right eyes were significantly smaller than that in left eyes in the macular subregions (2.5 mm circle, 5 mm circle, and the inner rim). Neither signed nor absolute interocular differences in MCT were correlated with corresponding CVI interocular differences. CONCLUSIONS Choroidal differences exist between normal fellow eyes in adults in the absence of obvious pathology. This study is useful in assisting clinicians and researchers in distinguishing asymmetric changes that are to be expected in normal eyes versus changes that could be associated with diseases.
Collapse
Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Hao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Yingying Shi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James Choe
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Mengxi Shen
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Liang Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kelly Chen
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - William J Feuer
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovanni Gregori
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Philip J Rosenfeld
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| |
Collapse
|
17
|
Asharari KS, Alali NM, Magliyah MS, Al-Dhibi HA, Almarek FA, AlBalawi HB. Central Serous Chorioretinopathy Following Oral Use of Adulterated Honey Mixed with Tadalafil: A Case Report. Int Med Case Rep J 2021; 14:773-776. [PMID: 34815718 PMCID: PMC8604643 DOI: 10.2147/imcrj.s341722] [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: 09/28/2021] [Accepted: 11/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Central serous chorioretinopathy (CSCR) is an idiopathic condition characterized by serous retinal detachment and/or retinal pigment epithelial (RPE) detachment, the condition associated with a fluid leak through the RPE into subretinal space. This article reports on an unusual case of CSCR following taking adulterated honey mixed with tadalafil powder. Case Presentation A 38-year-old male, not known to have any medical illnesses, came to our ophthalmology clinic complaining of sudden onset of blurred central vision in the left eye for five days after taking an adulterated honey which was claimed to improve sexual performance. On taking a history, the patient denied taking any medications or past eye trauma or surgery. On detailed ophthalmologic examination, the best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/80 in the left eye. Dilated fundus examination of the right eye showed a flat retina, normal macular reflex, healthy optic nerve head and the left eye showed blunt foveal reflex with neurosensory retinal detachment at the macula and subretinal fluid. Optical coherence tomography (OCT) of the left eye showed marked macular thickening, leading to the impression of central serous chorioretinopathy (CSCR). Four weeks after stopping the adulterated honey, BCVA improved to 20/20 in the left eye, with complete resolution of subretinal fluids. Conclusion Our case adds to recently reported cases of a link between tadalafil and CSCR.
Collapse
Affiliation(s)
- Khalid S Asharari
- Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia
| | - Naif M Alali
- Ophthalmology Division, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Moustafa S Magliyah
- Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia
| | - Hassan A Al-Dhibi
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Faisal A Almarek
- Department of Ophthalmology, College of Medicine, Imam Mohammad bin Saud Islamic University, Riyadh, Saudi Arabia
| | - Hani B AlBalawi
- Ophthalmology Division, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| |
Collapse
|
18
|
Alteration in choroidal microvasculature determined by optical coherence tomography angiography in patients with acromegaly. Photodiagnosis Photodyn Ther 2021; 36:102590. [PMID: 34673271 DOI: 10.1016/j.pdpdt.2021.102590] [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: 04/17/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 11/21/2022]
Abstract
AIM We aimed to investigate the retinal layers and macular capillary structure using optical coherence tomography angiography (OCTA) with acromegaly patients and determine the relationship between OCTA parameters and disease duration, Growth hormone (GH) and Insuline growth factor (IGF - 1) levels. PATIENTS AND METHOD Twenty-two patients with acromegaly who were followed up in the endocrinology outpatient clinic of Sisli Hamidiye Etfal Health Training and Research Hospital, were recruited into the study. Healthy control group was consisted of 22 age and gender matched subjects. Complete opthalmological examination including best visual acuity (BCVA), axial lenght, intraocular pressure (IOP) measurement, anterior segment and fundus examination, central corneal thickness with pachymetry and OCTA measurement were performed in the patients and healthy control group. Foveal avascular zone (FAZ), foveal vascular density (FVD), parafoveal vascular density (PFVD), choroidal flow (CF), foveal thickness (FT) and choroidal thickness (CT) were compared beetwen groups. Correlation between disease duration, GH and IGF-1 levels and OCTA parameters were evaluated. RESULTS There was no statistically significant difference between the groups in terms of BCVA, axial length, IOP, FT, FAZ, FD and PFVD. Choroidal thickness and CF was significantly high in the patients group compared to healthy controls (respectively, p = 0.003, p = 0.022). The mean follow-up period in patients with acromegaly was 90±50.2 months. There was a significant correlation between GH and subfoveal choroidal thickness in the patient group (p < 0.001, r = 0.52), a significant correlation was determined between disease duration and corneal thickness (p = 0.01, r = 0.41). In addition, an inverse correlation was detected between the IGF-1 level and the FAZ domain (p = 0.022, r= -0.34). CONCLUSION In patients with acromegaly, choroidal vasculature seems to be more affected than the retinal vasculature.
Collapse
|
19
|
Uslu H, Altinel MG. Comparison of the choroidal structural components and choroidal vascularity index between patients with obstructive sleep apnea syndrome and healthy controls. Photodiagnosis Photodyn Ther 2021; 36:102570. [PMID: 34619384 DOI: 10.1016/j.pdpdt.2021.102570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/11/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
AIM To compare the choroidal structural components and choroidal vascularity index (CVI) between patients with obstructive sleep apnea syndrome (OSAS) and healthy controls. METHODS The choroidal images of the eyes of patients with OSAS and healthy controls, which were obtained by using enhanced depth imaging optical coherence tomography (EDI-OCT), were binarized into luminal area (LA) and stromal area (SA) using the ImageJ software. CVI was calculated as the ratio of LA to the total choroid area (TCA). The CVI, LA, SA, and TCA measurements were compared between the groups. RESULTS Seventy-one eyes of 57 patients, 33 eyes of 27 patients with OSAS and 38 eyes of 30 healthy individuals, were included. The mean age of all patients was 46.77±9.75 (range, 30-67) years. There was no statistically significant difference for age, sex, axial length (AL) or the side of the eyes between the groups (p>0.05). The mean body mass index (BMI) of the patients was significantly higher in the OSAS group (p<0.05). The mean CVI value was 68.33±1.81% in the OSAS group and 69.21±1.27% in the control group (p<0.05). There was no statistically significant difference for the mean values of LA, SA, and TCA between the groups (p>0.05). No significant correlation was found between the polysomnography test results and the choroidal measurements (p>0.05). CONCLUSION In our study, CVI was found to be lower in patients with OSAS than in the healthy controls. Further studies with larger sample sizes are required to evaluate the role of CVI in OSAS.
