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Schreiberova Z, Rehak J, Babkova B, Sin M, Rybarikova M, Paskova B, Sinova I, Hubnerova P, Maluskova M, Maresova K, Karhanova M. Hypertension, hyperlipidaemia and thrombophilia as the most common risk factors for retinal vein occlusion in patients under 50 years. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:44-49. [PMID: 36036564 DOI: 10.5507/bp.2022.036] [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: 05/29/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. METHODS We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. RESULTS The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. CONCLUSION The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.
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Affiliation(s)
- Zuzana Schreiberova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Jiri Rehak
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Barbora Babkova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Martin Sin
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and Military University Hospital Prague, Czech Republic
| | - Martina Rybarikova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Barbora Paskova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Irena Sinova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Petra Hubnerova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Miroslava Maluskova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Klara Maresova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Marta Karhanova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Frederiksen KH, Pedersen FN, Vergmann AS, Yang D, Laugesen CS, Vestergaard JP, Sørensen TL, Cheung CY, Kawasaki R, Peto T, Grauslund J. Predictive value of retinal oximetry, optical coherence tomography angiography and microperimetry in patients with treatment-naïve branch retinal vein occlusion. Int J Retina Vitreous 2023; 9:38. [PMID: 37381014 DOI: 10.1186/s40942-023-00468-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/06/2023] [Indexed: 06/30/2023] Open
Abstract
Vascular endothelial growth factor inhibitors have substantially improved the visual outcomes in patients with macular edema (ME) caused by branch retinal vein occlusion (BRVO), but treatment outcomes are highly variable and early prediction of expected clinical outcome would be important for individualized treatment.As non-invasive metabolic, structural and functional retinal markers might act as early predictors of clinical outcomes, we performed a 12-month, prospective study aimed to evaluate if baseline retinal oximetry, optical coherence tomography angiography (OCT-A) or microperimetry were able to predict need of treatment, structural or functional outcome in patients with ME caused by treatment-näive BRVO.We evaluated 41 eyes of 41 patients with a mean age of 69.6 years and 56% females. We found a strong tendency towards a higher retinal arteriolar oxygen saturation in patients without a need of additional aflibercept treatment after the loading phase (99.8% vs. 92.3%, adjusted odds ratio 0.80 (95% confidence interval 0.64-1.00), adjusted p = 0.058), but otherwise, retinal oximetry, OCT-A or microperimetry were not able to predict need of treatment, structural nor functional outcomes. (Trial registration: clinicaltrials.gov, S-20,170,084. Registered 24 August 2014, https://clinicaltrials.gov/ct2/show/NCT03651011 ).
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Affiliation(s)
- Katrine Hartmund Frederiksen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Frederik Nørregaard Pedersen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Dawei Yang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | | | | | - Torben Lykke Sørensen
- Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
- Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Ryo Kawasaki
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Vision Informatics, Osaka University School of Medicine, Osaka, Japan
| | - Tunde Peto
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, Northern Ireland, UK
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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3
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Lowater SJ, Ellingsen TJ, Pedersen JK, Wied J, Grauslund J, Byg KE. Non-Invasive Metabolic and Structural Retinal Markers in Patients with Giant Cell Arteritis and Polymyalgia Rheumatica: A Cross-Sectional Study. Metabolites 2022; 12:metabo12090872. [PMID: 36144276 PMCID: PMC9504005 DOI: 10.3390/metabo12090872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Giant cell arteritis (GCA) is a potential sight-threatening disease. Although it is associated with polymyalgia rheumatica (PMR), visual loss is not common in PMR. A retinal oximeter can be used to conduct a direct, non-invasive, in vivo assessment of the vascular system. In a cross-sectional study, we measured the retinal oxygen saturation and retinal vessel calibers in GCA patients, PMR patients, and control participants. Twenty GCA patients (38 eyes), 19 PMR patients (33 eyes), and 12 controls (20 eyes) were investigated. Images were analyzed using Oxymap Analyzer software 2.5.0 (Oxymap ehf., Reykjavik, Iceland). Groups were compared using an age- and sex-adjusted linear mixed model regression. The median (IQR) age for GCA patients was 69.0 (66.5–76.5) years, for PMR 69.0 (67.0–72.0) years, and for the controls 75.5 (71.5–81.0) years, respectively. As compared to the controls (115.3 µm), the retinal arterioles were significantly wider in patients with GCA (124.4 µm; p = 0.023) and PMR (124.8 µm; p = 0.049). No difference was found in the retinal venular caliber or vascular oxygen saturation. These results indicate that GCA and PMR patients differ similarly in the retinal arteriolar diameter compared to controls. Further studies are needed in order to clarify the underlying inflammatory mechanisms in retinal arteriolar vessels and if these parameters can be used to predict clinical outcomes.
