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SenthilKumar G, Hammond ST, Zirgibel Z, Cohen KE, Beyer AM, Freed JK. Is the peripheral microcirculation a window into the human coronary microvasculature? J Mol Cell Cardiol 2024; 193:67-77. [PMID: 38848808 PMCID: PMC11260236 DOI: 10.1016/j.yjmcc.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/13/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024]
Abstract
An increasing body of evidence suggests a pivotal role for the microvasculature in the development of cardiovascular disease. A dysfunctional coronary microvascular network, specifically within endothelial cells-the inner most cell layer of vessels-is considered a strong, independent risk factor for future major adverse cardiac events. However, challenges exist with evaluating this critical vascular bed, as many of the currently available techniques are highly invasive and cost prohibitive. The more easily accessible peripheral microcirculation has surfaced as a potential surrogate in which to study mechanisms of coronary microvascular dysfunction and likewise may be used to predict poor cardiovascular outcomes. In this review, we critically evaluate a variety of prognostic, physiological, and mechanistic studies in humans to answer whether the peripheral microcirculation can add insight into coronary microvascular health. A conceptual framework is proposed that the health of the endothelium specifically may link the coronary and peripheral microvascular beds. This is supported by evidence showing a correlation between human coronary and peripheral endothelial function in vivo. Although not a replacement for investigating and understanding coronary microvascular function, the microvascular endothelium from the periphery responds similarly to (patho)physiological stress and may be leveraged to explore potential therapeutic pathways to mitigate stress-induced damage.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Stephen T Hammond
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States; Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Zachary Zirgibel
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Katie E Cohen
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States; Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Andreas M Beyer
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States; Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Julie K Freed
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States.
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Chauhan MZ, Elhusseiny AM, Kishor KS, Sanvicente CT, Ali AA, Sallam AB, Bhattacharya SK, Uwaydat SH. Association of Primary Open-Angle Glaucoma with Diabetic Retinopathy among Patients with Type 1 and Type 2 Diabetes: A Large Global Database Study. Ophthalmology 2024; 131:827-835. [PMID: 38215989 DOI: 10.1016/j.ophtha.2024.01.016] [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: 08/12/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024] Open
Abstract
PURPOSE To assess the correlation between primary open-angle glaucoma (POAG) and the risk of developing diabetic retinopathy (DR) in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). DESIGN A retrospective cohort study leveraging the global patient database of TriNetX Research Network. PARTICIPANTS The study included 44 359 patients with diabetes mellitus (DM) with POAG and 4 393 300 patients with DM without any glaucoma ≥ 18 years of age. Propensity score matching harmonized the cohorts to 39 680 patients each, covering diagnoses from January 1, 2005, to January 1, 2023. METHODS We analyzed data using specific International Classification of Diseases, 10th Revision (ICD-10) codes for DM and glaucoma. We matched the cohorts using propensity score matching, adjusting for age, sex, race/ethnicity, blood markers, relevant medical history, and ophthalmic service use. MAIN OUTCOME MEASURES The primary outcome was the first-time occurrence of DR, including nonproliferative DR (NPDR) and proliferative DR (PDR), in patients with DM with and without glaucoma at 1-, 5-, and 10-year intervals from their individual index dates. RESULTS At 10 years, patients with T1DM with POAG exhibited a heightened risk for any DR (adjusted risk ratios [RRs], 4.12; 95% confidence interval [CI], 3.05-5.57, P < 0.0001) and PDR (RR, 7.02; 95% CI, 3.62-13.61, P < 0.0001). Patients with T2DM and POAG also faced an increased 10-year risk for any DR (RR, 2.47; 95% CI, 2.28-2.68, P < 0.0001) and PDR (RR, 3.82; 95% CI, 3.09-4.70, P < 0.0001). The combined association of POAG on DR risk in those with T1DM and T2DM at 10 years was found to be significantly higher among patients with POAG (5.45%) compared with those without glaucoma (2.12%) (adjusted hazard ratio [aHR], 2.33; 95% CI, 2.14-2.53). The cumulative incidence of DR was significantly higher in the POAG group compared with nonglaucoma counterparts after a decade (log-rank P < 0.001). CONCLUSIONS Our findings underscore a substantial association between POAG and DR development in both T1DM and T2DM patients, emphasizing the need for vigilant screening and comprehensive management in glaucomatous patients with DM to mitigate the risk of DR. Future research should delve into elucidating the causal mechanisms driving these observed associations. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Muhammad Z Chauhan
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Abdelrahman M Elhusseiny
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Krishna S Kishor
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida
| | - Carina T Sanvicente
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Arsalan A Ali
- Anne Burnett Marion School of Medicine, Fort Worth, Texas
| | - Ahmed B Sallam
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sanjoy K Bhattacharya
- Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, University of Miami, Miami, Florida
| | - Sami H Uwaydat
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
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Connolly E, Knight SP, Duggan E, Scarlett S, Newman L, Cahill M, Kenny RA, Doyle SL, Romero-Ortuno R. Cardiovascular Autonomic Function and Progression of Age-Related Macular Degeneration in The Irish Longitudinal Study of Ageing (TILDA). Invest Ophthalmol Vis Sci 2024; 65:24. [PMID: 38874963 PMCID: PMC11182369 DOI: 10.1167/iovs.65.6.24] [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: 11/15/2023] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Purpose To examine if changes in hemodynamic measures during an orthostatic challenge were associated with progression of age-related macular degeneration (AMD) over a 4-year period in The Irish Longitudinal Study on Ageing. Methods Participants with AMD who underwent an active stand (AS) test at wave 1 (2009/2010) and retinal photographs at both wave 1 and wave 3 (2014/2015) were included (N = 159: 121 with no AMD progression and 38 with progression). Beat-to-beat hemodynamic data were non-invasively collected using a Finometer MIDI device during the AS at wave 1, recording systolic blood pressure (sBP), diastolic blood pressure (dBP), mean arterial pressure (MAP), and heart rate. Cardiac output, stroke volume, and total peripheral resistance (TPR) were derived from these measures. Baseline characteristics were compared between groups with and without AMD progression. Mixed-effects linear regression models were used to assess the association between changes in hemodynamic parameters during the AS and AMD progression, controlling for known AMD-associated risk factors. Results At baseline, increasing age and lower dBP were significantly associated with AMD progression. Mixed-effects models for the period between standing and 10 seconds post-stand revealed significant associations with AMD progression with a steeper drop in dBP and a slower drop in TPR. Between 10 and 20 seconds post-stand, AMD progression was significantly associated with less pronounced reduction in heart rate. Conclusions These observational data suggest that impaired hemodynamic responses within the first 20 seconds of orthostasis may be associated with the progression of AMD.
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Affiliation(s)
- Emma Connolly
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Silvin P. Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Eoin Duggan
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mark Cahill
- Progressive Vision Research, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sarah L. Doyle
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Kazantzis D, Machairoudia G, Kandarakis S, Theodossiadis G, Theodossiadis P, Chatziralli I. Retinal Nerve Fiber Layer Changes in Patients With Chronic Obstructive Pulmonary Disease Compared to Healthy Controls: A Meta-analysis. Ophthalmic Surg Lasers Imaging Retina 2024; 55:334-342. [PMID: 38531007 DOI: 10.3928/23258160-20240220-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVE This study investigated changes in retinal nerve fiber layers (RNFL) in patients diagnosed with chronic obstructive pulmonary disease (COPD) compared to healthy control patients, using optical coherence tomography. METHODS PubMed, Cochrane Library, and Google Scholar databases were systematically searched for published articles comparing RNFL between patients with COPD and healthy controls. Standardized mean difference (SMD) with 95% confidence interval (CI) was computed to compare continuous variables. RESULTS Average RNFL thickness was significantly reduced in COPD patients compared to healthy controls (SMD = -0.31, 95% CI = -0.48 to -0.14, P = 0.0004, I2 = 0%). Average RNFL thickness did not differ significantly between patients with mild/moderate COPD and healthy controls (SMD = -0.17, 95% CI = -0.39 to 0.04, P = 0.12, I2 = 2%), while a statistically significant reduction in average RNFL thickness was noticed in patients with severe COPD compared to healthy controls (SMD = -0.72, 95% CI = -1.23 to -0.21, P = 0.006, I2 = 83%). Average RNFL thickness was significantly higher in patients with mild/moderate COPD compared to patients with severe COPD (SMD = 0.69, 95% CI = 0.29 to 1.09, P = 0.0008, I2 = 66%). CONCLUSIONS This meta-analysis showed that RNFL thickness was decreased in patients with COPD compared to healthy controls. Patients diagnosed with severe COPD seem to be more affected and have thinner RNFL. [Ophthalmic Surg Lasers Imaging Retina 2024;55:334-342.].
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Zhou Y, Huang L, Xie Y, Liu W, Zhang S, Liu L, Lin P, Li N. Clinical and genetic studies for a cohort of patients with Leber congenital amaurosis. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06450-9. [PMID: 38662103 DOI: 10.1007/s00417-024-06450-9] [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: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE Leber congenital amaurosis (LCA) is a group of early-onset retinal degenerative disorders, resulting in blindness in children. This study aimed to describe the clinical and genetic characteristics of a cohort of patients with LCA and to investigate the retinal vascular characteristics in LCA patients. METHODS Fifty-two children with LCA were included in the study. All patients underwent detailed ocular examinations. Electroretinography (ERG) was used to evaluate the retinal function. Optical coherence tomography (OCT) was used to assess the structure change of the retina for those patients who were able to cooperate very well. Panel-based next-generation sequencing was performed to identify pathogenic variants in genes associated with LCA. Diameters of the retinal vessels were measured using the EVision AI screening system with an artificial intelligence (AI) technique. An ultrasound Doppler was used to evaluate hemodynamic parameters, including peak systolic velocity (PSV), resistive index (RI), and pulsatility index (PI), in the ophthalmic, central retinal, posterior ciliary, carotid, and internal carotid as well as external carotid arteries in 12 patients aged from 3 to 14 years. RESULTS We detected 75 pathogenic variants from ten genes of RPGRIP1, CEP290, GUCY2D, LCA5, AIPL1, CRB1, RPE65, CRX, RDH12, and TULP1, including 29 novel and 36 previously reported variants in 52 affected children with LCA, with the highest detective rate in RPGRIP1 (26.9%). Fundus appearance is diverse in patients with LCA, ranging from normal to severe peripheral or central retinopathy. Retinal vasculature was evaluated in 12 patients with different gene variants, showing narrowed arteries with an average diameter of 43.6 ± 3.8 μm compared to that of 51.7 ± 2.6 μm in the normal controls (P < 0.001, n = 12). Meanwhile, their hemodynamic parameters were changed as well in the ophthalmic artery (OA), with a decreased PSV (P = 0.0132, n = 12) and slightly increased PI (P = 0.0488, n = 12) compared to the normal controls. However, the hemodynamic parameters did not change significantly in the other vessels. CONCLUSIONS Blood supply to the eyeball is predicted to be reduced in patients with LCA, presumably due to photoreceptor cell degeneration. The novel identified variants will expand the spectrum of variants in LCA-related genes and be useful for studying the molecular mechanisms of LCA.
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Affiliation(s)
- Yunyu Zhou
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Lijuan Huang
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China
| | - Yan Xie
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Wen Liu
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Shasha Zhang
- Department of Ophthalmology, Xi'an Children's Hospital, Xi'an, 710002, China
| | - Lili Liu
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Ping Lin
- Department of Ophthalmology, Xi'an Children's Hospital, Xi'an, 710002, China.
| | - Ningdong Li
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
- Department of Ophthalmology, Xi'an Children's Hospital, Xi'an, 710002, China.
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200940, China.
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Lentz PC, Lim SY, Betzler BK, Miller DD, Dorairaj SK, Ang BCH. A deep dive into hyperbaric environments and intraocular pressure-a systematic review. Front Med (Lausanne) 2024; 11:1365259. [PMID: 38633303 PMCID: PMC11021581 DOI: 10.3389/fmed.2024.1365259] [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: 01/04/2024] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
Purpose SCUBA diving exposes participants to a unique hyperbaric environment, but few studies have examined the effects of such an environment on intraocular pressure (IOP) and glaucoma. This systematic review aims to consolidate recent literature findings regarding the impact of increased atmospheric pressure on IOP and glaucoma. Methods Three online databases were searched to identify publications encompassing the subjects of diving or increased atmospheric pressure in conjunction with IOP or glaucoma. Three reviewers independently screened the publications and identified eligible articles. Relevant data was extracted from each article. The heterogeneity of the data precluded the conduct of a meta-analysis. Results Nine studies met the inclusion criteria. Six experimental studies employed hyperbaric chambers to measure IOP under simulated diving conditions. Among these, IOP exhibited a reduction with increased atmospheric pressures in four studies, while the findings of two studies were inconclusive. One study measured IOP pre- and post-dive and another measured IOP with and without a diving mask. Post-dive, a decrease in IOP was observed, and a statistically significant reduction was noted when subjects wore a diving mask. A retrospective study examining the incidence of acute angle closure glaucoma attack found no association with weather or atmospheric pressure. Conclusion The majority of studies found IOP to decrease with increased atmospheric pressure and after diving. The mechanisms underlying this reduction remain incompletely understood, with potential contributors including changes in ocular blood flow, sympathetic responses, and increased oxygenation. Hyperbaric chambers may have potential in future glaucoma treatments, but more studies are required to draw reliable conclusions regarding the safety of diving for glaucoma patients.