Collapse
Affiliation(s)
- Hasim Uslu
- Hisar Intercontinental Hospital, Department of Ophthalmology, 34768 Istanbul, Turkey.
| | - Meltem Guzin Altinel
- Saglik Bilimleri University Fatih Sultan Mehmet Training and Research Hospital, Department of Ophthalmology, 34752 Istanbul, Turkey.
| |
Collapse
|
20
|
Arora S, Surakiatchanukul T, Arora T, Cagini C, Lupidi M, Chhablani J. Sildenafil in ophthalmology: An update. Surv Ophthalmol 2021; 67:463-487. [PMID: 34175342 DOI: 10.1016/j.survophthal.2021.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/14/2022]
Abstract
Sildenafil citrate, a selective oral phosphodiesterase 5 inhibitor, is a widely used drug for erectile dysfunction that acts by elevating cGMP levels and causing smooth muscle relaxation. It also has 10% activity against PDE6, a key enzyme in phototransduction cascade in the retina. Recent ocular imaging developments have further revealed the influence of sildenafil on ocular hemodynamics, particularly choroidal perfusion. Choroidal thickness is increased, and choroidal perfusion is also enhanced by autoregulatory mechanisms that are further dependent on age and microvascular abnormalities. Studies demonstrating high intraocular pressure via a "parallel pathway" from increased choroidal volume and blood flow to the ciliary body have challenged previous concepts. Another new observation is the effect of sildenafil on bipolar cells and cyclic-nucleotide gated channels. We discuss potential deleterious effects (central serous chorioretinopathy, glaucoma, ischemic optic neuropathy, and risks to recessive carriers of retinitis pigmentosa), potential beneficial effects (ameliorate choroidal ischemia, prevent thickening of Bruch membrane, and promote recovery of the ellipsoid zone) in macular degeneration, as well as potential drug interactions of sildenafil.
Collapse
Affiliation(s)
- Supriya Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau NP, Bahamas.
| | - Thamolwan Surakiatchanukul
- Department of Ophthalmology, Jamaica Hospital Medical Center, New York Medical College, Jamaica, NY, USA
| | - Tarun Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau NP, Bahamas.
| | - Carlo Cagini
- Department of Biochemical and Surgical Sciences, Section of ophthalmology, University of Perugia, Perugia, Italy
| | - Marco Lupidi
- Department of Biochemical and Surgical Sciences, Section of ophthalmology, University of Perugia, Perugia, Italy
| | - Jay Chhablani
- University of Pittsburgh, UPMC Eye Center, Pittsburgh, PA, USA.
| |
Collapse
|
21
|
Sabaner MC, Dogan M, Akdogan M, Karadag S, Onur IU, Tasci Aİ, Yigit FU. Evaluation of Retinal and Choroidal Microcirculation Alterations After a Single Dose of Oral 5-mg Tadalafil: A Prospective Pilot Optical Coherence Tomography Angiography Study. J Ocul Pharmacol Ther 2021; 37:421-429. [PMID: 34143665 DOI: 10.1089/jop.2020.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: To evaluate the effects of a single dose of oral 5-mg tadalafil on macular microcirculation as measured using optical coherence tomography (OCT) and angiography (OCTA) in healthy volunteers. Methods: Twenty-two healthy, middle-aged, sexually active, and male health care worker volunteers were included in this prospective study. All volunteers have a history of occasionally using off-label 5 mg tadalafil to enhance sexual performance. Superficial and deep capillary plexus vascular densities, foveal avascular zone parameters, outer retina, and choriocapillaris flow areas were performed using the OCTA, and subfoveal-choroidal thickness (CT) was performed by using the OCT. Measurements were performed preintake, 30 min, 1, 4, 24 h, 2, 3, 4, and 7 days after the intake of tadalafil off-label. Results: Twenty-two eyes of 22 male volunteers were included in the study. The mean age was 37.16 ± 4.52 years. At 30 min, 1 h, and 4 h after intake, a statistically significant increase was observed in the choriocapillaris flow area and CT compared with preintake (Friedman test, P = 0.034 and P < 0.001, respectively). Conclusion: This study showed that a single dose of oral 5-mg tadalafil causes an increase in choriocapillaris flow and CT. To evaluate the effects of tadalafil on the retina and choroid, an OCTA assessment may be helpful.
Collapse
Affiliation(s)
| | - Mustafa Dogan
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Muberra Akdogan
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Serdar Karadag
- Department of Urology, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ismail Umut Onur
- Department of Ophthalmology, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ali İhsan Tasci
- Department of Urology, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Fadime Ulviye Yigit
- Department of Ophthalmology, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
22
|
Capece M, Montorio D, Comune C, Aveta A, Melchionna A, Celentano G, Imbimbo C, Crocetto F, Califano G, Cennamo G. Retinal and Optic Disc Vascular Changes in Patients Using Long-Term Tadalafil: A Prospective Non-Randomized Matched-Pair Study. Diagnostics (Basel) 2021; 11:802. [PMID: 33925202 PMCID: PMC8146942 DOI: 10.3390/diagnostics11050802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/02/2022] Open
Abstract
Retinal, choroidal and optic disc vascularity has never been evaluated in patients taking PDE5is long-term. The aim of our study was to evaluate the neurostructural and vascular changes after long-term use of tadalafil, using spectral domain (SD)-optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In the present clinical trial, 27 patients who have been taking tadalafil 20 mg on alternate days (OAD) for at least 6 months (Group A) were enrolled. The matched group consisted of 27 healthy men (Group B). Both groups of patients underwent SD-OCT to study ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) and choroidal thickness and OCTA for the evaluation of superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and radial peripapillary capillary (RPC). A reduction in SCP, DCP and RPC vessel density was found in patients using tadalafil long-term. Retinal and optic disc toxicity may be detected using modifications of capillary vessel density. Further studies are needed to investigate the possibility of a causal association.
Collapse
Affiliation(s)
- Marco Capece
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Daniela Montorio
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Chiara Comune
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Achille Aveta
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Alberto Melchionna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Gilda Cennamo
- Eye Clinic, Public Health Department, University of Naples “Federico II”, 80131 Naples, Italy
| |
Collapse
|
23
|
Gu S, Li Z, Zhang Y, Liu Y, Zeng P, Zeng R, Wang W, Xiao J. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS OF MICROVASCULAR AND NEURAL CHANGES IN PRIMARY PULMONARY HYPERTENSION. Retina 2021; 41:784-792. [PMID: 32773605 PMCID: PMC7989611 DOI: 10.1097/iae.0000000000002940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate the microvascular and neural changes in primary pulmonary hypertension (PPH) patients compared with healthy controls. METHODS Forty-four eyes of 22 PPH patients were included in this observational clinical cohort study, and 44 eyes of 22 healthy participants were enrolled as controls. Optical coherence tomography angiography images were obtained from each participant using the RTVue XR Avanti device with AngioVue software 2.0. RESULTS Regarding the total macular-associated vessel density, including that of the superficial and deep retina, the optic disk-associated capillary density, including that of the whole image, capillary density inside the disk, and the peripapillary region, was significantly lower in the PPH group than in the control group. There was a similar trend in the retinal nerve fiber layer thickness and the ganglion cell complex thickness, whereas the focal loss volume and the global loss volume were greater in the PPH group than the control group. CONCLUSION Changes in the capillary density and thickness of the retina and the optic nerve head in PPH patients can be detected by optical coherence tomography angiography. Parameters including the macular-associated vessel density, optic disk-associated capillary density, retinal nerve fiber layer, ganglion cell complex, focal loss volume, and global loss volume may provide useful evidence for the early detection of microvascular and neural impairments in patients with PPH.