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Affiliation(s)
- Simon J. Lowater
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, 5000 Odense C, Denmark
| | - Torkell J. Ellingsen
- Research Unit of Rheumatology, Department of Rheumatology, Odense University Hospital, 5000 Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Jens K. Pedersen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
- Department of Medicine, Rheumatology Section, Odense University Hospital, Svendborg Sygehus, 5700 Svendborg, Denmark
| | - Jimmi Wied
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, 5000 Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Jakob Grauslund
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, 5000 Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Keld-Erik Byg
- Research Unit of Rheumatology, Department of Rheumatology, Odense University Hospital, 5000 Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
- Department of Neurology, Odense University Hospital, 5000 Odense C, Denmark
- Correspondence:
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Belamkar AV, Jabbehdari S, Harris A, Hajrasouliha AR. Clinical implications of retinal oximetry in retinal vein occlusion: a review. Acta Ophthalmol 2021; 100:624-631. [PMID: 34845846 DOI: 10.1111/aos.15066] [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: 09/14/2021] [Revised: 10/28/2021] [Accepted: 11/19/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To review retinal vein occlusion (RVO) and its relationship with retinal oxygen saturation via automated retinal oximetry in eyes with RVO. METHODS A literature review was performed in PubMed and Medline until October 2021 utilizing specific keywords and cross-matched reference lists. RESULTS This review found RVO to be associated with risk factors including age, hypertension, cardiovascular and metabolic conditions, male gender, and glaucoma. These may be attributed to a breakdown of regulatory processes in the retina. Retinal venous oxygen saturation (SvO2 ) and arteriovenous difference in eyes with central RVO have been found to be reduced and elevated, respectively. The literature indicates variable and contradictory findings in regard to branch RVO and retinal oxygenation. Additionally, ischaemic eyes have been found to have elevated retinal arterial oxygen saturation; however, the literature reports variable results regarding SvO2 levels. Medications have been suggested to increase SvO2 in RVO eyes, which may represent an important mechanism for disease management. Ranibizumab is currently the most studied drug for retinal oxygenation in RVO and has been suggested to increase SvO2 in RVO eyes. In comparison, dexamethasone was found to decrease SvO2 . CONCLUSION The current literature on retinal oxygenation in ischaemic subtypes of RVO and in drug therapies is minimal, and further work is required to expand upon our understanding of how ischaemia and drugs influence retinal oxygenation and clinical outcomes.
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Affiliation(s)
- Aditya V. Belamkar
- Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis Indiana USA
| | - Sayena Jabbehdari
- Jones Eye Institute University of Arkansas for Medical Sciences Little Rock Arkansas USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai Ophthalmic Vascular Diagnostic and Research Program at Mount Sinai Hospital New York New York USA
| | - Amir R. Hajrasouliha
- Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis Indiana USA
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5
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Tomita R, Iwase T, Fukami M, Goto K, Ra E, Terasaki H. Elevated retinal artery vascular resistance determined by novel visualized technique of laser speckle flowgraphy in branch retinal vein occlusion. Sci Rep 2021; 11:20034. [PMID: 34625616 PMCID: PMC8501139 DOI: 10.1038/s41598-021-99572-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate the increase in resistivity of the retinal artery in the branch retinal vein occlusion (BRVO)-affected area, and to visualize it. Thirty-two eyes of 32 patients with BRVO were measured by laser speckle flowgraphy (LSFG). The retinal artery and vein running to the BRVO-affected area and vertically symmetrical vessels in the unaffected area were examined. We applied the LSFG parameter beat strength over mean blur rate (BOM), calculated using a similar method to the pulsatility index used in Doppler flowmetry to evaluate resistivity of the vessels. Our results showed that the BOM map could clearly visualize the increase of resistivity in the retinal artery as a two-dimensional map. The BOM of the arteries in the affected area was significantly higher than that of the unaffected area (P = 0.001). Multiple regression analysis showed that the ratio of BOM in retinal arteries of the affected area to the unaffected was significantly associated with the extent of retinal hemorrhage (β = 0.447, P = 0.009). In conclusion, the index of resistivity of the retinal artery in the BRVO-affected area was higher and could be visualized in a two-dimensional map. These findings and techniques would contribute to elucidate the pathophysiology of BRVO.
