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Nouri H, Abtahi SH, Mazloumi M, Samadikhadem S, Arevalo JF, Ahmadieh H. Optical coherence tomography angiography in diabetic retinopathy: A major review. Surv Ophthalmol 2024; 69:558-574. [PMID: 38521424 DOI: 10.1016/j.survophthal.2024.03.004] [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: 09/23/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
Diabetic retinopathy (DR) is characterized by retinal vasculopathy and is a leading cause of visual impairment. Optical coherence tomography angiography (OCTA) is an innovative imaging technology that can detect various pathologies and quantifiable changes in retinal microvasculature. We briefly describe its functional principles and advantages over fluorescein angiography and perform a comprehensive review on its clinical applications in the screening or management of people with prediabetes, diabetes without clinical retinopathy (NDR), nonproliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME). OCTA reveals early microvascular alterations in prediabetic and NDR eyes, which may coexist with sub-clinical neuroretinal dysfunction. Its applications in NPDR include measuring ischemia, detecting retinal neovascularization, and timing of early treatment through predicting the risk of retinopathy worsening or development of DME. In PDR, OCTA helps characterize the flow within neovascular complexes and evaluate their progression or regression in response to treatment. In eyes with DME, OCTA perfusion parameters may be of predictive value regarding the visual and anatomical gains associated with treatment. We further discussed the limitations of OCTA and the benefits of its incorporation into an updated DR severity scale.
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Affiliation(s)
- Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehdi Mazloumi
- Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sanam Samadikhadem
- Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Parravano M, Cennamo G, Di Antonio L, Grassi MO, Lupidi M, Rispoli M, Savastano MC, Veritti D, Vujosevic S. Multimodal imaging in diabetic retinopathy and macular edema: An update about biomarkers. Surv Ophthalmol 2024:S0039-6257(24)00075-4. [PMID: 38942124 DOI: 10.1016/j.survophthal.2024.06.006] [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: 01/23/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024]
Abstract
Diabetic macular edema (DME), defined as retinal thickening near, or involving the fovea caused by fluid accumulation in the retina, can lead to vision impairment and blindness in patients with diabetes. Current knowledge of retina anatomy and function and DME pathophysiology has taken great advantage of the availability of several techniques for visualizing the retina. Combining these techniques in a multimodal imaging approach to DME is recommended to improve diagnosis and to guide treatment decisions. We review the recent literature about the following retinal imaging technologies: optical coherence tomography (OCT), OCT angiography (OCTA), wide-field and ultrawide-field techniques applied to fundus photography, fluorescein angiography, and OCTA. The emphasis will be on characteristic DME features identified by these imaging technologies and their potential or established role as diagnostic, prognostic, or predictive biomarkers. The role of artificial intelligence in the assessment and interpretation of retina images is also discussed.
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Affiliation(s)
| | - Gilda Cennamo
- Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
| | - Luca Di Antonio
- UOC Ophthalmology and Surgery Department, ASL-1 Avezzano-Sulmona, L'Aquila, Italy
| | - Maria Oliva Grassi
- Eye Clinic, Azienda Ospedaliero-Universitaria Policlinico, University of Bari, Bari, Italy
| | - Marco Lupidi
- Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | | | - Maria Cristina Savastano
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Daniele Veritti
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
| | - Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Eye Clinic, IRCCS MultiMedica, Milan, Italy.
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Torm MEW, Pircher M, Bonnin S, Johannesen J, Klefter ON, Schmidt MF, Frederiksen JL, Lefaudeux N, Andilla J, Valdes C, Loza-Alvarez P, Brea LS, De Jesus DA, Grieve K, Paques M, Larsen M, Gocho K. Detection of capillary abnormalities in early diabetic retinopathy using scanning laser ophthalmoscopy and optical coherence tomography combined with adaptive optics. Sci Rep 2024; 14:13450. [PMID: 38862584 PMCID: PMC11166634 DOI: 10.1038/s41598-024-63749-7] [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: 02/01/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024] Open
Abstract
This study tested if a high-resolution, multi-modal, multi-scale retinal imaging instrument can provide novel information about structural abnormalities in vivo. The study examined 11 patients with very mild to moderate non-proliferative diabetic retinopathy (NPDR) and 10 healthy subjects using fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), adaptive optics scanning laser ophthalmoscopy (AO-SLO), adaptive optics OCT and OCTA (AO-OCT(A)). Of 21 eyes of 11 patients, 11 had very mild NPDR, 8 had mild NPDR, 2 had moderate NPDR, and 1 had no retinopathy. Using AO-SLO, capillary looping, inflections and dilations were detected in 8 patients with very mild or mild NPDR, and microaneurysms containing hyperreflective granular elements were visible in 9 patients with mild or moderate NPDR. Most of the abnormalities were seen to be perfused in the corresponding OCTA scans while a few capillary loops appeared to be occluded or perfused at a non-detectable flow rate, possibly because of hypoperfusion. In one patient with moderate NPDR, non-perfused capillaries, also called ghost vessels, were identified by alignment of corresponding en face AO-OCT and AO-OCTA images. The combination of multiple non-invasive imaging methods could identify prominent microscopic abnormalities in diabetic retinopathy earlier and more detailed than conventional fundus imaging devices.
