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Dogan ME, Basol I, Ilhan HD, Ayaz Y, Ocal O. Evaluation of macular choroidal and microvascular network changes by activity scores and serum antibodies in thyroid eye patients and healthy subjects. Int J Ophthalmol 2023; 16:2089-2094. [PMID: 38111941 PMCID: PMC10700066 DOI: 10.18240/ijo.2023.12.23] [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: 08/07/2023] [Accepted: 10/20/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To investigate the choroidal thickness and the microvascular network changes around the macula in thyroid eye disease (TED) patients at different stages and the relationship of those changes with risk factors, serum antibodies and the severity of TED. METHODS A total of 85 participants were enrolled. All participants underwent ophthalmology and endocrinology examinations. Subfoveal choroidal thickness (SFCT), superficial (s) and deep (d) foveal avascular zone (FAZ) area, mean (m) and central (c) superficial vascular density (SVD), deep vascular density (DVD) measurements of the enrolled cases were performed with Topcon swept source optical coherence tomography (OCT)/OCT angiography (OCTA) DRI OCT Triton. Multiple linear regression analysis was used to explore the associations between SFCT, FAZ area, SVD, DVD and the relevant factors of TED. RESULTS Those with active TED patients had higher c-DVD and m-DVD levels (P<0.05), however there is no statistically significant difference in SFCT between active and stable TED patients. Among the serum antibodies, it was observed that s-FAZ and d-FAZ increased, c-SVD and m-SVD decreased in patients with high thyroid stimulating hormone-receptor autoantibodies (TRAB) level, whereas SFCT thickened in patients with high levels of both TRAB and human thyroglobulin (hTG). There was no significant difference in SFCT, FAZ, SVD and DVD measurement at gender, between hyperthyroid and euthyroid patients and among those with or without thyroid papillary carcinoma. CONCLUSION The results show that both disease activation and serum antibodies differentially affect both superficial and deep retinal vascular density. It has also been shown that high serum antibody levels affect choroidal thickness independent of clinical activity.
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Affiliation(s)
- Mehmet Erkan Dogan
- Department of Ophthalmology, Akdeniz University, Konyaalti 07070, Antalya, Turkey
| | - Ibrahim Basol
- Department of Ophthalmology, Kepez State Hospital, Antalya 07320, Turkey
| | - Hatice Deniz Ilhan
- Department of Ophthalmology, Akdeniz University, Konyaalti 07070, Antalya, Turkey
| | - Yusuf Ayaz
- Department of Ophthalmology, Akdeniz University, Konyaalti 07070, Antalya, Turkey
| | - Olgar Ocal
- Department of Ophthalmology, Suruc State Hospital, Sanliurfa 63800, Turkey
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Szydełko-Paśko U, Przeździecka-Dołyk J, Dołyk A, Małyszczak A, Misiuk-Hojło M. Evaluation of Choroidal and Retinal Features in Patients with Primary Vasculitis-An Original Optical Coherence Tomography and Optical Coherence Tomography Angiography Study. J Clin Med 2023; 12:6827. [PMID: 37959292 PMCID: PMC10648798 DOI: 10.3390/jcm12216827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Ocular manifestations have been described in the course of various types of vasculitis. However, there seems to be no routine ophthalmological examinations for patients suffering from those diseases. To ensure holistic care we aimed to investigate any retinal and choroidal abnormalities in patients suffering from primary vasculitis. The objective was to use non-invasive methods, which would not be time- and cost-consuming, yet would be helpful in routine tests. We conducted a prospective and observational study in 41 patients (78 eyes) with 5 types of primary vasculitis, including: Takayasu's arteritis; giant cell arteritis; Buerger's disease; granulomatosis with polyangiitis; and polyarteritis nodosa. A total of 44 healthy individuals were enrolled in the control group for comparison (88 eyes). With the use of optical coherence tomography, optical coherence tomography angiography, and MATLAB, the following parameters were assessed: choroidal thickness; vascularity index; area and perimeter of foveal avascular zone; and circularity index. The following parameters were lower in the study group compared to the control group: mean nasal and temporal CTs; mean central, temporal, and nasal CVI; and mean CI. In contrast, the results of mean central CT as well as the area and perimeter of FAZ were higher in the study group. The differences were statistically significant in the case of all parameters except for CI. Conducting routine ophthalmological examinations in patients diagnosed with vasculitis by assessment of the retina and choroid by measuring parameters like CT, CVI, area and perimeter of FAZ, and CI could be beneficial, as it may detect pathological changes before any ocular symptoms alarm the patients. CVI seems to be especially promising for choroidal evaluation, as it appears to be less influenced by various factors compared to CT.