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Affiliation(s)
- Paul Connor Lentz
- Mayo Clinic Alix School of Medicine, Jacksonville, FL, United States
| | - Sheng Yang Lim
- Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore
| | - Bjorn Kaijun Betzler
- Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore
| | - Darby D. Miller
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, United States
| | - Syril K. Dorairaj
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, United States
| | - Bryan Chin Hou Ang
- Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, United States
- Department of Ophthalmology, Woodlands Health Campus, National Healthcare Group Eye Institute, Singapore, Singapore
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Trinh M, Nam J, Kumar M, Nivison-Smith L. OCTA Signal Quality Augmentation Using the Isometric Handgrip Test to Maximize Vascular Flow (SQUEEZE): A Randomized Crossover Trial. Transl Vis Sci Technol 2024; 13:22. [PMID: 38530302 PMCID: PMC10981163 DOI: 10.1167/tvst.13.3.22] [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: 11/14/2023] [Accepted: 02/07/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose To determine if performing the isometric handgrip test (IHGT) can augment optical coherence tomography angiography (OCTA) vascular signal quality in eyes with macular abnormalities. Methods A randomized, single-blinded crossover trial was conducted including 36 participants with macular abnormalities, randomized to undergo OCTA with or without the IHGT, then crossed over to the alternate "intervention" after 1 minute. The primary outcome was OCTA signal quality after 1 minute of squeezing at 50% maximum grip strength. Secondary outcomes were other measures of vascular flow and systemic blood pressure (BP), also regressed against person- and eye-level covariables. Results Primary analysis of OCTA signal quality with versus without the IHGT was nonsignificant (P = 0.73). Nested analyses showed that the IHGT resulted in increased OCTA B-scan retinal vascular flow signal (2.95 [-1.64 to 7.55] Δ%, P < 0.05) and increased systolic BP, diastolic BP, pulse pressure, and mean arterial pressure (4.94 [0.41 to 9.47] to 12.38 [8.01 to 16.75] mm Hg, P < 0.05). OCTA signal quality and en face vessel density and perfusion changes were associated with sex, refraction, race/ethnicity, and right-hand IHGT use (P < 0.05). Greater increases in systolic and diastolic BP and mean arterial pressure were generally associated with right-hand IHGT use and greater maximum grip strength (P < 0.09). Conclusions The IHGT can temporarily increase OCTA B-scan retinal vascular flow signal in participants with macular abnormalities. IHGT-induced changes to systemic BP appear to be linked to absolute (rather than relative) grip strength, implying that the IHGT may be ineffective with low grip strength. Further research in larger populations is warranted. Translational Relevance This study provides early validation that the IHGT may augment OCTA output, which may lead to improved noninvasive detection of pathologic vascular changes.
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Affiliation(s)
- Matt Trinh
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Judy Nam
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Meenakshi Kumar
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Wu JY, Hu JY, Ge QM, Xu SH, Zou J, Kang M, Ying P, Wei H, Ling Q, He LQ, Chen C, Shao Y. Ocular microvascular alteration in patients with myocardial infarction-a new OCTA study. Sci Rep 2024; 14:4552. [PMID: 38402285 PMCID: PMC10894220 DOI: 10.1038/s41598-023-50283-1] [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: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 02/26/2024] Open
Abstract
Myocardial infarction is defined as a sudden decrease or interruption in blood flow to the coronary arteries, causing ischemic necrosis of the corresponding cardiomyocytes. It is unclear whether systemic macrovascular alterations are associated with retinal microvascular changes. This study utilized optical coherence tomography angiography (OCTA) to compare variations in conjunctival vascular density and fundus retinal vessel density between patients with myocardial infarction (MI) and healthy controls. This study recruited 16 patients (32 eyes) with MI and 16 healthy controls (32 eyes). The superficial retinal layer (SRL), deep retinal layer (DRL) and conjunctival capillary plexus in each eye were evaluated by OCTA. Parameters measured included the density of the temporal conjunctival capillary, retinal microvascular (MIR) and macrovascular (MAR) alterations and total MIR (TMI). The microvascular density of each retinal region was evaluated by the hemisphere segmentation (SR, SL, IL, and IR), annular partition (C1, C2, C3, C4, C5 and C6), and modified early treatment of diabetic retinopathy study (R, S, L, and I) methods. In the macular area, the superficial and deep retinal microvascular densities displayed notable variations. In the superficial layers, the superficial TMI, superficial MIR, and superficial MAR, as well as densities in the SL, IL, S, L, C1, C2, C5 and C6 regions, were significantly lower in MI patients (p < 0.05 each). In the deep layers, the deep MIR and deep TMI), as well as densities in the SL, IL, L, C1, C2 and C6 regions were significantly lower in MI patients (p < 0.05 each). In contrast, the conjunctival microvascular density was significantly higher in MI patients than in healthy controls (p < 0.001). The microvascular densities measured in the deep and superficial retinal layers and in the conjunctiva differ in MI patients and healthy controls. OCTA is effective in detecting changes in the ocular microcirculation.
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Affiliation(s)
- Jun-Yi Wu
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jin-Yu Hu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Qian-Min Ge
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - San-Hua Xu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jie Zou
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Min Kang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Ping Ying
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Hong Wei
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Qian Ling
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Liang-Qi He
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Cheng Chen
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Yi Shao
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China.
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
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9
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Rahimi M, Hossain F, Leahy S, Blair NP, Jiang X, Shahidi M. Inner retinal oxygen delivery and metabolism in progressive stages of diabetic retinopathy. Sci Rep 2024; 14:4414. [PMID: 38388657 PMCID: PMC10883954 DOI: 10.1038/s41598-024-54701-w] [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: 07/27/2023] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Previous studies have reported increased retinal venous oxygen saturation and decreased retinal blood flow and oxygen metabolism in non-proliferative diabetic retinopathy (NPDR). The current study aimed to determine alterations in both inner retinal oxygen delivery (DO2) and metabolism (MO2) in proliferative DR (PDR) as well as at stages of NPDR. A total of 123 subjects participated in the study and were categorized into five groups: non-diabetic control (N = 32), diabetic with no diabetic retinopathy (NDR, N = 34), mild NPDR (N = 31), moderate to severe NPDR (N = 17), or PDR (N = 9). Multi-modal imaging was performed to measure oxygen saturation and blood flow, which were used for derivation of DO2 and MO2. There were significant associations of groups with DO2 and MO2. DO2 was lower in PDR and not significantly different in NDR and NPDR stages as compared to the non-diabetic control group. MO2 was decreased in PDR and moderate to severe NPDR as compared to the control group, and not significantly reduced in NDR and mild NPDR. The findings demonstrate reductions in both DO2 and MO2 in PDR and MO2 in moderate to severe NPDR, suggesting their potential as biomarkers for monitoring progression and treatment of DR.
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Affiliation(s)
- Mansour Rahimi
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Farzana Hossain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sophie Leahy
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Norman P Blair
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Xuejuan Jiang
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Mahnaz Shahidi
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA.
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10
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Jiao L, Lv C, Zhang H. Effect of blood pressure variability on hypertensive retinopathy. Clin Exp Hypertens 2023; 45:2205050. [PMID: 37120839 DOI: 10.1080/10641963.2023.2205050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE This study intends to investigate the correlation between blood pressure variability (BPV) levels and the use of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) to measure retinal microvasculature in hypertensive patients. METHODS All individuals in the study had 24-hour ambulatory blood pressure monitoring and bilateral OCT and OCTA exams, and only data from the right eye were analyzed statistically. RESULTS The study included 170 individuals, with 60 in the control group. The experimental group was separated into two groups based on the average real variability (ARV) median, with 55 in the low ARV group and 55 in the high ARV group. The mean thicknesses of the Retinal Nerve Fiber Layer (RNFL), internal limiting membrane-retinal pigment epithelial cell layer (ILM-RPE), vessel density (VD), and perfusion density (PD) in the high-ARV group were substantially lower in the low-ARV and control groups (p<0.05). Multiple linear regression analysis revealed that disease duration, age, and 24 h diastolic standard deviation all affected RNFL mean thickness (p<0.05). VD and PD were influenced by disease duration, systolic-ARV, daytime systolic blood pressure, intraocular pressure(IOP), and best-corrected visual acuity (BCVA) (p<0.05). And the change in VD was connected to best-corrected visual acuity. CONCLUSION Hypertensive retinopathy is related to BPV. In clinical practice, we can assess the degree of BPV and retinopathy in hypertensive patients to track the progression of hypertension-mediated organ damage (HMOD). Correction of BPV may help treat or postpone the progression of HOMD.
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Affiliation(s)
- Lei Jiao
- Department of Family Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chaoran Lv
- Department of Ophthalmology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hongling Zhang
- Department of Family Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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11
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Storp JJ, Schatten H, Vietmeier FE, Merté RL, Lahme L, Zimmermann JA, Englmaier VA, Eter N, Brücher VC. The Preserflo MicroShunt Affects Microvascular Flow Density in Optical Coherence Tomography Angiography. Biomedicines 2023; 11:3254. [PMID: 38137475 PMCID: PMC10741543 DOI: 10.3390/biomedicines11123254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Intraocular pressure (IOP) lowering surgery has been shown to alter microvascular density in glaucoma patients. The aim of this study is to report changes in retinal flow density (FD) over the course of treatment with the Preserflo MicroShunt, using optical coherence tomography angiography (OCTA). 34 eyes from 34 patients who underwent Preserflo MicroShunt implantation were prospectively enrolled in this study. OCTA imaging was conducted at the superficial (SCP), deep (DCP) and radial peripapillary plexus (RPC) levels. The progression of FD and IOP was assessed at different time points from baseline to six months postoperatively for the entire patient population, as well as disease severity subgroups. The Preserflo MicroShunt achieved a significant reduction in IOP over the course of six months (median: 8 mmHg; p < 0.01). FD values of the SCP and DCP did not show significant fluctuations, even after adjusting for disease severity. FD of the RPC decreased significantly over the course of six months postoperatively from 42.31 at baseline to 39.59 at six months postoperatively (p < 0.01). The decrease in peripapillary FD was strongest in patients with advanced glaucoma (median: -3.58). These observations hint towards dysfunctional autoregulatory mechanisms in capillaries surrounding the optic nerve head in advanced glaucoma. In comparison, the microvascular structure of the macula appeared more resilient to changes in IOP.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Hannah Schatten
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
- Augenklinik Roth am St. Josef-Hospital, 53225 Bonn, Germany
| | - Friederike Elisabeth Vietmeier
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Ralph-Laurent Merté
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Larissa Lahme
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Verena Anna Englmaier
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Viktoria Constanze Brücher
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
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12
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González-Saldivar G, González-González JG, Chow DR, Mohamed-Hamsho J, González-Cortés JH, Sánchez-García A, Rodríguez-Gutiérrez R. Retinal Microvascular Density and Perfusion during an Insulin-Induced Hypoglycemia Episode: A Warning Call. Int J Clin Pract 2023; 2023:9928582. [PMID: 37876724 PMCID: PMC10593551 DOI: 10.1155/2023/9928582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
Aim To evaluate retinal vascular perfusion and density by optical coherence tomography angiography (OCTA) before, during, and after hypoglycemia in individuals with diabetes mellitus with or without diabetic retinopathy (DR). Methods A focused clinical history was performed, followed by an ophthalmological examination to document retinopathy status. OCTA was performed at baseline, at hypoglycemia, and at glucose normalization. Eye tracking and eye alignment devices on the platform were used to obtain a macular thickness cube (512 × 128) and vascular perfusion and density protocols of 3 × 3 mm. Retinal vascular reactivity was analyzed with superficial plexus vascular perfusion and density protocols on OCTA. Results Fifty-two participants encompassing 97 eyes fulfilled the eligibility criteria. Their mean age was 42.9 ± 15.1 years (range, 22 to 65), and 20 (38.2%) were men. We found a statistically significant difference in vascular perfusion and density when comparing all groups at baseline. The controls had higher vascular perfusion and density values than the cases. Vascular perfusion and density were significantly reduced in all groups during the hypoglycemia episode, except for vascular density in DR cases. Conclusion Acute hypoglycemia significantly alters the retinal vascularity in DM patients with and without DR, suggesting that repeated episodes of acute hypoglycemia could exacerbate retinopathy in the long term.