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Affiliation(s)
- Marie Elise Wistrup Torm
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark.
| | - Michael Pircher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Sophie Bonnin
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
- Foundation Rothschild Hospital, 25-29, Rue Manin, 75019, Paris, France
| | - Jesper Johannesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Pediatrics, Herlev-Gentofte Hospital, Borgmester Ib Juuls Vej 25C, Herlev, Denmark
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Oliver Niels Klefter
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - Mathias Falck Schmidt
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Neurology, Clinic of Optic Neuritis, The Danish Multiple Sclerosis Center (DMSC), Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark
| | - Jette Lautrup Frederiksen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Neurology, Clinic of Optic Neuritis, The Danish Multiple Sclerosis Center (DMSC), Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark
| | | | - Jordi Andilla
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Claudia Valdes
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Pablo Loza-Alvarez
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Luisa Sanchez Brea
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, The Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, The Netherlands
| | - Danilo Andrade De Jesus
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, The Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, The Netherlands
| | - Kate Grieve
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
| | - Michel Paques
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
| | - Michael Larsen
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - Kiyoko Gocho
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
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Li T, Qian Y, Li H, Wang T, Jiang Q, Wang Y, Zhu Y, Li S, He X, Shi G, Su W, Lu Y, Chen Y. Cellular communication network factor 1 promotes retinal leakage in diabetic retinopathy via inducing neutrophil stasis and neutrophil extracellular traps extrusion. Cell Commun Signal 2024; 22:275. [PMID: 38755602 PMCID: PMC11097549 DOI: 10.1186/s12964-024-01653-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a major cause of blindness and is characterized by dysfunction of the retinal microvasculature. Neutrophil stasis, resulting in retinal inflammation and the occlusion of retinal microvessels, is a key mechanism driving DR. These plugging neutrophils subsequently release neutrophil extracellular traps (NETs), which further disrupts the retinal vasculature. Nevertheless, the primary catalyst for NETs extrusion in the retinal microenvironment under diabetic conditions remains unidentified. In recent studies, cellular communication network factor 1 (CCN1) has emerged as a central molecule modulating inflammation in pathological settings. Additionally, our previous research has shed light on the pathogenic role of CCN1 in maintaining endothelial integrity. However, the precise role of CCN1 in microvascular occlusion and its potential interaction with neutrophils in diabetic retinopathy have not yet been investigated. METHODS We first examined the circulating level of CCN1 and NETs in our study cohort and analyzed related clinical parameters. To further evaluate the effects of CCN1 in vivo, we used recombinant CCN1 protein and CCN1 overexpression for gain-of-function, and CCN1 knockdown for loss-of-function by intravitreal injection in diabetic mice. The underlying mechanisms were further validated on human and mouse primary neutrophils and dHL60 cells. RESULTS We detected increases in CCN1 and neutrophil elastase in the plasma of DR patients and the retinas of diabetic mice. CCN1 gain-of-function in the retina resulted in neutrophil stasis, NETs extrusion, capillary degeneration, and retinal leakage. Pre-treatment with DNase I to reduce NETs effectively eliminated CCN1-induced retinal leakage. Notably, both CCN1 knockdown and DNase I treatment rescued the retinal leakage in the context of diabetes. In vitro, CCN1 promoted adherence, migration, and NETs extrusion of neutrophils. CONCLUSION In this study, we uncover that CCN1 contributed to retinal inflammation, vessel occlusion and leakage by recruiting neutrophils and triggering NETs extrusion under diabetic conditions. Notably, manipulating CCN1 was able to hold therapeutic promise for the treatment of diabetic retinopathy.