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Affiliation(s)
| | - Joanna Przeździecka-Dołyk
- Department of Optics and Photonics, Wrocław Univeristy of Science and Technology, 50-370 Wrocław, Poland
| | - Andrzej Dołyk
- Clinic of Angiology, Systemic Hypertension and Diabetology, Wrocław Teaching Hospital, 50-556 Wrocław, Poland
| | - Artur Małyszczak
- Department of Ophthalmology, Wrocław Medical University, 50-556 Wrocław, Poland
| | - Marta Misiuk-Hojło
- Department of Ophthalmology, Wrocław Medical University, 50-556 Wrocław, Poland
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AttaAllah HR, Abdelaziz STA, Mohamed AAM, Ibrahiem MFK. Assessment of macular microvascular changes in children following treatment of anisometropic myopic amblyopia using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 2023; 261:2689-2699. [PMID: 37052667 PMCID: PMC10432315 DOI: 10.1007/s00417-023-06055-8] [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: 11/01/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE To evaluate macular microvascular changes in the form of foveal avascular zone (FAZ) area and vessel density in the superficial, deep capillary plexuses, and choriocapillaris using optical coherence tomography angiography (OCTA) in children with anisometropic myopic amblyopia before and after treatment. METHODS This prospective observational study included 32 patients younger than 12 years old with anisomyopic amblyopia. OCTA was done before patients' treatment with optical correction with or without patching and was repeated after successful amblyopia treatment. Outcomes included superficial, deep, and choriocapillaris vessel density (VD) and superficial and deep FAZ areas. RESULTS The study included 13 males (40.6%) and 19 females (59.4%), and the mean age was 9.52 ± 1.33 years. Fifty-three percent (53%) of patients needed only optical correction, and the remaining 47% needed additional patching therapy. After successful treatment, there was a significant improvement in amblyopic eyes in best-corrected visual acuity (p < 0.001), with higher VD values in superficial capillary plexuses (p < 0.001), deep capillary plexuses (p < 0.001), and foveal choriocapillaris (p = 0.030). In the glasses with patching subgroup, the difference between pre-treatment and post-treatment parameters revealed a significant improvement in vessel density in superficial retinal plexuses (foveal and parafoveal; p values 0.023 and < 0.001, respectively) and deep retinal plexuses (whole image, foveal, and parafoveal; p values 0.003, < 0.001, and 0.002, respectively). While amblyopic eyes treated with glasses alone had a significantly greater difference in choriocapillaris foveal VD (p value = 0.022). CONCLUSION After effective amblyopia treatment, amblyopic eyes exhibited improved best-corrected visual acuity and better macular perfusion along the superficial, deep vascular density, and choriocapillaris foveal VD. CLINICAL TRIAL REGISTRATION CinicalTrials.gov Identifier: NCT05223153.
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Affiliation(s)
- Heba Radi AttaAllah
- Ophthalmology department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Sahar Torky Abdelrazik Abdelaziz
- Ophthalmology department, Faculty of Medicine, Minia University, Minia, Egypt.
- Ophthalmology department, Minia University Hospital, Minia University, Minia, 61111, Egypt.
