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Kal M, Brzdęk M, Karska-Basta I, Rzymski P, Pinna A, Zarębska-Michaluk D. Characteristics of the radial peripapillary capillary network in patients with COVID-19 based on optical coherence tomography angiography: A literature review. Adv Med Sci 2024; 69:312-319. [PMID: 38972386 DOI: 10.1016/j.advms.2024.07.001] [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: 01/03/2024] [Revised: 03/20/2024] [Accepted: 07/05/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE This review aimed to evaluate the significance of assessing radial peripheral capillary (RPC) network parameters by optical coherence tomography angiography (OCTA) in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection confirmed by polymerase chain reaction. METHODS A literature search was conducted in the PubMed database to select high-quality reviews and original articles on the use of OCTA for visualizing the RPC network and calculating RPC parameters. RESULTS The study revealed that systemic hypoxia, hypercoagulable state, and inflammation affect the RPC network in patients with coronavirus disease 2019 (COVID-19). Reduced RPC parameters were observed early in the course of SARS-CoV-2 infection and after several months of follow-up. Additionally, there was a correlation between reduced RPC parameters and subsequent thinning of the retinal nerve fiber layer. CONCLUSIONS The OCTA examination of the retina and optic disc should be considered in patients with a history of COVID-19 to assess the impact of systemic hypoxia and inflammation on ocular function. Follow-up assessment of these patients is also necessary to understand the potential consequences of ischemia affecting the optic nerve, retina, and choroid.
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Affiliation(s)
- Magdalena Kal
- Collegium Medicum of Jan Kochanowski University in Kielce, Kielce, Poland; Ophthalmic Clinic of the Voivodeship Hospital in Kielce, Kielce, Poland
| | - Michał Brzdęk
- Collegium Medicum of Jan Kochanowski University in Kielce, Kielce, Poland.
| | - Izabella Karska-Basta
- Jagiellonian University Medical College, Faculty of Medicine, Department of Ophthalmology, Krakow, Poland; University Hospital, Clinic of Ophthalmology and Ocular Oncology, Krakow, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan' University of Medical Sciences, Poznan, Poland
| | - Antonio Pinna
- Department of Medicine, Surgery, and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Dorota Zarębska-Michaluk
- Collegium Medicum of Jan Kochanowski University in Kielce, Kielce, Poland; Department of Infectious Disease, Provincial Hospital in Kielce, Kielce, Poland
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Viggiano P, Buonamassa R, Grassi MO, Boscia G, Borrelli E, Landini L, Evangelista F, Malerba MG, Alessio G, Boscia F. Immediate effect of anti-VEGF injections on optic nerve head: Correlation between intraocular pressure and anatomical peripapillary changes. Eur J Ophthalmol 2024; 34:1174-1182. [PMID: 37899575 DOI: 10.1177/11206721231210749] [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] [Indexed: 10/31/2023]
Abstract
PURPOSE This study was designed to investigate retinal nerve fiber layer (RNFL) and radial peripapillary capillaries (RPC) changes on optical coherence tomography (OCT) angiography and OCT thickness alterations associated with acutely increased intraocular pressure after intravitreal injections. METHODS This observational clinical study was conducted on 35 eyes (35 patients) with treatment-naïve age-related macular degeneration (AMD) and type 1 or type 2 MNV were enrolled. All patients underwent anti-vascular endothelial grow factor (VEGF) intravitreal injections with 0.05-mL aflibercept (2 mg) between January 2022 and October 2022. Peripapillary OCT angiography perfusion density, retinal nerve fiber layer thickness, and intraocular pressure (IOP) were measured before and immediately after intravitreal injections. In particular, the analysis was performed at the following visits: (T0) 5 to 15 min before the injection of aflibercept; (T1) 2 to 5 min after the injection of aflibercept. Paired t-test was used to compare pre-injection and post-injection values. RESULTS The mean baseline IOP (T0) value was 17.26 ± 2.4 mmHg and the immediate post-injection IOP (T1) mean value was 34.7 ± 11.50 mmHg (P < 0.01). The mean global RNFL thickness before and immediately after the injection was 100.9 ± 18.8 m and 98.6 ± 17.4 m (P = 0.001). Furthermore, the topographical RNFL analysis showed significant thickness reduction of the nasal and inferior sectors after the procedure when compared to T0 (P = 0.046 and P = 0.001). On the contrary, the mean RCP density changes at T1 did not reach statistically significant (P = 0.636). Furthermore, we found a significant negative correlation between the retinal nerve fiber layer global thickness and the IOP changes (Pearson's correlation = -0.126; P = 0.031). In particular, the nasal RNFL region showed a significant negative correlations with IOP values (Pearson's correlation = -0.198, P = 0,046). CONCLUSIONS We reported acute IOP changes that are associated with reduced RNFL thickness in a group of patients undergoing intravitreal injections of anti-VEGF drugs for neovascular age-related macular degeneration. Moreover, topographical sub-analysis revealed that the nasal RNFL region is most prone to IOP fluctuations. This finding may explain the sudden visual acuity change in patients immediately after injection and may sustain injuries to optic nerve head structures producing glaucomatous damage.
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Affiliation(s)
- Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Rosa Buonamassa
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Oliva Grassi
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
| | - Luca Landini
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Federica Evangelista
- Ente Ecclesiastico Ospedale Generale Regionale, "F.Miulli", Acquaviva delle Fonti, Italy
| | - Maria Giovanna Malerba
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Giovanni Alessio
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
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Sener H, Polat OA, Sener ABG. Optic nerve head vessel density in patients with pseudoexfoliation syndrome/glaucoma: a systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 42:103514. [PMID: 36933675 DOI: 10.1016/j.pdpdt.2023.103514] [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: 11/14/2022] [Revised: 02/18/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Exfoliative material has been shown to accumulate in ocular and systemic tissues. We aimed to perform a systematic review and meta-analysis of the current literature evaluating optic nerve head vessel density (VD) using optical coherence tomography angiography (OCTA) in patients with XFS and XFG. METHODS Studies were retrieved from PubMed, Scopus, and Web of Science databases. Studies comparing patients with XFS and/or XFG patients to healthy controls, using the optic nerve head-centred 4.5 × 4.5 mm square OCTA scan protocol were included. Pooled results are presented as standardised mean differences with 95% confidence intervals (CI). Meta-regression analysis was performed between mean difference in circumpapillary VD between XFG and controls and mean pRNFL thickness in patients with XFG. RESULTS Fifteen studies with 1475 eyes were included in this review. Whole image VD and circumpapillary VD (cpVD) were significantly decreased in patients with XFS [-0.78(95% Cl: -1.08, -0.47); [-0.55(95% Cl: -0.80, -0.30); respectively] and XFG [-1.85(95% CI: -2.33, -1.36); -1.84 (95% CI: -2.30, -1.39); respectively] compared to healthy controls. Furthermore, pRNFL thickness decreased in patients with XFS [-0.55(95% Cl: -0.72, -0.35)] and XFG [-1.78(95% Cl: -2.21, -1.36)] compared to healthy controls. Meta-regression showed that pRNFL thickness decreased with increasing mean cpVD difference in XFG patients compared to healthy controls. CONCLUSIONS OCTA provides non-invasive, objective and reproducible assessment of peripapillary VD and is important for the detection of vasculopathy in patients with XFS or XFG. This study provides strong evidence for decreased cpVD in the eyes of patients with XFS and XFG.
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Affiliation(s)
- Hidayet Sener
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey.
| | - Osman Ahmet Polat
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ayse Busra Gunay Sener
- Department of Medical Informatics and Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey
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Chen R, Liu X, Yao M, Zou Z, Chen X, Li Z, Chen X, Su M, Lian H, Lu W, Yang Y, McAlinden C, Wang Q, Chen S, Huang J. Precision (repeatability and reproducibility) of papillary and peripapillary vascular density measurements using optical coherence tomography angiography in children. Front Med (Lausanne) 2023; 10:1037919. [PMID: 37035305 PMCID: PMC10076795 DOI: 10.3389/fmed.2023.1037919] [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: 09/06/2022] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Importance Optical coherence tomography angiography (OCTA) has been widely applied into children, however, few studies have assessed the repeatability and reproducibility of papillary and peripapillary VD in healthy children. Objective To assess the precision of papillary and peripapillary vascular density (VD) measurements using optical coherence tomography angiography (OCTA) and analyze the effects of the signal strength index (SSI) and axial length (AL) on precision estimates. Design setting and participants This was a prospective observational study. Seventy-eight children aged 6-16 years underwent 4.5 × 4.5 mm OCTA (RTVue XR Avanti) disc scans: two scans by one examiner (repeatability) and two additional scans by another examiner (reproducibility). Within-subject standard deviation (Sw), test-retest reproducibility (TRT), within-subject coefficient of variation (CoV), intraclass correlation coefficient (ICC), and Bland-Altman analysis were performed. Main outcomes and measures In repeatability measurement, the fluctuation ranges (minimum to maximum) of VD between intraexaminer A/B in Sw, TRT, CoV, and ICC were (1.05-2.17)% / (1.16-2.32)%, (2.9-6)% / (3.21-6.44)%, (1.9-4.47)% / (2.08-5)%, and (0.588-0.783)% / (0.633-0.803)%, respectively. In reproducibility measurement, the fluctuation ranges of VD in Sw, TRT, CoV, and ICC were 1.11-2.13%, 3.07-5.91%, 1.99-4.41%, and 0.644-0.777%, respectively. VD was negatively correlated with SSI in most sectors of the peripapillary (e.g., inferior nasal, temporal inferior, temporal superior, superior temporal, and superior nasal). AL was positively correlated with inferior temporal VD and negatively correlated with superior nasal VD. Conclusion and relevance Optical coherence tomography angiography showed moderate-to-good repeatability and reproducibility for papillary and peripapillary perfusion measurements in healthy children. The SSI value affects most of the peripapillary VD, while AL affects only the temporal inferior and nasal superior peripapillary VD.
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Affiliation(s)
- Ruru Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinyu Liu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingyu Yao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhilin Zou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinyi Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zheng Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xin Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengjuan Su
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hengli Lian
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weiwei Lu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yizhou Yang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Colm McAlinden
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, United Kingdom
- Department of Ophthalmology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, United Kingdom
| | - Qinmei Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- *Correspondence: Qinmei Wang,
| | - Shihao Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Shihao Chen,
| | - Jinhai Huang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Jinhai Huang,
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Özyol P, Özyol E, Günel-Karadeniz P. Evaluation of vessel density in healthy subjects with family history of glaucoma. Eye (Lond) 2023; 37:82-87. [PMID: 35013608 PMCID: PMC9829665 DOI: 10.1038/s41433-021-01894-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To investigate whether any microvascular changes are present in optic disc, peripapillary or maculary regions in healthy subjects with a family history of glaucoma. METHODS A total of 82 healthy subjects including 42 first-degree relatives of primary open-angle glaucoma (POAG) and 40 controls were enroled in this cross-sectional study. Global and sectoral vessel density (VD) measurements excluding large vessels, retina nerve fibre layer (RNFL) and macula ganglion cell (mGCC) thicknesses were obtained from a combined optical coherence tomography-angiography (OCT-A) and spectral-domain OCT system. Effect size (ES) was used for evaluating the magnitude of the statistically significant difference. Area under receiver operating characteristic curves (AUCs) were used to examine the ability of parameters to differentiate first-degree relatives to controls. RESULTS There was no significant difference in RNFL and mGCC thicknesses between groups. Although lower VD measurements in optic disc, peripapillary region, and macula were observed in the first-degree relatives, statistically significant mean difference (3.13 ± 0.87, p = 0.001) and large ES (0.80) were in only lower nasal sector of peripapillary region. Inter-eye asymmetry of supero-nasal VD was also statistically higher (3.74 ± 2.55 vs 1.89 ± 1.64) with a large ES in the first-degree relatives (p < 0.001, ES = 0.86). AUC for differentiating first-degree relatives from controls was highest for inter-eye asymmetry of supero-nasal sector VD (0.74, p < 0.001), followed by lower nasal sector VD (0.72, p < 0.001). CONCLUSION Compared to controls, first-degree relatives of patients with POAG were found to have significantly greater inter-eye asymmetry in supero-nasal peripapillary VD and less VD in the lower nasal peripapillary region.