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Affiliation(s)
- Ting Li
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Yixia Qian
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Haicheng Li
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Tongtong Wang
- Department of Clinical Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Qi Jiang
- Department of Ocular Immunology & Uveitis, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510515, China
| | - Yuchan Wang
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Yanhua Zhu
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Shasha Li
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Xuemin He
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Guojun Shi
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Wenru Su
- Department of Ocular Immunology & Uveitis, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, 510515, China
| | - Yan Lu
- Department of Clinical Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
| | - Yanming Chen
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
- Department of Clinical Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
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5
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Campos AC, Lima EG, Jacobsen PK, Arnould L, Lottenberg S, Maia RM, Conci LS, Minelli T, Morato A, Dantas-Jr RN, Nomura CH, Rissoli P, Pimentel SG, Serrano Junior CV. Association between obstructive coronary disease and diabetic retinopathy: Cross-sectional study of coronary angiotomography and multimodal retinal imaging. J Diabetes Complications 2024; 38:108721. [PMID: 38471431 DOI: 10.1016/j.jdiacomp.2024.108721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/28/2024] [Accepted: 03/03/2024] [Indexed: 03/14/2024]
Abstract
AIMS To investigate the association between diabetic retinopathy (DR) and coronary artery disease (CAD) using coronary angiotomography (CCTA) and multimodal retinal imaging (MMRI) with ultra-widefield retinography and optical coherence tomography angiography and structural domain. METHODS Single-center, cross-sectional, single-blind. Patients with diabetes who had undergone CCTA underwent MMRI. Uni and multivariate analysis were used to assess the association between CAD and DR and to identify variables independently associated with DR. RESULTS We included 171 patients, 87 CAD and 84 non-CAD. Most CAD patients were males (74 % vs 38 %, P < 0.01), insulin users (52 % vs 38 %, p < 0.01) and revascularized (64 %). They had a higher prevalence of DR (48 % vs 22 %, p = 0.01), microaneurysms (25 % vs 13 %, p = 0.04), intraretinal cysts (22 % vs 8 %, p = 0.01) and areas of reduced capillary density (46 % vs 20 %, p < 0.01). CAD patients also had lower mean vascular density (MVD) (15.7 % vs 16.5,%, p = 0.049) and foveal avascular zone (FAZ) circularity (0.64 ± 0.1 vs 0.69 ± 0.1, p = 0.04). There were significant and negative correlations between Duke coronary score and MVD (r = -0.189; p = 0.03) and FAZ circularity (r = -0,206; p = 0.02). CAD, DM duration and insulin use independently associated with DR. CONCLUSIONS CAD patients had higher prevalence of DR and lower MVD. CAD, DM duration and insulin use were independently associated with DR.
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Affiliation(s)
- Andre Chateaubriand Campos
- Clinical Unit of Atherosclerosis, Instituto do Coracao do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Eduardo Gomes Lima
- Clinical Unit of Atherosclerosis, Instituto do Coracao do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Peter Karl Jacobsen
- Cardiology division - Rigshospitalet - University of Copenhagen, Blegdamsvej 9, 2100 Rigshospitalet, Copenhagen, Denmark
| | - Louis Arnould
- Ophthalmology Department, University Hospital, Dijon, France; Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), (EA 7460), Faculty of Health Sciences, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Simao Lottenberg
- Department of Endocrinology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Renata Martins Maia
- Department of Ophtalmology, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Livia Silva Conci
- Department of Ophtalmology, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Tomas Minelli
- Department of Ophtalmology, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Andrea Morato
- Department of Ophtalmology, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Roberto Nery Dantas-Jr
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Cesar Higa Nomura
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Pedro Rissoli
- Department of Ophtalmology, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Sergio Gianotti Pimentel
- Department of Ophtalmology, Hospital das Clinicas HCMFUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carlos Vicente Serrano Junior
- Clinical Unit of Atherosclerosis, Instituto do Coracao do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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6
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Budu, Esa T, Idrus HH. Addressing Technical Failures in a Diabetic Retinopathy Screening Program [Letter]. Clin Ophthalmol 2024; 18:849-850. [PMID: 38504936 PMCID: PMC10949999 DOI: 10.2147/opth.s465913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Budu
- Department of Ophthalmology, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