Collapse
Affiliation(s)
- Simin Gu
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Zijing Li
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Yichi Zhang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Yingmei Liu
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Peng Zeng
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Rui Zeng
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Wenhui Wang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Jianhui Xiao
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China; and
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| |
Collapse
|
24
|
Coleman DJ, Lee W, Daly S, Breazzano MP, Sparrow J, Tsang SH. Central serous chorioretinopathy treatment with a systemic PDE5 and PDE6 inhibitor (sildenafil). Am J Ophthalmol Case Rep 2020; 21:100998. [PMID: 33364520 PMCID: PMC7750488 DOI: 10.1016/j.ajoc.2020.100998] [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: 10/16/2019] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Examine the use of systemic phosphodiesterase inhibition (sildenafil) to clear central serous chorioretinopathy (CSCR). Observations In a long-standing CSCR patient, sildenafil produced a rapid resolution. When discontinued (dechallenge) the CSCR returned. When rechallenged, the CSCR again rapidly disappeared and did not recur in 5 months of continued therapy. Conclusions AND IMPORTANCE: Systemic sildenafil can cause rapid clearance of CSCR and can augment or replace other treatments.
Collapse
Affiliation(s)
- D Jackson Coleman
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Winston Lee
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Suzanne Daly
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Mark P Breazzano
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Janet Sparrow
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Stephen H Tsang
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA.,Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia Stem Cell Initiative, Departments of Ophthalmology, Pathology & Cell Biology, Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| |
Collapse
|
25
|
Kaye R, Chandra S, Sheth J, Boon CJF, Sivaprasad S, Lotery A. Central serous chorioretinopathy: An update on risk factors, pathophysiology and imaging modalities. Prog Retin Eye Res 2020; 79:100865. [PMID: 32407978 DOI: 10.1016/j.preteyeres.2020.100865] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/02/2020] [Accepted: 04/27/2020] [Indexed: 02/08/2023]
Abstract
Central serous chorioretinopathy (CSC) is a common form of vision loss, typically seen in working-age men. The pathophysiology behind CSC still eludes us, however significant advances have been made in understanding this disease over the last decade using information from genetic and cell-based studies and imaging modalities. This review aims to give an overview of the current pathophysiology hypotheses surrounding CSC in addition to future directions in cellular work from human induced pluripotent stem cell derived choroidal endothelial cells from CSC patients. Furthermore, this review will provide the reader with an update on the clinical aspects of CSC including risk factors, diagnostic challenges and findings from multimodal imaging.
Collapse
Affiliation(s)
- Rebecca Kaye
- Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, SO16 6YD, United Kingdom
| | - Shruti Chandra
- NIHR Moorfields Biomedical Research Centre, 162, City Road, London, EC1V 2PD, United Kingdom
| | - Jay Sheth
- Surya Eye Institute and Research Center, Mumbai, India
| | - Camiel J F Boon
- Leiden University Medical Centre, Department of Ophthalmology, P.O. Box 9600, 2300 RC, Leiden, the Netherlands; Amsterdam University Medical Centers, Department of Ophthalmology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, 162, City Road, London, EC1V 2PD, United Kingdom
| | - Andrew Lotery
- Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, SO16 6YD, United Kingdom.
| |
Collapse
|
26
|
Effects of phosphodiesterase type 5 inhibitors on choroid and ocular vasculature: a literature review. Int J Retina Vitreous 2020; 6:38. [PMID: 32782824 PMCID: PMC7412824 DOI: 10.1186/s40942-020-00241-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
To provide information on the effects of phosphodiesterase type 5 (PDE5) inhibitors on choroidal vessels and central serous chorioretinopathy (CSC) and possible implications for development of exudative age-related macular degeneration (AMD). Two independent investigators conducted a qualitative review of PubMed to identify studies on the choroidal effect of PDE5 inhibitors in June 2019. The search used key words that included PDE5 inhibitors, sildenafil, tadalafil, vardenafil, choroid, choroidal flow, choroidal vessels, choroidal thickness, CSC, AMD or a combination. Only studies which assessed choroidal findings were included. Many ocular diseases are related to changes in choroidal thickness and perfusion. Patients with AMD, who have decreased choroidal perfusion, may manifest more severely diminished choroidal ability to deliver oxygen and other metabolites to the retina, leading to growth of neovascular tissue. As a result of this engorgement of the choroidal vasculature, some patients may have leakage across the retinal pigment epithelium (RPE) and accumulation of subretinal fluid, resulting in CSC. Transient visual symptoms, i.e., changes in color perception and increased light sensitivity, are well-known adverse effects, but there have been rare reports of vision-threatening ocular complications in users of PDE5 inhibitors, such as nonarteritic anterior ischemic optic neuropathy and cilioretinal artery occlusion. The choroid is a vascular tissue analogous in many respects to the corpus cavernosum, and PDE5 inhibitors may increase the choroidal thickness and perfusion. While it is intuitively obvious that thickness of the choroid alone does not guarantee better choriocapillaris oxygenation, it is a reasonable step towards ameliorating ischemia. These drugs have numerous physiologic effects on the choroid related to blood flow, such as clinical consequences in CSC and AMD.