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Sun KX, Xiang YG, Zhang T, Yi SL, Xia JY, Yang X, Zheng SJ, Ji Y, Wan WJ, Hu K. Evaluation of childhood developing via optical coherence tomography-angiography in Qamdo, Tibet, China: A prospective cross-sectional, school-based study. World J Clin Cases 2023; 11:5479-5493. [PMID: 37637695 PMCID: PMC10450379 DOI: 10.12998/wjcc.v11.i23.5479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/11/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Optical coherence tomography angiography (OCTA) is a new and reliable machine used to evaluate retinal structure and macular perfusion in children. The use of OCTA under bad condition such as high altitude, low atmospheric oxygen, and low humidity, in children is rarely. AIM To quantify the macular micro-vasculature in healthy children of various ages using OCTA in Qamdo. METHODS Design: Prospective cross-sectional, school-based study. Three hundred and forty-seven normal students from 9 schools in 4 different areas in Qamdo were included. OCTA was performed on a 3 mm × 3 mm area centered on the macular region and macular cube 512 × 128 showed details in macular. Early treatment of diabetic retinopathy study Vessel Flow Density (VD) of the macular central vascular plexus density (CVD), inner vascular plexus density (IVD), full vascular plexus density (FVD), and the size of the foveal avascular zone (FAZ) were measured. All these results corrected by t/s = 3.382 × 0.01306 × (axial length-1.82). The differences were compared among various ages, sexes and living environments. RESULTS The mean FAZ area in all eyes was 0.27 mm2 ± 0.12 mm2. The mean foveal thickness (MFT) in the macular cube was 227.64 μm ± 23.51 μm. Compared with girls, boys had a lager FAZ (P = 0.0029). Among the different age groups, MFT (P < 0.001) and FVD (P < 0.0001), IVD (P < 0.0001), and CVD (P = 0.0050) increased with age. FAZ areas were not correlated with age (P = 0.8853) or others (MFT, area). CONCLUSION OCTA can use to evaluate macular perfusion in children. Our data bridge the gap between structural OCT and perfusion density in children in high altitude. Even though these were not a longitudinal study, it may provide us with hints about retina development during puberty and clinical implications of OCTA in children.
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Affiliation(s)
- Ke-Xin Sun
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yong-Guo Xiang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Tong Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400016, China
| | - Sheng-Lan Yi
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jiu-Yi Xia
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Shi-Jie Zheng
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yan Ji
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Wen-Juan Wan
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ke Hu
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Tang W, Ouyang J, Luo Y. Distribution of the Retinal Microcirculation Based on the Morphology of Peripapillary Atrophy in High Myopia. Ophthalmic Res 2023; 66:1085-1095. [PMID: 37459845 PMCID: PMC10614452 DOI: 10.1159/000531509] [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: 01/14/2023] [Accepted: 06/06/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the retinal microvasculature of the optic nerve head and macula in high myopia (HM), investigate the association between the vascular parameters and peripapillary atrophy (PPA) deformation, and assess and identify the PPA morphology changes during the development of HM. METHODS One hundred sixty-seven right eyes from 167 HM patients were enrolled in this cross-sectional study. Using the optical coherence tomography angiography (OCTA) and fundus camera, we evaluated the following parameters: radian and type of PPA, intrapapillary vascular density (IVD), peripapillary vascular density (PVD), macular vascular density (MVD), and foveal avascular zone (FAZ). Based on the PPA radian, subjects were divided into four groups: the non-PPA, temporal PPA, advanced PPA, and annular PPA. At the same time, the above parameters were compared between the groups using analysis of variance (ANOVA) and least significant difference test. RESULTS Total enrolled patients were divided into the non-PPA group (22 eyes), temporal-PPA group (70 eyes), advanced-PPA group (60 eyes), and annular-PPA group (15 eyes). The results showed that the PVD in the annular-PPA group was smaller than that in the non-PPA group, especially in the superonasal, nasosuperior, nasoinferior, inferotemporal, temporoinferior, and superotemporal directions (F = 4.059, 5.014, 2.830, 4.798, 5.892, 3.439; p < 0.05). Notably, the PVD showcased the highest value in temporal, followed by that in superior and inferior, and the lowest in the nasal. Concerning the fovea deep macular vascular density, FAZ area, and subfoveal choroidal thickness in the annular-PPA group, they were less than those of the rest of the groups (p < 0.05). CONCLUSION The retinal microvasculature differed significantly in HM according to the PPA morphology. In addition to PVD and SFCT, the PPA can also affect FAZ. Finally, we speculated that PVD demonstrated better predictability of myopic progression than MVD.