| | - Tenri Esa
- Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Hasta Handayani Idrus
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Center, Cibinong – Bogor, West Java, Indonesia
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7
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Riazi-Esfahani H, Jafari B, Azimi H, Rahimi M, Saeidian J, Pouya P, Faghihi H, Mirzaei A, Asadi Khameneh E, Khalili Pour E. Assessment of area and structural irregularity of retinal layers in diabetic retinopathy using machine learning and image processing techniques. Sci Rep 2024; 14:4013. [PMID: 38369610 PMCID: PMC10874958 DOI: 10.1038/s41598-024-54535-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/13/2024] [Indexed: 02/20/2024] Open
Abstract
Diabetes retinopathy prevention necessitates early detection, monitoring, and treatment. Non-invasive optical coherence tomography (OCT) shows structural changes in the retinal layer. OCT image evaluation necessitates retinal layer segmentation. The ability of our automated retinal layer segmentation to distinguish between normal, non-proliferative (NPDR), and proliferative diabetic retinopathy (PDR) was investigated in this study using quantifiable biomarkers such as retina layer smoothness index (SI) and area (S) in horizontal and vertical OCT images for each zone (fovea, superior, inferior, nasal, and temporal). This research includes 84 eyes from 57 individuals. The study shows a significant difference in the Area (S) of inner nuclear layer (INL) and outer nuclear layer (ONL) in the horizontal foveal zone across the three groups (p < 0.001). In the horizontal scan, there is a significant difference in the smoothness index (SI) of the inner plexiform layer (IPL) and the upper border of the outer plexiform layer (OPL) among three groups (p < 0.05). There is also a significant difference in the area (S) of the OPL in the foveal zone among the three groups (p = 0.003). The area (S) of the INL in the foveal region of horizontal slabs performed best for distinguishing diabetic patients (NPDR and PDR) from normal individuals, with an accuracy of 87.6%. The smoothness index (SI) of IPL in the nasal zone of horizontal foveal slabs was the most accurate at 97.2% in distinguishing PDR from NPDR. The smoothness index of the top border of the OPL in the nasal zone of horizontal slabs was 84.1% accurate in distinguishing NPDR from PDR. Smoothness index of IPL in the temporal zone of horizontal slabs was 89.8% accurate in identifying NPDR from PDR patients. In conclusion, optical coherence tomography can assess the smoothness index and irregularity of the inner and outer plexiform layers, particularly in the nasal and temporal regions of horizontal foveal slabs, to distinguish non-proliferative from proliferative diabetic retinopathy. The evolution of diabetic retinopathy throughout severity levels and its effects on retinal layer irregularity need more study.
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Affiliation(s)
- Hamid Riazi-Esfahani
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Behzad Jafari
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Hossein Azimi
- Faculty of Mathematical Sciences and Computer, Kharazmi University, No. 50, Taleghani Ave, Tehran, Iran
| | - Masoud Rahimi
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Jamshid Saeidian
- Faculty of Mathematical Sciences and Computer, Kharazmi University, No. 50, Taleghani Ave, Tehran, Iran
| | - Parnia Pouya
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hooshang Faghihi
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Arash Mirzaei
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Esmaeil Asadi Khameneh
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Elias Khalili Pour
- Retina Ward, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran.
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8
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Wijesingha N, Tsai WS, Keskin AM, Holmes C, Kazantzis D, Chandak S, Kubravi H, Sivaprasad S. Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy. Diagnostics (Basel) 2024; 14:326. [PMID: 38337841 PMCID: PMC10855126 DOI: 10.3390/diagnostics14030326] [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: 01/05/2024] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus, leading to visual impairment if left untreated. This review discusses the use of optical coherence tomography angiography (OCTA) as a diagnostic tool for the early detection and management of DR. OCTA is a fast, non-invasive, non-contact test that enables the detailed visualisation of the macular microvasculature in different plexuses. OCTA offers several advantages over fundus fluorescein angiography (FFA), notably offering quantitative data. OCTA is not without limitations, including the requirement for careful interpretation of artefacts and the limited region of interest that can be captured currently. We explore how OCTA has been instrumental in detecting early microvascular changes that precede clinical signs of DR. We also discuss the application of OCTA in the diagnosis and management of various stages of DR, including non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), diabetic macular oedema (DMO), diabetic macular ischaemia (DMI), and pre-diabetes. Finally, we discuss the future role of OCTA and how it may be used to enhance the clinical outcomes of DR.