Collapse
|
27
|
Breazzano MP, Coleman DJ, Chen RWS, Chang S, Daly S, Tsang SH. Prospective Impact of Sildenafil on Chronic cEntral Serous Chorioretinopathy: PISCES Trial. Ophthalmol Retina 2020; 4:1119-1123. [PMID: 32525054 DOI: 10.1016/j.oret.2020.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Mark P Breazzano
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York University Langone Health, New York, New York; Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, Northwell Health, New York, New York
| | - D Jackson Coleman
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York.
| | - Royce W S Chen
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York
| | - Stanley Chang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York
| | - Suzanne Daly
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York
| | - Stephen H Tsang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York; Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia Stem Cell Initiative, Department of Pathology & Cell Biology, Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| |
Collapse
|
28
|
SUBFOVEAL CHOROIDAL THICKNESS AND VASCULAR ARCHITECTURE IN FELLOW EYES OF PATIENTS WITH CIRCUMSCRIBED CHOROIDAL HEMANGIOMA. Retina 2020; 40:758-764. [DOI: 10.1097/iae.0000000000002438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
[Chorioretinal folds of interesting etiology]. Ophthalmologe 2020; 117:1234-1238. [PMID: 32108250 DOI: 10.1007/s00347-020-01057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
30
|
Akca Bayar S, Kayaarası Öztürker Z, Pınarcı EY, Ercan ZE, Akay HT, Yılmaz G. Structural Analysis of the Retina and Choroid before and after Carotid Artery Surgery. Curr Eye Res 2019; 45:496-503. [PMID: 31507205 DOI: 10.1080/02713683.2019.1666994] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate retinal and choroidal changes in patients with internal carotid artery stenosis who had undergone carotid artery stenting or endarterectomy.Methods: The study included 43 patients with internal carotid artery (ICA) stenosis that required stenting or endarterectomy and 40 healthy controls. Patients were divided into two groups according to the degree of stenosis evaluated by magnetic resonance angiography. Group 1 consisted of patients having ICA stenosis of 50 to 70%, and Group 2 has more than 70%. Enhanced depth imaging optical coherence tomography (EDI-OCT) was used to measure the retinal thickness (RT) and choroidal thickness (CT) in all subjects before surgery and at 1, 3, and 6 months after surgery.Results: Subfoveal and parafoveal CT were significantly lower in patients with ICA stenosis than the control group (p < .05, respectively). Patients with 50-70% stenosis had a significant increase in the CT at 1, 3, and 6 months after ICA stenting or endarterectomy (p < .05). Patients with >%70 stenosis did not have a significant increase in the CT at any time after ICA stenting or endarterectomy. Retinal thickness was not statistically different between the patients with ICA stenosis and the control subjects, and RT showed no significant change in patients with ICA stenosis before and after the surgery.Conclusion: Choroidal thickness was significantly thinner in patients with internal carotid artery stenosis. ICA stenting provided a recovery in the choroidal thickness in patients with moderate to advanced stenosis.
Collapse
Affiliation(s)
- Sezin Akca Bayar
- Faculty of Medicine, Ophthalmology, Baskent University, Ankara, Turkey
| | | | | | | | - Hakkı Tankut Akay
- Faculty of Medicine, Cardiovascular Surgery, Baskent University, Ankara, Turkey
| | - Gürsel Yılmaz
- Faculty of Medicine, Ophthalmology, Baskent University, Ankara, Turkey
| |
Collapse
|
31
|
Sohn EH, Flamme-Wiese MJ, Whitmore SS, Workalemahu G, Marneros AG, Boese EA, Kwon YH, Wang K, Abramoff MD, Tucker BA, Stone EM, Mullins RF. Choriocapillaris Degeneration in Geographic Atrophy. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 189:1473-1480. [PMID: 31051169 DOI: 10.1016/j.ajpath.2019.04.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/22/2019] [Accepted: 04/01/2019] [Indexed: 12/01/2022]
Abstract
Early age-related macular degeneration (AMD) is characterized by degeneration of the choriocapillaris, the vascular supply of retinal photoreceptor cells. We assessed vascular loss during disease progression in the choriocapillaris and larger vessels in the deeper choroid. Human donor maculae from controls (n = 99), early AMD (n = 35), or clinically diagnosed with geographic atrophy (GA; n = 9, collected from outside the zone of retinal pigment epithelium degeneration) were evaluated using Ulex europaeus agglutinin-I labeling to discriminate between vessels with intact endothelial cells and ghost vessels. Morphometric analyses of choriocapillaris density (cross-sectional area of capillary lumens divided by length) and of vascular lumen/stroma ratio in the outer choroid were performed. Choriocapillaris loss was observed in early AMD (Bonferroni-corrected P = 0.024) with greater loss in GA (Bonferroni-corrected P < 10-9), even in areas of intact retinal pigment epithelium. In contrast, changes in lumen/stroma ratio in the outer choroid were not found to differ between controls and AMD or GA eyes (P > 0.05), suggesting choriocapillaris changes are more prevalent in AMD than those in the outer choroid. In addition, vascular endothelial growth factor-A levels were negatively correlated with choriocapillaris vascular density. These findings support the concept that choroidal vascular degeneration, predominantly in the microvasculature, contributes to dry AMD progression. Addressing capillary loss in AMD remains an important translational target.
Collapse
Affiliation(s)
- Elliott H Sohn
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Miles J Flamme-Wiese
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - S Scott Whitmore
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Grefachew Workalemahu
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Alexander G Marneros
- Cutaneous Biology Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Erin A Boese
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Young H Kwon
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Kai Wang
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | - Michael D Abramoff
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa; Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa; Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa
| | - Budd A Tucker
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Edwin M Stone
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
| | - Robert F Mullins
- Institute for Vision Research, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa.
| |
Collapse
|
32
|
Vascular Response to Sildenafil Citrate in Aging and Age-Related Macular Degeneration. Sci Rep 2019; 9:5049. [PMID: 30911094 PMCID: PMC6434029 DOI: 10.1038/s41598-019-41509-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/11/2019] [Indexed: 01/21/2023] Open
Abstract
Age-related macular degeneration (AMD) - the leading cause of vision loss in the elderly - share many risks factors as atherosclerosis, which exhibits loss of vascular compliance resulting from aging and oxidative stress. Here, we attempt to explore choroidal and retinal vascular compliance in patients with AMD by evaluating dynamic vascular changes using live ocular imaging following treatment with oral sildenafil citrate, a phosphodiesterase type 5 (PDE5) inhibitor and potent vasodilator. Enhanced-depth imaging optical coherence tomography (EDI-OCT) and OCT angiography (OCT-A) were performed on 46 eyes of 23 subjects, including 15 patients with non-exudative AMD in one eye and exudative AMD in the fellow eye, and 8 age-matched control subjects. Choroidal thickness, choroidal vascularity, and retinal vessel density were measured across the central macula at 1 and 3 hours after a 100 mg oral dose of sildenafil citrate. Baseline choroidal thickness was 172.1 ± 60.0 μm in non-exudative AMD eyes, 196.4 ± 89.8 μm in exudative AMD eyes, and 207.4 ± 77.7 μm in control eyes, with no difference between the 3 groups (P = 0.116). After sildenafil, choroidal thickness increased by 6.0% to 9.0% at 1 and 3 hours in all groups (P = 0.001-0.014). Eyes from older subjects were associated with choroidal thinning at baseline (P = 0.005) and showed less choroidal expansion at 1 hour and 3 hours after sildenafil (P = 0.001) regardless of AMD status (P = 0.666). The choroidal thickening appeared to be primarily attributed to expansion of the stroma rather than luminal component. Retinal vascular density remained unchanged after sildenafil in all 3 groups (P = 0.281-0.587). Together, our studies suggest that vascular response of the choroid to sildenafil decreases with age, but is not affected by the presence of non-exudative or exudative AMD, providing insight into changes in vessel compliance in aging and AMD.