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Affiliation(s)
- Gerardo González-Saldivar
- Department of Ophthalmology, Facultad de Medicina y Hospital Universitario “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Av. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Calle Dr. Eduardo Aguirre Pequeño s/n, Sotano Edificio CRIDS, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
| | - José Gerardo González-González
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Calle Dr. Eduardo Aguirre Pequeño s/n, Sotano Edificio CRIDS, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
- Endocrinology Division, Facultad de Medicina y Hospital Universitario “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Av. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
| | - David Robert Chow
- Department of Ophthalmology, St. Michael's Hospital, Toronto, ON, Canada
| | - Jesús Mohamed-Hamsho
- Department of Ophthalmology, Facultad de Medicina y Hospital Universitario “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Av. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
| | - Jesús Hernan González-Cortés
- Department of Ophthalmology, Facultad de Medicina y Hospital Universitario “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Av. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
| | - Adriana Sánchez-García
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Calle Dr. Eduardo Aguirre Pequeño s/n, Sotano Edificio CRIDS, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
- Endocrinology Division, Facultad de Medicina y Hospital Universitario “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Av. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
| | - René Rodríguez-Gutiérrez
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Calle Dr. Eduardo Aguirre Pequeño s/n, Sotano Edificio CRIDS, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
- Endocrinology Division, Facultad de Medicina y Hospital Universitario “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Av. Madero y Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico
- Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
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Saloň A, Vladic N, Schmid-Zalaudek K, Steuber B, Hawliczek A, Urevc J, Bergauer A, Pivec V, Shankhwar V, Goswami N. Sex Variations in Retinal Microcirculation Response to Lower Body Negative Pressure. BIOLOGY 2023; 12:1224. [PMID: 37759623 PMCID: PMC10525942 DOI: 10.3390/biology12091224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Lower body negative pressure (LBNP) is routinely used to induce central hypovolemia. LBNP leads to a shift in blood to the lower extremities. While the effects of LBNP on physiological responses and large arteries have been widely reported, there is almost no literature regarding how these cephalad fluid shifts affect the microvasculature. The present study evaluated the changes in retinal microcirculation parameters induced by LBNP in both males and females. METHODOLOGY Forty-four participants were recruited for the present study. The retinal measurements were performed at six time points during the LBNP protocol. To prevent the development of cardiovascular collapse (syncope) in the healthy participants, graded LBNP until a maximum of -40 mmHg was applied. A non-mydriatic, hand-held Optomed Aurora retinal camera was used to capture the retinal images. MONA Reva software (version 2.1.1) was used to analyze the central retinal arterial and venous diameter changes during the LBNP application. Repeated measures ANOVAs, including sex as the between-subjects factor and the grade of the LBNP as the within-subjects factor, were performed. RESULTS No significant changes in retinal microcirculation were observed between the evaluated time points or across the sexes. CONCLUSIONS Graded LBNP application did not lead to changes in the retinal microvasculature across the sexes. The present study is the first in the given area that attempted to capture the changes in retinal microcirculation caused by central hypovolemia during LBNP. However, further research is needed with higher LBNP levels, including those that can induce pre-fainting (presyncope), to fully understand how retinal microcirculation adapts during complete cardiovascular collapse (e.g., during hypovolemic shock) and/or during severe hemorrhage.
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Affiliation(s)
- Adam Saloň
- Division of Physiology & Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria (K.S.-Z.)
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, 2624 Lillehammer, Norway
| | - Nikola Vladic
- Division of Physiology & Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria (K.S.-Z.)
- College of Medicine, Medical University of Rijeka, 51000 Rijeka, Croatia
| | - Karin Schmid-Zalaudek
- Division of Physiology & Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria (K.S.-Z.)
| | - Bianca Steuber
- Division of Physiology & Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria (K.S.-Z.)
| | - Anna Hawliczek
- Division of Physiology & Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria (K.S.-Z.)
| | - Janez Urevc
- Faculty of Mechanical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Vid Pivec
- Clinical Department for General and Abdominal Surgery, University Clinical Centre Maribor, 2000 Maribor, Slovenia
| | - Vishwajeet Shankhwar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
| | - Nandu Goswami
- Division of Physiology & Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria (K.S.-Z.)
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
- Department of Integrative Health, Alma Mater Europaea Maribor, 2000 Maribor, Slovenia
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14
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Erturk A, Erogul O, Kasikci M. Optical Coherence Tomography Angiography Is a Useful Tool for Distinguishing Primary Raynaud's Phenomenon from Systemic Sclerosis and/or Very Early Disease of Systemic Sclerosis. Diagnostics (Basel) 2023; 13:2607. [PMID: 37568970 PMCID: PMC10417700 DOI: 10.3390/diagnostics13152607] [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: 06/23/2023] [Revised: 07/20/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
This cross-sectional study aimed to compare optical coherence tomography angiography (OCT-A) findings in patients with primary Raynaud's phenomenon (PRP; n = 22), very early disease of systemic sclerosis (VEDOSS; n = 19), and systemic sclerosis (SSc; 25 patients with limited cutaneous SSc (lcSSc) and 13 patients with diffuse cutaneous SSc (dcSSc)). Whole, parafoveal, and perifoveal superficial capillary plexus (SCP) vessel densities (VDs), deep capillary plexus VDs, and whole, inside, and peripapillary VDs were significantly higher in the PRP group (p < 0.001). In the lcSSc group, the FAZ perimeter was significantly higher than that in the VEDOSS group (p = 0.017). Retinal nerve fiber layer VDs were significantly lower in the lcSSc group than in the PRP and VEDOSS groups (p < 0.001). The whole and peripapillary optic disc VDs of the VEDOSS group were significantly higher than in the lcSSc group (p < 0.001). Whole SCP VDs (94.74% sensitivity, 100.00% specificity) and parafoveal SCP VDs (89.47% sensitivity, 100.00% specificity) showed the best performance in distinguishing patients with SSc from those with PRP. OCT-A seems to have potential diagnostic value in differentiating patients with PRP from patients with SSc and VEDOSS, and there is potential value in assessing prognostic roles, since findings from OCT-A images could be early indicators of retinal vascular injury long before overt SSc symptoms develop.
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Affiliation(s)
- Adem Erturk
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, Turkey
| | - Ozgur Erogul
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, Turkey;
| | - Murat Kasikci
- Department of Ophthalmology, Mugla Training and Research Hospital, Mugla 48000, Turkey;
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15
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Yu M, Sun X, Zeng F, Gao X, Li Z, Yuan G, Wang T. The short-term effects of blood donation on the ocular parameters including blood flow of the retina and choroid in healthy people using OCT- angiography. BMC Ophthalmol 2023; 23:259. [PMID: 37303035 DOI: 10.1186/s12886-023-03002-3] [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: 01/15/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND To investigate the short-term effects of blood donation on the morphology and blood flow of the retina and choroid in healthy people using optical coherence tomography angiography (OCTA). METHODS Twenty-eight healthy blood donors (56 eyes) who participated in the 200 ml voluntary blood donation between March 2, 2021 and January 20, 2022 were included. The best corrected visual acuity (BCVA), systolic (SBP) and diastolic blood pressure (DBP), intraocular pressure (IOP), subfoveal choroid thickness (SFCT), retinal thickness (RT), retinal superficial vascular density (SVD), deep vascular density (DVD) and foveal avascular were a (FAZ) were measured and statistically analysed 10 min before, 30 min and 24 h after the blood donation. RESULTS The 200 ml blood donation could cause significant IOP reduction at 24 h (P = 0.006), which was negatively correlated with SBP (r = -0.268, P = 0.046), while SBP, DBP, or ocular perfusion pressure were not affected (> 0.05). Moreover, no significant difference existed in the OCT and OCTA indexes, including SFCT, RT, SVD, DVD, and FAZ, before and after the 200 ml blood donation (P > 0.05). The visual acuity was not affected either (P > 0.05). CONCLUSIONS The 200 ml blood donation was noted to be associated with statistically significant IOP reduction at 24 h, while SBP, DBP, or OPP was not affected. The blood flow of the retina and choroid or the visual acuity did not change significantly after the blood donation. Larger studies with different volumes of blood donation were needed to further analysis the effect of blood donation on ocular parameters.
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Affiliation(s)
- Mengmeng Yu
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Xiaolei Sun
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Fanxing Zeng
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Xiang Gao
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Zhenzhen Li
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Gongqiang Yuan
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China.
- School of Ophthalmology, Shandong First Medical University, Jinan, China.
| | - Ting Wang
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Jinan, China.
- School of Ophthalmology, Shandong First Medical University, Jinan, China.
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Somogye RH, Roberts CJ, Spoerl E, Pillunat KR, Pillunat LE, Small RH. Estimating pulsatile ocular blood volume from intraocular pressure, ocular pulse amplitude, and axial length. PLoS One 2023; 18:e0283387. [PMID: 36952489 PMCID: PMC10035833 DOI: 10.1371/journal.pone.0283387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
The purpose of this study was to develop a method of estimating pulsatile ocular blood volume (POBV) from measurements taken during an ophthalmic exam, including axial length and using a tonometer capable of measuring intraocular pressure (IOP) and ocular pulse amplitude (OPA). Unpublished OPA data from a previous invasive study was used in the derivation, along with central corneal thickness (CCT) and axial length (AL), as well as IOP from the PASCAL dynamic contour tonometer (DCT) and intracameral (ICM) measurements of IOP for 60 cataract patients. Intracameral mean pressure was set to 15, 20, and 35 mmHg (randomized sequence) in the supine position, using a fluid-filled manometer. IOP and OPA measurements were acquired at each manometric setpoint (DCT and ICM simultaneously). In the current study, ocular rigidity (OR) was estimated using a published significant relationship of OR to the natural log of AL in which OR was invasively measured through fluid injection. Friedenwald’s original pressure volume relationship was then used to derive the estimated POBV, delivered to the choroid with each heartbeat as a function of OR, systolic IOP (IOPsys), diastolic IOP (IOPdia), and OPA, according to the derived equation POBV = log (IOPsys/IOPdia) / OR. Linear regression analyses were performed comparing OPA to OR and calculated POBV at each of the three manometric setpoints. POBV was also compared to OPA/IOPdia with all data points combined. Significance threshold was p < 0.05. OR estimated from AL showed a significant positive relationship to OPA for both DCT (p < 0.011) and ICM (p < 0.006) at all three manometric pressure setpoints, with a greater slope for lower IOP. Calculated POBV also showed a significant positive relationship to OPA (p < 0.001) at all three setpoints with greater slope at lower IOP, and a significant negative relationship with IOPdia. In the combined analysis, POBV showed a significant positive relationship to OPA/ IOPdia (p < 0.001) in both ICM and DCT measurements with R2 = 0.9685, and R2 = 0.9589, respectively. POBV provides a straight-forward, clinically applicable method to estimate ocular blood supply noninvasively. Higher IOP in combination with lower OPA results in the lowest values of POBV. The simplified ratio, OPA/ IOPdia, may also provide a useful clinical tool for evaluating changes in ocular blood supply in diseases with a vascular component, such as diabetic retinopathy and normal tension glaucoma. Future studies are warranted.
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Affiliation(s)
- Ryan H. Somogye
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States of America
| | - Cynthia J. Roberts
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States of America
- Department of Ophthalmology & Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America
- * E-mail:
| | - Eberhard Spoerl
- Department of Ophthalmology, Universitatsklinikum Carl Gustav Carus, Dresden, Germany
| | - Karin R. Pillunat
- Department of Ophthalmology, Universitatsklinikum Carl Gustav Carus, Dresden, Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology, Universitatsklinikum Carl Gustav Carus, Dresden, Germany
| | - Robert H. Small
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States of America
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America
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Banou L, Dastiridou A, Giannoukas A, Kouvelos G, Baros C, Androudi S. The Role of Color Doppler Imaging in the Diagnosis of Glaucoma: A Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13040588. [PMID: 36832076 PMCID: PMC9954817 DOI: 10.3390/diagnostics13040588] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is a progressive optic neuropathy and one of the leading causes of irreversible blindness worldwide. Elevated intraocular pressure (IOP) is the major risk factor for the onset and progression of glaucoma. In addition to elevated IOP, impaired intraocular blood flow is also considered to be involved in the pathogenesis of glaucoma. Various techniques have been used to assess ocular blood flow (OBF), including Color Doppler Imaging (CDI), a technique used in ophthalmology in recent decades. This article reviews the role of CDI in both the diagnosis and effective monitoring of glaucoma progression, presenting the protocol for imaging and its advantages, as well as the limitations of its use. Moreover, it analyzes the pathophysiology of glaucoma, focusing on vascular theory and its role in the onset and progression of the disease.