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Affiliation(s)
- Pelin Özyol
- Ophthalmology Department, SANKO University Faculty of Medicine, Gaziantep, Turkey.
| | - Erhan Özyol
- Ophthalmology Department, SANKO University Faculty of Medicine, Gaziantep, Turkey
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Mannil SS, Agarwal A, Conner IP, Kumar RS. A comprehensive update on the use of optical coherence tomography angiography in glaucoma. Int Ophthalmol 2022; 43:1785-1802. [PMID: 36472722 DOI: 10.1007/s10792-022-02574-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The primary purpose of this review is to provide a comprehensive summary on the technical principles of OCTA and to enumerate vascular parameters being explicated for glaucoma diagnosis and progression with emphasis on recent studies. In addition, the authors also summarize the future clinical potentials of OCTA in glaucoma and enumerate the limitations of this imaging modality in the present-day scenario. METHODS The index study is a narrative review on OCTA in glaucoma. The authors searched the PubMed database using the key phrases ''optical coherence tomography angiography" AND "glaucoma,'' AND/OR "vascular parameters" AND/OR "ocular perfusion." Being a relatively recent development in ocular imaging, studies in which OCTA imaging had been used for glaucoma evaluation since 2012 were included until March 2022. The literature search included original studies and previous review articles, while case reports were excluded. Preliminary search was based on relevant articles with search keywords in the title and abstract. The second screening was performed by reading the full text of the literature. RESULTS Recent studies indicate reduction in microcirculation in glaucomatous eyes compared to the normal subjects. The area of interest for glaucoma evaluation using OCTA varies among the different studies. Based on the literature reviewed here, (1) OCTA parameters measured in the peripapillary; ONH and macular area have been shown to differentiate between glaucoma and normal eyes with a discriminatory power comparable to OCT parameters used routinely in clinics, (2) monitoring of peripapillary and macular vessel density may provide important information to the evaluation of glaucoma progression and prediction of rates of disease worsening, (3) studies suggest strong correlation between the OCTA parameters, the OCT parameters and visual function, measured by visual field testing, in glaucomatous eyes, (4) future prospects of OCTA in glaucoma evaluations using AI predicting structural and functional features and prognosis based on early vascular findings would open up scope for early detection of high-risk suspects and fast progressors in glaucoma. CONCLUSION OCTA can be useful in quantifying vascular parameters in the optic disc, peripapillary and the macular regions for glaucoma evaluation. OCTA shows potential to become a part of everyday glaucoma management.
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Affiliation(s)
- Suria S Mannil
- Byers Eye Institute, Stanford University, Palo Alto, USA
| | - Aniruddha Agarwal
- Cleveland Clinic Abu Dhabi, The Eye Institute, Al Maryah Island, 112412, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western, Reserve University, Cleveland, OH, USA
| | - Ian P Conner
- Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Rajesh S Kumar
- Cleveland Clinic Abu Dhabi, The Eye Institute, Al Maryah Island, 112412, Abu Dhabi, United Arab Emirates.
- Cleveland Clinic Lerner College of Medicine, Case Western, Reserve University, Cleveland, OH, USA.
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Glaucoma Detection in Myopic Eyes: Structural and Vascular Assessment by Optic Coherence Tomography Methods. J Glaucoma 2022; 31:947-954. [PMID: 36223326 DOI: 10.1097/ijg.0000000000002121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/22/2022] [Indexed: 11/07/2022]
Abstract
PRCIS Retinal nerve fiber layer (RNFL) thickness is helpful in the diagnosis of glaucoma in myopic eyes but neuroretinal rim (NRR) thickness is the most valuable measure. However, changes in optical coherence tomography angiography (OCT-A) parameters are insufficient for the diagnosis of mild to moderate glaucoma in myopia. PURPOSE To detect how a multimodal evaluation, which includes RNFL, NRR thickness, and optic nerve head (ONH) OCT-A, affects glaucoma diagnosis in myopic patients. MATERIALS AND METHODS Parameters of healthy myopic and myopic glaucoma eyes with an axial length of ≥24 mm were compared. The ONH structural features and peripapillary RNFL thickness were determined with Cirrus 5000 HD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA). The Cirrus 5000 HD-OCT with AngioPlex was utilized to perform OCT-A imaging. The sensitivity and specificity levels were calculated by the best cut-off values with area under curve (AUC). RESULTS One hundred healthy myopic and 54 myopic glaucoma eyes were evaluated. In all areas, myopic glaucoma patients exhibited lower RNFL and NRR thickness than healthy myopic individuals ( P <0.05), with the exception of nasal quadrant RNFL thickness ( P =0.152). The mean entire and 4 quadrants of global radial peripapillary capillary (RPC)-perfusion and global RPC flux index (FI) were significantly lower in the group of myopic glaucoma patients except for the nasal quadrant mean RPC perfusion ( P =0.224). The average RNFL and NRR thickness had a significant difference in AUC for the diagnosis of glaucoma in myopic individuals ( P =0.001, for each). The average NRR showed excellent diagnostic performance, whereas the average RNFL showed good diagnostic performance. Average RPC perfusion and average RPC FI showed poor diagnostic ability. The average NRR AUC was more significant than average RPC perfusion and average RPC FI AUC ( P <0.001). CONCLUSIONS Although RNFL thickness was helpful to diagnose glaucoma in patients with myopia, the diagnostic power of NRR thickness performed best. OCT-A parameters showed poor diagnostic accuracy for glaucoma and the observed perfusion decrease in myopic glaucoma eyes was not sufficiently discriminative compared with NRR and RNFL thickness measurements.
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Salari F, Hatami V, Mohebbi M, Ghassemi F. Assessment of relationship between retinal perfusion and retina thickness in healthy children and adolescents. PLoS One 2022; 17:e0273001. [PMID: 35951598 PMCID: PMC9371266 DOI: 10.1371/journal.pone.0273001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/30/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine the correlations between inner, mid, and outer retinal thickness (RT) and allied retinal and choroidal vascular densities (VD) at macula in normal healthy children and adolescents. Methods This cross-sectional study included a total of 108 eyes of 59 subjects. Optical coherence tomography angiography (OCTA-Optovue) was used to measure the thickness of the inner-retina (IRT), mid-retina (MRT), and outer-retina (ORT) at foveal (central 1mm), parafoveal (1–3 mm), and perifoveal (3–6 mm) areas, as well as the corresponding VD of the superficial capillary plexus (SVD), deep capillary plexus (DVD), and choricapillaris (CVD). Results The study enrolled 108 normal eyes from 54 participants with a mean age of 10.9 years. Partial correlations showed that the nasal and inferior parafoveal and perifoveal subsegments IRT, MRT and ORT are more affected by all SVD, DVD, and CVD. Nasal parafoveal and perifoveal MRT and all three capillary layers have a constant negative correlation. ORT was not affected by all three layers except for CVD at fovea. The regression analysis revealed that SVD and CVD were significantly associated with foveal and parafoveal and perifoveal IRT. DVD and gender could significantly affect perifoveal IRT. However, only CVD was significantly affected foveal MRT. Based on regression analysis, only CVD was significantly associated with foveal and parafoveal ORT, but not with perifoveal ORT. Conclusion The thickness of different retinal layers correlates with retinal and choroidal VD in different ways according to their zones.
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Affiliation(s)
- Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Hatami
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mohebbi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Cornea Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Ghassemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Retina & Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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Düzova E, Demirok G, Üney G, Kaderli A, Yakın M, Özbek-Uzman S, Ekşioğlu Ü. Optical Coherence Tomography Angiography Findings in Primary Open- Angle and Pseudoexfoliation Glaucoma. Turk J Ophthalmol 2022; 52:252-261. [PMID: 36017118 PMCID: PMC9421929 DOI: 10.4274/tjo.galenos.2021.72654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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The use of optical coherence tomography angiography in patients with chiasmal compression (literature review). OPHTHALMOLOGY JOURNAL 2022. [DOI: 10.17816/ov105176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Optical coherence tomography (OCT) is currently the leading method for the observation and evaluation of microstructural changes in the retina in vivo. In recent years, OCT has been used in clinical practice to monitor the progression of compressive optic neuropathy in patients with chiasmal-sellar region neoplasms. The results obtained in the course of the studies opened up new opportunities for studying the pathogenesis of the development of compressive optic neuropathy in patients of this group. The advent of OCT-angiography (OCTA), developed on the basis of OCT, made it possible to study changes in the blood flow of the radial peripapillary capillary network, superficial and deep capillary plexuses, which opens up many opportunities for further research into the pathogenesis of visual impairment in this group of patients, prognosis of the development of the disease, and selection optimal terms of treatment. The literature review presents and analyzes the currently available results of the use of OCTA in patients with chiasmal compression.
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Vu AF, Alber SA, Chang MY, Park SS. Prospective Cross-Sectional Study of Repeatability of Peripapillary Capillary Density Measurement Using Optical Coherence Tomography Angiography in Eyes With Optic Nerve and Retinal Vascular Pathology. J Neuroophthalmol 2022; 42:73-78. [PMID: 33870951 PMCID: PMC8514563 DOI: 10.1097/wno.0000000000001216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Optical coherence tomography angiography (OCTA) is a new noninvasive imaging modality that provides high resolution images of the optic nerve head and peripapillary retinal capillary vasculature which can be affected by optic nerve or retinal pathologies. High repeatability of peripapillary capillary density measurement using OCTA has been demonstrated in normal eyes and eyes with glaucoma. The purpose of our study was to quantify the repeatability of peripapillary capillary density measurement using OCTA in both normal eyes and eyes with optic atrophy, optic disc edema, and retinal vasculopathy. METHODS This prospective cross-sectional study enrolled 31 patients (59 eyes) including 16 eyes with optic nerve pathology (7 with disc edema from papilledema and 9 with optic atrophy), 35 eyes with retinal vascular disease, and 8 normal eyes. All eyes were imaged twice (30 minutes apart) with the Optovue AngioVue OCTA instrument to obtain 4.5 × 4.5 mm peripapillary scans. Scans were considered good quality if signal strength was 6 or greater. The OCTA parameters obtained include the radial peripapillary capillary (RPC) density of the whole disc, inside the disc, peripapillary region, and the 4 quadrants of the disc (superior, nasal, inferior, and temporal). A Student's t test was used to compare means. Intraclass correlation coefficient (ICC) was calculated to measure repeatability. RESULTS Repeatability of RPC density measurements for all regions analyzed demonstrated good to excellent repeatability for the whole cohort {ICC for the whole image was 0.915 (95% confidence interval [CI] = 0.855-0.951)}; ICC for the peripapillary region was 0.945 (95% CI = 0.905-0.969). In the subset of eyes with good image quality (i.e., signal strength ≥ 6), ICC was slightly higher for all regions, with excellent repeatability of the peripapillary region (ICC was 0.971 [95% CI = 0.943-0.986]). Conversely, for eyes with poor image quality scans (i.e., signal strength < 6), ICC was lower, corresponding to moderate to good repeatability for most parameters. For the subset of eyes with optic atrophy, disc edema from papilledema or retinal vasculopathy, all had good to excellent repeatability of the vessel density of the entire disc (ICC values were 0.954 [95% CI = 0.804-0.990], 0.921 [95% CI = 0.711-0.982], and 0.895 [95% CI = 0.788-0.951, respectively]) and of the peripapillary region (ICC values were 0.980 [95% CI = 0.904-0.996], 0.966 [95% CI = 0.854-0.993], and 0.916 [95% CI = 0.827-0.961], respectively). CONCLUSIONS The peripapillary capillary density measurement obtained using a commercial OCTA instrument is highly repeatable in eyes with optic nerve atrophy, disc edema from papilledema, or retinal vasculopathy.