Collapse
|
33
|
Uyar E, Dogan U, Ulas F, Celebi S. Effect of Fasting on Choroidal Thickness and Its Diurnal Variation. Curr Eye Res 2019; 44:695-700. [DOI: 10.1080/02713683.2019.1584677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Enes Uyar
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Umit Dogan
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Fatih Ulas
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Serdal Celebi
- Department of Ophthalmology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| |
Collapse
|
34
|
Kim YK, Lee JH, Park SP, Yang DY. Choroidal Thickness Analysis in Patients with Erectile Dysfunction. World J Mens Health 2019; 37:85-92. [PMID: 30584992 PMCID: PMC6305867 DOI: 10.5534/wjmh.180038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/31/2018] [Accepted: 08/07/2018] [Indexed: 01/01/2023] Open
Abstract
Purpose To investigate the morphological features of choroidal vasculature in patients with erectile dysfunction (ED) by analyzing choroidal thickness using optical coherence tomography. Materials and Methods We enrolled 39 patients with ED and 19 controls. ED was defined as an erectile function domain score <26 on the International Index of Erectile Function (IIEF) questionnaire. Small-choroidal-vessel-layer (SCVL) thickness was calculated by subtracting large-choroidal-vessel-layer (which corresponded to Haller's layer) thickness from total choroidal thickness. Choroidal thickness was compared between the ED and control groups. Results SCVL thickness was lesser in the ED group than in the control group (control, 69.8±24.3 µm vs. ED, 55.1±19.9 µm; p=0.017). Among patients without diabetes, the ED group showed significantly lesser SCVL thickness than did the control group (control, 77.1±22.7 µm vs. ED, 56.5±20.9 µm; p=0.021). However, among patients with diabetes, choroidal thickness showed no significant intergroup difference. Multiple linear regression analysis revealed that spherical equivalent (standardized coefficient β=0.294; p=0.019) and the IIEF erectile function score (standardized coefficient β=0.315; p=0.012) were significantly associated with SCVL thickness. Conclusions SCVL thickness, including the choriocapillaris layer and medium-sized choroidal vascular layer, decreased in
proportion to ED severity, suggesting that microvascular changes in choroidal vessels may occur before specific ocular diseases
in patients with ED.
Collapse
Affiliation(s)
- Yong Kyu Kim
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jang Hoon Lee
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sung Pyo Park
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
| | - Dae Yul Yang
- Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
| |
Collapse
|
35
|
Read SA, Fuss JA, Vincent SJ, Collins MJ, Alonso-Caneiro D. Choroidal changes in human myopia: insights from optical coherence tomography imaging. Clin Exp Optom 2018; 102:270-285. [PMID: 30565333 DOI: 10.1111/cxo.12862] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/23/2018] [Accepted: 11/12/2018] [Indexed: 01/05/2023] Open
Abstract
The choroid is a vascular tissue which plays a range of critical roles in the normal physiology of the eye, such as supplying the outer retina with oxygen and nutrients and the regulation of intraocular pressure. There is also substantial evidence, particularly from animal studies, that the choroid plays an important role in the regulation of eye growth and the development of common refractive errors like myopia. In recent years, advances in optical coherence tomography technology have improved our ability to image and measure the choroid in the human eye. Research using this technology over the past decade has dramatically improved our knowledge of the normal choroid, and its potential role in the regulation of eye growth and refractive error development. This review aims to provide an overview of recent work examining the normal human choroid, its changes with myopia and the possible role of the choroid in the mechanism regulating eye growth. Studies have demonstrated that choroidal thinning accompanies the development and progression of myopia, and have established a close link between eye growth and choroidal thickness changes. Dramatic thinning of the choroid is seen with high myopia, and associations are also observed between choroidal thinning and reduced vision, and the development of retinal pathology associated with high myopia. In the short-term, environmental factors known to be associated with myopia development and more rapid eye growth typically lead to a thinning of the choroid, whereas factors linked to a slowing of eye growth are typically associated with short-term choroidal thickening. Collectively, these findings suggest that the choroid is an important biomarker of eye growth in the human eye, and additional research to better understand the human choroid is likely to further our knowledge of the signals and pathways regulating eye growth, myopia development and progression.
Collapse
Affiliation(s)
- Scott A Read
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - James A Fuss
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
36
|
Ishida M, Wakakuri T, Imamura Y. Correlation between choroidal thickness and intraocular pressure after 23-gauge vitrectomy for idiopathic epiretinal membrane. Int J Ophthalmol 2018; 11:1774-1778. [PMID: 30450307 DOI: 10.18240/ijo.2018.11.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 04/13/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the relationship between the subfoveal choroidal thickness (CT) and intraocular pressure (IOP) following idiopathic epiretinal membrane (ERM) surgery. METHODS Retrospective observational case series of patients who had undergone 23-gauge vitrectomy for an ERM. The measurements of CT and IOP were done at the baseline and 1d, 1wk, 1, 3, 6, and 12mo after the surgery. RESULTS Forty-four eyes of 43 patients with a mean age of 69.8±9.5y were studied. The CT was 200.8±86.3 µm at the baseline, 210.1±83.5 µm at 1d, 213.2±85.4 µm at 1wk, 203.1±84.0 µm at 1mo, 197.5±85.5 µm at 3mo, 197.7±84.0 µm at 6mo, and 191.2±86.8 µm at 12mo after surgery. The CT on day 1 and week 1 after the surgery was significantly thicker than that at the baseline CT (P=0.0023 and P<0.0001). The CT at 12mo after surgery was significantly thinner than the baseline (P=0.0062). The IOP on day 1 and week 1 were significantly lower than the baseline (P<0.0001 and P=0.0042). The IOP at 1, 3, 6, and 12mo after surgery were significantly higher than the baseline IOP (P=0.0087, P=0.0023, P<0.00051, and P<0.0001). The rates of changes in the CT between baseline and day 1 and week 1 were significantly and negatively correlated with the rates of change in the IOP (P<0.0001 and P=0.046). In the group with the IOP change rate of -30% or less at 1d postoperatively, the change rate of CT was -21.1% to 31.2% (9.8%±12.4%) and in the group of -29% or more, it was -8.9% to 28.0% (2.6%±8.9%). The change rate of CT in the group with the IOP change rate of -30% or less was significantly higher than the group of -29% or more (P=0.016). CONCLUSION CT increases soon after the ERM surgery which is probably due to the transient hypotony, showing that IOP may be a significant confounding factor for CT.