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Affiliation(s)
- Wenquan Tang
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China,
| | | | - YuLin Luo
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China
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Tang W, Luo Y, Duan X. Distribution of the Retinal Microcirculation Based on the Morphology of the Optic Nerve Head in High Myopia. Semin Ophthalmol 2023:1-8. [PMID: 36658739 DOI: 10.1080/08820538.2023.2169581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE To explore the retinal microvasculature of the optic nerve head and macula and their associations with the optic nerve head deformation in high myopia. METHODS One hundred sixty-seven eyes from patients with high myopia (HM) were enrolled in a cross-sectional study. We have evaluated and measured characteristics like the tilt ratio of the optic disc, interpupillary vascular density (IVD), peripapillary vascular density (PVD), macular vascular density (MVD), subfoveal choroidal thickness (SFCT) and foveal avascular zone (FAZ). The subjects were classified as a non-tilt group (control group) and a tilt group based on the tilt index. The above parameters were utilized to compare the two groups. In addition, we collected the data from the subjects' right eyes to analyze variance, the Kruskal-Wallis test, and the least significant difference. RESULTS The patients were divided into the non-tilt group of ninety-one eyes and the tilt group of seventy-six eyes. We found that the IVD in the tilt group was more significant than in the non-tilt group (t = -2.794, P = .006). On the other hand, the PVD was less in the tilt group than in the non-tilt, especially in the NS, NI and IN directions (tNS = 3.782; tNI = 3.07; tIN = 2.086; P < .05). Interestingly, the values of PVD were the highest in temporal, second in superior and inferior and lowest in nasal. Concerning the fovea-DMVD (including fovea, parafovea and perifovea), we characterized them as more minor in the tilt group when compared to those in the non-tilt group (P < .05). CONCLUSION Herein, we discovered that the retinal microvasculature differed significantly in patients with HM according to the ONH morphology. In this population, lower PVD and thinner SFCT were associated with higher odds of the tilted optic disc. In addition, the other two characteristics, the IVD and DMVD, were affected by the ONH deformation. Finally, we showed that PVD demonstrated better predictability of rapid myopic progression than MVD.
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Affiliation(s)
- Wenquan Tang
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China.,College of Pharmacy, Changsha Medical University, Changsha, China
| | - YuLin Luo
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China
| | - Xuanchu Duan
- Department of refractive, Aier School of Ophthalmology, Central South University, Changsha, China
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Dong YM, Zhu HY, Liu ZH, Fu SY, Wang K, Du LP, Jin XM. Various configuration types of the foveal avascular zone with related factors in normal Chinese adults with or without myopia assessed by swept-source OCT angiography. Int J Ophthalmol 2022; 15:1502-1510. [PMID: 36124188 DOI: 10.18240/ijo.2022.09.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To describe the morphological characteristics of foveal avascular zone (FAZ) in normal Chinese adults with or without myopia by swept-source optical coherence tomography angiography (SS-OCTA) and analyze the possible associated factors. METHODS Normal Chinese adults with or without myopia aged between 18 and 60y were recruited into the study. One eye in each individual was randomly selected for scanning using SS-OCTA. FAZ parameters, central retinal thickness (CRT) and central choroidal thickness (CCT) were then analyzed. Correlations between systemic and ocular variables and FAZ parameters were subsequently evaluated. The subgroup analysis based on refractive error was also carried out. RESULTS In total, 127 eyes out of 127 normal subjects were finally included in the study (mean age 29.5±8.22y, 61 males and 66 females). The pattern of FAZ was variable: round configuration in 28 eyes (22%), quadrilateral configuration in 23 eyes (18%), pentagonal configuration in 20 eyes (16%), oval configuration in 15 eyes (12%), triangular configuration in 6 eyes (5%) and irregular configuration in 35 eyes (28%). The mean area of FAZ was 0.37±0.12 mm2. Females had a larger FAZ (0.41±0.11 mm2 vs 0.32±0.11 mm2) compared with that of males (P<0.01). All myopic individuals showed smaller FAZ area and perimeter compared with that of normal individuals (P<0.01). There was no obvious correlation between age and FAZ. In the univariate regression analysis, both axial length (AL) and refractive error were significantly related to FAZ parameters. However, only CRT showed negative correlation with FAZ in the multivariate regression analysis. CONCLUSION The pattern of FAZ configuration in normal Chinese adults with or without myopia is highly variable. Establishing quantitative parameters of FAZ would not only provide details of macular pathophysiology but could possibly contribute as a biomarker in disease staging.