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Affiliation(s)
- Alexander F. Vu
- Department of Ophthalmology & Vision Science, University of California Davis Eye Center, Sacramento, CA
| | - Susan A. Alber
- Department of Public Health Sciences / Biostatistics, Clinical and Translational Science Center, University of California Davis, Sacramento, CA
| | - Melinda Y Chang
- Department of Ophthalmology & Vision Science, University of California Davis Eye Center, Sacramento, CA
- Vision Center, Children’s Hospital of Los Angeles, Los Angeles, CA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Susanna S. Park
- Department of Ophthalmology & Vision Science, University of California Davis Eye Center, Sacramento, CA
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Xiang L, Zhou Y, Chen Y, Jiang S, Fei C, Wang Y, Bai Y, Zhang X, Li K, Shen X. Assessment of the retinal vasculature in healthy Chinese preschool children aged 4-6 years old using optical coherence tomography angiography. BMC Ophthalmol 2021; 21:415. [PMID: 34856943 PMCID: PMC8638475 DOI: 10.1186/s12886-021-02154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4-6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. METHODS In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. RESULTS A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. CONCLUSIONS Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.
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Affiliation(s)
- Lu Xiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yingming Zhou
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yanwei Chen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Siyu Jiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Chunli Fei
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yangyang Wang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yang Bai
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xuan Zhang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Kai Li
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China.
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Combined wide-field optical coherence tomography angiography density map for high myopic glaucoma detection. Sci Rep 2021; 11:22034. [PMID: 34764370 PMCID: PMC8585951 DOI: 10.1038/s41598-021-01661-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/01/2021] [Indexed: 02/01/2023] Open
Abstract
The present study aimed to evaluate the diagnostic ability of wide-field optical coherence tomography angiography (OCTA) density map for detection of glaucomatous damage in high myopic (HM) eyes and to further compare the diagnostic ability of OCTA with that of conventional imaging approaches including red-free photography and swept-source OCT (SS-OCT) wide-field maps. A total of 77 healthy HM eyes and 72 HM eyes with open angle glaucoma (OAG) participated in this retrospective observational study. Patients underwent a comprehensive ocular examination, including wide-field SS-OCT scan and peripapillary area and macular OCTA scans. An integrated OCTA density map thereafter was merged by vascular landmark-guided superimposition of peripapillary and macular superficial vascular density maps onto the red-free photography (resulting in the OCTA-PanoMap). Glaucoma specialists then determined the presence of glaucomatous damage in HM eyes by reading the OCTA-PanoMap and compared its sensitivity and specificity with those of conventional images. Sensitivity and specificity of OCTA-PanoMap for HM-OAG diagnosis was 94.4% and 96.1%, respectively. Compared with other imaging methods, the sensitivity of OCTA-PanoMap was significantly higher than that of red-free photography (P = 0.022) and comparable to that of wide-field SS-OCT maps. Specificity of OCTA-PanoMap was significantly higher than those of other conventional imaging methods (except for wide-field thickness map). The OCTA-PanoMap showed good diagnostic ability for discrimination of HM-OAG eyes from healthy HM eyes. As a complementary method of an alternative imaging modality, OCTA-PanoMap can be a useful tool for detection of HM-OAG.
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Pan X, Ruan MZC, Fan W, Cao K, Feng H, Hu Z, Yang Y, Yan F, Zhao M, Liu Q, Fu M, Xiang F, Lee R, Li S, Han Y. Retina Vascular Structures Near the Optic Disc and in the Macula in Primary Angle Closure Suspects. Ophthalmic Res 2021; 65:575-583. [PMID: 34649251 DOI: 10.1159/000520030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/24/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Xiaohua Pan
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China,
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China,
| | - Merry Z C Ruan
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Wudi Fan
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
- College of Engineering, University of California, Berkeley, California, USA
| | - Kai Cao
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hui Feng
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China
| | - Zhongyin Hu
- Department of Ophthalmology, First People's Hospital of Yunnan Province, Kunming, China
| | - Yue Yang
- Department of Ophthalmology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Fancheng Yan
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Mengya Zhao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
| | - Qian Liu
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital and Zhengzhou University People's Hospital, Zhengzhou, China
| | - Min Fu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fei Xiang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China
| | - Richard Lee
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Shuning Li
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China
| | - Ying Han
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
- Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Dastiridou A, Kassos I, Samouilidou M, Koutali D, Mataftsi A, Androudi S, Ziakas N. Age and signal strength-related changes in vessel density in the choroid and the retina: an OCT angiography study of the macula and optic disc. Acta Ophthalmol 2021; 100:e1095-e1102. [PMID: 34532980 DOI: 10.1111/aos.15028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 07/30/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the effects of ageing and signal strength index (SSI) on vessel density (VD) measurements of the radial peripapillary capillaries (RPC) in the optic disc, the retinal superficial (SCP) and deep (DCP) capillary plexi and the choriocapillaris (CC) of the macular area using optical coherence tomography angiography (OCT-A) imaging. METHODS This cross-sectional study included 138 eyes from 77 healthy participants. High-definition (HD) disc Angio scan (4.5X4.5 mm) and HD Angio retina scan (6X6 mm) were acquired. Whole image (WI) VDs, inside disc (ID) VD and global and hemifield peripapillary RPC VDs were evaluated from the Angio Disc scans. Global and hemifield VD for the SCP, DCP and CC slab in the macula area were also recorded across different age groups. RESULTS Mean age was 48.2 ± 15.0 years (range 25-82 years). Signal strength index (SSI) was 71.6 ± 7.6 in the macula and 74.6 ± 9.2 in the disc OCT-A image. VD for both SCP and DCP decreased by 0.084% and 0.188%/year (both p < 0.001). WI VD and ID VD also decreased by 0.037%/year (p = 0.005) and 0.092%/year (p < 0.001). Peripapillary RPC VD did not change with age or SSI. The effect of SSI was significant in SCP, DCP, WI RPC, ID RPC and CC VD. In the generalized estimating equation model testing for both SSI and age, SSI remained significant against SCP, DCP and ID RPC. CONCLUSION With ageing, a decrease in VD in the SCP, DCP, WI and ID RPC, as well as in SSI, is seen. SSI and age are associated with VD changes, but only SSI is the significant variable that explains the variation in the retina microvasculature in the macula and the optic disc in multivariate analysis. In the CC, a larger SSI was associated with a lower VD. These findings underscore the importance of controlling for SSI in future studies using OCT-A.
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Affiliation(s)
- Anna Dastiridou
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
- Ophthalmology Department Medical School, University of Thessalia Larissa Greece
| | - Ioannis Kassos
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Maria Samouilidou
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Despoina Koutali
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Asimina Mataftsi
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Sofia Androudi
- Ophthalmology Department Medical School, University of Thessalia Larissa Greece
| | - Nikolaos Ziakas
- 2nd Ophthalmology Department Aristotle University of Thessaloniki Thessaloniki Greece
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Liu G, Wang Y, Gao P. Distributions of Radial Peripapillary Capillary Density and Correlations with Retinal Nerve Fiber Layer Thickness in Normal Subjects. Med Sci Monit 2021; 27:e933601. [PMID: 34456330 PMCID: PMC8383818 DOI: 10.12659/msm.933601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate distribution rules of radial peripapillary capillaries (RPCs) density and correlations with retinal nerve fiber layers (RNFL) thickness in normal subjects. MATERIAL AND METHODS We included 78 eyes of 78 healthy subjects examined by optical coherence tomography angiography (OCTA). RPCs density and RNFL thickness were measured automatically. Distributions of RPCs density and RNFL thickness were analyzed at different locations. Correlations of these 2 parameters and relationship with large vessels were evaluated by Spearman test. RESULTS Average density for overall, peripapillary, and inside disc RCPs was 56.12±2.51%, 58.56±2.84%, and 60.16±4.01%, respectively. Overall and peripapillary RCPs density were positively correlated with RNFL thickness (r=0.595, P.
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Affiliation(s)
- Guodong Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital Affiliated with Tongji University, Shanghai, China (mainland)
| | - Yanliang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital Affiliated with Tongji University, Shanghai, China (mainland)
| | - Peng Gao
- Department of Ophthalmology, Shanghai Tenth People's Hospital Affiliated with Tongji University, Shanghai, China (mainland)
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Dastiridou A, Kassos I, Katsanos A, Diafas A, Androudi S, Chopra V, Francis BA, Ziakas N. Does the ISNT rule apply to the radial peripapillary capillary vessel density in OCT angiography? Graefes Arch Clin Exp Ophthalmol 2021; 260:265-270. [PMID: 34379186 DOI: 10.1007/s00417-021-05367-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To investigate the applicability of ISNT (inferior ≥ superior ≥ nasal ≥ temporal), IST (inferior ≥ superior ≥ temporal), and T min (temporal quadrant with the minimum value) rules to the peripapillary nerve fiber layer (NFL) thickness and radial peripapillary capillary (RPC) vessel density (VD) using Optical Coherence Tomography (OCT) and OCT angiography (OCT-A). MATERIALS AND METHODS This cross-sectional study included 134 eyes of 74 healthy individuals. NFL thickness and RPC VD were measured in all four quadrants using OCT and OCT-A in order to determine the number of eyes that obey the ISNT, IST, and T min rules. RESULTS Mean age was 48.8 ± 15.5 (range 25-82) years. The ISNT rule was valid in 52 eyes (38.81%) on OCT and only 12 eyes (8.95%) on OCT-A scans. The IST rule was followed by 83 (61.94%) and 37 (27.61%) eyes on OCT and OCT-A scans respectively. The T min rule was valid in 86 eyes (64.18%) in OCT scans and in 26 eyes (19.4%) in OCT-A scans. CONCLUSION The topography of the RPC network does not obey the ISNT rule in healthy eyes. The ISNT rule and its variants were found to be more relevant in OCT NFL thickness measurements compared to OCT-A RPC VD measurements.