Collapse
Affiliation(s)
- Masahiro Ishida
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan
| | - Takashi Wakakuri
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1 Futago, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan
| |
Collapse
|
37
|
Feola AJ, Nelson ES, Myers J, Ethier CR, Samuels BC. The Impact of Choroidal Swelling on Optic Nerve Head Deformation. ACTA ACUST UNITED AC 2018; 59:4172-4181. [DOI: 10.1167/iovs.18-24463] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Andrew J. Feola
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Atlanta, Georgia, United States
| | | | - Jerry Myers
- NASA Glenn Research Center, Cleveland, Ohio, United States
| | - C. Ross Ethier
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
| | - Brian C. Samuels
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| |
Collapse
|
38
|
Coleman DJ, Lee W, Chang S, Silverman RH, Lloyd HO, Daly S, Tsang SH. Treatment of Macular Degeneration with Sildenafil: Results of a Two-Year Trial. Ophthalmologica 2018; 240:45-54. [PMID: 29694963 DOI: 10.1159/000486105] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/05/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate PDE5/6 inhibition with sildenafil to reduce choroidal ischemia and treat age-related macular degeneration. METHODS Sildenafil was prescribed to treat participants with macular degenerations or macular dystrophies measured by spectral-domain optical coherence tomography, color fundus photography, enhanced depth imaging, and best-corrected visual acuity. RESULTS No change in calcified drusen was noted. Vitelliform-type soft drusen were not substantially changed. A participant with Best vitelliform macular dystrophy had a significant improvement in vision as well as in photoreceptor and ellipsoid layers. CONCLUSIONS Our research supports sildenafil as a safe treatment for age-related and vitelliform macular degenerations. Thickened Bruch's membrane reduces the beneficial effect of perfusion increase, but all eyes appear to benefit from PDE6. Notably, maintenance or improvement in the photoreceptor layer may be the most significant result of sildenafil and is consistent with PDE6 inhibition. Thus, sil-denafil treatment of macular degeneration offers significant potential for vision retention and recovery.
Collapse
Affiliation(s)
- D Jackson Coleman
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Winston Lee
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Stanley Chang
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Ronald H Silverman
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Harriet O Lloyd
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Suzanne Daly
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Stephen H Tsang
- Department of Ophthalmology, Columbia University, New York, New York, USA.,Jonas Children's Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, New York, USA.,Department of Pathology and Cell Biology, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| |
Collapse
|
39
|
Sander BP, Collins MJ, Read SA. The interaction between homatropine and optical blur on choroidal thickness. Ophthalmic Physiol Opt 2018; 38:257-265. [DOI: 10.1111/opo.12450] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 03/09/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Beata P. Sander
- Contact Lens and Visual Optics Laboratory; School of Optometry and Vision Science; Queensland University of Technology; Brisbane Australia
| | - Michael J. Collins
- Contact Lens and Visual Optics Laboratory; School of Optometry and Vision Science; Queensland University of Technology; Brisbane Australia
| | - Scott A. Read
- Contact Lens and Visual Optics Laboratory; School of Optometry and Vision Science; Queensland University of Technology; Brisbane Australia
| |
Collapse
|
40
|
Kim SH, Kim HK, Yang JY, Lee SC, Kim SS. Visual Recovery after Macular Hole Surgery and Related Prognostic Factors. KOREAN JOURNAL OF OPHTHALMOLOGY 2018; 32:140-146. [PMID: 29611371 PMCID: PMC5906399 DOI: 10.3341/kjo.2017.0085] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/04/2017] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To describe the visual recovery and prognostic factors after macular hole surgery. METHODS A retrospective chart review was conducted. Charts of patients with idiopathic macular holes who underwent surgery by a single surgeon at Severance Hospital between January 1, 2013 and July 31, 2015 were reviewed. The best-corrected visual acuity (BCVA) score was recorded preoperatively and at 1 day and 1, 3, 6, 9, and 12 months after surgery. The variables of age, sex, macular hole size, basal hole diameter, choroidal thickness, and axial length were also noted. RESULTS Twenty-six eyes of 26 patients were evaluated. Twenty-five patients (96.2%) showed successful macular hole closure after the primary operation. The BCVA stabilized 6 months postoperatively. A large basal hole diameter (p = 0.006) and thin choroid (p = 0.005) were related to poor visual outcomes. Poor preoperative BCVA (p < 0.001) and a thick choroid (p = 0.020) were associated with greater improvement in BCVA after surgery. CONCLUSIONS Visual acuity stabilized by 6 months after macular hole surgery. Choroidal thickness was a protective factor for final BCVA and visual improvement after the operation.
Collapse
Affiliation(s)
- Soo Han Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hong Kyu Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | | | - Sung Chul Lee
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
41
|
Li YY, Yu YJ, Liu XP, Liu NP. Visual impairment with possible macular changes after a high dose of sildenafil in a healthy young woman. Int J Ophthalmol 2018; 11:340-342. [PMID: 29487830 DOI: 10.18240/ijo.2018.02.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 08/25/2017] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yun-Yun Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ya-Jie Yu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Xi-Pu Liu
- Sekwa Institute of Medicine, Beijing 100035, China
| | - Ning-Pu Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| |
Collapse
|
42
|
VISION LOSS IN A PATIENT WITH PRIMARY PULMONARY HYPERTENSION AND LONG-TERM USE OF SILDENAFIL. Retin Cases Brief Rep 2018; 11:325-328. [PMID: 27355186 DOI: 10.1097/icb.0000000000000355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a case of bilateral, asymmetrical outer macular atrophy in a patient with pulmonary hypertension treated with long-term sildenafil (Revatio). METHODS Case report with fundus photography, spectral domain optical coherence tomography, fundus autofluorescence, and fluorescein angiography imaging. RESULTS A 32-year-old African American woman with a history of primary pulmonary hypertension and 5-year history of oral sildenafil (Revatio) use presented with decreasing central vision in her left eye. She reported a decline in central vision in the left eye that started 1 month after treatment initiation and progressed until discontinuation 5 years later. Visual acuity was 20/20 in the right eye and 20/100 in the left eye. Fundus photography revealed retinal pigment epithelial mottling and atrophy in the right eye and parafoveal retinal pigment epithelial mottling and atrophy in a ring-like configuration of the left eye. Optical coherence tomography demonstrated outer retinal irregularity in the right eye and disrupted outer retina involving the external limiting membrane, inner segment/outer segment junction, and the retinal pigment epithelium in the left eye; no choroidal thickening was observed. Fundus autofluorescence showed mild hypoautofluorescence in the foveal center with an irregular autofluorescence pattern in the parafovea of the left eye. Fluorescein angiography revealed capillary dropout with pinpoint hyperfluorescence and leakage in the far periphery bilaterally. A window defect was also observed in the foveal center of the left eye. CONCLUSION Sildenafil and other PDE5 inhibitors have been associated with several ocular side effects. However, this is the first report in the literature of outer macular atrophy in a patient with pulmonary hypertension and long-term use of oral sildenafil. All patients with long-term use of sildenafil should be educated on the risk of potential visual adverse effects.