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Affiliation(s)
- Yan-Min Dong
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Hai-Yan Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Zhen-Hui Liu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Shu-Ying Fu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Ke Wang
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Li-Ping Du
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Xue-Min Jin
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
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Bromeo AJ, Grulla-Quilendrino P, Antolin RC, Salcedo EJJ, Arcinue CA, De Jesus RA, Veloso A. Optical coherence tomography angiography analysis of changes in the foveal avascular zone in eyes with diabetic macular edema treated with intravitreal anti-vascular endothelial growth factor. Int J Retina Vitreous 2022; 8:57. [PMID: 36028899 PMCID: PMC9419407 DOI: 10.1186/s40942-022-00406-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background To analyze the changes in foveal avascular zone (FAZ) area, perimeter, and circularity in the superficial (SCP) and deep (DCP) capillary plexuses in eyes with diabetic macular edema (DME) treated with intravitreal anti-VEGF using optical coherence tomography angiography (OCTA). Methods This prospective observational study included 56 eyes from 32 patients with DME that received intravitreal anti-VEGF. OCTA images were obtained at baseline and 1, 3, and 6 months of follow-up. The outcome measures were FAZ area, perimeter, and circularity in both the SCP and DCP, as well as central subfield thickness (CST) and best-corrected visual acuity (BCVA). Results The mean number of intravitreal anti-VEGF injections received during the observation period was 4.60 ± 0.82 (range: 3–6). The FAZ area, perimeter, and circularity were statistically unchanged at all observation points in both the SCP (p = 0.772, p = 0.405, p = 0.157, respectively) and the DCP (p = 0.620, p = 0.769, p = 0.481, respectively). Despite having no change in the FAZ parameters, there was still a statistically significant decrease in CST (p < 0.001) as well as a statistically significant increase in BCVA (p = 0.004) during the observation period. Conclusions The FAZ area, perimeter, and circularity in the SCP and DCP as measured by OCTA remained stable during the first 6 months of intravitreal anti-VEGF therapy in eyes with DME. While there were no significant changes in the FAZ, treatment with intravitreal anti-VEGF still resulted in decreased CST and improved BCVA.
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Affiliation(s)
| | | | | | | | - Cheryl A Arcinue
- Asian Eye Institute, Makati, Philippines.,Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines, Manila, Philippines
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Kim HM, Han JW, Park YJ, Bae JB, Woo SJ, Kim KW. Association Between Retinal Layer Thickness and Cognitive Decline in Older Adults. JAMA Ophthalmol 2022; 140:683-690. [PMID: 35616950 PMCID: PMC9136677 DOI: 10.1001/jamaophthalmol.2022.1563] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Question Is retinal layer thickness associated with cognitive decline in an older population? Findings In this cohort study including 430 community-dwelling participants in Korea, baseline macular retinal nerve fiber layer (RNFL) thickness was associated with baseline cognitive function scores and follow-up cognitive decline. Meaning These findings suggest that macular RNFL thickness could be considered a predictive biomarker for evaluating cognitive function in older individuals. Importance Retinal layer thickness is hypothesized to be related to cognitive function in patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). However, longitudinal cohort studies of the healthy older population are scarce. Objective To investigate the association between retinal layer thickness and cognitive impairment and future cognitive decline in a community-based population cohort. Design, Setting, and Participants A total of 430 randomly sampled community-dwelling Korean individuals 60 years or older participated in the baseline assessment (mean [SD], 76.3 [6.6] years) 215 of whom completed a mean (SD) of 5.4 (0.6) years (range, 4.1-6.2 years) of follow-up. Using spectral-domain optical coherence tomography, the study team assessed the thickness of 6 retinal layers in the macular region, the peripapillary retinal nerve fiber layers (RNFLs), and the subfoveal choroid at baseline. Exposures Age, sex, education, diabetes, hypertension, and apolipoprotein E4 gene status. Main Outcomes and Measures Retinal layer thickness and cognitive function test scores were analyzed. Results This study included 430 participants (female, 208 [48.6%]). Baseline macular RNFL thickness was associated with baseline Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) score (coefficient [β] = 0.077; 95% CI, 0.054-0.100; P = .04 for total macular area) and Mini-Mental State Examination (MMSE) score (coefficient [β] = 0.082; 95% CI, 0.063-0.101; P = .03 for total macular area). A thinner baseline total macular RNFL thickness (lowest quartile, <231 μm) was associated with a larger decline in the CERAD and MMSE scores during the follow-up period (P = .003 and P = .01, respectively). Furthermore, participants with baseline total macular RNFL thickness below the lowest quartile cutoff value presented a greater decline in cognitive scores and a higher prevalence of cognitive impairment and Alzheimer disease than those with RNFL thickness above the lowest quartile cutoff value. Conclusions and Relevance In this study, macular RNFL thickness could be used as a prognostic biomarker of long-term cognitive decline in adults 60 years or older. However, to confirm these results, further large-scale population-based studies should be performed.