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Affiliation(s)
- Anna Dastiridou
- 2Nd Ophthalmology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. .,Ophthalmology Department, University of Thessalia, Larissa, Greece.
| | - Ioannis Kassos
- 2Nd Ophthalmology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Katsanos
- Ophthalmology Department, University of Ioannina, Ioannina, Greece
| | - Asterios Diafas
- 2Nd Ophthalmology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia Androudi
- Ophthalmology Department, University of Thessalia, Larissa, Greece
| | - Vikas Chopra
- Doheny Eye Institute, Department of Ophthalmology, University of California Los Angeles, Los Angeles, CA, USA
| | - Brian A Francis
- Doheny Eye Institute, Department of Ophthalmology, University of California Los Angeles, Los Angeles, CA, USA
| | - Nikolaos Ziakas
- 2Nd Ophthalmology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sefic S, Kasumovic A, Matoc I, Halimic T, Voloder B, Muhamedagic L, Delic SC, Sesar I. Assessment of Perfused Peripapillary Capillaries and Peripapillary Capillary Density Maps in Glaucoma Patients. Med Arch 2021; 74:275-278. [PMID: 33041444 PMCID: PMC7520061 DOI: 10.5455/medarh.2020.74.275-278] [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] [Indexed: 11/16/2022] Open
Abstract
Introduction: Monitoring and diagnosing glaucoma until 2017 included funduscopy, IOP measurements, gonioscopy, pachymetry, as well as visual field tests, optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A). Radial peripapillary capillaries (RPC) can be observed by fluorescein angiography, as well as histologically - superficial and deep capillary layer. Aim: To correlate density of radial peripapillary capillary network (RPC) and retinal nerve fiber layer (RNFL) thickness in eight peripapillary segments in patients with a primary open angle glaucoma (POAG) which have the disease under 10 years of duration, over 10 years of duration and in a group of healthy patients. Methods: This is a cross-sectional review which included three groups of patients: POAG patients under 10 years of disease duration, over 10 years of disease duration and control group of patients. The study is performed on the commercial optical coherence tomography angiography system (AngioVue, Avanti RTVue-XR, Optovue, CA). Sectoral RPC density values, RPC maps and RNFL thickness were analyzed in three groups of patients, data was compared and correlation between parameters was examined. Results: Mean RPC Density values in both superior segments (S1, S2) were significantly lower in patients with glaucoma over 10 years of disease duration compared to patients with glaucoma under 10 years of disease duration (p<0.05). Statistically significant positive correlation was established between RNFL thickness and RPC density in all eight peripapillary segments. Conclusion: Analysis of radial peripapillary capillary network density on optical coherence tomography angiography may provide an earliest functional sign of progressive optic nerve disease and new insights into the pathophysiology of glaucomatous damage.
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Affiliation(s)
- Sanja Sefic
- Eye Polyclinic "Dr. Sefić", Sarajevo, Bosnia and Herzegovina
| | - Aida Kasumovic
- Eye Polyclinic "Dr. Sefić", Sarajevo, Bosnia and Herzegovina
| | - Ines Matoc
- Eye Polyclinic "Dr. Sefić", Sarajevo, Bosnia and Herzegovina
| | - Tarik Halimic
- Eye Polyclinic "Dr. Sefić", Sarajevo, Bosnia and Herzegovina
| | - Bahrija Voloder
- The Cantonal Public Institution Health Center of Sarajevo, Bosnia and Herzegovina
| | - Lejla Muhamedagic
- The Cantonal Public Institution Health Center of Sarajevo, Bosnia and Herzegovina
| | | | - Irena Sesar
- University Clinical Hospital Mostar, Bosnia and Herzegovina
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Zhou LJ, Luo XZ, Shen PY, Li X, Su P, Zhu Z, Yan SG, Kong XB, Lu XH. Quantitative assessment and determinants of the papillary microvasculature in healthy subjects. BMC Ophthalmol 2021; 21:140. [PMID: 33743618 PMCID: PMC7981900 DOI: 10.1186/s12886-021-01896-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/05/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND It is critical to monitor the optic disc's vessel density using Optical coherence tomography angiography (OCTA) and evaluate its determinants. In the current study, we investigate the superficial vessel density (VD) of the papillary microvasculature and its determinants in healthy subjects of Southern China. METHODS This was a prospective, cross-sectional study. Superficial VD in healthy individuals' optic disc region was measured by OCTA. The factors associated with ocular and systemic parameters were analyzed using a generalized estimation equation (GEE) model. RESULTS A total of 510 eyes of 260 healthy subjects were analyzed in the study. The total VD in the optic disc area was 17.21 ± 2.15 mm- 1 (95% CI, 17.02-17.40 mm- 1). The VD in the inner ring and the outer ring of the optic disc were significantly higher compared with the central ring, while the VD of the superior quadrant and inferior quadrant was significantly higher compared with the temporal and nasal quadrant. After adjusting for the ocular factors and systemic factors, AL (β = - 0.4917, P = 0.0003), disc area (β = - 0.3748, P = 0.0143), CMT (β = - 0.0183, P = 0.0003) and SSI (β = 1.0588, P < 0.001) were significantly associated with total VD of the optic disc. CONCLUSION The mean total VD in the optic disc area was 17.21 ± 2.15 mm- 1 in healthy subjects, and the superior and inferior VD was significantly higher than the temporal and nasal VD. AL, disc area, CMT, and SSI may affect the total VD in the optic disc area and should be considered in clinical practice.
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Affiliation(s)
- Li-Jun Zhou
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, 515282, China
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Xiu-Zhi Luo
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Pei-Yang Shen
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, 515282, China
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Xin Li
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Peng Su
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Zhe Zhu
- Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, 92037, USA
| | - Shi-Gang Yan
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China
| | - Xiang-Bin Kong
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, 528000, China.
| | - Xiao-He Lu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, 515282, China.
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Peripapillary and Macular Microcirculation in Glaucoma Patients of African and European Descent Using Optical Coherence Tomography Angiography. J Glaucoma 2021; 29:885-889. [PMID: 32769732 DOI: 10.1097/ijg.0000000000001629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PRéCIS:: We found no significant differences in peripapillary and macula microcirculation blood flow metrics in eyes with open-angle glaucoma of African descent (AD) and European descent (ED) as detected by optical coherence tomography angiography (OCTA). PURPOSE The purpose of this study was to investigate the peripapillary retinal nerve fiber layer (RNFL) and macular vascular microcirculation in subjects of AD and ED with open-angle glaucoma using OCTA. PATIENTS AND METHODS One eye from each subject was scanned using AngioPlex OCTA system covering both a 6×6 mm scanning area centered at the optic nerve head and at the foveola. Peripapillary RNFL and macular microcirculation were measured by calculating the overall flux and vessel area density excluding the large retinal vessels. Two-sample, independent t tests were used to compare the OCTA metrics between AD and ED eyes. Linear regression models were used to investigate the correlation between OCTA metrics and structural and functional parameters. RESULTS Twenty-eight eyes of AD and 56 eyes of ED were included in the study. There was no significant difference in age, sex, hypertension, antihypertensive medications, diabetes, systolic and diastolic blood pressure, mean ocular perfusion pressure, RNFL thickness and visual field (VF) mean deviation and VF pattern standard deviation (P≥0.054) between AD and ED eyes included. Both groups had similar OCTA blood flow metrics (P≥0.161). OCTA blood flow metrics were significantly correlated with VF mean deviation (r≥0.466), VF pattern standard deviation (r≤-0.366) and RNFL thickness (r≥0.333). CONCLUSIONS No significant differences were found in peripapillary and macular microcirculation detected by OCTA between AD and ED glaucomatous eyes. Peripapillary and macular microcirculation were significantly correlated with disease severity in AD and ED glaucomatous eyes.
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Elessawy K, El-Saied HA, Elhalim WA, Abdelhamid M. Changes in peripapillary blood flow after dorzolamide 2%/timolol 0.5% versus latanoprost 0.005%/timolol 0.5% using optical coherence tomography angiography. EGYPTIAN RETINA JOURNAL 2021; 8:19. [DOI: 10.4103/erj.erj_7_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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22
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Ozcan Y, Ozcaliskan S, Balci S, Artunay O. The correlation of radial peripapillary capillary density measurements with optic nerve head morphology and retinal nerve fiber layer thickness in healthy eyes. Photodiagnosis Photodyn Ther 2020; 32:102008. [DOI: 10.1016/j.pdpdt.2020.102008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
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Cennamo G, Solari D, Montorio D, Scala MR, Melenzane A, Fossataro F, Somma T, Tranfa F, Cavallo LM. Early vascular modifications after endoscopic endonasal pituitary surgery: The role of OCT-angiography. PLoS One 2020; 15:e0241295. [PMID: 33119707 PMCID: PMC7595382 DOI: 10.1371/journal.pone.0241295] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim of the present study is to analyze the changes in retinal vessel density (VD), using Optical Coherence Tomography Angiography (OCT-A), in patients that received endoscopic endonasal approach for the removal of an intra-suprasellar pituitary adenoma compressing optic chiasm. Methods We evaluated the VD in Superficial Capillary Plexus (SCP), Deep Capillary Plexus (DCP), Radial Peripapillary Capillary (RPC) and the Foveal Avascular Zone (FAZ) area in a series of fourteen patients (7 males, 7 females, mean age 56 ± 13 years), as compared to healthy controls. We also detected the structural Spectral Domain (SD)-OCT parameters: Ganglion Cell Complex (GCC), Retinal Nerve Fiber Layer (RNFL), visual field parameters (Mean Deviation, Pattern Standard Deviation) and Best Corrected Visual Acuity (BCVA). These measurements were performed prior than surgery and 48 hours after. Results The patients showed a significant decrease in VD of the macular and papillary regions, a significant increase in FAZ area, a significant impairment in SD-OCT, VF parameters and BCVA respect to 14 eyes of 14 healthy controls (p<0.05), at pre-op evaluation. In patients group the VD in SCP, DCP and RPC increased after surgery respect to baseline but the difference turned to be out statistically significant only in RPC (p = 0.003). Also the BCVA (p = 0.040) and the Mean Deviation at visual field (p = 0.015) significantly improved after surgery. While there was a reduction in structural OCT parameters but it was statistically significant only in GCC (p = 0.039). A positive correlation was found between the preoperative VD of the RPC, Mean Deviation, BCVA and the postoperative Mean Deviation (r = 0.426 p = 0.027; r = 0.624 p = 0.001; r = 0.515 p = 0.006). Conclusion OCT-A allows to detect the early changes occurring within 48 hours after surgery showing that the improvement in retinal vessel density could occur before the recovery of the structural OCT parameters and can be a positive predictive factor for the functional recovery.
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Affiliation(s)
- Gilda Cennamo
- Public Health Department, University of Naples "Federico II", Naples, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Daniela Montorio
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Maria Rosaria Scala
- Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Antonietta Melenzane
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Federica Fossataro
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Fausto Tranfa
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
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Woo JM, Cha JB, Lee CK. Comparison of lamina cribrosa properties and the peripapillary vessel density between branch retinal vein occlusion and normal-tension glaucoma. PLoS One 2020; 15:e0240109. [PMID: 33007029 PMCID: PMC7531791 DOI: 10.1371/journal.pone.0240109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 09/18/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To compare the properties of the lamina cribrosa (LC) and the peripapillary vessel density between branch retinal vein occlusion (BRVO) and normal-tension glaucoma (NTG), using swept-source optical coherence tomography and optical coherence tomography angiography. METHODS This retrospective study included 21 eyes of 21 patients with BRVO and 43 eyes of 43 patients with NTG who were treated from June 2016 to September 2017. The anterior LC depth (ALCD) and LC thickness (LCT) at the mid-superior, central, and mid-inferior levels; the mean difference in ALCD; and the peripapillary vessel density in the superficial and deep capillary plexuses and the choriocapillaris were compared between groups. RESULTS ALCD at the mid-superior, central, and mid-inferior levels was significantly greater in the NTG group (P < 0.05), while LCT was comparable between the groups. The mean difference in ALCD was significantly greater in the BRVO group (P = 0.03). The peripapillary vessel density in the superotemporal segment of the superficial capillary plexus was significantly lower in the BRVO group, while the density in all segments of the choriocapillaris was significantly lower in the NTG group (P < 0.05 for all). CONCLUSIONS Our findings demonstrate that BRVO and NTG have different LC structures and peripapillary vessel densities.