Collapse
|
43
|
Lareyre F, Nguyen E, Raffort J, Carboni J, Doyen J, Hassen-Khodja R, Gastaud P, Chofflet J, Jean-Baptiste E. Changes in Ocular Subfoveal Choroidal Thickness After Carotid Endarterectomy Using Enhanced Depth Imaging Optical Coherence Tomography: A Pilot Study. Angiology 2017; 69:574-581. [PMID: 29082746 DOI: 10.1177/0003319717737223] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The influence of both severe chronic carotid stenosis and carotid endarterectomy (CEA) on ocular tissue has been poorly evaluated. The goal of this study was to measure subfoveal choroidal thickness (SFCT), before and after CEA, in patients with severe carotid stenosis. Consecutive patients (n = 36) with severe carotid stenosis were prospectively included. Patients (n = 19) were followed up at 1 and 3 months after CEA. The SFCT was measured bilaterally using enhanced depth imaging optical coherence tomography (EDI-OCT). Preoperatively, the median SFCT of the ipsilateral eye did not differ significantly from the contralateral eye (223 vs 236 µm; P = .75). In the ipsilateral eye, the mean SFCT was significantly higher at 1 month postsurgery and the effect was maintained at 3 months (226.3 ± 17.1 at 3 months vs 210.8 ± 16.5 µm at baseline; P < .001). For the contralateral eye, the increase in SFCT reached statistical significance at 3 months (220.1 ± 11.3 at 3 months vs 214.8 ± 11.5 µm at baseline; P = .04). The mean SFCT significantly increased bilaterally after CEA, with a more noticeable effect in the ipsilateral eye. Further studies are required to determine whether EDI-OCT could be useful as a potential marker of ophthalmologic outcomes.
Collapse
Affiliation(s)
- Fabien Lareyre
- 1 Department of Vascular Surgery, University Hospital of Nice, Nice, France.,2 Université Côte d'Azur, CNRS, Inserm, IRCAN, Nice, France
| | - Elisabeth Nguyen
- 3 Department of Ophthalmologic Surgery, University Hospital of Nice, Nice, France
| | - Juliette Raffort
- 2 Université Côte d'Azur, CNRS, Inserm, IRCAN, Nice, France.,4 Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France
| | - Joseph Carboni
- 1 Department of Vascular Surgery, University Hospital of Nice, Nice, France.,5 Université Côte d'Azur, Nice, France
| | | | - Réda Hassen-Khodja
- 1 Department of Vascular Surgery, University Hospital of Nice, Nice, France.,5 Université Côte d'Azur, Nice, France
| | - Pierre Gastaud
- 3 Department of Ophthalmologic Surgery, University Hospital of Nice, Nice, France
| | - Jacques Chofflet
- 3 Department of Ophthalmologic Surgery, University Hospital of Nice, Nice, France
| | - Elixène Jean-Baptiste
- 1 Department of Vascular Surgery, University Hospital of Nice, Nice, France.,5 Université Côte d'Azur, Nice, France
| |
Collapse
|
44
|
Changes in Retinal and Choroidal Vascular Blood Flow after Oral Sildenafil: An Optical Coherence Tomography Angiography Study. J Ophthalmol 2017; 2017:7174540. [PMID: 29129998 PMCID: PMC5654255 DOI: 10.1155/2017/7174540] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/16/2017] [Accepted: 09/25/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose To describe changes in the retina and choroidal flow by optical coherence tomography angiography (OCT-A) after a single dose of oral sildenafil. Method A case-control study. Patients in the study group received 50 mg of oral sildenafil. Patients in the control group received a sham pill. Retinal and choroidal images were obtained at baseline (before pill ingestion) and 1 hour after ingestion. Central macular and choroidal thickness, choroidal and outer retina flow, and the retinal and choroidal vascular density were compared using a Mann-Whitney U test. Results Twenty eyes were enrolled into the study group and 10 eyes in the control group. There was a significant difference in central choroidal thickness and outer retina blood flow between groups after 1 hour of sildenafil ingestion (p < 0.01). There were no differences in central macular thickness, choroidal flow, and retinal vascular density among groups. Conclusions A single dose of oral sildenafil increases choroidal thickness, probably due to sildenafil-induced vasodilation.
Collapse
|
45
|
CHANGES IN CHOROIDAL THICKNESS IN AND OUTSIDE THE MACULA AFTER HEMODIALYSIS IN PATIENTS WITH END-STAGE RENAL DISEASE. Retina 2017; 37:896-905. [PMID: 27557086 PMCID: PMC5424578 DOI: 10.1097/iae.0000000000001262] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Changes in body weight, serum osmolarity, and blood pressure during hemodialysis may affect choroidal thickness in and outside the macula. Purpose: To evaluate changes in choroidal thickness in and outside the macula as a result of hemodialysis (HD) in patients with end-stage renal disease. Methods: Patients with end-stage renal disease treated with maintenance HD in the Dialysis Unit of Sanggye Paik Hospital, Seoul, South Korea, were included in this study. The choroidal thickness was measured in and outside the macula before and after HD (paired t-test). Choroidal thickness in the macula was measured at the foveal center and 1.5 mm temporal to the foveal center and outside the macula was measured at superior, inferior, and nasal area 3.5 mm from the optic disk margin. Peripapillary retinal nerve fiber layer thickness, intraocular pressure, central corneal thickness, and systemic parameters such as serum osmolarity and blood pressure (BP) were measured before and after HD (paired t-test). We divided patients into two groups, diabetic and nondiabetic groups to compare the changes in choroidal thickness. Patients with diabetes were subdivided into two groups: severe retinal change group and moderate retinal change group (Mann–Whitney test). Pearson's correlation test was used to evaluate the correlations between choroidal thickness and changes in serum osmolarity, BP, and body weight loss. Choroidal thickness and peripapillary retinal nerve fiber layer thickness were measured using spectral-domain optical coherence tomography. Results: Fifty-four eyes of 31 patients with end-stage renal disease were included. After HD, the mean intraocular pressure was significantly decreased from 14.8 ± 2.5 mmHg to 13.0 ± 2.6 mmHg (P < 0.001). Choroidal thickness was reduced in all areas (P < 0.001). The reduction in choroidal thickness correlated with body weight loss, decrease in serum osmolarity, and decrease in systolic BP (P < 0.05). In the diabetic group, the mean choroidal thickness changes were greater than those in the nondiabetic group (P < 0.05). The severe retinal change group showed greater changes in choroidal thickness in all areas (P < 0.05). Other factors that significantly decreased after HD included serum osmolarity, body weight, and systolic BP (all P < 0.001). The diabetic group showed greater changes in serum osmolarity and body weight (P < 0.001, P = 0.048, respectively). The measured overall changes in peripapillary retinal nerve fiber layer thickness or central corneal thickness were not statistically significant. Conclusion: Changes in body weight, serum osmolarity, and BP during HD may affect choroidal thickness in and outside the macula.