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Affiliation(s)
- Naomi Wijesingha
- UCL Institute of Ophthalmology, London EC1V 9EL, UK;
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Wei-Shan Tsai
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Ayse Merve Keskin
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Christopher Holmes
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Dimitrios Kazantzis
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Swati Chandak
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Heena Kubravi
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Sobha Sivaprasad
- UCL Institute of Ophthalmology, London EC1V 9EL, UK;
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
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9
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Dan AO, Mocanu CL, Bălășoiu AT, Tănasie CA, Puiu I, Târtea AE, Sfredel V. Correlations between Retinal Microvascular Parameters and Clinical Parameters in Young Patients with Type 1 Diabetes Mellitus: An Optical Coherence Tomography Angiography Study. Diagnostics (Basel) 2024; 14:317. [PMID: 38337833 PMCID: PMC10855750 DOI: 10.3390/diagnostics14030317] [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: 12/27/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVES In the current study, we investigated the correlations between retinal microvascular parameters using optical coherence tomography angiography (OCTA) and clinical parameters for a group of 69 young patients with type 1 diabetes mellitus (T1DM). MATERIALS AND METHODS This retrospective, exploratory study enrolled 69 patients between 5 years old and 30 years old who met the inclusion criteria. All the study participants underwent a comprehensive ophthalmic examination and OCTA scans for the evaluation of the retinal microcirculation. The retinal OCTA parameters were correlated with the following clinical parameters: the patient's age at the onset of the disease, the duration of T1DM, the BMI at the time of enrollment in the study, the HbA1C values at onset, the mean values of HbA1C over the period of monitoring the disease and the degree of DKA at onset. RESULTS For the study group, the foveal avascular zone (FAZ) area and perimeter correlated positively with the mean value of HbA1C (Pearson correlation, Sig.2-Tailed Area: 0.044; perimeter: 0.049). The total vessel density in the superficial capillary plexus (SCP) correlated negatively with the duration of T1DM, based on the superior and inferior analyzed areas (Spearman correlation, Sig.2-Tailed SCP in total region: 0.002; SCP in the superior region: 0.024; SCP in the inferior region: 0.050). The foveal thickness also correlated negatively with the levels of diabetic ketoacidosis (DKA) at onset (Spearman correlation, Sig.2-Tailed: 0.034) and the levels of HbA1C at onset (Spearman correlation, Sig.2-Tailed: 0.047). Further on, the study patients were distributed into two groups according to the duration of the disease: group 1 included 32 patients with a duration of T1DM of less than 5 years, and group 2 included 37 patients with a duration of T1DM of more than 5 years. Independent t-tests were used to compare the OCTA retinal parameters for the two subgroups. While the FAZ-related parameters did not show significant statistical differences between the two groups, the vessel densities in both the SCP and DCP were significantly lower in group 2. CONCLUSIONS Our data suggest that specific alterations in OCTA imaging biomarkers correlate with various clinical parameters: the FAZ area and perimeter increase with higher mean values of HbA1C, leading to poor metabolic control. Moreover, the SCP total vessel density decreases as the duration of T1DM increases. Regarding the vessel densities in the SCP and the DCP, they decrease with a duration of the disease of more than 5 years.
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Affiliation(s)
- Alexandra Oltea Dan
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.O.D.)
| | - Carmen Luminița Mocanu
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Andrei Teodor Bălășoiu
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cornelia Andreea Tănasie
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.O.D.)
| | - Ileana Puiu
- Department of Pediatrics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Anca Elena Târtea
- Department of Neurology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Veronica Sfredel
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.O.D.)