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Affiliation(s)
- Je Moon Woo
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jae Bong Cha
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Chang Kyu Lee
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
- Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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Savastano A, Crincoli E, Savastano MC, Younis S, Gambini G, De Vico U, Cozzupoli GM, Culiersi C, Rizzo S. Peripapillary Retinal Vascular Involvement in Early Post-COVID-19 Patients. J Clin Med 2020; 9:E2895. [PMID: 32911619 PMCID: PMC7565672 DOI: 10.3390/jcm9092895] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/30/2020] [Accepted: 09/03/2020] [Indexed: 12/11/2022] Open
Abstract
The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2's) to cause multi-organ ischemia and coronavirus-induced posterior segment eye diseases in mammals gave concern about potential sight-threatening ischemia in post coronavirus disease 2019 patients. The radial peripapillary capillary plexus (RPCP) is a sensitive target due to the important role in the vascular supply of the peripapillary retinal nerve fiber layer (RNFL). Eighty patients one month after SARS-CoV-2 infection and 30 healthy patients were selected to undergo structural OCT (optical coherence tomography) and OCTA (optical coherence tomography angiography) exams. Primary outcome was a difference in RPCP perfusion density (RPCP-PD) and RPCP flow index (RPCP-FI). No significant difference was observed in age, sex, intraocular pressure (IOP) and prevalence of myopia. RPCP-PD was lower in post SARS-CoV-2 patients compared to controls. Within the post-COVID-19 group, patients with systemic arterial hypertension had lower RPCP-FI and age was inversely correlated to both RPCP-FI and RPCP-PD. Patients treated with lopinavir + ritonavir or antiplatelet therapy during admission had lower RPCP-FI and RPCP-PD. RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection.
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Affiliation(s)
- Alfonso Savastano
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Emanuele Crincoli
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Maria Cristina Savastano
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Saad Younis
- Department of Ophthalmology, Western Eye Hospital, Imperial College Healthcare NHS Trust, London NW1 5QH, UK;
| | - Gloria Gambini
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Umberto De Vico
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Grazia Maria Cozzupoli
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Carola Culiersi
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy; (A.S.); (E.C.); (G.G.); (U.D.V.); (G.M.C.); (C.C.); (S.R.)
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
- Neuroscience Institute, Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, 56124 Pisa, Italy
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RETRACTED: Retinal microvasculature alterations in neuromyelitis optica spectrum disorders before optic neuritis. Mult Scler Relat Disord 2020; 44:102277. [DOI: 10.1016/j.msard.2020.102277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/24/2020] [Accepted: 06/06/2020] [Indexed: 11/22/2022]
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Subasi S, Yuksel N, Basaran E, Pirhan D. Comparison of vessel density in macular and peripapillary regions between primary open-angle glaucoma and pseudoexfoliation glaucoma using OCTA. Int Ophthalmol 2020; 41:173-184. [PMID: 32851558 DOI: 10.1007/s10792-020-01564-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of our study was to compare macular and peripapillary vessel density using optical coherence tomography angiography (OCTA) between eyes with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG). METHODS Thirty-six POAG and 34 PXG eyes with similar visual field defect (no statistically significant difference between average mean deviation and pattern standard deviation scores) were included. Macular superficial vessel density (msVD) in the superficial macular layer and foveal avascular zone (FAZ) parameters were assessed with (6 × 6 mm) and peripapillary vessel density (ppVD) in the radial peripapillary capillary (RPC) with (4.5 × 4.5 mm) OCTA scans. Area under the receiver operating curve was used for assessing diagnostic capability. RESULTS In PXG group, all msVD parameters had lesser values, and especially in parafoveal region, statistically significant decrease was shown (p = 0.008) in all subdivisions except nasal (p = 0.053). FAZ area was more larger in PXG [0.32(0.25-0.36)] than POAG [0.28(0.22-0.39)],(p = 0.944). FAZ density - 300 μm had statistically significant decrease in PXG (47.22 ± 6.92) according to POAG groups (50.63 ± 7.25) (p = 0.048). Most of RPC VD parameters had decreasing values in PXG group (p > 0.05). VDs and corresponding thicknesses had significant remarkable positive correlation in both macular and peripapillary regions. Significant remarkable negative correlations were observed between fovea VD and FAZ area, FAZ perimeter and between fovea thickness and FAZ area, FAZ perimeter. CONCLUSION PXG eyes were found to have lesser values in terms of VD in the macular area, especially in the parafoveal and FD-300 regions, compared to POAG eyes which had similar functional and structural glaucomatous damage. Patients whose etiology was PXG and who seemed to have the same functional damage as those with POAG were actually found to have greater macular vascular damage. In addition, it was observed that macular vascular parameters correlated with peripapillary vascular parameters.
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Affiliation(s)
- Sevgi Subasi
- Medical Faculty Department of Ophthalmology, Kocaeli University, Gazanfer Bilge Bulvarı Akçakent 2 Sitesi C4/15, İzmit, Kocaeli, Turkey.
| | - Nursen Yuksel
- Medical Faculty Department of Ophthalmology, Kocaeli University, Gazanfer Bilge Bulvarı Akçakent 2 Sitesi C4/15, İzmit, Kocaeli, Turkey
| | - Ece Basaran
- Medical Faculty Department of Ophthalmology, Kocaeli University, Gazanfer Bilge Bulvarı Akçakent 2 Sitesi C4/15, İzmit, Kocaeli, Turkey
| | - Dilara Pirhan
- Medical Faculty Department of Ophthalmology, Kocaeli University, Gazanfer Bilge Bulvarı Akçakent 2 Sitesi C4/15, İzmit, Kocaeli, Turkey
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Celik Buyuktepe T, Bingöl Kızıltunç P, Buyuktepe M, Atilla H. Direct and transsynaptic retrograde degeneration and optic nerve head microvascular changes in patients with hemianopia. Eur J Ophthalmol 2020; 31:1785-1794. [PMID: 32811169 DOI: 10.1177/1120672120951731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To investigate optic nerve head (ONH) microvascular changes secondary to transsynaptic retrograde degeneration (TRD), comperatively with direct retrograde degeneration and healthy controls. METHODS Patients with hemianopia due to intracranial lesion included in the study. Intracranial lesion was categorized by location: postgeniculate (causing TRD), chiasmal (causing direct retrograde degeneration). For the postgeniculate lesions, the eye on the same side of the lesion was defined as the ipsilateral eye and the eye on the opposite side as the contralateral eye. Optic disc microvasculature was evaluated with the help of optic coherence tomography angiography. RESULTS Sixteen eyes of 16 patients with chiasmal lesion, 28 eyes of 14 patients with postgeniculate lesion, and 30 eyes of 30 healthy subjects were included in the study. Ipsilateral eyes of the patients with postgeniculate lesion had decreased vessel density at the temporal sectors compatible with the affected nasal side of the visual field. Contralateral eyes showed no reduction of the vessel density at the affected nasal sectors. The eyes with chiasmal lesions had decreased vessel density at the peripapillary region and nasal half of the ONH compatible with temporal hemianopia. Vascular changes in the chiasmal lesion were more prominent than those of the postgeniculate lesion. Retinal nerve fiber layer and ganglion cell complex thickness were reduced. CONCLUSION Vessel density of ONH was reduced in patients with homonymous hemianopia, providing evidence for TRD secondary to acquired postgeniculate lesion. Direct retrograde degeneration was more prominent in affected sectors when compared to TRD.
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Affiliation(s)
- Tuna Celik Buyuktepe
- Department of Ophthalmology, Dr Nafiz Korez Sincan State Hospital, Ankara, Turkey
| | | | - Murat Buyuktepe
- Department of Neurosurgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Huban Atilla
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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Köse HC, Tekeli O. Optical coherence tomography angiography of the peripapillary region and macula in normal, primary open angle glaucoma, pseudoexfoliation glaucoma and ocular hypertension eyes. Int J Ophthalmol 2020; 13:744-754. [PMID: 32420221 DOI: 10.18240/ijo.2020.05.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023] Open
Abstract
AIM To evaluate and compare the peripapillary and retinal vasculature changes in primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), ocular hypertension (OHT) and normal eyes using optical coherence tomography angiography (OCTA). METHODS A total of 114 POAG, PXG and OHT eyes of 60 patients and 46 eyes of 23 healthy control participants with good quality OCTA images were included. The PXG, POAG, OHT, and control groups (aged 68.17±6.30y, 61.11±10.26y, 58.1±8.9y, and 56.9±4.6y, respectively) contained of 46, 36, 32, and 46 eyes, respectively. Measurements of vessel density (VD) in the peripapillary region and macula, average retinal inner thickness, and retinal nerve fiber layer thickness (RNFLT) were compared among groups. In order to test the accuracy of differentiation between eyes with and without glaucoma, the area was calculated under the receiver operating characteristic (ROC) curves. RESULTS The VD in glaucomatous eyes was significantly lower than the control group in all peripapillary sectors (44.35%±6.78% vs 50.47%±1.83%, P<0.001), the superficial (44.08%±5.46% vs 51.28%±2.85%, P<0.001) and the deep (45.13%±8.55% vs 54.20%±5.44%, P<0.001) vascular plexus. There was a significant difference in peripapillary VD between glaucomatous and OHT eyes (44.35%±6.78% vs 49.86%±2.45%, P<0.001). The OHT group featured a lower superficial (48.06%±4.32% vs 51.28%±2.85%, P=0.027) and deep plexus (48.70%±5.99% vs 54.20%±5.44%, P=0.013) whole image vessel density (wiVD) than did the control group. The average macular superficial plexus wiVD was significantly lower in eyes with PXG than in eyes with POAG (42.22%±5.36% vs 46.54%±5.56%, P=0.046). CONCLUSION OCTA can measure reduced peripapillary and macular VD in eyes with glaucoma and OHT, and these results are correlated to functional and structural glaucomatous alterations. Peripapillary and macular superficial plexus VD is lower in eyes with PXG than in eyes with POAG. Furthermore, the OHT eyes demonstrate impaired macular vasculature in both superficial and deep plexus.