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Affiliation(s)
- Ryo Tomita
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan. .,Department of Ophthalmology, Akita University Graduate School of Medicine, 1-1-1 Hondou, Akita, 010-8543, Japan.
| | - Marie Fukami
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan
| | - Kensuke Goto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan
| | - Eimei Ra
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan
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6
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Choi YJ, Choi YJ, Cho YW, Yoo WS, Chung IY. Treatment Results of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.9.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). Methods: The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. Results: Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (<i>p</i> = 0.025, <i>p</i> = 0.019, and <i>p</i> = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (<i>p</i> = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (<i>p</i> = 0.044, <i>p</i> = 0.047, <i>p</i> = 0.004, <i>p</i> = 0.045, and <i>p</i> = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (<i>p</i> = 0.045, <i>p</i> = 0.046, <i>p</i> = 0.002, and <i>p</i> = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (<i>p</i> = 0.042, <i>p</i> = 0.009, and <i>p</i> = 0.015, respectively). Conclusions: In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.
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DOU PENG, ZHANG YANG, ZHENG RUI, YE YU, MAO JIANBO, LIU LEI, WU MING, SUN MINGZHAI. RETINAL IMAGING AND ANALYSIS USING MACHINE LEARNING WITH INFORMATION FUSION OF THE FUNCTIONAL AND STRUCTURAL FEATURES BASED ON A DUAL-MODAL FUNDUS CAMERA. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421500305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Retinal diseases and systemic diseases, such as diabetic retinopathy (DR) and Alzheimer’s disease, may manifest themselves in the retina, changing the retinal oxygen saturation ([Formula: see text]) level or the retinal vascular structures. Recent studies explored the correlation of diseases with either retina vascular structures or [Formula: see text] level, but not both due to the lack of proper instrument or methodology. In this study, we applied a dual-modal fundus camera and developed a deep learning-based analysis method to simultaneously acquire and quantify the [Formula: see text] and vascular structures. Deep learning was used to automatically locate the optic discs and segment arterioles and venules of the blood vessels. We then sought to apply machine learning methods, such as random forest (RF) and support vector machine (SVM), to fuse the [Formula: see text] level and retinal vessel parameters as different features to discriminate against the disease from the healthy controls. We showed that the fusion of the functional (oxygen saturation) and structural (vascular parameters) features offers better performance to classify diseased and healthy subjects. For example, we gained a 13.8% and 2.0% increase in the accuracy with fusion using the RF and SVM to classify the nonproliferative DR and the healthy controls.
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Affiliation(s)
- PENG DOU
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, P. R. China
| | - YANG ZHANG
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, P. R. China
| | - RUI ZHENG
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, P. R. China
| | - YU YE
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, P. R. China
| | - JIANBO MAO
- Eye Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, P. R. China
| | - LEI LIU
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, P. R. China
| | - MING WU
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, P. R. China
| | - MINGZHAI SUN
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, P. R. China
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Tang W, Guo J, Zhuang X, Zhang T, Wang L, Wang K, Chang Q, Liu W, Xu G. Wide-Field Swept-Source Optical Coherence Tomography Angiography Analysis of the Periarterial Capillary-Free Zone in Branch Retinal Vein Occlusion. Transl Vis Sci Technol 2021; 10:9. [PMID: 34003897 PMCID: PMC7881276 DOI: 10.1167/tvst.10.2.9] [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: 01/19/2023] Open
Abstract
Purpose To investigate the characteristics of the retinal periarterial capillary-free zone (paCFZ) with wide-field swept-source optical coherence tomography angiography (SS-OCTA) in eyes with branch retinal vein occlusion (BRVO). Methods Seventy treatment-naïve eyes with BRVO and 35 healthy eyes were included. The paCFZ areas, artery calibers, and areas of the major arteries in the unaffected quadrants of BRVO eyes were measured in 12 × 12-mm SS-OCTA images and compared with those of the contralateral eyes and healthy eyes. Other multimodal imaging data were collected. Results There were no significant differences in the unaffected artery caliber or area among the three groups (all P > 0.05). The unaffected paCFZ areas and the ratios of the unaffected paCFZ area to the counterpart artery area (paCFZ/artery area) of the major arteries were significantly larger than those in the contralateral or healthy eyes (all P < 0.05). Subgroup analysis revealed that the paCFZ/artery area value differed significantly between ischemic and nonischemic BRVO eyes (P < 0.01). The paCFZ/artery area value was positively correlated with logMAR best-corrected visual acuity, symptom duration, central macular thickness, and retinal nonperfusion area in BRVO. Conclusions Quantitative SS-OCTA measurements confirmed enlarged paCFZs along the unaffected major retinal arteries in BRVO eyes. The paCFZ parameters were correlated with symptom duration, retinal ischemia, and visual function. Translational Relevance Retinal periarterial capillary-free zones in BRVO can be non-invasively measured by SS-OCTA, assisting in clinically identifying retinal ischemia and evaluating visual function.