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Affiliation(s)
- Lamprini Banou
- Department of Ophthalmology, University of Thessaly, 41334 Larissa, Greece
| | - Anna Dastiridou
- Department of Ophthalmology, University of Thessaly, 41334 Larissa, Greece
- Correspondence:
| | | | - Georgios Kouvelos
- Department of Vascular Surgery, University of Thessaly, 41334 Larissa, Greece
| | - Christos Baros
- Department of Vascular Surgery, University of Thessaly, 41334 Larissa, Greece
| | - Sofia Androudi
- Department of Ophthalmology, University of Thessaly, 41334 Larissa, Greece
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Loo JH, Wang Z, Chong RS. Caveolin-1 in vascular health and glaucoma: A critical vascular regulator and potential therapeutic target. Front Med (Lausanne) 2023; 10:1087123. [PMID: 36760400 PMCID: PMC9902660 DOI: 10.3389/fmed.2023.1087123] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Caveolin-1 (Cav-1) is an integral scaffolding membrane protein found in most cell types. Cav-1 has been found to contribute significantly to ocular function, with mutations of Cav-1 being associated with a genetic risk of glaucoma development. Raised intraocular pressure (IOP) is a major modifiable risk factor for glaucoma. Cav-1 may be involved in both IOP-dependent and independent mechanisms involving vascular dysregulation. Systemic vascular diseases including hypertension, diabetes and hyperlipidaemia, have been shown to be associated with glaucoma development. Cav-1 is closely interlinked with endothelial nitric oxide synthase pathways that mediate vascular function and prevent cardiovascular diseases. Endothelial nitric oxide synthase and endothelin-1 are key vasoactive molecules expressed in retinal blood vessels that function to autoregulate ocular blood flow (OBF). Disruptions in the homeostasis of OBF have led to a growing concept of impaired neurovascular coupling in glaucoma. The imbalance between perfusion and neuronal stimulation arising from Cav-1 depletion may result in relative ischemia of the optic nerve head and glaucomatous injury. OBF is also governed by circadian variation in IOP and systemic blood pressure (BP). Cav-1 has been shown to influence central BP variability and other circadian rhythms such as the diurnal phagolysosomal digestion of photoreceptor fragments and toxic substrates to maintain ocular health. Overall, the vast implications of Cav-1 on various ocular mechanisms leading to glaucoma suggest a potential for new therapeutics to enhance Cav-1 expression, which has seen success in other neurodegenerative diseases.
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Affiliation(s)
- Jing Hong Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Rachel S. Chong
- Glaucoma Department, Singapore National Eye Center, Singapore, Singapore,Ocular Imaging Department, Singapore Eye Research Institute, Singapore, Singapore,*Correspondence: Rachel S. Chong ✉
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Swiatczak B, Schaeffel F, Calzetti G. Imposed positive defocus changes choroidal blood flow in young human subjects. Graefes Arch Clin Exp Ophthalmol 2023; 261:115-125. [PMID: 36171460 PMCID: PMC9803748 DOI: 10.1007/s00417-022-05842-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE It has previously been found that imposing positive defocus changes axial length and choroidal thickness after only 30 min. In the present study, we investigated whether these changes may result from an altered choroidal blood flow. METHODS Eighteen young adult subjects watched a movie from a large screen (65 in.) in a dark room at 2 m distance. A 15-min wash-out period was followed by 30 min of watching the movie with a monocular positive defocus (+ 2.5D). Changes in axial length and ocular blood flow were measured before and after the defocus, by using low-coherent interferometer (LS 900, Haag-Streit, Switzerland) and a laser speckle flowgraphy (LSFG) RetFlow unit (Nidek Co., LTD, Japan), respectively. Three regions were analyzed: (1) the macular area, where choroidal blood flow can be measured, (2) the optic nerve head (ONH), and (3) retinal vessel segments. RESULTS Changes in choroidal blood flow were significantly and negatively correlated with changes in axial length that followed positive defocus in exposed eyes (R = - 0.67, p < 0.01). The absolute values of changes in choroidal blood flow in the defocused eyes were significantly larger than in the fellow control eyes (2.35 ± 2.16 AU vs. 1.37 ± 1.44 AU, respectively, p < 0.05). ONH and retinal blood flow were not associated with the induced changes in axial length. CONCLUSIONS Positive defocus selectively alters choroidal, but not retinal or ONH blood flow in young human subjects after short-term visual exposure. The results suggest that blood flow modulation is involved in the mechanism of choroidal responses to optical defocus.
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Affiliation(s)
- Barbara Swiatczak
- grid.508836.0Institute of Molecular and Clinical Ophthalmology Basel (IOB), Mittlere Strasse 91, 4056 Basel, Switzerland
| | - Frank Schaeffel
- grid.508836.0Institute of Molecular and Clinical Ophthalmology Basel (IOB), Mittlere Strasse 91, 4056 Basel, Switzerland ,grid.10392.390000 0001 2190 1447Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany ,grid.10392.390000 0001 2190 1447Zeiss Vision Lab, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany
| | - Giacomo Calzetti
- grid.508836.0Institute of Molecular and Clinical Ophthalmology Basel (IOB), Mittlere Strasse 91, 4056 Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Ophthalmology, University of Basel, Basel, Switzerland ,grid.10383.390000 0004 1758 0937Department of Ophthalmology, University of Parma, Parma, Italy
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Dogan B, Bozdogan YC, Gedik B, Erol MK, Bulut M, Duman F. Optic disc and retinal vessel densities assessment by optical coherence tomography angiography in patients with keratoconus. Photodiagnosis Photodyn Ther 2022; 41:103218. [PMID: 36462703 DOI: 10.1016/j.pdpdt.2022.103218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/13/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND This study aimed to evaluate retinal and optic disc vascular changes in patients with keratoconus (KC) using optical coherence tomography angiography (OCTA). METHODS Thirty-two eyes of 22 patients with KC and 24 eyes of 24 age- and sex-matched healthy controls were included in this study. Corneal topography and OCTA were performed. Quantitative vessel density of the macular superficial capillary plexus (SCP), macular deep capillary plexus (DCP), and radial peripapillary capillaries (RPC); choriocapillaris flow area; and choroidal thickness were compared between the KC and control groups. RESULTS SCP and DCP vessel densities showed a significant reduction in the KC group compared to that in the control group (p < 0.001 and p < 0.001 in the whole image and parafovea, respectively). Choriocapillaris flow area was significantly higher in patients with KC than in the control group (p = 0.003). The foveal avascular zone area did not significantly differ between the two groups (p = 0.949). RPC inside disc vessel density was significantly decreased in the KC group compared to that in the control group (p < 0.001). CONCLUSION This study revealed important macular, choroidal, and optic disc vessel densities changes in patients with KC. Macular whole vessel density and parafoveal vessel density of the SCP and DCP decreased, while choriocapillaris flow area increased in patients with KC.
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Affiliation(s)
- Berna Dogan
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey.
| | - Yigit Caglar Bozdogan
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Birumut Gedik
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Muhammet Kazim Erol
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Mehmet Bulut
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Fulya Duman
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
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21
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Marchese A, Cavalleri M, Bandello F, Modorati G, Miserocchi E. Ocular Decompression Retinopathy after Cataract Surgery in HLA-B27 Associated Anterior Uveitis. Ocul Immunol Inflamm 2022; 30:1977-1979. [PMID: 34242112 DOI: 10.1080/09273948.2021.1912361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To describe the development and management of ocular decompression retinopathy after cataract surgery in a patient with chronic severe HLA-B27 associated anterior uveitis. METHODS Case report. RESULTS A 45-year-old woman affected by ankylosing spondylitis and HLA-B27 associated anterior uveitis was referred for left eye pain and inflammation one week after phacoemulsification and intraocular lens implantation. She had a history of anterior uveitis complicated by iris bombé for posterior synechiae and cataract. Intraocular pressure (IOP) prior surgery was 14 mmHg. Clinical examination after cataract surgery showed intense inflammation in the anterior chamber and marked hypotony. Fundus examination revealed the presence of ocular decompression retinopathy. High-dose corticosteroids were supplemented to control the uveitis, with a progressive IOP increase and resolution of retinal hemorrhages over the following months. CONCLUSION Ocular decompression retinopathy may present after cataract surgery in patients with complicated HLA-B27 associated anterior uveitis who develop severe post-surgical hypotony and inflammation. Close monitoring of IOP and intraocular inflammation are warranted to prevent severe complications after cataract surgery in these patients.
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Affiliation(s)
- Alessandro Marchese
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Michele Cavalleri
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Giulio Modorati
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisabetta Miserocchi
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
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Adenigba PT, Adekanmi AJ, Ogun OA. Central Retinal and Ophthalmic Artery Doppler Velocimetry among Hypertensives and Normotensive Adults at a Nigerian Tertiary Health Facility. Niger Med J 2022; 63:385-393. [PMID: 38867744 PMCID: PMC11165325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background Haemodynamic alterations of the retrobulbar circulation are sequelae of untreated, long-standing hypertension. Early evaluation of the retrobulbar blood flow is very crucial to prevent irreversible ocular complications. The objective of this study was to evaluate the differences in central retinal artery (CRA) and ophthalmic artery (OA) haemodynamics in adult hypertensive and non-hypertensive subjects. Methodology This prospective, comparative cross-sectional study was conducted among 63 hypertensives and 75 normotensive controls. Using Doppler ultrasonography, the CRA and OA Doppler velocimetry parameters among cases and controls were evaluated and analysed. Results The CRA Peak Systolic Velocity (PSV) and End-diastolic velocity (EDV) was 7.54 ± 2.60cm/s and 2.99 ± 1.15cm/s (p<0.001) in hypertensives but 10.8 ± 2.51cm/s and 4.50 ± 1.25cm/s) p<0.001 in controls. The systolic/diastolic ratio (S/D) in cases was 2.64 ± 0.75 and 2.44 ± 0.38 p=0.045 in controls. The CRA's Pulsatility Index (PI) between cases and controls was not statistically significant, p =0.082. Furthermore, the CRA's PSV, PI, Resistivity index (RI) and S/D, were higher among subjects with stage 1 compared to stage 2 hypertension (p=0.004; p=0.027; p<0.001 and p=0.001 respectively). The OA mean EDV in hypertensives was 4.57 ± 1.97 and in controls= 5.31 ± 1.79 (p=0.022), while the OA mean RI and Peak Ratio, p=0.009 and 0.003, respectively, were higher in stage 1 hypertension. Conclusion The Central retinal and ophthalmic artery blood flow parameters were significantly lower among hypertensive cases. Also, hypertensive stage 2 cases had significantly lower blood flow and vascular impedance parameters in the CRA and both Central retinal and ophthalmic artery, respectively.
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Affiliation(s)
- Peter T. Adenigba
- Department of Radiology, University College Hospital Ibadan, Nigeria
| | - Ademola J. Adekanmi
- Department of Radiology, College of Medicine, University of Ibadan, Nigeria
- Institute of cardiovascular diseases, College of Medicine, University of Ibadan, Nigeria
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Matulevičiūtė I, Sidaraitė A, Tatarūnas V, Veikutienė A, Dobilienė O, Žaliūnienė D. Retinal and Choroidal Thinning—A Predictor of Coronary Artery Occlusion? Diagnostics (Basel) 2022; 12:diagnostics12082016. [PMID: 36010366 PMCID: PMC9407460 DOI: 10.3390/diagnostics12082016] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) allowed visualization of retina and choroid to nearly the capillary level; however, the relationship between systemic macrovascular status and retinal microvascular changes is not yet known well. Aim. Our purpose was to assess the impact of retinal optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters on prediction of coronary heart disease (CHD) in acute myocardial infarction (MI) and chronic three vessel disease (3VD) groups. Methods. This observational study included 184 patients—26 in 3VD, 76 in MI and 82 in healthy participants groups. Radial scans of the macula and OCTA scans of the central macula (superficial (SCP) and deep (DCP) capillary plexuses) were performed on all participants. All participants underwent coronary angiography. Results. Patients in MI groups showed decreased parafoveal total retinal thickness as well as GCL+ retinal thickness. Outer circle total retinal thickness and GCL+ retinal thickness were lowest in the 3VD group. The MI group had thinner, while 3VD the thinnest, choroid. A decrease in choroidal thickness and vascular density could predict 3VD. Conclusions. A decrease in retinal and choroidal thickness as well as decreased vascular density in the central retinal region may predict coronary artery disease. OCT and OCTA could be a significant, safe, and noninvasive tool for the prediction of coronary artery disease.