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Affiliation(s)
- Helin Ceren Köse
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara 06620, Turkey
| | - Oya Tekeli
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara 06620, Turkey
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Chen L, Yuan M, Sun L, Wang Y, Chen Y. Evaluation of microvascular network with optical coherence tomography angiography (OCTA) in branch retinal vein occlusion (BRVO). BMC Ophthalmol 2020; 20:154. [PMID: 32306978 PMCID: PMC7169004 DOI: 10.1186/s12886-020-01405-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/25/2020] [Indexed: 12/17/2022] Open
Abstract
Background To evaluate changes of microvascular network of macular and peripapillary regions and to provide a quantitative measurement of foveal avascular zone (FAZ) in unilateral BRVO patients. Methods Forty-seven unilateral BRVO patients and forty-seven normal controls were enrolled. A 3*3 mm scan centered on fovea followed by a 4.5*4.5 mm scan centered on optic nerve head (ONH) were obtained in BRVO eyes, fellow eyes and control eyes of each individual using OCTA (Optovue Inc., Fremont, CA, USA). Vessel density (VD) in superficial (SVC) and deep vascular complex (DVC) of macula and radial peripapillary capillary (RPC) were automatically calculated. Parameters of FAZ region including size, perimeter, acircularity index (AI) and foveal vessel density 300 (FD-300) were measured. Results VDs of SCV and DVC were significantly lower, especially in affected regions, in BRVO eyes compared with fellow eyes (P < 0.05). BRVO affected eyes has larger FAZ size, FAZ perimeter, AI and lower FD-300 compared with fellow eyes (all P < 0.05). VD of SVC and FD-300 were lower in fellow eyes compared with normal control eyes (P < 0.05). The average vessel density in whole area and peripapillary area in BRVO eyes were significantly lower compared with fellow eyes (P < 0.05). VD of inside disc in fellow eyes was lower than normal eyes (P < 0.05). Conclusions OCTA provided quantitative information of vascular changes in BRVO. FAZ in BRVO eyes showed significant morphological alterations and decreases of VD in surrounding area. Decreases of VD existed not only in SVC and DVC in macular region but also in RPCs in BRVO eyes. Unaffected eyes of unilateral BRVO showed vascular abnormalities in superficial retinal layer, peri-FAZ area and also peripapillary regions.
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Affiliation(s)
- Lulu Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Mingzhen Yuan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Lu Sun
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yuelin Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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Fernández-Vigo JI, Kudsieh B, Shi H, De-Pablo-Gómez-de-Liaño L, Serrano-Garcia I, Ruiz-Moreno JM, Martínez-de-la-Casa JM, García-Feijóo J, Fernández-Vigo JÁ. Normative Database of Peripapillary Vessel Density Measured by Optical Coherence Tomography Angiography and Correlation Study. Curr Eye Res 2020; 45:1430-1437. [PMID: 32188270 DOI: 10.1080/02713683.2020.1744164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose: To provide a normative data set of swept-source optical coherence tomography angiography (SS-OCTA) peripapillary vessel density (VD) measurements and assess correlations with age, gender, disc area and axial length (AL). Material and Methods: This was an observational cross-sectional study conducted on 346 right eyes of healthy subjects. Peripapillary SS-OCTA VD measurements were obtained in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) in all four quadrants using the Triton device (Topcon, Nagoya, Japan). AL measurements were made by optical biometry. Results: Mean participant age was 37.7 ± 19.8 years (range 5- 83), AL was 23.9 ± 1.3 mm (21-27), and 59% were women. Mean VDs for all quadrants were 57.2 ± 5.7% for SCP (52.4 ± 4.0% - 62.1 ± 4.2%), 46.3 ± 6.5% for DCP (41.9 ± 5.8% - 49.7 ± 4.8%) and 60.8 ± 7.4% for CC (53.4 ± 5.8% - 65.7 ± 5.5%). Negative correlation was detected between SCP VD and age (R = -0.264; P < .001), while correlation between DCP densities and age was positive (R = 0.202; P = .002). No associations were detected between peripapillary VD and gender (P ≥ 0.087) and negative correlation was found with AL and disc area only in the CC (P ≤ 0.004). In a subgroup analysis of 33 individuals, we noted no differences in VD between fellow eyes (P ≥ 0.139). Conclusion: Peripapillary VD showed wide individual variation when measured with the Triton SS-OCTA in the different retinal plexuses and CC. While correlations were observed with age, no relationships emerged with gender and only CC showed negative correlation with AL and disc area.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain.,Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain
| | - Bachar Kudsieh
- Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain.,Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda , Madrid, Spain
| | - Hang Shi
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain.,Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain
| | - Lucía De-Pablo-Gómez-de-Liaño
- Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain.,Department of Ophthalmology, Hospital 12 de Octubre , Madrid, Spain
| | - Irene Serrano-Garcia
- Department of Preventive Medicine, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Universitario Clínico San Carlos , Madrid, Spain
| | - José María Ruiz-Moreno
- Department of Ophthalmology, Hospital Puerta de Hierro Majadahonda , Madrid, Spain.,Department of Ophthalmology, Castilla La Mancha University , Albacete, Spain
| | - José María Martínez-de-la-Casa
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain
| | - Julián García-Feijóo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), OFTARED , Madrid, Spain
| | - José Ángel Fernández-Vigo
- Ophthalmology, Centro Internacional de Oftalmología Avanzada , Madrid, Spain.,Department of Ophthalmology, Universidad de Extremadura , Badajoz, Spain
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Le A, Chen J, Lesgart M, Gawargious BA, Suh SY, Demer JL. Age-dependent Deformation of the Optic Nerve Head and Peripapillary Retina by Horizontal Duction. Am J Ophthalmol 2020; 209:107-116. [PMID: 31472159 PMCID: PMC6911619 DOI: 10.1016/j.ajo.2019.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE To study effects of age and horizontal duction on deformation of the optic nerve head (ONH) and peripapillary retina (PPR), as reflected by displacement of vascular landmarks, to explore the influence of adduction tethering. DESIGN Cross-sectional study. METHODS Setting: University. STUDY POPULATION Single eyes of 20 healthy young adults (average age 23.9 ± 3.9 [SD] years) were compared to 20 older subjects (average age 61.4 ± 9.3 years). Observational Procedure: The disc and PPR were imaged by scanning laser ophthalmoscopy in central gaze and at 35 degrees abduction and adduction. MAIN OUTCOME MEASURE Deformations of the disc and adjacent PPR were measured by comparing positions of epipapillary and epiretinal blood vessels. RESULTS Vessels within the ONH of younger subjects shifted temporally during adduction and nasally during abduction. Displacement of the nasal hemi-disc in adduction was greater at 38.5 ± 1.7 μm (standard error of mean) than the temporal half at 4.1 ± 2.1 μm (P < .001). PPR within 1 radius of the disc margin underwent 7.6 ± 1.6 μm average temporal displacement in adduction in young subjects. In abduction, the young temporal hemi-disc shifted 4.4 ± 0.6 μm nasally without significant displacement in the nasal half. Older subjects' ONH showed less temporal shift and less displacement in the PPR within 1 disc radius (P < .0001) in adduction; the nasal hemi-disc shifted 24.5 ± 1.3 μm compared with 4.4 ± 2.1 μm in the temporal half. There were no significant deformations of the disc during abduction by older subjects. CONCLUSION Large horizontal duction, particularly adduction, deforms the disc and peripapillary vasculature. This deformation, which is larger in younger than older subjects, may be due to optic nerve tethering in adduction.
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Affiliation(s)
- Alan Le
- Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California, USA; Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA; Bioengineering Interdepartmental Programs, University of California, Los Angeles, Los Angeles, California, USA
| | - Jessica Chen
- Computational and Systems Biology Interdepartmental Program, University of California, Los Angeles, Los Angeles, California, USA
| | - Michael Lesgart
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Bola A Gawargious
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, California, USA
| | - Soh Youn Suh
- Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California, USA; Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA
| | - Joseph L Demer
- Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California, USA; Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA; Bioengineering Interdepartmental Programs, University of California, Los Angeles, Los Angeles, California, USA; Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA; David Geffen Medical School, University of California, Los Angeles, Los Angeles, California, USA.
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Chang R, Nelson AJ, LeTran V, Vu B, Burkemper B, Chu Z, Fard A, Kashani AH, Xu BY, Wang RK, Varma R, Richter GM. Systemic Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study. Am J Ophthalmol 2019; 207:240-247. [PMID: 31229463 DOI: 10.1016/j.ajo.2019.06.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine the relationship between systemic factors and radial peripapillary capillary (RPC) vessel density (VD) in healthy African American (AA) participants of the African American Eye Disease Study. DESIGN A population-based, cross-sectional study. METHODS A total of 4135 eyes from 2127 AA participants aged 40 years and older in Inglewood, California, were imaged for 6×6-mm optic disc scans on a spectral-domain optical coherence tomography angiography (OCTA) device. Of these, 1029 eyes from 1029 participants who met the inclusion and exclusion criteria were analyzed, including only 1 eye per participant. Custom software was used to quantify RPC VD. Multivariate linear regression was used to identify systemic factors associated with RPC VD with a significance level set at 0.05. The contribution of each variable to the final model was estimated with the magnitude of standardized regression coefficients (SRCs). The fit of the final model was measured by R2. RESULTS The average RPC VD was 0.346±0.045. Controlling for signal strength, the systemic variables in the final multivariate model associated with reduced RPC VD were older age (β = -0.0123 per decade; SRC = -0.2733; P < .0001), male sex (β = -0.0067; SRC = -0.0716; P = .0060), and longer diabetes duration (β = -0.0022 per 5 years; SRC = -0.0527; P = .0427). The model R2 was 0.3689. CONCLUSIONS Age, sex, and systemic influences, such as diabetes duration, need to be considered when assessing changes in RPC VD in glaucoma and other ocular diseases. Longitudinal studies are needed to investigate whether reduced RPC VD and the factors that affect it are associated with an increased risk of developing glaucomatous nerve damage.
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Affiliation(s)
- Ryuna Chang
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Andrew J Nelson
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Vivian LeTran
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Brian Vu
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Bruce Burkemper
- Southern California Eyecare and Vision Research Institute, Los Angeles, California, USA
| | - Zhongdi Chu
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Ali Fard
- Carl Zeiss Meditec, Inc, Dublin, California, USA
| | - Amir H Kashani
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Benjamin Y Xu
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Rohit Varma
- Southern California Eyecare and Vision Research Institute, Los Angeles, California, USA
| | - Grace M Richter
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA.
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Kwon HJ, Kwon J, Sung KR. Additive Role of Optical Coherence Tomography Angiography Vessel Density Measurements in Glaucoma Diagnoses. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:315-325. [PMID: 31389207 PMCID: PMC6685832 DOI: 10.3341/kjo.2019.0016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 12/02/2022] Open
Abstract
Purpose This study compared the glaucoma diagnostic abilities of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In addition, the possibility of enhancing diagnostic capability by combining the two modalities was investigated. Methods A total of 131 healthy eyes and 113 glaucomatous eyes were imaged by both OCT and OCTA. In OCT, glaucoma was defined as when the color of the superior or inferior quadrant of the peripapillary retinal nerve fiber layer thickness map was yellow (borderline, <5%) or red (outside normal limits, <1%). In OCTA, glaucoma was determined using the cut-off value of the superior or inferior peripapillary vessel density, calculated after receiver operating characteristic curve analysis. Sensitivity and specificity were determined by OCT alone, by OCTA alone, or by OCT and OCTA combined. Results The sensitivity of OCT (86.7%) was better than that of OCTA (74.3%), whereas the specificity of OCTA (87.0%) was better than that of OCT (67.9%). When these two modalities were combined, both sensitivity and specificity were enhanced (90.3% and 92.4%, respectively). Among the 131 eyes, 32 were misdiagnosed as glaucomatous by OCT but accurately diagnosed as normal by OCTA. These eyes were myopic, with a longer axial length and a thinner and temporally displaced peak of peripapillary retinal nerve fiber layer thickness, causing the false positive result in OCT. Conclusions When OCTA was combined with OCT, the specificity of glaucoma diagnoses were enhanced. OCTA may compensate for the shortcomings of OCT in the diagnosis of glaucoma.