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10
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Karam-Palos S, Andrés-Blasco I, Campos-Borges C, Zanón-Moreno V, Gallego-Martínez A, Alegre-Ituarte V, García-Medina JJ, Pastor-Idoate S, Sellés-Navarro I, Vila-Arteaga J, Lleó-Perez AV, Pinazo-Durán MD. Oxidative Stress Mediates Epigenetic Modifications and the Expression of miRNAs and Genes Related to Apoptosis in Diabetic Retinopathy Patients. J Clin Med 2023; 13:74. [PMID: 38202081 PMCID: PMC10780047 DOI: 10.3390/jcm13010074] [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: 11/14/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Knowledge on the underlying mechanisms and molecular targets for managing the ocular complications of type 2 diabetes mellitus (T2DM) remains incomplete. Diabetic retinopathy (DR) is a major cause of irreversible visual disability worldwide. By using ophthalmological and molecular-genetic approaches, we gathered specific information to build a data network for deciphering the crosslink of oxidative stress (OS) and apoptosis (AP) processes, as well as to identify potential epigenetic modifications related to noncoding RNAs in the eyes of patients with T2DM. A total of 120 participants were recruited, being classified into two groups: individuals with T2MD (T2MDG, n = 67), divided into a group of individuals with (+DR, n = 49) and without (-DR, n = 18) DR, and a control group (CG, n = 53). Analyses of compiled data reflected significantly higher plasma levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) and significantly lower total antioxidant capacity (TAC) in the +DR patients compared with the -DR and the CG groups. Furthermore, the plasma caspase-3 (CAS3), highly involved in apoptosis (AP), showed significantly higher values in the +DR group than in the -DR patients. The microRNAs (miR) hsa-miR 10a-5p and hsa-miR 15b-5p, as well as the genes BCL2L2 and TP53 involved in these pathways, were identified in relation to DR clinical changes. Our data suggest an interaction between OS and the above players in DR pathogenesis. Furthermore, potential miRNA-regulated target genes were identified in relation to DR. In this concern, we may raise new diagnostic and therapeutic challenges that hold the potential to significantly improve managing the diabetic eye.
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Affiliation(s)
- Sarah Karam-Palos
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
- Department of Ophthalmology, University Hospital “Arnau de Vilanova”, 25196 Valencia, Spain
| | - Irene Andrés-Blasco
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
- Net of Research in Inflammatory Diseases and Immunopathology of Organs and Systems “REI-RICORS” RD, Institute of Health Carlos III, 28029 Madrid, Spain; (J.J.G.-M.); (S.P.-I.); (I.S.-N.)
| | - Cristina Campos-Borges
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
- Institute of Biotechnology, University of Porto, 4169-007 Porto, Portugal
| | - Vicente Zanón-Moreno
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
- Net of Research in Inflammatory Diseases and Immunopathology of Organs and Systems “REI-RICORS” RD, Institute of Health Carlos III, 28029 Madrid, Spain; (J.J.G.-M.); (S.P.-I.); (I.S.-N.)
- Department of Preventive Medicine and Public Health, University of Valencia, 46010 Valencia, Spain
| | - Alex Gallego-Martínez
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
| | - Victor Alegre-Ituarte
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
| | - Jose J. García-Medina
- Net of Research in Inflammatory Diseases and Immunopathology of Organs and Systems “REI-RICORS” RD, Institute of Health Carlos III, 28029 Madrid, Spain; (J.J.G.-M.); (S.P.-I.); (I.S.-N.)
- Department of Ophthalmology, University Hospital “Morales Meseguer”, 30008 Murcia, Spain
- Department of Surgery, Pediatrics, Obstetrics and Ginecology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
| | - Salvador Pastor-Idoate
- Net of Research in Inflammatory Diseases and Immunopathology of Organs and Systems “REI-RICORS” RD, Institute of Health Carlos III, 28029 Madrid, Spain; (J.J.G.-M.); (S.P.-I.); (I.S.-N.)
- Institute of Applied Ophthalmobiology “IOBA”, University of Valladolid, 47002 Valladolid, Spain
- Department of Ophthalmology, University Clinic Hospital of Valladolid, 47003 Valladolid, Spain
| | - Inmaculada Sellés-Navarro
- Net of Research in Inflammatory Diseases and Immunopathology of Organs and Systems “REI-RICORS” RD, Institute of Health Carlos III, 28029 Madrid, Spain; (J.J.G.-M.); (S.P.-I.); (I.S.-N.)
- Department of Surgery, Pediatrics, Obstetrics and Ginecology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Department of Ophthalmology, University Hospital “Reina Sofia”, 30003 Murcia, Spain
| | - Jorge Vila-Arteaga
- Department of Ophthalmology, University and Polyclinic Hospital “La Fé”, 46026 Valencia, Spain;
- Innova Ocular Vila Clinic, 46004 Valencia, Spain
| | - Antonio V. Lleó-Perez
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
- Department of Ophthalmology, University Hospital “Arnau de Vilanova”, 25196 Valencia, Spain
| | - Maria D. Pinazo-Durán
- Ophthalmic Research Unit “Santiago Grisolía”/FISABIO, 46017 Valencia, Spain; (S.K.-P.); (I.A.-B.); (C.C.-B.); (V.A.-I.); (A.V.L.-P.)