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Affiliation(s)
- Indrė Matulevičiūtė
- Department of Ophthalmology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Correspondence: ; Tel.: +370-655-06381
| | - Agnė Sidaraitė
- Department of Ophthalmology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Vacis Tatarūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Audronė Veikutienė
- Institute of Cardiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Olivija Dobilienė
- Department of Cardiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Dalia Žaliūnienė
- Department of Ophthalmology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
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Bastia E, Sgambellone S, Lucarini L, Provensi G, Brambilla S, Galli C, Almirante N, Impagnatiello F. NCX 470 Restores Ocular Hemodynamics and Retinal Cell Physiology After ET-1-Induced Ischemia/Reperfusion Injury of Optic Nerve and Retina in Rabbits. J Ocul Pharmacol Ther 2022; 38:496-504. [PMID: 35787180 DOI: 10.1089/jop.2022.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Determine whether NCX 470, a nitric oxide (NO)-donating bimatoprost with clinically demonstrated intraocular pressure (IOP)-lowering effects, improves ocular hemodynamics and retinal physiology. Methods: Endothelin-1 (ET-1)-induced ischemia/reperfusion model in New Zealand white rabbits was used. ET-1 was injected next to the optic nerve twice/week (Monday and Thursday) for 6 weeks. Starting on week 3, animals received NCX 470 (0.1% bid, 6 days/week Monday-Saturday) or vehicle until the end of ET-1 treatment. IOP, ophthalmic artery resistive index (OA-RI) and retina physiology (electroretinogram, ERG) were determined before dosing and at different times post-dosing. All measurements were taken on Mondays before the AM daily dosing (36 h treatment-free). Finally, oxidative stress markers were determined in dissected retina and iris/ciliary body of treated eyes. Results: Injection of ET-1 progressively increased IOP (20.7 ± 0.6, 24.9 ± 1.2, and 27.0 ± 0.6 mmHg at baseline, week 2 and 6, respectively) and OA-RI (0.30 ± 0.02, 0.39 ± 0.02, and 0.42 ± 0.03 at baseline, week 2 and 6, respectively) and reduced rods and/or cones response as indicated by changes in ERG amplitudes under different stimulating conditions. NCX 470 re-established baseline IOP (21.8 ± 1.0 mmHg), OA-RI (0.33 ± 0.02), and ERG amplitude by week 6 (mostly rod response, 0.01Dark_AVeh_6week = 32.2 ± 3.0 μV and 0.01Dark_ANCX470_6week 44.3 ± 4.5 μV; mostly cone response, 3.0Dark_AVeh_6week = 87.6 ± 10.1 μV and 3.0Dark_ANCX470_6week = 122.8 ± 11.4 μV; combined rod/cone response, 3.0Light_AVeh_6week = 49.8 ± 6.5 μV and 3.0Light_ANCX470_6week = 64.2 ± 6.8 μV). NCX 470 also reversed ET-1-induced changes in glutathione and manganese superoxide dismutase (oxidative stress markers) in retina and iris/ciliary body. Conclusions: Repeated ocular topical dosing with NCX 470 reverses ET-1-induced changes in IOP, OA-RI, and ERG suggesting improved ocular hemodynamics and retinal physiology likely independently from its demonstrated IOP-lowering effect.
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Affiliation(s)
| | - Silvia Sgambellone
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, Italy
| | - Laura Lucarini
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, Italy
| | - Gustavo Provensi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, Italy
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Peripapillary Oxygenation and Retinal Vascular Responsiveness to Flicker Light in Primary Open Angle Glaucoma. Metabolites 2022; 12:metabo12070597. [PMID: 35888721 PMCID: PMC9318708 DOI: 10.3390/metabo12070597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was to evaluate peripapillary oxygenation and its relationship to retinal vascular responsiveness to flicker light in patients with primary open angle glaucoma (POAG). Retinal vessel oxygen saturation was measured in 46 eyes of 34 Caucasian patients with POAG and in 21 eyes of 17 age-matched controls using the oximetry tool of Retinal Vessel Analyser (RVA: IMEDOS Systems UG, Jena, Germany). The mean oxygen saturation of the major arterioles (A-SO2; %) and venules (V-SO2; %), as well as the corresponding arterio−venular difference (A-V SO2; %), were calculated. We also measured retinal vascular responsiveness (RVR) to flicker light by means of RVA. Glaucoma patients were divided in two subgroups according to their median arteriolar and venular vascular responsiveness to flicker light (AFR and VFR). Glaucomatous damage was assessed by optical coherence tomography (Carl Zeiss Meditec, Dublin, CA, USA) and static automated perimetry (Octopus, program G2/standard strategy: Haag-Streit International, Köniz, Switzerland). In addition, we calculated the mean peripapillary oxygen exposure [ppO2E; %/µm] by dividing the mean A-V SO2 with the mean retinal nerve fibre layer (RNFL) thickness. In glaucoma patients, A-SO2 and V-SO2 values were significantly increased, and their difference decreased when compared to controls (p < 0.017; linear mixed-effects model). Grouped with respect to retinal vascular responsiveness to flicker light, subjects with reduced VFR (≤2.9%) had significantly higher ppO2E (0.49 ± 0.08%/µm, respectively, 0.43 ± 0.06%/µm; p = 0.027). Additionally, higher ppO2E in glaucoma patients correlated negatively with the neuroretinal rim area (p < 0.001) and the RNFL thickness (p = 0.017), and positively with the mean defect of the visual field (p = 0.012). Reduced venular vascular responsiveness in our glaucoma patients was associated with increased peripapillary oxygenation exposure. Thus, ganglion cells and their axons in glaucomatous eyes with reduced retinal vascular responsiveness are prone to be more exposed to higher oxidative stress, probably contributing to the further progression of glaucomatous damage.
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Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res 2022; 91:101095. [PMID: 35760749 DOI: 10.1016/j.preteyeres.2022.101095] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 12/13/2022]
Abstract
In the last two decades evidence has gradually accumulated suggesting that the eye may be a unique window for cardiovascular risk stratification based on the assessment of subclinical damage of retinal microvascular structure and function. This can be facilitated by non-invasive analysis of static retinal vessel diameters and dynamic recording of flicker light-induced and endothelial function-related dilation of both retinal arterioles and venules. Recent new findings have made retinal microvascular biomarkers strong candidates for clinical implementation as reliable risk predictors. Beyond a review of the current evidence and state of research, the article aims to discuss the methodological benefits and pitfalls and to identify research gaps and future directions. Above all, the potential use for screening and treatment monitoring of cardiovascular disease risk are highlighted. The article provides fundamental comprehension of retinal vessel imaging by explaining anatomical and physiological essentials of the retinal microcirculation leading to a detailed description of the methodological approach. This allows for better understanding of the underlying retinal microvascular pathology associated with the prevalence and development of cardiovascular disease. A body of new evidence is presented on the clinical validity and predictive value of retinal vessel diameters and function for incidence cardiovascular disease and outcome. Findings in children indicate the potential for utility in childhood cardiovascular disease prevention, and the efficacy of exercise interventions highlight the treatment sensitivity of retinal microvascular biomarkers. Finally, coming from the availability of normative data, solutions for diagnostic challenges are discussed and conceptual steps towards clinical implementation are put into perspective.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland.
| | - Lukas Streese
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland
| | - Walthard Vilser
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany; Neonatology and Pediatric Intensive Care Unit, Department of Pediatrics, Jena University Hospital, Jena, Germany
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Awwad MA, Masoud M, Elhadad MA. Quantitative OCT Angiography Assessment of the Effect of Peribulbar Anesthesia on Retinal Microvasculature in Primary Open-Angle Glaucoma Patients Undergoing Cataract Surgery. Clin Ophthalmol 2022; 16:2011-2024. [PMID: 35757020 PMCID: PMC9231634 DOI: 10.2147/opth.s369969] [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: 04/13/2022] [Accepted: 06/10/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To assess the effect of peribulbar anesthesia on retinal microvasculature in primary open-angle glaucoma (POAG) patients undergoing cataract surgery using OCT Angiography. Participants Forty-nine patients undergoing cataract surgery were divided into two groups. Group I included patients with no history of glaucoma, while group II included patients previously diagnosed as POAG with controlled IOP. Each participant received 6 mL of peribulbar anesthetic injection of 4 mL lidocaine 2% containing 150 IU hyaluronidase and 2 mL bupivacaine 0.5%. They were scanned with the OCT-A 10 minutes before and 10 minutes after injection for foveal deep (DCP), superficial (SCP) capillary plexuses density and total vessel density, foveal avascular zone (FAZ) diameter, optic disc total vessel density, and radial peripapillary capillary (RPC) network density. In addition, IOP was checked before and 10 minutes after injection. Results Median percent change in DCP post-injection was significantly greater in group II (−43%) than in group I (−2.5%) (P < 0.001). Also, DCP total density median percent change post-injection was significantly higher in group II (−21%) than in group I (−0.9%) (P < 0.001). Foveal SCP vessel density and total vessel density median percent change post-injection were −62.6% and −16.2%, respectively, in group II and were −2.6% and −1.1%, respectively, in group I, which are statistically significant (P < 0.001). The FAZ diameter median percentage change post-injection was higher in group II (40.6%) than in group I (2.5%) (P < 0.001). Optic disc total vessel density and radial peripapillary capillary (RPC) network density post-injection median percent change were significantly higher in group II (−13.6%) and (−13.1%) respectively than in group I (−1.1%) and (−1.25%) respectively (P < 0.001). Conclusion Peribulbar anesthesia harbors a deleterious ischemic effect on the retinal vascular tree of glaucoma patients, which could harmfully affect the vision and the visual field in those vulnerable patients.
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Affiliation(s)
- Mohamed A Awwad
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
- Correspondence: Mohamed A Awwad, Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt, Tel +20 1017014208, Email ;
| | - Mohamed Masoud
- Department of Ophthalmology, Benha University Hospital, Benha, Qualubia, Egypt
| | - Mona Ahmed Elhadad
- Department of Anesthesia and Surgical Intensive Care, Benha University Hospital, Benha, Qualubia, Egypt
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Wu X, Konieczka K, Liu X, Chen M, Yao K, Wang K, Flammer J. Role of ocular blood flow in normal tension glaucoma. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100036. [PMID: 37846223 PMCID: PMC10577859 DOI: 10.1016/j.aopr.2022.100036] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/06/2022] [Accepted: 02/14/2022] [Indexed: 10/18/2023]
Abstract
Background Normal tension glaucoma (NTG) is a multifactorial disease in the pathogenesis of which intraocular pressure (IOP)-independent factors play a key role. Main text There is considerable evidence that impairment of the ocular blood flow (OBF) is involved both in the onset and progression of this disease. With the development of the hypothesis of OBF in NTG, various imaging techniques have been developed to evaluate the OBF and blood vessels. Moreover, vascular dysregulation, which is a main factor in Flammer syndrome, was frequently observed in NTG patients. Disturbed OBF leads to increased oxidative stress, which plays an important role in the pathogenesis of glaucomatous optic neuropathy. These results suggested that IOP-independent management may provide alternative treatment options for NTG patients. Conclusions In this review, we mainly focus on the mechanisms of the abnormal OBF in NTG.
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Affiliation(s)
- Xingdi Wu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Katarzyna Konieczka
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, Basel, 4031, Switzerland
| | - Xin Liu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Min Chen
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Kaijun Wang
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Josef Flammer
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, Basel, 4031, Switzerland
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Shin DY, Hong KE, Lee NY, Park CK, Park HYL. Association of choroidal blood flow with autonomic dysfunction in patients with normal tension glaucoma. Sci Rep 2022; 12:5136. [PMID: 35332217 PMCID: PMC8948179 DOI: 10.1038/s41598-022-09162-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/04/2022] [Indexed: 11/09/2022] Open
Abstract
There is increasing evidence that autonomic dysfunction is an important factor in the progression of glaucoma. Mechanism of the association between autonomic dysfunction and progression of glaucoma is poorly understood. Since blood circulation is basically regulated by the autonomic nervous system, autonomic dysfunction may contribute to unstable or fluctuating blood pressure. Therefore, It is hypothesized that autonomic dysfunction may contribute to impaired ocular blood flow and lead to glaucoma progression. However, no clinical study yet has evaluated the relationship between ocular blood flow and autonomic nervous function. We enrolled 152 open angle glaucoma patient. Ocular blood flow was assessed by measuring vessel density (VD) using optical coherence tomography angiography, and autonomic nervous function was evaluated with heart-rate variability (HRV) parameters. The low frequency/high frequency (LF/HF) ratio, which is one of the HRV parameters, quantified the degree of sympathovagal balance. This indicator could represent autonomic dysfunction. Higher LF/HF ratio was associated with reduction of the deep parapapillary VD (R = − 0.243, P = 0.003). Linear regression analysis showed a significant negative association between parapapillary choroidal VD and LF/HF ratio (β = − 0.249; 95% confidential interval = − 1.193 to − 0.249; P = 0.002) in multivariate analysis. We demonstarted the association between impaired ocular blood flow (parapapillary choroidal vessel density) and autonomic dysfunction (LF/HF ratio). This study could help understand the role of the autonomic dysfunction in pathophysiology of glaucoma progression.