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Affiliation(s)
- Wenyi Tang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jingli Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaonan Zhuang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ting Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ling Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Keyan Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qing Chang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wei Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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9
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Svrčinová T, Hok P, Šínová I, Dorňák T, Král M, Hübnerová P, Mareš J, Kaňovský P, Šín M. Changes in oxygen saturation and the retinal nerve fibre layer in patients with optic neuritis associated with multiple sclerosis in a 6-month follow-up. Acta Ophthalmol 2020; 98:841-847. [PMID: 32395882 PMCID: PMC7754403 DOI: 10.1111/aos.14463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 03/19/2020] [Accepted: 04/18/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE Optic neuritis (ON) is an inflammatory demyelinating disorder of the optic nerve, which can be the first manifestation of multiple sclerosis (MS). The main goal was to assess changes in the retinal nerve fibre layer (RNFL) and in retinal oxygen saturation [arterial (AS), venous (VS) and arterio-venous (A-V) difference] in the affected and unaffected eye. METHODS Fifty patients with ON due to MS within 3 months of onset of symptoms were enrolled (17 males, mean age 35.3). All patients were examined at baseline (V1) and after 6 months (V2) using optical coherence tomography (OCT) to get RNFL values; automatic retinal oximetry to obtain saturation values; and ultrasound to exclude arterial stenosis, and orbital colour Doppler imaging was performed in the ophthalmic artery. RESULTS At V1, AS was significantly increased in affected eye compared to unaffected eye (99.5% versus 98.0%, p = 0.03). Significant decrease in A-V difference from baseline was detected in both eyes for ON eye: 32.0% versus 29.0%, p = 0.004; for fellow eye: 31.4% versus 30.0%, p = 0.04. We did not observe any changes in retinal vessel diameter. There were no changes observed in blood flow in ophthalmic artery. At V1, there were no significant differences in RNFL, and significant loss of RNFL was confirmed in the affected eye at V2 (95 μm versus 86 μm, p = 0.0002) and in comparison with the fellow eye (86 μm versus 94 μm, p = 0.0002). There were no correlations between RNFL and saturation values at V1, although at V2, there was a negative correlation between the RNFL and AS (Spearman's rho = -0.480, p = 0.003) and between the RNFL and VS (rho = -0.620, p = 0.00007). CONCLUSION Retinal oximetry is altered in both eyes in MS patients with unilateral ON. During the course of the disease, the retinal oxygen consumption decreases to a different degree in each eye and this change is not completely followed by changes in the RNFL thickness, suggesting either sub-clinical ON or systemic effects in the clinically unaffected eye. Since this is the first and initial longitudinal evaluation of the saturation changes in MS patients, the clinical value of these findings needs to be deeper evaluated in the future studies.
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Affiliation(s)
- Tereza Svrčinová
- Department of NeurologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Pavel Hok
- Department of NeurologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Irena Šínová
- Department of OphthalmologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Tomáš Dorňák
- Department of NeurologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Michal Král
- Department of NeurologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Petra Hübnerová
- Department of OphthalmologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Jan Mareš
- Department of NeurologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Petr Kaňovský
- Department of NeurologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
| | - Martin Šín
- Department of OphthalmologyFaculty of Medicine and DentistryUniversity HospitalPalacký University OlomoucOlomoucCzech Republic
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