- Cellular and Molecular Ophthalmo-Biology Group, Department of Surgery, University of Valencia, 46010 Valencia, Spain
- Net of Research in Inflammatory Diseases and Immunopathology of Organs and Systems “REI-RICORS” RD, Institute of Health Carlos III, 28029 Madrid, Spain; (J.J.G.-M.); (S.P.-I.); (I.S.-N.)
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11
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Suchand Sandeep CS, Khairyanto A, Aung T, Vadakke Matham M. Bessel Beams in Ophthalmology: A Review. MICROMACHINES 2023; 14:1672. [PMID: 37763835 PMCID: PMC10536271 DOI: 10.3390/mi14091672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023]
Abstract
The achievable resolution of a conventional imaging system is inevitably limited due to diffraction. Dealing with precise imaging in scattering media, such as in the case of biomedical imaging, is even more difficult owing to the weak signal-to-noise ratios. Recent developments in non-diffractive beams such as Bessel beams, Airy beams, vortex beams, and Mathieu beams have paved the way to tackle some of these challenges. This review specifically focuses on non-diffractive Bessel beams for ophthalmological applications. The theoretical foundation of the non-diffractive Bessel beam is discussed first followed by a review of various ophthalmological applications utilizing Bessel beams. The advantages and disadvantages of these techniques in comparison to those of existing state-of-the-art ophthalmological systems are discussed. The review concludes with an overview of the current developments and the future perspectives of non-diffractive beams in ophthalmology.
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Affiliation(s)
- C. S. Suchand Sandeep
- Centre for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Ahmad Khairyanto
- Centre for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - Murukeshan Vadakke Matham
- Centre for Optical and Laser Engineering, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
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12
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Castro C, Marques JH, Silva N, Abreu AC, Furtado MJ, Lume M. Comparison of Color Fundus Photography and Multicolor Fundus Imaging for Detection of Lesions in Diabetic Retinopathy and Retinal Vein Occlusion. Clin Ophthalmol 2023; 17:2515-2524. [PMID: 37641738 PMCID: PMC10460587 DOI: 10.2147/opth.s414603] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023] Open
Abstract
Purpose To evaluate the agreement between conventional fundus photography (CFP) and multicolor fundus imaging (MFI) for the detection of lesions of diabetic retinopathy (DR) and retinal vein occlusion (RVO). Methods Cross-sectional analysis of eyes with DR or RVO who underwent CFP and MFI. All images were independently analyzed by two observers (O1 and O2), and the evaluated lesions were classified as "present" or "absent". Then, a paired comparison between both exams of the same eye was performed, to assess which made it easier to detect the lesions. Results Considering DR, the agreement was substantial for cotton wool spots and photocoagulation scars for both observers (O1: κ=0.75 and κ=0.67; O2: κ=0.71 and κ=0.64, respectively) and for hard exudates for O1 (κ=0.80). These lesions were detected more frequently on MFI. Regarding RVO, the agreement was considered substantial for venous sheathing by O1 (κ=0.64) and moderate for optociliary shunts by O2 (κ=0.60). Optociliary shunts were detected more frequently in CPF by both observers and venous sheathing on MFI by O1. For microaneurysms, retinal hemorrhages, retinal neovascularization, and proliferative membranes, in DR, and retinal hemorrhages, venous engorgement, and retinal neovascularization in RVO, the agreement was almost perfect (κ>0.82). In the paired analysis, both observers considered that, in DR, microaneurysms and retinal hemorrhages were easier to detect on CFP and that retinal neovascularization, cotton wool spots, and photocoagulation scars were easier to identify on MFI. Regarding RVO, optocilliary shunts were easier to identify on CFP and venous engorgement on MFI. Conclusion The agreement of MFI and CFP was substantial to almost perfect for most lesions. MFI seems better to detect cotton wool spots and photocoagulations scars in DR and venous sheathing in RVO. Optocilliary shunts seem easier to detect on CFP.
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Affiliation(s)
- Catarina Castro
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - João Heitor Marques
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Nisa Silva
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Ana Carolina Abreu
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Maria João Furtado
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar – Universidade do Porto, Porto, Portugal
| | - Miguel Lume
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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13
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Jin K, Shen W, Liang Y, He M. Epidemiology, Translation and Clinical Research of Ophthalmology. J Clin Med 2023; 12:jcm12113819. [PMID: 37298014 DOI: 10.3390/jcm12113819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
The human eye is a complex and vital organ that plays a significant role in maintaining a high quality of human life [...].