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Affiliation(s)
- Hye Ji Kwon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Junki Kwon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Rim Sung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Alnawaiseh M, Brand C, Lauermann JL, Eter N. [Flow density measurements using optical coherence tomography angiography : Impact of age and gender]. Ophthalmologe 2019; 115:659-662. [PMID: 28726070 DOI: 10.1007/s00347-017-0539-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND This article presents the normative data for flow density measured using optical coherence tomography (OCT) angiography and the impact of age and gender is evaluated. METHODS In this study 58 eyes from 58 healthy volunteers with no history of any ocular disease or ocular surgery were included. The OCT angiography imaging was performed using the RTVue XR Avanti with the AngioVue (Optovue, Fremont, CA). The macula was imaged using a 3 × 3 mm scan, and the flow density data in the superficial retinal OCT angiogram and deep retinal OCT angiogram were extracted and analyzed. The groups were compared using the Mann-Whitney U‑test and the degree of correlation between two variables was expressed as the Spearman's correlation coefficient (rSp.) RESULTS: The mean subject age was 38.3 ± 14.6 years. The flow density (whole en face) in the deep retinal OCT angiogram was significantly higher compared to the flow density in the superficial retinal OCT angiogram (p < 0.001). There was no significant difference in the mean flow density in superficial and deep OCT angiograms of the macula between males (n = 27) and females (n = 31). There was a significant correlation between the flow density in the deep retinal OCT angiogram and age (rSp. = -0.41, p = 0.001). CONCLUSION Whereas gender has no impact on the flow density measured using OCT angiography, there was a significant correlation between the flow density in the deep retinal OCT angiogram and age.
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Affiliation(s)
- M Alnawaiseh
- Universitäts-Augenklinik Münster, Domagkstr.15, 48149, Münster, Deutschland.
| | - C Brand
- Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinikum Münster, Münster, Deutschland
| | - J L Lauermann
- Universitäts-Augenklinik Münster, Domagkstr.15, 48149, Münster, Deutschland
| | - N Eter
- Universitäts-Augenklinik Münster, Domagkstr.15, 48149, Münster, Deutschland
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Ciloglu E, Okcu NT, Dogan NÇ. Optical coherence tomography angiography findings in preeclampsia. Eye (Lond) 2019; 33:1946-1951. [PMID: 31316159 DOI: 10.1038/s41433-019-0531-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/03/2019] [Accepted: 07/01/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To investigate vascular density analysis in the superficial (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ), peripapillary vascular density analysis (PPCVD), and peripapillary retinal nerve fiber thickness analysis (PPRNFL) using optical coherence tomography angiography (OCTA) in pregnant women with preeclampsia and to compare the obtained values with healthy pregnant and nonpregnant healthy individuals. METHODS A total of 98 pregnant women (55 had preeclampsia, 43 were healthy pregnant women) and 38 healthy nonpregnant women of reproductive age were included in the study. The patients were divided into three groups. Group 1 consisted of pregnant women with preeclampsia, group 2 comprised healthy pregnant women without preeclampsia, and group 3 consisted of healthy women who were not pregnant. All participants underwent a comprehensive ophthalmologic examination including OCTA. RESULTS Superficial foveal density (SFD) and deep foveal density (DFD) were lower in group 1 than in group 3 (p = 0.033, p = 0.041, respectively). Deep parafoveal density (DPD), deep temporal density (DTD), and deep superior density (DSD) values were lower in group 1 than in group 2 and group 3 (p = 0.001). PPRNFL superior and mean values were higher in group 1 and group 2 than in group 3 (p = 0.022, p = 0.029, respectively). The mean superior and inferior RPCVD values were significantly higher in group 1 than in group 2 and group 3 (p = 0.001, p = 0.043, and p = 0.001, respectively). CONCLUSIONS In preeclampsia, OCTA shows changes in the microvascular structure of the retina, even without retinopathy findings on biomicroscopy examination.
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Affiliation(s)
- Emine Ciloglu
- Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey.
| | - Nefise Tanrıdan Okcu
- Department of Obstetrics and Gynaecology, Adana City Training and Research Hospital, Adana, Turkey
| | - Neşe Çetin Dogan
- Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey
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Purtscher’s retinopathy case report: short posterior ciliary arteries contribution to radial peripapillary capillary system observed with optical coherence tomography angiography. Int Ophthalmol 2019; 39:2661-2665. [DOI: 10.1007/s10792-019-01086-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/23/2019] [Indexed: 10/27/2022]
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Abstract
PURPOSE OF REVIEW Optical coherence tomography angiography (OCTA) studies have demonstrated reduced microcirculation in the superficial optic nerve, peripapillary retina, and the macula of glaucoma patients. The scope of this review is to outline recent studies using OCTA in glaucoma and highlight how OCTA may help improve diagnosis and follow-up in glaucoma patients. RECENT FINDINGS OCTA studies have provided evidence of vascular changes in the optic nerve head, peripapillary, and macula region in glaucoma in comparison to glaucoma suspects and normal eyes. Additionally, OCTA can detect longitudinal reduction of peripapillary and macula vessel density in glaucoma patients. It remains unclear whether the reduced microcirculation in glaucoma patients induces the neuronal damage or arises through reduced circulation requirements in damaged tissue. SUMMARY OCTA is a novel imaging modality that has great potential to enhance our understanding of glaucoma and to improve our ability to detect and treat it.
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Mansoori T, Balakrishna N. Peripapillary Vessel Density and Retinal Nerve Fiber Layer Thickness in Patients with Unilateral Primary Angle Closure Glaucoma with Superior Hemifield Defect. J Curr Glaucoma Pract 2019; 13:21-27. [PMID: 31496557 PMCID: PMC6710934 DOI: 10.5005/jp-journals-10078-1247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate peripapillary retinal nerve fiber layer (RNFL) thickness and radial peripapillary capillary (RPC) vessel density (VD) in the eyes with unilateral primary angle-closure glaucoma (PACG) with the visual field (VF) defect confined to the superior hemifield and compare these parameters with the corresponding perimetrically intact regions of the fellow eye with primary angle-closure (PAC) and normal control eyes, using optical coherence tomography angiography (OCTA). Materials and methods This prospective, cross-sectional study included 28 eyes with unilateral PACG, with VF defects restricted to the superior hemifield, 28 fellow eyes with PAC, and 30 age-matched normal controls. Peripapillary RNFL thickness and RPC VD were measured in the eight peripapillary sectors, using OCTA, and these parameters were compared among the corresponding sectors of PACG, PAC, and healthy eyes using analysis of variance (ANOVA) with the Bonferroni post hoc analysis. Results In PACG eyes, there was a significant difference in the RNFL thickness (p < 0.0001) and RPC VD (p = 0.001) between the superior and the inferior hemifield. In PAC and normal eyes, there was no significant difference in the RNFL thickness and RPC VD between the superior and the inferior hemifield. Within the perimetrically intact regions of the PACG eyes, the mean RNFL thickness was significantly reduced in the superonasal (SN) and upper nasal (UN) sectors (p = 0.02), but the VD did not show any significant difference, when compared to the fellow PAC eyes. In PACG eyes, the mean RNFL thickness was significantly reduced in the perimetrically normal SN and UN sectors (p < 0.0001) and the VD was reduced in the UN sector (p = 0.01), when compared to the normal eyes. When comparing the peripapillary sectors of the PAC and healthy eyes, RNFL thickness was reduced in UN (p = 0.02), lower nasal (LN) (p = 0.01), inferonasal (IN) (p = 0.02), and inferotemporal (IT) sectors (p = 0.03) and there was no significant difference in the VD in any of the sectors. Inside disc capillaries were preserved in all the three groups. Conclusion Sector-wise RNFL thinning seems to precede the vascular changes and functional loss in the PAC and PACG eyes. How to cite this article Mansoori T, Balakrishna N. Peripapillary Vessel Density and Retinal Nerve Fiber Layer Thickness in Patients with Unilateral Primary Angle Closure Glaucoma with Superior Hemifield Defect. J Curr Glaucoma Pract 2019;13(1):21–27.
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Affiliation(s)
- Tarannum Mansoori
- Department of Glaucoma, Sita Lakshmi Glaucoma Center, Anand Eye Institute, Hyderabad, Telangana, India
| | - Nagalla Balakrishna
- Department of Statistics, National Institute of Nutrition, Hyderabad, Telangana, India
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Lim CW, Cheng J, Tay ELT, Teo HY, Wong EPY, Yong VKY, Lim BA, Hee OK, Wong HT, Yip LWL. Optical coherence tomography angiography of the macula and optic nerve head: microvascular density and test-retest repeatability in normal subjects. BMC Ophthalmol 2018; 18:315. [PMID: 30526537 PMCID: PMC6288920 DOI: 10.1186/s12886-018-0976-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/16/2018] [Indexed: 01/01/2023] Open
Abstract
Background Despite the potential usefulness of optical coherence tomography angiography in retinal and optic disc conditions, the reliability of the imaging modality remains unclear. This study set out to measure the microvascular density of macula and optic disc by mean of optical coherence tomography angiography and report the repeatability of the vessel density measurements. Methods Cross sectional observational cohort study. Subjects with normal eyes were recruited. Two sets of optical coherence tomography angiography images of macula and optic nerve head were acquired during one visit. Novel in-house developed software was used to count the pixels in each images and to compute the microvessel density of the macula and optic disc. Data were analysed to determine the measurement repeatability. Results A total of 176 eyes from 88 consecutive normal subjects were recruited. For macular images, the mean vessel density at superficial retina, deep retina, outer retina and choriocapillaries segment was OD 0.113 and OS 0.111, OD 0.239 and OS 0.230, OD 0.179 and OS 0.164, OD 0.237 and OS 0.215 respectively. For optic disc images, mean vessel density at vitreoretinal interface, radial peripapillary capillary, superficial nerve head and disc segment at the level of choroid were OD 0.084 and OS 0.085, OD 0.140 and OS 0.138, OD 0.216 and OS 0.209, OD 0.227 and OS 0.236 respectively. The measurement repeatability tests showed that the coefficient of variation of macular scans, for right and left eyes, ranged from 6.4 to 31.1% and 5.3 to 59.4%. Likewise, the coefficient of variation of optic disc scans, for right and left eyes, ranged from 14.3 to 77.4% and 13.5 to 75.3%. Conclusions Optical coherence tomography angiography is a useful modality to visualise the microvasculature plexus of macula and optic nerve head. The vessel density measurement of macular scan by mean of optical coherence tomography angiography demonstrated good repeatability. The optic disc scan, on the other hand, showed a higher coefficient of variation indicating a lower measurement repeatability than macular scan. Interpretation of optical coherence tomography angiography should take into account test-retest repeatability of the imaging system. Trial registration National Healthcare Group Domain Specific Review Board (NHG DSRB) Singapore. DSRB Reference: 2015/00301. Electronic supplementary material The online version of this article (10.1186/s12886-018-0976-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ching Wei Lim
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.,Department of Ophthalmology, Sarawak General Hospital, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Jun Cheng
- Ocular Imaging Department, Institute for Infocomm Research, Agency for Science, Technology and Research, Singapore, Singapore
| | - Elton Lik Tong Tay
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Hwei Yee Teo
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Elizabeth Poh Ying Wong
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Vernon Khet Yau Yong
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Boon Ang Lim
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Owen Kim Hee
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Hon Tym Wong
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Leonard Wei Leon Yip
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
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Correlation of optic disc morphometry and optic disc microvasculature assessed with optical coherence tomography angiography. Can J Ophthalmol 2018; 53:595-599. [DOI: 10.1016/j.jcjo.2018.01.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 11/22/2022]
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Mansoori T, Gamalapati J, Sivaswamy J, Balakrishna N. Optical coherence tomography angiography measured capillary density in the normal and glaucoma eyes. Saudi J Ophthalmol 2018; 32:295-302. [PMID: 30581300 PMCID: PMC6300758 DOI: 10.1016/j.sjopt.2018.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/30/2018] [Accepted: 09/25/2018] [Indexed: 11/05/2022] Open
Abstract
Purpose To compare the diagnostic ability of optical coherence tomography angiography (OCT-A) derived radial peripapillary capillary (RPC) measured capillary density (CD) and inside the optic nerve head (ONH) CD measurements to differentiate between the normal and primary open angle glaucoma (POAG) eyes. Methods AngioVue disc OCT-A images were obtained and assessed in 83 eyes of POAG patients and 74 age matched healthy eyes. RPC CD was quantitatively measured in the peripapillary area within 3.45 mm circle diameter around the ONH and inside the ONH in 8 equally divided sectors, using Bar – Selective Combination of Shifted Filter Responses method after the suppressing large vessels. Area under receiver operating characteristic (AUROC) curve was used to assess the diagnostic accuracy of the two scanning regions of CD to differentiate between the normal and POAG eyes. Results The mean peripapillary RPC density (0.12 ± 0.03) and mean ONH CD (0.09 ± 0.03) were significantly lower in POAG eyes when compared to the normal eyes (RPC CD: 0.17 ± 0.05, p < 0.0001 and ONH CD 0.11 ± 0.02, p = 0.01 respectively). The POAG patients showed 29% reduction in the RPC CD and 19% reduction in the ONH CD when compared to the normal eyes. The AUROC for discriminating between healthy and glaucomatous eyes was 0.784 for mean RPC CD and 0.743 for the mean ONH CD. Conclusions Diagnostic ability of OCT-A derived peripapillary CD and ONH CD was moderate for differentiating between the normal and glaucomatous eyes. Diagnostic ability of even the best peripapillary average and inferotemporal sector for RPC CD and average and superonasal sector for the ONH CD was moderate.