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Affiliation(s)
- Da Young Shin
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung Euy Hong
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Na Young Lee
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hae Young L Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Hamarat Y, Deimantavicius M, Dambrauskas V, Labunskas V, Putnynaite V, Lucinskas P, Siaudvytyte L, Simiene E, Stoskuviene A, Januleviciene I, Petkus V, Ragauskas A. Prospective Pilot Clinical Study of Noninvasive Cerebrovascular Autoregulation Monitoring in Open-Angle Glaucoma Patients and Healthy Subjects. Transl Vis Sci Technol 2022; 11:17. [PMID: 35138342 PMCID: PMC8842541 DOI: 10.1167/tvst.11.2.17] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To analyze the cerebrovascular autoregulation (CA) dynamics in patients with normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) as well as healthy subjects using noninvasive ultrasound technologies for the first time. Methods The CA status of 10 patients with NTG, 8 patients with HTG, and 10 healthy subjects was assessed, using an innovative noninvasive ultrasonic technique, based on intracranial blood volume slow-wave measurements. Identified in each participant were intraocular pressure, ocular perfusion pressure, and CA-related parameter volumetric reactivity index (VRx), as well as the duration and doses of the longest cerebral autoregulation impairment (LCAI). In addition, we calculated the associations of these parameters with patients' diagnoses. Results The VRx value, the LCAI dose, and duration in healthy subjects were significantly lower than in patients with NTG (P < 0.05). However, no significant differences were noted in these parameters between healthy subjects and HTG and between NTG and HTG groups. Conclusions NTG is associated with the disturbed cerebral blood flow and could be diagnosed by performing noninvasive CA assessments. Translational Relevance The VRx monitoring method can be applied to a wider range of patient groups, especially patients with normal-tension glaucoma.
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Affiliation(s)
- Yasin Hamarat
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.,0000-0002-1343-5068
| | - Mantas Deimantavicius
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Vilius Dambrauskas
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Vaidas Labunskas
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Vilma Putnynaite
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Paulius Lucinskas
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Lina Siaudvytyte
- Eye Clinic, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Evelina Simiene
- Eye Clinic, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Vytautas Petkus
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Arminas Ragauskas
- Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
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Zampiccoli E, Barthelmes J, Kreysing L, Nägele MP, Nebunu D, Haider T, Eckardstein A, Gerber B, Schwotzer R, Ruschitzka F, Sudano I, Flammer AJ. Eyes on amyloidosis: microvascular retinal dysfunction in cardiac amyloidosis. ESC Heart Fail 2022; 9:1186-1194. [PMID: 35060356 PMCID: PMC8934987 DOI: 10.1002/ehf2.13792] [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: 08/13/2021] [Revised: 11/08/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022] Open
Abstract
Aims Methods and results Conclusions
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Affiliation(s)
- Emanuel Zampiccoli
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Jens Barthelmes
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Leonie Kreysing
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Matthias P. Nägele
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Delia Nebunu
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Thomas Haider
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Arnold Eckardstein
- Department of Clinical Chemistry University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Bernhard Gerber
- Clinic of Haematology Oncology Institute of Southern Switzerland Piazza Indipendenza 2 Bellinzona 6500 Switzerland
| | - Rahel Schwotzer
- Department of Medical Oncology and Haematology University Hospital Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Frank Ruschitzka
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Isabella Sudano
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
| | - Andreas J. Flammer
- Department of Cardiology University Hospital Zurich, University of Zurich Raemistrasse 100 Zurich 8091 Switzerland
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Cai Y, Liu WB, Zhou M, Jin YT, Sun GS, Zhao L, Han F, Qu JF, Shi X, Zhao MW. Diurnal changes of retinal microvascular circulation and RNFL thickness measured by optical coherence tomography angiography in patients with obstructive sleep apnea-hypopnea. Front Endocrinol (Lausanne) 2022; 13:947586. [PMID: 36017325 PMCID: PMC9395661 DOI: 10.3389/fendo.2022.947586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To evaluate capillaries perfusion and retinal nerve fiber layer (RNFL) thickness diurnal changes of macular/optic disc regions among participants with or without obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA). METHODS In this study, we enrolled a cohort of 35 participants including 14 patients with mild-to-moderate OSA, 12 patients with severe OSA, and 9 healthy individuals. All participants had Berlin questionnaire filled. At 20:00 and 6:30, right before and after the polysomnography examination, a comprehensive ocular examination was conducted. The systemic and ocular clinical characteristics were collected, and OCTA scans were performed repeatedly. Blood flow and RNFL thickness parameters were then exported using built-in software and analyzed accordingly. RESULTS After sleep, the overall vessel density (VD) variables, especially macular and choriocapillaris VDs, were relatively comparative and stable. One exception was the RPC vessel density at the inside-disc region with a decreasing trend in the mild-to-moderate group (p=0.023). RNFL changes before and after sleep in the nasal-inferior and peripapillary region were statistically significant (p=0.003; p=0.043) among three groups. And multiple testing correction verified the significant difference in diurnal changes between the mild-to-moderate group and the control group in pairwise comparisons (p=0.006; p=0.02). CONCLUSIONS The changes of imperceptible blood flow and RNFL thickness overnight around optic disc areas could be observed in OSA patients. Despite physiological fluctuations, aberrant diurnal changes might be useful for identifying a decrease in micro-environmental stability associated with the development of various ocular diseases such as glaucoma. Other VD variables, especially macular and choriocapillaris VDs, are relatively stable in eyes of patients having OSA with different severity.
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Affiliation(s)
- Yi Cai
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Wen-Bo Liu
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Miao Zhou
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Yu-Tong Jin
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | - Guo-Sheng Sun
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Long Zhao
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Fang Han
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Jin-Feng Qu
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Xuan Shi
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
- *Correspondence: Xuan Shi,
| | - Ming-Wei Zhao
- Department of Ophthalmology, Peking University People’s Hospital; Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
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Gunzinger JM, Ibrahimi B, Baur J, Wiest MRJ, Piccirelli M, Pangalu A, Straumann D, Nietlispach F, Moarof I, Zweifel SA. Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography. Diagnostics (Basel) 2021; 11:diagnostics11122399. [PMID: 34943635 PMCID: PMC8700652 DOI: 10.3390/diagnostics11122399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is an alternative to open heart surgery in the treatment of symptomatic aortic valve stenosis, which is often the treatment of choice in elderly and frail patients. It carries a risk of embolic complications in the whole cerebral vascular bed, which includes the retinal vasculature. The main objective was the evaluation of retinal emboli visible on optical coherence tomography angiography (OCTA) following TAVI. This is a prospective, single center, observational study enrolling consecutive patients over two years. Patients were assessed pre- and post-TAVI. Twenty-eight patients were included in the final analysis, 82.1% were male, median age was 79.5 (range 52–88), median BCVA was 82.5 letters (range 75–93). Eight patients (28.6%) presented new capillary dropout lesions in their post-TAVI OCTA scans. There was no statistically significant change in BCVA. Quantitative analysis of macular or peripapillary OCTA parameters did not show any statistically significant difference in pre- and post-intervention. In conclusion, capillary dropout lesions could frequently be found in patients after TAVI. Quantitative measurements of macular and peripapillary flow remained stable, possibly indicating effective ocular blood flow regulation within the range of left ventricular ejection fraction in our cohort.
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Affiliation(s)
- Jeanne Martine Gunzinger
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.B.); (M.R.J.W.); (S.A.Z.)
- Correspondence:
| | - Burbuqe Ibrahimi
- Department of Cardiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (B.I.); (F.N.)
| | - Joel Baur
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.B.); (M.R.J.W.); (S.A.Z.)
| | - Maximilian Robert Justus Wiest
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.B.); (M.R.J.W.); (S.A.Z.)
| | - Marco Piccirelli
- Department of Information Technology and Electrical Engineering, ETH Zurich, 8092 Zurich, Switzerland;
| | - Athina Pangalu
- Department of Neuroradiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Dominik Straumann
- Department of Neurology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Fabian Nietlispach
- Department of Cardiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (B.I.); (F.N.)
- Heartcenter im Park, Hirslanden Clinic Im Park, 8027 Zurich, Switzerland
| | - Igal Moarof
- Department of Cardiology, Kantonsspital Baden, 5404 Baden, Switzerland;
| | - Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.B.); (M.R.J.W.); (S.A.Z.)
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Shalaby WS, Ahmed OM, Waisbourd M, Katz LJ. A Review of Potential Novel Glaucoma Therapeutic Options Independent of Intraocular Pressure. Surv Ophthalmol 2021; 67:1062-1080. [PMID: 34890600 DOI: 10.1016/j.survophthal.2021.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 02/06/2023]
Abstract
Glaucoma, a progressive optic neuropathy characterized by retinal ganglion cell degeneration and visual field loss, is the leading cause of irreversible blindness worldwide. Intraocular pressure (IOP) is presently the only modifiable risk factor demonstrated to slow or halt disease progression; however, glaucomatous damage persists in almost 50% of patients despite significant IOP reduction. Many studies have investigated the non-IOP-related risk factors that contribute to glaucoma progression as well as interventions that can prevent or delay glaucomatous neurodegeneration and preserve vision throughout life, independently of IOP. A vast number of experimental studies have reported effective neuroprotection in glaucoma, and clinical studies are ongoing attempting to provide strong evidence of effectiveness of these interventions. In this review, we look into the current understanding of the pathophysiology of glaucoma and explore the recent advances in non-IOP related strategies for neuroprotection and neuroregeneration in glaucoma.
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Key Words
- AMD, Age-related macular degeneration
- BDNF, Brain derived neurotrophic factor
- CNTF, Ciliary neurotrophic factor
- GDNF, Glial‐derived neurotrophic factor
- Glaucoma
- IOP, Intraocular pressure
- LoGTS, Low-Pressure Glaucoma Treatment Study
- MRI, Magnetic resonance imaging
- MSCs, Mesenchymal stem cells
- NGF, Nerve growth factor
- NTG, Normal tension glaucoma
- OCTA, Optical coherence tomography angiography
- PBM, hotobiomodulation
- PDGF, Platelet derived growth factor
- POAG, Primary open angle glaucoma
- RGCs, Retinal ganglion cells
- TNF-α, Tumor necrosis factor- α
- bFGF, Basic fibroblast growth factor
- gene therapy
- intracranial pressure
- intraocular pressure
- neuroprotection
- ocular blood flow
- oxidative stress
- retinal ganglion cells
- stem cell therapy
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Affiliation(s)
- Wesam Shamseldin Shalaby
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; Department of Ophthalmology, Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt
| | - Osama M Ahmed
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; Yale University School of Medicine, New Haven, CT, USA
| | - Michael Waisbourd
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - L Jay Katz
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA.
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Kannenkeril D, Jung S, Harazny J, Striepe K, Ott C, Dahlmann A, Kopp C, Schiffer M, Linz P, Nagel AM, Uder M, Schmieder RE. Tissue sodium content correlates with hypertrophic vascular remodeling in type 2 diabetes. J Diabetes Complications 2021; 35:108055. [PMID: 34620556 DOI: 10.1016/j.jdiacomp.2021.108055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/16/2021] [Accepted: 09/25/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Prospective studies describe a linkage between increased sodium intake and higher incidence of cardiovascular organ damage and end points. We analyzed whether tissue sodium content in the skin and muscles correlate with vascular hypertrophic remodeling, a risk factor for cardiovascular disease. METHODS In patients with type 2 diabetes we assessed tissue sodium content and vascular structural parameters of the retinal arterioles. The structural parameters of retinal arterioles assessed by Scanning Laser Doppler Flowmetry were vessel (VD) and lumen diameter (LD), wall thickness (WT), wall-to-lumen ratio (WLR) and wall cross sectional area (WCSA). Tissue sodium content was measured with a 3.0 T clinical 23Sodium-Magnetic Resonance Imaging (23Na-MRI) system. RESULTS In patients with type 2 diabetes (N = 52) we observed a significant correlation between muscle sodium content and VD (p = 0.005), WT (p = 0.003), WCSA (p = 0.002) and WLR (p = 0.013). With respect to skin sodium content a significant correlation has been found with VD (p = 0.042), WT (p = 0.023) and WCSA (p = 0.019). Further analysis demonstrated that tissue sodium content of skin and muscle is a significant determinant of hypertrophic vascular remodeling independent of age, gender, diuretic use and 24-hour ambulatory BP. CONCLUSION With the 23Na-MRI technology we could demonstrate that high tissue sodium content is independently linked to hypertrophic vascular remodeling in type 2 diabetes. TRIAL REGISTRATION Trial registration number: NCT02383238 Date of registration: March 9, 2015.
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Affiliation(s)
- Dennis Kannenkeril
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Susanne Jung
- Department of Cardiology, University Hospital Erlangen, Erlangen, Germany
| | - Joanna Harazny
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany; Department of Human Physiology and Pathophysiology, University of Warmia and Mazury, Olsztyn, Poland
| | - Kristina Striepe
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Christian Ott
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Anke Dahlmann
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Christoph Kopp
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Mario Schiffer
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Peter Linz
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany; Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Roland E Schmieder
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany.