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Affiliation(s)
- Kai Jin
- Eye Center, The Second Affiliated Hospital School of Medicine Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, China
| | - Wenyue Shen
- Eye Center, The Second Affiliated Hospital School of Medicine Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, China
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian, Eye and Ear Hospital, University of Melbourne, Melbourne 3002, Australia
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14
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Invernizzi A, Chhablani J, Viola F, Gabrielle PH, Zarranz-Ventura J, Staurenghi G. Diabetic retinopathy in the pediatric population: Pathophysiology, screening, current and future treatments. Pharmacol Res 2023; 188:106670. [PMID: 36681366 DOI: 10.1016/j.phrs.2023.106670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023]
Abstract
Diabetic retinopathy (DR) is a sight threatening complication of diabetes mellitus (DM). The incidence of DR in the pediatric population has increased in the last two decades and it is expected to further rise in the future, following the increase in DM prevalence and obesity in youth. As early stages of the retinal disease are asymptomatic, screening programs are of extreme importance to guarantee a prompt diagnosis and avoid progression to more advanced, sight threatening stages. The management of DR comprises a wide range of actions starting from glycemic control, continuing with systemic and local medical treatments, up to para-surgical and surgical approaches to deal with the more aggressive complications. In this review we will describe the pathophysiology of DR trying to understand all the possible targets for currently available or future treatments. We will briefly consider the impact of screening techniques, screening strategies and their social and economic impact. Finally a large part of the review will be dedicated to medical and surgical treatments for DR including both currently available and under development therapies. Most of the available data in the literature on DR are focused on the adult population. The aim of our work is to provide clinicians and researchers with a comprehensive overview of the state of the art regarding DR in the pediatric population, considering the increasing numbers of this diseases in youth and the inevitable consequences that such a chronic disease could have if poorly managed in children.
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Affiliation(s)
- Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy; The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia.
| | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Francesco Viola
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pierre Henry Gabrielle
- Department of Ophthalmology, University Hospital, 14 rue Paul Gaffarel, 21079 Dijon, France
| | - Javier Zarranz-Ventura
- Institut Clínic of Ophthalmology (ICOF), Hospital Clínic, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy
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15
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Ding C, Wang N, Wang Z, Yue W, Li B, Zeng J, Yoshida S, Yang Y, Zhou Y. Integrated Analysis of Metabolomics and Lipidomics in Plasma of T2DM Patients with Diabetic Retinopathy. Pharmaceutics 2022; 14:pharmaceutics14122751. [PMID: 36559245 PMCID: PMC9786316 DOI: 10.3390/pharmaceutics14122751] [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: 10/29/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Diabetic retinopathy (DR) is a major cause of blindness worldwide and may be non-proliferative (NPDR) or proliferative (PDR). To Investig.gate the metabolomic and lipidomic characteristics of plasma in DR patients, plasma samples were collected from patients with type 2 diabetes mellitus (DR group) with PDR (n = 27), NPDR (n = 18), or no retinopathy (controls, n = 21). Levels of 54 and 41 metabolites were significantly altered in the plasma of DR patients under positive and negative ion modes, respectively. By subgroup analysis, 74 and 29 significantly changed plasma metabolites were detected in PDR patients compared with NPDR patients under positive and negative ion modes, respectively. KEGG analysis indicated that pathways such as biosynthesis of amino acids and neuroactive ligand-receptor interaction were among the most enriched pathways in altered metabolites in the DR group and PDR subgroup. Moreover, a total of 26 and 41 lipids were significantly changed in the DR group and the PDR subgroup, respectively. The panel using the 29-item index could discriminate effectively between diabetic patients with and without retinopathy, and the panel of 22 items showed effective discrimination between PDR and NPDR. These results provide a basis for further research into the therapeutic targets associated with these metabolite and lipid alterations.
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Affiliation(s)
- Chun Ding
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Nan Wang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zicong Wang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Wenyun Yue
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Bingyan Li
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Jun Zeng
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Yan Yang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Correspondence: (Y.Y.); (Y.Z.)
| | - Yedi Zhou
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Correspondence: (Y.Y.); (Y.Z.)
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