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Guo Y, Sung MS, Park SW. Assessment of superficial retinal microvascular density in healthy myopia. Int Ophthalmol 2018; 39:1861-1870. [DOI: 10.1007/s10792-018-1014-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/29/2018] [Indexed: 12/21/2022]
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Kiyota N, Kunikata H, Shiga Y, Omodaka K, Nakazawa T. Ocular microcirculation measurement with laser speckle flowgraphy and optical coherence tomography angiography in glaucoma. Acta Ophthalmol 2018; 96:e485-e492. [PMID: 29575676 DOI: 10.1111/aos.13639] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/02/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare glaucoma severity with ocular microcirculation, measured with either laser speckle flowgraphy (LSFG) or optical coherence tomography angiography (OCTA). METHODS We retrospectively studied 82 eyes of 82 open-angle glaucoma (OAG) patients who underwent same-day LSFG and OCTA examinations, with 20 eyes of 20 healthy subjects as controls. In OCTA images, vessel density (VD) (%) was calculated in concentric regions (regions 1, 2 and 3: R1, R2 and R3, respectively) defined by 1.6-, 3.2- and 3.6-mm-diameter circles around the optic nerve head (ONH). In R3, the large vessels were automatically masked to calculate pure capillary density (auto R3 VD). LSFG-measured mean blur rate (MBR) was examined in the overall ONH (MA), vessel-area ONH (MV) and tissue-area ONH (MT). RESULTS Auto R3 VD had high reproducibility (coefficient of variation: 1.65-3.88%) and accurately reflected manual R3 VD [mean bias: -0.0087% (auto R3 VD - manual R3 VD)]. MA and MT decreased significantly with OAG severity, especially in the early OAG stages (control vs. mild: p = 0.003 and p < 0.001, respectively). R1 VD did not change with severity. R2 and auto R3 VD decreased significantly with OAG severity, especially in the severe stages (R2, mild vs. severe: p = 0.008; auto R3 VD, mild vs. severe: p < 0.001, moderate vs. severe: p = 0.028). CONCLUSION Optical coherence tomography angiography-derived auto R3 VD is novel, reproducible and accurately reflects manual measurements. It is useful for differentiating moderate and advanced glaucoma, while LSFG-derived MT is useful for identifying early glaucoma.
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Affiliation(s)
- Naoki Kiyota
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Hiroshi Kunikata
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Retinal Disease Control; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yukihiro Shiga
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kazuko Omodaka
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Ophthalmic Imaging and Information Analytics; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Toru Nakazawa
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Retinal Disease Control; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Ophthalmic Imaging and Information Analytics; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Advanced Ophthalmic Medicine; Tohoku University Graduate School of Medicine; Sendai Japan
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Pinhas A, Linderman R, Mo S, Krawitz BD, Geyman LS, Carroll J, Rosen RB, Chui TY. A method for age-matched OCT angiography deviation mapping in the assessment of disease- related changes to the radial peripapillary capillaries. PLoS One 2018; 13:e0197062. [PMID: 29795576 PMCID: PMC5993123 DOI: 10.1371/journal.pone.0197062] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/25/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To present a method for age-matched deviation mapping in the assessment of disease-related changes to the radial peripapillary capillaries (RPCs). METHODS We reviewed 4.5x4.5mm en face peripapillary OCT-A scans of 133 healthy control eyes (133 subjects, mean 41.5 yrs, range 11-82 yrs) and 4 eyes with distinct retinal pathologies, obtained using spectral-domain optical coherence tomography angiography. Statistical analysis was performed to evaluate the impact of age on RPC perfusion densities. RPC density group mean and standard deviation maps were generated for each decade of life. Deviation maps were created for the diseased eyes based on these maps. Large peripapillary vessel (LPV; noncapillary vessel) perfusion density was also studied for impact of age. RESULTS Average healthy RPC density was 42.5±1.47%. ANOVA and pairwise Tukey-Kramer tests showed that RPC density in the ≥60yr group was significantly lower compared to RPC density in all younger decades of life (p<0.01). Average healthy LPV density was 21.5±3.07%. Linear regression models indicated that LPV density decreased with age, however ANOVA and pairwise Tukey-Kramer tests did not reach statistical significance. Deviation mapping enabled us to quantitatively and visually elucidate the significance of RPC density changes in disease. CONCLUSIONS It is important to consider changes that occur with aging when analyzing RPC and LPV density changes in disease. RPC density, coupled with age-matched deviation mapping techniques, represents a potentially clinically useful method in detecting changes to peripapillary perfusion in disease.
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Affiliation(s)
- Alexander Pinhas
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
- Department of Ophthalmology, State University of New York Downstate Medical Center, Brooklyn, NY, United States of America
| | - Rachel Linderman
- Department of Cell Biology, Neurology and Anatomy, The Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Shelley Mo
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Brian D. Krawitz
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Lawrence S. Geyman
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Joseph Carroll
- Department of Cell Biology, Neurology and Anatomy, The Medical College of Wisconsin, Milwaukee, WI, United States of America
- Department of Ophthalmology & Visual Sciences, The Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Richard B. Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Toco Y. Chui
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Fan W, Uji A, Borrelli E, Singer M, Sagong M, van Hemert J, Sadda SR. Precise Measurement of Retinal Vascular Bed Area and Density on Ultra-wide Fluorescein Angiography in Normal Subjects. Am J Ophthalmol 2018; 188:155-163. [PMID: 29428456 DOI: 10.1016/j.ajo.2018.01.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE To characterize and quantify the total retinal vascular bed area (RVBA) and vascular density (VD) in normal eyes using stereographically corrected ultra-wide-field (UWF) fluorescein angiography (FA). DESIGN Cross-sectional study. METHODS Fifty-nine eyes of 31 normal subjects with no evidence of ocular disease underwent FA using the Optos 200Tx (Optos plc, Dunfermline, United Kingdom). Central and peripheral-steered FA images were montaged and stereographically projected. The early-phase FA was used to extract the retinal vasculature as a binary mask. Two independent, masked reading center-certified graders delineated the peripheral edge of the total retinal area (TRA) on a middle-phase frame. The RVBA and TRA were computed automatically in mm2 using software provided by the manufacturer. The VD was calculated by dividing RVBA by TRA. RESULTS The mean RVBA was 42.3 ± 14.8 mm2 for the entire retina, with no difference between male and female subjects (P = .439) or between right and left eyes (P = .407). The mean VD was 4.3% ± 1.4% for the entire retina, with no difference based on sex (P = .629) or laterality (P = .426). A negative correlation was observed between age and both RVBA and VD (RVBA: R = -0.6, P < .001; VD: R = -0.52, P < .001). Pairwise comparisons showed that subjects aged >65 years had smaller RVBA and VD than those younger than 50 years for the entire retina and in all quadrants. CONCLUSIONS RVBA and VD can be extracted from UWF FA images using automated processing techniques and may provide a reliable alternative to measures such as nonperfusion area.
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The Quantitative Measurements of Vascular Density and Flow Area of Optic Nerve Head Using Optical Coherence Tomography Angiography. J Glaucoma 2018; 27:e51-e52. [DOI: 10.1097/ijg.0000000000000850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Correlation of flow density, as measured using optical coherence tomography angiography, with structural and functional parameters in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 2018; 256:589-597. [DOI: 10.1007/s00417-017-3865-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/24/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022] Open
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Glaucoma Diagnostic Capabilities of Foveal Avascular Zone Parameters Using Optical Coherence Tomography Angiography According to Visual Field Defect Location. J Glaucoma 2017; 26:1120-1129. [PMID: 29016521 DOI: 10.1097/ijg.0000000000000800] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the diagnostic ability of foveal avascular zone (FAZ) parameters to discriminate glaucomatous eyes with visual field defects (VFDs) in different locations (central vs. peripheral) from normal eyes. PATIENTS AND METHODS Totally, 125 participants were separated into 3 groups: normal (n=45), glaucoma with peripheral VFD (PVFD, n=45), and glaucoma with central VFD (CVFD, n=35). The FAZ area, perimeter, and circularity and parafoveal vessel density were calculated from optical coherence tomography angiography images. The diagnostic ability of the FAZ parameters and other structural parameters was determined according to glaucomatous VFD location. Associations between the FAZ parameters and central visual function were evaluated. RESULTS A larger FAZ area and longer FAZ perimeter were observed in the CVFD group than in the PVFD and normal groups. The FAZ area, perimeter, and circularity were better in differentiating glaucomatous eyes with CVFDs from normal eyes [areas under the receiver operating characteristic curves (AUC), 0.78 to 0.88] than in differentiating PVFDs from normal eyes (AUC, 0.51 to 0.64). The FAZ perimeter had a similar AUC value to the circumpapillary retinal nerve fiber layer and macular ganglion cell-inner plexiform layer thickness for differentiating eyes with CVFDs from normal eyes (all P>0.05, the DeLong test). The FAZ area was significantly correlated with central visual function (β=-112.7, P=0.035, multivariate linear regression). CONCLUSIONS The FAZ perimeter had good diagnostic capability in differentiating glaucomatous eyes with CVFDs from normal eyes, and may be a potential diagnostic biomarker for detecting glaucomatous patients with CVFDs.
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