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Wu LT, Wang JL, Wang YL. Ophthalmic Artery Morphological and Hemodynamic Features in Acute Coronary Syndrome. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 34757418 PMCID: PMC8590173 DOI: 10.1167/iovs.62.14.7] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine the morphological and hemodynamic changes of the ophthalmic artery (OA) in patients with acute coronary syndrome (ACS). Methods This cross-sectional observational study included 31 patients with ACS and 10 healthy controls (HCs). The ACS subgroups were ST-segment elevation myocardial infarction (STEMI; n = 10), non-STEMI (n = 10), and unstable angina (n = 11). OA three-dimensional (3D) models were reconstructed based on computed tomographic angiography, and morphological aspects of the OA were measured quantitatively. Moreover, numerical simulation by computational fluid dynamics was used to obtain hemodynamic information of the OA. Results The study reconstructed 41 OA models. Hemodynamic simulation revealed a significant decrease in OA blood velocity in patients with ACS compared with the HCs (median velocity, 0.046 vs. 0.147 m/s; P < 0.001). No differences in the morphological data for the OA were observed. Also, no differences in the mass flow ratio of OA to the ipsilateral internal carotid artery was found. Similar differences were observed between the ACS subgroups and HCs. OA blood velocity was negatively correlated with body mass index, abdominal circumference, left ventricular ejection fraction, and triacylglycerol and was positively correlated with early to late transmitral flow velocity, N-terminal pro-brain natriuretic peptide, serum creatinine, and potassium. Conclusions The initial OA blood velocity was slower in patients with ACS and was associated with ACS-related clinical parameters. To our knowledge, this is the first study to analyze OA characteristics in ACS using 3D model reconstruction and hemodynamic simulation, providing new perspectives on the relationship between ischemic heart disease and ocular manifestations.
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Affiliation(s)
- Lan-Ting Wu
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jia-Lin Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yan-Ling Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Li Y, Mitchell W, Elze T, Zebardast N. Association Between Diabetes, Diabetic Retinopathy, and Glaucoma. Curr Diab Rep 2021; 21:38. [PMID: 34495413 DOI: 10.1007/s11892-021-01404-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW The strength of the relationship between diabetes, diabetic retinopathy (DR), and glaucoma remains controversial. We review evidence supporting and refuting this association and explore mechanistic pathological and treatment relationships linking these diseases. RECENT FINDINGS While studies have shown diabetes/DR may increase the risk for glaucoma, this remains inconsistently demonstrated. Diabetes/DR may contribute toward glaucomatous optic neuropathy indirectly (either by increasing intraocular pressure or vasculopathy) or through direct damage to the optic nerve. However, certain elements of diabetes may slow glaucoma progression, and diabetic treatment may concurrently be beneficial in glaucoma management. Diabetes plays a significant role in poor outcomes after glaucoma surgery. While the relationship between diabetes/DR and glaucoma remains controversial, multiple mechanistic links connecting pathophysiology and management of diabetes, DR, and glaucoma have been made. However, a deeper understanding of the causes of disease association is needed.
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Affiliation(s)
- Yangjiani Li
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, 510060, China
| | - William Mitchell
- Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Ophthalmology, Royal Victorian Eye and Ear, Melbourne, VIC, 3002, Australia
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
- Department of Ophthalmology, Harvard Medical School, Boston, MA, 02115, USA.
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Wu JH, Penteado RC, Moghimi S, Zangwill LM, Proudfoot JA, Weinreb RN. Diurnal Variation of Retinal Vessel Density in Healthy Human Eyes. J Glaucoma 2021; 30:820-826. [PMID: 34172629 PMCID: PMC8405550 DOI: 10.1097/ijg.0000000000001903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022]
Abstract
PRECIS A small increase in optic nerve head vessel density (VD), but not macular VD, in the evening compared with the morning is observed in healthy subjects. PURPOSE To evaluate the diurnal variation of the macular and optic nerve head (ONH) VD in healthy eyes as measured with optical coherence tomography angiography (OCT-A). METHODS In this prospective study of healthy individuals older than 18 years old, VD parameters, including macular whole image vessel density, parafoveal vessel density, ONH whole image vessel density, ONH whole image capillary density, circumpapillary vessel density (cpVD), and circumpapillary capillary density, were measured with OCT-A at 4 time points throughout the day (8 am, 12 pm, 4 pm, and 8 pm). RESULTS Twenty-nine healthy eyes were included from 15 subjects (mean age: 30.9 y). After adjustment for age and mean ocular perfusion pressure, a significant positive rate of change was found for cpVD (0.05%/h; P=0.027). In contrast, macular VD changes were not significantly different. When comparing morning (8 am and 12 pm) and evening (4 pm and 8 pm) measurements, there were small, but statistically significant, increases for all ONH measurements. The greatest increase was found for cpVD (0.58%; P=0.022). Significant but small increases in mean arterial pressure and mean ocular perfusion pressure were also observed. CONCLUSIONS There was a small increase in ONH VD, but not macular VD, in the evening compared with the morning in healthy human eyes. As the observed difference was within the measurement variability, our results suggest the timing of OCT-A examination does not affect retinal VD measurements.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Rafaella C. Penteado
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - James A. Proudfoot
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
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Enhanced Physiological Stress Response in Patients with Normal Tension Glaucoma during Hypoxia. J Ophthalmol 2021; 2021:5826361. [PMID: 34430053 PMCID: PMC8049796 DOI: 10.1155/2021/5826361] [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: 07/20/2020] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate whether patients with normal tension glaucoma (NTG) show an enhanced stress response to reduced oxygen supply compared to age-matched healthy controls, measured by serum adrenaline and endothelin-1 (ET-1) levels and changes in distal finger temperature. Methods A thorough clinical characterization of patients with NTG and age-matched controls was performed prior to inclusion in the study. Twelve patients with NTG and eleven healthy controls met the inclusion criteria and were enrolled in the study. All subjects underwent a two-day investigation. Participants were randomly exposed to either hypoxia or normoxia during the first visit. Hypoxia or normoxia was induced for two hours through a tightly fitting face mask. In addition, the peripheral circulation was assessed with a thermographic camera. Blood samples were obtained before, during, and after hypoxia or normoxia to evaluate systemic stress molecules such as catecholamines and ET-1 levels. Results In patients with NTG, reduced oxygen supply induced an increase in peripheral blood adrenaline (p < 0.05) and a decrease during recovery (p < 0.01). A difference in distal finger temperature was shown in patients with NTG under hypoxia compared to normoxia (exposure: p < 0.05; recovery: p < 0.05). Hypoxia induced an increase in peripheral blood ET-1 levels in both groups (NTG: p < 0.01; controls: p < 0.05). Conclusion Patients with NTG had an enhanced physiological stress response as a consequence of hypoxia compared with age-matched controls. Although more studies are needed, the present study supports the involvement of vascular risk factors in the pathophysiology of NTG.
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Visualization of three-dimensional microcirculation of rodents' retina and choroid for studies of critical illness using optical coherence tomography angiography. Sci Rep 2021; 11:14302. [PMID: 34253747 PMCID: PMC8275781 DOI: 10.1038/s41598-021-93631-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
We developed a method to measure the relative blood flow speed using optical coherence tomography angiography (OCTA) in retina and choroid, and investigated the feasibility of this method for assessing microcirculatory function in rat models of sepsis and hemorrhagic shock. Two sepsis models, 6-h severe sepsis without treatment and 30-h moderate sepsis maintaining mean arterial pressure, and volume controlled hemorrhagic shock and fluid resuscitation model were used to see the change of microcirculation. The blood flow index (BFI), which was calculated from the OCTA images to represent the average relative blood flow, was decreasing during the 6-h severe sepsis model. Its change is in parallel with the mean arterial blood pressure (MAP) and blood lactate levels. In the 30-h moderate sepsis model, the BFI was decreased while maintaining MAP, and lactate was increased. In the hemorrhagic shock model, the change of BFI is in line with MAP and lactate levels. In all models, BFI change is more sensitive in choroid than in retina. This study presents the OCTA-based retinal and choroidal microcirculatory blood flow monitoring method and shows its utility for assessment of critical illness.
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Yu T, Xie X, Wei H, Shen H, Wu Q, Zhang X, Ji H, Tian Q, Song J, Bi H. Choroidal changes in lens-induced myopia in guinea pigs. Microvasc Res 2021; 138:104213. [PMID: 34171364 DOI: 10.1016/j.mvr.2021.104213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to determine the role of the choroid in lens-induced myopia (LIM) in guinea pigs. METHODS Guinea pigs were randomly divided into two groups: a normal control (NC) group and a LIM group. Refraction and axial length (AL) were measured by streak retinoscopy and A-scan ultrasonography. The choroidal thickness (ChT), vessel density of the choriocapillaris (VDCC) and vessel density of the choroidal layer (VDCL) were assessed by Spectral-domain Optical Coherence Tomography Angiography (SD-OCT). In addition, the choroidal expression of nitric oxide synthase (NOS) enzymes at the mRNA and protein levels was analyzed by real-time fluorescence quantitative PCR, enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry. RESULTS In the LIM group, refraction and AL were increased significantly compared with those in the NC group at 2 weeks (refraction: LIM vs. NC, -4.23 ± 0.43 D vs. 2.20 ± 0.48 D; AL: LIM vs. NC, 8.36 ± 0.05 mm vs. 8.22 ± 0.03 mm) and 4 weeks (refraction: LIM vs. NC, -5.88 ± 0.49 D vs. 1.63 ± 0.41 D; AL: 8.57 ± 0.06 mm vs. 8.40 ± 0.04 mm). The ChT and VDCC were decreased significantly compared with those in the NC group at 2 weeks (ChT: LIM vs. NC, 60.92 ± 8.15 μm vs. 79.11 ± 7.47 μm; VDCC: LIM vs. NC, 23.43 ± 3.85% vs. 28.74 ± 4.11%) and 4 weeks (ChT: LIM vs. NC, 48.43 ± 6.85 μm vs. 76.38 ± 7.84 μm; VDCC: LIM vs. NC, 21.29 ± 2.17% vs. 27.64 ± 2.91%). The VDCL was also decreased compared with that in the NC group at 2 weeks and 4 weeks (NC vs. LIM, 24.87 ± 5.16% vs. 22.45 ± 3.26%; 23.37 ± 5.85% vs. 21.39 ± 2.62%; all P > 0.05). Moreover, the ChT was positively correlated with the VDCC and VDCL. The mRNA and protein expression of NOS enzymes (eNOS and nNOS) was increased. CONCLUSIONS During the development of myopia, the ChT, VDCC and VDCL were decreased, while NOS expression in the choroid was increased. The expression of NOS was negatively correlated with the ChT, VDCC and VDCL. NO may play an important role in regulating the choroid during myopia development.
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Affiliation(s)
- Ting Yu
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan 250014, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - Xiaofeng Xie
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - Huixia Wei
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan 250014, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - Hui Shen
- People's Hospital of Rizhao, No. 126#, Tai'an Road, Rizhao 276826, PR China
| | - Qiuxin Wu
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan 250014, PR China; Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - Xiuyan Zhang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - HaiFeng Ji
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan 250014, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - QingMei Tian
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China
| | - Jike Song
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan 250014, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China.
| | - Hongsheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China; Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, PR China.
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Gameiro GR, Gameiro GR, Farah ME, Wang J, Schor P. Retinal microvascular density modifications during the water drinking test. Eur J Ophthalmol 2021; 32:1602-1609. [PMID: 34137302 DOI: 10.1177/11206721211024058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The water drinking test (WDT) is a well-known stress test that increases intraocular pressure (IOP) momentarily and can indicate risk of glaucoma progression. This study focuses on correlating changes in the retinal microvascular plexus with the WDT in young healthy subjects. METHODS A total of 20 eyes of 20 healthy young subjects (mean age 24.37 ± 2.17 years) were included in this study. In our protocol, WDT consisted of drinking 1 L of water within 5 min. Outcome measures in this prospective observational study were mean arterial pressure (MAP), heart rate (HR), IOP, and retinal vessel density of both superficial and deep macular retina using optical coherence tomography angiography (OCTA), which were assessed before water ingestion and four times after at 15-min intervals. OCTA images were later quantified by fractal analysis (box counting [Dbox]). One-way repeated measures analysis of variance (ANOVA) was used to assess the effects of WDT on each of the parameters. RESULTS The WDT resulted in significant peak changes of the following parameters compared to baseline: IOP: 15.63 ± 3.37 versus 18.38 ± 4.53 mmHg at 30 min, p < 0.001; HR: 75.74 ± 12.23 versus 64.95 ± 11.37 bpm at 15 min, p < 0.001; deep retinal vessel density 1.758 ± 0.14 versus 1.749 ± 0.16 at 15 min, p = 0.040. CONCLUSIONS Besides IOP elevation and systemic effects in HR, WDT is associated with temporary modifications of the deep vascular plexus in young healthy subjects.