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Affiliation(s)
- Hyeong Min Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Young Joo Park
- Department of Ophthalmology, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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Lal B, Alonso-Caneiro D, Read SA, Tran B, Van Bui C, Tang D, Fiedler JT, Ho S, Carkeet A. Changes in Retinal Optical Coherence Tomography Angiography Indexes Over 24 Hours. Invest Ophthalmol Vis Sci 2022; 63:25. [PMID: 35348589 PMCID: PMC8976927 DOI: 10.1167/iovs.63.3.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate changes in the retinal microvasculature of young adults over 24 hours using optical coherence tomography angiography (OCT-A). Methods Participants (n = 44, mean age 23.2 ± 4.1 years, 24 myopes and 20 nonmyopes) with normal ophthalmological findings were recruited. Two macular OCT-A and OCT scans, systemic blood pressure, intraocular pressure (IOP), and biometry measurements were taken every four hours over 24 hours. Superficial and deep retinal layer en face images were analyzed to extract magnification-corrected vascular indexes using image analysis including foveal avascular zone metrics, vessel density, and perfusion density for the foveal, parafoveal, and perifoveal zones. Results Significant diurnal variations (P < 0.001) were observed in the vessel and perfusion density in the three superficial retinal layer regions, with acrophase between 4:30 PM and 8:30 PM. Only foveal and parafoveal regions of the deep retinal layer exhibited significant diurnal variations with acrophase between 9 AM and 3 PM. Myopes and nonmyopes had different acrophases but not amplitudes in the parafoveal perfusion density of superficial retinal layer (P = 0.039). Significant correlations were observed between diurnal amplitudes or acrophases of superficial retinal layer indexes and systemic pulse pressure, IOP, axial length and retinal thickness. Conclusions This study shows, for the first time, that significant diurnal variation exists in OCT-A indexes of macular superficial and deep retinal layer over 24 hours and were related to variations in various ocular and systemic measurements. Myopes and nonmyopes showed differences in the timing but not in amplitude of the superficial retinal layer parafoveal perfusion density variations but not in deep retinal layer.
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Affiliation(s)
- Barsha Lal
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - David Alonso-Caneiro
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Scott A Read
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Binh Tran
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Cong Van Bui
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Daniel Tang
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Joshua T Fiedler
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Steven Ho
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Andrew Carkeet
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
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11
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Shpak AA, Morina NA, Pismenskaya VA. [Area of the foveal avascular zone in patients with refractive errors]. Vestn Oftalmol 2022; 138:26-31. [PMID: 36573945 DOI: 10.17116/oftalma202213806126] [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: 12/28/2022]
Abstract
PURPOSE To investigate the dependence of the area of the foveal avascular zone (FAZ) on axial eye length (AL) and to develop a feasible method for correcting this dependence. MATERIAL AND METHODS The study involved 209 patients over the age of 18 years (209 eyes), of them 52 patients with AL of 20-22 mm (hyperopia group), 60 patients with AL of 25.5-28.5 mm (myopia group) and 97 patients with AL of 22.5-24.5 mm (emmetropia group). Optical coherence tomography angiography (OCTA) examination was performed on Cirrus HD-OCT 5000 with AngioPlex («Carl Zeiss Meditec», Germany). RESULTS FAZ area was corrected using the Littmann-Bennett formula modified by A.A. Shpak and M.V. Korobkova. FAZ area values both in emmetropic patients and in patients with refractive errors varied over a very wide range. Before correction, AL had a significant influence on the FAZ area (mm2), which compared to the emmetropia group (0.27±0.09) was significantly reduced in the myopia group (0.21±0.07; p<0.000) and increased in the hyperopia group (0.31±0.11; p=0.015). The corrected FAZ area values did not differ in the compared groups. After correction the FAZ area decreased on average by 19% in the hyperopia group and increased by 25% in the myopia group. A chart and an Excel (Microsoft)/LibreOffice Calc program have been developed for correction of the FAZ area depending on the AL. CONCLUSION Refractive errors, especially high-degree ones, have a significant effect on the FAZ area. This study proposes an original chart and a calculation program for correct interpretation of FAZ area measurements in patients with refractive errors, providing an accessible and quick way to assess the obtained results.