Collapse
|
46
|
Abstract
Phosphodiesterase-5 inhibitors (PDE5I) are used for treatment of erectile dysfunction and pulmonary arterial hypertension and have been implicated as a causative factor for development of nonarteritic anterior ischemic optic neuropathy (NAION). Controversy remains regarding a cause and effect between PDE5I use and NAION because the mechanism by which NAION occurs is still not well understood. Because neuro-ophthalmologists have accepted that there is a potential relationship between ingestion of the PDE5I class of medications and NAION, the neuro-ophthalmologist should inquire about PDE5I use when evaluating a patient with a new diagnosis of NAION, and counsel patients regarding the implication of continued use of PDE5I.
Collapse
|
47
|
Chhablani PP, Ambiya V, Nair AG, Bondalapati S, Chhablani J. Retinal Findings on OCT in Systemic Conditions. Semin Ophthalmol 2017. [DOI: 10.1080/08820538.2017.1332233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Preeti Patil Chhablani
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Vikas Ambiya
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Akshay G. Nair
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Jay Chhablani
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| |
Collapse
|
48
|
Bulut M, Kurtuluş F, Gözkaya O, Erol MK, Cengiz A, Akıdan M, Yaman A. Evaluation of optical coherence tomography angiographic findings in Alzheimer's type dementia. Br J Ophthalmol 2017; 102:233-237. [PMID: 28600299 DOI: 10.1136/bjophthalmol-2017-310476] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/26/2017] [Accepted: 05/06/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND/AIMS To identify the retinal vascular pathologies in patients with Alzheimer's type dementia (ATD) through optical coherence tomography angiography (OCTA) imaging. METHODS Our study included 26 patients in the patient group, and age-matched and sex-matched 26 subjects in the control group. A detailed ophthalmological and neurological examination was performed for all subjects included in the study. The retinal, choroidal vascular structures and choroidal thickness (CT) of all subjects were analysed in a detailed way with a commercial spectral domain OCTA. Moreover, all participants underwent detailed neurological examination including Mini Mental State Examination (MMSE) test to evaluate cognitive function. RESULTS In the group of patients with ATD, the MMSE score was significantly lower than that of the control group (p<0.001). The retinal vascular density was significantly lower than that of the control group in all zones (p<0.05). Foveal avascular zone (FAZ) was significantly enlarged compared with the control group (p=0.001). CT was significantly lower in the group of patients with ATD (p<0.001). Outer retinal and choroidal flow rates were lower in the group of patients with ATD, while the difference was not significant (p>0.05). Furthermore, significant correlation was found between the MMSE and all vascular density parameters, CT parameter and FAZ tested with OCTA imaging (p<0.05). CONCLUSIONS In patients with ATD, retinal and choroidal vascular pathologies detected through OCTA imaging can be used as a new biomarker in the early diagnosis of the disease, follow-up of its progression and in investigating the efficacy of the drugs.
Collapse
Affiliation(s)
- Mehmet Bulut
- Department of Ophthalmology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatma Kurtuluş
- Department of Neurology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Onursal Gözkaya
- Department of Ophthalmology, Antalya Private Life Hospital, Antalya, Turkey
| | - Muhammet Kazım Erol
- Department of Ophthalmology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayşe Cengiz
- Department of Ophthalmology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Melih Akıdan
- Department of Ophthalmology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Aylin Yaman
- Department of Neurology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
49
|
Balkarli A, Erol MK, Yalcinkaya S, Erol RS. Frequency of Erectile Dysfunction in Males with Central Serous Chorioretinopathy. Semin Ophthalmol 2017; 33:482-487. [PMID: 28328282 DOI: 10.1080/08820538.2017.1301968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the frequency of sexual dysfunction and associated factors in patients with central serous chorioretinopathy (CSCR). MATERIAL AND METHODS Fifty-eight CSCR patients who met the inclusion criteria and 99 age- and sex-matched healthy controls were prospectively investigated for sexual dysfunction and associated factors. All participants were investigated using the Beck Depression Inventory (BDI), Beck Anxiety Scale (BAS), and the15-question Index of Erectile Function-15 (IIEF-15) and by extensive examination of CSCR, associated factors, and confounding factors. RESULTS The mean ages of the patient and control groups were 46.95±11.27 and 45.3±10.93 years, respectively (p=0.370). The erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall sexual satisfaction scores of the patient group were significantly lower than those of the control group (p<0.001). Severe erectile dysfunction (ED) was diagnosed in 3 (5.2%), moderate ED in 10 (17.2%), mild-to-moderate ED in 7 (12.1%), and mild ED in 15 (25.9%) patients in the patient group, whereas no severe or moderate ED was diagnosed in the control group. The erectile function score was found to be negatively correlated with age and BMI. No sexual parameters were found to be correlated with choroidal thickness (CT) in either the patient or control group. CONCLUSION CSCR patients experience a higher incidence of sexual dysfunction compared to healthy individuals without CSCR. The exclusion of confounding factors suggests that factors involved in CSCR pathogenesis may also play a role in ED.
Collapse
Affiliation(s)
- Ayse Balkarli
- a Department of Internal Medicine, Division of Rheumatology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Muhammet Kazim Erol
- b Department of Ophthalmology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Soner Yalcinkaya
- c Department of Urology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Rumeysa Selvinaz Erol
- d Department of Internal Medicine, Division of Endocrinology , Ordu State Hospital , Ordu , Turkey
| |
Collapse
|
50
|
Fuwa K, Hosono S, Nagano N, Takahashi S, Nakashima M. Retinopathy of prematurity after sildenafil treatment. Pediatr Int 2017; 59:360-361. [PMID: 28317302 DOI: 10.1111/ped.13187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/16/2016] [Accepted: 10/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Kazumasa Fuwa
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Shigeharu Hosono
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Shori Takahashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Motohiro Nakashima
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| |
Collapse
|