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Affiliation(s)
- Gustavo Rosa Gameiro
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - EPM/UNIFESP, São Paulo, São Paulo, Brazil
| | - Giovana Rosa Gameiro
- Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil.,Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Michel Eid Farah
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - EPM/UNIFESP, São Paulo, São Paulo, Brazil
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Paulo Schor
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - EPM/UNIFESP, São Paulo, São Paulo, Brazil
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Nadeem B, Bacha R, Gilani SA, Manzoor I. Comparison of the Doppler Indices in the Ophthalmic Artery and Central Retinal Artery in Diabetic and Nondiabetic Individuals. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/87564793211014876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Diabetes can lead to diabetic retinopathy, which damages the retina due to blood flow remodeling of occular vessels. Early stages of diabetic retinopathy may not present with patient symptoms. Doppler indices, of the ophthalmic arteries, could help in determining the effect of diabetic vascular remodeling. This research was designed to compare the Doppler indices, in the ophthalmic artery and central retinal artery, in both diabetic and nondiabetic patients. Materials and Methods: This was a cross-sectional observational study of 72 total patients. Sonography was performed on the ophthalmic arteries of 36 diabetics and 36 nondiabetics, to compare Doppler indices. All patients were voluntarily consented to this research that was approved by the university’s Institutional Review Board (IRB). Doppler parameters recorded were peak systolic velocity, end dystopic velocity, resistive index, and pulsatility index, which were taken in both patient groups and compared. Results: A significant difference was noted in the ophthalmic artery peak systolic velocity, end-diastolic velocity, pulsatility index, and resistive index for diabetic and nondiabetic individuals, with a statistically significant set at .01. Conclusions: There was a significant difference between diabetic and nondiabetic ophthalmic Doppler indices in this cohort of patients. This cohort demonstrated vascular remodeling of the ophthalmic arteries, caused by diabetes; therefore, blood flow resistance was increased due to diabetes.
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Affiliation(s)
- Baby Nadeem
- University Institute of Radiological Sciences and Medical Imaging Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Raham Bacha
- University Institute of Radiological Sciences and Medical Imaging Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Syed Amir Gilani
- University Institute of Radiological Sciences and Medical Imaging Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Iqra Manzoor
- University Institute of Radiological Sciences and Medical Imaging Technologies, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
- Gilani Ultrasound Center, Lahore, Pakistan
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Bursali Ö, Altintaş Ö, Ağir A, Yüksel N, Özkan B. Optical coherence tomography measurements in patients with systemic hypertension. Scott Med J 2021; 66:115-121. [PMID: 33947281 DOI: 10.1177/00369330211011175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the effect of systemic arterial hypertension (SAH) on retinal optical coherence tomography (OCT) parameters and investigate whether a correlation exists between ambulatory blood pressure monitoring (ABPM) and OCT measurements.Material-methods: 115 SAH patients (225 eyes) and 123 healthy control cases (234 eyes) were included. ABPM was performed on 89 of 115 SAH patients. All patients underwent detailed ophthalmologic examination including imaging with OCT. SAH patients were divided into two groups (dippers, non-dippers) according to their nocturnal blood pressure (BP) reduction, and OCT measurements were compared. RESULTS Average and superior retinal nerve fiber layer (RNFL) quadrants were significantly thin in hypertensive cases (p:0.002, p < 0.001, respectively). Cup area, cup/disk (c/d) area, and c/d horizontal ratios were wider; the rim area was smaller in hypertensive cases (respectively: p:0.024, p:0.017, p:0.003, p < 0.001). Total macular volume (TMV), the thicknesses in 1-3 and 1-6 mm of the macula were less in hypertensives (p < 0.001). There was no significant difference between dippers and non-dippers in RNFL thickness, macula and optic nerve head (ONH) parameters. CONCLUSION There were statistically significant differences between healthy cases and patients with SAH in terms of RNFL, macula thicknesses and ONH parameters.
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Affiliation(s)
- Özlem Bursali
- Medical Doctor, Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Turkey
| | - Özgül Altintaş
- Medical Doctor, Department of Ophthalmology, Acıbadem Mehmet Aydınlar University Medical Faculty, Turkey
| | - Ayşen Ağir
- Medical Doctor, Department of Cardiology, Kocaeli University Medical Faculty, Turkey
| | - Nurşen Yüksel
- Medical Doctor, Department of Ophthalmology, Kocaeli University Medical Faculty, Turkey
| | - Berna Özkan
- Medical Doctor, Department of Ophthalmology, Acıbadem Mehmet Aydınlar University Medical Faculty, Turkey
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Lanier OL, Manfre MG, Bailey C, Liu Z, Sparks Z, Kulkarni S, Chauhan A. Review of Approaches for Increasing Ophthalmic Bioavailability for Eye Drop Formulations. AAPS PharmSciTech 2021; 22:107. [PMID: 33719019 DOI: 10.1208/s12249-021-01977-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/27/2021] [Indexed: 01/09/2023] Open
Abstract
Ophthalmic diseases represent a significant problem as over 2 billion people worldwide suffer from vison impairment and blindness. Eye drops account for around 90% of ophthalmic medications but are limited in success due to poor patient compliance and low bioavailability. Low bioavailability can be attributed to short retention times in the eye caused by rapid tear turnover and the difficulty of drug diffusion through the multi-layered structure of the eye that includes lipid-rich endothelial and epithelial layers as well as the stroma which is high in water content. In addition, there are barriers such as tight junctional complexes in the corneal epithelium, lacrimal turnover, nasolacrimal drainage, blinking reflexes, efflux transporters, drug metabolism by ocular enzymes, and drug binding to or repulsion from conjunctival mucins, tear proteins, and melanin. In order to maximize transport through the cornea while minimizing drug loss through other pathways, researchers have developed numerous methods to improve eye drop formulations including the addition of viscosity enhancers, permeability enhancers, mucoadhesives, and vasoconstrictors, or using formulations that include puncta occlusion, nanocarriers, or prodrugs. This review explains the mechanism behind each of these methods, examines their history, analyzes previous and current research, evaluates future applications, and discusses the pros and cons of each technique.
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Dascalu AM, Stana D, Nicolae VA, Cirstoveanu C, Vancea G, Serban D, Socea B. Association between vascular comorbidity and glaucoma progression: A four-year observational study. Exp Ther Med 2021; 21:283. [PMID: 33603890 PMCID: PMC7851678 DOI: 10.3892/etm.2021.9714] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/24/2020] [Indexed: 12/23/2022] Open
Abstract
Glaucoma, one of the significant causes of blindness worldwide, is a chronic optic neuropathy, characterized by progressive loss of retinal ganglion cells and specific perimetric defects. This study aimed to assess the association between the risk of glaucoma progression and different systemic vascular abnormalities. A 4-year prospective study was carried out on 204 patients diagnosed with open-angle glaucoma. Associated systemic vascular pathology was documented in 102 cases. Progression was encountered in 57 (55.9%) patients with vascular comorbidities and only in 10 (9.8%) patients with no associated vascular diseases (OR 13.81, P<0.01). The vascular risk factors associated with glaucoma progression in the study group were diastolic hypotension (OR 5.444, P=0.027), ischemic cardiac disease (OR 5.826; P<0.01), peripheral vasospasm (OR 3.108, P=0.042) and arterial hypertension (OR 2.593, P=0.05). Diabetes was not significantly correlated with progression in the study group, but only patients without diabetic retinopathy were included. This study highlights that systemic comorbidities associated with endothelial lesions, atherosclerosis and hypoperfusion can lead to damage to the retinal nerve fiber layer and the underlying conjunctive tissue.
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Affiliation(s)
- Ana Maria Dascalu
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Daniela Stana
- Department of Ophthalmology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Vanesa Andrada Nicolae
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Catalin Cirstoveanu
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Geta Vancea
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dragos Serban
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Bogdan Socea
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Izumiya Y, Okuda Y, Ueki S, Takeda M, Sato K, Nakayama K. Unusual morphologies of blood eosinophils in GM-CSF-producing lung cancer. QJM 2021; 114:42-44. [PMID: 32343814 DOI: 10.1093/qjmed/hcaa144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Izumiya
- Department of Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Y Okuda
- Department of Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - S Ueki
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - M Takeda
- Department of Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - K Sato
- Department of Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - K Nakayama
- Department of Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
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Correlation of retinal and choroidal microvascular impairment in systemic sclerosis. Orphanet J Rare Dis 2021; 16:27. [PMID: 33441156 PMCID: PMC7807887 DOI: 10.1186/s13023-020-01649-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 12/17/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the correlation between retinal and choroidal microperfusion in patients with systemic sclerosis (SSc) using optical coherence tomography angiography (OCTA). Methods In this cross-sectional study SSc patients without clinical evidence of ocular involvement and healthy, age- and sex-matched volunteers were recruited. Participants underwent specific rheumatological and ophthalmological examinations, including optical coherence tomography (OCT) and OCTA. Retinal and choroidal thicknesses as well as perfusion of the retina and the choroidal sublayers were evaluated. Results A total of 15 SSc patients (30 eyes) with a median disease duration of 60 months and 15 matched, healthy controls (30 eyes) were recruited. OCT data revealed a significantly lower macular volume, as well as Sattler’s layer and Haller’s layer thickness in SSc patients compared to controls. In OCTA analysis, the perfusion of both retinal plexus as well as Sattler’s and Haller’s layer were significantly reduced in the SSc group. Patients with a disease duration of more than 60 months showed a statistically significant positive correlation between retinal and choroidal malperfusion, while those with a shorter disease duration did not. Conclusion OCTA analysis confirmed impairment of retinal and choroidal microperfusion in SSc patients, supporting the hypothesis of wide spreading vascular injury. In early stages, either the retinal or the choroidal perfusion seems to be involved, while later on, vascular impairment affects both tissues alike. Both, retinal and choroidal examinations should be considered as soon as the diagnosis of SSc is made, to avoid missing out on early alterations.
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High-salt intake affects retinal vascular tortuosity in healthy males: an exploratory randomized cross-over trial. Sci Rep 2021; 11:801. [PMID: 33436709 PMCID: PMC7803999 DOI: 10.1038/s41598-020-79753-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/07/2020] [Indexed: 01/10/2023] Open
Abstract
The retinal microcirculation is increasingly receiving credit as a relatively easily accessible microcirculatory bed that correlates closely with clinical cardiovascular outcomes. The effect of high salt (NaCl) intake on the retinal microcirculation is currently unknown. Therefore, we performed an exploratory randomized cross-over dietary intervention study in 18 healthy males. All subjects adhered to a two-week high-salt diet and low-salt diet, in randomized order, after which fundus photographs were taken and assessed using a semi-automated computer-assisted program (SIVA, version 4.0). Outcome parameters involved retinal venular and arteriolar tortuosity, vessel diameter, branching angle and fractal dimension. At baseline, participants had a mean (SD) age of 29.8 (4.4) years and blood pressure of 117 (9)/73 (5) mmHg. Overall, high-salt diet significantly increased venular tortuosity (12.2%, p = 0.001). Other retinal parameters were not significantly different between diets. Changes in arteriolar tortuosity correlated with changes in ambulatory systolic blood pressure (r = - 0.513; p = 0.04). In conclusion, high-salt diet increases retinal venular tortuosity, and salt-induced increases in ambulatory systolic blood pressure associate with decreases in retinal arteriolar tortuosity. Besides potential eye-specific consequences, both phenomena have previously been associated with hypertension and other cardiovascular risk factors, underlining the deleterious microcirculatory effects of high salt intake.
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Jeon SJ, Hwang HB, Lee NY. Evaluation of Systemic Renin and Angiotensin II Levels in Normal Tension Glaucoma. J Clin Med 2020; 9:jcm9123838. [PMID: 33256138 PMCID: PMC7761439 DOI: 10.3390/jcm9123838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study was to investigate the function of the renin-angiotensin-aldosterone system (RAAS) in normal tension glaucoma (NTG) patients by measuring the level of renin and angiotensin II (AngII) in the plasma. Twenty-four patients with NTG and 38 control subjects were included in this study. Renin and AngII were measured in the blood samples of all subjects by enzyme-linked immunosorbent assay (ELISA). No significant differences were found in the complete blood count, fasting glucose, low-density lipoprotein (LDL), and high-sensitivity C-reactive protein (hs-CRP) levels between the control and NTG groups. The systemic concentration and variability of the renin concentration in the blood was significantly higher in the NTG group (p = 0.005 and 0.005, respectively). According to multivariate logistic regression analysis, the variability of the renin concentration was associated with NTG (p = 0.006). In conclusion, the systemic concentration and variability of renin levels were elevated in NTG patients. An altered renin concentration could represent a difference in RAAS function in NTG patients.
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Affiliation(s)
- Soo Ji Jeon
- Department of Ophthalmology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea;
| | - Hyung Bin Hwang
- Department of Ophthalmology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea;
| | - Na Young Lee
- Department of Ophthalmology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea;
- Correspondence: ; Tel.: +82-2-2030-2795; Fax: +82-2-599-7405
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