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Affiliation(s)
- A A Shpak
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
| | - N A Morina
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
| | - V A Pismenskaya
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
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Xiang L, Zhou Y, Chen Y, Jiang S, Fei C, Wang Y, Bai Y, Zhang X, Li K, Shen X. Assessment of the retinal vasculature in healthy Chinese preschool children aged 4-6 years old using optical coherence tomography angiography. BMC Ophthalmol 2021; 21:415. [PMID: 34856943 PMCID: PMC8638475 DOI: 10.1186/s12886-021-02154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4-6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. METHODS In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. RESULTS A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. CONCLUSIONS Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.
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Affiliation(s)
- Lu Xiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yingming Zhou
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yanwei Chen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Siyu Jiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Chunli Fei
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yangyang Wang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yang Bai
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xuan Zhang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Kai Li
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China.
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Zhou L, Wang F, Wang L, Shen P, Cao Y, He Y, Yan S, Kong X, Lu X. Quantitative assessment and determinants of foveal avascular zone in healthy volunteers. J Int Med Res 2021; 49:3000605211014994. [PMID: 33990149 PMCID: PMC8127766 DOI: 10.1177/03000605211014994] [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] [Indexed: 12/31/2022] Open
Abstract
Objectives To evaluate the foveal avascular zone (FAZ) area in healthy volunteers using optical coherence tomography angiography (OCTA) and identify factors that influence the FAZ. Methods This single-center cross-sectional study included 526 eyes of 263 healthy volunteers who underwent macular scanning by Zeiss OCTA. A linear mixed model was used to investigate the effects of systemic factors (age, sex, blood pressure, height, and weight) and ocular factors (intraocular pressure, biometric parameters, and central macular thickness) on FAZ. Results In total, 520 eyes of 262 healthy volunteers were included in the analysis. The mean volunteer age was 38.59 ± 22.03 years (range, 5–84 years); 124 volunteers were male (47.33%) and 138 volunteers were female (52.67%). The mean FAZ area was 0.30 ± 0.03 mm2 (95% confidence interval [CI], 0.29–0.31 mm2). Univariate analysis showed that FAZ area was associated with age (β = 0.0011), anterior chamber depth (β = −0.0513), and axial length (β = −0.0202). Multivariate analysis showed that FAZ area was negatively correlated with axial length (β = −0.0181). Conclusions The mean FAZ area in healthy volunteers, measured using Zeiss OCTA, was 0.30 ± 0.03 mm2. Furthermore, FAZ area was negatively associated with axial length; this relationship should be considered in clinical practice.
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Affiliation(s)
- Lijun Zhou
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China.,Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fengqun Wang
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Ling Wang
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Peiyang Shen
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China.,Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yi Cao
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Yushen He
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Shigang Yan
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Xiangbin Kong
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Xiaohe Lu
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
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The foveal avascular zone area in healthy eyes measured by ocular coherence tomography angiography using a full spectrum probabilistic algorithm. Int Ophthalmol 2021; 41:2187-2196. [PMID: 33725269 DOI: 10.1007/s10792-021-01776-3] [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: 08/09/2020] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Report the foveal avascular zone (FAZ) area imaged by OCT angiography (OCTA) using a full spectrum probabilistic algorithm in eyes of healthy individuals from Costa Rica without any ocular or systemic pathology. METHODS Retrospective chart review of consecutive healthy patients that were evaluated from January 2018 to October 2018 that underwent OCTA of the macular area. The OCTA consisted of a 10° × 10° cube of 512 A scans separated by 6 µm each with an automated real time mode of 5. The FAZ area of the superficial vascular complex (SVC), the deep vascular complex (DVC), superficial vascular plexus (SVP), intermediate vascular plexus (IVP) and the deep vascular plexus (DVP) were measured manually by 2 different observers at 3 different times. RESULTS A total of 234 eyes of 121 patients were included in this study. Mean age was 50 years (range, 15-89), 85 patients (70%) were female. Inter- and intra-observer agreements were excellent. The mean FAZ areas in the different layers were 0.258 ± 0.0035 mm2 for the SVC, 0.205 ± 0.01 mm2 for the DVC, 0.415 ± 0.01 mm2 for the SVP, 0.305 ± 0.01 mm2 for the ICP and 0.420 ± 0.01 mm2 for the DCP. The mean FAZ areas in most of the measured layers increased with age and decreased with CMT. Gender and spherical equivalence were not correlated with FAZ area. CONCLUSION Manual measurements of the FAZ imaged by OCT-A using a full spectrum probabilistic algorithm are widely reproducible both by the same observer and between observers. The FAZ increases with age and decreases with CMT in normal individuals.
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